bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine for Adolescents With Type 1 Diabetes
Authors: Dougherty Jennifer P. , Lipman Terri H. , Hyams Sandra , Montgomery Kathleen A.
Published: April 2014

Diabetes is the third most common chronic disease in the pediatric population and diabetes management in adolescents presents a unique challenge for health care providers. The purpose of this article is to define telemedicine, review a variety of telemedicine intervention studies in the adolescent population, and interpret those results in the context of the current health care climate. Clinicians and researchers will be provided with education related to adolescent needs and telemedicine interventions so that telemedicine can be used effectively to promote the health of adolescents with diabetes. Because telemedicine has yet to demonstrate consistent and significant positive outcomes in this population, further research and continued development of technology are essential to improve diabetes control in adolescents and prevent the long-term complications of this disease.
Glomus tumor of the trachea
Authors: Masoum Seyyed Hossein Fattahi , Jafarian Amir Hossein , Attar Ali Reza Sharifian , Attaran Davood , Afghani Reza , Noghabi Azadeh Jabbari
Published: April 2014

Glomus tumors of the trachea are rare and benign, but most become symptomatic, so they need intervention. A 21-year-old man was evaluated due to cough and hemoptysis. Computed tomography and bronchoscopy showed a polypoid mass above the carina. The tumor was removed completely by rigid bronchoscopy. The pathologic diagnosis was glomus tumor. After one year, because of recurrence of the tumor at the same site, the patient underwent reoperation, and resection and anastomosis of trachea through a right posterolateral thoracotomy was performed.
Factors associated with atrial fibrillation in rheumatic mitral stenosis
Authors: Pourafkari Leili , Ghaffari Samad , Bancroft George R , Tajlil Arezou , Nader Nader D
Published: April 2014

Background

Atrial fibrillation is a complication of mitral valve stenosis that causes several adverse neurologic outcomes. Our objective was to establish a mathematical model to predict the risk of atrial fibrillation in patients with mitral stenosis.

Methods

Of 819 patients with mitral stenosis who were screened, 603 were enrolled in the study and grouped according to whether they were in sinus rhythm or atrial fibrillation. Demographic, echocardiographic, and hemodynamic data were recorded. Logistic regression models were constructed to identify the relative risks for each contributing factor and calculate the probability of developing atrial fibrillation. Receiver operating characteristic curves were plotted.

Results

Two hundred (33%) patients had atrial fibrillation; this group was older, in a higher functional class, more likely to have suffered previous thromboembolic events, and had significantly larger left atrial diameters, lower ejection fractions, and lower left atrial appendage emptying flow velocity. The factors independently associated with atrial fibrillation were left atrial strain (odds ratio = 7.53 [4.47–12.69], p < 0.001), right atrial pressure (odds ratio = 1.09 [1.02–1.17], p = 0.01), age (odds ratio = 1.14 [1.05–1.25], p = 0.002), and ejection fraction (odds ratio = 0.92 [0.87–0.97], p = 0.003). The area under the curve for the combined receiver operating characteristic for this model was 0.90 ± 0.12.

Conclusion

Age, right atrial pressure, ejection fraction, and left atrial strain can be used to construct a mathematical model to predict the development of atrial fibrillation in rheumatic mitral stenosis.
General practitioners’ perspectives on the avoidability of hospitalizations at the end of life: A mixed-method study
Authors: De Korte-Verhoef Maria C , Pasman H Roeline W , Schweitzer Bart PM , Francke Anneke L , Onwuteaka-Philipsen Bregje D , Deliens Luc
Published: April 2014

Background:

Many patients are hospitalized in the last months of life. Little is known about the avoidability of these hospitalizations.

Aim:

To explore whether and how hospitalizations could have been avoided in the last 3 months of life and barriers to avoid this, according to general practitioners in the Netherlands.

Design:

Sequential mixed-method design, starting with a cross-sectional nationwide questionnaire study among general practitioners, followed by in-depth interviews.

Setting/participants:

General practitioners were asked about their most recent patient who died non-suddenly and who was hospitalized in the last 3 months of life. Additionally, 18 of these general practitioners were interviewed in depth about the situation surrounding hospitalization.

Results:

According to 24% of 319 general practitioners, the last hospitalization in the final 3 months of their patient’s life could have been avoided. Of all avoidable hospitalizations, 46% could have been avoided by proactive communication with the patient, 36% by more communication between professionals around hospitalization, 28% by additional care and treatment at home, and 10% by patient and family support. In the in-depth interviews, general practitioners confirmed the aforementioned strategies, but also mentioned various barriers in daily practice, such as the timing of proactive communication with the patient, incompleteness of information transfer in acute situations, and the lack of awareness among patients and family that death was near.

Conclusion:

A proactive approach could avoid some of the hospitalizations at the end of life, in the opinion of general practitioners. More insight is needed into communication and psychological barriers for timely discussions about end-of-life issues.
Naltrexone implant treatment for buprenorphine dependence – Mauritian case series
Authors: Jhugroo Anil , Ellayah Darmen , Norman Amanda , Hulse Gary
Published: April 2014

Although substitution therapy with opiate agonist treatments such as methadone and buprenorphine has resulted in a reduction of illicit drug use related harm, such treatment has also resulted in severe problems in some countries where opioid-dependent individuals now inject illicitly sold buprenorphine or buprenorphine-naloxone instead of heroin. There is no approved treatment for buprenorphine dependence. Naltrexone is an opioid antagonist which has been used for the treatment of both alcohol and opioid dependencies. Although both buprenorphine and heroin resemble each other concerning their effects, buprenorphine has a higher affinity to opioid receptors than heroin. Therefore, it is not known if naltrexone can block the psychoactive effects of buprenorphine as it does for heroin. This paper presents observational case series data on the use of a sustained-release naltrexone implant for the treatment of buprenorphine dependence. To the authors’ knowledge this is the first use of sustained-release naltrexone for this indication.
Utility Values for Adults with Unipolar Depression
Authors: Mohiuddin Syed , Payne Katherine
Published: April 2014

Background. Unipolar depression is a mental illness with a substantial health-related and economic burden. Health interventions for depression predominately focus on improving sufferers’ health-related quality of life (HRQoL). Utility is a measure of HRQoL that is required for use in model-based cost-utility analyses to assess the added value of health interventions. This review aimed to identify, summarize, and where feasible, synthesize published utilities for unipolar depression. Methods. A structured electronic search combining common terms for unipolar depression and utility was conducted in MEDLINE, EMBASE, and PsycINFO. Utility values identified were summarized, and the study designs were appraised in terms of the patient population and valuation method used to generate utilities. Random-effect meta-analyses were applied to pool mean utilities identified for 3 depressive health states (mild, moderate, and severe) elicited from direct and indirect valuation methods separately. Results. Thirty-five studies were identified that reported utilities for various levels of depression severity. The most commonly used direct valuation method for eliciting utilities was standard gamble (SG) ( n = 5), and the most commonly used indirect valuation method was EQ-5D ( n = 20). The pooled mean (standard deviation) utilities from studies using SG as a direct valuation method were mild = 0.69 (0.14), moderate = 0.52 (0.28), and severe = 0.27 (0.26). The pooled utilities from studies using EQ-5D as an indirect valuation method were mild = 0.56 (0.16), moderate = 0.45 (0.18), and severe = 0.25 (0.15). Conclusions. This systematic review is a useful resource for decision analysts who need health-related utility values to populate model-based cost-utility analyses of health interventions for the management of unipolar depression. Further research is necessary to understand whether direct or indirect valuation methods are the most robust sources for utilities in depression.
MRI characteristics of intraductal papilloma
Authors: Wang Wei , Ding Jianhui , Yang Wentao , Li Yuan , Zhou Liangping , Zhang Shengjian , Zhu Hui , Mao Jian , Tang Jie , Gu Yajia , Peng Weijun
Published: April 2014

Background

Intraductal papilloma (IDP) is the most common pathological finding in women with pathological nipple discharge. Magnetic resonance imaging (MRI) has shown potential for characterizing breast tumors; however, MRI findings of IDPs are inconclusive, and certain diagnostic standards are lacking. Purpose: To characterize the MRI features of IDP from a relatively large cohort.

Material and Methods

We retrospectively reviewed from 358 women with IDPs that were confirmed by histopathology. The clinical and imaging findings in 70 patients who underwent preoperative MRI were analyzed. MRI analyses included morphology and dynamic contrast-enhanced MRI.

Results

In 70 patients, 77 IDPs were detected on MRI, which revealed the following three patterns: small luminal mass papillomas; tumor-like papillomas; and MRI-occult papillomas. Fourteen IDPs involved small, oval, smooth, and contrast-enhanced masses at the posterior end of the enlarged duct corresponding to small luminal mass papillomas. Seven IDPs had large diameters along the direction of the breast duct, indicating the typical MRI findings for IDP. Of 47 tumor-like papillomas, 16 cases showed large diameters along the direction of the breast duct and close to the nipple (within 4 cm), seven cases resembled invasive breast cancer on MRI, and the remaining 24 were (24/47) undistinguishable from other benign breast diseases. Sixteen IDPs were MRI-occult papillomas that could not be distinguished from the surrounding benign disease by either contrast-enhanced MRI or fat-suppressed T2-weighted MRI.

Conclusion

Small luminal mass papillomas or tumor-like papillomas with the largest diameters along the direction of the breast duct and close to the nipple (within 4 cm) might be the typical MRI findings for IDPs.
Jasper’s story: ‘Letting me down and picking me up’ – one boy’s story of despair and hope at primary schools in England
Authors: Gilling Anya
Published: April 2014

Jasper is now 12 years old. When he was seven he started primary school in England after moving to the UK with his family. He had been adopted from Eastern Europe when he was two years old. From the beginning of his schooling in England he struggled and others struggled with him. At one school he was faced with exclusion but before this could happen his parents moved him to another school where, immediately, his ‘special’ needs were considered. This article is the educational story of Jasper, how his needs were ignored and misunderstood at one school, yet fully taken into account by another. Told from a service-user perspective, it explores Jasper’s experiences of despair and hope, and how his adoptive parents worked strategically with a range of services to ensure that his educational needs were met in the context of understanding his emotional needs. It provides suggestions for improved educational practice with adopted children like Jasper. The story is based on real events but names, locations and other identifiers have been changed to ensure anonymity.
Meeting the adoption support needs of adopted adults who have been abused in their adoptive family: lessons from historical placements
Authors: Harris Perlita
Published: April 2014

This article focuses on a group whose voice is rarely heard: adopted adults who have been abused or neglected within their adoptive family. The findings are drawn from a larger study of post-adoption services and suggest that the abuse and neglect of children by adoptive family members may be more common historically than has been hitherto acknowledged. The article considers this finding in the context of the changes that have occurred in adoption legislation, policy and practice since these adults were placed. It highlights barriers to effective support for abused adopted adults and discusses their support needs. By looking at one aspect of what can go wrong in adoptions – abuse and neglect perpetrated by adoptive family members – it is argued that appropriate support will not be forthcoming unless we are truly hearing what people want. Suggestions are made regarding the development of support services for abused adopted adults and their birth parents and opportunities for adopted children to disclose maltreatment.
‘The children were fine’: acknowledging complex feelings in the move from foster care into adoption
Authors: Boswell Sophie , Cudmore Lynne
Published: April 2014

When children move from foster care into adoption the transition tends to take place within a tight timeframe, usually between seven and 14 days, with no contact between the child and the foster carer for several months after the move, if at all. Very little attention or research has been aimed at understanding the rationale for these procedures. Together with social work colleagues in a Looked After Children’s team, two child psychotherapists carried out a piece of qualitative research, interviewing foster carers, adopters and social workers to analyse in detail five children’s moves into adoption. We found that the emotional experience of the child, particularly their experience of losing their foster carer, became less prominent in people’s minds during this transition. It is a highly anxious time for the adults and in the grip of these anxieties they can lose sight of what is happening emotionally for the child. The child’s outward compliance with the move and lack of obvious emotion at losing her or his carers can be interpreted as signs that they are ‘fine’. These research findings are explored in the light of our understanding of attachment and loss in childhood, and of individual and organisational defences against pain and loss. Implications for future practice are discussed.
Recycling of engineering plastics from waste electrical and electronic equipments: Influence of virgin polycarbonate and impact modifier on the final performance of blends
Authors: V Ramesh , Biswal Manoranjan , Mohanty Smita , Nayak Sanjay K
Published: April 2014

This study is focused on the recovery and recycling of plastics waste, primarily polycarbonate, poly(acrylonitrile-butadiene-styrene) and high impact polystyrene, from end-of-life waste electrical and electronic equipments. Recycling of used polycarbonate, acrylonitrile-butadiene-styrene, polycarbonate/acrylonitrile-butadiene-styrene and acrylonitrile-butadiene-styrene/high impact polystrene material was carried out using material recycling through a melt blending process. An optimized blend composition was formulated to achieve desired properties from different plastics present in the waste electrical and electronic equipments. The toughness of blended plastics was improved with the addition of 10 wt% of virgin polycarbonate and impact modifier (ethylene-acrylic ester-glycidyl methacrylate). The mechanical, thermal, dynamic-mechanical and morphological properties of recycled blend were investigated. Improved properties of blended plastics indicate better miscibility in the presence of a compatibilizer suitable for high-end application.
Profiles of Personal Resiliency in Youth Who Have Experienced Physical or Sexual Abuse
Authors: Deblinger Esther , Runyon Melissa K. , Steer Robert A.
Published: April 2014

To determine whether children and adolescents (7-17 years old) who had experienced physical, sexual, or both types of abuse reflected distinct profiles of personal resiliency, we administered the Resiliency Scales for Children and Adolescents (RSCA) to 250 youth. We performed cluster analyses with T scores for the RSCA Self-Mastery, Relatedness, and Emotional Reactivity scales, and four profiles of resiliency representing high (20%), average (28%), and slightly below-average (30%) resiliency, and high vulnerability (22%) were identified. The youth with the high vulnerability profile described themselves as more depressed and were rated by their parents as having more internalizing and externalizing problems than the youth with high resiliency. We propose different treatment approaches that might be used with youth representing each of the four different profiles.
A Closer Look at the Psychometric Properties of the Revised Children’s Manifest Anxiety Scale–Second Edition Among U.S. Elementary and Secondary School Students
Authors: Lowe Patricia A.
Published: April 2014

The psychometric properties of the Revised Children’s Manifest Anxiety Scale–Second Edition (RCMAS-2) were examined in a sample of 1,003 U.S. elementary and secondary students in Grades 2 to 12. Confirmatory factor analyses (CFAs) were performed comparing the five-factor (target) model consisting of three anxiety (Physiological Anxiety, Social Anxiety, and Worry) factors and two defensiveness (Defensiveness 1 and 2) factors with a three-factor model (one anxiety factor and two defensiveness factors). The results of the CFAs conducted indicated that the five-factor model provided a better fit to the data than the three-factor model. Tests of measurement invariance were also performed and the results provided support for configural, metric, and partial scalar invariance of the RCMAS-2 scores across gender. Latent mean analyses were also conducted and the results of these analyses indicated that females scored significantly higher than males on the three anxiety factors. These findings provide support for the construct validity of the RCMAS-2 scores. Implications of the findings for mental health professionals who work with elementary and secondary school students are discussed.
Community Participation and Water Supply Sustainability
Authors: Marks Sara J. , Komives Kristin , Davis Jennifer
Published: April 2014

We investigate the extent to which different forms of community participation explain variation in handpump sustainability using data collected from 200 rural communities in Ghana. Data sources include household surveys, engineering assessments of water points, and interviews with water committees and village leaders. The depth of community members’ involvement in project planning is positively associated with handpump sustainability, whereas the breadth of community participation is not. All else held constant, handpump sustainability is enhanced by household members’ involvement in management-related decisions, but is compromised when households are responsible for technical decisions.
“Dude, You’re Such a Slut!” Barriers and Facilitators of Sexual Communication Among Young Gay Men and Their Best Friends
Authors: McDavitt Bryce , Mutchler Matt G.
Published: April 2014

Conversations with friends are a crucial source of information about sexuality for young gay men, and a key way that sexual health norms are shared during emerging adulthood. However, friends can only provide this support if they are able to talk openly about sexuality. We explored this issue through qualitative interviews with an ethnically diverse sample of young gay men and their best friends. Using theories of sexual scripts, stigma, and emerging adulthood, we examined how conversations about sex could be obstructed or facilitated by several key factors, including judgmentalism, comfort/discomfort, and receptivity. Gay male friends sometimes spoke about unprotected sex in judgmental ways (e.g., calling a friend “slut” or “whore” for having sex without condoms). In some cases, this language could be used playfully, while in others it had the effect of shaming a friend and obstructing further communication about sexual risk. Female friends were rarely openly judgmental, but often felt uncomfortable talking about gay male sexuality, which could render this topic taboo. Sexual communication was facilitated most effectively when friends encouraged it through humor or supportive questioning. Drawing on these findings, we show how judgmentalism and discomfort may generate sexual scripts with contradictory norms, and potentially obstruct support from friends around sexual exploration during a period of life when it may be most developmentally important.
Collision avoidance maneuvers for multiple threatening objects using heuristic algorithms
Authors: Seong Jae-Dong , Kim Hae-Dong
Published: April 2014

This paper compares and analyzes four heuristic algorithms for collision avoidance maneuver optimization (CAMO) when multiple space objects threaten a satellite. Classical gradient-based optimization methods are not appropriate for this kind of problem due to their discontinuities. On the other hand, heuristic algorithms can obtain suboptimal solutions due to their robustness and flexibility. In this paper, we develop CAMO planning methods using four heuristic algorithms. Their performance is compared in terms of the Del-V achieved under constraints on the minimum distance between the user satellite and multiple threatening objects, the maximum burn duration, and the boundary conditions for the maneuver start time. To validate the proposed strategy with the heuristic algorithms, two CAMO problems are analyzed. One is a simple problem using two control parameters (the maneuver start time and Del-V along the in-track direction) when a single threatening object is approaching. The second is a more complex CAMO problem that uses four control parameters (the maneuver start time and Del-V in three directions, i.e. radial, in-track, and cross-track) when four threatening objects are approaching from different angles and at different times. As a result, we minimize Del-V for each CAMO problem while satisfying all constraints. The differential evolution heuristic algorithm is found to exhibit the best performance in terms of minimized Del-V.
Discordant prevalence of Chlamydia trachomatis in asymptomatic couples screened by two screening approaches
Authors: Corbeto Evelin L , Gonzalez Victoria , Lugo R , Almirall Ma Rosa , Espelt Ramon , Avecilla Angels , González Isabel , Campo Imma , Arranz Estrella , Casabona Jordi ,   CT/NG study group
Published: April 2014

This study was carried out to observe the effect of screening both members of an asymptomatic couple for Chlamydia trachomatis. First void urine samples were collected from 105 women and their male sex partners. Women were recruited for screening at a sexual health clinical setting (age 16–25 years), and home sampling screening options were used for men. Using PCR we detected seven positive C. trachomatis samples in women (6.6%) and five in men (4.6%). The concordant infection rate was 33% (3/9 couples). Routine urine screening of the female partner might result in substantial underestimation of the C. trachomatis prevalence within the couple, where perhaps 56% of the couples where at least one partner tested positive would remain undiagnosed. Screening both partners compared with women- or men-only screening increased the detection rate of positive couples. Furthermore, the use of alternative screening approaches in different clinical settings increases testing in at risk populations.
Predictors of return rate for an HIV-positive result in a French Voluntary Counseling and Testing centre
Authors: Pahlavan Golriz , Burdet Charles , Laouénan Cédric , Guiroy Frédérique , Bouscarat Fabrice , Tosini William , Yazdanpanah Yazdan , Bouvet Elisabeth
Published: April 2014

Bichat Hospital's free and anonymous Voluntary Counseling and Testing centre in Paris is widely visited, with a high rate of HIV-positive diagnosis. This study proposed, in this centre, to describe the HIV newly-diagnosed patients over an 8-year period and to determinate risk factors for failure to return for a positive result. Higher risk for failure to return was found among the heterosexual subjects regardless of their socio-economic background.
Medical care following multiple perpetrator sexual assault: A retrospective review
Authors: Morgan Louise , Brittain Bernadette , Welch Jan
Published: April 2014

This paper describes the healthcare needs of victims of multiple perpetrator sexual assault (MPSA) and single perpetrator sexual assault (SPSA) presenting to the Haven sexual assault referral centre in south-east London, and aims to identify any characteristics that might be related to attendance at follow-up appointments. We reviewed standardised casenotes of 136 MPSA victims and 139 SPSA victims attending for forensic medical examination (FME) between 1 July 2005 and 31 July 2009. MPSA victims reported a higher rate of stranger assaults, higher rates of vaginal, anal and oral rapes, more rapes at multiple anatomical sites or multiple rapes and were more likely to sustain injuries, all of which put MPSA victims at higher risk of subsequent health problems. Rates of attendance at follow-up appointments were low for all (53.5%) as were rates of completion of post-exposure prophylaxis (PEP) for HIV (33.3%). Attendance at follow-up was associated with presence of anogenital injury at the time of FME. Those over the age of 30 years were less likely to attend.
Climatically-driven impacts on sedimentation processes in the Bay of Quiberon (south Brittany, France) over the last 10,000 years
Authors: Baltzer Agnès , Walter-Simonnet Anne-Véronique , Mokeddem Zohra , Tessier Bernadette , Goubert Evelyne , Cassen Serge , Diffo Ange
Published: April 2014

The Bay of Quiberon (NW France), which is protected by the Quiberon Peninsula, provides well-preserved sedimentary archives for high-resolution reconstruction of Holocene climate variability. Very-high-resolution seismic profiles were obtained from two Seistec boomer seismic campaigns conducted in the bay. The seismic surveys reveal the deposition of five distinct sedimentary units. This succession is correlated with radiocarbon-dated sediments sampled in a long CASQ core (MD08-3204CQ). The analysis of the sediments shows significant changes in grain size, indicating a complex series of palaeo-climate events dated at 8800, 8600, 4270, 3860, 2470 and 1060 cal. yr BP. These may be correlated with millennial timescale climate variability corresponding to the phases of Holocene rapid climate changes (RCCs), associated with negative North Atlantic Oscillation (NAO) index and usually characterized by weaker winter storms. On the contrary, periods between RCCs are characterized by the predominance of westerly winds and stormy conditions for Brittany (i.e. positive NAO). However, only storm events occurring during the RCCs have been preserved in the Bay of Quiberon. This paper aims to reconstruct the Holocene sedimentary infill of the bay, highlighting the role of episodic acceleration phases of the sea-level rise on the preservation of sedimentary archives. Thus, the Bay of Quiberon provides substantially a complete sedimentation record of the last 10,000 years characterized by a series of complex palaeo-environmental changes.
Phospholipid-binding proteins differ in their capacity to induce autoantibodies and murine systemic lupus erythematosus
Authors: Levine JS , Subang R , Setty S , Cabrera J , Laplante P , Fritzler MJ , Rauch J
Published: April 2014

We have previously shown that immunization of nonautoimmune mice with the phospholipid-binding protein β2-glycoprotein I (β2GPI), in combination with lipopolysaccharide (LPS), induces a murine model of systemic lupus erythematosus (SLE), with sequential emergence of autoantibodies and glomerulonephritis. Here, we determine whether the paradigm for induction of murine SLE extends to other phospholipid-binding proteins. Mice were immunized with a phospholipid-binding protein (prothrombin (PT), protein S, or β2GPI), or a nonphospholipid-binding protein (glu-plasminogen), in the presence of LPS. The breadth and degree of the autoantibody response, and the frequency of glomerulonephritis, varied among the three proteins, with β2GPI being the most effective in inducing SLE-like disease. The phospholipid-binding proteins also differed in the pattern of serum cytokines they elicited. The most apparent difference between β2GPI and the other phospholipid-binding proteins was in their ability to bind to LPS: β2GPI bound to LPS, while PT and protein S did not. Our data suggest that binding to phospholipid(s) is a necessary, but not sufficient, condition for full induction of murine SLE. We propose that other properties, such as physiologic function, avidity for anionic phospholipids, and degree of interaction with other cell surface and/or circulating molecules (particularly LPS) may determine the range and severity of disease.
‘Out of the frying pan’: the challenges of prescribing for insomnia in psychiatric patients
Authors: Huthwaite Mark , Cleghorn Mark , MacDonald Joanna
Published: April 2014

Objectives:

Managing insomnia is a common challenge for psychiatrists and their patients. We have observed an increasing use of quetiapine as a hypnosedative.

Methods:

We conducted an audit with the aim of establishing the prescribing patterns of local general psychiatrists in New Zealand, comparing them with established guidelines and determining the extent of the prescribing of quetiapine as a hypnosedative. Participant psychiatrists were recruited from peer review groups. Each participant provided anonymised prescribing information from 10 patients and noted their intention when prescribing.

Results:

Twenty-five clinicians (58% response rate) responded with prescriptions for 100 in-patients and 177 community mental health patients. 60% of in-patients and 62% of community patients were prescribed medications to aid with sleep. The most commonly prescribed medications were zopiclone, quetiapine and benzodiazepines. Prescribing adhered with the recommended guidelines for 20% of benzodiazepine and 35% of zopiclone prescriptions. Two thirds (60%) of the community prescriptions for quetiapine were primarily for hypnosedation.

Conclusions:

There is little concordance between guidelines for hypnosedative prescribing and the practices of general psychiatrists. Less zopiclone and fewer benzodiazepines were prescribed than in other studies, while more quetiapine was prescribed. The ‘off-label’ use of quetiapine and the duration of zopiclone and benzodiazepine use are discussed.
Current Status of Marriage and Family Therapy Education in Uzbekistan
Authors: Hundley Gulnora , Hagedorn W. Bryce
Published: April 2014

Although the practice of marriage and family therapy in the former Union of Soviet Socialist Republics (USSR) has been gaining popularity since the late 1990s, the establishment of formal marriage and family therapy education in Uzbekistan has proceeded much slower than the other regions of the former USSR. The purpose of this study was to ascertain the quality and quantity of marriage and family therapy education in Uzbekistan by studying a sample of current practitioners. This article provides (a) an overview of Uzbekistan’s culture and family dynamics, (b) the status of current psychotherapeutic services provided, and (c) the availability and quality of education in psychotherapy and marriage and family therapy in that country. Implications for curriculum development and training are included.
Modified Oblique Keller Capsular Interposition Arthroplasty (MOKCIA) for Treatment of Late-Stage Hallux Rigidus
Authors: Johnson Jeffrey E. , McCormick Jeremy J.
Published: April 2014

Hallux rigidus is a term used to describe painful, limited motion and localized arthritis at the hallux metatarsophalangeal (MTP) joint. With early hallux rigidus, a dorsal cheilectomy can decrease pain and improve motion. With later stage disease, a hallux MTP arthrodesis is commonly chosen to decrease pain, sacrificing motion by fusing the hallux MTP joint. We present an alternative technique to arthrodesis for late stage hallux rigidus—the modified oblique Keller capsular interposition arthroplasty (MOKCIA). With this operation, the dorsal capsule of the hallux MTP joint is interposed into the joint, offering pain relief without sacrificing range of motion.

Level of Evidence: Level V, expert opinion.
Modified optimization and experimental investigation of transmission error, vibration and noise for double helical gears
Authors: Wang Cheng , Cui Huan Yong , Zhang Qing Ping , Wang Wen Ming
Published: April 2014

A new method of modified optimization of double helical gears is proposed based on reducing vibration and noise and raising machining efficiency. Firstly, the straight profile of rack-cutter edge is replaced by three segment parabolas, and the equation of the rack-cutter profile is ultimately represented in the rack-cutter surface. Secondly, the physical and mathematical model of tooth contact analysis and loaded tooth contact analysis of double helical gears are introduced and then the loaded transmission errors are obtained. The optimal modification parameters are achieved based on the minimum amplitude of loaded transmission error. Finally, a set of equipment for measuring loaded transmission error, the analysis software platform and the test-bed of vibration and noise are designed, respectively. The feasibility of the method of modified optimization is verified. Compared with vibration and noise before modification, those after modification averagely decrease 18% and 2.7 dB.
A study of geographical distance groups on length of visitors’ stay at local food festival destinations
Authors: Lee Kwang-Ho , Alexander Amanda C , Kim Dae-Young
Published: April 2014

The primary aims of this study are to (1) explain the geographical distance groups (GDGs) in relation to the origin of visitors to local festival destinations, (2) examine the probability of visitors staying overnight at a festival destination as affected by GDGs and salient trip-related variables, and (3) identify the effects of GDGs and trip-related variables on length of stay (LOS). Data were collected during two local food festivals in the Midwestern area of the United States in 2010. The results of this study reveal that the consideration of geographical distance is most beneficial in capturing the target market for local festivals. Additionally, it is also found that LOS and overnight stay is predicted by the visitors’ trip-related characteristics of the destination, such as the number of previous visits to the festival, immediate group size, and distance from festival. From the results and findings of this study, managerial and academic implications are offered.
Examining the moderating role of rational-versus emotional-focused websites
Authors: Lwin Michael , Phau Ian , Huang Yu-An , Lim Aaron
Published: April 2014

This article examines whether emotional or rational advertising appeals are more effective for website hospitality services. Specifically, it considers how attitudes towards websites, service expectations and attitudes towards boutique hotels may influence the two different types of advertising appeals and purchase intention. Results show that websites using emotional appeals tend to show a positive relationship between attitude towards hotels and attitude towards websites and purchase intention. It also indicates that emotional advertisements are better at gaining and retaining interest and attention, and as such can be highly beneficial for small boutique hotels. This article provides several marketing and business policy implications to aid practitioners and strategists in making better decisions.
Risk perception, prior knowledge, and willingness to travel
Authors: Sharifpour Mona , Walters Gabrielle , Ritchie Brent W
Published: April 2014

Despite the importance of risk perceptions in decision making and destination choice, limited research has been undertaken to explore tourists’ risk perceptions, especially those of rapidly growing destinations such as the Middle East. The purpose of this article is to explore the primary risk dimensions that the Australian tourism market associates with the United Arab Emirates, Oman, and Jordan and to investigate how prior knowledge may counter these perceived risks. Using a sample of potential Australian tourists, this study identified three risk dimensions associated with the region, namely: physical, general, and destination specific. Various dimensions of knowledge were found to influence tourist risk perceptions differently. Conclusions and recommendations for those responsible for the marketing and promotion of these destinations are put forward.
Confucian-heritage travel bloggers
Authors: Ng Liane Yuyan , Lee Young-Sook
Published: April 2014

This article investigates the use of travel weblogs within Asian markets, in particular those with a Confucian cultural heritage, in an attempt to understand the knowledge-sharing practices of Confucian-heritage travel bloggers. Two significant Confucian markets in Asia, Chinese Singaporeans and South Koreans, are studied in this article. Results of content and semiotics analyses of 17 weblog sites from the Singaporean market and 20 from the South Korean market suggest that cultural aspects can characterise users’ behaviour in virtual environments. In the studied Asian blog user communities, the Confucian value of respect for authority appears to be embedded, affecting the types of knowledge sharing as well as technology-enhanced sharing. The article suggests that tourism marketing researchers and practitioners should recognise that the Asian market’s use of blog sites is influenced by the Confucian value of respect for authority and that practitioners are recommended to consider partnering with authority figures to deliver more ‘credible’ information to the wider community.
Exploring aesthetic dimensions in a nature-based tourism context
Authors: Breiby Monica Adele
Published: April 2014

Given the historical relationship between viewing or ‘gazing’ and tourism, it is rather incongruous that the concept of aesthetics has received little attention in tourism marketing and nature-based tourism research. Although a substantial body of literature exists on aesthetic notions with regard to landscape preferences and the establishment of national parks, the literature is limited on the concept as it relates to man-made environments in nature-based tourism. Accordingly, the purpose of this study is to add to the understanding of the concept of aesthetics in the context of nature-based tourism. This study’s main results from qualitative interviews with key informants reveal five aesthetic dimensions that may influence the tourists’ satisfaction in a nature-based tourism context: ‘harmony’, ‘variation/contrast’, ‘scenery/viewing’, ‘genuineness’, and ‘art/architecture’. The study closes with suggestions for further research.
Clothing norms as markers of status in a hospital setting: A Bourdieusian analysis
Authors: Jenkins Tania M
Published: April 2014

This article uses a Bourdieusian framework to understand the importance of clothing norms for symbolizing and reproducing social, as well as professional, hierarchy in hospitals. Using data from participant observation, it examines how a complex yet informal dress code has emerged at a community hospital in the Northeastern United States, in a setting where very few formal guidelines exist on how to dress. By conceptualizing professionals as holders of various types of capital (economic, cultural, and symbolic), this article expands previous research which considered clothing only as a marker of professional identity. The findings demonstrate (1) how clothing norms are used in subtle, but purposeful, ways to reflect varying degrees of cultural and economic capital and (2) how these complex norms also reflect professional boundaries in medical authority (symbolic capital), which is important during critical moments where clothing can quickly signal who can take control. The discussion borrows Bourdieu’s concepts of habitus and field to explain why subordinates subscribe to these clothing norms, in the absence of a formal organizational dress code.
The use of verbal morphology in Turkish as a third language: The case of Russian–English–Turkish trilinguals
Authors: Antonova-Ünlü Elena , Sağın-Şimşek Çiğdem
Published: April 2014

Aims and Objectives:

Several studies suggest that third language acquisition (TLA) is marked with complex patterns of language interaction. However, it is not clear yet to what extent multilinguals activate each of their background languages in TLA, as various factors may trigger the activation of one of the previously learnt languages. This study aims to contribute to the discussion by examining the use of verbal morphology in third language (L3) Turkish of Russian–English–Turkish trilinguals. We investigate whether the use of verbal morphology in L3 Turkish of Russian–English–Turkish trilinguals differs from that of Turkish native speakers and in the case of a deviation, which of the background languages can account for it.

Design/Methodology/Approach:

The study is done within the framework of cross-linguistic influence.

Data and Analysis:

The data are collected from eight native speakers of Russian who are highly proficient in their L2 English and L3 Turkish, and use their three languages more or less equally every day. Fictional narratives are employed in the study as the tool for data collection. The use of finite and non-finite verbal forms in Turkish is compared with the baseline data coming from native speakers of Turkish.

Findings/Conclusions:

The results reveal that the trilingual participants mainly use the verbal morphology consistently with native speakers of Turkish; nonetheless, two deviations from the Turkish baseline stand out: tendency to use finite verbal forms in their noun clauses and inconsistency in the use of temporal-aspectual markers in finite verbal forms. The former can be attributed to the L1 and L2 interlanguage, while the latter can be attributed to the influence of particularly L1 Russian.

Originality, and significance/Implications:

Thus, the study provides evidence that the source of interference into L3 production is likely to occur due to the cross-linguistic influence from L1, which in turn might imply the predominant position of L1 over sequentially learnt languages at the morphosyntactic level in the language processing.
Functioning, coping and work status three years after participating in an interdisciplinary, occupational rehabilitation program
Authors: Øyeflaten Irene , Midtgarden Inger Johanne , Maeland Silje , Eriksen Hege R , Magnussen Liv Heide
Published: April 2014

Aim:

The aim of this study was to explore how functional ability, coping and health were related to work and benefit status three years after participating in a four-week inpatient interdisciplinary occupational rehabilitation program.

Methods:

The cohort consisted of 338 individuals (75% females, mean age 51 years (SD=8.6)) who three years earlier had participated in a comprehensive inpatient interdisciplinary occupational rehabilitation program, due to long-term sick leave. The participants answered standardised questionnaires about subjective health complaints, functional ability, coping, and current work and benefit status. The relationships between these variables were analysed using logistic regression analyses.

Results:

At the time of the survey, 59% of the participants worked at least 50% of a full working day. Twenty-five percent received at least 50% disability pension and 16% received other benefits. Poor functional ability (OR 4.8; CI 3.0–7.6), poor general health (OR 3.8; CI 2.3–6.1), high level of subjective health complaints (OR 3.3; CI 2.1–5.2), low coping (OR 2.8; CI 1.7–4.4), poor physical fitness (OR 2.8; CI 1.7–4.6) and poor sleep quality (OR 2.4; CI 1.5–3.7) were associated with receiving allowances. In a fully adjusted model, only poor functional ability and low coping were associated with receiving allowances three years after occupational rehabilitation.

Conclusions:

Functional ability and coping were the variables most strongly associated with not having returned to work. More attention should therefore be paid to enhance these factors in occupational rehabilitation programs. Part-time work may be a feasible way to integrate individuals with reduced workability in working life, if the alternative is complete absence from work.
Evaluation of a fast-track protocol for patients undergoing colorectal surgery
Authors: Ehrlich A. , Wagner B. , Kairaluoma M. , Mecklin J.-P. , Kautiainen H. , Kellokumpu I.
Published: April 2014

Background and Aims:

Fast-track protocols have been used to optimize the perioperative care and to enhance postoperative recovery. This study examined short-term clinical outcomes and determinants affecting the length of postoperative hospital stay.

Material and Methods:

From 2007 to 2009, 180 patients underwent laparoscopic or open bowel resection ( N = 138) or sacrocolporectopexy ( N = 42) in the Central Hospital of Central Finland for various colorectal diseases in the fast-track setting. The main measures of outcome were time to functional recovery, 30-day morbidity, and readmission rates, with hospital stay and patient satisfaction as secondary outcomes.

Results:

There were no deaths. Time to functional recovery was median 2 (interquartile range 2–3) days. The overall 30-day postoperative morbidity was 14.5% after bowel resection and 0% after sacrocolporectopexy. Relaparotomy rate was 3.6% and 30-day readmission rate 7.2%. Postoperative hospital stay was median 3 days after small bowel and ileo-colic resection, 4 days after segmental colectomy, and 6 days after rectal resection and subtotal colectomy. Patient’s body mass index > 30 kg/m2, malignant disease, complexity of surgery, recovery of bowel function later than 2 days after surgery, time to functional recovery > 2 days and postoperative morbidity were patient- and treatment-related determinants increasing postoperative hospital stay. Protocol compliance–related determinants increasing postoperative hospital stay were intake of normal food and mobilization ≥ 6 h/day later than 2 days after surgery and removal of urinary catheter later than 1 day after surgery.

Conclusion:

Postoperative functional recovery was fast, morbidity and readmission rates were low, and postoperative hospital stay short indicating that fast-track care should form the mainstay of elective colorectal surgery.
Birth outcomes and academic achievement in childhood: A population record linkage study
Authors: Moore Elizabeth A , Harris Felicity , Laurens Kristin R , Green Melissa J , Brinkman Sally , Lenroot Rhoshel K , Carr Vaughan J
Published: April 2014

Poor academic performance during childhood predicts later adverse outcomes, and could be targeted for improvement if detected early. This study used population-based record linkage to examine the association between early life risk factors and academic achievement at two different stages of development using two different cohorts: a kindergarten (~age 5 years) and a grade 3 cohort (~age 8 years). Similar factors were predictive of academic performance in both age groups, including positive effects of increasing maternal age and lack of maternal prenatal smoking. Female sex was associated with higher scores for literacy. The results suggest that children with less developed academic skills can be identified earlier, with effective programmes to enhance academic skills needed during the first year of school to enhance subsequent results.