bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a structured educational programme on patient‐controlled analgesia (PCA) for gynaecological patients in South Korea
Authors: Hong Sung‐Jung , Lee Eunjoo
Published: May 2012

Aims and objectives.  The purpose of the study was to evaluate the effects of a structured educational programme on the patient‐controlled analgesia device in terms of postoperative pain, dose of analgesics used, adverse reactions, patient knowledge and attitudes of patient‐controlled analgesia and patient satisfaction with postoperative pain management among gynaecological patients in South Korea.

Background.  Patient‐controlled intravenous analgesia has become the most common method to manage postoperative pain. Although the patient‐controlled analgesia device can be very effective in managing pain, patients using external pump delivery have several problems because of their lack of knowledge of patient‐controlled analgesia. To minimise these problems, nursing interventions that may decrease the number of problems should be developed and adopted into clinical practice.

Design.  A non‐equivalent control group, non‐synchronised design.

Methods.  The participants were 79 patients who had gynaecological surgery under general anaesthesia. Of the 79 patients, 39 were assigned to the experimental group and 40 to the control group. A day before surgery, 40 minutes of structured education on the patient‐controlled analgesia device was provided individually to the patients in the experimental group using both a CD‐ROM and brochure.

Results.  Pain level and adverse reactions were significantly lower in the experimental group than in the control group. Furthermore, the analgesic dose administered and the level of patient satisfaction with postoperative pain management increased significantly in the experimental group compared with the control group.

Conclusion.  A structured educational programme on the patient‐controlled analgesia can be an effective nursing intervention for pain management in gynaecological patients.

Relevance to clinical practice.  Nurses caring for the patients who are using the patient‐controlled analgesia should provide a structured educational programme to increase knowledge of pain management with patient‐controlled analgesia, patient satisfaction with pain management, as well as more effective management of the pain and adverse reaction caused by patient‐controlled analgesia.
Interactions between occlusion and human brain function activities
Authors: OHKUBO C. , MOROKUMA M. , YONEYAMA Y. , MATSUDA R. , LEE J. S.
Published: May 2012

Summary  There are few review articles in the area of human research that focus on the interactions between occlusion and brain function. This systematic review discusses the effect of occlusion on the health of the entire body with a focus on brain function. Available relevant articles in English from 1999 to 2011 were assessed in an online database and as hard copies in libraries. The selected 19 articles were classified into the following five categories: chewing and tongue movements, clenching and grinding, occlusal splints and occlusal interference, prosthetic rehabilitation, and pain and stimulation. The relationships between the brain activity observed in the motor and sensory cortices and movements of the oral and maxillofacial area, such as those produced by gum chewing, tapping and clenching, were investigated. It was found that the sensorimotor cortex was also affected by the placement of the occlusal interference devices, splints and implant prostheses. Brain activity may change depending on the strength of the movements in the oral and maxillofacial area. Therefore, mastication and other movements stimulate the activity in the cerebral cortex and may be helpful in preventing degradation of a brain function. However, these findings must be verified by evidence gathered from more subjects.
Acute experimental stress evokes a differential gender‐determined increase in human intestinal macromolecular permeability
Authors: Alonso C. , Guilarte M. , Vicario M. , Ramos L. , Rezzi S. , Martínez C. , Lobo B. , Martin F.‐P. , Pigrau M. , González‐Castro A. M. , Gallart M. , Malagelada J. R. , Azpiroz F. , Kochhar S. , Santos J.
Published: May 2012

Background  Intestinal epithelial dysfunction is a common pathophysiologic feature in irritable bowel syndrome (IBS) patients and might be the link to its clinical manifestations. We previously showed that chronic psychosocial stress induces jejunal epithelial barrier dysfunction; however, whether this epithelial response is gender‐specific and might thus explain the enhanced female susceptibility to IBS remains unknown.

Methods  Intestinal responses to acute stress were compared in age‐matched groups of healthy women and men (n = 10 each) experiencing low background stress. A 20‐cm jejunal segment, was perfused with an isosmotic solution, and intestinal effluents were collected under basal conditions, for 15 min during cold pain stress and for a 45‐min recovery period. Epithelial function (net water flux and albumin output), changes in stress hormones, and cardiovascular and psychologic responses to cold stress were measured.

Key Results  Heart rate and blood pressure significantly increased during cold pain stress with no differences between men and women. Adrenocorticotropic hormone and cortisol levels during cold pain stress were significantly higher in men. Basal net water flux and epithelial permeability were similar in men and women. Cold pain stress increased water flux in both groups (72 ± 23 and 107 ± 18 μL min−1 cm−1, respectively; F(5, 90) = 5.5; P = 0.003 for Time) and, interestingly, this was associated with a marked increase of albumin permeability in women but not in men (0.8 ± 0.2 vs.−0.7 ± 0.2 mg/15 min; P < 0.0001).

Conclusions & Inferences  Intestinal macromolecular permeability in response to acute experimental stress is increased in healthy women, a mechanism that may contribute to female oversusceptibility to IBS.
Population structure of Sclerotinia sclerotiorum in crop and wild hosts in the UK
Authors: Clarkson J. P. , Coventry E. , Kitchen J. , Carter H. E. , Whipps J. M.
Published: May 2012

Sclerotinia sclerotiorum is an important pathogen of many crop plants which also infects wild hosts. The population structure of this fungus was studied for different crop plants and Ranunculus acris (meadow buttercup) in the UK using eight microsatellite markers and sequenced sections of the intergenic spacer (IGS) region of the rRNA gene and the elongation factor 1‐alpha (EF) gene. A total of 228 microsatellite haplotypes were identified within 384 isolates from 12 S. sclerotiorum populations sampled in England and Wales. One microsatellite haplotype was generally found at high frequency in each population and was distributed widely across different hosts, locations and years. Fourteen IGS and five EF haplotypes were found in the 12 populations, with six IGS haplotypes and one EF haplotype exclusive to buttercup. Analysis of published sequences for S. sclerotiorum populations from the USA, Canada, New Zealand and Norway showed that three of the IGS haplotypes and one EF haplotype were widely distributed, while eight IGS haplotypes were only found in the UK. Although common microsatellite and IGS/EF haplotypes were found on different hosts in the UK, there was evidence of differentiation, particularly for one isolated population on buttercup. However, overall there was no consistent differentiation of S. sclerotiorum populations from buttercup and crop hosts. Sclerotinia sclerotiorum therefore has a multiclonal population structure in the UK and the wide distribution of one microsatellite haplotype suggests spatial mixing at a national scale. The related species S. subarctica was also identified in one buttercup population.
Effect of susceptible and resistant canola plants on Plasmodiophora brassicae resting spore populations in the soil
Authors: Hwang S. F. , Ahmed H. U. , Zhou Q. , Rashid A. , Strelkov S. E. , Gossen B. D. , Peng G. , Turnbull G. D.
Published: May 2012

Clubroot, caused by Plasmodiophora brassicae, has become a serious threat to canola (Brassica napus) production in western Canada. Experiments were conducted to assess the effect of growing resistant and susceptible canola genotypes on P. brassicae soil resting spore populations under greenhouse, mini‐plot and field conditions. One crop of susceptible canola contributed 1·4 × 108 spores mL−1 soil in mini‐plot experiments, and 1 × 1010 spores g−1 gall under field conditions. Repeated cropping of susceptible canola resulted in greater gall mass compared to resistant canola lines. It also resulted in reduced plant height, increased clubroot severity in susceptible canola, and increased numbers of resting spores in the soil mix.
Characterization of the phosphoproteome of mature Arabidopsis pollen
Authors: Mayank Pururawa , Grossman Jonas , Wuest Samuel , Boisson‐Dernier Aurélien , Roschitzki Bernd , Nanni Paolo , Nühse Thomas , Grossniklaus Ueli
Published: May 2012

Successful pollination depends on cell–cell communication and rapid cellular responses. In Arabidopsis, the pollen grain lands on a dry stigma, where it hydrates, germinates and grows a pollen tube that delivers the sperm cells to the female gametophyte to effect double fertilization. Various studies have emphasized that a mature, dehydrated pollen grain contains all the transcripts and proteins required for germination and initial pollen tube growth. Therefore, it is important to explore the role of post‐translational modifications (here phosphorylation), through which many processes induced by pollination are probably controlled. We report here a phosphoproteomic study conducted on mature Arabidopsis pollen grains with the aim of identifying potential targets of phosphorylation. Using three enrichment chromatographies, a broad coverage of pollen phosphoproteins with 962 phosphorylated peptides corresponding to 598 phosphoproteins was obtained. Additionally, 609 confirmed phosphorylation sites were successfully mapped. Two hundred and seven of 240 phosphoproteins that were absent from the PhosPhAt database containing the empirical Arabidopsis phosphoproteome showed highly enriched expression in pollen. Gene ontology (GO) enrichment analysis of these 240 phosphoproteins shows an over‐representation of GO categories crucial for pollen tube growth, suggesting that phosphorylation regulates later processes of pollen development. Moreover, motif analyses of pollen phosphopeptides showed an over‐representation of motifs specific for Ca2+/calmodulin‐dependent protein kinases, mitogen‐activated protein kinases, and binding motifs for 14‐3‐3 proteins. Lastly, one tyrosine phosphorylation site was identified, validating the TDY dual phosphorylation motif of mitogen‐activated protein kinases (MPK8/MPK15). This study provides a solid basis to further explore the role of phosphorylation during pollen development.
Exhaled NO is a poor marker of asthma control in children with a reported use of asthma medication: a pharmacy‐based study
Authors: Vijverberg Susanne J. H. , Koster Ellen S. , Koenderman Leo , Arets Hubertus G. M. , van der Ent Cornelis K. , Postma Dirkje S. , Koppelman Gerard H. , Raaijmakers Jan A. M. , Maitland‐van der Zee Anke‐Hilse
Published: May 2012

To cite this article: Vijverberg SJH, Koster ES, Koenderman L, Arets HGM, van der Ent CK, Postma DS, Koppelman GH, Raaijmakers JAM, Maitland‐van der Zee A‐H. Exhaled NO is a poor marker of asthma control in children with a reported use of asthma medication: a pharmacy‐based study. Pediatr Allergy Immunol 2012: 23: 529–536.

Background:  A high fraction of nitric oxide in exhaled breath (FeNO) has been suggested to be a marker of ongoing airway inflammation and poorly controlled disease in asthma. The usefulness of FeNO to monitor asthma control is still debated today.

Aim:  To assess the validity of FeNO as a marker of asthma control in children with reported use of asthma medication.

Methods:  Fraction of nitric oxide in exhaled breath was measured in 601 children (aged 4–12 yr) with reported use of asthma medication in the past 6 months and in 63 healthy non‐asthmatic children (aged 5–12). Asthma control was assessed by the Asthma Control Questionnaire (ACQ). A receiver‐operator characteristics (ROC) curve was generated to assess the accuracy of FeNO as a marker for asthma control. Logistic regression analysis was used to study whether clinical, healthcare, medication, and environmental factors are associated with high FeNO levels (>25 ppb).

Results:  Fraction of nitric oxide in exhaled breath had a poor accuracy to discriminate well‐controlled from not well‐controlled asthma [area under the ROC curve: 0.56 (95% CI: 0.52–0.61, p = 0.008)]. In addition, high FeNO (>25 ppb) was associated with lower medication adherence rates (OR: 0.4; 95% CI 0.3–0.6), fewer antibiotic courses in the past year (OR: 0.6; 95% CI: 0.4–0.9), fewer leukotriene antagonists use in the past year (OR: 0.4; 95% CI: 0.2–0.9), and fewer visits to a (pulmonary) pediatrician (OR: 0.6; 95% CI: 0.4–0.9). Children living in a non‐urban environment had more often high FeNO levels (OR: 1.7; 95% CI: 1.1–2.6).

Conclusion:  High FeNO is a poor marker of asthma control in children with reported use of asthma medication. Various other factors, including medication adherence and medication use, are associated with increased FeNO levels.
Is prevention of atopic eczema with hydrolyzed formulas cost‐effective? A health economic evaluation from Germany
Authors: Mertens Janina , Stock Stephanie , Lüngen Markus , v. Berg Andrea , Krämer Ursula , Filipiak‐Pittroff Birgit , Heinrich Joachim , Koletzko Sibylle , Grübl Armin , Wichmann H.‐Erich , Bauer Carl‐P. , Reinhardt Dietrich , Berdel Dietrich , Gerber Andreas
Published: May 2012

To cite this article:Mertens J, Stock S, Lüngen M, Berg AV, Krämer U, Filipiak‐Pittroff B, Heinrich J, Koletzko S, Grübl A, Wichmann H‐E, Bauer C‐P, Reinhardt D, Berdel D, Gerber A. Is Prevention of Atopic Eczema with Hydrolyzed Formulas Cost‐Effective? A Health Economic Evaluation from Germany.Pediatr Allergy Immunol2012:23: 597–604.

Objective: The German Infant Nutritional Intervention (GINI) trial, a prospective, randomized, double‐blind intervention, enrolled children with a hereditary risk for atopy. When fed with certain hydrolyzed formulas for the first 4 months of life, the risk was reduced by 26–45% in PP and 8–29% in intention‐to‐treat (ITT) analyses compared with children fed with regular cow’s milk at age 6. The objective was to assess the cost‐effectiveness of feeding hydrolyzed formulas.

Patients and Methods: Cost‐effectiveness was assessed with a decision tree model programmed in TreeAge. Costs and effects over a 6‐yr period were analyzed from the perspective of the German statutory health insurance (SHI) and a societal perspective at a 3% effective discount rate followed by sensitivity analyses.

Results: The extensively hydrolyzed casein formula would be the most cost‐saving strategy with savings of 478 € per child treated in the ITT analysis (CI95%: 12 €; 852 €) and 979 € in the PP analysis (95%CI: 355 €; 1455 €) from a societal perspective. If prevented cases are considered, the partially whey hydrolyzed formula is cost‐saving (ITT ‐5404 €, PP ‐6358 €). From an SHI perspective, the partially whey hydrolyzed formula is cost‐effective, but may also be cost‐saving depending on the scenario. An extensively hydrolyzed whey formula also included into the analysis was dominated in all analyses.

Conclusions: For the prevention of AE, two formulas can be cost‐effective or even cost‐saving. We recommend that SHI should reimburse formula feeding or at least the difference between costs for cow’s milk formula and the most cost‐effective formula.
Outcomes of transplantation using organs from a donor infected with Klebsiella pneumoniae carbapenemase (KPC)‐producing K. pneumoniae
Authors: Ariza‐Heredia E.J. , Patel R. , Blumberg E.A. , Walker R.C. , Lewis R. , Evans J. , Sankar A. , Willliams M.D. , Rogers J. , Milano C. , Razonable R.R.
Published: May 2012

Transmission of pathogens from donor to recipient is a potential complication of organ transplantation. Herein, we describe the clinical course and outcomes of 4 transplant recipients who received tissues from a donor with multi‐organ infection with Klebsiella pneumoniae carbapenemase (KPC)‐producing K. pneumoniae. Recipient 1 underwent simultaneous liver and kidney transplantation for alpha‐1 antitrypsin deficiency and alcohol‐related cirrhosis, and acute tubular necrosis, respectively. Soon after transplantation, he developed an infected hematoma and peritonitis due to KPC‐producing K. pneumoniae despite receiving tigecycline prophylaxis. He was treated with a prolonged course of tigecycline, amikacin, and meropenem, in conjunction with surgical evacuation and percutaneous drainage of the infected fluid collections. Recipient 2 underwent living‐donor liver transplantation for cholangiocarcinoma and primary sclerosing cholangitis using vein graft from the donor infected with KPC‐producing K. pneumoniae. Culture of the preservation fluid containing the vein graft was positive for KPC‐producing K. pneumoniae. The patient received preemptive amikacin and tigecycline, and he did not develop any infection (as evidenced by negative surveillance blood cultures). The isolates from the donor and Recipients 1 and 2 were indistinguishable by pulsed‐field gel electrophoresis. Recipients 3 and 4 underwent kidney and heart transplantation, respectively; both patients received perioperative tigecycline prophylaxis and did not develop infections due to KPC‐producing K. pneumoniae. All transplant recipients had good short‐term outcomes. These cases highlight the importance of inter‐institutional communication and collaboration to ensure the successful management of recipients of organs from donors infected with multidrug‐resistant organisms.
Pattern recognition analyses of brain activation elicited by happy and neutral faces in unipolar and bipolar depression
Authors: Mourão‐Miranda Janaina , Almeida Jorge RC , Hassel Stefanie , de Oliveira Leticia , Versace Amelia , Marquand Andre F , Sato Joao R , Brammer Michael , Phillips Mary L
Published: May 2012

Mourão‐Miranda J, Almeida JRC, Hassel S, de Oliveira L, Versace A, Marquand AF, Sato JR, Brammer M, Phillips ML. Pattern recognition analyses of brain activation elicited by happy and neutral faces in unipolar and bipolar depression.  Bipolar Disord 2012: 14: 451–460. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S.

Objectives:  Recently, pattern recognition approaches have been used to classify patterns of brain activity elicited by sensory or cognitive processes. In the clinical context, these approaches have been mainly applied to classify groups of individuals based on structural magnetic resonance imaging (MRI) data. Only a few studies have applied similar methods to functional MRI (fMRI) data.

Methods:  We used a novel analytic framework to examine the extent to which unipolar and bipolar depressed individuals differed on discrimination between patterns of neural activity for happy and neutral faces. We used data from 18 currently depressed individuals with bipolar I disorder (BD) and 18 currently depressed individuals with recurrent unipolar depression (UD), matched on depression severity, age, and illness duration, and 18 age‐ and gender ratio‐matched healthy comparison subjects (HC). fMRI data were analyzed using a general linear model and Gaussian process classifiers.

Results:  The accuracy for discriminating between patterns of neural activity for happy versus neutral faces overall was lower in both patient groups relative to HC. The predictive probabilities for intense and mild happy faces were higher in HC than in BD, and for mild happy faces were higher in HC than UD (all p < 0.001). Interestingly, the predictive probability for intense happy faces was significantly higher in UD than BD (p = 0.03).

Conclusions:  These results indicate that patterns of whole‐brain neural activity to intense happy faces were significantly less distinct from those for neutral faces in BD than in either HC or UD. These findings indicate that pattern recognition approaches can be used to identify abnormal brain activity patterns in patient populations and have promising clinical utility as techniques that can help to discriminate between patients with different psychiatric illnesses.
The functional neuroanatomy of bipolar disorder: a consensus model
Authors: Strakowski Stephen M , Adler Caleb M , Almeida Jorge , Altshuler Lori L , Blumberg Hilary P , Chang Kiki D , DelBello Melissa P , Frangou Sophia , McIntosh Andrew , Phillips Mary L , Sussman Jessika E , Townsend Jennifer D
Published: May 2012

Strakowski SM, Adler CM, Almeida J, Altshuler LL, Blumberg HP, Chang KD, DelBello MP, Frangou S, McIntosh A, Phillips ML, Sussman JE, Townsend JD. The functional neuroanatomy of bipolar disorder: a consensus model.  Bipolar Disord 2012: 14: 313–325. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S.

Objectives:  Functional neuroimaging methods have proliferated in recent years, such that functional magnetic resonance imaging, in particular, is now widely used to study bipolar disorder. However, discrepant findings are common. A workgroup was organized by the Department of Psychiatry, University of Cincinnati (Cincinnati, OH, USA) to develop a consensus functional neuroanatomic model of bipolar I disorder based upon the participants’ work as well as that of others.

Methods:  Representatives from several leading bipolar disorder neuroimaging groups were organized to present an overview of their areas of expertise as well as focused reviews of existing data. The workgroup then developed a consensus model of the functional neuroanatomy of bipolar disorder based upon these data.

Results:  Among the participants, a general consensus emerged that bipolar I disorder arises from abnormalities in the structure and function of key emotional control networks in the human brain. Namely, disruption in early development (e.g., white matter connectivity and prefrontal pruning) within brain networks that modulate emotional behavior leads to decreased connectivity among ventral prefrontal networks and limbic brain regions, especially the amygdala. This developmental failure to establish healthy ventral prefrontal–limbic modulation underlies the onset of mania and ultimately, with progressive changes throughout these networks over time and with affective episodes, a bipolar course of illness.

Conclusions:  This model provides a potential substrate to guide future investigations and areas needing additional focus are identified.
Effects of medication on neuroimaging findings in bipolar disorder: an updated review
Authors: Hafeman Danella M , Chang Kiki D , Garrett Amy S , Sanders Erica M , Phillips Mary L
Published: May 2012

Hafeman DM, Chang KD, Garrett AS, Sanders EM, Phillips ML. Effects of medication on neuroimaging findings in bipolar disorder: an updated review.  Bipolar Disord 2012: 14: 375–410. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S.

Objective:  Neuroimaging is an important tool for better understanding the neurobiological underpinnings of bipolar disorder (BD). However, potential study participants are often receiving psychotropic medications which can possibly confound imaging data. To better interpret the results of neuroimaging studies in BD, it is important to understand the impact of medications on structural magnetic resonance imaging (sMRI), functional MRI (fMRI), and diffusion tensor imaging (DTI).

Methods:  To better understand the impact of medications on imaging data, we conducted a literature review and searched MEDLINE for papers that included the key words bipolar disorder and fMRI, sMRI, or DTI. The search was limited to papers that assessed medication effects and had not been included in a previous review by Phillips et al. (Medication effects in neuroimaging studies of bipolar disorder. Am J Psychiatry 2008; 165: 313–320). This search yielded 74 sMRI studies, 46 fMRI studies, and 15 DTI studies.

Results:  Medication appeared to influence many sMRI studies, but had limited impact on fMRI and DTI findings. From the structural studies, the most robust finding (20/45 studies) was that lithium was associated with increased volumes in areas important for mood regulation, while antipsychotic agents and anticonvulsants were generally not. Regarding secondary analysis of the medication effects of fMRI and DTI studies, few showed significant effects of medication, although rigorous analyses were typically not possible when the majority of subjects were medicated. Medication effects were more frequently observed in longitudinal studies designed to assess the impact of particular medications on the blood oxygen level‐dependent (BOLD) signal. With a few exceptions, the observed effects were normalizing, meaning that the medicated individuals with BD were more similar than their unmedicated counterparts to healthy subjects.

Conclusions:  The effects of psychotropic medications, when present, are predominantly normalizing and thus do not seem to provide an alternative explanation for differences in volume, white matter tracts, or BOLD signal between BD participants and healthy subjects. However, the normalizing effects of medication could obfuscate differences between BD and healthy subjects, and thus might lead to type II errors.
Fostering excellence: development of a course to prepare graduate students for research on migration and health
Authors: Ogilvie Linda , Higginbottom Gina , Burgess‐Pinto Elizabeth , Murray Christina
Published: May 2012

Canada is an immigrant‐receiving nation and many graduate students in nursing and other disciplines pursue immigrant health research. As these students often start with inadequate understanding of the policy, theoretical, and research contexts in which their work should be situated, we became concerned that the theses and dissertations were less sophisticated than were both possible and desirable. This led to development of a PhD‐level course titled Migration and Health in the Canadian Context. In this study, we provide an analytic overview including course description, objectives, assignments, and specific class topics. Areas of focus include historical and theoretical considerations; determinants of immigrant health; refugee health; cultural competence and cultural safety; research challenges, approaches, and skills; policy‐relevant research; and educational imperatives in the health and related disciplines. Salient research is introduced in each of these classes. While Canada is the main focus, comparative data are provided and there is relevance for nurse‐researchers in other immigrant‐receiving countries.
Effects of an assertive community program in patients with severe mental disorders and impact on their families
Authors: Huguelet Philippe , Koellner Vanessa , Boulguy Serge , Nagalingum Kriss , Amani Soumaia , Borras Laurence , Perroud Nader
Published: May 2012

Aims:  Assertive community treatment (ACT) is known to have a positive impact on the number and length of inpatient stays. However, recent studies have shown little or no effect of such programs in European settings. This paper aims to describe the impact of a newly implemented ACT program on patients and their families' burden. Predictive factors have also been examined.

Method:  Fifty‐five patients characterized by heavy use of psychiatric care, numerous hospitalizations, or failure to link with outpatient psychiatric care and their relatives were followed. Data were gathered on patients before and after follow up as well as on relatives' burden and costs. The number and domains of clinician interventions have been detailed.

Results:  The ACT program had a positive effect on symptoms, psychosocial adaptation and quality of life. Age was the most significant predictor of changes. Older patients, most of them suffering from delusional disorders, showed no improvement or even some impairment. Finally, the program appeared to have a marked effect on easing families' burden in domains such as assistance in daily life activities and costs.

Conclusions:  ACT appears to be recommended for patients with poor outcome when treated in other settings. Early intervention seems to be justified as highlighted by younger age being the best predictor of positive changes. Families can be helped considerably, particularly those confronted with patients with persistent disturbing symptoms which do not, however, warrant hospitalization. Finally, the fact that patients with delusional disorder do not seem to improve warrants further research.
Characterization of the anaerobic microbial community in oil‐polluted subtidal sediments: aromatic biodegradation potential after thePrestigeoil spill
Authors: Acosta‐González Alejandro , Rosselló‐Móra Ramon , Marqués Silvia
Published: May 2012

The influence of massive crude oil contamination on the microbial population of coastal sediments was investigated in the Cíes Islands 18 and 53 months after the tankerPrestigesank off the NW coast of Spain. Communities were studied by means of culturable and non‐culturable methods at three horizons in the sediment (2–5 cm, 12–15 cm and 25–30 cm) in an area heavily affected by the spill. Most probable number of aerobic hydrocarbon degraders was highest in the upper zone and decreased dramatically with depth. Aromatic oxidizing nitrate‐reducing bacteria counts were slightly higher than aerobes in the oxidized layer, and also decreased considerably with depth. Iron‐reducing bacteria were barely detectable. The highest counts were obtained for sulfate‐reducing bacteria, which represented the most relevant fraction of aromatic oxidizers, being maximal at 12–15 cm depth. The community response to high pollution levels was characterized by an increase in culturable populations active towards crude oil components despite the strong decay in the total cell counts. Analysis of whole 16S rRNA gene libraries obtained from the two sampling times and different depths (1460 sequences in all) showed a predominance ofGamma‐ andDeltaproteobacteria, which was confirmed by fluorescentin situhybridization.Desulfobacteraceaewas the most abundant group amongDeltaproteobacteria, followed by sequences affiliated with the orderMyxococcales. All retrieved sequences of this order affiliated with a marine myxobacterial clade. Interestingly, sequences affiliated to the orderDesulfarculalesconstituted half of theDeltaproteobacteriasequences retrieved from the heaviest contaminated sample. Principal coordinates analysis of 16S rRNA gene libraries suggested fluctuation in the community distribution with time. Changes in the abundance of certain groups such asBacteroidetescontributed to these observed differences. Although predominance of certain metabolic types in each horizon could be delimited, a considerable overlap in the use of electron acceptors was observed, confirming that each selected zone could be influenced by more than one respiratory metabolism. Altogether, our results evidence the presence in these sediments of a microbial community with potential to respond against hydrocarbon contamination, consistent with the long pollution history of the site.
Clinical effectiveness of transversus abdominis plane (TAP) block in abdominal surgery: a systematic review and meta‐analysis
Authors: Johns N. , O’Neill S. , Ventham N. T. , Barron F. , Brady R. R. , Daniel T.
Published: May 2012

Aim  Reduced opioid use in the immediate postoperative period is associated with decreased complications. This study aimed to determine the effect of transversus abdominis plane (TAP) block on morphine requirements 24 h after abdominal surgery. Secondary outcomes included the effect of TAP block on morphine use 48 h after surgery, incidence of postoperative nausea and vomiting (PONV) and impact on reported pain scores (visual analogue scale).

Method  A systematic review of the literature was conducted for randomised controlled trials (RCTs) evaluating the effects of TAP block in adults undergoing abdominal surgery. For continuous data, weighted mean differences (WMD) were formulated; for dichotomous data, odds ratios (OR) were calculated. Results were produced with a random effects model with 95% confidence intervals (CI).

Results  Nine studies, including published and unpublished data, containing a total of 413 patients were included. Of these 205 received a TAP block and 208 a placebo. Cumulative morphine utilization was statistically significantly reduced at 24 h. [WMD = 23.71 mg (38.66–8.76); P = 0.002] and 48 h [WMD = 38.08 mg (18.97–57.19); P < 0.0001] in patients who received a TAP block and the incidence of PONV was significantly reduced [OR = 0.41(0.22–0.74); P = 0.003]. There was a nonsignificant reduction in the visual analogue scales of postoperative pain [WMD = 0.73 cm (1.84–0.38), P = 0.2]. There were no reported adverse events following TAP block.

Conclusion  Transversus abdominis plane block is safe, reduces postoperative morphine requirements, nausea and vomiting and possibly the severity of pain after abdominal surgery. It should be considered as part of a multimodal approach to anaesthesia and enhanced recovery in patients undergoing abdominal surgery.
Episodic blindness and ataxia in a horse with cholesterinic granulomas
Authors: Tofflemire Kyle L. , David Whitley R. , Wong David M. , Waller Kenneth R. , Myers Ronald K. , Pillatzki Angela E. , Ben‐Shlomo Gil
Published: May 2012

An 11‐year‐old Oldenburg mare presented following three episodes of acute, transient blindness, ataxia, and disorientation within the preceding 7 months. Clinical improvement, including return of vision, occurred within 1 week of initiating corticosteroid therapy for each of the three episodes. However, mild right‐sided miosis was a consistent finding on ophthalmic examinations. Routine clinicopathologic testing revealed no significant abnormalities, and testing of cerebral spinal fluid for selected infectious diseases was unrewarding. Computed tomography of the brain demonstrated a hyperattenuating mass with peripheral mineralization in the rostroventral aspect of each lateral ventricle. The mare was euthanized due to a guarded to poor prognosis. On histopathology, the masses consisted of clusters of cholesterol clefts admixed with leukocytes, mineral deposits, and connective tissue. Cholesterinic granulomas of the lateral ventricles and hydrocephaly were diagnosed. Cholesterinic granulomas should be considered a differential diagnosis in horses presenting for intermittent blindness.
What is a nurse? Is there an international consensus?
Authors: Currie E.J. , Carr‐Hill R.A.
Published: May 2012

CURRIE E.J. & CARR HILL R.A. (2013) What is a nurse? Is there an international consensus? International Nursing Review60, 67–74

Background:  Historical experience and health service modernization partly account for the variation seen in definitions of what a ‘nurse’ is from country to country. It is unclear if international disparities in nursing provision, apparent in health data for developed countries, demonstrate real differences in staffing patterns or simply reflect the wide variations in understanding and use of terms for different categories of nurse.

Aim:  This paper is an opinion piece of international interest discussing the need for standardization in definitions of different categories of nurse internationally.

Discussion:  The International Council for Nurses (ICN), the World Health Organization and the Organisation for Economic Cooperation and Development (OECD) all have different ways of defining a nurse. The wide variation in terms is particularly apparent from OECD countries however, where nursing density data present wide disparities, not readily accounted for by gross national product. Skill mix and clinical role developments may account for these better.

Conclusion:  Until proper consensus is reached on what a nurse is and does, any skill mix or clinical role developments will only have limited international relevance, especially in OECD countries. If nursing qualifications are to be valid even across the European Union, then recommended standards such as those of the ICN, must be specified in terms of what different categories of nurses actually can do, and their responsibilities and roles within that scope of practice. Standardization of definitions of categories of nurse internationally should reduce confusion and promote better understanding of patterns of nurse staffing and the effect these may have on patient outcomes.
Infant pointing serves an interrogative function
Authors: Begus Katarina , Southgate Victoria
Published: May 2012

In recent years there has been a resurgence of interest in the motivations behind, and the function of, infant pointing behaviour. Many studies have converged on the view that early pointing reflects a motivation to share attention and interest with others. Under one view, it is the sharing of attention itself that is the ultimate function of pointing, and is an early manifestation of a uniquely human social cognition that is geared towards cooperation and collaboration. In the current study, we tested an alternative hypothesis in which the goal of pointing is not attention sharing itself, but the information‐laden response that infants tend to receive as a result of sharing attention. If infants indeed point in order to obtain information, their pointing should be modulated by the perceived ability of the other to provide this information. In Experiment 1, 16‐month‐olds who interacted with a demonstrably knowledgeable experimenter pointed significantly more to novel objects than infants who interacted with an ignorant experimenter. In Experiment 2, we confirmed that this finding was due to the perceived competence of the experimenter rather than to the different ways in which the experimenter responded to infants’ points. Our results suggest that one function of pointing in infancy is to obtain information from others, and that infants selectively elicit desired information from those whom they perceive could competently provide it.
Unfree Again: Social Reproduction, Flexible Labour Markets and the Resurgence of Gang Labour in the UK
Authors: Strauss Kendra
Published: May 2012

Abstract:  The reproduction of human insecurity in contemporary capitalist societies is linked to the need to “produce” labour at a price that permits the realisation of surplus value, and crises of social reproduction (both generalised and specific). In this paper I use a social reproduction lens to focus on the example of the emergence, and recent resurgence, of gang labour in the UK. I look first at the gang labour system, its evolution, and processes and institutions of regulation. The paper then examines the ways in which the gang labour system sheds light on interrelationship of relations of production and reproduction, processes of class formation, and how the power of supermarkets and the political imperative to keep food costs down, which are related to patterns of migration and racialisation, privilege the reproduction of some workers over others. This in turn signals the need to engage with the role and significance of unfree labour in contemporary economies.
After the Exception: HIV/AIDS Beyond Salvation and Scarcity
Authors: Ingram Alan
Published: May 2012

Abstract:  Access to treatment for HIV/AIDS became a flashpoint for global justice struggles in the late 1990s. An expanding international response, premised to a significant extent on the idea of HIV/AIDS as an exceptional global problem, has since delivered treatment, care and prevention to growing numbers of people. HIV/AIDS exceptionalism, however, has increasingly been questioned, many aspects of the response have been critiqued and donor funding has started to decline. I argue that, having been framed as an exceptional humanitarian emergency, the question of HIV/AIDS as a global problem is increasingly located within a discourse of scarcity. Tracking the growing entanglement of global HIV/AIDS relief with neoliberal governmentality and the emergence of something I term therapeutic neoliberalism, I argue that the shift from a rationality of salvation to one of administration poses new challenges for global health activism. Questioning the discourse of scarcity remains essential to an alternative global health agenda.
Relationship between total bilirubin and endothelial function, inflammation and oxidative stress in HIV‐infected adults on stable antiretroviral therapy
Authors: Hileman CO , Longenecker CT , Carman TL , Milne GL , Labbato DE , Storer NJ , White CA , McComsey GA
Published: May 2012

Objectives

Enhanced inflammation is evident in HIV infection, even with virological suppression. Outside HIV infection, studies show an independent association between higher total bilirubin and better endothelial function as well as a lower prevalence of coronary heart disease, possibly as a consequence of the anti‐inflammatory and antioxidant effect of bilirubin. The aim of this study was to determine whether such an association exists in HIV‐infected individuals.

Methods

A cross‐sectional study was performed in HIV‐1‐infected adults on stable antiretroviral therapy (ART) to determine if a relationship exists between total bilirubin and endothelial function [flow‐mediated dilation (FMD) of the brachial artery], inflammation [interleukin‐6 (IL‐6), soluble tumour necrosis factor receptors, C‐reactive protein, and adhesion molecules], coagulation markers (fibrinogen and D‐dimer) and oxidative stress (F
2‐isoprostanes). Endpoints were compared based on total bilirubin levels and atazanavir status using distributionally appropriate, two‐sample tests. Correlation coefficients were determined between total bilirubin and endpoints. Linear regression was used to model the relationship between total bilirubin (and atazanavir status) and FMD.

Results

A total of 98 adults were included in the study. Total bilirubin was higher in the atazanavir group when compared to the non‐atazanavir group [median (interquartile range) 1.8 (1.1–2.6) vs. 0.6 (0.4–1.4) mg/dL; P < 0.01] as were insulin, the homeostasis model assessment of insulin resistance (HOMA‐IR) and fibrinogen. Total bilirubin was positively correlated with fibrinogen and was not correlated with other outcomes. After adjustment, neither total bilirubin nor atazanavir status was associated with FMD.

Conclusions

In virologically suppressed, HIV‐infected adults on stable ART, neither total bilirubin nor atazanavir use was associated with improved endothelial function as measured using FMD, inflammation or oxidative stress as measured using biomarkers.
Rethinking community and public space from the margins: a study of community libraries in Bangalore's slums
Authors: Pyati Ajit K , Kamal Ahmad M
Published: May 2012

The growth of slums in urban regions of the Global South is an issue of major concern for a variety of fields. These rapid urban changes are presenting a myriad of challenges, including the provision of social and educational services to urban populations that are often invisible to the gaze of the state. One issue that is not often discussed in slums is the role that educational spaces and places can play in facilitating community development. Specifically, this article discusses the case of community libraries in the slums of Bangalore, India. Community libraries, while only part of a larger empowerment and development strategy, can play an important role in providing a sense of place and belonging. The libraries that are part of this case study are focused on providing services to children, which in certain respects creates wider community support.
Practising workplace geographies: embodied labour as method in human geography
Authors: McMorran Chris
Published: May 2012

Embodied experience, situated corporeal knowledge(s), and bodily mobility lie at the forefront of many research agendas within geography. However, the body has been largely ignored in workplace studies. That is, the context‐specific, embodied daily practices of work remain overlooked within workplace geographies. In this paper, I reiterate a call made nearly two decades ago for more analyses of ‘bodies at work’ in geography, and I suggest a way of studying bodies at work that integrates the context‐specific concerns of labour geographers with the theoretical interest on the body found elsewhere in geography: working participant observation. I claim working participant observation provides an opportunity to analyse how generic ideas about flexible labour are put into practice and creatively adapted by bodies in the workplace, especially in service industries. Through a description of working participant observation carried out in a handful of inns in Japan, I discuss how this method allows one to conduct research through the body and enables geographers to take seriously the spatiality and creativeness of embodied work practices.
A Focus Group Study of Mexican Immigrant Men's Perceptions of Weight and Lifestyle
Authors: Martinez Joseph , Powell Jamie , Agne April , Scarinci Isabel , Cherrington Andrea
Published: May 2012

Objective

Despite interest in family‐centered obesity and diabetes prevention programs for Latinos, few studies have assessed men's perspectives on obesity‐related behaviors. The objective of this study was to explore Mexican immigrant men's perspectives regarding weight, diet, and physical activity as they relate to the individual and the family.

Design and Sample

This was a focus group study with a convenience sample of Mexican immigrant men (n = 16).

Measures

A moderator's guide was used to elicit perceptions of personal and family behaviors influencing weight and lifestyle.

Results

Mean age of participants was 41 years (SD ± 12.7), and 100% were born in Mexico. Mean time in Alabama was 8 years. Perceived benefits of a healthy weight included improved mobility and decreased morbidities. Perceived barriers to a healthy lifestyle included demanding work schedules and an environment not conducive to walking. Participants described immigration as having a negative impact on family unity and established meal structures.

Conclusion

Previous studies among Latinas cite husband resistance as a barrier to sustained diet and lifestyle change; however, men in this study voiced openness to programs for obesity and diabetes prevention. Future family centered programs should engage men and promote communication within the family on common goals related to health and illness prevention.