bluuebunny/crossref_metadata_2025 huggingface dataset:
The Atmospheric Compensation Component of a Landsat Land Surface Temperature (LST) Product: Assessment of Errors Expected for a North American Test Product
Authors: Cook M. J. , Schott J. R.
Published: November 2014

Abstract. The Landsat archive of thermal data (Landsats 4, 5 and 7) has gone through a rigorous calibration assessment and update. However, in order to be useful to most users the calibrated sensor reaching radiance must be corrected to surface temperatures by first compensating for atmospheric effects and then emissivity variations. The USGS is exploring the possibility of producing a LST product through a joint program with RIT (the atmospheric compensation component) and JPL (the emissivity compensation component). This paper addresses the atmospheric compensation component for an initial North American pilot study. In particular, the results of a comparison of retrieved water surface temperature (where emissivity is well known) and truth temperatures for over 800 sites are presented. The errors are broken down by cloud conditions with extremely good results for cloud-free conditions (errors less than 1 K). The results of the error assessment for North America by cloud class are presented along with a discussion of potential quality data for a LST product. An initial assessment of the LST errors observed for Landsat 8 bands 10 and 11 are also presented. The next steps on this effort include testing of a global atmospheric compensation approach and full integration of the atmospheric and emissivity compensation tools into an operational LST product.
Dynamics of turbulent western boundary currents at low latitude in a shallow water model
Authors: Akuetevi C. Q. C. , Wirth A.
Published: November 2014

Abstract. The dynamics of low latitude turbulent western boundary currents crossing the equator is considered using numerical results from integrations of a reduced gravity shallow-water model. For viscosity values of 1000 m2 s−1 and more, the boundary layer dynamics compares well to the analytical Munk-layer solution. When the viscosity is reduced, the boundary layer becomes turbulent and coherent structures in form of anticyclonic eddies, bursts (violent detachments of the viscous sub-layer) and dipoles appear. Three distinct boundary layers emerge, the viscous sub-layer, the advective boundary layer and the extended boundary layer. The first is characterized by a dominant vorticity balance between the viscous transport and the advective transport of vorticity. The second by a balance between the advection of planetary vorticity and the advective transport of relative vorticity. The extended boundary layer is the area to which turbulent motion from the boundary extends. The scaling of the three boundary layer thicknesses with viscosity is evaluated. Characteristic scales of the dynamics and dissipation are determined. A pragmatic approach to determine the eddy viscosity diagnostically for coarse resolution numerical models is proposed.
A model study of Abrahamsenbreen, a surging glacier in northern Spitsbergen
Authors: Oerlemans J. , van Pelt W. J. J.
Published: November 2014

Abstract. The climate sensitivity of Abrahamsenbreen, a 20 km long surge-type glacier in northern Spitsbergen, is studied with a simple glacier model. A scheme to describe the surges is included, which makes it possible to account for the effect of surges on the total mass budget of the glacier. A climate reconstruction back to AD 1300, based on ice-core data from Lomonosovfonna and climate records from Longyearbyen, is used to drive the model. The model is calibrated by requesting that it produces the correct Little Ice Age maximum glacier length and simulates the observed magnitude of the 1978-surge. Abrahamsenbreen is strongly out of balance with the current climate. If climatic conditions will remain as they were for the period 1989–2010, the glacier will ultimately shrink to a length of about 4 km (but this will take hundreds of years). For a climate change scenario involving a 2 m yr−1 rise of the equilibrium line from now onwards, we predict that in the year 2100 Abrahamsenbreen will be about 12 km long. The main effect of a surge is to lower the mean surface elevation and to increase the ablation area, thereby causing a negative perturbation of the mass budget. We found that the occurrence of surges leads to a somewhat stronger retreat of the glacier in a warming climate. Because of the very small bed slope, Abrahamsenbreen is sensitive to small perturbations in the equilibrium-line altitude E. For a decrease of E of only 160 m, the glacier would steadily grow into the Woodfjorddalen until after 2000 years it would reach the Woodfjord and calving could slow down the advance.
Prophylaktische Faktorsubstitution bei schwerer Hämophilie A
Authors: Eheberg D. , Oldenburg J. , Tiede A. , Schramm W. , Berger K. , Schopohl D.
Published: November 2014

Prophylaxe kann bei Erwachsenen mit schwerer Hämophilie A klinisch notwendig sein. Ziel war es, die prophylaktische Faktor-VIII-Substitution bei erwachsenen Patienten mit Hämophilie in Deutschland ökonomisch zu bewerten. Patienten, Methoden: Für die Analysen wurde ein Entscheidungsmodell erstellt: Zeithorizont ein Jahr; Perspektive gesetzliche Krankenkassen; Referenzpatient (RP) und zwei Patientenprofile. Die Berech-nungen basieren auf Daten aus einer struktu-rierten Literatursuche, -analyse und einer Pharmakovigilanzstudie mit Patienten zu Therapiewechsel On-demand/Prophylaxe (OD/Proph). Ergebnisse: RP: 45 Jahre, 20 Blutungen p.a. OD, 16 vermiedene Blutungen mit 8,5 I.U./kg/d Proph, Zusatzkosten 141 113 Euro p.a.; Profil 1: 50 Jahre, 55 Blutungen p.a. OD, Faktorverbrauch pro Blutung 20 I.U./kg höher als bei R P, 39 vermiedene Blutungen mit 8,5 I.U./kg/d Proph, Zusatzkosten 19 134 Euro p.a.; Profil 2: 60 Jahre, 35 Blutungen p.a. OD, Faktorverbrauch pro Blutung 40–80 I.U./kg höher als bei R P, 34 vermiedene Blutungen mit 11 I.U./kg/d Proph, Einsparung 660 Euro p.a. Schlussfolgerung: In der indivi-duellen Situation kann eine prophylaktische Faktorsubstitution bei erwachsenen Patienten auch ökonomisch sinnvoll sein. Um künftig diesen Effekt umfassend zu bewerten, werden longitudinale Daten aus dem Versorgungsalltag inklusive klinischer Outcomes, Lebensqua-lität und Adhärenz benötigt.
Therapie hereditärer Thrombozytopathien
Authors: Streif W. , Eberl W. , Andres O. , Bakchoul T. , Bergmann F. , Beutel K. , Dittmer R. , Gehrisch S. , Gottstein S. , Halimeh S. , Haselböck J. , Hassenpflug W.-A. , Heine S. , Holzhauer S. , King S. , Kirchmaier C. M. , Krause M. , Kreuz W. , Lösche W. , Mahnel R. , Maurer M. , Nimtz-Talaska A. , Olivieri M. , Rott H. , Schambeck Ch. M. , Schedel A. , Schilling F. H. , Schmugge M. , Schneppenheim R. , Scholz U. , Scholz T. , Schulze H. , Siegemund A. , Strauß G. , Sykora K.-W. , Wermes C. , Wiegering V. , Wieland I. , Zieger B. , Zotz R. B. , Knöfler R.
Published: November 2014

Angeborene Thrombozytopathien sind komplexe Erkrankungen. Zur optimalen Blutungsprophylaxe und -behandlung empfehlen wir eine Abklärung und Diagnose der zugrunde liegenden Funktionsstörung. Dazu steht eine interdisziplinäre Leitlinie zur Verfügung (AWMF # 86–003 S2K; Hämostaseologie 2014; 34: 201–212).

Die Behandlung ist auf den Defekt, die Thrombozytenzahl, das Lebensalter und die klinischen Umstände abzustimmen. Die Transfusion von Thrombozyten allein kann wegen der damit verbundenen Risiken unangemessen sein. Empfohlen wird ein stufenweiser und individualisierter Behandlungsplan. Antifibrinolytika sind generell anwendbar, besonders bei der Quebec-Erkrankung. Desmopressin ist älteren Kindern vor behalten und vor allem zur Behandlung der Storage- Pool-Erkrankungen und nicht klassifizierter Defekte geeignet. Rekombinanter FVIIa ist zwar nur für die Behandlung der Thrombasthenie Glanzmann mit Alloantikörpern zugelassen, wird jedoch in der klinischen Praxis auch bei Thrombozytendefekten mit schwerer Blutungsneigung eingesetzt. Das Ziel dieser Leitlinie ist die Behandlung von Patienten mit angeborenen Thrombozytenfunktionsstörungen bestmöglich zu unterstützen.
Proactieve verkeersveiligheid in veranderende bestuurlijke verhoudingen
Authors: van der Knaap Peter
Published: November 2014

The philosophy behind road safety policy in the Netherlands

The Netherlands enjoys a long-standing reputation in the field of road safety. Following the ‘Sustainable Road Safety’ program of the 1990s, the infrastructural layout considerably reduces the risk of accidents while at the same time many measures are in place to improve road user behavior. In recent years, however, there have been several developments that may affect the success of the approach. In addition to an ageing population, urbanization, and the rise of new technologies, there is a combination of decentralization, policy integration, and budgetary restraints.

This contribution presents the philosophy behind the sustainable road safety program and describes its key elements. It discusses policy and societal developments, and the continuing need to improve road safety, especially at a decentralized level. The article argues in favor of a continued systematic approach towards safer road traffic, also in periods of decentralization and limited budgets. It presents a concrete perspective of the role of policy analysis and policy evaluation to develop a proactive approach to road safety under the new conditions. In this, evidence-based interventions, an active use of safety performance indicators, and a focus on success are key elements.
Recorregut de recerca geològica, geoambiental i mineralògica per la comarca del Baix Llobregat: des d’Esparreguera al Coll de Ca n´Estruc, a l´Ermita del Puig, la Colònia Sedó i a Esparreguera
Authors: Mata Perelló Josep Maria , Sanz Balagué Joaquim
Published: November 2014

Itinerari realitzat el dia 06 d’abril del 20131. El recorregut del present itinerari discorrerà, en la seva totalitat per una sola unitat geològica: pel Sistema Mediterrani (i més concretament, ho farà per dues de les quatre sotsunitats que el constitueixen: per la Depressió Prelitoral Catalana (per on s’iniciarà i finalitzarà el recorregut, a Esparreguera) i per la Serralada Prelitoral Catalana (per on es desenvoluparà la major part del recorregut). Així, l´itinerari s’iniciarà a la localitat d’Esparreguera, d´on s´anirà cap als voltants de la Colònia Sedo, per a retornar finalment a Esparreguera. Així, l´haurem iniciat dintre de la Depressió Prelitoral Catalana, entrant després a la Serralada Prelitoral Catalana, per a finalitzar el trajecte de nou a la Depressió Prelitoral Catalana.Per d’altra banda, el recorregut de l´itinerari, s´haurà desenvolupat totalment dintre de la comarca del Baix Llobregat i dintre del terme d´Esparreguera, exclusivament.
Recorregut de recerca geològica, geoambiental i mineralògica per la comarca del Baix Llobregat: des d’Esparreguera a Collbató i de nou cap a Esparreguera
Authors: Mata Perelló Josep Maria , Sanz Balagué Joaquim
Published: November 2014

Itinerari realitzat el 13 d’abril del 2013. El recorregut del present itinerari discorrerà, en la seva totalitat per una sola unitat geològica: pel Sistema Mediterrani (i més concretament, ho farà per dues de les quatre sotsunitats que el constitueixen: per la Depressió Prelitoral Catalana (per on s’iniciarà i finalitzarà el recorregut, a la població d´Esparreguera) i per la Serralada Prelitoral Catalana (per on es desenvoluparà la major part del recorregut). Tot i així, molt breument es passarà també per la Depressió Geològica de l´Ebre, pels voltants de Collbató i molt puntualment.Així, l´itinerari s’iniciarà a la localitat d’Esparreguera, d´on s´anirà cap als voltants de la població de Collbató, per a retornar finalment a Esparreguera. Així, l´haurem iniciat dintre de la Depressió Prelitoral Catalana, entrant després a la Serralada Prelitoral Catalana, per a finalitzar el trajecte de nou a la Depressió Prelitoral Catalana. I com hem dit abans, també haurem tocat molt tangencialment la Depressió Geològica de l´Ebre, prop de Collbató.Per d’altra banda, el recorregut de l´itinerari, s´haurà desenvolupat totalment dintre de la comarca del Baix Llobregat. I més concretament, haurem circulat pels termes municipals de d´Esparreguera i de Collbató.
Rectificacions al recorregut de recerca geològica, geoambiental i mineralògica per la comarca del Baix Llobregat: des d’Esparreguera a Collbató i de nou cap a Esparreguera
Authors: Mata Perelló Josep Maria , Sanz Balagué Joaquim
Published: November 2014

Aquest itinerari es va fer el 13 d’abril del 20131. El recorregut del present itinerari discorrerà, en la seva totalitat per una sola unitat geològica: pel Sistema Mediterrani (i més concretament, ho farà per dues de les quatre sotsunitats que el constitueixen: per la Depressió Prelitoral Catalana (per on s’iniciarà i finalitzarà el recorregut, a la població d´Esparreguera) i per la Serralada Prelitoral Catalana (per on es desenvoluparà la major part del recorregut). Tot i així, molt breument es passarà també per la Depressió Geològica de l´Ebre, pels voltants de Collbató i molt puntualment.Així, l´itinerari s’iniciarà a la localitat d’Esparreguera, d´on s´anirà cap als voltants de la població de Collbató, per a retornar finalment a Esparreguera. Així, l´haurem iniciat dintre de la Depressió Prelitoral Catalana, entrant després a la Serralada Prelitoral Catalana, per a finalitzar el trajecte de nou a la Depressió Prelitoral Catalana. I com hem dit abans, també haurem tocat molt tangencialment la Depressió Geològica de l´Ebre, prop de Collbató.Per d’altra banda, el recorregut de l´itinerari, s´haurà desenvolupat totalment dintre de la comarca del Baix Llobregat. I més concretament, haurem circulat pels termes municipals de d´Esparreguera i de Collbató.
Recorregut de recerca geològica i mineralògica per la subcomarca del Lluçanès (comarca d´Osona): des de Lluçà a Santa Eulàlia de Puig-Oriol, Alpens, Sant Agustí de Lluçanès i al santuari de la Mare de Déu dels Munts
Authors: Mata Perelló Josep Maria , Sanz Balagué Joaquim
Published: November 2014

Aquest itinerari es va realitzar el 14 d’abril del 2013. El recorregut és una variant del Recorregut de recerca geològica i mineralògica per la subcomarca del Lluçanès (comarca d´Osona): des de Lluçà a Santa Eulàlia de Puig-Oriol, Sant Agustí de Lluçanès i Alpens, publicat al núm. 4 (abril 214) de la revista Xaragall. En aquesta ocasió el recorregut de l’itinerari discorre  en la seva totalitat per la Depressió Geològica de l´Ebre (i més concretament, ho farà pel seu sector corresponent a la seva Depressió Central). Tot i així, l’itinerari passarà per les proximitats d’alguns indrets més o menys replegats de l´esmentada depressió. Així, entre altres, creurem el Sinclinal de Gironella i l´Anticlinal de Puig-reig, entre altres elements. Per d’altra banda, i com ja s’entreveu al títol, el recorregut de d’itinerari discorrerà per íntegrament per la subcomarca del Lluçanès i més concretament pels seus sectors osonencs, des del principi a Lluçà  a fi del recorregut .
Recorregut circular de recerca geològica i mineralògica per la comarca del Ripollès: des de Sant Joan de les Abadesses a les Mines de Perella, Sant Pau Seguries, Colònia Estevenell, Surroca, Ogassa i a Sant Joan de les Abadesses
Authors: Mata Perelló Josep Maria , Sanz Balagué Joaquim
Published: November 2014

Itinerari realitzat el 22 de juny de 2013. El recorregut del present itinerari, es desenvoluparà íntegrament pel Sistema Pirinenc; i més concretament: per la zona de contacte entre la Zona Sudpirenenca i la Zona Axial del Sistema Pirinenc. Així, s´iniciarà dintre de la Zona Sudpirenenca, prop de la població de Sant Joan de les Abadesses, des d´on s´anirà cap Ant Pau de Seguries. Poc després d´aquesta població, entrarem al Mantell del Cadí, que ja no abandonarem fins arribar prop de Sant Joan de les Abadesses, ja en el recorregut de tornada.Tot i això, en diferent trams del recorregut entre la Colònia ESTEVENELL i Sant Martí de Surroca, passarem prop de l´Encavalcament de Ribes de Fresser – Setcases, al Sud del Mantell del Canigó.Per d´altra banda, també cal dir que aquest recorregut s´efectuarà, íntegrament per la comarca pirinenca del Ripollès.
Efficiency Evaluation of Leakage Management Using Data Envelopment Analysis
Authors: Choi Taeho , Kang Kyunghwa , Koo Jayong
Published: November 2014

In this study, a cluster analysis was conducted to examine differences in leakage‐management (LM) efficiency. The authors next conducted a data envelopment analysis to examine the efficiency of LM in water distribution systems on the basis of four input factors—active LM cost, rapid and accurate leakage‐repair cost, appropriate pipe‐body‐management cost, and indirect labor cost for pipe network management. These factors represent the direct LM cost during a five‐year period (2006–2010). The output factor was defined as the leakage reduction directly attributed to LM activities. The optimal efficiency point of each LM cost, calculated on the basis of the efficiency evaluation results, was used to conduct multiple regression analysis. The analysis results were examined to develop an economical LM model that could be used to predict the optimal combination of LM methods.
Multifactorial Approaches for Correction of the Drooping Tip of a Long Nose in East Asians
Authors: Park Seong Geun , Jeong Hoijoon , Ye Choon Ho
Published: November 2014

A long nose with a drooping tip is a major aesthetic problem. It creates a negative and aged appearance and looks worse when smiling. In order to rectify this problem, the underlying anatomical causes should be understood and corrected simultaneously to optimize surgical outcomes. The causes of a drooping tip of a long nose are generally classified into two mechanisms. Static causes usually result from malposition and incorrect innate shape of the nasal structure: the nasal septum, upper and lower lateral cartilages, and the ligaments in between. The dynamic causes result from the facial expression muscles, the depressor septi nasi muscle, and the levator labii superioris alaeque nasi muscle. The depressor septi nasi depresses the nasal tip and the levator labii superioris alaeque nasi pulls the alar base upwards. Many surgical methods have been introduced, but partial approaches to correct such deformities generally do not satisfy East Asians, making the problem more challenging to surgeons. Typically, East Asians have thick nasal tip soft tissue and skin, and a depressed columella and alar bases. The authors suggest that multifactorial approaches to static and dynamic factors along with ancillary causes should be considered for correcting the drooping tip of the long noses of East Asians.
Skin Thickness of the Anterior, Anteromedial, and Anterolateral Thigh: A Cadaveric Study for Split-Skin Graft Donor Sites
Authors: Chan Jeffrey CY , Ward John , Quondamatteo Fabio , Dockery Peter , Kelly John L
Published: November 2014

Background The depth of graft harvest and the residual dermis available for reepithelization primarily influence the healing of split-skin graft donor sites. When the thigh region is chosen, the authors hypothesize based on thickness measurements that the anterolateral region is the optimal donor site.

Methods Full-thickness skin specimens were sampled from the anteromedial, anterior, and anterolateral regions of human cadavers. Skin specimens were cut perpendicularly with a custom-made precision apparatus to avoid the overestimation of thickness measurements. The combined epidermal and dermal thicknesses (overall skin thickness) were measured using a digital calliper. The specimens were histologically stained to visualize their basement membrane, and microscopy images were captured. Since the epidermal thickness varies across the specimen, a stereological method was used to eliminate observer bias.

Results Epidermal thickness represented 2.5% to 9.9% of the overall skin thickness. There was a significant difference in epidermal thickness from one region to another (P<0.05). The anterolateral thigh region had the most consistent and highest mean epidermal thickness (60±3.2 µm). We observed that overall skin thickness increased laterally from the anteromedial region to the anterior and anterolateral regions of the thigh. The overall skin thickness measured 1,032±435 µm in the anteromedial region compared to 1,220±257 µm in the anterolateral region.

Conclusions Based on skin thickness measurements, the anterolateral thigh had the thickest epidermal and dermal layers. We suggest that the anterolateral thigh region is the optimal donor site for split-skin graft harvests from the thigh.
Practical Considerations for Perforator Flap Thinning Procedures Revisited
Authors: Prasetyono Theddeus OH , Bangun Kristaninta , Buchari Frank B , Rezkini Putri
Published: November 2014

Background A thin perforator flap is one of the best methods for covering defects. This study aimed to revisit and further test the rapidly advancing field of flap thinning techniques.

Methods We performed two cadaveric studies to test the known flap thinning methods, and then applied these methods to a clinical series. In the first study, five cadavers were used to observe the anatomical relation of the perforator with the subdermal plexuses and the subcutaneous fat layer by injecting a colored latex solution. The second study was done on four cadavers independently from the first study. Last, a clinical series was performed on 15 patients.

Results The areolar fat lobules of 10 anterolateral thigh perforator (ALT), seven deep inferior epigastric artery perforator (DIEAP), and six thoracodorsal artery perforator (TAP) flaps were dissected to reduce the flap thickness guided by the colored vascular pattern. On average, the ALT, DIEAP, and TAP flaps were reduced to 32.76%±9.76%, 37.01%±9.21%, and 35.42%±9.41%, respectively. In the second study, the areolar fat lobules were directly dissected in six ALT, six TAP, and four MSAP flaps, and an average reduction in flap thickness of 53.41%±5.64%, 52.30%±2.88%, and 47.87%±6.41%, respectively, was found. In the clinical series, 13 out of the 15 cases yielded satisfactory outcomes with an average thickness reduction of 37.91%±7.15%.

Conclusions These multiple studies showed that the deep fat layer could be safely removed to obtain a thin yet viable perforator flap. This evidence suggests that the macroscopic flap thinning technique can achieve thin flaps. Surgeons should consider this technique before embracing the latest technique of supermicrosurgery.
Comparison of the Complications in Vertical Rectus Abdominis Musculocutaneous Flap with Non-Reconstructed Cases after Pelvic Exenteration
Authors: Jeon Heechang , Yoon Eul Sik , You Hi-Jin , Kim Hyon-Surk , Lee Byung-Il , Park Seung Ha
Published: November 2014

Background Perineal reconstruction following pelvic exenteration is a challenging area in plastic surgery. Its advantages include preventing complications by obliterating the pelvic dead space and minimizing the scar by using the previous abdominal incision and a vertical rectus abdominis musculocutaneous (VRAM) flap. However, only a few studies have compared the complications and the outcomes following pelvic exenteration between cases with and without a VRAM flap. In this study, we aimed to compare the complications and the outcomes following pelvic exenteration with or without VRAM flap coverage.

Methods We retrospectively reviewed the cases of nine patients for whom transpelvic VRAM flaps were created following pelvic exenteration due to pelvic malignancy. The complications and outcomes in these patients were compared with those of another nine patients who did not undergo such reconstruction.

Results Flap reconstruction was successful in eight cases, with minor complications such as wound infection and dehiscence. In all cases in the reconstructed group (n=9), structural integrity was maintained and major complications including bowel obstruction and infection were prevented by obliterating the pelvic dead space. In contrast, in the control group (n=9), peritonitis and bowel obstruction occurred in 1 case (11%).

Conclusions Despite the possibility of flap failure and minor complications, a VRAM flap can result in adequate perineal reconstruction to prevent major complications of pelvic exenteration.
A Retrospective Analysis of Ruptured Breast Implants
Authors: Baek Woo Yeol , Lew Dae Hyun , Lee Dong Won
Published: November 2014

Background Rupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants.

Methods We performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone), duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management.

Results Forty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case), microfat graft (2 case), removal only (14 case), and follow-up loss (17 case).

Conclusions Saline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.
Metastatic Bone Marrow Tumors Manifested by Hematologic Disorders: Study of Thirty-Four Cases and Review of Literature
Authors: Guan Min Lai  , Jen-Tsun Lin  , Cheng-Shyong Chang
Published: November 2014

Purpose: Bone marrow metastasis of cancer is a sign of extensively hematogenous spreading of cancer and may be a terminal event of those patients. With the improvement of systemic chemotherapy for malignant disease, some patients may have longer survival. We plan to find out the clinical hematologic presentation and prognostic factors in cancer patients with bone marrow metastasis. Materials & Methods: In this retrospective study, we reviewed the results of 162 bone marrow examination carried out in adult malignancy patients (colon, lung, gastric, breast and prostate cancers) between January 2002 and December 2012 in Changhua Christian Hospital. The indication for bone marrow study for those patients with hematologic disorders included: leukoerythroblastosis, microangiopathic hemolytic anemia, unknown etiology of anemia, thrombocytopenia, bicytopenia and pancytopenia. Statistics analysis used SPSS 18.0 and overall survival was analyzed with the use of Kaplan-Meier curves and the log-rank test. Results: Thirty-four patients (20.9%) had evidence of involvement of the bone marrow by a solid tumor, most common cancers were prostate and lung. At the time of diagnosis, the most common hematologic disorders were leukoerythroblastosis and microangiopathic hemolytic anemia. Median survival after the diagnosis of bone marrow metastasis with supportive care only compared with definite treatments was 0.3 months and 20.6 months (p<0.0001). Patients with visceral organ metastasis (0.4 months vs 6.4 months, respectively; p <0.002) and anemia (2.1 months vs 6.4 months, p=0.031) had inferior survival. Patents without any cytopenia had better survival (12.5 months vs 4.1 months, p=0.029). Initial level of thrombocyte and neutrophil, bone marrow infiltration type (focal or diffuse) and disease status were not significant prognostic factor. Conclusions: Visceral metastasis and anemia are most poor prognostic factors in solid cancers with bone marrow metastasis. Since the improvement of the diagnosis and treatment for cancers during the recent decades, a portion of patients can be had better disease control after definite treatment especially in breast and prostate cancers with bone marrow metastasis.
Amelanotic Melanoma of the Root of the Tongue in A Canine Patient Treated by Electrochemotherapy
Authors: F.H. Maglietti  , S.D. Michinski  , I. Ricotti  , P. Maure  , L.M. Mir  , N. Olaiz  , G. Marshall
Published: November 2014

Background: Electrochemotherapy is a novel tumor treatment routinely used for cutaneous and subcutaneous tumors in human patients in the European Union since 2006. Here we used it to treat an amelanotic melanoma of the root of the tongue in a canine patient. Case Presentation: The patient was a 9 year-old, female, Golden Retriever, dehydrated, cachectic and in a bad general condition due to the difficulty in eating and drinking provoked by the tumor. The procedure was performed with general anesthesia, with intravenous administration of bleomycin, and went uneventful. The only adverse effect was an important swelling of the tongue which lasted 2 days and was controlled with non-steroidal anti-inflammatory drugs. Results and Conclusion: A good local control of the disease was achieved with a 83% reduction of the tumor mass, at day 21 after a single treatment. On the 33rd day the patient died after a digestive hemorrhage not related to the treatment. Electrochemotherapy was found a good approach to locally control the disease. The swelling of the tongue was an important side effect which has to be taken into account when treating this organ, and should be controlled with medication.
The Canadian Journal of Community Mental Health From 1982 to 2006: A Content Analysis
Authors: Fortin-Pellerin Laurence , Pouliot-Lapointe Joëlle , Thibodeau Caroline , Gagné Marie-Hélène
Published: November 2014

This article presents a content analysis of articles published in the Canadian Journal of Community Mental Health (CJCMH) between 1982 and 2006. The analysis aims to provide an overall description of the articles, identify the major trends over time, and suggest future directions for CJCMH issues. The article highlights the development over time of various dimensions of CJCMH's content: identity and location of CJCMH's editors and most productive authors, language of publication, affiliation of the articles' first authors, themes of special issues and supplements, types of articles and areas of interest covered, and source of financing for empirical studies published in CJCMH. These findings are discussed in the context of the history and current knowledge of community mental health.
Strengthening Ontario's System of Housing for People with Serious Mental Illness
Authors: Sylvestre John , George Lindsey , Aubry Tim , Durbin Janet , Nelson Geoffrey , Trainor John
Published: November 2014

This article describes recent work to support recommendations for improving Ontario's system of housing for people with serious mental illness. This multifaceted project engaged stakeholders in discussions concerning strategies for improving the system based on (a) values that underlie housing programs, (b) evidence of effective housing practices, (c) the current status of the system, and (d) international practices for monitoring community mental health systems. Stakeholders reviewed summaries of the work and discussed implications for improving the provincial system of housing and supports. Recommendations are made for improving the system, focusing on both regional and provincial level actions.
Can Act Lead to More Work? the Ontario Experience
Authors: Lurie Steve , Kirsh Bonnie , Hodge Scot
Published: November 2014

While assertive community treatment (ACT) teams are now an important resource for over 3,300 people living with severe and persistent mental illness in Ontario, ACT teams have had limited success reducing the unemployment rate of consumers. Results from the most recent survey of Ontario ACT teams show the unemployment rate stuck at 77% (Ministry of Health and Long-Term Care, ACT Technical Advisory Panel, 2006). This article reviews the characteristics and service outcomes reported by ACT teams in Ontario and explores the paradox of impressive outcomes of reduced hospitalization and improved housing tenure alongside limited progress on the employment front. It also examines the plans of one organization (Canadian Mental Health Association, Toronto Branch) to improve employment results for consumers of its ACT teams.
Community Restructuring and the Emotional and Social Health of Youth: A Study of a Small Coastal Community in Newfoundland, Canada
Authors: Jackson Lois A. , Tirone Susan , Donovan Catherine , Hood Rob
Published: November 2014

This paper presents findings from a qualitative study which examined the health implications of community restructuring (social, economic, environmental, and industrial change) for youth living in a small coastal community in Newfoundland, Canada. Eleven focus groups with youth ages 13–24 (n = 74) were conducted to obtain their perceptions on the impacts of the community restructuring that has occurred since the 1992 cod moratorium. Researcher observations over 5 visits were also part of the methodology. From the perspective of youth, significant losses have occurred within the community that have negatively affected their emotional and social health. At the same time, some aspects of the community have been relatively untouched by the changes and are reported to play a positive role in the youth's sense of well-being. However, current trends of youth leaving the community in search of economic stability may rupture these positive ties, which could have far-reaching negative implications as the youth move into adulthood.
Exploring Social Support Through Collective Kitchen Participation in Three Canadian Cities
Authors: Engler-Stringer Rachel , Berenbaum Shawna
Published: November 2014

Collective kitchens are community-based cooking programs in which small groups of people cook in bulk. The limited research literature is in agreement that their social benefits are important. This article presents qualitative data from collective kitchen members exploring the social support developed through participation in three Canadian cities: Saskatoon, Toronto, and Montreal. Important themes that emerged include building friendships, breaking social isolation, increasing participation in community activities, and using the group as a means for sharing community resources and information. Overall, activities that encouraged socializing and the sharing of life experiences were important to the positive experiences associated with participation.
Supporting Family Carers: Identifying the Role of A Provincial Organization in the Context of Regionalization
Authors: Sims-Gould Joanie , O'Connor Deborah
Published: November 2014

Family members caring for a frail, depressed, or cognitively impaired senior play an important role in our health care system. However, they require support in this role. Family support groups have emerged as an important means of providing this reinforcement. In British Columbia, the Caregivers Association of BC (CABC) played an active role during the mid-1990s in facilitating the development of a network of support groups across the province. The purpose of this study is to explore, through an intensive community consultation process, how these groups are faring within the context of health care regionalization.
Distinguishing Differences in Pathways to Resilience Among Canadian Youth
Authors: Ungar Michael , Brown Marion , Liebenberg Linda , Cheung Maria , Levine Kathryn
Published: November 2014

As part of an 11-country qualitative study of resilience among at-risk youth, 19 Aboriginal and non-Aboriginal Canadian adolescents were interviewed. In this paper, we report on the Canadian youths' culturally specific and generic strategies to cope with adversity. Findings suggest that the youths' resilience, or capacity to cope under stress, reflects different degrees of access to 7 mental health-enhancing experiences (we term these “tensions”): access to material resources; access to supportive relationships; development of a desirable personal identity; experiences of power and control; adherence to cultural traditions; experiences of social justice; and experiences of a sense of cohesion with others.
Psychosocial Stressors and Buffers Affecting Black Women in Montreal
Authors: Whitley Rob , Green Steve
Published: November 2014

Black women in Canada have not been the focus of intensive mental health research, even though data suggests they may be vulnerable to mental health disparities. The present study utilizes in-depth qualitative methods to explore the psychosocial experience of Black women in Montreal. Twelve women participated in semi-structured interviews that aimed to elicit principal psychosocial stressors and buffers. Three notable stressors emerged from analyses: financial adversity, racism, and absent fathers. Three notable buffers emerged from analyses: families, the church, and cultural pride. Implications for further research on this vulnerable population are discussed.
Voluntary Participation in Rehabilitation: Lessons Learned From A Clubhouse Environment
Authors: Schiff Jeannette Waegemakers , Coleman Heather , Miner Deeana
Published: November 2014

Clubhouses, as voluntary communities, can be excellent indicators of recovery environments for persons who have a mental illness. To understand why people become affiliated with a Clubhouse and others disengage, 4 focus groups with Clubhouse members and 1 with staff explored questions of membership retention. Responses encompassed 4 domains: personal, interpersonal, structure, and organizational environment. These domains were interwoven with values of acceptance without stigma, empowerment, self-determination, egalitarian relationships, independence, interdependence, dignity, respect, hope, and positive expectations. The domains and values correspond to elements that aid recovery. The presence and absence of such domains encouraged people to either attend or stay away from the organization. Overall analyses of the groups' responses suggest that recovery-oriented values and organizational climate are important factors in determining attendance in a consumer-oriented program.
Integration Strategies in Mental Health Care: Lessons Drawn From a Pilot Project
Authors: Fleury Marie-Josée , Grenier Guy , Cazale Linda , Perreault Michel
Published: November 2014

This study evaluates the implementation and impact of a pilot project aimed at establishing an integrated service network for adults with severe mental disorders in an urban area in the province of Quebec. Post-implementation evaluation shows that the project helped improve the perceived integration and quality of services. However, the implementation of a true integrated service network in mental health necessitates involvement of all providers who play a significant role in mental health, including general practitioners and intersectoral resources, a sufficient pool of diversified resources, strong governance, and the development of a complete set of coherent clinical and administrative integration strategies.
Peer Support Shows Promise in Helping Persons Living with Mental Illness Address Their Physical Health Needs
Authors: Bates Ann , Kemp Vivien , Isaac Mohan
Published: November 2014

The physical health of individuals with long-term mental illnesses has long been of concern. In Western Australia, the overall mortality rate from preventable causes of people living with mental illness was reported to be 2.5 times greater than that of the general population. A trial peer support service was initiated to assist people with mental illness to attend to their physical health needs. This paper presents the planning, implementation, and results of this collaborative initiative involving nongovernment agencies, the public mental health service, consumers of mental health services, and the University of Western Australia.
Advancing Community-Based Collaborative Mental Health Care Through Interdisciplinary Family Health Teams in Ontario
Authors: Mulvale Gillian , Danner Ursula , Pasic Dianna
Published: November 2014

Collaborative mental health care is a widely advocated model of community-based mental health care delivery. Previous work suggests that several contextual factors, such as the lack of stable funding for non-physician providers, have prevented widespread implementation of this model in Ontario. The introduction of interdisciplinary Family Health Teams (FHTs) as part of Ontario's primary health care renewal strategy presents an opportunity to overcome some of these barriers. This case study of emerging FHTs examines how contextual factors influence the mix of providers and quality of collaborative mental health delivery in FHTs. The findings inform policy-makers of opportunities to further develop community-based collaborative mental health care.
Supporting Primary Care Through Pediatric Telepsychiatry
Authors: Pignatiello Antonio , Boydell Katherine , Teshima John , Volpe Tiziana
Published: November 2014

This paper describes a pediatric telepsychiatry program serving communities in rural Ontario, Canada. Since the program's inception in 2000, over 4,300 direct clinical consultations have been provided for a variety of presenting issues. Indirect consultations and educational sessions have augmented clinicians' knowledge. Participant evaluation of the program indicates that a comprehensive model of psychiatric consultation and education can be delivered effectively via live interactive videoconferencing to support primary care and to enhance capacity in remote, underserviced areas in Ontario.
Integrating Children's Mental Health in Primary Health Care
Authors: Lipton Harold , Raivio Elaine , Perrault Ellen , Bryden Barbara , Caputy Virginia , Binding Linda , Pace Deborah , Donsky Allan , Peters Alanda , Plotsky Kristy , Ayala Jessica , Pada Carolyn
Published: November 2014

The Healthy Minds/Healthy Children Outreach Service is part of Alberta's strategy to increase the capacity of primary care providers to identify and treat children and youth with mental health issues. Program development, implementation, and interim results are presented. Particular challenges connecting with Aboriginal communities, developing resources, and providing clinical consultation and online professional development are discussed. Evaluation data suggest that this form of collaborative, educational, interprofessional service is a promising approach to narrowing the care gap for children with mental health issues.
Project Direct: Pilot Study of A Collaborative Intervention for Depressed Seniors
Authors: McCusker Jane , Cole Martin , Yaffe Mark , Cappeliez Philippe , Dawes Martin , Sewitch Maida , Ciampi Antonio , Latimer Eric
Published: November 2014

This pilot study assessed the feasibility of a randomized controlled trial of an intervention for major depression among seniors in Canadian family practice. The intervention involved care by a family physician augmented by a Depression Care Practitioner, the latter working under the supervision of a psychiatrist. Treatments included family doctors' prescriptions of antidepressants according to an evidence-based study algorithm and/or brief problem-solving therapy. Eligible patients aged 60+ were identified in a 2-step screening process: 68 patients from 29 Montreal family practices were randomized, and 66 completed the 2-month follow-up. Results support the feasibility of a multisite trial of this intervention.
Shared Care Depression Collaborative Model: From Project Inception to Outcome Data
Authors: Sedgwick Whitney , Washburn Cheryl , Newton Christie , Mirwaldt Patricia
Published: November 2014

The University of British Columbia (UBC) has partnered with community primary care providers to implement a shared care pilot project for the management of depression. The National College Health Assessment survey conducted at UBC in 2004 identified a significant gap in the management of depression. This finding highlighted a need to better integrate existing resources and strengthen the capacity of primary care providers to effectively recognize, assess, and treat depression. This article outlines the development and evaluation of a shared care collaborative approach to the primary care of depression in the UBC campus community.
The Effect of a Pamphlet on Women's Experiences of Postpartum Depression
Authors: Sealy Patricia A. , Simpson Joanne P. , Evans Marilyn K.
Published: November 2014

A randomized controlled trial was used to test the effect of an educational pamphlet mailed at 4-weeks postpartum to women who were at low risk of postpartum depression (n = 256). Based on telephone interviews at 3-months postpartum, women in the intervention group scored significantly lower on the Edinburgh Postnatal Depression Scale (EPDS) than those in the control group. Few women scored 12 or higher on the EPDS (n = 3 intervention group, n = 9 control group). The pamphlet did not influence the women's awareness of the symptoms of postpartum depression.
A Qualitative Analysis of Clients' Evaluation of a Psychiatric Day Hospital
Authors: Larivière Nadine , Melançon Laurence , Fortier Linda , David Pierre , Cournoyer Jocelyne , Baril Marie-Claire , Bisson Jocelyn
Published: November 2014

The purpose of this study was to qualitatively explore and describe the evaluation of a psychiatric day hospital by a group of participants. Clients attending a day hospital between 1999 and 2003 completed a program evaluation questionnaire during their last week (N = 567). A qualitative content analysis of 104 questionnaires was conducted by three investigators. Results indicated that clients had both positive and negative views of the health care professionals, program structure, and group therapy. Participants highlighted that they learned about themselves and their illness, improved their self-esteem, and acquired valuable life skills and renewed hope.
Deinstitutionalization of People With Developmental Disabilities: A Review of the Literature
Authors: Lemay Raymond A.
Published: November 2014

Ontario has recently closed its last 3 institutions for persons with developmental disabilities. Very little research has been conducted on Canadian deinstitutionalization projects, and the impacts and bona fides of such endeavours have not been well documented in Canada. However, the closing of institutions has occurred in most Western jurisdictions and has been the subject of much research in Australia, the United Kingdom, and the United States. Although community services are of variable quality, this literature review suggests that the Ontario plan to close institutional facilities in favour of community-based residential services will be of general benefit to former institutional residents.
A Model of Housing Stability for People With Serious Mental Illness
Authors: Sylvestre John , Ollenberg Melanie , Trainor John
Published: November 2014

Housing programs are complex social interventions. Research on housing for people with mental illness has proceeded without a framework for integrating emerging findings and guiding new research directions. This paper describes a definition and model of housing stability developed with stakeholders in 3 local housing systems for people with mental illness. The model describes housing stability as a dynamic relationship among 3 factors (person, housing, and support) that are influenced by broader system influences. The model is discussed in terms of its usefulness for integrating existing research, guiding new research, and integrating research with practice to improve housing practices.
The Development of a Recovery-Oriented Mental Health System in Canada: What the Experience of Commonwealth Countries Tells Us
Authors: Piat Myra , Sabetti Judith
Published: November 2014

This article examines how the recovery concept has been introduced into national mental health policies in New Zealand, Australia, and England. Five overall themes are identified as critical in shifting to a recovery-oriented system: restructuring of mental health services, promoting mental health and preventing mental illness, developing and training the workforce, cultivating consumer participation and leadership, and establishing outcome-oriented and measurable practices. These issues are vital in the uptake of recovery and should guide the overall direction of the Canadian Mental Health Commission's mental health strategy.