bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary Protein Intake in Elderly Women
Authors: Genaro Patrícia de Souza , Pinheiro Marcelo de Medeiros , Szejnfeld Vera Lúcia , Martini Lígia Araújo
Published: August 2014

Background: An inadequate food intake, mainly with regard to protein intake, seems to contribute to a reduction of skeletal muscle and bone mass in the elderly. This study was undertaken to evaluate differences in protein intake in women with or without sarcopenia and verify the intake level that is related to a better bone and muscle mass. Methods: Elderly women older than 65 years with sarcopenia (n = 35) and without sarcopenia (n = 165) participated in the study. Assessment of bone mineral density of the lumbar spine and femur was taken, body composition was evaluated by dual‐energy x‐ray absorptiometry, and an evaluation of protein intake was performed through 3‐day dietary records. Results: Muscle, bone, and fat mass was significantly higher in women who had protein intake >1.2 g/kg/d. A lower intake of essential amino acids in women with sarcopenia was also observed. Protein and energy intake were significant predictors of muscle mass. The presence of osteoporosis was a predictor of muscle strength. In conclusion, the present study demonstrated that in elderly women, an adequate protein intake in terms of quality and quantity, without need of supplementation, could have a positive impact on bone mineral density, lean mass, and skeletal muscle mass.
Young Arab Muslim Women’s Agency Challenging Western Feminism
Authors: Zimmerman Danielle Dunand
Published: August 2014

In a phenomenological study with 16 American and French Arab Muslim women attending college in the United States and France, all self-declared as religious and half of them wearing the hijab, participants express strong arguments against stereotypes of oppression and submission. They affirm agency and personal choice with respect to veiling, in a context of ambient skepticism that is often endorsed by Western feminism. Attention to intersectional experiences of Muslim women and reference to feminist models centered on non-Western women may help understand how second-generation Arab Muslim women experience and express agency.
Psychiatric Deinstitutionalization and Prison Population Growth
Authors: Kim Dae-Young
Published: August 2014

A substantial amount of research has been devoted to explaining the reasons behind the unprecedented explosion of U.S. prison populations. While the majority of prior studies related imprisonment to four factors—specifically crimes, changes in the labor markets, politics, and demographic changes—other relevant factors have not received as much attention. In the historical context of decreases in mental hospital populations resulting from psychiatric deinstitutionalization, imprisonment rates have skyrocketed nationwide since the late 1970s. This inverse relationship between both trends has called for prior research that empirically examines the impact of mental hospitalization on imprisonment, especially through the criminalization of mental illness. However, empirical findings are equivocal in general at the aggregate level. This article conducts a comprehensive and critical literature review, discusses the important conceptual and methodological limitations of the existing literature, and finally provides guidance for future research.
Monitoring of Outpatient Parenteral Antimicrobial Therapy and Implementation of Clinical Pharmacy Services at a Community Hospital Infusion Unit
Authors: Shah Punit J. , Bergman Scott J. , Graham Donald R. , Glenn Stephanie
Published: August 2014

Background:

In 2004, the Infectious Diseases Society of America (IDSA) published monitoring guidelines for outpatient parenteral antimicrobial therapy (OPAT), but no assessment of their utilization has been reported. We evaluated adherence to these recommendations by physicians at infusion centers and then piloted a program of supervision of monitoring by pharmacists.

Methods:

Phase I: We performed a retrospective case–control study of patients who received OPAT over 1 year at 2 hospital infusion centers. Controls were patients treated by an infectious diseases (ID) physician, and cases were those without an ID physician. Patients were excluded if they received fewer than 3 days of OPAT. Clinical pharmacy monitoring services were then implemented for patients on OPAT prescribed by non-ID physicians at 1 hospital’s infusion unit. Two outcomes were measured: adherence to guidelines on monitoring and attainment of goal vancomycin and aminoglycoside serum concentrations when appropriate. The results for non-ID physicians were compared to both ID physicians and subsequently a pharmacist.

Results:

Ninety-nine patients were included in the retrospective study. Compared with patients who had ID physician supervision, the non-ID physicians who prescribed OPAT for 39 patients had lower adherence to monitoring recommendations (35.9% vs 68.3%, P = .003). No difference could be detected in achievement of goal vancomycin and aminoglycoside serum concentrations for the 14 cases and 19 controls requiring therapeutic drug monitoring (57.1% vs 68.4%, respectively, P = .765). Seven patients were enrolled in the study after pharmacy monitoring was implemented. Adherence to monitoring recommendations for these patients was significantly improved compared to the prior patients who lacked ID physician supervision (35.9% vs 100%, P = .0065).

Conclusion:

Non-ID physicians are less likely to monitor OPAT according to the IDSA guidelines than ID physicians; however, pharmacist oversight improves adherence to recommendations. Further studies of monitoring of OPAT by pharmacists should investigate the impact of pharmacist involvement on prevention of adverse events and hospital readmissions.
Identifying and Communicating Clinically Meaningful Drug–Drug Interactions
Authors: Nelson Scott D. , LaFleur Joanne , Hunter Emily , Archer Melissa , Steinvoort Carin , Maden CarrieAnn , Oderda Gary M.
Published: August 2014

Objective:

Providing care to patients with comorbid medical problems may result in complicated, multiple drug therapy regimens, increasing the risk of clinically meaningful drug–drug interactions (DDIs). The purpose of this article is to describe the prevalence of DDIs and provide examples on how to identify and intervene on DDIs.

Methods:

We described DDI data from the Utah Drug Regimen Review Center, where adult Medicaid patients were reviewed by pharmacists from 2005 to 2009. Patients were selected by the number of prescriptions filled per month (>7) or having a high RxRisk score.

A total of 8860 patients were reviewed, and 16.6% had at least 1 clinically meaningful DDI. Patients with DDIs were slightly younger (mean age 45.2 vs 48.2), more likely to be female (75.0% vs 68.9%), and had more prescriptions per month (13.4 vs 12.5) compared to patients without ( P < .001). Pharmacodynamic DDIs were more prevalent (80.2%) than pharmacokinetic. Pharmacodynamic DDIs mainly occurred with drugs used to treat psychiatric/seizure/sleep disorders (69.4%) and pain/migraine (56.6%). Pharmacokinetic DDIs mainly occurred with drugs used to treat psychiatric/seizure/sleep disorders (53.2%), cardiovascular diseases (46.3%), and infectious diseases (29.6%).

Conclusions:

Clinically meaningful DDIs are common in patients with complex medication regimens. A systematic approach for identifying DDIs, determining clinical significance, formulating patient-specific recommendations, and communicating recommendations is important in pharmacy practice.
Pharmacists as Members of the Rapid Response Team
Authors: Groth Christine M. , Acquisto Nicole M.
Published: August 2014

Purpose:

Rapid response teams (RRTs) have been developed to provide early therapy to patients with risk factors for cardiopulmonary arrest. We sought to investigate the role a pharmacist could have as a member of the RRT.

Methods:

Two pharmacists trained in critical care and emergency medicine proposed a pilot program to determine whether a pharmacist as a member of the RRT could help to optimize pharmacotherapy and facilitate medication administration. During response, 1 pharmacist was at the bedside with the RRT for patient evaluation, consult, chart review, and to facilitate medication administration. The responding RRT pharmacist collected patient demographics, medications administered, pharmacotherapy recommendations, and time commitment.

Results:

The pharmacists responded to 32 RRT alerts. A majority (65.6%) of patients required at least 1 medication, and a total of 45 medications were administered. The pharmacists performed 49 pharmacotherapy-related interventions in 21 patients. These included medication facilitation (15), dose (15) or therapy (8) recommendations, and adding (6) or discontinuing (5) a medication. The pharmacists spent a median time of 15 minutes (interquartile range [IQR] 15, range 2-70) for each RRT alert and a total of 612 minutes (10.2 hours).

Conclusion:

With a minimal time commitment, pharmacists can be valuable members of the RRT.
Aripiprazole-Associated Hiccups
Authors: Silverman Melissa A. , Leung Jonathan G. , Schak Kathryn M.
Published: August 2014

Aripiprazole’s pharmacologic properties (including dopamine 2 and 5-hydroxytryptamine 1A [5HT1A] receptor partial agonism and 5HT2A receptors antagonism) may be associated with the onset of hiccups.

Case Description:

A 21-year-old, antipsychotic-naive patient with bipolar I disorder and remote brain trauma developed persistent hiccups following aripiprazole titration. Despite trials of metoclopramide and chlorpromazine, hiccups continued. Remission of hiccups occurred with discontinuation of aripiprazole.

Discussion:

The exact etiology of hiccups is unknown but likely involves dopamine and/or γ-butyric acid. Highlighting the uncertainty related to drug-induced hiccups is the fact that multiple antipsychotics have been reported to not only induce hiccups but also to alleviate them. As the development of persistent hiccups may result in extensive medical workup, clinicians should be aware of drug-associated causes including aripiprazole.
Introduction of a Continuing Professional Development Tool for Preceptors
Authors: Tofade Toyin , Kim Jane , Lebovitz Lisa , Leadon Kim , Maynor Lena , Culhane Nicole , Freeberry Mark , Harris JoAnn Stacy , Abate Marie
Published: August 2014

Accreditation Council for Pharmacy Education (ACPE) guidelines state that preceptors should “have a systematic, self-directed approach to their own continuing professional development (CPD).” The objective of this study was to encourage preceptors to take advantage of the ACPE CPD resources and implement the concept of CPD (reflect, plan, act, evaluate, record) as a framework for guiding individual preceptor’s continuing development as educators and to determine their opinion regarding the usefulness, effectiveness, and obstacles to implementation of this approach. A total of 3713 preceptors from the participating schools were encouraged to undergo CPD training and invited to respond to a series of questions. Of the initial respondents, 48% represented health system/hospital preceptors, followed by community/independent pharmacists (64 of 236, 28%). Preceptor respondents often train students from multiple schools/colleges (average = 1.9 schools/colleges per preceptor) and 90% agreed or strongly agreed with the statement, “the CPD model, as learned in the webcasts, is beneficial for ongoing preceptor development.” The general consensus was that the preceptor portfolio provided motivation to reflect, plan, and set more defined and realistic goals for students, residents, and themselves as educators and could be a valuable starting point for promoting preceptors’ reflection, planning, and action related to rotation management, professional teaching, and student learning goals.
Comparison of 2 Methods of Local Anesthetic-Based Injection as Part of a Multimodal Approach to Pain Management After Total Knee Arthroplasty
Authors: Tietje Teya , Davis Andrew B. , Rivey Michael P.
Published: August 2014

Background:

It is estimated that up to 50% of patients undergoing total knee arthroplasty (TKA) receive suboptimal postoperative pain management.

Methods:

In a retrospective study, 224 patients who underwent TKA between January 1, 2011, and September 30, 2012, were identified by surgical records for 2 surgeons at Community Medical Center in Missoula, Montana. Patient records were reviewed and data collected for patient hospital length of stay (LOS), postoperative opioid use, opioid-associated adverse events, and nonopioid analgesic use. Data were analyzed for differences in outcomes between patients who received an intraoperative intra-articular (IOIA) injection followed by a postoperative infusion (0.25%-0.5% bupivacaine) or an intraoperative periarticular (IOPA) injection (ropivacaine, ketorolac, epinephrine, and clonidine) for sustained analgesia after TKA.

Results:

Patients who received an IOPA injection had a statistically significant decrease in hospital LOS (67.0 vs 75.9 hours; P = .027) and postoperative nausea and vomiting (39.3% vs 54.9%; P = .023) when compared to patients who received an IOIA infusion. The incidence of having either oversedation or pruritus did not differ between groups (9.8% vs 9.8%; P = 1.00).

Conclusion:

The use of IOPA injections containing ropivacaine, epinephrine, ketorolac, and clonidine during TKA offered some benefit over IOIA infusions containing 0.25% to 0.5% bupivacaine at our institution.
Public pensions and the intergenerational politics of aging societies
Authors: Grafstein Robert
Published: August 2014

Nearly all modern public pension programs involve a substantial transfer of wealth from workers to retirees. If parents love their children, why are these intergenerational transfers politically sustainable? This paper develops a cross-national overlapping generations model to explore the impact of income mobility on the way workers and retirees calculate the long-term value of these programs to their children. Mobility affects their evaluations because these programs also redistribute intragenerationally. The analysis shows why a majority of rational voters who care about their descendants can insist on the preservation of current public pension benefits for themselves but accept a future reduction. Implications of this explanation are tested using comparative intergenerational mobility data and a 2001 Eurobarometer survey on pensions.
Design and implementation of a new statically balanced mechanism for slider-type desktop monitor stands
Authors: Hsiu Wei-Hsiang , Syu Fong-Ci , Kuo Chin-Hsing
Published: August 2014

A desktop monitor stand is a device that supports the weight of a desktop monitor. The statically balanced mechanism within the stand can help the monitor travel to and stop at any different positions, i.e. in a state of static equilibrium at any position. The current statically balanced mechanisms used in the slider-type desktop monitor stands can be classified into two types. The first type integrates a cam and a spring as a statically balanced mechanism for which the cam profile machining could be costly. On the other hand, the second type utilizes a constant-force spring for balancing the weight of the monitor, but the springs must be tailor-made, which costs more. In this paper, a new statically balanced mechanism for slider-type desktop monitor stands is presented. The shown design uses common links and general spring only, which introduces a breakthrough advantage for reducing the manufacturing cost of the monitor stands. Furthermore, the kinematic and force analyses of the proposed design are carried out, and the mechanism dimension is determined via optimization technique. A prototype of the design is made up, and the experimental test in a practical monitor stand is done. As a result, the proposed mechanism can allow the monitor to remain statically balanced at any working position, which proves that the presenting design is practically workable.
Short fatigue crack initiation and growth modeling in aluminum 7075-T6
Authors: Amiri M , Modarres M
Published: August 2014

A series of fatigue tests is carried out to investigate the behavior of microcrack initiation and propagation in Al 7075-T6. Plate specimens with semi-circular single edge notch are tested under uniaxial loading at different load amplitudes. Optical microscopy is used to detect the initiation and growth of short cracks. Continuum damage mechanics is used to model the crack initiation. After the initiation, crack growth is studied using fracture mechanics models. For both regions of crack initiation and growth, Bayesian estimation method is used to account for uncertainties in the parameters of the model. Results of the entire fatigue life, including initiation and growth, are compared with experiments. Good agreement is observed.
Nonlinear dynamic study and vibration reduction of a power turret gear train with modified design parameters
Authors: Xu Lijiao , Chen Nan
Published: August 2014

This work presents the nonlinear dynamic characteristics and vibration reduction of a numerical control power turret three-stage gear transmission system composed of four spur gears. Considering translational and rotational motions, the nonlinear lumped-parameter and multi-degrees of freedom models of modified and unmodified transmission systems are introduced to study the dynamic behavior while the time-varying mesh stiffness and backlash of gear mesh pairs are involved as internal excitations. For the requirement of high speed and low vibration, high contact ratio by modifying design parameters is suggested in this study. By numerical method, the dynamic vibration responses are calculated. Results in the time and frequency domains show that the vibration amplitudes and mesh forces are efficiently decreased after modification. The influences of key parameters, such as mesh stiffness, damping, backlash, and torque on the dynamic response are also studied here. To demonstrate the effectiveness of the proposed model, the vibration tests are conducted by two physical prototypes of the power turret. The values of vibration acceleration at different tests points and speeds are obtained and analyzed. Experimental results validate that the vibration of turret is decreased by the design improvement of gear system.
Everyday urban violence and transnational displacement of Colombian urban migrants to London, UK
Authors: McIlwaine Cathy
Published: August 2014

Most research on the mobility outcomes of violence focuses on Internally Displaced Peoples (IDPs) or refugees displaced in response to armed conflict. The influence of everyday urban violence on population movements has been largely invisible, especially transnationally. This paper addresses these issues in relation to transnational migration and displacement among Colombians in the United Kingdom. Cities in the global South have porous violence boundaries in terms of rural–urban linkages but also with regard to the more neglected dimension of transnational migration, a crucial response to everyday urban violence and less directly influenced by armed conflict. The paper also highlights transnational linkages between countries, forged and maintained especially through remittances that fund security infrastructure back home as well as further migration. The notion of displacement also encapsulates how fear and security in cities in the South are often transformed into anxiety and the experience of discrimination among those with no legal papers in cities such as London.
Gangs in global perspective
Authors: Winton Ailsa
Published: August 2014

As processes and patterns of organized violence across different contexts continue to take new and complex turns, this paper takes stock of some of the most important trends to emerge in research on gangs in recent years. Shifting social, political and economic conditions and diverse systemic shocks continue to interweave with often dynamic and flexible organizational and operational gang structures, contributing to ever more complex landscapes of violence. In addition, the increasingly blurred boundaries between violent groups at local, national and even regional scales have complicated attempts to disentangle and distinguish different violent actors and institutions. The paper grapples with contemporary dynamics of violence, conflict and gangs, considering both change and continuity. It highlights the need to continue developing research and interventions that move beyond pre-existing, inappropriate or exaggerated understandings of gangs, by engaging with the increasing blurring between different violent groups and the complex relationships between gangs, the state and society, so capturing the fluidity of gang identities and motivations.
Does dropping day 5 PEP follow-up affect outcomes? An audit of HIV post-exposure prophylaxis at a central London sexual health clinic
Authors: O’Keeffe C , Nwokolo N , McOwan A , Whitlock G
Published: August 2014

UK post-exposure prophylaxis (PEP) guidelines were updated by the British Association for Sexual Health and HIV (BASHH) in 2011. In 2013, we changed policy to omit day 5 PEP follow-up at 56 Dean Street as it was felt clinically unnecessary. This audit compares our performance against BASHH standards for PEP attenders during June 2012 and June 2013. We identified 162 PEP prescriptions; PEP assessment and appropriate sexually transmitted infection testing was done well. PEP completion rates and post-PEP HIV testing were lower than BASHH standards. Following omission of day 5 review, documentation that results have been checked was poor; however, attendance at follow-up was not adversely affected.
Measuring patient satisfaction: three years’ data and experience of using a validated patient questionnaire
Authors: Challenor Rachel , Perry Ryan
Published: August 2014

A validated patient satisfaction questionnaire for use in sexual health clinics was run throughout the southwest region (the UK) three times over three years (13 clinics in January 2012 and 12/13 clinics in January 2013 and the same 12 clinics again in January 2014). The questionnaire covered aspects of pre-appointment, performance of health care professionals, facilities, privacy, respectful communication, information on leaving and overall experience. Data from 1750 questionnaires are presented with means and 95% confidence intervals. Patients under the age of 25 were less likely to rate care as excellent and/or very good ( P = 0.001) compared with those above the age of 25. There was no difference in satisfaction levels according to gender or sexual orientation. Time in clinic was strongly associated with satisfaction levels – those in clinic for over 90 min expressed less satisfaction ( P = 0.0005). We hope that other clinics may find it useful to use the validated questionnaire to look at their own performance and compare it against the southwest data. The main value is to identify areas where changes to service delivery could translate into improved practice and improved satisfaction, particularly where performance is identified as less than the 95% confidence intervals.
Palaeo-oceanographic development and human adaptive strategies in the Pleistocene–Holocene transition: A study from the Norwegian coast
Authors: Breivik Heidi Mjelva
Published: August 2014

The human colonization of Norway occurred in the Pleistocene–Holocene transition – one of the most abrupt and severe climatic shifts in human history. For 1500 years (9500–8000 bc), the whole coast was occupied by mobile, marine-oriented hunter-gatherers. This paper explores dynamic relations between human adaptation and marine environmental variations in this period. An updated record of archaeological sites and palaeo-oceanographic data suggests a correlation between marine productivity and site distribution and density. The data further demonstrate spatial and temporal differences in the environment. A cooling pulse at 9300–9200 bc (the Preboreal Oscillation) with widespread ecological consequences must have been noticeable to humans occupying Norwegian landscapes. A more gradual shift occurred around 8800 bc when the arctic climate gave way to warmer conditions: The Norwegian Atlantic current stabilized, all fjord systems became ice-free, and animal diversity increased. In the northernmost region, the impact of Atlantic water was less severe, and Polar conditions with more sea ice seem to have lingered throughout the period. Variations in the site pattern may be related to these fluctuations in the resource situation. Variations in the lithic industry, on the other hand, seem to be connected to technological choices or local traditions, rather than environmental dissimilarities. The archaeological record indicates that the lifestyle, which developed under arctic conditions, was maintained through a flexible mobility pattern and a versatile tool technology, but the Norwegian coast also provided a good base to uphold such a lifestyle.
Anti-ribosomal P antibodies are associated with elevated circulating IFNα and IL-10 levels in systemic lupus erythematosus patients
Authors: Mozo L , López P , Caminal-Montero L , Rodríguez-Carrio J , Suárez A
Published: August 2014

Objective

The objective of this paper is to analyze the relationship of anti-protein ribosomal P (RibP) antibodies with circulating levels of IFNα, TNFα, IFNγ, IL-17 and IL-10 in SLE. Disease activity and other systemic lupus erythematosus (SLE) features were also analyzed.

Methods

Anti-RibP and other SLE-related antinuclear antibodies (ANA) were determined by fluoro-enzyme immunoassay in the sera of 107 SLE patients. Circulating cytokines were quantified by flow cytometry (IFNα, IL-10 and IL-17) or ELISA (TNFα and IFNγ).

Results

Anti-RibP-positive patients (14.9%) displayed significantly higher serum levels of IFNα ( p = 0.023) and IL-10 ( p = 0.016) than their negative counterparts. This cytokine upregulation was independent of the presence of other ANA even though, in our patient cohort, anti-dsDNA was found to be associated with anti-RibP (OR, CI 95%: 6.03, 1.32–27.93, p = 0.021) and to correlate with IL-10 levels ( r = 0.204, p = 0.036). In fact, patients positive for anti-RibP but negative for anti-dsDNA exhibited the highest amounts of both IL-10 and IFN-α that were not related to disease activity since these patients showed lower SLEDAI than patients also positive for anti-dsDNA ( p = 0.018). Anti-RibP positivity was also associated with early diagnosis, hypocomplementemia and leukopenia.

Conclusions

Presence of anti-RibP was found to be related to increased serum IFNα and IL-10 levels independently of both antibody status and disease activity.
A nationwide study of SLE in Japanese identified subgroups of patients with clear signs patterns and associations between signs and age or sex
Authors: Terao C , Yamada R , Mimori T , Yamamoto K , Sumida T
Published: August 2014

We performed a nationwide study to determine the distributions of the signs and clinical markers of systemic lupus erythematosus (SLE) and identify any patterns in their distributions to allow patient subclassification. We obtained 256,999 patient-year records describing the disease status of SLE patients from 2003 to 2010. Of these, 14,779 involved patients diagnosed within the last year, and 242,220 involved patients being followed up. Along with basic descriptive statistics, we analyzed the effects of sex, age and disease duration on the frequencies of signs in the first year and follow-up years. The patients and major signs were clustered using the Ward method. The female patients were younger at onset. Renal involvement and discoid eczema were more frequent in males, whereas arthritis, photosensitivity and cytopenia were less. Autoantibody production and malar rash were positively associated with young age, and serositis and arthritis were negatively associated. Photosensitivity was positively associated with a long disease duration, and autoantibody production, serositis and cytopenia were negatively associated. The SLE patients were clustered into subgroups, as were the major signs. We identified differences in SLE clinical features according to sex, age and disease duration. Subgroups of SLE patients and the major signs of SLE exist.
How did the fracking controversy emerge in the period 2010-2012?
Authors: Mazur Allan
Published: August 2014

In 2010-2012, the controversy over fracking grew rapidly, first in the United States, and then internationally. An important step was the anti-fracking documentary film Gasland. With help from celebrity sources, the film was produced and won a prize at the Sundance Film Festival by early 2010 and had an Oscar nomination by early 2011, in the meantime popularizing potent images of hazard including tainted aquifers and ignitable water running from kitchen faucets. During this period, major US news organizations paid little attention to the issue. The offshore Deepwater Horizon disaster of April 2010 spurred The New York Times to prolific reporting on potential risks of the new onshore technique for extracting shale gas. With flagship news coverage, the controversy had by 2012 gained wide media attention that evoked public concern and opposition, spreading from the United States to other nations.
Student nurses’ experiences of undignified caring in perioperative practice – Part II
Authors: Willassen Elin , Blomberg Ann-Catrin , von Post Iréne , Lindwall Lillemor
Published: August 2014

Background:

In recent years, operating theatre nurse students’ education focused on ethics, basic values and protecting and promoting the patients' dignity in perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient’s care during surgery.

Objective:

The objective of this study was to present what operating theatre nursing students perceived and interpreted as undignified caring in perioperative practice.

Research design:

The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan’s critical incident technique.

Participants and research context:

Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation.

Ethical considerations:

The study was approved by the Karlstad University's Research Ethics Committee.

Findings:

The findings show careless behaviour and humiliating actions among health professionals. Health professionals commit careless acts by rendering the patient invisible, ignoring the patient’s worry and pain and treating the patient as an object. They also humiliate the patient when speaking in negative terms about the patient’s body, and certain health professionals blame the patients for the situation they are in. Health professionals lack the willingness and courage to protect the patient’s dignity in perioperative practice.

Discussion:

In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act.

Conclusion:

The findings reveal that patients were exposed to unnecessary suffering; furthermore, the operating theatre nurse students suffered an inner ethical conflict due to the undignified caring situations they had witnessed.
Prevalence and Risk Factors of Respiratory Symptoms Among Home-Based Garment Workers in Bangkok, Thailand
Authors: Chumchai Pornlert , Silapasuwan Pimpan , Wiwatwongkasem Chukiat , Arphorn Sara , Suwan-ampai Plernpit
Published: August 2014

This study aimed to determine the prevalence and risk factors associated with respiratory symptoms. A cross-sectional study with random sampling method was employed and 300 home-based garment workers (HBGWs) were recruited. Risk factors, including personal factors; knowledge, health preventive behaviors, and skill of self-health surveillance, working condition, and respiratory symptoms were assessed. Data were collected using self-reported questionnaires. Prevalence of respiratory symptom was 22.3%. Majority of participants were female (78%). Mean age and working experience were 37.38 years (SD = 10.70) and 13.58 years (SD = 8.71), respectively. Allergic respiratory symptoms (odds ratio [OR] = 16.5; 95% confidence interval [CI] = 8.61-31.7) and garment dust exposure (OR = 12.3; 95% CI = 6.49-23.3) were significantly associated with respiratory symptoms ( P < .001). Logistic regression analysis indicated history of allergic predicted the respiratory symptoms (OR = 12.96; 95% CI = 4.24-39.55). HBGWs who had serious allergic symptoms and high exposure to dust were at risk of respiratory symptoms. Therefore, preventive program for garment dust exposure among HBGWs is needed.
Design, fabrication, and benchtop testing of a helicopter rotor blade section with warp-induced spanwise camber variation
Authors: Mistry Mihir , Gandhi Farhan
Published: August 2014

This article focuses on the design, fabrication, testing, modeling, and validation of a spanwise variable camber section of a helicopter rotor blade. The lower surface skin was slit aft of the trailing edge spar and subjected to a spanwise warping actuation input. A kinematic linkage facilitates a corresponding chordwise motion of the skin along the span length (from zero at the no-camber end to maximum at the maximum camber end). Input warping actuation of 0.18 in length produced an 18° camber variation over a 45 in span section of a modified CH-46 blade. Finite element model predictions of the active camber section showed good agreement with benchtop test data for both the output camber for a given warping actuation input and the corresponding actuation force required. Finite element results suggest that some geometry distortions in the active camber section could be experienced due to the presence of centrifugal and aerodynamic loads, but these distortions could be alleviated with the introduction of a shear-flexible (but stiff through the thickness) core.
Quality Assessment of Acute Inpatient Pain Management in an Academic Health Center
Authors: Lin Richard J. , Reid M. Carrington , Chused Amy E. , Evans Arthur T.
Published: August 2014

The quality of acute inpatient pain management remains suboptimal and poorly understood. In this retrospective study, we analyze acute pain management practice in a large academic health center using several quality indicators. Not surprisingly, despite high rate of pain assessment, many patients still have frequent, prolonged, and unrelieved severe pain episodes. Upon examination of naloxone administration, we identify potential inappropriate opioid prescription practices such as the use of wrong opioids in hepatic and renal failure and simultaneous use of multiple short-acting opioids. Most importantly, we find that chronic opioid users appear to suffer the most in terms of undertreatment of pain as well as opioid overdose, highlighting the urgent need to target this underserved population of patients.
Validity of Arabic Version of Beliefs About Medication Questionnaire
Authors: Alhalaiqa Fadwa , Masa’Deh Rami , Batiha Abdul-Monim , Deane Katherine
Published: August 2014

To assess the validity and reliability of the Arabic version of the Beliefs About Medication Questionnaire, a cross-sectional design was used and the data were collected from 605 patients with chronic diseases. The study was conducted between July 2013 and December 2013. The results showed that the Cronbach’s alpha coefficient (.71) was satisfactory. There was a significant strong positive correlation between test–retest for the same group subsample, with a correlation coefficient range of .45 to .78. There were no statistically significant differences between retest subgroups and remaining samples in the questionnaire subscales. The percentage of missing value was around 0.03, which confirmed the feasibility of the Arabic version of the questionnaire. These findings suggested that having a culturally acceptable, valid and reliable instrument to identify patients’ beliefs toward medication in Jordan will play an important role in tailoring appropriate intervention to enhance patient compliance with their prescribed medication.
Intraosseous Fixation Compared to Plantar Plate Fixation for First Metatarsocuneiform Arthrodesis
Authors: Roth Klaus Edgar , Peters Jennifer , Schmidtmann Irene , Maus Uwe , Stephan Daniel , Augat Peter
Published: August 2014

Background:

Metatarsocuneiform (MTC) fusion is a treatment option for management of hallux valgus. We compared the biomechanical characteristics of an internal fixation device with plantar plate fixation.

Methods:

Seven matched pairs of feet from human cadavers were used to compare the intramedullary (IM) device plus compression screw to plantar plate combined with a compression screw. Specimen constructs were loaded in a cyclic 4-point bending test. We obtained initial/final stiffness, maximum load, and number of cycles to failure. Bone mineral density was measured with peripheral quantitative computed tomography. Performance was compared using time to event analysis with number of cycles as time variable, and a proportional hazard model including shared frailty model fitted with treatment and bone mineral density as covariates.

Results:

On average the plates failed after 7517 cycles and a maximum load of 167 N, while the IM-implants failed on average after 2946 cycles and a maximum load of 69 N. In all pairs the 1 treated with IM-implant failed earlier than the 1 treated with a plate (hazard ratio for IM-implant versus plate was 79.9 (95% confidence interval [6.1, 1052.2], P = .0009). The initial stiffness was 131 N/mm for the plantar plate and 43.3 N/mm for the IM implant. Initial stiffness ( r = .955) and final stiffness ( r = .952) were strongly related to the number of cycles to failure. Bone mineral density had no effect on the number of cycles to failure.

Conclusion:

Plantar plate fixation created a stronger and stiffer construct than IM fixation.

Clinical Relevance:

A stiffer construct can reduce the risk of nonunion and shorten the period of non-weight-bearing.
The X-Linked Hypothesis of Brain Disorders
Authors: Turkheimer Federico E. , Bodini Benedetta , Politis Marios , Pariante Carmine M. , Ciccarelli Olga , Yeo Ronald A.
Published: August 2014

In this article, we propose an X-linked hypothesis of brain disorders that postulates a neuronal origin of those neurodegenerative and psychiatric disorders with a greater male prevalence. The hypothesis is based on the accumulated genetics and genomic evidence linking X chromosome genes and transcripts to neuronal cells. The behavioral genetics literature has long pointed to the link between postsynaptic protein complexes coded on chromosome X and mental retardation. More recently, novel genomic evidence has emerged of X-linked mRNA overexpression of neuronal source in the human brain. We review the evidence for this hypothesis and its consistency with the distribution across genders of brain disorders of known aetiology. We then provide examples of the utilization of this hypothesis in the investigation of the pathophysiology of complex brain disorders in both the stratification of disease cohorts and the development of realistic preclinical models. We conclude by providing a general framework for testing its validity, which will be exploited in future studies, and provide future directions for research.
Endothelial Protein C Receptor Gene Variants and Risk of Thrombosis
Authors: Anastasiou Georgia , Politou Marianna , Rallidis Loukianos , Grouzi Elisavet , Karakitsos Petros , Merkouri Efrosini , Travlou Anthi , Gialeraki Argyri
Published: August 2014

Endothelial protein C receptor (EPCR) is a candidate mediator in the pathogenesis of thrombosis, as several data in the literature indicate that polymorphisms such as EPCR 4678G/C and 4600A/G are associated with either protective effect or increased risk of thrombosis, respectively. We investigated the prevalence of these polymorphisms in patients with thrombotic disorders as well as their impact on the risk of thrombosis, the age of first thrombotic episode, and recurrence. The prevalence of the rare EPCR alleles 4600G and 4678C was comparable in patients and controls. However, in a subset analysis, we observed that 4600G allele was more prevalent among patients who developed thrombosis at younger age (<35 years). Moreover, the prevalence of 4678C allele was significantly lower in younger patients compared to older patients. Neither polymorphism seemed to have an impact on recurrence regardless of age. Soluble EPCR levels were elevated in 4600AG patients compared to controls while 4678CC patients presented with lower levels of soluble form of EPCR compared to carriers of at least 1 4678G allele. Our data suggest that either the lack of the protective EPCR 4678C allele or the presence of EPCR 4600G allele may be associated with earlier development of thrombosis.
Being in the Second Iraq War
Authors: Hanauer David Ian
Published: August 2014

Utilizing the methodology of poetic ethnography, the current article presents a U.S. soldier’s narrative of his experiences during the second Iraq war in 2003. The study provides a methodological, ethnographic platform through which remembered lived experiences of the Iraq war from the perspective of one U.S. soldier can be presented for examination and reflection. This political, critical ethnography attempts to offer a counterweight to prevalent rhetorical constructions of the Iraq war and its participants. The study follows the development and psychological contortions of one soldier as he moves through and expresses his remembered experiences and raises serious questions about the ways in which this soldier was positioned and manipulated and his response to these nearly incomprehensible events. This poetic ethnography aims to add to the growing literature on the very real complexities of what war actually means to all those who participate in it.
Organizing Sustainability and the Problem of Scale
Authors: Perey Robert
Published: August 2014

Organizing for sustainability seeks systems change at a global level. This objective is captured in the phrase “Think global, act local”; the assumption is that global change will happen through summative local action. This article argues that local action will not necessarily produce systems change and that a new scale-independent categorization for interacting with systems is needed. I introduce the concept of fractal as a useful tool for engaging with problems of scale in organizational settings and argue that change for sustainability needs to be framed as a fractal narrative in order to facilitate implementation success.
The Effect of the District of Columbia’s Assessment Limitation on Property Tax Equity
Authors: Sjoquist David L.
Published: August 2014

In 2002, the District of Columbia implemented the Residential Property Tax Credit program. This program, while technically a credit, is in effect a property tax assessment limitation that applies to owner-occupied housing. Initially, the maximum growth in net assessed value was set at 25 percent, but is now 10 percent. Property tax assessment limitations are expected to create significant variations in net taxable assessments across property, both vertically and horizontally, and we explore the extent of the variations created by the assessment limitation in the District of Columbia. We find substantial variations, both vertically and horizontally. We also explore explanation for the magnitude of the variations.
The central role of mitochondria in axonal degeneration in multiple sclerosis
Authors: Campbell Graham R , Worrall Joseph T , Mahad Don J
Published: August 2014

Neurodegeneration in multiple sclerosis (MS) is related to inflammation and demyelination. In acute MS lesions and experimental autoimmune encephalomyelitis focal immune attacks damage axons by injuring axonal mitochondria. In progressive MS, however, axonal damage occurs in chronically demyelinated regions, myelinated regions and also at the active edge of slowly expanding chronic lesions. How axonal energy failure occurs in progressive MS is incompletely understood. Recent studies show that oligodendrocytes supply lactate to myelinated axons as a metabolic substrate for mitochondria to generate ATP, a process which will be altered upon demyelination. In addition, a number of studies have identified mitochondrial abnormalities within neuronal cell bodies in progressive MS, leading to a deficiency of mitochondrial respiratory chain complexes or enzymes. Here, we summarise the mitochondrial abnormalities evident within neurons and discuss how these grey matter mitochondrial abnormalities may increase the vulnerability of axons to degeneration in progressive MS. Although neuronal mitochondrial abnormalities will culminate in axonal degeneration, understanding the different contributions of mitochondria to the degeneration of myelinated and demyelinated axons is an important step towards identifying potential therapeutic targets for progressive MS.
How do religious norms diffuse? Institutional translation and international change in a post-secular world society
Authors: Bettiza Gregorio , Dionigi Filippo
Published: August 2014

This article draws from Habermasian post-secular theory to broaden the scope of Constructivist research on norm dynamics beyond its current Western-centric focus. In an increasingly post-secular world society, we conceptualize the mechanism of institutional translation to explain processes of norm diffusion whereby culturally situated ‘thick’ norms acquire a ‘thinner’ ethical status via a dialogical process of normative contestation across diverse ethical perspectives. Institutional translation differs from, but also complements, mechanisms of norm diffusion, such as persuasion and localization, by illustrating how norms conceived and promoted by non-Western religious-based actors can acquire global legitimacy within the institutions of the international liberal order. The article investigates the explanatory value of this framework through an empirical analysis of two contrasting cases of norm promotion by the Organization of Islamic Conference at the United Nations. The first case considers the global diffusion of the norm of dialogue of civilizations as an example of successful institutional translation. The second case illustrates the failed diffusion of the norm against the defamation of religion as an instance of unsuccessful institutional translation.
Ontology, epistemology, and irony: Richard Rorty and re-imagining pragmatic criminology
Authors: Wheeldon Johannes
Published: August 2014

In this article I apply Richard Rorty’s view of pragmatism to contemporary criminology through the lens of ontology and criminological theory, epistemology and methodological decision making, and irony in the neo-liberal academy. Although pragmatism in criminology is often used to refer to practical criminal justice suggestions drawn from conservative theories of criminology, in this article I argue that this singular use is an affront to pragmatism’s philosophical pedigree. Consonant with pragmatism, this article includes practical suggestions about how Rorty’s approach can be adapted to teach criminological theory, advance mixed methods research, and acknowledge the dangers inherent in careerist criminology.
The significance of religious imagery in The Philosophy of Money
Authors: Silver Daniel , O’Neill Kristie
Published: August 2014

This article seeks to understand a puzzling aspect of Georg Simmel’s The Philosophy of Money, namely, the many religious analogies Simmel uses to characterize money. We argue that with these analogies Simmel indicates how what he would later term ‘the transcendent character of life’ permeates mundane monetary interactions. Specifically, we articulate how key religious forms of experience – faith, unity, and individuality – exist in monetary exchange and point toward a distinctively Simmelian way to understand the interplay between religion and economics.