bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacist-Led Shared Medical Appointments for Multiple Cardiovascular Risk Reduction in Patients With Type 2 Diabetes
Authors: Cohen Lisa B. , Taveira Tracey H. , Khatana Sameed Ahmed M. , Dooley Andrea G. , Pirraglia Paul A. , Wu Wen-Chih
Published: October 2011

Purpose

To assess whether VA MEDIC-E (Veterans Affairs Multi-disciplinary Education and Diabetes Intervention for Cardiac risk reduction[EM DASH] Extended for 6 months), a pharmacist-led shared medical appointments program, could improve attainment of target goals for hypertension, hyperglycemia, hyperlipidemia, and tobacco use in patients with type 2 diabetes compared to standard primary care after 6 months of intervention.

Methods

A randomized, controlled trial of VA MEDIC-E (n = 50) versus standard primary care (n = 49) in veterans with type 2 diabetes, hemoglobin A1c (A1C) > 7%, blood pressure (BP) > 130/80 mmHg, and low density lipoprotein cholesterol (LDL-C) > 100mg/dl (2.59 mmol/l) in the previous 6 months was conducted. The VA MEDIC-E intervention consisted of 4 weekly group sessions followed by 5 monthly booster group sessions. Each 2-hour session included 1 hour of multidisciplinary diabetes specific healthy lifestyle education and 1 hour of pharmacotherapeutic interventions performed by a clinical pharmacist. Evaluation measures included lab values of A1C, LDL cholesterol, BP, and goal attainment of these values, and diabetes self-care behavior questionnaires at 6 months.

Results

The randomization groups were similar at baseline in all cardiovascular risk factors except for LDL, which was significantly lower in the MEDIC-E arm. At 6 months, significant improvements from baseline were found in the intervention arm for exercise, foot care, and goal attainment of A1C, LDL-C, and BP but not in the control arm.

Conclusions

The results of this study demonstrate that the pharmacist-led group intervention program for 6 months was an efficacious and sustainable collaborative care approach to managing diabetes and reducing associated cardiovascular risk.
Disparities in Diabetes Self-management Education for Uninsured and Underinsured Adults
Authors: Shaw Kathy , Killeen Maureen , Sullivan Erin , Bowman Patricia
Published: October 2011

Purpose

To examine accessibility, availability, and quality of diabetes self-management education (DSME) for uninsured adults or those utilizing Medicaid in a community with a high poverty rate.

Methods

A descriptive needs assessment was conducted in 8 health care agencies serving the uninsured. Face-to-face audiotaped interviews were conducted with 22 health care providers, educators, and administrators to capture descriptive characteristics about clinical care, DSME, continuity of care, and organizational function.

Results

Twenty-nine percent of adults with diabetes were reported to be uninsured or utilizing Medicaid in these settings. Only 4% of adults received the American Diabetes Association’s DSME standards of care. At 5 agencies, there was no direct access to DSME. Uninsured individuals had access to 2 programs; individuals utilizing Medicaid had access to 1 program. Certified diabetes educators were available at only 3 agencies. There were DSME programs that adhered to recommended guidelines but limited availability for these adults. The majority of education (86%) was limited to clinical encounters with providers, which were infrequent and variable in duration. Time spent on education ranged from 2 to 120 minutes depending on agency type. Education topics addressed by providers varied by agency.

Conclusions

Findings of this study suggest that adults who are utilizing Medicaid or are uninsured do not get the amount, type, or quality of DSME needed to sustain successful self-management. Limited availability and inadequate access to quality DSME place vulnerable adults at increased risk for devastating and costly complications despite the known benefits.
Differences Between Humor Comprehension and Appreciation in Healthy Children and Children With Epilepsy
Authors: Suits Kristi , Tulviste Tiia , Ong Ruth , Tulviste Jaan , Kolk Anneli
Published: October 2011

This study explored verbal, visual, motor, and tactile humor appreciation and comprehension among preschool children with epilepsy as compared with healthy children. Participants included 32 children with focal epilepsy, as well as 70 healthy controls. The results suggest that children with epilepsy assess humor dichotomously (as either not funny at all or as extremely funny) and generally as less amusing when compared with ratings given by controls ( M = 6.08, and M = 7.44, P = .01, respectively). They also gave significantly lower ratings to verbal jokes than to visual jokes. Furthermore, children with epilepsy assessed the jokes they understood (ie, gave expected explanations to the content of jokes) as less funny. An important finding from our study was that children with epilepsy assess aggressive humor as not funny. The most frequent emotional reaction in both groups to jokes from all subtests was a smile, followed by a half-smile.
Electroencephalographic Features in Dravet Syndrome
Authors: Specchio Nicola , Balestri Martina , Trivisano Marina , Japaridze Natia , Striano Pasquale , Carotenuto Antonio , Cappelletti Simona , Specchio Luigi M. , Fusco Lucia , Vigevano Federico
Published: October 2011

The aim of the study was to evaluate interictal electroencephalogram features in 22 patients with Dravet syndrome from the onset of the disease through the next 5 years. Electroencephalogram was abnormal in 5 patients (22.7%) at onset, and in 17 (77.3%) at the end of the study. Epileptiform abnormalities (focal, multifocal, or generalized) were seen in 6 patients at the onset and in 14 (27% vs 64%) at the end of the study. Photoparoxysmal response was present in 41% of patients at the end of follow-up. No statistical differences were found between mutated and nonmutated groups regarding evolution of background activity, interictal abnormalities, and presence of photoparoxysmal response. Electroencephalogram findings seemed to be age dependent, variable among different patients, and not influenced by the presence of sodium channel, voltage-gated, type I, alpha subunit ( SCN1A) mutation. The lack of specific epileptiform abnormalities contributes to the difficulty of patients’ management in Dravet syndrome.
Child Neurology Services in Africa
Authors: Wilmshurst Jo M. , Badoe Eben , Wammanda Robinson D. , Mallewa Macpherson , Kakooza-Mwesige Angelina , Venter Andre , Newton Charles R.
Published: October 2011

The first African Child Neurology Association meeting identified key challenges that the continent faces to improve the health of children with neurology disorders. The capacity to diagnose common neurologic conditions and rare disorders is lacking. The burden of neurologic disease on the continent is not known, and this lack of knowledge limits the ability to lobby for better health care provision. Inability to practice in resource-limited settings has led to the migration of skilled professionals away from Africa. Referral systems from primary to tertiary are often unpredictable and chaotic. There is a lack of access to reliable supplies of basic neurology treatments such as antiepileptic drugs. Few countries have nationally accepted guidelines either for the management of epilepsy or status epilepticus. There is a great need to develop better training capacity across Africa in the recognition and management of neurologic conditions in children, from primary health care to the subspecialist level.
A Proposed Multidisciplinary Approach for Identifying Feeding Abnormalities in Children With Cerebral Palsy
Authors: Santoro Amelia , Lang Maria Bianca Dasso , Moretti Elena , Sellari-Franceschini Stefano , Orazini Laura , Cipriani Paola , Cioni Giovanni , Battini Roberta
Published: October 2011

Children with neurodevelopmental disabilities, such as cerebral palsy, frequently have associated oral motor dysfunction, which leads to feeding difficulties, risk of aspiration, prolonged feeding times, and malnutrition with its attendant physical compromise. The authors propose a comprehensive multidisciplinary assessment, including neurological and dysphagia examination and ear, nose, and throat examination, to evaluate clinical indicators and severity of feeding impairment in children affected by neurodevelopmental disorders. A representative sample of 40 children with cerebral palsy (spastic, dyskinetic, or mixed), intellectual disability, and feeding problems was included in the study. A specific multidisciplinary evaluation and standardized mealtime observation in patients with cerebral palsy appear feasible and appropriate to recognize proactive indicators of dysphagia and to establish personalized programs of gastric and rehabilitative interventions.
Screening for dementia: Fluidity and the Mini Mental State Examination in India
Authors: Brijnath Bianca
Published: October 2011

The Mini Mental State Examination (MMSE) is a popular screening instrument for dementia. Drawing on ethnographic data from India, three vignettes are presented to examine how the MMSE is operationalised by interviewers and respondents. Using the concept of ‘fluidity’ from Science and Technology Studies, it will be demonstrated that the MMSE is fluid and changes according to individual norms, institutional resources, and cultural settings. In some environments, the scores are discounted in order to count; in others, the scale is perceived as an invitation to talk; and finally, the MMSE can also operate as an entry-point to seek treatment for other psychological concerns.
The meanings of suicidal behaviour to psychology students in Ghana: A qualitative approach
Authors: Osafo Joseph , Hjelmeland Heidi , Akotia Charity S. , Knizek Birthe Loa
Published: October 2011

The objective of this study was to examine psychology students' attitudes toward suicidal behaviour and the meanings they assign to the act. In-depth interviews were conducted with 15 final year psychology students at a university in Ghana. Interpretative Phenomenological Analysis (IPA) was used to analyze the data. The results indicated that the students had a generalized negative attitude toward suicide. Religious beliefs and family harmony are cultural contexts influencing the interpretation of suicidal behaviour as breach of divine and communal moralities. The implications of these meanings of suicidal behaviour for suicide prevention in Ghana are discussed.
Does perceived stress mediate the effect of cultural consonance on depression?
Authors: Balieiro Mauro C. , dos Santos Manoel Antônio , dos Santos José Ernesto , Dressler William W.
Published: October 2011

The importance of appraisal in the stress process is unquestioned. Experience in the social environment that impacts outcomes such as depression are thought to have these effects because they are appraised as a threat to the individual and overwhelm the individual's capacity to cope. In terms of the nature of social experience that is associated with depression, several recent studies have examined the impact of cultural consonance. Cultural consonance is the degree to which individuals, in their own beliefs and behaviors, approximate the prototypes for belief and behavior encoded in shared cultural models. Low cultural consonance is associated with more depressive symptoms both cross-sectionally and longitudinally. In this paper we ask the question: does perceived stress mediate the effects of cultural consonance on depression? Data are drawn from a longitudinal study of depressive symptoms in the urban community of Ribeirão Preto, Brazil. A sample of 210 individuals was followed for 2 years. Cultural consonance was assessed in four cultural domains, using a mixed-methods research design that integrated techniques of cultural domain analysis with social survey research. Perceived stress was measured with Cohen's Perceived Stress Scale. When cultural consonance was examined separately for each domain, perceived stress partially mediated the impact of cultural consonance in family life and cultural consonance in lifestyle on depressive symptoms. When generalized cultural consonance (combining consonance in all four domains) was examined, there was no evidence of mediation. These results raise questions about how culturally salient experience rises to the level of conscious reflection.
Indigenous perspectives on depression in rural regions of India and the United States
Authors: Nieuwsma Jason A. , Pepper Carolyn M. , Maack Danielle J. , Birgenheir Denis G.
Published: October 2011

Depression is a major health concern in India, yet indigenous Indian perspectives on depression have often been disregarded in favor of Western conceptualizations. The present study used quantitative and qualitative measures modeled on the Explanatory Model Interview Catalogue (EMIC) to elicit beliefs about the symptoms, causes, treatments, and stigma associated with depression. Data were collected from 92 students at a university in the Himalayan region of Northern India and from 97 students at a university in the Rocky Mountain region of the United States. U.S. participants in this study were included primarily to approximate a “Western baseline” (in which professional conceptions of depression are predominantly rooted) from which to elucidate Indian perspectives. Compared to U.S. participants, Indian participants were more likely to view restive symptoms (e.g., irritation, anxiety, difficulty thinking) as common features of depression, to view depression as the result of personally controllable causes (e.g., failure), to endorse social support and spiritual reflection or relaxation (e.g., yoga, meditation) as useful means for dealing with depression, and to associate stigma with depression. Efforts aimed at reducing depression among Indians should focus more on implementing effective and culturally acceptable interventions, such as yoga, meditation, and increasing social support.
Sveinbergeite, Ca(Fe2+6 Fe3+)Ti2(Si4O12)2O2(OH)5(H2O)4, a new astrophyllite-group mineral from the Larvik Plutonic Complex, Oslo Region, Norway: description and crystal structure
Authors: Khomyakov A. P. , Cámara F. , Sokolova E. , Abdu Y. , Hawthorne F. C.
Published: October 2011

Sveinbergeite, Ca(Fe2+6Fe3+)Ti2(Si4O12)2O2(OH)5(H2O)4, is a new astrophyllite-group mineral discovered in a syenite pegmatite at Buer on the Vesteroya peninsula, Sandefjord, Oslo Region, Norway. The mineral occurs in pegmatite cavities as 0.01—0.05 mm thick lamellar (0.2—0.5×5—10 mm) crystals forming rosette-like divergent groups and spherical aggregates, which are covered by brown coatings of iron (and possibly manganese) oxides, associated with magnesiokatophorite, aegirine, microcline, albite. calcite, fluorapatite, molybdenite, galena and a hochelagaite-like mineral. Crystals of sveinbergeite are deep green with a pale green streak and a vitreous and pearly lustre. Sveinbergeite has perfect cleavage on ﹛001﹜ and a Mohs hardness of 3. Its calculated density is 3.152 g/cm3. It is biaxial positive with α 1.745(2), β 1.746(2), γ 1.753(2), 2V(meas.) = 20(3)°. The mineral is pleochroic according to the scheme Z > X ∽ Y : Z is deep green, X and Y are brownish green. Orientation is as follows: X ┴ L (001), Y ᶺ b = 12°, Z = a, elongation positive. Sveinbergeite is triclinic, space group P1̄, a = 5.329(4), b = 11.803(8), c = 11.822(8) Å; α = 101.140(8)°, β = 98.224(8)°, γ = 102.442(8)°; V = 699.0(8) Å3; Z = 1. The nine strongest lines in the X-ray powder diffraction pattern [d in Å(I)(hkl)] are: 11.395(100)(001,010). 2.880(38)(004), 2.640(31)(2̄10,l̄41), 1.643(24)(07̄1,072), 2.492(20)(2l̄l), 1.616(15)(070), 1.573(14)(3̄2̄2), 2.270(13)(1̄3̄4) and 2.757(12)(1̄40,1̄3̄2). Chemical analysis by electron microprobe gave Nb2O5 0.55, TiO2 10.76, ZrO2 0.48, SiO2 34.41, A12O3 0.34, Fe2O3 5.57, FeO 29.39, MnO 1.27, CaO 3.87, MgO 0.52, K2O 0.49, Na2O 0.27, F 0.24, H2O 8.05, O=F -0.10, sum 96.11 wt.%, the amount of H2O was determined from structure refinement, and the valence state of Fe was calculated from structure refinement in accord with Mossbauer spectroscopy. The empirical formula, calculated on the basis of eight (Si + Al) p.f.u., is (Ca0.95Na0.12K0.14)Σ1.21(Fe2+5.65Fe3+0.93Mn0.25Mg0.18)Σ7.01(Ti1.86Nb0.06Zr0.05Fe3+)Σ2 (Si7091Al0.09)Σ8O34.61H12.34F0.17, Z = 1. The infrared spectrum of the mineral contains the following absorption frequencies: 3588, ∽3398 (broad), ∽3204 (broad), 1628, 1069, 1009, 942, 702, 655 and 560 cm–1. The crystal structure of the mineral was solved by direct methods and refined to an R1 index of 21.81%. The main structural unit in the sveinbergeite structure is an HOH layer which is topologically identical to that in the astrophyllite structure. Sveinbergeite differs from all other minerals of the astrophyllite group in the composition and topology of the interstitial A and B sites and linkage of adjacent HOH layers. The mineral is named in honour of Svein Arne Berge (b. 1949), a noted Norwegian amateur mineralogist and collector who was the first to observe and record this mineral from its type locality as a potential new species.
Reconstitution and Organization of Photosynthetic Antenna Protein Complex Bearing Functional Hydrophilic Domains
Authors: Sakai Shunsuke , Hiro Akito , Sumino Ayumi , Mizuno Toshihisa , Tanaka Toshiki , Hashimoto Hideki , Dewa Takehisa , Nango Mamoru
Published: October 2011

Bacterial photosynthetic antenna polypeptide (LH1-α) was synthesized as a water-soluble fusion protein with maltose-binding protein (MBP) and a His-tag portion (MBP–rubα-YH) using an E. coli expression system. Reconstitution experiments indicated that LH1-type complexes with pigments were successfully formed, regardless of the presence of a large hydrophilic MBP portion. The reconstituted complex was immobilized onto a Au electrode via a His-tag–Ni–NTA interaction. When the complex was incorporated into a planar lipid bilayer, protruding MBP portions were clearly observed by AFM.
Lewis Acid-mediated ArSE Aroylation of Naphthalene Derivative: Distinct Second Aroylation Behavior of α-Naphthyl Ketone
Authors: Okamoto Akiko , Mitsui Ryosuke , Oike Hideaki , Yonezawa Noriyuki
Published: October 2011

Dual ArSE aroylation of 2,7-dimethoxynaphthalene proceeds with distinct susceptibility and regioselectivity depending on the Lewis acid. The TiCl4-mediated reaction readily affords 1,8-diaroylated product. In the AlCl3-mediated reaction, monoaroylation essentially proceeds with partial ether cleavage and under some specific conditions 1,6-diaroylation proceeds in preference to 1,8-diaroylation.
Systematic review of sonographic chronic cerebrospinal venous insufficiency findings in multiple sclerosis
Authors: Thapar A , Lane T , Nicholas R , Friede T , Ellis M , Assenheim J , Franklin I J , Davies A H
Published: October 2011

Objective

The sonographic findings of chronic cerebrospinal venous insufficiency (CCSVI) are used by some as selection criteria for venography. We performed a systematic review to establish the prevalence and strength of association between sonographic CCSVI and multiple sclerosis (MS).

Method

Two reviewers searched PubMed and EMBASE from 1948 to date using the keywords ‘chronic cerebrospinal venous insufficiency’ according to PRISMA guidelines.

Results

Four cross-sectional studies met the criteria for inclusion. The prevalence of CCSVI ranged from 7% to 100% in MS patients and from 2% to 36% in healthy controls. Diagnostic odds ratios for MS varied between 2 and 26, 499 ( I 2 = 94%). Sensitivities of CCSVI for MS varied between 7% and 100% ( I 2 = 98%). Specificities varied between 64% and 100% ( I 2 = 95%).

Conclusion

There is substantial variation in the strength of association between CCSVI and MS beyond that explained by demographic differences or sonographer training. Reliable evidence on which to base decisions requires sonographic consensus and assessment of the reproducibility of individual criteria between trained sonographers.
Validation of a one-stop carpal tunnel clinic including nerve conduction studies and hand therapy
Authors: Ball C , Pearse M , Kennedy D , Hall A , Nanchahal J
Published: October 2011

INTRODUCTION

Carpal tunnel syndrome is the most common hand disorder. We describe a pathway that includes clinical assessment, neurophysiological testing, surgery and physical therapy all at the same visit.

METHODS

All referrals for carpal tunnel syndrome were screened for inclusion in a ‘one-stop’ surgeon-led clinic. Prospective clinical data collected included patient reported outcome measures and satisfaction scores, touch threshold, pinch and grip strength. Patients were assessed clinically, underwent nerve conduction studies and surgery as indicated, all on the same day. Baseline and one-year follow-up data were analysed for 57 patients (62 hands).

RESULTS

There was significant improvement in all domains of the Boston Carpal Tunnel and Michigan Hand Outcomes questionnaires, grip strength and touch threshold. There were no adverse events. The total mean operating time was 12.8 minutes (range: 5–15 minutes) and the mean tourniquet time was 2.5 minutes (range: 1–11 minutes). Using a dual theatre model produced a short mean turnaround time of 14.8 minutes (range: 2–37 minutes). Patient satisfaction as judged using a Picker questionnaire was very high.

CONCLUSIONS

A highly efficient clinical service involving both diagnostics and treatment can be delivered at a single hospital visit while maintaining optimal outcomes and high patient satisfaction.
Management of perforated peptic ulcer in a district general hospital
Authors: Critchley AC , Phillips AW , Bawa SM , Gallagher PV
Published: October 2011

INTRODUCTION

Laparoscopic surgery has become increasingly popular for elective surgery but it has gained slow transference to emergency surgery. The management of perforated peptic ulcers (PPU) laparoscopically is an accepted strategy yet it still remains infrequently used. The purpose of this study was to analyse the utility and outcomes of laparoscopy versus open repair for PPU in a district general hospital. In addition, we evaluated whether the subspecialty of the on-call consultant affected the method of repair performed and the training opportunities for trainee surgeons.

METHODS

Between 2003 and 2009, 53 patients underwent laparoscopic repair, 89 patients underwent open repair and a further 20 patients had laparoscopic repair that was converted to open repair for PPU. The results from a prospectively compiled database were analysed with primary outcome measures including operative time, length of hospital stay and mortality.

RESULTS

The median operating time in the laparoscopic group was 60.0 minutes compared with 50.5 minutes in the open group. Hospital stay in surviving patients was significantly shorter in patients treated completely laparoscopically (5 days) when compared with the open group (6 days) (p<0.01). There were six deaths in the laparoscopic group (11%) compared with 13 in the open group (15%) and one in the converted group (5%). Trainees performed 53% (47/89) of open repairs and 13% (7/54) of laparoscopic repairs.

CONCLUSIONS

Both laparoscopic and open repair are equally safe in the management of PPU. Our findings support the view that this procedure can be successfully used as a training operation.
Temporary gastric neuromodulation for intractable nausea and vomiting
Authors: Ullah S , Arsalani-Zadeh R , Sedman P , Avery G , Duthie GS , MacFie J
Published: October 2011

INTRODUCTION

Gastric neuromodulation (GNM) has been advocated for the treatment of drug refractory gastroparesis or persistent nausea and vomiting in the absence of a mechanical bowel obstruction. There is, however, little in the way of objective data to support its use, particularly with regards to its effects on gastric emptying.

METHODS

Six patients (male-to-female ratio: 4:2, mean age: 49 years, range: 44–57 years) underwent the GNM between April and August 2010. Three patients had confirmed slow gastrointestinal transit. Aetiology included previous gastric surgery in two, diabetes in one and idiopathic nausea and vomiting in three patients. GNM pacing wires were placed endoscopically and left in situ for seven days. Pa-tients underwent gastric scintigraphy before and 24 hours after the commencement of GNM. Total gastroparesis symptom scores (TSS), weekly vomiting frequency scores (VFS), health-related quality of life (using the SF-12® questionnaire), gastric emptying, nutri-tional status and weight were compared before and after GNM.

RESULTS

TSS improved after GNM in comparison with baseline data. VFS improved in three of four symptomatic patients. The SF-12® physical composite score improved in four patients (27.5 vs 34.3) and the mental composite score improved in five patients (34.9 vs 35.9). All patients reported an improvement in oral intake. A significant weight gain (mean: 1kg, range: 0.3–2.4kg) was observed over seven days. Gastric emptying half-time improved in four patients.

CONCLUSIONS

GNM improved upper gastrointestinal symptoms, quality of life and nutritional status in patients with intractable nausea and vomiting. GNM merits further investigation.
Supporting surgical skills training in Brunei and Borneo
Authors: Singh Jagdeep K , Singh Pritam , Thomas William EG , Goodacre Tim , Smith Frank CT
Published: October 2011

Our visit began in Brunei, officially known as Brunei Darussalam, located on the north coast of Borneo, in south-east Asia. With a population of only 400,000 and as the third-largest oil producer in south-east Asia and the fourth-largest producer of natural gas, Brunei has the fourth-highest gross domestic product per capita in the world. With no income tax, free education, free healthcare and petrol cheaper than bottled water, Bruneians have an enviable quality of life. Under the governance of the Ministry of Health (MoH), each state has its own government hospital and rural areas are served by the Flying Medical Services division. Impressively, if a treatment is not available locally, for example organ transplantation, the MoH arranges treatment at overseas centres, often in nearby Singapore or Malaysia.
Flying the FGDP(UK) and RCS flags overseas
Authors: Ladwa Russ
Published: October 2011

They looked like baby dolls, until they moved, cried or opened their eyes – real babies in the 80-bed intensive care unit in the Narayana Hrudayalaya (NH) heart hospital in Bangalore, India. On my visit there in September 2011 I was overwhelmed by the sheer number of cardiac surgeries performed – more than 60 a day. Their cuttingedge diagnosis and matching aftercare bring some of the highest success rates in the world.
Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study
Authors: Williamson JS , Ingrams D , Jones H
Published: October 2011

INTRODUCTION

Laryngeal cancer treatment inherently affects life's most basic functions and significantly affects quality of life (QOL). We aimed to identify which aspects of QOL and which patients are most affected by the various treatment options.

METHODS

The University of Washington Quality of Life (UW-QOL) questionnaire was administered to all patients with laryngeal cancer treated at a single institution over a seven-year period (2003–2010).

RESULTS

In total, 41 patients responded. All had been treated for squamous cell carcinoma of the larynx. Questionnaires were completed at a median of 18.5 months after treatment. The overall quality of life was 81.1/100 as assessed by the UW-QOL scale, with only 4.9% reporting ‘poor’ or worse QOL. Neither patient age nor time after treatment significantly affected any aspect of QOL. Patients undergoing primary radiotherapy reported the best QOL. Those undergoing chemoradiotherapy or combined surgical treatment and chemoradiotherapy reported the worst QOL, particularly in terms of social eating, taste and saliva production. Patients with a T stage ≥2 and those with nodal metastases reported a significantly worse QOL.

CONCLUSIONS

Overall, QOL in our patients was good. This study highlights the aspects of QOL most affected by various treatments for laryngeal cancer and identifies areas in which therapeutic intervention may be focused. It also provides information to guide clinicians when assisting patients to make informed decisions regarding treatment of their head and neck cancer.
Clinical outcome of laparoscopic and open colectomy for right colonic carcinoma
Authors: Khan JS , Hemandas AK , Flashman KG , Senapati A , O'Leary D , Parvaiz A
Published: October 2011

INTRODUCTION

Laparoscopic colorectal surgery has gained widespread acceptance. While many studies have compared laparoscopic and open left-sided resections, there is limited literature on right colonic resections. We aimed to analyse the short-term outcome of laparoscopic (LRH) and open right hemicolectomy (ORH) in our unit.

METHODS

Consecutive patients undergoing elective right hemicolectomies over a period of 28 months were included in the study. No selection criteria were used to allocate the surgical approach. Study parameters included surgical technique, demographic details, ASA grade, body mass index (BMI), length of hospital stay (LOS), post-operative mortality and morbidity, readmission rate and histopathological data.

RESULTS

A total of 164 patients underwent right hemicolectomies during the study period (LRH: 89, ORH: 75). Both groups were comparable in age, sex, BMI, ASA grade, tumour stage and lymph node harvest. Four patients (4.5%) in the laparoscopic group required conversion to open surgery. In resections with curative intent, microscopic margins were positive in two patients (3%) in the ORH group compared to one (1%) in the LRH group. Seven ORH patients had an adverse post-operative outcome (three anastomotic leaks, four deaths); there were no deaths/immediate complications in the LRH group (p<0.05). The median LOS for LRH patients (4 days, range: 2–21 days) was significantly shorter than for ORH patients (8 days, range: 3–38 days) (p<0.0001, Mann–Whitney U test). By day 5, 77% of LRH patients were discharged compared with only 21% of patients in the ORH group. There were two readmissions (2.7%) in the ORH group and nine (10.1%) in the LRH group.

CONCLUSIONS

Our findings demonstrate advantages in favour of LRH in terms of a shorter hospital stay and reduced post-operative major complications. LRH is safe and should therefore be available to all patients requiring colonic resection.
Serotonin syndrome: take a closer look at the unwell surgical patient
Authors: Shaikh ZS , Krueper S , Malins TJ
Published: October 2011

This article describes the sequence of acute clinical deterioration seen in a head and neck oncology patient who developed serotonin syndrome perioperatively. It highlights the clinical dilemma that can be encountered when a septic picture masks the onset of serotonin syndrome and reinforces the importance of awareness of the potential interactions and side effects associated with drugs that surgeons prescribe. We discuss the pathophysiology, causal factors, clinical presentation and diagnosis of serotonin syndrome as well as highlighting some of the dilemmas that this condition presents in the surgical setting.
Strapped to the drainpipe: Emma Peel and the vinyl catsuit
Authors: Black Prudence , Driscoll Catherine
Published: October 2011

In 1965 Diana Rigg, aka Mrs Emma Peel, burst onto English television screens in the ‘spy-fi’ series The Avengers (Roy Baker, 1965) wearing, amongst other things, a skin-tight black vinyl catsuit. Her costumes offered a visual excess which reinforced the effects of the series’
highly stylized mise-en-scène. This visual excess was also played out in public life, where Mrs Peel’s clothes were available in retail outlets, and Diana Rigg as exemplary modern woman wore some of the styles both as public obligation and private pleasure. This article outlines
the way the catsuit, as worn by Mrs Peel, is part of a technological nexus: its fabrication, its implicit and imminent activity and its sexual narrative. In her catsuit Mrs Peel represents and manifests the modern technological body, and this clothed body became central to conflict in The
Avengers’ narrative. But despite being strapped to a drainpipe or bound into a catsuit Mrs Peel was always firmly in control.
Frame of reference: toward a definition of animation
Authors: Wells Brian
Published: October 2011

Some animation scholars assert that framing animation in a formal definition would necessarily impose intellectual limits on inquiry, while others contend that any definition wide enough to encapsulate the full gamut of ‘all things animated’ must be too wide to be meaningful.
International organizations of animation ‘experts’, who have taken on the responsibility of helping humankind to understand animation, fare poorly in terms of their commitment to the pursuit of a definition, citing ‘too wide a range’ of things qualifying as being animation,
and that forcing a definition could create dissonance within the animation community of scholars. Despite being experts however, the group will not formally say what properties or commonalities unite the things that they consider to be animated. After a pointed and persistent effort at uncovering
a definition through spirited queries and dialogue with these groups of animation experts, I was left with many unanswered questions. Why don’t international organizations of animation scholars believe that a definition of animation is necessary? Is a definition of animation necessary?
If these organizations of animation scholars cannot define animation, who can? Who will? If an ‘animated thing’ is part of a distinct group of ‘things that are animated’, then what are the properties of the thing that makes it a part of the group of ‘animated
things’? Moreover, who would benefit from a definition of animation, and who would not? The purpose of this article is to explore and discuss some of these questions, in the hope that knowledge and understanding will result from the central question: what is the core set of properties
that makes a thing ‘animated’?
Searching ‘In the Attic’: a visual production diary
Authors: Batra Jiri
Published: October 2011

This is a visual essay recording the production process of a 75-minute stop-motion feature animation, made in the spirit of traditional Czech puppet animation, but using mixed media techniques. It is a story called In the Attic: Who Has a Birthday Today? and though it is a children’s
animation, based on the way children conduct their games and imagine their play environment, it is also a political metaphor, reflecting upon past Czech history. The images in the essay show different aspects of production and reveal some of the approaches taken to achieve certain craft effects.
The film includes puppet animation, clay animation, cut-out animation and drawn animation; and uses post-production tools, but has no computer animation.
Poetics and public space: an investigation into animated installation
Authors: Bond Rose
Published: October 2011

We live in a society not only dominated by the screen but increasingly colonized by multiple moving-image ‘screens’. This article investigates aspects of the phenomenon of viewing multi-channel animated work that coexists with architecture. Referencing historic projections,
such as Glimpses of the USA by Charles and Ray Eames (1959) as well as my own animated installations, I raise questions on how the brain may be processing multiple images and explore the concept of light in a window from the perspective of Gaston Bachelard and Thomas Kincaid in order to suggest
differences between projecting on or projecting from – a difference between emanation and reflection. The article closes with brief thoughts on the window – illusion and collapse of 3D space, the image and the archetype and the idea of spectacle with content.
Animating by numbers: workflow issues in Shane Acker’s 9
Authors: Teevan Matthew
Published: October 2011

This is a short overview of Starz Animation’s production process for Shane Acker’s debut animated feature, 9. The film was challenging to make because it was done on a small budget and a limited time frame and required a high degree of invention and creativity to address
the issues raised without compromising the quality of the film. The piece details some of the ways in which we approached problems, and how we developed solutions, especially in relation to character design, art direction and workflow in the production pipeline. It seeks to offer an insight
about a smaller studio seeking to make a ‘Hollywood’-style animated feature that can stand up against the work of major studios like Pixar and Dreamworks, and also find a crossover audience in art cinema and festival circles.
Privatizing the public: Three rhetorics of art’s public good in ‘Third Way’ cultural policy
Authors: Hewitt Andy
Published: October 2011

This article considers the development of cultural policy as part of New Labour’s Third Way governance and identifies three rhetorics of state-funded art: art as a form of cultural democracy; art as an economic driver; and art providing solutions for social amelioration. The text
describes how the liberal conception of art and culture, i.e., having universal benefit as a public good, was extended to function within wider policy directives that were ultimately aimed at driving Third Way conceptions of public good. It provides a critique of the positivist claims for
state-funded art as producing social transformation and instead points to how art commissioned as part of culture-led regeneration was instrumental and complicit with an agenda of privatization and marketization. It suggests that this has had negative consequences for democracy.
From cultural populism to cool capitalism
Authors: McGuigan Jim
Published: October 2011

During the 1980s, cultural studies in Britain – and elsewhere – took an uncritical populist turn. The field of study had hitherto focused, with a distinctly oppositional orientation, upon the arts, popular and mass culture as sites of ideological contestation. Yet, increasing
concern with describing and indeed celebrating processes of cultural consumption – the active audience, resistance through rituals etc. – lost sight of economic and political struggle over the circulation of culture in society. This cultural populist tendency became less concerned
with questioning the status quo and unwittingly, in effect, endorsed neo-liberal development over the past thirty years. Mainstream cultural studies thus ceased to be a critical means of analysing the present cultural condition and tended, instead, to identify itself with it. That was possible
because the prevailing culture was incorporating the very kind of dissent that cultural studies as a field of research and education had sought to support and foster. The prevailing culture today is characterized in this article as cool capitalism. Tracing the historical transmogrification
of the meaning of ‘cool’, the article presents the concept of cool capitalism – the incorporation of disaffection into capitalism itself – and examines its origins in African-American culture, and its incorporation and neutralization over time, in order to characterize
the most pronounced features of mainstream culture around the world today. In conclusion, the article calls for a renewal of critique in the public interest that applies multidimensional analysis to a wide range of issues. The analytical purpose is to account adequately for the ontological
complexity of cultural circulation in various symbolic, economic, political and ecological contexts under neo-liberal capitalism. In this respect it aims to clarify the object of contestation for critical cultural intervention in the public sphere.
Advancing the study of place brands, tourism and reputation management
Authors: Morgan Nigel , Huertas Assumpció
Published: October 2011

This editorial provides an introduction to this special issue on tourism, place brands and reputation management. It explains the themes addressed in the following collection of articles and briefly locates the emerging field of place brand studies and identifies its origins in the
place promotion literature. The issue is conceived as a kind of open-ended exchange of ideas between scholars interested in tourism, place brands and cultural and communication studies in their widest sense, with the central focus being the further conceptualization and practical understanding
of the nature of place brands. The second part of the editorial briefly introduces each of the following articles that attempt to make progress in engaging with some of these important issues.
Place media events and place image communication: The role of festivals and special events from the perspective of media relations
Authors: Feng Bingqi , Dong Bing , Xu Taolong , Feng Ruofei
Published: October 2011

This article attempts to demonstrate the significant role played by festivals and special events in place image communication from the perspective of media relations through a review of the literature referring to place image and media relations. By developing the term ‘place
media event’, the authors arise a number of issues in place image communication. The authors argue that to win satisfactory uncontrolled media coverage, the importance of inner place image, media relations practitioners, media logic and routine media relations practices should been highlighted.
These factors determine the successful transformation of standard events into media events.
Tourism and cultural identity: Promoting Buenos Aires as the cultural capital of Latin America
Authors: Schettini Mariana Gómez , Troncoso Claudia Alejandra
Published: October 2011

Some urban areas in Buenos Aires were neglected for many decades by both public and private investment. As a result these areas underwent a process of degradation. However, in the last twenty years the city has undergone renewal processes and urban restructuring that have slowly redefined
different cultural and tourist enclaves. As part of this process, and in the context of a tourist boom, public and private investment flourished, rooted in new public policies whose main purpose was to promote cultural tourism. At the same time several cultural manifestations considered threatened
by globalizing forces were protected by heritage legislation. The main purpose of this article is to analyse the role of culture in tourism promotion of Buenos Aires. In particular, it examines the urban heritage and local identity valorization processes as part of tourism policies developed
specially during the 2000s.
Websites and place branding for seven Galician cities: An exploratory study
Authors: Míguez González María IsabelL
Published: October 2011

In this article, we analyse the content of the municipal and tourist websites of the seven main cities in Galicia. The aim was to assess the degree of development of their place branding strategies. Results indicate that graphic brands are not fully developed and functional, and emotional
brand attributes, despite being present on sites, are not optimized and thus do not contribute to city identification and differentiation.
Participatory methods and critical models: Arts, migration and diaspora
Authors: O’Neill Maggie
Published: October 2011

This article reflects on a ten-year trajectory of research, predominantly in the East Midlands, funded by the Arts and Humanities Research Council. The projects all employed participatory action research methods that involved working in partnership with forced migrants (those situated
in the asylum–migration nexus) and community arts organizations to explore the connections between arts, migration and diaspora. The article considers the benefits and issues surrounding this kind of creative, participatory and arts-based work in relation to the transformative potential
of art, narrativity and storytelling, and the processes and senses of belonging and place-making experienced by the participants. Key themes raised by the research include the tension between human rights, dignity and humiliation; the role of nation states in the production of refugees; the
wider context of globalization and neo-liberalism; and the possibilities for a radical democratic imaginary in arts-based research with migrants.
The emporium’s new clothes? The New Zealand-based ‘World of Wearable Art’ as a mobile urban imaginary
Authors: Perry Nick , Poulsen Ann
Published: October 2011

In 1987 a young artist named Susan Moncrief first organized a ‘wearable art’ show as a means of publicizing a local art gallery located in the small provincial New Zealand city of Nelson. Both the origins of the concept (clothing as art) and its practical expression were
very modest, but it subsequently became an annual event, growing in size and complexity and attracting ever more elaborate and ornate contributions. It is now officially designated as WOW, the World of Wearable Art, and features on government websites, attracting corporate sponsorship, prime
ministerial patronage, and extensive media coverage and contributions from a dozen countries. In this article its development and trajectory is interpreted as mediated in and through its relation to the dominant urban imaginaries and cultural aspirations of Wellington and Auckland as, respectively,
New Zealand’s political and economic capitals. For in 2005, the organizers determined that it had outgrown the infrastructural capacity of the location from which it had first derived. Thus, although Nelson now has a museum dedicated to the display of some of the works that have been
featured over the years, the event itself has migrated to Wellington as New Zealand’s capital city, where it attracts an audience of around 35,000. In WOW, ‘globalization from below’ thus engages with ‘globalization from above’, via an event in which conceptions
of the ‘local’, the ‘national’ and the ‘global’ are perforce both understood and contested.
Digitally printed textiles: A number of specific issues surrounding research
Authors: Carden Susan
Published: October 2011

The digital printing of textiles currently encompasses a wide range of processes, from craft related to technology based. As a result, artists, designers and craft practitioners are increasingly provided with new and exciting ways of combining and intertwining multiple layers of meaning
from within the handmade and the digital. This article focuses on doctoral research into some of the opportunities for, and consequences of, using craft practices as interventions in the digital printing of textiles.

The article discusses a number of issues surrounding research through
design (Frayling 1993: 1; Scrivener 2009: 76), and considers the impact that multiple materials, multiple processes and multiple technologies can have on practice. It seeks to explain why established research methods and methodologies are often inadequate for capturing and analysing the range
and depth of interactions that exist between the material and the immaterial in digitally printed textile design. It argues instead for the development of a new generic methodology to take advantage of advanced technologies and extend existing methods for the benefit of researchers, practitioner–researchers,
artists and designers, in order to bring the digital printing of textiles into line with established disciplines, such as those from the social sciences.
Young people's intentions about their political activity
Authors: Ross Alistair , Dooly Melinda
Published: October 2011

We discuss some implications for citizenship education, based on a survey of young people in four European countries in which they were asked how they think they will act politically when they are adult. The empirical sections of the article are based on a survey of 2,400 students aged
between 11–17 in 2008–2009 in Poland, Spain, Turkey and England. This study is discussed within the broader context of a widespread concern about a so-called 'democratic deficit', and in particular about the political apathy of youth. We suggest that young people appear to intend
to act in very similar ways as adults do. We raise questions about expectations of political activity, especially concerning particular kinds of political behaviour, about young people's own intentions, and about what might be an appropriate educational response to these intentions.