bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacist and Technician Perceptions of Tech-Check-Tech in Community Pharmacy Practice Settings
Authors: Frost Timothy P. , Adams Alex J.
Published: April 2017

Objective:

Tech-check-tech (TCT) is a practice model in which pharmacy technicians with advanced training can perform final verification of prescriptions that have been previously reviewed for appropriateness by a pharmacist. Few states have adopted TCT in part because of the common view that this model is controversial among members of the profession. This article aims to summarize the existing research on pharmacist and technician perceptions of community pharmacy–based TCT.

Data Sources:

A literature review was conducted using MEDLINE (January 1990 to August 2016) and Google Scholar (January 1990 to August 2016) using the terms “tech* and check,” “tech-check-tech,” “checking technician,” and “accuracy checking tech*.”

Data Synthesis:

Of the 7 studies identified we found general agreement among both pharmacists and technicians that TCT in community pharmacy settings can be safely performed. This agreement persisted in studies of theoretical TCT models and in studies assessing participants in actual community-based TCT models. Pharmacists who had previously worked with a checking technician were generally more favorable toward TCT.

Conclusion:

Both pharmacists and technicians in community pharmacy settings generally perceived TCT to be safe, in both theoretical surveys and in surveys following actual TCT demonstration projects. These perceptions of safety align well with the actual outcomes achieved from community pharmacy TCT studies.
Advancing commission scholarship by inferring leadership legacy motivations from commission reports: The case of Sir Michael Lyons
Authors: Wallis Joe , Brodtkorb Tor , Dollery Brian
Published: April 2017

This article contributes to commission scholarship by exploring how and why chairs use their reports to shape their leadership legacies. It distinguishes two types of legacy – fiduciary and expressive – that chairs shape through their reports. The expressive legacy of the chair can be shaped through judgements about the scope of stakeholder engagement and agenda adjustment that generate four types of leadership identity: conservator, consolidator, advocate and catalyst. We explore the particular ways in which the chair of the Lyons Inquiry into Local Government in the UK used his three reports to shape his legacy. Through his distinctive integration of historical and contemporary perspectives into a leading vision for local government, he expressed a consolidator identity with his short-term recommendations and a catalytic identity with his far-reaching envisioning of the institutional space within which a greater place-shaping role for local government could be established.
Antoine-Marie Chambeyron (1797–1851): a forgotten disciple of Jean-Etienne Esquirol (1772–1840)
Authors: Walusinski Olivier
Published: April 2017

Antoine-Marie Chambeyron (1797–1851) was a disciple of Jean-Etienne Esquirol (1772–1840) that history forgot, undoubtedly because he made no original contribution to psychiatric nosography. In 1827, his interest in the medical-legal status of the insane led him to translate into French and annotate the first medical-legal psychiatric treatise ever published, which was the work of the German philosopher Johann Christoph Hoffbauer (1766–1827). His translation played a role in shaping the French Law of 1838, the first piece of modern legislation aimed at protecting the rights of mental patients and limiting the State’s power to confine them arbitrarily. Chambeyron is among the least-cited contributors to the prestigious work of nineteenth-century French alienists.
Advanced MRI techniques: biomarkers in neuropsychiatric lupus
Authors: Sarbu N , Toledano P , Calvo A , Roura E , Sarbu M I , Espinosa G , Lladó X , Cervera R , Bargalló N
Published: April 2017

Objectives

The objective of this study was to determine whether advanced MRI could provide biomarkers for diagnosis and prognosis in neuropsychiatric systemic lupus erythematosus (NPSLE).

Methods

Our prospective study included 28 systemic lupus erythematosus (SLE) patients with primary central NPSLE, 22 patients without NPSLE and 20 healthy controls. We used visual scales to evaluate atrophy and white matter hyperintensities, voxel-based morphometry and Freesurfer to measure brain volume, plus diffusion-tensor imaging (DTI) to assess white matter (WM) and gray matter (GM) damage. We compared the groups and correlated MRI abnormalities with clinical data.

Results

NPSLE patients had less GM and WM than controls ( p = 0.042) in the fronto-temporal regions and corpus callosum. They also had increased diffusivities in the temporal lobe WM ( p < 0.010) and reduced fractional anisotropy in the right frontal lobe WM ( p = 0.018). High clinical scores, longstanding disease, and low serum C3 were associated with atrophy, lower fractional anisotropy and higher diffusivity in the fronto-temporal lobes. Antimalarial treatment correlated negatively with atrophy in the frontal cortex and thalamus; it was also associated with lower diffusivity in the fronto-temporal WM clusters.

Conclusions

Atrophy and microstructural damage in fronto-temporal WM and GM in NPSLE correlate with severity, activity and the time from disease onset. Antimalarial treatment seems to give some brain-protective effects.
Anti-ribosomal P antibody: a multicenter study in childhood-onset systemic lupus erythematosus patients
Authors: Valões C C M , Molinari B C , Pitta A C G , Gormezano N W S , Farhat S C L , Kozu K , Sallum A M E , Appenzeller S , Sakamoto A P , Terreri M T , Pereira R M R , Magalhães C S , Ferreira J C O A , Barbosa C M , Gomes FH , Bonfá E , Silva C A ,   Brazilian Childhood-onset Systemic Lupus Erythematosus Group
Published: April 2017

Objectives

Anti-ribosomal P protein (anti-P) autoantibodies are highly specific for systemic lupus erythematosus (SLE). However, the evaluation of this autoantibody in childhood-onset SLE (cSLE) populations has been limited to a few small series, hampering the interpretation of the clinical and laboratorial associations. Therefore, the objective of this multicenter cohort study was to evaluate demographic, clinical/laboratorial features, and disease damage score in cSLE patients with and without the presence of anti-P antibody.

Methods

This was a retrospective multicenter study performed in 10 pediatric rheumatology services of São Paulo state, Brazil. Anti-P antibodies were measured by ELISA in 228 cSLE patients.

Results

Anti-P antibodies were observed in 61/228 (27%) cSLE patients. Frequencies of cumulative lymphadenopathy (29% vs. 15%, p = 0.014), acute confusional state (13% vs. 5%, p = 0.041), mood disorder (18% vs. 8%, p = 0.041), autoimmune hemolytic anemia (34% vs. 15%, p = 0.001), as well as presence of anti-Sm (67% vs. 40%, p = 0.001), anti-RNP (39% vs. 21%, p = 0.012) and anti-Ro/SSA antibodies (43% vs. 25%, p = 0.016) were significantly higher in cSLE patients with anti-P antibodies compared to those without these autoantibodies. A multiple regression model revealed that anti-P antibodies were associated with autoimmune hemolytic anemia (odds ratio (OR) = 2.758, 95% confidence interval (CI): 1.304–5.833, p = 0.008) and anti-Sm antibody (OR = 2.719, 95% CI: 1.365–5.418, p = 0.004). The SLICC/ACR damage index was comparable in patients with and without anti-P antibodies ( p = 0.780).

Conclusions

The novel association of anti-P antibodies and autoimmune hemolytic anemia was evidenced in cSLE patients and further studies are necessary to determine if anti-P titers may vary with this hematological manifestation.
Stroke in systemic lupus erythematosus and antiphospholipid syndrome: risk factors, clinical manifestations, neuroimaging, and treatment
Authors: de Amorim L C D , Maia F M , Rodrigues C E M
Published: April 2017

Neurologic disorders are among the most common and important clinical manifestations associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), mainly those that affect the central nervous system (CNS). Risk of cerebrovascular events in both conditions is increased, and stroke represents one of the most severe complications, with an incidence rate between 3% and 20%, especially in the first five years of diagnosis. This article updates the data regarding the risk factors, clinical manifestations, neuroimaging, and treatment of stroke in SLE and APS.
Strategic Types and Competences of Domestic and Foreign Plants: An Empirical Study
Authors: Nassimbeni Guido , Orzes Guido , Sartor Marco
Published: April 2017

A very important decision for multinational companies’ managers concerns what activities, phases and competences should be located in the home country and what could instead be offshored. Our study seeks to support them in this choice by answering to the following questions: (a) should the specializations assigned to foreign plants be different from those of domestic plants? (b) should key competences be held only in the domestic manufacturing base or also in the offshore one? We collect and analyze a wide set of data of an international research project, concerning competences and manufacturing practices of 236 MNC plants located in nine countries. We identify through cluster analysis different group profiles within domestic and foreign subsamples and compare the corresponding ones. We then compare domestic and foreign plants in a set of competences and manufacturing practices. Our empirical findings show that (a) the specializations (strategic types) of domestic and foreign plants can be substantially the same and (b) offshore plants rather than domestic ones tend in general to hold the most advanced competences.
Interpersonal Skills in MBA Admissions: How Are They Conceptualized and Assessed?
Authors: Beenen Gerard , Pichler Shaun , Davoudpour Shahin
Published: April 2017

Employers and students concur that soft skills or interpersonal skills are critical to managerial success, yet we know little about how MBA program admissions professionals conceptualize and assess these skills in the context of global management education. Such practices have key implications for interpersonal skills curriculum and training in MBA programs around the globe. A survey of 182 MBA admissions professionals from 24 countries revealed surprising agreement in how interpersonal skills were conceptualized, and suggest interpersonal skills and soft skills are not synonymous. Results also indicated that only 30% of U.S. and international MBA programs use specific criteria to assess applicants’ interpersonal skills, with the remainder using nonspecific criteria or no assessment method. We discuss the need for more rigorous assessment of interpersonal skills in MBA admissions, closer coordination between admissions officers and curriculum developers, and tighter alignment between interpersonal skills assessment and MBA curriculum and learning outcomes.
A Threshold Concept in Managing: What Students in Introductory Management Courses Must Know
Authors: Donovan Paul
Published: April 2017

In the field of management, a practice–theory gap has developed and consequently, management education has been criticized for being irrelevant to the needs of stakeholders. This article argues that introduction to management courses in higher education perpetuate this gap by not teaching what managers do. These courses fail to communicate well the threshold concept of managing as accomplishing results through other people. Understanding this threshold concept would give students clearer perspectives on the distinction between doing work and managing work in organizations—between being “one of the team” and “managing the team.” Using a class exercise as exemplar, the author demonstrates the use of a set of debate questions in the form of contestable statements regarding doing and managing, which are argued by students in small groups in class before final resolution in a plenary session. Students emerge from these debating sessions with a clearer definition and understanding of the core work that managers actually do. Learners also become cognizant of the need for managers to have an appropriate balance between the amount of managing and doing work they engage in on a daily basis. Without these understandings students become “stuck” and their learning lacks posteducational relevance.
Eversion Strength and Surface Electromyography Measures With and Without Chronic Ankle Instability Measured in 2 Positions
Authors: Donnelly Lindsy , Donovan Luke , Hart Joseph M. , Hertel Jay
Published: April 2017

Background:

Individuals with chronic ankle instability (CAI) have demonstrated strength deficits compared to healthy controls; however, the influence of ankle position on force measures and surface electromyography (sEMG) activation of the peroneus longus and brevis has not been investigated. The purpose of this study was to compare sEMG amplitudes of the peroneus longus and brevis and eversion force measures in 2 testing positions, neutral and plantarflexion, in groups with and without CAI.

Methods:

Twenty-eight adults (19 females, 9 males) with CAI and 28 healthy controls (19 females, 9 males) participated. Hand-held dynamometer force measures were assessed during isometric eversion contractions in 2 testing positions (neutral, plantarflexion) while surface sEMG amplitudes of the peroneal muscles were recorded. Force measures were normalized to body mass, and sEMG amplitudes were normalized to a resting period.

Results:

The group with CAI demonstrated less force when compared to the control group ( P < .001) in both the neutral and plantarflexion positions: neutral position, CAI: 1.64 Nm/kg and control: 2.10 Nm/kg) and plantarflexion position, CAI: 1.40 Nm/kg and control: 1.73 Nm/kg). There were no differences in sEMG amplitudes between the groups or muscles ( P > .05). Force measures correlated with both muscles’ sEMG amplitudes in the healthy group (neutral peroneus longus: r = 0.42, P = .03; plantarflexion peroneus longus: r = 0.56, P = .002; neutral peroneus brevis: r = 0.38, P = .05; plantarflexion peroneus longus: r = 0.40, P = .04), but not in the group with CAI ( P > .05).

Conclusions:

The group with CAI generated less force when compared to the control group during both testing positions. There was no selective activation of the peroneal muscles with testing in both positions, and force output and sEMG activity was only related in the healthy group.

Clinical relevance:

Clinicians should assess eversion strength and implement strength training exercises in different sagittal plane positions and evaluate for other pathologies that may contribute to reduced eversion strength in patients with CAI.

Level of Evidence:

Level III, cross-sectional
Residual Vein Thrombosis Echogenicity Is Associated to the Risk of DVT Recurrence: A Cohort Study
Authors: Mazetto Bruna M. , Orsi Fernanda L. A. , Silveira Sandra A. F. , Bittar Luis F. , Flores-Nascimento Mariane M. C. , Zapponi Kiara C. S. , Colella Marina P. , de Paula Erich V. , Annichino-Bizzacchi Joyce M.
Published: April 2017

Although deep vein thrombosis (DVT) recurrence is a common late complication of the disease, there are few predictive markers to risk-stratify patients long-term after the thrombotic event. The accuracy of residual vein thrombosis (RVT) in this context is controversial, possibly due to a lack of a standardized methodology. The objective of the study was to evaluate the accuracy of RVT echogenicity as a predictive marker of late DVT recurrence. To evaluate the accuracy of RVT echogenicity as a predictive marker of late DVT recurrence. This prospective study included patients with history of DVT in the past 33 months. Ultrasound examination was performed to detect the presence of RVT, and its echogenicity was determined by calculating the grayscale median (GSM) of the images. Blood samplings were taken for plasma D-dimer levels. Patients were followed-up for 28 months and the primary end point was DVT recurrence. Deep vein thrombosis recurrence was confirmed or excluded by ultrasound during the follow-up. Fifty-six patients were included, of which 10 presented DVT recurrence during the follow-up. D-dimer levels above 630 ng/mL conferred higher risk for recurrence with a negative predictive value of 94%. The absence of RVT was a protective marker for recurrence with a negative predictive value of 100%. Also, the presence of hypoechoic RVT, determined by GSM values below 24, positively predicted 75% of DVT recurrences. Our results suggest that the persistence of RVT and, particularly, the presence of hypoechoic thrombi (GSM < 24) are predictive markers of the risk of DVT recurrence. Residual vein thrombosis echogenicity, by GSM analysis, could represent a new strategy for the evaluation of recurrence risk in patients with DVT.
Progressively Worsening Premature Coronary Artery Disease: Adding Anticoagulation Stabilizes–Reverses Clinical Symptomatic Disease Progression in Thrombophilic–Atherothrombotic Patients: A Pilot Study
Authors: Rothschild Matan , Jetty Vybhav , Mahida Christopher , Wang Ping , Prince Marloe , Goldenberg Naila , Glueck Charles J.
Published: April 2017

In 35 patients with 116 severe premature cardiovascular disease (CVD) events (median age: 48 years), 14 having worsening CVD despite maximal intervention, we evaluated thrombophilia and speculated that anticoagulation might arrest–reverse progressive thrombophilic–atherothrombotic CVD. Thrombophilia–hypofibrinolysis in the 35 patients was compared to 110 patients with venous thromboembolism (VTE) without CVD and to 110 healthy normal controls. Efficacy–safety of anticoagulation was prospectively assessed in 14 of the 35 patients whose CVD worsened over 2 years despite maximal medical–surgical intervention. At entry on maximally tolerated lipid-lowering therapy, median low-density lipoprotein was 88 mg/dL. Measures of thrombophilia–hypofibrinolysis in the 35 cases differed from 110 VTE controls only for the lupus anticoagulant, present in 6 (21%) of 28 cases versus 4 (4%) of 91 VTE controls ( P = .01), and for high anticardiolipin antibodies (ACLAs) immunoglobulin G, 5 (14%) of 35 cases versus 4 of 108 VTE controls (4%), P = .04. The 14 patients who were anticoagulated differed from 110 VTE controls only for the lupus anticoagulant, 38% versus 4%, P = .001, and for high lipoprotein (a), 46% versus 17%, P = .028, respectively. The 14 patients with atherothrombosis having inexorably worsening CAD despite maximal medical–surgical therapy were anticoagulated for 6.5 years (median), with clinical CVD progression arrested in 12 (86%), and all 12 became asymptomatic. In the 35 patients with premature CVD, thrombophilia was pervasive, comparable to or more severe than in VTE controls without CVD. When CVD progressively worsens despite maximal intervention, thrombophilia and atherosclerosis (atherothrombosis) are commonly concurrent, and the downhill course of CVD may be arrested–stabilized by anticoagulation.
Dose-finding study comparing three treatments of remifentanil in cats anesthetized with isoflurane undergoing ovariohysterectomy
Authors: Machado Marcela L , Soares João Henrique N , Kuster de Albuquerque Gress Maria Alice , dos Santos e Castro Douglas , Teodoro Rosa Kaleizu , Bauer de Araujo Doria Phillipe , Otero Ascoli Fabio
Published: April 2017

Objectives

Three infusion rates of remifentanil were used in isoflurane-anesthetized cats undergoing ovariohysterectomy. The aim of this study was to identify a dosage regimen that would provide optimal anesthetic and surgical conditions, as well as to compare cardiovascular response to surgical stimulation, postoperative analgesia, anesthetic duration and quality of recovery among the tested remifentanil infusion rates.

Methods

Twenty-seven client-owned, mixed-breed adult healthy female cats were randomized to receive remifentanil 0.1 µg/kg/min (REMI01), remifentanil 0.2 µg/kg/min (REMI02) or remifentanil 0.4 µg/kg/min (REMI04). After premedication with acepromazine and induction of anesthesia with propofol, cats were mechanically ventilated and anesthesia was maintained at approximately 1.0 minimum alveolar concentration (MAC) of isoflurane (1.63% end-tidal isoflurane [ETISO]). Remifentanil infusion rate was increased or decreased by 20% if blood pressure had increased or decreased by 20% from previous values. Pulse rate (PR), systolic arterial pressure (SAP), esophageal temperature, pulse oximetry, end-tidal partial pressure of CO2 and ETISO were recorded at different time points during surgery. Meloxicam was administered before the end of surgery. Data within each treatment group were analyzed using a mixed-model ANOVA and Friedman’s test followed by the Wilcoxon signed rank test. Bonferroni or Dunnett’s post-hoc tests were used. The Kruskal-Wallis test followed by Dunn’s post-hoc test were used to compare data between groups; significance was set at P <0.05.

Results

Time to sternal recumbency and time to standing were significantly longer in REMI04 than in the other groups. SAP was higher when compared with baseline in REMI01 and REMI02 groups than in REMI04. No significant difference in PR among groups was observed. One cat in REMI01 and another in REMI02 required postoperative rescue analgesia.

Conclusion and relevance

The dosage regimen of 0.4 µg/kg/min seemed to be the most appropriate to be used in cats undergoing ovariohysterectomy and anesthetized with 1.0 MAC of isoflurane.
Composite MRI measures and short-term disability in patients with clinically isolated syndrome suggestive of MS
Authors: Bommarito Giulia , Bellini Alessandro , Pardini Matteo , Solaro Claudio , Roccatagliata Luca , Laroni Alice , Capello Elisabetta , Mancardi Giovanni Luigi , Uccelli Antonio , Inglese Matilde
Published: April 2017

Background:

The use of composite magnetic resonance imaging (MRI) measures has been suggested to better explain disability in patients with multiple sclerosis (MS). However, little is known about the utility of composite scores at the earliest stages of the disease.

Objective:

To investigate whether, in patients with clinically isolated syndrome (CIS), a composite MRI measure, rather than the single metrics, would explain conversion to MS and would better correlate with disability at baseline and at 1 year of follow-up.

Methods:

Corticospinal tract (CST), corpus callosum (CC) and optic radiation (OR) volume, fractional anisotropy (FA), and mean diffusivity (MD) values were measured in 27 CIS patients and 24 healthy controls (HCs). Z-scores of FA, MD, and tract volume measures were calculated in patients, based on the corresponding measures obtained from HCs, and then combined in a composite score for each tract. Correlations between Z-scores at baseline and both the Expanded Disability Status Scale (EDSS) at baseline and at follow-up (FU-EDSS) were investigated.

Results:

Only CST, CC, and OR composite scores as well as the CST volume were significantly associated with FU-EDSS ( p = 0.005, p = 0.007, p = 0.020, and p = 0.010, respectively).

Conclusion:

The combination of MRI measures rather than the individual metrics better captured the association between tissue damage in both the CC, OR and CST and short-term follow-up disability.
The European Commission’s use of consultation during policy formulation: The effects of policy characteristics
Authors: Van Ballaert Bart
Published: April 2017

This article asks to what extent the European Commission’s use of consultation depends on policy characteristics of the proposal being formulated. It examines all consultations organized during a formulation process and looks at the number of open consultations (online consultations) as well as the number of repeat consultations (expert groups, policy fora) by the total number of consultations. Three types of use of consultation are conceptualized. A multinomial logistic regression is performed on a cross-sectional sample of 150 policy proposals adopted between 2010 and 2014. Data are triangulated from official documents. The empirical analysis indicates that the Commission’s use of consultation depends on the complexity, newness, and salience of a proposal. These findings are also discussed in view of the 2015 reform of Better Regulation.
Sex bias in diagnostic delay in bronchiectasis: An analysis of the Spanish Historical Registry of Bronchiectasis
Authors: Girón Rosa Ma , de Gracia Roldán Javier , Olveira Casilda , Vendrell Montserrat , Martínez-García Miguel Ángel , de la Rosa David , Máiz Luis , Ancochea Julio , Vázquez Liliana , Borderías Luis , Polverino Eva , Martínez-Moragón Eva , Rajas Olga , Soriano Joan B
Published: April 2017

Diagnostic delay is common in most respiratory diseases, particularly in bronchiectasis. However, sex bias in diagnostic delay has not been studied to date. Objective: Assessment of diagnostic delay in bronchiectasis by sex. Methods: The Spanish Historical Registry of Bronchiectasis recruited adults diagnosed with bronchiectasis from 2002 to 2011 in 36 centres in Spain. From a total of 2113 patients registered we studied 2099, of whom 1125 (53.6%) were women. Results: No differences were found for sex or age (61.0 ± 20.6, p = 0.88) or for localization of bronchiectasis ( p = 0.31). Bronchiectasis of unknown aetiology and secondary to asthma, childhood infections and tuberculosis was more common in women (all ps < 0.05). More men than women were chronic obstructive pulmonary disease-related bronchiectasis and colonized by Haemophilus influenzae ( p < 0.001 for both). Onset of symptoms was earlier in women. The diagnostic delay for women with bronchiectasis was 2.1 years more than for men ( p = 0.001). Discussion: We recorded a substantial delay in the diagnosis of bronchiectasis. This delay was significantly longer in women than in men (>2 years). Independent factors associated with this sex bias were age at onset of symptoms, smoking history, daily expectoration and reduced lung function.
Presentation, management and mortality after a first MI in people with and without asthma: A study using UK MINAP data
Authors: Pinto Paulo , Rothnie Kieran J , Lui Kelvin , Timmis Adam , Smeeth Liam , Quint Jennifer K
Published: April 2017

Asthma has been associated with a higher incidence of myocardial infarction (MI), higher prevalence of MI risk factors and higher burden of cardiovascular diseases. However, detailed associations between the presentation and initial management at the time of MI and post-MI outcomes in people with asthma compared to the general population have not been studied. A total of 300,161 people were identified with a first MI over the period 2003–2013 in the Myocardial Ischaemia National Audit Project database, of whom 8922 (3%) had asthma. Logistic regression was used to compare presentation, in-hospital care, in-hospital and 180-day post-discharge all-cause mortality in people with and without asthma adjusting for demographics and comorbidities, diagnosis on arrival and secondary prevention. People with asthma were more likely to have a delay in their MI diagnosis following an STEMI (ST-elevation myocardial infarction; odds ratio (OR) 1.38, confidence interval CI 1.06–1.79) but not an nSTEMI (non-ST-elevation myocardial infarction; OR 1.04, CI 0.92–1.17) compared to people without asthma and a delay in reperfusion (OR 1.19, CI 1.09–1.30) following an STEMI. They were much less likely to be discharged on a beta blocker following an STEMI or nSTEMI (OR 0.24, CI 0.21–0.28 and OR 0.27, CI 0.24–0.30, respectively). There was no difference in in-hospital or 180-day mortality (OR 0.98, CI 0.59–1.62 and OR 0.99, CI 0.72–1.36) following an STEMI or nSTEMI (OR 0.89, CI 0.47–1.68 and OR 1.05, CI 0.85–1.28). Although people with asthma were more likely to have a delay in diagnosis following an STEMI but not an nSTEMI compared to the general population, were more likely to have a delay in reperfusion therapy and were much less likely to receive beta blockers following an STEMI or nSTEMI, there was no difference in the prescriptions of other secondary prevention medications. None of the differences in presentation or management were associated with an increase in all-cause in-hospital or 180-day mortality in people with asthma compared to the general population.
Updating Supreme Court Legitimacy: Testing the “Rule, Learn, Update” Model of Political Communication
Authors: Gibson James L. , Pereira Miguel M. , Ziegler Jeffrey
Published: April 2017

One of the more important innovations in the study of how citizens assess the U.S. Supreme Court is the ideological updating model, which assumes that citizens grant legitimacy to the institution according to the perceived distance between themselves and the Court on a unidimensional ideological (liberal–conservative) continuum. Under this model, citizens are also said to update this calculation with every new salient Supreme Court decision. The model’s requirements, however, do not seem to square with the long-established view that Americans are largely innocent of ideology. Here, we conduct an audit of the model’s mechanisms using a series of empirical tests applied to a nationally representative sample. Our general conclusion is that the ideological updating model, especially when supplemented with the requirement that citizens must become aware of Court decisions, simply does not square with the realities of American politics. Students of Supreme Court legitimacy may therefore want to search for other theories of legitimacy updating.
World Vaping Day: Contextualizing Vaping Culture in Online Social Media Using a Mixed Methods Approach
Authors: Colditz Jason B. , Welling Joel , Smith Noah A. , James A. Everette , Primack Brian A.
Published: April 2017

Few studies have demonstrated the use of mixed methods research to contextualize health topics using primary data from social media. To address this gap in the methodological literature, we present research about electronic nicotine delivery systems, using Twitter data from “World Vaping Day.” To engage with the quantitative breadth and qualitative depth of 5,149 collected tweets, we utilized a convergent parallel mixed methods framework, integrating thematic prevalence estimates with phenomenological contextualization. Sentiment was more positive than negative across all categories except policy related. A total of 23% of tweets were promotional and relatively few tweets related to tobacco use (4.9%) or health concerns (4.2%). Salient themes included modifying or upgrading electronic nicotine delivery systems devices, and general mistrust of public health advocates and tobacco companies.
Isolated AA Amyloidosis of the Radial Nerve
Authors: Pérez-de la Fuente Teresa , Fernández-Jara Javier , Rodríguez-Urcelay Pilar , Jiménez-Heffernan Jose , Juárez Ángel
Published: April 2017

Background: Amyloidosis affecting peripheral nerve is usually seen in primary amyloidosis. Methods: We are reporting on the case of a 74-year-old man with a 16-month history of progressive left radial nerve paralysis. Perioperative imaging detected an enlarged radial nerve in the middle-distal part of the arm. The patient had an antecedent of amyloid deposits in the lung. Results: A radial nerve amyloidosis was suspected and confirmed with a biopsy assisted by ultrasonography, resulting in a secondary amyloidosis form. Conclusions: Isolated radial nerve palsy due to nerve damage by amyloidosis has been reported before, but not in AA or secondary amyloidosis.
Explaining young British Muslim men’s involvement in heroin and crack
Authors: Qasim Mohammed
Published: April 2017

Recent years have seen an upsurge in the numbers of British Muslim men, particularly young British Muslim men aged from 18–35 involved in the sale of drugs. However, despite this alleged increase, very little is known as to what motivates young British Muslim men to become involved with drugs. This has led some commentators to deliberate whether there are perhaps cultural or religious reasons which may motivate Muslim men to become involved with drugs. This article, which is taken from a four-year phenomenological study (2010–2014) with a social group of young British Pakistani Muslim men who traded in heroin and crack argues that the young men (also known as The Boys) were not motivated by religious or cultural reasons but were instead motivated by a number of underlying issues. Factors such as deprivation, a need for status, the challenge of finding suitable paid employment, a reluctance to work in jobs that could affect status were all possible factors which explained why The Boys were involved in drugs.
Evaluation of the suggestions system performance using robust DEA model: The case of National Iranian Gas Company
Authors: Soltani Ali , Alam Tabriz Akbar , Sanei Masoud , Najafi Trojeni Ismaeil
Published: April 2017

The suggestions system is a part of total quality management to create individual and group spirit of partnership between staff and increase efficiency in the organization. Also, diagnosis and improvement process is one of the steps of the chain in the processes of suggestions system. In this study, an approach has been proposed to evaluate efficiency of organizations in performing suggestions system with these aims: (1) Reviewing all the elements in the successful implementation of the suggestions system and (2) providing an effective scientific approach to evaluate the organizations on implementing this system considering the uncertainty in the data. Methodology used in this study included the following techniques: (1) Factor analyzing to clarify the internal correlation between significant criteria and detect the major criteria and (2) using robust data envelopment analysis (RDEA) model to evaluate efficiency of organizations in performing suggestions system. The method is based on 3 inputs and 17 outputs in which some outputs are uncertain scores in form of intervals with uncertain bounds. This model has been solved for different Γs, and a value of weights and rankings for each Decision Making Unit (DMU) has been saved by using the obtained values. In the following a simulation has been used to compute the conformity of the rankings from the RDEA model with reality. Doing so shows that the maximum conformity occurs Γ = 6. Therefore, we can conclude that specific values of Γ can maximize conformity and thus more authentic final rankings for the DMUs in this interval of Γ may be expected.
Persistence of Macrocytosis after Discontinuation of Zidovudine in HIV-Infected Patients
Authors: Yu Inski , Greenberg Richard N. , Crawford Timothy N. , Thornton Alice C. , Myint Thein
Published: April 2017

The duration of macrocytosis after stopping zidovudine (ZDV) is unknown. Among 104 HIV-infected patients treated with ZDV for more than 1 year, 84 patients had macrocytosis at ZDV discontinuation. The median mean corpuscular volume (MCV) was 114.6 fL (range 100-128 fL). Patients were divided into 2 groups: those who did (resolved macrocytosis, n = 36) and did not (persistent macrocytosis, n = 48) normalize MCV at 3 to 6 months after ZDV discontinuation. Alcohol use ( P = .02), smoking ( P = .03), and lower (but within normal range) folic acid levels ( P = .05) were related to the persistence of macrocytosis. A persistence of macrocytosis was observed in 57% at 3 to 6 months, 38% at 1 year and 37% at 2 years after ZDV therapy had stopped. Duration of ZDV therapy did not have an effect on the persistence of macrocytosis ( P = .73). The median time for the MCV to normalize after stopping ZDV was 12.5 months.
Association of Fatigue With Sarcopenia and its Elements: A Secondary Analysis of SABE-Bogotá
Authors: Patino-Hernandez Daniela , David-Pardo David Gabriel , Borda Miguel Germán , Pérez-Zepeda Mario Ulises , Cano-Gutiérrez Carlos
Published: April 2017

Objective: Sarcopenia, fatigue, and depression are associated with higher mortality rates and adverse outcomes in the aging population. Understanding the association among clinical variables, mainly symptoms, is important for screening and appropriately managing these conditions. The aim of this article is to evaluate the association among sarcopenia and its elements with depression and fatigue. Method: We used cross-sectional data from 2012 SABE ( Salud, Bienestar y Envejecimiento)-Bogotá study, which included 2,000 participants of ages ≥60 years. Sarcopenia and its elements were taken as the dependent variable, while fatigue and depression were the main independent variables. We tested the association among these through multiple logistic regression models, which were fitted for each dependent variable and adjusted for confounding variables. Results: Our findings showed that gait speed was associated with fatigue (adjusted odds ratio [OR] = 1.41, 95% confidence interval [CI] = [1.05, 1.90], p = .02) as well as abnormal handgrip strength (adjusted OR = 1.40, 95% CI = [1.02, 1.93], p = .04). No other associations were significant. Conclusion: While sarcopenia and fatigue are not associated, two of the sarcopenia-defining variables are associated with fatigue; this suggests that lack of sarcopenia does not exclude undesirable outcomes related to fatigue in aging adults. Also, the lack of association between sarcopenia-defining elements and depression demonstrates that depression and fatigue are different concepts.
Patient waiting time in the outpatient clinic at a central surgical hospital of Vietnam: Implications for resource allocation
Authors: Tran Tho Dinh , Nguyen Uy Van , Minh Nong Vuong , Tran Bach Xuan
Published: April 2017

Background: Patient waiting time is considered as a crucial parameter in the assessment of healthcare quality and patients’ satisfaction towards healthcare services. Data concerning this has remained limited in Vietnam. Thus, this study aims to assess patient waiting time in the outpatient clinic in Viet Duc Hospital (Hanoi, Vietnam) in order to enable stakeholders to inform evidence-based interventions to improve the quality of healthcare services.

Methods: A cross-sectional study was conducted from June 2014 to June 2015 in the outpatient clinic at Viet Duc Hospital. Waiting time stratified by years (2014 and 2015), months of the year, weekdays, and hours of the day were extracted from Hospital Management software and carefully calculated. Stata 12.0 was employed to analyze data, including the average time (M± SD), frequencies and percentage (%).

Results: There was a total of 137,881 patients involved in the study. The average waiting time from registration to preliminary diagnosis in 2014 was 50.41 minutes, and in 2015 was 42.05 minutes. A longer waiting time was recorded in the morning and in those having health insurance.

Conclusions: Our study highlights the essential need for human resource promotion to reduce patient waiting time. Also, attention should be paid to the simplification of administrative procedures in order to reduce waiting time among insured patients.
Protein sites with more coevolutionary connections tend to evolve slower, while more variable protein families acquire higher coevolutionary connections
Authors: Mandloi Sapan , Chakrabarti Saikat
Published: April 2017

Background: Correlated mutation or coevolution of positions in a protein is tightly linked with the protein’s respective evolutionary rate. It is essential to investigate the intricate relationship between the extent of coevolution and the evolutionary variability exerted at individual protein sites, as well as the whole protein.

Methods: In this study, we have used a reliable set of coevolutionary connections (sites within 10Å spatial distance) and investigated their correlation with the evolutionary diversity within the respective protein sites.

Results: Based on our observations, we propose an interesting hypothesis that higher numbers of coevolutionary connections are associated with lesser evolutionary variable protein sites, while higher numbers of the coevolutionary connections can be observed for a protein family that has higher evolutionary variability. Our findings also indicate that highly coevolved sites located in a solvent accessible state tend to be less evolutionary variable. This relationship reverts at the whole protein level where cytoplasmic and extracellular proteins show moderately higher anti-correlation between the number of coevolutionary connections and the average evolutionary conservation of the whole protein.

Conclusions: Observations and hypothesis presented in this study provide intriguing insights towards understanding the critical relationship between coevolutionary and evolutionary changes observed within proteins. Our observations encourage further investigation to find out the reasons behind subtle variations in the relationship between coevolutionary connectivity and evolutionary diversity for proteins located at various cellular localizations and/or involved in different molecular-biological functions.
Barriers to Abortion Care and Their Consequences For Patients Traveling for Services: Qualitative Findings from Two States
Authors: Jerman Jenna , Frohwirth Lori , Kavanaugh Megan L. , Blades Nakeisha
Published: April 2017

CONTEXT

Abortion availability and accessibility vary by state. Especially in areas where services are restricted or limited, some women travel to obtain abortion services in other states. Little is known about the experience of travel to obtain abortion.

METHODS

In January and February 2015, in‐depth interviews were conducted with 29 patients seeking abortion services at six facilities in Michigan and New Mexico. Eligible women were 18 or older, spoke English, and had traveled either across state lines or more than 100 miles within the state. Respondents were asked to describe their experience from pregnancy discovery to the day of the abortion procedure. Barriers to accessing abortion care and consequences of these barriers were identified through inductive and deductive analysis.

RESULTS

Respondents described 15 barriers to abortion care while traveling to obtain services, and three major consequences of experiencing those barriers. Barriers were grouped into five categories: travel‐related logistical issues, system navigation issues, limited clinic options, financial issues, and state or clinic restrictions. Consequences were delays in care, negative mental health impacts and considering self‐induction. The experience of barriers complicated the process of obtaining an abortion, but the effect of any individual barrier was unclear. Instead, the experience of multiple barriers appeared to have a compounding effect, resulting in negative consequences for women traveling for abortion.

CONCLUSION

The amalgamation of barriers to abortion care experienced simultaneously can have significant consequences for patients.
Compatriotas, alianças familiares e desigualdades econômicas: a trajetória do português José Lopes Ferreira nas sociedades de Morretes e Paranaguá (Província de São Paulo, 1824-1837)
Authors: Cavazzani André Luiz Moscaleski , Gomes Sandro Aramis Richter
Published: April 2017

Este artigo comporta uma investigação acerca da trajetória do imigrante português José Lopes Ferreira (1797-1837) nos municípios litorâneos de Morretes e Paranaguá, no período que abrange os anos de 1824 e 1837. Nesse contexto, esses municípios pertenciam à jurisdição da Província de São Paulo. Por meio desse estudo, são evidenciados dois elementos basilares do processo de enraizamento social dos negociantes de origem portuguesa no litoral sul paulista na primeira metade do século XIX. O primeiro elemento consiste no fato de que nessa época os imigrantes conquistavam suas primeiras oportunidades econômicas e sociais por meio do estabelecimento de relações familiares com pequenos comerciantes também provenientes de Portugal. As principais oportunidades sociais desses imigrantes eram contrair matrimônio com a filha de um patrício e inaugurar um armazém de secos e molhados. O segundo elemento é a notável desigualdade econômica entre os portugueses.Palavras-chave: Hierarquias sociais. Imigração portuguesa. Relações familiares.
Total quality management and its applications: Example of Kalekim
Toplam kalite yönetimi ve uygulamaları: Kalekim örneği
Authors: Güzel Dilşad , Aykol Selin
Published: April 2017

The importance of Total Quality Management (TQM) can not be denied in increasing business efficiency and productivity. For this reason, companies should be able to apply this philosophy professionally in all business process. It has been stated that TQM is to be a philosophy which are reduces costs and defects, provides customer satisfaction, including workers in the decision-making processes and improves education in all business processes. However, some firms in Turkey can’t practice the TQM philosophy completely. Accordingly, it can be stated that many firms have some deficiencies to implement aims of this philosophy. The aim of this study is to explain the total quality management philosophy, its historical development process and some applications in the world and Turkey and to analyze TQM applications of Kalekim company. The results of this study show that Kalekim company implemented TQM applications successfully. Özetİşletmelerin etkinliklerinin ve verimliliklerinin artırılmasında Toplam Kalite Yönetimi (TKY)’ nin önemi yadsınamaz. Bu nedenle şirketler, bu felsefeyi tüm işletme süreçlerinde profesyonelce uygulayabilmelidir. TKY, tüm iş süreçlerinde, maliyetlerin ve hataların azaltıldığı, müşteri memnuniyetinin sağlandığı, işçilerin karar alma süreçlerine dahil edildiği, eğitimin artırıldığı bir felsefe olarak ifade edilmektedir. Ancak, Türkiye’deki bazı firmalar TKY felsefesini tam olarak uygulayamamaktadırlar. Dolayısıyla birçok firmanın bu felsefedeki amaçlarını gerçekleştirmede bazı eksiklileri olduğu söylenebilir. Bu çalışmanın amacı, TKY’nin felsefesini, tarihsel gelişimini, dünya ve Türkiye’deki bazı uygulamalarını belirtmek ve Kalekim firmasının TKY uygulamalarını analiz etmektir. Çalışma sonucunda, Kalekim firmasının TKY uygulamalarını başarı ile gerçekleştirdiği görülmüştür.
Mark E Josephson: Characteristics of Leadership
Authors: Callans David J ,   David J Callans Section of Cardiac Electrophysiology, Division of Cardiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
Published: April 2017

Mark Josephson is without a doubt the most fascinating person I have ever met. I am proud to have had a close friendship with him and I miss him immensely. I have written in the past about his amazing academic contributions, but in a way I am relieved that this is not my topic today. I will instead talk about the unique aspects of his personality that allowed him to be a great leader in the field of electrophysiology and a powerful influence on the personal development of those of us who had the great good fortune of interacting with him closely.