bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of radiographic contrast media on proliferation and apoptosis of human vascular endothelial cells.
Authors: Zhang H , Holt C M , Malik N , Shepherd L , Morcos S K
Published: June 2014

The aim of the study was to determine the effects of radiographic contrast media (RCM) on proliferation and apoptosis of human vascular endothelial cells. Human umbilical vein endothelial cells (HUVECs) were exposed for either 1 min or 15 min to RCM (diatrizoate, ioxaglate, iopromide, iotrolan) at an iodine concentration of 250 mgl ml-1. Controls were complete growth medium (CGM) and saturated mannitol (osmotic control). [3H]thymidine incorporation was used to determine cell proliferation 24 h after exposure. Apoptosis was determined at 1 h and 6 h by terminal uridine nick end labelling (TUNEL), time lapse video microscopy (TLVM) and DNA electrophoresis. Mean proliferation rates (%) (+/- SEM) (p-values compared with the CGM control) at 1 min and 15 min, respectively, were: diatrizoate: 31.9 (10.6), 5.8 (1.5) (p < 0.001); ioxaglate: 48.4 (10.9), 20.4 (4.5) (p < 0.001); iopromide: 63.4 (8.7), 58.2 (10.2) (p < 0.05); iotrolan: 84.7 (7.3), 72.8 (12.4) (p = ns); saturated mannitol 50.5 (9.6), 45.9 (10.0) (p < 0.001). Mean apoptotic indices (%) (+/- SEM) at 1 h and 6 h following 1 min exposure, respectively, were: CGM: 0.25 (0.13), 0.23 (0.08); diatrizoate: 2.18 (0.19), 2.69 (0.34) (p < 0.001); ioxaglate: 1.90 (0.23), 1.69 (0.02) (p < 0.05); iopromide: 0.59 (0.04), 0.33 (0.02) (p = ns); iotrolan: 0.30 (0.07), 0.27 (0.1) (p = ns); saturated mannitol 2.11 (0.24), 1.4 (0.1) (p < 0.05). After 15 min exposure, apoptosis rates at both 1 h and 6 h, respectively, were: iotrolan: 0.29 (0.17), 0.51 (0.16) (p = ns); diatrizoate: 3.19 (0.81), 11.66 (1.75) (p < 0.001); ioxaglate: 1.88 (0.14), 2.87 (0.20) (p < 0.05); iopromide: 1.06 (0.11), 1.52 (0.15) (p < 0.05); saturated mannitol 1.62 (0.09), 4.63 (0.74) (p < 0.05). TLVM and DNA electrophoresis confirmed the occurence of apoptosis after exposure to RCM. In conclusion, saturated mannitol and all tested RCM, with the exception of iotrolan, (diatrizoate > ioxaglate > iopromide) reduced proliferation and increased apoptosis of HUVECs. The effects were more pronounced with ionic RCM and seem to depend on osmolality as well as the chemical structure of these agents. Endothelial injury and apoptosis may be responsible for some of the side effects associated with intravascular use of RCM.
Influence of anode/filter material and tube potential on contrast, signal-to-noise ratio and average absorbed dose in mammography: a Monte Carlo study.
Authors: Dance D R , Thilander A K , Sandborg M , Skinner C L , Castellano I A , Carlsson G A
Published: June 2014

The comparative performance of mammographic X-ray systems that use different anode/filter combinations has been assessed for screen-film and digital imaging. Monte Carlo techniques have been used to calculate average glandular dose as well as contrast and signal-to-noise ratio for imaging two test details. Five anode/filter combinations have been studied to establish the potential for dose saving or image quality improvement. For screen-film mammography, it was found that little benefit is gained by changing from a standard 28 kV molybdenum/molybdenum spectrum for breasts up to 6 cm thick. For thicker breasts, where the tube potential for the standard technique might be increased, 20% improvement in contrast can be achieved without dose penalty using molybdenum/rhodium or rhodium/rhodium spectra, whereas dose savings of more than 50% can be attained whilst maintaining contrast using tungsten/rhodium or rhodium/aluminium spectra. In digital mammography, a molybdenum/molybdenum spectrum delivers the lowest dose for a 2 cm breast, but gives the highest dose for thicker breasts. Tungsten/rhodium or rhodium/aluminium spectra provide the lowest doses at greater thicknesses. It is concluded that for screen-film mammography, molybdenum/molybdenum is the spectrum of choice for all but the thickest or most glandular breasts. In digital mammography, an alternative spectrum is preferable for breasts thicker than 2 cm.
Gas exchange parameters in radiotherapy patients during breathing of 2%, 3.5% and 5% carbogen gas mixtures.
Authors: Baddeley H , Brodrick P M , Taylor N J , Abdelatti M O , Jordan L C , Vasudevan A S , Phillips H , Saunders M I , Hoskin P J
Published: June 2014

The gas mixture carbogen may be breathed by patients to enhance the oxygenation level and therefore the radiosensitivity of tumours. However, owing to the high CO2 content, its inhalation is associated with patient intolerance. Our aim was to determine a suitable carbon dioxide and oxygen gas mixture with similar enhancement of arterial oxygenation to 5% carbogen and with improved patient tolerance. 14 patients entered the study; of those 14, 8 were able to tolerate 2%, 3.5% and 5% carbogen mixtures as well as a control gas for sufficient time to allow successful arterial blood gas sampling. Gas exchange parameters were measured using a carbon dioxide monitor and a blood gas analyser. Arterial carbon dioxide tension ranged from 2.9 kPa to 6.82 kPa whilst breathing the carbogen mixtures, and arterial oxygen tension increased at least three-fold from basal values. There were no significant changes in the respiratory rate, heart rate and blood pH. The results suggest that 2% CO2 in O2 enhances arterial oxygen levels to a similar extent as 3.5% and 5% CO2 and that it is well tolerated.
MRI with mangafodipir trisodium in the detection of pancreatic tumours: comparison with helical CT.
Authors: Rieber A , Tomczak R , Nüssle K , Klaus H , Brambs H J
Published: June 2014

The aim was to compare spiral CT and MRI enhanced with mangafodipir trisodium (Mn-DPDP) in the detection and staging of pancreatic lesions. 20 patients with suspected pancreatic cancer were included in a phase III study. Triphasic spiral CT (4 ml s-1) and MRI (axial T1 weighted turbo spin echo with and without fat suppression, T1 weighted gradient echo and T2 weighted turbo spin echo at 1.5 T) were performed. All sequences were repeated following contrast medium using the same instrument settings as in the unenhanced sequences. Mn-DPDP was administered by slow injection of 5 mumol kg-1 body weight. Imaging results were correlated with surgery, laparoscopy, biopsy and/or follow-up. Eight pancreatic adenocarcinomas were present. Ten patients had chronic pancreatitis, and two showed a stenosing papillitis. CT detected eight malignant lesions and MRI detected seven. One pancreatic cancer was not detected with MRI. CT and MRI excluded malignancy in nine patients. MRI and CT returned three false positive results. Mn-DPDP improved delineation of the lesion, resulting in a higher level of diagnostic confidence. Differentiation between pseudotumorous lesions in chronic pancreatitis and pancreatic carcinoma was difficult due to similar slight contrast enhancement. Owing to better delineation of the lesion and the higher confidence in diagnosis, MRI with Mn-DPDP may have the potential to improve the detection rate and the staging accuracy of focal pancreatic lesions. These results need to be confirmed in a larger patient trial.
The influence of different technique factors on image quality of lumbar spine radiographs as evaluated by established CEC image criteria.
Authors: Almén A , Tingberg A , Mattsson S , Besjakov J , Kheddache S , Lanhede B , Månsson L G , Zankl M
Published: June 2014

In this study we have investigated the image quality of lumbar spine radiographs taken after recording technical and physical parameters. Two technical parameters were altered, tube voltage (70 kV and 90 kV for the anteroposterior (AP) projection and 77 kV and 95 kV for the lateral projection) and sensitivity of the film-screen system (sensitivity class 400 and 600). In total, 85 images were included in the study. Entrance surface dose (ESD) was measured using thermoluminescent dosemeters. The mean value of ESD for the different technique groups varied between 1.9 mGy (90 kV, sensitivity class 400) and 4.6 mGy (70 kV, sensitivity class 400) for the AP projection, and between 6.4 mGy (95 kV, sensitivity class 600) and 20.4 mGy (70 kV, sensitivity class 400) for the lateral projection. Image criteria given in the "European Guidelines on Quality Criteria for Radiographic Images" were used to assess image quality. Two evaluation methods have been employed. A straightforward scoring of fulfilled image criteria, and visual grading analysis using the structures defined in the image criteria. The latter method provided a sharper distinction between groups of images taken using different radiographic techniques. The average number of fulfilled image criteria for the AP projections varied between 0.74 (90 kV, sensitivity class 400) and 0.87 (70 kV, sensitivity class 400). For the lateral projection this number varied between 0.79 (95 kV, sensitivity class 600) and 0.84 (77 kV, sensitivity class 600). This study shows that image criteria are useful tools in clinical studies of image quality.
Proton magnetic resonance spectroscopy and morphometry of the hippocampus in chronic fatigue syndrome.
Authors: Brooks J C , Roberts N , Whitehouse G , Majeed T
Published: June 2014

Seven patients with chronic fatigue syndrome (CFS) were matched with ten healthy control subjects of similar age. Hippocampal volume, obtained from magnetic resonance images using an unbiased method, showed no difference between the two groups, whereas proton magnetic resonance spectroscopy showed a significantly reduced concentration of N-acetylaspartate in the right hippocampus of CFS patients (p = 0.005).
Radiation protection consequences of the care of a terminally ill patient having received a thyroid ablation dose of 131I-sodium iodide.
Authors: Griffiths P A , Jones G P , Marshall C , Powley S K
Published: June 2014

The death of a patient soon after an ablation dose of 131I-sodium iodide is a rare occurrence. We report a case of a patient who died, following emergency surgery to treat gastric bleeding, whilst still radioactive. The doses received by clinical staff involved in management of the patient were measured and were found to be within acceptable limits. However, there was an appreciable level of unsealed radioactivity in the Intensive Care Unit. The issues raised by this case are discussed in the context of legislative requirements and the worst case scenario. The event highlights the need for close liaison between the different specialities to ensure that clinical staff are properly advised and that necessary safety precautions are taken to avoid compromising the safety of staff or the care of the patient.
Pulmonary vasculitis: the spectrum of radiological findings.
Authors: Seo J B , Im J G , Chung J W , Song J W , Goo J M , Park J H , Yeon K M
Published: June 2014

Pulmonary vasculitis includes various disease entities with a wide range of clinical presentations and overlapping imaging features. Radiological findings of vasculitis in the angiitis-granulomatosis group are nodular and patchy opacities, whereas the principal feature of those diseases causing widespread capillaritis is diffuse air space consolidation. Aneurysms or stenoses of pulmonary arteries are seen in patients with Takayasu arteritis or Behçet's disease.
The vascular manifestations of Behçet's disease: angiographic and CT findings.
Authors: Ko G Y , Byun J Y , Choi B G , Cho S H
Published: June 2014

The purpose was to evaluate angiographic and CT manifestations of vascular Behçet's disease. The medical records of 64 patients with Behçet's disease, treated in our hospital during the last 4 years, were reviewed. 37 patients underwent angiography or CT in the symptomatic regions because of symptoms or clinical signs of vascular involvement by Behçet's disease. 33 (male:female ratio 28:5; mean age 35 years) of the 37 patients demonstrated vascular involvement, which was surgically proven (18 patients) or diagnosed on angiography (15 patients). Angiograms and CT images of these 33 patients were retrospectively analysed for lesion type, location, extent and other characteristic findings of vascular involvement. 12 patients had only venous lesions, 11 had only arterial lesions and 10 had both arterial and venous lesions. The major angiographic findings of vascular Behçet's disease were acute or chronic thrombosis in deep veins of the lower extremities (19 patients), in the inferior vena cava (4 patients) and in the superior vena cava (2 patients), pseudoaneurysms of large or medium sized arteries (11 patients), and occlusions/ stenoses of distal run-off arteries (13 patients). Common CT findings were obliterated deep veins (8 patients) and non-calcified thickened aneurysmal walls (9 patients), with or without contrast enhancement. The combination of these angiographic and CT findings with clinical manifestations are helpful in distinguishing vascular Behçet's disease from other vasculitides.
Non-tumorous enhancement caused by cholecystic venous inflow shown on biphasic CT hepatic arteriography: comparison with hepatocellular carcinoma.
Authors: Yamagami T , Nakamura T , Kin Y , Nishimura T
Published: June 2014

The haemodynamics in non-tumorous abnormalities on CT arterial portography (CTAP) owing to cholecystic venous direct inflow to the liver were compared with the haemodynamics in hepatocellular carcinoma. 53 patients who simultaneously underwent CTAP and CT during hepatic arteriography (CTHA) to detect hepatocellular carcinoma had the late phase added to CTHA. Changes in size, shape and pattern of 47 non-tumorous enhancement abnormalities on the liver around the gall bladder or in the dorsum of segment IV between the early and late phases on biphasic CTHA as well as of 60 tumorous lesions were determined. Enhancement on biphasic CTHA was seen in all 47 lesions with a non-tumorous portal defect (early phase alone, n=8; late phase alone, n = 3; both, n = 36). In these 47 lesions, the size and the shape of enhancement changed in 63.8% and 51.1%, respectively, between the early and late phases on CTHA; the pattern of enhancement did not change in 72.3%. On the other hand, the size of enhancement on biphasic CTHA changed in only 16.7% of 60 tumours, and the shape in only 5%, although the enhancement pattern changed in a large proportion (80%). In conclusion, owing to the difference in haemodynamics, non-tumorous abnormalities caused by cholecystic venous inflow and tumours are clearly delineated on biphasic CTHA. Thus, adding the late phase to previous single phase CTHA (i.e. performing biphasic CTHA) is useful in differentiating the two entities.
Treatment of a false aneurysm of an intercostal artery using a covered intracoronary stent-graft and a radial artery puncture.
Authors: Callaway M P , Wilde P , Angelini G
Published: June 2014

This case report documents the successful treatment of a false aneurysm of the left internal mammary artery with a covered coronary artery stent. The advantages and disadvantages of this novel method of treatment are discussed, together with a review of alternative methods of treatment of false aneurysms.
A user experience of supervisory support in the South East
Authors: Stone Rebekah Joy
Published: June 2014

In the UK, caesarean section incidence is on the increase. Now, between 25 and 30% of births are by caesarean section ( Royal College of Obstetricians and Gynaecologists (RCOG), 2013 ). This article looks at the role supervisory support can play on birth outcomes and whether it can contribute to the cascade of intervention. It highlights the need for positive and proactive supervisory support, based on one user's experience.
Collaborative Action in Lowering Maternity Encountered Deaths
Authors: Duncombe Caroline , Roseghini Manjit
Published: June 2014

The Collaborative Action in Lowering Maternity Encountered Deaths (CALMED) aims to send vocational training teams (VTTs) to help reduce maternal and newborn mortality. This article outlines two midwives' experience during a 2-week VTT programme to manage obstetric emergencies in India in March 2013. The CALMED project was organised by two Rotary groups in London and two in Mumbai.
An exploratory study into student midwives understanding of the role of the physiotherapist
Authors: Goodwin Katie
Published: June 2014

Background:

It is important that health professionals have an understanding of each others' roles in order to promote patient-centred care and services available. Within obstetrics it is necessary, as key information informers, that midwives and student midwives understand the role physiotherapists can offer.

Aim:

To explore student midwives understanding of physiotherapy in the antenatal and postnatal setting and what role they recognise it plays within UK healthcare.

Method:

Adopting a qualitative exploratory approach, a focus group was conducted to explore midwifery students' experiences. Data were analysed using an adapted thematic analysis process. Results: Five key themes were identified: 1. Role recognition is needed, 2. Lack of knowledge: ‘But we don't know what a physiotherapist does’, 3. A perceived view, 4. Utilised? ‘Yes. But…’ and 5. Beneficial?

Conclusion:

Participants recognised the importance for role understanding, had a perceived view of physiotherapy closely related to the Association of Chartered Physiotherapists in Women's Health (ACPWH) role definition and described physiotherapy as beneficial. Numerous barriers prevent utilisation. Interprofessional education does not promote or aid role understanding. It is questionable whether student midwives are able to promote physiotherapy services appropriately.
Supporting children and young people with psoriasis
Authors: Van Onselen Julie
Published: June 2014

This article is part of a series of interviews with a range of professionals working with children and young people. This month, Julie Van Onselen, dermatology nurse specialist, offers advice on supporting children and young people with psoriasis in schools.
Dealing with a tuberculosis diagnosis in the school setting
Authors: Lepkowska Dorothy
Published: June 2014

Tuberculosis is a potentially fatal bacterial infection. Dorothy Lepkowska looks at the prevalence of tuberculosis in the UK and the importance of teaching children and young people hygiene and infection control.
Beatrix Potter's birthday party
Authors: Neville Sarah
Published: June 2014

She is one of the most popular children's authors the world has ever known and her illustrated books make it easy to introduce activities based on her lovable animals.
Readers' stories
Authors: Smith Sue
Published: June 2014

Send your letters to: The Editor, Child Care, St Jude's Church, Dulwich Road, Herne Hill, London, SE24 0PB email: childcare@markallengroup.com
Stories in the garden
Authors: Sowerby Jennifer
Published: June 2014

What better way to encourage imagination and communication through outdoor play than by taking your storytelling sessions into your garden or even down to your local park.
Planning for senses: Seeing eyes
Authors: Harries Judith
Published: June 2014

In this extract from Planning for Learning Through the Senses [Practical Pre-School Books] we explore activities, based on the early learning goals: this month, we focus on eyesight.
Lessons from the field: strategies to improve patient recruitment for low vision interventional research
Authors: Aw Ai Tee , Drury Vicki , Chiang Peggy , Soon Hasita JT , Tey Ching Siong , Lim Priscilla SH
Published: June 2014

Studies in Australia have found that self-management programmes for people with vision impairment can improve quality of life and decrease health service use. Conducting research with people with vision impairment raises specific scientific and operational challenges. This article describes the challenges encountered during patient recruitment into a randomised control trial evaluating a self-management programme for people with low vision in Singapore. The discussion also includes strategies to facilitate recruitment for studies with people with vision impairment.
Patient support and counselling: an interview with Jasmine Thombs and Louise de Board
Authors: Thombs Jasmine , de Board Louise
Published: June 2014

Counselling is important in the eye clinic because patients attend with a wide range of conditions that require investigation and treatment, and often experience high level of anxiety and stress. Visual loss has a huge psychological as well as practical impact and is associated with a higher than normal risk of depression. Jasmine Thombs and Louise de Board, who are both ophthalmic nurse counsellors, explain how counselling offers patients a confidential space to talk and think about their eye problems, and how this can: reduce levels of anxiety and depression, equip patients with specialist information, and provide access to support groups.
Dry eye treatment: choosing the best product for your patient
Authors: Källmark Fredrik
Published: June 2014

Dry eye disease (DED) is a multifactorial condition that is complex to diagnose and treat. Over the last two decades, major advances have occured in the treatment of DED and ocular surface disease. There has also been an equal increase in knowledge concerning the processes or mechanisms whereby the condition develops and progresses. This has led to a paradigm shift in DED management from simply lubricating and hydrating the ocular surface with artificial tears to strategies that stimulate natural production of tear constituents, maintain ocular surface epithelial health and barrier function, and inhibit the inflammatory factors that adversely impact the ability of the ocular surface and glandular epithelia to produce tears. Preliminary experience with this new therapeutic approach suggests that quality of life can be improved for many patients with dry eye, and that initiating these strategies early in the course of the disease may prevent potentially blinding complications of DED.
Diabetes and eye health: screening for diabetic retinopathy
Authors: Phillips Anne
Published: June 2014

Regular eye screening is vital for people with diabetes, and all practitioners have an important role to play in encouraging attendance and understanding of eye screening within diabetes care. This can help reduce risk factors and help save sight.
Upper limb pain and decline in strength during rehabilitation for a lower limb injury
Authors: Stagnitti Karen , da Graca Costa Melissa , Falzon Larna , Williams Catherine , Chi Jicheng , Richards Kieva
Published: June 2014

Background/aim:

This study aimed to establish changes in upper limb strength and range of motion that may occur over a short period of time when rehabilitation is focused on lower limb injuries.

Methods:

The research study was a single group with a pre-post design. A total of 24 patients receiving therapy services for a lower limb injury received an upper limb assessment on admission then three weeks later during lower limb inpatient rehabilitation. Upper limb assessment involved goniometry, dynamometric evaluations, manual muscle testing (MMT) and an assessment of pain.

Findings:

A significant decrease in right grasp strength (change of −1.2, 95% CI: −2.4–0.0, P=0.04) occurred between Time 1 (initial admission) and Time 2 (three weeks later). There was a decrease of more than 3° for right shoulder flexion (−3.1, CI −6.2, −0.1) and abduction (−4, CI −8.1, −0.17) between Times 1 and 2. Approximately 42% of participants reported musculoskeletal pain at both times. Pain occurred most commonly in the shoulders. Pain intensity showed a significant increase (P=0.04) between Time 1 (4.8) and Time 2 (6.3).

Conclusion:

When patients are admitted for lower limb injuries, strengthening exercises for the upper limbs should be considered as patients rely more on upper limb strength when lower limb function is decreased.
Management of schizophrenia
Authors: Roberts Glenn A
Published: June 2014

In the second of this series, Glenn Roberts discusses the current treatment of patients with schizophrenia
The future starts here
Authors: Martin Jeannett
Published: June 2014

Jeannett Martin discusses the potential for practice nurses of the transitional arrangements agreed by the UKCC and national boards.
Folic acid: Preventing neural tube defects
Authors: Noble Joan
Published: June 2014

Studies have shown that folic acid supplements are needed to prevent neural tube defects. Joan Noble explains why altering diet is not enough.
Rough guide to diabetes treatment
Authors: Beckwith Sue
Published: June 2014

The purpose of this article is to outline the basic treatment recommended for people with Type 2 diabetes. As we all know from the hit song from the show South Pacific ‘There is nothing like a dame’, or in the case of Type 2 diabetes — DAMES. This acronym stands for diet, Acarbose, Metformin, exercise and Sulphonylureas.
Attention Deficit Disorder
Authors: Orford Eileen
Published: June 2014

There has recently been much media exposure of a ‘condition’ variously called Attention Deficit Disorder (ADD) or Attention Deficit and Hyperactivity Disorder (ADHD) which has caused many parents to consult professionals who know about children. It is very familiar to such professionals; it covers a range of child behaviour that has worried adults since time immemorial. It is a clinical term for the sort of fidgety, over-active, impulsive behaviour and inability to concentrate that affects most children at some point in their lives some of the time, and a few children most of the time, and since they were quite little.
Walk-in Clinic: Nosebleeds
Authors: Reece Philip , Jaskaran Yvonne
Published: June 2014

Nosebleed or epistaxis is extremely common and will happen to 60% of individuals sometime in their life (Doyle, 1986). The GP and practice nurse will be involved in assessing the severity of the nosebleed, controlling the bleeding, and finding and treating the cause
Nurses and doctors back in the driving seat
Authors: Halpern Stephen
Published: June 2014

Nurses working in primary care will move centre stage in the Governments plans for the NHS. The central theme of the White Paper, launched last month, is to base services on the needs of patients as determined by local clinical staff, and administered by multidisciplinary teams.
Liquid drug aerosol delivery
Authors: Johnson Sue
Published: June 2014

This article examines the difficulties associated with liquid aerosol delivery in the long term none acute domiciliary care of patients with COPD. Its purpose is to clarify the practical and educational services which are required by this patient group and examine the difficulties facing the health care professional in delivering them.
Writing For Publication
Authors: Carnwell Ros
Published: June 2014

Two previous articles published in Practice Nursing covered critiquing and writing research (Carnwell, 1997a, 1997b). These represent two distinct stages of the research process: examining the literature and writing up research findings. The final, and most important stage of the research process is publishing research findings so that others may use them.
Latex allergy: Preventing problems
Authors: Hubbard Jane
Published: June 2014

Latex is an excellent material for all kinds of gloves, tubing and condoms. Unfortunately, as Jane Hubbard explains, it may also cause allergic reactions, with occasionally tragic consequences.
Implications of the ‘New NHS’ for PNs
Authors: Milne Christina
Published: June 2014

The New NHS raises a lot of questions about employment and new responsibilities and duties for PNs. Christina Milne provides some answers.
Understanding Leg Ulcers
Authors: Bennett Andrew
Published: June 2014

To formulate an effective management plan practice nurses need to understand what has caused the ulcer. Andrew Bennett explains.
Experiences of a Youth Advisory Clinic Bournemouth
Authors: Watkins Jean , Palmer Pat
Published: June 2014

‘The Junction’ youth advisory service has proved to be extremely popular. Jean Watkins and Pat Palmer reveal the secret of its success.
Push button prescribing
Authors: Mangan Paul
Published: June 2014

A new computer system which gives GPs the latest prescribing advice while they see patients, is set to be launched nationwide. Paul Mangan reports.
In defence of records
Authors: Birt Gill
Published: June 2014

The UKCC has released updated guidelines on record keeping. Gill Birt outlines the importance of good, contemporaneous records.
Hidden depression blights old age
Authors: Watson Dave , Mottram Pat , Choudhury Tafika
Published: June 2014

In those aged over 65 years depression is the most common psychiatric disorder. Although the prevalence varies according to the criteria used and the methodology involved in making the diagnosis, a figure of around 10–15% is reported (Livingston et al, 1990; Copeland et al, 1987).

Depression in older people is too often undetected and untreated, Dave Watson and colleagues explain.
Pioneering treatment in a memory clinic
Authors: Watson Dave , Mottram Pat , Choudhury Tafika
Published: June 2014

The introduction of drug therapy for the treatment of Alzheimer's disease has implications for primary care in terms of the recognition and referral of patients with memory problems. With a rapidly ageing population demand for services will increase.

A specialist memory clinic in the Wirral is proving promising in treatment of mild to moderate dementia.
Defining dementia in old age
Authors: Watson Dave , Mottram Pat , Choudhury Tafika
Published: June 2014

Dementia describes a condition characterized by loss of memory and skills, and a change in personality and behaviour caused by a variety of illnesses, the commonest and most well known being Alzheimer's disease.

Practice nurses can be in the forefront of identifying dementia and arranging appropriate intervention.
The true cost of infertility?
Authors: Ashcroft Sue
Published: June 2014

Inequality in service provision makes the pain of childlessness even more severe for some couples, as Sue Ashcroft explains.
New year brings old questions
Authors: Richards Sue
Published: June 2014

It's been a long and hectic year for nurses in primary care, with many issues still unresolved at the end of it. Sue Richards looks forward to some positive answers for nurses in 1999.
Product focus: Canesten Hydrocortisone
Authors: Bayliss Jane
Published: June 2014

Fungal infections can be made worse by use of topical steroids, but on occasion relief of pain and inflammation can be the priority. Canesten Hydrocortisone can provide a solution.
Estratégia de produção na indústria de autopeças: estudo multicasos em empresas da região de Sorocaba
Authors: Neves Guimarães Márcia Regina , Teodoro Filho Alberto Magno , Lara Felipe Ferreira de , Saltorato Patricia
Published: June 2014

O alinhamento da estratégia de produção com a estratégia de negócios é fundamental para a obtenção de vantagem competitiva sustentável. No caso particular da indústria automobilística, verifica-se também que a estratégia de produção dos fornecedores é fortemente influenciada pela estratégia das montadoras. Nesse contexto, o artigo tem como objetivo apresentar características referentes ao conteúdo da estratégia de produção de quatro empresas de autopeças, além de analisar a influência das montadoras na definição desse conteúdo. Trata-se de uma pesquisa descritiva e exploratória, que utiliza a abordagem qualitativa e o método do estudo de multicasos. Entre os principais resultados, verificou-se que a prioridade competitiva predominante nas empresas é a qualidade, seguida da entrega.  Nas áreas de decisão, observou-se, entre outros, que os clientes exercem grande influência na gestão da qualidade dessas empresas e nas atividades de P&D, além de exigirem entregas frequentes. Por fim, verificou-se que as empresas de autopeças buscam reforçar suas prioridades competitivas por meio, também, da adoção de critérios de escolha e avaliação de fornecedores.
Associações entre CMMI-DEV 1.2 E ISO/TS 16949
Authors: Albanez Altamar Urbanetz de Araújo , Estorilio Carla Cristina Amodio
Published: June 2014

O setor automotivo é um dos mais arrojados em termos de qualidade, demandando a certificação ISO/TS 16949. Apesar disso, algumas empresas a perdem ou obtêm poucas melhorias por indícios de que não possuam maturidade suficiente para manter essa certificação, nem diretrizes para melhoria contínua. Considerando que o CMMI é um dos métodos de diagnóstico de maturidade, o objetivo desse trabalho é identificar a viabilidade de associar a ISO/TS 16949 com o CMMI-DEV 1.2. O procedimento metodológico adotado consiste em uma revisão sobre PDPs, certificação da qualidade e maturidade de processo e, posteriormente, uma associação entre os dois modelos. Da análise, conclui-se que uma empresa certificada pela ISO/TS não necessariamente atinge nem ao nível 2 de maturidade. Além disso, constata-se que, enquanto o CMMI aponta quais itens estão descobertos e devem ser desenvolvidos a ISO/TS apenas estimula a “melhoria contínua”, sem um plano ou diagnóstico para a empresa atingi-la operacionalmente.
Aplicação de célula de produção no serviço de execução de fachada: um estudo de caso na construção civil
Authors: Mariz Renato Nunes , Picchi Flávio Agusto
Published: June 2014

A construção civil é um ambiente com alto índice de desperdício. A filosofia Lean pode trazer grande contribuição através de seu foco na eliminação dos desperdícios. Uma ferramenta muito utilizada na manufatura enxuta (lean) é a célula de produção, cujo principal objetivo é manter a produção o mais próximo possível do fluxo contínuo. Já no contexto da construção, as aplicações desta ferramenta são ainda embrionárias, despertando o interesse por seu maior estudo. O objetivo deste trabalho é analisar como foi aplicada uma célula de produção em um serviço de execução de fachada e avaliar os resultados obtidos. Para tanto, utilizou-se o método do estudo de caso em um fornecedor que executa fachadas para uma grande incorporadora. Foram coletados dados qualitativos (observações in loco e entrevista com funcionários) e quantitativos (dados de prazos e custos fornecidos pela construtora) para posterior análise dos mesmos, antes e pós implementação da célula de fachada. Através da revisão bibliográfica e análise da implantação identificou-se que foram introduzidas melhorias relacionadas a: a) métodos b) materiais c) mão de obra d) máquinas e equipamentos. Os resultados indicam melhoria na relação da administração com os funcionários, aumento do compromisso dos funcionários, redução de custos com mão de obra direta (pedreiros) e aumento da remuneração recebida pelos funcionários. Este trabalho contribui para expansão da utilização desta ferramenta (célula de produção) no contexto da construção registrando boas práticas e mostrando que através desta aplicação, benefícios significativos podem ser alcançados.
Procesos, dimensiones y herramientas para la gestión del conocimiento en el mantenimiento industrial
Authors: Carrasco Javier Cárcel , Méndez Manuel Rodriguez
Published: June 2014

La gestión del conocimiento, implantada en algunas áreas de la empresa, es normalmente olvidada en las propias organizaciones de mantenimiento que sin embargo, es una de las actividades donde se requiere un profundo conocimiento de los activos físicos de la empresa, y que influye en la propia fiabilidad de los procesos de explotación, la productividad de la empresa y es donde se encuentra mayor nivel de conocimiento tácito basado en las propia experiencia de los operarios. En este artículo se hace una revisión de la literatura, marcando los procesos, dimensiones y herramientas que pueden ser utilizadas para la gestión del conocimiento en el ámbito del mantenimiento industrial.
Authors: Brysina Iryna V. , Makarichev Victor A.
Published: June 2014

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A Criminological Perspective on Power Grid Cyber attacks: Using Routine Activities Theory to Rational Choice Perspective to Explore Adversarial Decision-Making
Authors: Rege Aunshul
Published: June 2014

The US power grid has been identified by security experts as a prime target for terrorist-based and state-sponsored cyber attacks. In addition to downing the grid, cyber attacks can also destroy and manipulate data systems, obtain sensitive intellectual property and steal trade secrets. Existing research has addressed the technical factors, such as vulnerabilities and poor intrusion detection systems, which lead to cyber attacks. However, it remains silent on the human factors in the cyber attack equation. This study uses a criminological framework, specifically Routine Activities Theory and Rational Choice Perspective to capture intelligent adversaries who plan and execute attacks based on their analysis of target suitability and guardianship efficacy. It uses a two-step methodology to identify adversary-, target-, and guardianship-specific factors that collectively impact decision-making processes. First, a document analysis of existing literature reveals nine factors (PARE RISKS) that influence adversarial decision-making: Prevention measures, Attacks and Alliances, Results, Ease of Access, Response and Recovery, Interconnectedness and Interdependencies, Security Testing, Assessments and Audits, Knowledge, Skills, Research and Development, and System Weaknesses. Second, surveys and interviews conducted between 2010 and 2012 with various hackers, penetration testers, and power grid representatives helps validate and refine the PARE RISKS framework. This study identifies (i) adversary-specific factors as resources (skills, money, and time), and research (targets and techniques); (ii) target-specific factors as accessibility (electronic and physical) and weaknesses (outdated architecture and inadequate testing/updates); and (iii) guardian-specific factors as prevention (quality of prevention and intrusion detection measures). It argues that altering each of these three elements of Routine Activities Theory can impact adversarial decision-making, which may help reduce the likelihood of power grid cyber attacks.
Energy absorption rate of composite tube as a function of stacking sequence using finite element method
Authors: Amid Ramin , Fawaz Zouheir , Ghaemi Hamid
Published: June 2014

Numerical investigations were performed on a series of laminated composites when subjected to dynamic loadings, in order to determine their energy absorption rate and dissipating energy during impact. The details of numerical modeling, contact analysis, material parameters, and failure criteria were explained and discussed. We aimed to determine the energy absorption rate of various quasi-isotropic lay-ups when subjected to the dynamic loadings, and found that energy dissipation rate varied depending on stacking sequence. In this investigation, we studied how the energy absorption rate and the peak impact load change as a result of changing stacking sequence, with all stacking sequences being quasi-isotropic. Using a constant impacting mass and varied impacting speeds, we found that stacking sequence can significantly control the energy transfer rate or energy absorption rate under dynamic load condition.
Modeling and Vibration Analysis of Road Profile Measuring System
Authors: C.B. Patel  , P.P. Gohil  , B. Borhade
Published: June 2014

During a vehicle development program, load data representing severe customer usage is required. The dilemma faced by a design engineer during the design process is that during the initial stage, only predicted loads estimated from historical targets are available, whereas the actual loads are available only at the fag end of the process. At the same time, changes required, if any, are easier and inexpensive during the initial stages of the design process whereas they are extremely costly in the latter stages of the process. The use of road profiles and vehicle models to predict the load acting on the whole vehicle is currently being researched. This work hinges on the ability to accurately measure road profiles. The objective of the work is to develop an algorithm, using MATLAB Simulink software, to convert the input signals into measured road profile. The algorithm is checked by the MATLAB Simulink 4 degrees of freedom half car model. To make the whole Simulink model more realistic, accelerometer and laser sensor properties are introduced. The present work contains the simulation of the mentioned algorithm with a half car model and studies the results in distance, time, and the frequency domain.
Experimental Investigations of Oxygen Stripping from Feed Water in A Spray Cum Tray Type Deaerator
Authors: Sharma K.V
Published: June 2014

The influence of various parameters on oxygen stripping for a two stage spray and tray type de-aerator is analyzed experimentally. It is observed that increasing the mass flow rate of water leads to an increase in heat and mass transfer coefficients in both stages. There is no significant influence of de-aerator pressure and length of the second stage on the heat transfer coefficients in the range tested. The increase in de-aerator pressure enhances the mass transfer coefficient by 14 percent, whereas the increase in length of the second stage has no significant influence. The empirical correlations available in the literature predict the mass transfer coefficients satisfactorily in the experimental range tested. The total length of the de-aerator is a significant parameter influencing the quantity of oxygen removed from the feed water.
Study of Flow in Air-Intake System for A Single-Cylinder Go-Kart Engine
Authors: Sulaiman S.A. , Murad S. H. M. , Ibrahim I. , Abdul Karim Z.A.
Published: June 2014

Intake-air manifolds have a major effect on a vehicle’s engine performance and emission of noise and pollutants. Differences in engine outputs and applications require different designs of intake-air manifolds in order to achieve the best volumetric efficiency and thus the best engine performance. In the present work, the flow characteristics of air flowing in various designs of air-intake manifold of a 200-cc fourstroke Go-Kart engine are studied. The study is done by three dimensional simulations of the flow of air within six designs of air-intake manifold into the combustion chamber by using commercial CFD software, Fluent version 6.2. The simulation results arevalidated by an experimental study performed using a flow bench. The study reveals that the variations in the geometry of the air-intake system can result in a difference of up to 20% in the mass flow rate of air entering the combustion chamber.
Comparison of Cryo-treatment Effect on Machining Characteristics of Titanium in Electric Discharge Machining
Authors: Rupinder Singh  , Bhupinder Singh
Published: June 2014

Earlier studies on cryogenic treatment highlighted that certain metals, after being cryogenically treated, show a significant increase in tool life when used in manufacturing, cutting and shaping processes. The present work deals with experimental investigation of the role of cryogenic treatment on the machining characteristics of titanium in electric discharge machining (EDM). EDM is a potential process to commercially machine tough materials like titanium alloys, due to the properties of non-mechanical contact between the tool and workpiece and the capability to machine intricate shapes. In this research work an effort has been made to compare the machining characteristics of titanium with EDM, before and after cryogenic treatment of the tool and workpiece using a Taguchi design approach. The output parameters for study are material removal rate (MRR), tool wear rate (TWR), surface roughness (SR) and dimensional accuracy (Δd). The results of the study suggest that with cryogenic treatment MRR, TWR, SR and Δd show an improvement of 60.39%, 58.77%, 7.99% and 80.00% respectively.
Mathematical Approach for Drilling
Authors: Hussien Mahmoud Al-Wedyan  , Saad A Mutasher
Published: June 2014

The present paper is on the study of whirling dynamics of the tool workpiece system in a deep hole machining process. An innovative analytical model is proposed in order to carry out simulation studies on the whirling vibrations of the tool workpiece system in a deep hole boring process. At the interaction point of the boring bar-workpiece system there will be an additional displacement in addition to the torque transmitted. This displacement is of a dynamic origin and could be simulated as a wedge introduced between the cutting head-workpiece assemblies. An assumed mode method with the Lagrangian equations was used to derive the mathematical model of the system.
Historical ethnobotany: an overview of selected studies
Authors: Silva Taline Cristina , Medeiros Patrícia Muniz , Balcázar Alejandro Lozano , Araújo Thiago Antônio de Sousa , Pirondo Analia , Medeiros Maria Franco Trindade
Published: June 2014

Historical Ethnobotany is an area of research responsible for understanding past interrelationships between people and plant using written records and iconography. The literature on this topic is scattered, and many of these studies are not recognised as such; therefore, it is difficult to compile historical ethnobotanical data. Accordingly, this study attempted to draw a general picture of the publications in this field. The Scopus, ISI Web of Knowledge and Scirus databases were used to search for articles with such keywords as “Ethnobotany + History” and “Historical Ethnobotany” among others. After the studies were selected, information was extracted that included the continents addressed and historical ages. Most studies encompassed a time frame that began in the Modern Age (54.7%), and 46% of the studies were focused on the American continent. With regard to the nature of the source, 98% of the studies included written records, and publications that used the documental analysis as a secondary data in their scope of research were among the most frequent types of studies that were found. In respect to iconographic sources, paintings were used in 6% of the studies. A total of 66% of the studies involved a species or species group as the study object. Our survey revealed the vast scope of these Historical Ethnobotany studies. We believe that this scientific field has great potential for future development and that its findings will only grow in importance considering the current ethnobotanical debate.
Thermal Analysis of Pu6Fe Synthesized from Hydride Precursor
Authors: Schwartz Daniel S. , Tobash Paul H. , Richmond Scott
Published: June 2014

The intermetallic Pu6Fe is a precipitate commonly found in standard-purity Pu alloys. We are interested in measuring thermophysical properties of this intermetallic, so we are developing methods for producing Pu6Fe with potential for being scaled up. We had success using a powder-based method, where finely divided PuH2 powder was mechanically mixed with Fe powder and reacted in vacuum. Differential scanning calorimetry was used to analyze the phase content of the product. We estimate ∼90% yield of Pu6Fe by weight, with the remainder being Pu. Enthalpy of melting for Pu6Fe was measured to be 31.2 J/g, and the onset temperature was 411.5°C. The product was melted 3 times and appeared to become more homogeneous after each cycle.
A delegacia da mulher perante as normas e leis para o enfrentamento da violência contra a mulher: um estudo de caso
Authors: Souza Lídio de , Cortez Mirian Beccheri
Published: June 2014

Este estudo analisa o funcionamento de uma Delegacia Especializada no Atendimento à Mulher (Deam) na cidade de Vitória (ES), considerando sua equipe de funcionários e infraestrutura. Os dados foram obtidos por meio de observações de campo e entrevistas individuais com os 14 funcionários da delegacia, analisados com base na "Norma Técnica de Padronização das Deams" e nas informações do relatório "Observe - Sobre as condições para aplicação da Lei nº 11.340/2006 (Lei Maria da Penha) nas Deams". Houve coesão entre as respostas dos participantes, que destacaram: prejuízo em suas atividades decorrente da falta de funcionários; bom relacionamento entre os membros da equipe; e demanda por treinamento dos profissionais e por equipe psicossocial na Deam. Sobre a delegacia, foram feitas críticas à precariedade da estrutura física do prédio e dos equipamentos (viaturas, computadores), bem como à falta de apoio da Polícia Civil à Deam. Destaca-se a necessidade de investimentos na infraestrutura, na ampliação e qualificação da equipe, bem como na concretização da tríade prevenção/assistência/repressão, usualmente ignorada pelo Estado e órgãos responsáveis.