bluuebunny/crossref_metadata_2025 huggingface dataset:
Urban homelessness and the right to water and sanitation: experiences from India's cities
Authors: Walters Vicky
Published: July 2014

Improving access to water and sanitation for vulnerable groups has been a significant development priority in recent decades and this has been coupled with calls for water and sanitation to be recognised as fundamental human rights. However, to date there has been very limited attention on the right to water and sanitation for homeless people, despite their high vulnerability to a range of water and sanitation insecurities. Drawing on empirical data from the Indian cities of Delhi and Bangalore, this paper examines homelessness and the right to water and sanitation. It highlights the everyday practices and experiences of homeless people in their efforts to access water and sanitation, and sheds light on some of the factors that contribute to their water and sanitation insecurity. It concludes that addressing the human right to water and sanitation for homeless people will require going beyond a technical and sector approach, to the more challenging task of tackling the complex factors that create and sustain their vulnerability and marginality in urban spaces.
Water markets as a response to scarcity
Authors: Debaere Peter , Richter Brian D. , Davis Kyle Frankel , Duvall Melissa S. , Gephart Jessica Ann , O'Bannon Clark E. , Pelnik Carolyn , Powell Emily Maynard , Smith Tyler William
Published: July 2014

Existing water governance systems are proving to be quite ineffective in managing water scarcity, creating severe risk for many aspects of our societies and economies. Water markets are a relatively new and increasingly popular tool in the fight against growing water scarcity. They make a voluntary exchange possible between interested buyers and sellers of water rights. This paper presents direct evidence from seven water markets around the globe to document key economic and ecological challenges and achievements of water markets with respect to water scarcity. We specifically approach water markets as localized cap-and-trade systems, similar to those for carbon emissions. We examine whether water use remains within the set limits on use of water rights (i.e., under the cap), the degree to which water markets help protect the health of ecosystems and species, and whether (as predicted by economic theory) the explicit pricing of water is accompanied by improving efficiency, as less productive water users decide to sell water to more productive water users.
A Rare Association of Celiac Disease and Aplastic Anemia: Case Report of a Child and Review of Literature
Authors: Badyal Rama Kumari , Sachdeva Man Updesh Singh , Varma Neelam , Thapa Babu Ram
Published: July 2014

An association between severe aplastic anemia and other autoimmune diseases is rare and has been described in adults for eosinophilic fasciitis, thymomas, systemic lupus erythematosus, and thyroid disorders. Herein we report a patient with celiac disease who was not strictly following a gluten-free diet and presented with progressive pallor, fever, and weakness of 1 month's duration. On investigation, he had pancytopenia, which on subsequent evaluation revealed aplastic anemia. An association between aplastic anemia and celiac disease has rarely been reported. To the best of author's knowledge, only 1 pediatric case of celiac disease associated with aplastic anemia has been published. This is the second report to suggest such an association in children.
Liquid-Droplet as a model for the rotation curve problem
Authors: Darabi Farhad
Published: July 2014

The dynamics of large scale gravitational structures like galaxies, local groups and clusters is studied based on the so-called Liquid-Droplet model describing the saturation property of the nuclear force. Using the assumption that the gravitational force is also saturated over large scale structures, it is argued that the Newtonian gravitational potential may be replaced by an effective Machian gravitational potential. Application of this new potential at these large scale structures may give the rotation curves in good agreement with observations. Then, the virial theorem for this kind of gravitational interaction is developed and also the Tully-Fisher relation is obtained. A physical explanation is given for the so-called constant acceleration in the MOND as the effective gravitational strength of these structures. Finally, a brief argument is given for comparison with dark matter models.
Eruption of palmoplantar pustular psoriasis in patient treated with anti-androgen therapy for prostate cancer and aggravation of lesions after statin treatment
Authors: Pietrzak Aldona , Mosiewicz Jerzy , Chodorowska Grażyna , Brzozowska Anna , Michalak-Stoma Anna , Szumiło Justyna , Trojnar Marcin , Krasowska Dorota , Wawrzycki Bartłomiej , Franciszkiewicz-Pietrzak Kinga , Polkowski Wojciech , Lotti Torello
Published: July 2014

The article focuses on the eruption of palmoplantar pustular psoriasis, which was documented in a 53-year-old man diagnosed with prostate cancer with bone metastases. This clinical finding was made during routine hormone therapy and palliative radiotherapy. The local improvement in skin lesions was achieved following administration of topical ointments and the use of UVA 311 nm radiation therapy. The management of prostate cancer in this subject resulted in malaise, onset of diabetes mellitus and increased concentration of serum lipids. Interestingly, a few days after the statin treatment was initiated, the intensive pustule eruption was observed as well as severe pain and burning sensation in the palms and soles. The dermatological treatment led to significant improvement. The patient is still receiving oncological therapy and is monitored by dermatologists on a regular basis.
Speech evoked auditory brainstem response in learning disabled children
Authors: Ghannoum Mohamed Tarek , Shalaby Amani Ahmed , Dabbous Abeir Osman , Abd-El-Raouf Ehab Ragaa , Abd-El-Hady Hebatallah Sherif
Published: July 2014

Background:

Children with learning disability (LD) are thought to have deficits of neural origin. Speech evoked auditory brainstem responses (ABR) can objectively assess the biological processes underlying auditory processing of complex signals, not revealed using standard ABR responses to clicks.

Objective:

To assess central auditory processing functions in children with learning disability through electrophysiological testing.

Methods:

The present study comprised 60 normal hearing children of both genders. Cases included 30 learning disabled children and the controls included 30 healthy children without a learning disability. Each group was further subdivided into three subgroups according to age: subgroup age ranging from 6 to 8 years, > 8 to 10 years and > 10 to 12 years. All subjects were submitted to full history taking, otological examination, basic audiological evaluation, and Speech ABR testing. Parameters measured were latencies and amplitudes of the onset response and the steady state response waves.

Results:

This study showed that all subjects demonstrated identifiable and repeatable waves. The reliability of the response peaks was generally very good. All LD children showed statistically significant delayed latencies of waves V, A and F in both ears in all tested subgroups, compared to their controls. There was a statistically significant diminished amplitude of wave F in all tested subgroups in both ears compared to their controls. There was a statistically significant decreased amplitudes of waves D and E in 6–8 years subgroup and waves C and D in 8–10 years subgroup compared to their controls. In addition, compared to the controls, the amplitude of waves D and E were statistically significantly decreased in the 6-8 years subgroup, and waves C and D in the 8-10 years subgroup.

Conclusion:

Speech evoked ABR response parameters are affected in LD children, reflecting abnormalities in brainstem encoding of speech signals.
Ethics in Health Science Journals
Authors: Neupane Harish Chandra
Published: July 2014

DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10839 Journal of Chitwan Medical College 2014; 4(1)
Knowledge on health effects and practices of smoking among the smokers in the Eastern Terai Region of Nepal
Authors: Uprety S , Poudel IS , Bhattarai S , Ghimire A , Singh N , Poudel M , Rayamajhi RB , Pokharel PK
Published: July 2014

Tobacco smoking kills more than five million people a year worldwide. According to Nepal Adolescent and Young Adult (NAYA) Survey 2000, about one quarter of young boys and one in 10 girls have smoked tobacco at some time or the other. A cross sectional study was done in Jalthal & Maheshpur Village Development Committee of Jhapa district using simple random sampling method among 200 participants. Interview methods with semi-structured questionnaires were used as tool for data collection. The objective of this study was to identify the reason of initiation of smoking, explore the pattern of smoking and to assess the health knowledge among the smokers regarding effect of smoking. It was reported that, 63% of them started to smoke at the age of 10-19 years. Most smokers were male, illiterate, unemployed and fell below the poverty line. Though most of the smokers knew the ill effect due to smoking; habituation was the main reason for not being able to stop smoking and 10% of them smoked for recreation. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10843 Journal of Chitwan Medical College 2014; 4(1): 22-25
Penile nerve block at the base of penis in combination with intravenous ketamin plus midazolam versus general anaesthesia(GA) in children undergoing circumcision for post operative pain management in the Eastern Nepal
Authors: Sharma NR , Timalsena P , Rai U
Published: July 2014

Adequate post operative analgesia in children provides satisfactory psychological objective of this study was to compare the post operative analgesia requirement and child satisfaction between two groups, general anaesthesia(GA) alone and GA in combination with penile nerve block. This prospective randomized study was conducted in 50 children aged 6 to 14 years, who underwent circumcision. The boys were randomly allocated into two groups. Group A (n = 25) received GA with Single shot ketamin 2mg/kg IV plus midazolam 0.1 mg/kg and dorsal penile nerve block at the base of penis prior to circumcision with and Group B (n = 25) received GA with ketamine 2mg/kg IV plus midazolam 0.1 mg/kg plus halothane by laryngeal mask. Severity of pain was assessed quantitatively by children’s hospital eastern Ontario pain scale (CHEOPS). The pain intensity was assessed at one hour A1 in group A and B1 for group B and at two hour A2 for group A and B2 for group B during postoperatively period for two hours. Statistical analysis was done by SPSS method. The post operative analgesia was satisfactory with CHEOPS score 6 or <6 in group A 1. In group A 2 twenty two out of twenty five cases had CHEOPS score <6.Where as in group B1 and B2 it was > 6 .Which was statistically 100% significant. In conclu­sion, combined penile nerve block in combination with intravenous ketamine plus midazolam is the satisfactory method of Post operative pain management in children undergoing circumcision. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10846 Journal of Chitwan Medical College 2014; 4(1): 33-36
Role of Impact Factor in assessment of quality of a medical journal
Authors: Deo Gopendra Prasad
Published: July 2014

DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10850 Journal of Chitwan Medical College 2014; 4(2): 1
Effectiveness of Helping Babies Breathe(HBB) training on knowledge for Health Professionals and Medical Students at Chitwan Medical College
Authors: Maharjan U , Rajbanshi L , Dhungana G
Published: July 2014

The educational effectiveness of HBB training on newborn simulator, knowledge of trainees from Doctors, Nurses and Medical Students was evaluated before and after training on 19 & 20 March, 10 & 11 April and 6 & 7 May 2014 respectively. A post course practical skills evaluation was performed on a Neonatalie Newborn Simulator. Participants underwent a 2 day training course of 5 hours each. Thirty nine participants completed the course. The percentages of correct answers on a written test significantly increased from 82% to 99% after training. 100% of the trainees achieved passing scores. The trainees who participate in HBB training can significantly improve their knowledge and skills on simulators. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10855 Journal of Chitwan Medical College 2014; 4(2): 17-19
A study on sanitary and hygiene practices in Chungwang VDC of Dhankuta District, Eastern Nepal
Authors: Rayamajhi RB , Budhathoki SS , Ghimire A , Niraula SR , Khanal VK , Neupane B , Shakya B , Pokharel PK
Published: July 2014

Lack of proper practices of sanitary habit leads to ill health of household members, community and the nation as a whole. Provision of sanitary latrines and safe drinking water are necessary to prevent fecal oral transmission of infections. To con­duct a study on sanitary hygiene and practices among the residents of Chungwang VDC. 97.4% of the respondents wash their hands with soap or other detergents though 99.3% of them had soaps at their home on observation. Similarly, 81.2% of them had toilet at home but only 79.2% used on regular basis. Basic hand washing was practiced by everyone during/after defecation and before meal but the importance of it after cleaning the bottom and nose of children and before preparing the meal was known to few of the participants. A need of behavioral change regarding optimum hygiene practices is required among the participants. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10856 Journal of Chitwan Medical College 2014; 4(2): 20-24
Ultrasonographically detected renal fusion anomalies in Western Region of Nepal
Authors: Shrestha OK , Shrestha GL
Published: July 2014

To establish the incidence and patterns of renal fusion anomalies based on Ultrasonography (USG) in Western region of Nepal. In 2 years period, patients undergoing abdominal USG at Gandaki Medical College between 2010 and 2012 were screened for renal fusion anomalies. After identification, incidence and male:female ratio were stratified for total renal fu­sion anomalies, horseshoe kidney, crossed fused ectopia and fused pelvic kidney. Out of 31498 patients who underwent abdominal USG, there were 71(1:444) cases of renal fusion anomalies, 61 (1:516) of horseshoe kidneys, 9 (1:3500) of crossed-fused ectopia and 1 (1:31498) of fused pelvic kidney. Male:Female ratio was 1:2 for horseshoe kidney and 1.25:1 for crossed fused ectopia. Renal fusion anomalies are rare congenital malformation. USG is a sensitive and reliable modality for its detection. Horseshoe kidney is the most common renal fusion anomaly followed by crossed fused ectopia. Our ultrasonograhic evaluation for incidence of renal fusion anomalies closely matches past autopsy and radiographic data. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10857 Journal of Chitwan Medical College 2014; 4(2): 25-28
Ocular morbidity among primary school children
Authors: Sherpa D
Published: July 2014

Knowledge of disease pattern in children can help design preventive and curative strategies. This study is conducted to determine the pattern of ocular morbidity among the primary school children. Children of primary school were included in this study. A complete eye examination was done in all children including loupe examination, refraction and Perkins tonometry. funduscopy were done in selected children. A total of 332 primary school children were included in the study, of which 332 children 99 (29.82 %) had ocular morbidity. Refractive error was the commonest type of ocular morbidity in 31 (9.33 %). Myopia was the commonest type of refractive error (84.77%) in contrast to hypermetropia (0.30 %). 27. Conjunctivitis was the second common type of ocular morbidity (17%). Among others, Convergence insufficiency in 17 children (5.12%), exodeviation in 10 children (3.01%), blepharitis in 5 children (1.5%), vitamin A deficiency in 5 children (1.50%), ocular trauma in 2 patients (0.60%) and stye in 2 children (0.60%) were found. Refractive error is the commonest form of ocular morbidity in primary school children. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10860 Journal of Chitwan Medical College 2014; 4(2): 32-34
An unusual cause of hypoglycemia: A case report
Authors: Pokharel S , Shrestha A , Maskey D , Shrestha B , Poudel P , Shrestha B , Poudel KN , Kandel G
Published: July 2014

Hypoglycemia is characterized by a reduction in plasma glucose concentration to a level that may induce symptoms or signs such as altered mental status or sympathetic nervous system stimulation. Glucose levels <55 mg/dL (3.0 mmol/L) with symptoms that are relieved promptly after the glucose level is raised document hypoglycemia. 1 Hypoglycemia is most convincingly documented by Whipple’s triad: (1) symptoms consistent with hypoglycemia, (2) a low plasma glucose concentration measured with a precise method (not a glucose monitor), and (3) relief of those symptoms after the plasma glucose level is raised[1]. Hypoglycemia is most commonly a result of the treatment of diabetes, however it can also be seen in patients with critical organ failure (hepatic, renal or cardiac failure), severe sepsis, pancreatic tumors, adrenal or pituitary insufficiency, alcohol use or who have had stomach surgery. There are very few case reports of patients presenting as hypoglycemia caused by panhypopituitarism. 2 The potentially life-threatening consequences of sudden, unexpected hy­poglycemia may endanger not only the affected person but others as well (eg, hypoglycemia in a driver of a motor vehicle). DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10865 Journal of Chitwan Medical College 2014; 4(2): 48-50
Synchronous Juvenile ossifying Fibroma in maxilla and mandible- A case report
Authors: Shrestha B , Subedi S , Pandey S
Published: July 2014

Juvenile ossifying fibroma (JOF), one of the fibroosseous lesions is an uncommon clinical entity and involving both jaw is even rarer. Here, we present the case of a 15-year-old female patient with synchronous occurrence of JOF in the right sided maxilla and in the periapical area of mandibular right premolar molar region. After the clinical, radiographical and histopathological examination, the surgical treatment was carried out and the patient was kept under long term follow up. Owning to its aggressive local behaviour and high recurrence, early diagnosis, appropriate treatment and long term regular follow up are of prime importance. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10867 Journal of Chitwan Medical College 2014; 4(2): 54-57
My multiple, manifold, and endlessly contested 1989s
Authors: Kalb Don
Published: July 2014

Nineteen eighty-nine was for me, like for so many other Europeans and in particular Central Europeans, a year of miracles. In mid-November of that year I was traveling through the United States and giving papers on working class culture, anthropology, and history. Whenever I was asked where I came from I always answered “from the continent of the revolutions.” What a joy. But I was sad that I had traveled west rather than east.
Remembering 1989 and its aftermaths in the depths of Russia
Authors: Humphrey Caroline
Published: July 2014

From a distance—I was glued to television and newspapers in Cambridge—nothing dramatic seemed to be happening in the Siberian provinces of Russia in 1989. All attention was focused on the amazing events in Germany, Czechoslova- kia, Romania, and Bulgaria; yet I remember not only my astonishment at the tumbling of regimes but also constant twinges of regret and impatience that I could not be there.
Analysing and Enriching Focused Semantic Web Archives for Parliament Applications
Authors: Demidova Elena , Barbieri Nicola , Dietze Stefan , Funk Adam , Holzmann Helge , Maynard Diana , Papailiou Nikolaos , Peters Wim , Risse Thomas , Spiliotopoulos Dimitris
Published: July 2014

The web and the social web play an increasingly important role as an information source for Members of Parliament and their assistants, journalists, political analysts and researchers. It provides important and crucial background information, like reactions to political events and comments made by the general public. The case study presented in this paper is driven by two European parliaments (the Greek and the Austrian parliament) and targets an effective exploration of political web archives. In this paper, we describe semantic technologies deployed to ease the exploration of the archived web and social web content and present evaluation results.
(Re)interpreting Human Rights: The Case of the “Torture Memos” and their Translation into Italian
Authors: Romagnuolo Anna
Published: July 2014

The language of human rights can prove as difficult to define as it is to determine its boundaries as a legal discipline and to assert its universal acceptance. The indeterminacy and vagueness often observed in the language of its documents is clearly aimed at fostering Human Rights acknowledgment and protection; however, these same features are also a powerful tool for States seeking manipulative interpretations of human rights conventions. By combining the Appraisal Framework with an analysis of the rhetorical strategies employed in a specific type of legal document, this paper will explore the linguistic devices and rendering in translation of the so-called “Torture Memos” released by the US Government after 9/11 in an attempt to provide a legal framework for the CIA interrogation program for “unlawful combatants”.
Non-Synonymous Single Nucleotide Polymorphisms in the P2X Receptor Genes: Association with Diseases, Impact on Receptor Functions and Potential Use as Diagnosis Biomarkers
Authors: Caseley Emily , Muench Stephen , Roger Sebastien , Mao Hong-Ju , Baldwin Stephen , Jiang Lin-Hua
Published: July 2014

P2X receptors are Ca2+-permeable cationic channels in the cell membranes, where they play an important role in mediating a diversity of physiological and pathophysiological functions of extracellular ATP. Mammalian cells express seven P2X receptor genes. Single nucleotide polymorphisms (SNPs) are widespread in the P2RX genes encoding the human P2X receptors, particularly the human P2X7 receptor. This article will provide an overview of the non-synonymous SNPs (NS-SNPs) that have been associated with or implicated in altering the susceptibility to pathologies or disease conditions, and discuss the consequences of the mutations resulting from such NS-SNPs on the receptor functions. Disease-associated NS-SNPs in the P2RX genes have been valuable in understanding the disease etiology and the receptor function, and are promising as biomarkers to be used for the diagnosis and development of stratified therapeutics.
Thermodynamic Analysis for the Refining Ability of Salt Flux for Aluminum Recycling
Authors: Hiraki Takehito , Miki Takahiro , Nakajima Kenichi , Matsubae Kazuyo , Nakamura Shinichiro , Nagasaka Tetsuya
Published: July 2014

The removability of impurities during the aluminum remelting process by oxidation was previously investigated by our research group. In the present work, alternative impurity removal with chlorination has been evaluated by thermodynamic analysis. For 43 different elements, equilibrium distribution ratios among metal, chloride flux and oxide slag phases in the aluminum remelting process were calculated by assuming the binary systems of aluminum and an impurity element. It was found that the removability of impurities isn’t significantly affected by process parameters such as chloride partial pressure, temperature and flux composition. It was shown that Ho, Dy, Li, La, Mg, Gd, Ce, Yb, Ca and Sr can be potentially eliminated into flux by chlorination from the remelted aluminum. Chlorination and oxidation are not effective to remove other impurities from the melting aluminum, due to the limited parameters which can be controlled during the remelting process. It follows that a proper management of aluminum scrap such as sorting based on the composition of the products is important for sustainable aluminum recycling.
Mesoporous Titania Powders: The Role of Precursors, Ligand Addition and Calcination Rate on Their Morphology, Crystalline Structure and Photocatalytic Activity
Authors: Masolo Elisabetta , Meloni Manuela , Garroni Sebastiano , Mulas Gabriele , Enzo Stefano , Baró Maria , Rossinyol Emma , Rzeszutek Agnieszka , Herrmann-Geppert Iris , Pilo Maria
Published: July 2014

We evaluate the influence of the use of different titania precursors, calcination rate, and ligand addition on the morphology, texture and phase content of synthesized mesoporous titania samples, parameters which, in turn, can play a key role in titania photocatalytic performances. The powders, obtained through the evaporation-induced self-assembly method, are characterized by means of ex situ X-Ray Powder Diffraction (XRPD) measurements, N2 physisorption isotherms and transmission electron microscopy. The precursors are selected basing on two different approaches: the acid-base pair, using TiCl4 and Ti(OBu)4, and a more classic route with Ti(OiPr)4 and HCl. For both precursors, different specimens were prepared by resorting to different calcination rates and with and without the addition of acetylacetone, that creates coordinated species with lower hydrolysis rates, and with different calcination rates. Each sample was employed as photoanode and tested in the water splitting reaction by recording I-V curves and comparing the results with commercial P25 powders. The complex data framework suggests that a narrow pore size distribution, due to the use of acetylacetone, plays a major role in the photoactivity, leading to a current density value higher than that of P25.
High-Sensitivity Low-Noise Miniature Fluxgate Magnetometers Using a Flip Chip Conceptual Design
Authors: Lu Chih-Cheng , Huang Jeff , Chiu Po-Kai , Chiu Shih-Liang , Jeng Jen-Tzong
Published: July 2014

This paper presents a novel class of miniature fluxgate magnetometers fabricated on a print circuit board (PCB) substrate and electrically connected to each other similar to the current “flip chip” concept in semiconductor package. This sensor is soldered together by reversely flipping a 5 cm × 3 cm PCB substrate to the other identical one which includes dual magnetic cores, planar pick-up coils, and 3-D excitation coils constructed by planar Cu interconnections patterned on PCB substrates. Principles and analysis of the fluxgate sensor are introduced first, and followed by FEA electromagnetic modeling and simulation for the proposed sensor. Comprehensive characteristic experiments of the miniature fluxgate device exhibit favorable results in terms of sensitivity (or “responsivity” for magnetometers) and field noise spectrum. The sensor is driven and characterized by employing the improved second-harmonic detection technique that enables linear V-B correlation and responsivity verification. In addition, the double magnitude of responsivity measured under very low frequency (1 Hz) magnetic fields is experimentally demonstrated. As a result, the maximum responsivity of 593 V/T occurs at 50 kHz of excitation frequency with the second harmonic wave of excitation; however, the minimum magnetic field noise is found to be 0.05 nT/Hz1/2 at 1 Hz under the same excitation. In comparison with other miniature planar fluxgates published to date, the fluxgate magnetic sensor with flip chip configuration offers advances in both device functionality and fabrication simplicity. More importantly, the novel design can be further extended to a silicon-based micro-fluxgate chip manufactured by emerging CMOS-MEMS technologies, thus enriching its potential range of applications in modern engineering and the consumer electronics market.
Performance Evaluation of Industrial Land Policy in China
Authors: Zheng Xinqi , Geng Bing , Wu Xiang , Lv Lina , Hu Yecui
Published: July 2014

Rapid industrialization, as one of the main driving forces promoting sustainable economic growth, has increased the area of industrial land use significantly. Industrial land use manifests that the competition between it and other kinds of land use is growing. During the last decade in China, many targeted industrial land use policies have been enacted to stimulate appropriate industrial land use and to promote healthy economic development. However, it is difficult for scholars and governments of rapidly developing countries to judge and evaluate the performance of such policies. Based on statistical data gathered over almost 10 years and an idea called “industrial land equivalent” (ILE), this paper analyzes the contribution made by the implementation of industrial land use policy to economic development, using a Cobb-Douglas production function by which to quantify the influence of land institutions and land regulation systems. The result of the study shows that factors, such as industrial land, labor and capital, all play an important role in GDP growth. Additionally, it is found that industrial land institutions and regulation systems have a strongly positive influence on economic development. It was also found that the influence of policy in eastern China is greater than that in the west and that repeated, short-term land regulation has a negative effect on the economy. Therefore, it is profoundly important for the Chinese economy that a stable and durable industrial land use policy be maintained as the industrial center migrates to the Midwest. The research philosophy and method offered by this paper have great significance for the quantitative evaluation of policy performance.
Impact Pathways to Address Social Well-Being and Social Justice in SLCA—Fair Wage and Level of Education
Authors: Neugebauer Sabrina , Traverso Marzia , Scheumann René , Chang Ya-Ju , Wolf Kirana , Finkbeiner Matthias
Published: July 2014

Social well-being and social justice are meant to create a positive outcome meaningful for people and societies. According to the guidelines of social life cycle assessment, especially well-being should be considered as the main area of protection to assess social impacts of products. In addition, equity and equality need to be addressed in terms of social justice to ensure a fair and ethic society. However, even if a lot of studies focused on the definition social indicators to assess resulting impacts, neither have scientific or common agreements been founded to define a valid set of indicators, nor have consistent pathways from inventory towards impact indicators been established. This work, therefore, proposes possible pathways from life cycle inventory to impact assessment of two social midpoint categories: fair wage and level of education. Respective cause-effect-chains are developed based on the environmental life cycle assessment principle. Correspondingly, social inventory indicators throughout direct impacts to midpoint and endpoint categories are defined. Three endpoint categories are included (economic welfare, damage to human health and environmental stability) to address social well-being and social justice. Qualitative characterization factors and a scaling method are proposed to evaluate the impacts according to threshold and reference values from valuable literature.
The Use of Chemical Weapons in the Syrian Conflict
Authors: Pita René , Domingo Juan
Published: July 2014

This paper aims at explaining the lessons learned from the chemical attacks that took place in 2013 in the Syrian military conflict, especially the sarin attacks on the Ghouta area of Damascus on August 21. Despite the limitations the UN Mission found while investigating the use of chemical weapons (CW) in Syria, some interesting conclusions for the scientific and medical community can be obtained from its reports. These include the advantages of the Chemical Weapons Convention procedure for the investigation of alleged CW use, when compared with the United Nations mechanism for similar investigations, the difficulties of differential diagnosis based only on clinical signs and symptoms and the impact of secondary contamination when responding to a CW attack.
Electron-beam induced deposition and autocatalytic decomposition of Co(CO)3NO
Authors: Vollnhals Florian , Drost Martin , Tu Fan , Carrasco Esther , Späth Andreas , Fink Rainer H , Steinrück Hans-Peter , Marbach Hubertus
Published: July 2014

The autocatalytic growth of arbitrarily shaped nanostructures fabricated by electron beam-induced deposition (EBID) and electron beam-induced surface activation (EBISA) is studied for two precursors: iron pentacarbonyl, Fe(CO)5, and cobalt tricarbonyl nitrosyl, Co(CO)3NO. Different deposits are prepared on silicon nitride membranes and silicon wafers under ultrahigh vacuum conditions, and are studied by scanning electron microscopy (SEM) and scanning transmission X-ray microscopy (STXM), including near edge X-ray absorption fine structure (NEXAFS) spectroscopy. It has previously been shown that Fe(CO)5 decomposes autocatalytically on Fe seed layers (EBID) and on certain electron beam-activated surfaces, yielding high purity, polycrystalline Fe nanostructures. In this contribution, we investigate the growth of structures from Co(CO)3NO and compare it to results obtained from Fe(CO)5. Co(CO)3NO exhibits autocatalytic growth on Co-containing seed layers prepared by EBID using the same precursor. The growth yields granular, oxygen-, carbon- and nitrogen-containing deposits. In contrast to Fe(CO)5 no decomposition on electron beam-activated surfaces is observed. In addition, we show that the autocatalytic growth of nanostructures from Co(CO)3NO can also be initiated by an Fe seed layer, which presents a novel approach to the fabrication of layered nanostructures.
Synthesis of rigid p-terphenyl-linked carbohydrate mimetics
Authors: Kandziora Maja , Reissig Hans-Ulrich
Published: July 2014

An approach to β-D-2-aminotalose- and β-D-2-aminoidose-configured carbohydrate mimetics bearing a phenyl substituent is described. Unnatural divalent rigid p-terphenyl-linked C-aryl glycosides with 2.0 nm dimension are available using Suzuki cross-couplings. The key compound, a p-bromophenyl-substituted 1,2-oxazine, was prepared by a stereoselective [3 + 3]-cyclization of a D-isoascorbic acid-derived (Z)-nitrone and lithiated TMSE-allene. The Lewis acid-induced rearrangement of this heterocycle provided the corresponding bicyclic 1,2-oxazine derivative that may be regarded as internally protected amino sugar analogue. After subsequent reduction of the carbonyl group, the resulting bicyclic compound was used for Suzuki cross-couplings to form biphenyl aminopyran or p-terphenyl-linked dimers. Hydrogenolysis afforded new unnatural aminosugar mimetics. Zinc in the presence of acid or samarium diiodide were examined for the N–O bond cleavage in order to obtain the rigid p-terphenyl-linked C-glycosyl dimers.
Considérations sur les phénomènes somatiques et l'autisme adulte. Une tension du 3 e Plan autisme
Authors: Diébold Lionel , Pedinielli Jean-Louis
Published: July 2014

La séparation entre organisme et vivant tend à révéler les deux médecines qui s’opposent dans l’autisme adulte. Il apparaît que la maladie somatique peut échapper au discernement, en raison d’un envahissement trop important de la structure psychopathologique de l’autisme et d’une absence de connaissances des maladies somatiques. Parallèlement, la méconnaissance de la médecine somatique vers l’accompagnement soignant de la façon d’être autistique, montre une défaillance susceptible d’empêcher l’accès aux soins. Conformément au Plan autisme 2013, pour tenter de contrarier ces deux tendances, nous plaidons en faveur d’une formation pour les soignants intervenant en somatique et pour les soignants intervenant en psychiatrie, en rappelant que ce rapprochement, programmé dans le plan, noue les deux grandes peurs de nos sociétés modernes : la mort et la folie.
El ciclo narrativo del cura difunto y la misa no celebrada en vida: un precedente historiográfico del siglo XVII
Authors: Mahiques Climent Joan
Published: July 2014

Este artículo presenta un estudio y la primera edición de un capítulo de los Anales de los carmelitas descalzos de la provincia de san José en el Principado de Cataluña, escritos por fray Juan de san José (1642-1718), cuya copia autógrafa se conserva en el ms. 991 de la Biblioteca de la Universidad de Barcelona. El texto se presenta como un hecho real, documentado a través de declaraciones juradas y examinado por el clero, que se contextualiza entre los años 1677-1681 en la ciudad de Vic y sus alrededores. Se inserta en la tradición de los procesos sobre apariciones de ánimas del purgatorio y, en algunos aspectos, constituye un notable precedente del cuento folclórico del cura difunto que vuelve para decir una misa no celebrada en vida.
Understanding Integrated Care
Authors: Goodwin Nick , Alonso Albert
Published: July 2014

This chapter provides a thorough grounding in the meaning and logic of integrated care and the role of ICT. It begins with an overview that describes why integrated care has become a central theme to the reform of health and social care in the face of mounting demographic and economic challenges that require a new way of thinking about how care can be more cost-effectively delivered. Following an in-depth analysis of what is meant by integrated care, including an interpretation of the various definitions and interpretations that have been provided, the chapter moves on to provide an understanding of the challenges faced when implementing integrated care programmes in practice and the key lessons in how systems of integrated care can be built. The role of information, communication, and technology as essential components for the success of integrated care is then considered together with an assessment of the future research agenda.
Socio-Economic Impact Assessment and Business Models for Integrated eCare
Authors: Hammerschmidt Reinhard , Meyer Ingo
Published: July 2014

Putting into place ICT-supported, integrated health and social care services means that a multitude of stakeholders are affected by changes to their working process and often to their economic performance. In this chapter, the authors describe their approach to assessing integrated eCare services to enable care integrators in making strategic decisions during development and early operation. The approach is founded on cost-benefit analysis. It stands out from other assessment frameworks in that it 1) allows identifying and addressing stakeholders that lose through the service and thus may become strong veto players, 2) allows monitoring of the actual and prospective service development over time, 3) includes non-financial factors that in many cases have a major impact on the behaviour of a stakeholder, and 4) provides probabilistic methods for achieving rigorous results from data of varying quality. Following an exemplary integration case developed from one of their pilot projects, the steps of the assessment process are described, including an exemplary interpretation of the analytic results and their application in practice. The chapter concludes with an outlook on future work.
Making Integrated eCare a Reality in the UK
Authors: Gretton Mark
Published: July 2014

Integrated health and social care has been a missed goal in the United Kingdom for many years. This chapter examines why this has been the case and what might be done to remedy this. The inception of the welfare state is described in its historical context to provide clues as to why integration has proved difficult, before examining Wistow's forensic analysis of the barriers to integration in light of this, focusing in particular on his emphasis on the difficulty of integrating the diversity of social care with the monolith of healthcare. Rigby's analogy of technological road mapping as a model for integrating care and planning services is explored in detail, before explaining how this method was utilised in the INDEPENDENT project in Hull. The chapter concludes that the analogy of “technological mapping” is a useful guide for directing services and helping to integrate care but that government too has a vital role to play.
From Agreement to Realization
Authors: Reime Birgit , Kardel Udo , Melle Christian , Roth Monika , Auel Marcus , Hildebrandt Helmut
Published: July 2014

Gesundes Kinzigtal is a population-based integrated care approach in Germany that organises care across all health service sectors and indications. This chapter describes the development of an electronic networking system in the project between 2006 and 2013. The IT system that was developed shall supply physicians' offices and other providers such as ambulant nursing care services and hospitals with time saving services providing the complete relevant information of the patient. The status of IT systems in practices at the start of the project and steps to achieve a mutual IT system and intersectoral cooperation are described. Pros and cons for small or large IT companies as partners and patients concerns on data safety and confidentiality are discussed. The chapter closes with an outlook on expanding the project to further healthcare sectors and raises ideas for future studies on self tracking and mobile health data from APPs as well as community resources and voluntary networks to join electronic patient networks.
Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital
Authors: Bam Nokwanda E. , Naidoo Joanne R.
Published: July 2014

Background: Whilst the discourse of palliative care in HIV management is largely documented and regarded as being an essential component, various authors have further argued that within the context of HIV care in sub-Saharan Africa, palliative care and exploration of the dimensions thereof is largely lacking. This article presents the lived experiences of nurses involved in palliative care, thus providing the perspective of nurses and the multi-faceted dimensions of the nature of caring inherent.Objectives: This study explored the respondents’ understanding of the concepts ‘caring’ and ‘terminal patient’ and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered.Methods: Qualitative research using Husserl’s approach of phenomenology design underpinned the study and Giorgi’s steps of analysis were used to make meaning of the data.Results: The concept ‘caring’ was experienced by the nurses as transforming the patients’ quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes.Conclusion: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context.
Incidence and Risk of Infection in Egyptian Patients with Systemic Lupus Erythematosus
Authors: Mohamed Dalia F. , Habeeb Reem A. , Hosny Sherin M. , Ebrahim Shafika E.
Published: July 2014

Background

Infection in systemic lupus erythematosus (SLE) is common and is one of the leading causes of morbidity and mortality.

Objective

To study the risk and occurrence of infection in Egyptian SLE patients and to determine its characteristics.

Methods

A total of 200 SLE patients were followed up for 1 year at monthly intervals, undergoing clinical and laboratory evaluation. Disease activity was assessed by SLE disease activity measurement (SLAM) score. Infections were diagnosed on basis of clinical findings, medical opinion, positive blood and urine cultures, Gram stain results, and specific serological assays as measurement of CMV and EBV antibodies.

Results

A total of 55% of patients developed infection, 45% had one infection, and the rest had multiple infection episodes. Total number of infections was 233 infections/year, 47.2% were major and 52.8% were minor infections. Urinary tract was the most commonly involved site with bacterial infection being the commonest isolated organism (46.4%), and E. coli the commonest isolated bacteria (14.2%). There were 51 episodes caused by systemic viral infection (CMV in 25, EBV in 22, HCV in 3, and 1 in HBV).

Conclusion

There is a high rate of infection among SLE patients. Disease activity, leukopenia, high CRP level, positive anti-dsDNA, consumed C3, and cyclophosphamide therapy are independent risk factors for infection in SLE.
Combined First-Trimester Screening in Northern Finland: Experiences of the First Ten Years
Authors: Anna Merilainen , Sini Peuhkurinen , Timppa Honkasalo , Paivi Laitinen , Hannaleena Kokkonen , Markku Ryynanen , Jaana Marttala
Published: July 2014

Objective

To evaluate the efficacy of first trimester combined screening for Down's syndrome in Northern Finland during the first 10 years of practice.

Methods

During 1 January 2002 to 31 December 2011, 47,896 women participated voluntarily in combined screening during first trimester. The risk cutoff was 1:250. The study period was divided into two time periods; 2002-2006 and 2007-2011.

Results

During the first half of the study period, the detection rate (DR) was 77.3% with a 4.9% false-positive rate (FPR). During the latter half, the DR was 77.1% with a 2.8% FPR.

Conclusions

An important issue is the number of invasive procedures needed to detect one case of Down's syndrome. The screening performance improved markedly in the latter five years period since the FPR lowered from 4.9% to 2.8% and the number of invasive procedures needed to detect one case of Down's syndrome lowered from 15 to 11.
Comprehensive electronic medical record implementation levels not associated with 30-day all-cause readmissions within Medicare beneficiaries with heart failure.
Authors: Marken P. , Zhong Y. , Simon S. D. , Ketcherside W. , Patterson M. E.
Published: July 2014

Background: Regulatory standards for 30-day readmissions incentivize hospitals to improve quality of care. Implementing comprehensive electronic health record systems potentially decreases readmission rates by improving medication reconciliation at discharge, demonstrating the additional benefits of inpatient EHRs beyond improved safety and decreased errors.

Objective: To compare 30-day all-cause readmission incidence rates within Medicare fee-for-service with heart failure discharged from hospitals with full implementation levels of comprehensive EHR systems versus those without.

Methods: This retrospective cohort study uses data from the American Hospital Association Health IT survey and Medicare Part A claims to measure associations between hospital EHR implementation levels and beneficiary readmissions. Multivariable Cox regressions estimate the hazard ratio of 30-day all-cause readmissions within beneficiaries discharged from hospitals implementing comprehensive EHRs versus those without, controlling for beneficiary health status and hospital organizational factors. Propensity scores are used to account for selection bias.

Results: The proportion of heart failure patients with 30-day all-cause readmissions was 30%, 29%, and 32% for those discharged from hospitals with full, some, and no comprehensive EHR systems. Heart failure patients discharged from hospitals with fully implemented comprehensive EHRs compared to those with no comprehensive EHR systems had equivalent 30-day readmission incidence rates (HR = 0.97, 95% CI 0.73 – 1.3)

Conclusions: Implementation of comprehensive electronic health record systems does not necessarily improve a hospital’s ability to decrease 30-day readmission rates. Improving the efficiency of post-acute care will require more coordination of information systems between inpatient and ambulatory providers.

Citation: Patterson ME, Marken P, Zhong Y, Simon SD, Ketcherside W. Comprehensive electronic medical record implementation levels not associated with 30-day all-cause readmissions within Medicare beneficiaries with heart failure. Appl Clin Inf 2014; 5: 670–684

http://dx.doi.org/10.4338/ACI-2014-01-RA-0008