bluuebunny/crossref_metadata_2025 huggingface dataset:
Sudden Advanced Illness
Authors: Barnett Michael D. , Williams Beverly R. , Tucker Rodney O.
Published: December 2014

Background:

End-of-life discussions in critically-ill patients with acute surgical conditions may be rushed and occur earlier during hospitalization. This study explores the concept of sudden advanced illness (SAI) and its relevance to patients requiring Palliative and Surgical Critical Care.

Methods:

Semi-structured interviews were completed with 16 physicians, querying each about (1) definitional components, (2) illustrative cases, and (3) comfort with SAI. Analysis was done by grounded theory.

Results:

SAI was characterized as unforeseen, emerging abruptly and producing devastating injury, often in healthy, younger patients. There is (1) prognostic uncertainty, (2) loss of capacity, and (3) unprepared surrogate decision-making. Cases are emotionally-charged and often personal.

Conclusion:

The emerging concept of SAI is important for understanding how Palliative Care can enhance care for this subset of patients.
Everyday Fragments on the Ceiling of Room 407
Authors: Bramwell-Davis Prunella , Filer Jan , Maddern Lynn , Nolan Miljevic Jelena , Nymanhall Sarah , Porter Sue , Pyrsou Bubukee , Reed Malcolm , Sakellariadis Artemi , Speedy Jane , Styles Peggy , Wilson Vasquez Goya
Published: December 2014

Jane Speedy was leading the community of scholars in the “open space” session for March 2014 in Room 407. The Narrative Inquiry Centre held an “open space” session every month on the fourth floor of the Graduate School of Education. In “open space” sessions, one scholar led with exemplars of work that was troubling them/that they were troubling, after which others contributed their thoughts/comments and writing. Jane Speedy’s recent stroke had reduced/distilled/extended her writing into fragments. Her colleagues followed/responded with fragments of their own and thus this text was collaboratively written, in real time, on March 3, 2014.
A Multiple-Group Confirmatory Factor Analysis of Self-Determination Between Groups of Adolescents With Intellectual Disability or Learning Disabilities
Authors: Seong Youjin , Wehmeyer Michael L. , Palmer Susan B. , Little Todd D.
Published: December 2014

Promoting self-determination has been identified as an important practice for the successful transition of youth and young adults with disabilities, and numerous studies have examined the relationship between levels of self-determination and transition-related and postsecondary outcomes. Only a few such studies, however, have examined the global self-determination of students with disabilities. The majority of those studies measured self-determination using The Arc’s Self-Determination Scale (SDS) and involved students with intellectual disability (ID) or learning disabilities (LD), examining the impact of interventions, environment, disability category, intelligence level, and gender on self-determination. Although students with intellectual and LD are often studied as a single group, for students with cognitive disabilities, there have been no studies that examine whether assessments are measuring the same construct within these two populations. The purpose of this study is to test for measurement invariance to examine further whether a measure like the SDS is assessing the same concept in students with ID and in students with LD by conducting analysis with a series of multiple-group confirmatory factor analysis (CFA). Results showed that the SDS is measuring the same construct across both groups; however, significant differences in both groups were found in latent variances/covariances and latent means.
An Ecological Model for Intervention for Juvenile Justice-Involved Girls
Authors: Javdani Shabnam , Allen Nicole E.
Published: December 2014

Despite increased attention on girls’ delinquency, evidence-based interventions have been largely lacking. We aim to (a) describe the design and implementation of a gender-specific program for juvenile justice-involved girls and (b) present prospective data on three cohorts of participants. Fifty-two girls were enrolled in the program called the Girls Advocacy Project (GAP). Key risk and protective factors were identified based on existing literature and assessed. Over time, youth reported greater resilience and self-efficacy; fewer risk behaviors, including violence, crime, and substance use; and decreased distress (e.g., depression, anxiety, and anger). Hypothesized program mechanisms and recommendations for future research are discussed.
The typology and function of private speech in a young man with intellectual disabilities
Authors: Lechler Suzanne , Hare Dougal Julian
Published: December 2014

A naturalistic observational single case study was carried out to investigate the form and function of private speech (PS) in a young man with Dandy–Walker variant syndrome and trisomy 22. Video recordings were observed, transcribed and coded to identify all combinations of type and form of PS. Through comparison between theories of PS and the results, five putative functions were identified in this case. In contrast to the predominant theoretical models of inner and PS, it is proposed that PS cannot necessarily be reduced to a single functional definition.
Vein grafts to augment flexor tendon repairs: a biomechanical study on strength and gap resistance
Authors: Rodger M. P. , Theobald P. , Giddins G.
Published: December 2014

The ultimate tensile repair strength and gap formation of the pig extensor tendons repaired with a standard 4-strand Savage with epitendinous suture repair, was compared with a new technique of adding a vein sleeve. Force and displacement data were recorded, and video images during linear cyclic loading up to failure. At 35 N, video-graphic observation detected significantly smaller gap lengths in the standard and vein repair specimens compared with standard repair specimens ( p = 0.047). The incidence of 3 mm gaps between the repaired tendon ends in the standard repair group was 20 %, but no 3 mm gaps were seen in the standard and vein specimens. The addition of a vein sleeve increased the ultimate tensile strength of the standard repair from 50.4 N (4.5) to 55.4 N (4.5); this was statistically significant ( p = 0.03). This study demonstrated that the addition of a vein graft prevented gap formation and increased ultimate tensile strength of tendon repair.
Schwannomatosis on a Single Foot
Authors: Min Hak-Jin , Kim Ki Chun , Jun Sung Han , Lee Young Gun
Published: December 2014

Schwannomatosis has been recently recognized as the third major type of neurofibromatosis. It causes multiple schwannomas without the vestibular tumors that are diagnostic of neurofibromatosis type 2. Schwannoma is rarely found in the foot, and it is still rarer to find multiple schawannomas in a single peripheral nerve on the foot. In this article, we describe a case of schwannomatosis case on a single foot.

Levels of Evidence: Case report, Level IV
Neonatal Repair of Common Arterial Trunk With Intact Ventricular Septum
Authors: Garg Pankaj , Mishra Amit , Shah Ritesh , Parmar Divyakant , Anderson Robert H.
Published: December 2014

We report a rare case of common arterial trunk with intact ventricular septum, a large patent arterial duct, and normally developed aortic arch. We discuss its possible embryology, emphasizing the phenotypic differences from aortopulmonary window, and describe our surgical management.
Contained Rupture of Mycotic Aneurysm of the Left Circumflex Coronary Artery in a Child
Authors: Joshi Reena K. , Jyoti Aman , Aggarwal Neeraj , Aggarwal Mridul , Joshi Raja
Published: December 2014

Coronary artery aneurysm (CAA) is defined as dilatation of a coronary artery segment to a diameter of more than 1.5-fold normal size. Rupture of CAA is a catastrophic event and may result in sudden death or myocardial infarction. We report this unusual case of contained rupture of the left circumflex CAA.
Role of Socioeconomic Status in Predicting Sonographically Detected Breast Cancer Compared With Family History, Age, or Ethnicity
Authors: Swarts Katlin L. , Guthrie Joy D.
Published: December 2014

To determine if socioeconomic status is another risk factor in the development and treatment of breast cancer, the records of 250 women, equally divided between those with and without breast cancer, were studied at an outpatient clinic. The frequency of sonographically detected breast cancer increased systematically with respect to age, from 0% at age <30 years to 70.5% at age ≥50 years. The frequency of detection was higher among white (non-Hispanic) women, 69.4%, compared with nonwhite (Hispanic, Black, Asian) women, 42.3%. Breast cancer detection was higher (55.3%) among the lowest income group (<$40,345) than among higher income groups (45.6%) and higher among patients with Medicare (89.2%) and Medicaid (50%) compared with private, other, or no medical insurance (38.1%–44.4%). Detection was higher among women with a family history of breast cancer (55.0%) compared with no family history (46.7%) and higher among nulliparous women (100%) than nonnulliparous women (29.1%). These data suggest that aspects of socioeconomic status may be as predictive of sonographically detected breast cancer as age, ethnicity, and nulliparity.
Effect of filler metal and post-weld friction stir processing on stress corrosion cracking susceptibility of Al–Zn–Mg arc welds
Authors: Borchers T. E. , Seid A. , Babu S. S. , Shafer P. , Zhang W.
Published: December 2014

Localised T (tau) phase precipitation at the weld toe of gas metal arc welds was correlated to stress corrosion cracking in the lap joints of aluminium alloy (AA) 7003 (Al–Zn–Mg) welded with AA 5356 (Al–Mg) type filler wire. To further investigate the detrimental effect of T phase precipitates on cracking initiation, two strategies were developed. First, welds were made with AA 4043 (Al–Si), eliminating the T phase precipitation, while maintaining similar heat affected zone characteristics. Second, the toe region of Al–Zn–Mg weld, made with AA 5356 filler wire, was post-weld friction stir processed through which the T precipitates were displaced and encapsulated in a subsurface region, isolating those precipitates from the surface corrosive environment. For both cases, an increase in cracking resistance was demonstrated. The impact of processing on joint strength was discussed based on the lap shear tensile testing data.
Evidence of an oncogenic role of aberrant TOX activation in cutaneous T-cell lymphoma
Authors: Huang Yuanshen , Su Ming-Wan , Jiang Xiaoyan , Zhou Youwen
Published: December 2014

Key Points

TOX is aberrantly expressed in primary Sézary cells and its levels correlate with increased risk of disease-specific mortality. TOX knockdown promotes apoptosis and reduces cell proliferation in CTCL cells, partially through inducing p27 and p57.
Elafin is downregulated during breast and ovarian tumorigenesis but its residual expression predicts recurrence
Authors: Caruso Joseph A , Karakas Cansu , Zhang Jing , Yi Min , Albarracin Constance , Sahin Aysegul , Bondy Melissa , Liu Jinsong , Hunt Kelly K , Keyomarsi Khandan
Published: December 2014

Introduction

Elafin is an endogenous serine protease inhibitor. The majority of breast cancer cell lines lack elafin expression compared to human mammary epithelial cells. In this study, we hypothesized that elafin is downregulated during breast and ovarian tumorigenesis.

Methods

We examined elafin expression by immunohistochemistry (IHC) in specimens of normal breast tissue (n = 24), ductal carcinoma in situ (DCIS) (n = 54), and invasive breast cancer (n = 793). IHC analysis of elafin expression was also performed in normal fallopian tube tissue (n = 20), ovarian cystadenomas (n = 9), borderline ovarian tumors (n = 21), and invasive ovarian carcinomas (n = 216). To understand the significance of elafin in luminal breast cancer cell lines, wild-type or M25G elafin (lacking the protease inhibitory function) were exogenously expressed in MCF-7 and T47D cells.

Results

Elafin expression was downregulated in 24% of DCIS and 83% of invasive breast tumors when compared to elafin expression in the normal mammary epithelium. However, the presence of elafin-positive cells in invasive breast tumors, even at low frequency, correlated with poor recurrence-free survival (RFS), reduced overall survival (OS), and clinicopathological markers of aggressive tumor behavior. Elafin-positive cells were an especially strong and independent prognostic marker of reduced RFS in IHC-defined luminal A-like tumors. Elafin was also downregulated in 33% of ovarian cystadenomas, 43% of borderline ovarian tumors, and 86% of invasive ovarian carcinomas when compared to elafin expression in the normal fallopian tube. In ovarian tumors, elafin-positive cells were correlated with reduced RFS, OS and disease-specific survival (DSS) only in stage I/II patients and not in stage III/IV patients. Notably, exogenous expression of elafin or elafin M25G in the luminal breast cancer cell lines MCF-7 and T47D significantly decreased cell proliferation in a protease inhibitory domain-independent manner.

Conclusions

Elafin predicts poor outcome in breast and ovarian cancer patients and delineates a subset of endocrine receptor-positive breast cancer patients susceptible to recurrence who could benefit from more aggressive intervention. Our in vitro results suggest that elafin arrests luminal breast cancer cells, perhaps suggesting a role in tumor dormancy.
Neutrophil homeostasis and inflammation: novel paradigms from studying periodontitis
Authors: Hajishengallis George , Chavakis Triantafyllos , Hajishengallis Evlambia , Lambris John D
Published: December 2014

Once viewed as simply antibacterial effector cells packed with antimicrobials, neutrophils are now increasingly appreciated for their regulatory roles in immunity and inflammation. The homeostatic regulation of neutrophils is thus crucial for optimal operation of the immune system. An attractive model to understand mechanistically the role of neutrophils is periodontitis, an oral inflammatory disease that is particularly sensitive to neutrophil alterations in numbers or function. The recruitment and proper activation of neutrophils are largely dependent on leukocyte integrins and complement. This review discusses how these processes are affected by host genetic or microbial factors leading to the development of periodontitis. For instance, both hypo- and hyper-recruitment of neutrophils as a result of deficiencies in the expression of β2 integrins or their negative regulators, respectively, causes unwarranted IL-17-dependent inflammatory bone loss. Moreover, microbial hijacking of C5aR (CD88) signaling in neutrophils impairs their antimicrobial function while promoting destructive inflammatory responses. These studies not only support the concept that neutrophil homeostasis is key to periodontal health but also reveal promising, new therapeutic targets as discussed in the review.
Context-dependent role of IL-18 in cancer biology and counter-regulation by IL-18BP
Authors: Fabbi Marina , Carbotti Grazia , Ferrini Silvano
Published: December 2014

IL-18 is a proinflammatory and immune regulatory cytokine, member of the IL-1 family. IL-18 was initially identified as an IFN-γ-inducing factor in T and NK cells, involved in Th1 responses. IL-18 is produced as an inactive precursor (pro-IL-18) that is enzymatically processed into a mature form by Casp1. Different cells, such as macrophages, DCs, microglial cells, synovial fibroblasts, and epithelial cells, express pro-IL-18, and the production of bioactive IL-18 is mainly regulated at the processing level. PAMP or DAMP molecules activate inflammasomes, which trigger Casp1 activation and IL-18 conversion. The natural inhibitor IL-18BP, whose production is enhanced by IFN-γ and IL-27, further regulates IL-18 activity in the extracellular environment. Inflammasomes and IL-18 represent double-edged swords in cancer, as their activation may promote tumor development and progression or oppositely, enhance anti-tumor immunity and limit tumor growth. IL-18 has shown anti-tumor activity in different preclinical models of cancer immunotherapy through the activation of NK and/or T cell responses and has been tested in clinical studies in cancer patients. However, the dual role of IL-18 in different experimental tumor models and human cancers raises critical issues on its therapeutic use in cancer. This review will summarize the biology of the IL-18/IL-18R/IL-18BP system and will address the role of IL-18 and its inhibitor, IL-18BP, in cancer biology and immunotherapy.
Allogeneic Stem-Cell Transplantation in Patients With NPM1-Mutated Acute Myeloid Leukemia: Results From a Prospective Donor Versus No-Donor Analysis of Patients After Upfront HLA Typing Within the SAL-AML 2003 Trial
Authors: Röllig Christoph , Bornhäuser Martin , Kramer Michael , Thiede Christian , Ho Anthony D. , Krämer Alwin , Schäfer-Eckart Kerstin , Wandt Hannes , Hänel Mathias , Einsele Hermann , Aulitzky Walter E. , Schmitz Norbert , Berdel Wolfgang E. , Stelljes Matthias , Müller-Tidow Carsten , Krug Utz , Platzbecker Uwe , Wermke Martin , Baldus Claudia D. , Krause Stefan W. , Stölzel Friedrich , von Bonin Malte , Schaich Markus , Serve Hubert , Schetelig Johannes , Ehninger Gerhard
Published: December 2014

Purpose

The presence of a mutated nucleophosmin-1 gene (NPM1mut) in acute myeloid leukemia (AML) is associated with a favorable prognosis. To assess the predictive value with regard to allogeneic stem-cell transplantation (SCT), we compared the clinical course of patients with NPM1mut AML eligible for allogeneic SCT in a donor versus no-donor analysis.

Patients and Methods

Of 1,179 patients with AML (age 18 to 60 years) treated in the Study Alliance Leukemia AML 2003 trial, we identified all NPM1mut patients with an intermediate-risk karyotype. According to the trial protocol, patients were intended to receive an allogeneic SCT if an HLA-identical sibling donor was available. Patients with no available donor received consolidation or autologous SCT. We compared relapse-free survival (RFS) and overall survival (OS) depending on the availability of a suitable donor.

Results

Of 304 eligible patients, 77 patients had a sibling donor and 227 had no available matched family donor. The 3-year RFS rates in the donor and no-donor groups were 71% and 47%, respectively (P = .005); OS rates were 70% and 60%, respectively (P = .114). In patients with normal karyotype and no FLT3 internal tandem duplication (n = 148), the 3-year RFS rates in the donor and no-donor groups were 83% and 53%, respectively (P = .004); and the 3-year OS rates were 81% and 75%, respectively (P = .300).

Conclusion

Allogeneic SCT led to a significantly prolonged RFS in patients with NPM1mut AML. The absence of a statistically significant difference in OS is most likely a result of the fact that NPM1mut patients who experienced relapse responded well to salvage treatment. Allogeneic SCT in first remission has potent antileukemic efficacy and is a valuable treatment option in patients with NPM1mut AML with a sibling donor.
Levothyroxine Improves Abnormal Cardiac Bioenergetics in Subclinical Hypothyroidism: A Cardiac Magnetic Resonance Spectroscopic Study
Authors: Madathil Asgar , Hollingsworth Kieren G. , Blamire Andrew M. , Razvi Salman , Newton Julia L. , Taylor Roy , Weaver Jolanta U.
Published: December 2014

Context:

It is well established that subclinical hypothyroidism (SCH) is associated with mild cardiac dysfunction, but it is unknown whether there is an underlying impairment of cardiac bioenergetic function.

Objective:

The objective of the study was to quantify the cardiac phosphocreatine to adenosine triphosphate ratio (PCr to ATP) in SCH, compared with healthy controls, and to measure the effect of 6 months of levothyroxine treatment.

Design and Setting:

This was a 6-month, prospective, case-controlled interventional study.

Participants and Main Outcome Measures:

The PCr to ATP ratio was measured using phosphorus-31 magnetic resonance spectroscopy in subjects with SCH at baseline and after levothyroxine therapy (1.6 μg/kg·d) and compared with age- and gender-matched euthyroid controls. All subjects were free of overt heart disease.

Results:

Twenty-one subjects with SCH (normal free T4 and serum TSH between 4.1 and 10 mIU/L) and 17 controls were matched for age (mean age 40.5 vs 43.3 y) and sex (females 81% vs 82%) but differed in mean TSH (6.5 vs 2.1 mIU/L, P < .001). At baseline the mean (±SD) PCr to ATP ratio in SCH was lower than in controls (1.80 ± 0.26 vs 2.07 ± 0.20, P = .001). In the 16 subjects studied after levothyroxine treatment, the PCr to ATP ratio improved (from 1.74 ± 0.24 to 1.91 ± 0.26, P = .004) and approached controls (borderline loss of significance, P = .051). On multivariate analysis, SCH was independently associated with a reduced PCr to ATP ratio, even after adjusting for confounding variables (body mass index and fasting glucose) (P = .001).

Conclusion:

Our results demonstrate early cardiac bioenergetic impairment in SCH, which is reversible with levothyroxine therapy. This mechanistic insight provides justification for longitudinal trials to determine whether improvement in bioenergetic function improves cardiovascular outcome.
Synthesis of Crystalline Poly(lactic acid) from Glycerol By-product via Hydrothermal Reaction and Stereoselective Polymerization
Authors: Hasegawa Takashi , Kishida Hisanori , Nomura Nobuyoshi , Moriya Takehiko
Published: December 2014

In this article, we discuss that glycerol by-product can be a good feedstock for crystalline poly(lactic acid) (PLA). The glycerol by-product containing 46% of glycerol is first converted into racemic lactic acid by an alkaline hydrothermal reaction. The racemic lactic acid is then converted into a stereomixture of lactide, followed by a purification process to obtain racemic lactide. The racemic lactide is stereoselectively polymerized into isotactic PLA, which is crystalline with a high melting temperature of 208 °C.
Dimesitylboryl- and Amino-substituted Acetylene Having Butatriene-type Resonance Contribution
Authors: Onuma Kaoru , Suzuki Katsunori , Yamashita Makoto
Published: December 2014

Boryl- and amino-substituted acetylenes would have a butatriene-type resonance contribution due to the interaction between boron empty orbital and nitrogen lone pair. However, a few examples of boryl- and amino-substituted acetylenes have been synthesized up to date, and structural analysis by X-ray crystallography has remained unknown. Here we report the synthesis and characterization of dimesitylboryl- and diethylamino-substituted acetylene. In addition to the spectroscopic studies, the X-ray crystallography of the acetylene revealed the lengthening of the triple bond and the shortening of C–B and C–N bonds, being consistent with the butatriene-type resonance contribution.
DNA Binding of Pentaamino[60]fullerene Synthesized Using Click Chemistry
Authors: Nitta Hirohisa , Minami Kosuke , Harano Koji , Nakamura Eiichi
Published: December 2014

We have synthesized pentaaminofullerene 4 by the introduction of dimethylamino groups using a click reaction. The dendritic fullerene amphiphile showed a low critical micelle concentration of 3.6 ± 0.5 µM. 4 is shown to be an efficient DNA binder that compacts DNA into nanoparticles at low nitrogen/phosphorus ratios.
A case study of a 59-year-old male with a cardiac variant of Anderson–Fabry disease
Authors: Jackson Sarah , Ashton Lisa
Published: December 2014

Anderson–Fabry disease is a rare X-linked lysosomal storage disorder caused by deficiency of the enzyme alpha-galactosidase A, affecting around 1 in 100,000 births. Waste products build up within cells throughout the body, affecting the heart, nervous system, skin, eyes and kidneys. In the cardiac variant, Anderson–Fabry disease the effects are limited to the heart, causing left-ventricular hypertrophy (LVH), valve defects and conduction abnormalities. Involvement of the heart contributes to morbidity and premature death because of increased prevalence of heart failure, arrhythmia and strokes. Utilising a case study of a 59-year-old male with the cardiac variant of Anderson–Fabry disease, this article discusses the treatment options available, including dual chamber pacing and implantable cardioverter defibrillator (ICD) therapy, in line with American Heart Association/American College of Cardiology (AHA/ACC) guideline criteria. Additionally research into enzyme replacement therapy (ERT) suggests treatment can reverse damage and prevent further damage occurring, therefore the use of ERT and its effectiveness in this case is also discussed.
Electrophysiological testing
Authors: Mendes Aysha
Published: December 2014

This section presents a brief, concise overview of the treatments and clinical procedures regularly carried out in the field of cardiovascular care. This ‘back to basics’ article aims to refresh nurses' knowledge on correct practice, as well as introduce students and junior nurses to procedures
Recommendations for care of patients with acute coronary syndromes
Authors: Linden Belinda
Published: December 2014

Belinda Linden outlines the statements made in the NICE Quality Standard for acute coronary syndromes, including myocardial infarction
The ins and outs of fluid balance in the acutely ill patient
Authors: McGloin Sarah
Published: December 2014

Many reports and studies have highlighted concerns with fluid management in acute care settings. The level of knowledge displayed by nurses and the influence this has on fluid management is often analysed. Nurses measure patients' fluid intake and output in the belief that medical staff will use the data to prescribe appropriate fluid management. However, in reality, medical staff often disregard such data as inaccurate, with terms such as ‘OTT’ (out to toilet) clearly affecting the accuracy of data. Consequently, practitioners require a comprehensive understanding of fluid physiology and the potential risks to the patient when there is inappropriate documentation of fluid status. The use of the fluid balance chart is examined as a means to assess fluid status, and other supplementary assessment strategies are also considered. The aim is to ensure comprehensive assessment and evaluation of an individual's fluid status, thereby guiding appropriate fluid management in the acute care setting.
Antibiotic resistance and irrational prescribing in paediatric clinics in Greece
Authors: Toska Aikaterini , Geitona Mary
Published: December 2014

Introduction:

Greece is among the countries with the highest rates of antimicrobial resistance (AMR) and simultaneous antibiotic consumption.

Aim:

The aim of this study was to assess the perceptions and knowledge of AMR and irrational antibiotic prescribing of nurses working in paediatric hospitals in Greece.

Method:

A self-administered questionnaire was distributed to nurses in paediatric hospitals and paediatric clinics in Greece. Descriptive and multivariate statistical analyses were performed. Levels of significance were two-tailed and statistical significance was p=0.05.

Results:

A total of 87% of participants reported irrational prescribing to be an important cause of AMR. Diagnostic uncertainty was stated by 55.5% as the main cause of irrational antibiotic prescribing and 94% suggested the use of protocols and guidelines as the main measure to control overprescribing. Parental demand for antibiotics in hospitals has increased according to 51.8% of respondents. Strong correlation was observed between social-demographic characteristics and antibiotic resistance, as well as irrational prescribing.

Conclusions:

Assessing nurses' knowledge and perceptions of antimicrobial resistance and irrational prescribing is vital as nurses actively participate in the antibiotics administration process and antimicrobial management in Greece. Their involvement could contribute to educate patients and parents on the public-health implications of overprescribing and antimicrobial resistance.
Development and implementation of a safeguarding tracker tool
Authors: Stupple Lucy , Marks-Maran Diane , Morris-Thompson Trish
Published: December 2014

This article reports on the development and implementation of a Safeguarding Tracker Tool at one hospital that cares for vulnerable patients who are suffering from early onset dementia, Huntingdon's disease and alcohol-related brain injury. The tool was developed in association with the local multi-agency safeguarding hub (MASH). The hospital has in place systems and processes for training staff in their safeguarding role and have developed a Safeguarding Tracker Tool to record individual safeguarding concerns, communicate with and involve all relevant people and agencies, investigate the concern and establish an action plan.
Management of abdominal pain in children
Authors: El-Radhi A Sahib
Published: December 2014

Abdominal pain (AP) is a very common complaint caused by a variety of conditions. Mild or moderate AP affects practically all children of all ages. The pain usually settles spontaneously without medical intervention. AP severe enough to require medical intervention has both surgical and non-surgical causes. It is responsible for considerable morbidity, missed school days, and significant use of health resources. Children usually present either with an acute or recurrent AP. In comparison, chronic AP with persistent symptoms, lasting days or weeks, is rare in children. Surgical conditions may be the underlying causes in acute AP, but non-surgical conditions are diagnosed more commonly in children with recurrent AP. Management can be difficult, time-consuming and often clinically challenging to diagnose and treat. In most instances, the cause of AP can be diagnosed through the history and physical examination. The main objective in managing an affected child is to differentiate between benign, self-limited conditions such as constipation or gastroenteritis, and more life-threatening surgical conditions such as intussusception or appendicitis. Irritable bowel syndrome (IBS) and Crohn's disease should be considered in any child presenting with recurrent AP.
A view from Valencia
Authors: Blakey Emma
Published: December 2014

Emma Blakey wanted to experience life as a nursing student in Spain, to see a different way of nursing and to explore the impact of austerity measures. She reflects on her time in Valencia and how this experience has influenced her nursing practice
The sum of parent power
Authors: Moffett Pamela
Published: December 2014

There is widespread agreement in the relevant literature that children perform better academically and have more positive attitudes towards mathematics if their parents are more involved in learning.
The paperless setting
Authors: Honey Jemma
Published: December 2014

Fed up with the endless reams of paperwork and documentation in your setting, but do not want to go digital? One chain has been successfully using whiteboards for planning, with positive results.
Making the government listen
Authors: Leitch Neil
Published: December 2014

The ‘free entitlement’ is underfunded, a fact that everyone but our current ministers know. But with the Affordable Childcare Committee due to report and the election looming, perhaps they will now act.
Funding must match free hours
Authors: Tanuku Purnima
Published: December 2014

Politicians are vying for the ‘childcare’ vote as they try to get more mums into the workplace. However, increasing free nursery hours will drive nurseries out of business unless funding levels rise significantly.
Making sense of sounds
Authors: Chalmers Debbie
Published: December 2014

Young children need to be able to identify and make sense of what they hear in order to stay safe, learn effectively, develop confident speaking and listening skills and respond appropriately to others.
If you look very closely
Authors: Cruickshank Sarah
Published: December 2014

The telescope was perfected back in 1621 and it changed the way we looked at the world overnight, making accessible distant worlds. These activities will look at both the magnified and the microscopic.
Tips on supporting school business managers
Authors: Bannister Nick
Published: December 2014

This month, Nick Bannister focuses on the training and support programmes that can help support school business managers (SBMs) with income generation for their schools.
One size does not fit all
Authors: Weston David
Published: December 2014

David Weston, CEO of the Teacher Development Trust, explores the importance of CPD and looks at ways to break down the barriers that can impede its implementation.
Put comics in the frame
Authors: Hewson Claire
Published: December 2014

Comic books have perennial appeal and can provide a powerful way to help children connect with character and plot across a wide range of stories and literature.
Down to the woods for an outdoor adventure
Authors: Donohoe Tom
Published: December 2014

Tom Donohoe outlines how his approach to Forest Schools has proved successful in helping pupils to enjoy physical outdoor activities, be resilient and solve problems.
Active learning with graphs and charts
Authors: Rachel  , Bosley Mark
Published: December 2014

This tutorial explores three methods of graphically presenting data, based on real-life surveys. Pupils learn how to control both the input and presentation of statistics.
Quizzical about reading
Authors: McKeown Sal
Published: December 2014

The Accelerated Reading Programme is proving highly effective in engaging reluctant readers by involving them in a quiz about what they have read.
Be a great team player
Authors: Adams Margaret
Published: December 2014

To be recognised as a strong team member you will not only need to make a valuable personal contribution but also help others to succeed, says Margaret Adams.
No time to waste
Authors: Adams Margaret
Published: December 2014

Have you so much to do that you do not know whether you are coming or going? Margaret Adams has some timely advice on making your day stretch further.
DNA barcoding and phylogenetic reconstruction of shark species landed in Muncar fisheries landing site in comparison with Southern Java fishing port
Authors: PREHADI PREHADI , SEMBIRING ANDRIANUS , KURNIASIH EKA MAYA , RAHMAD RAHMAD , ARAFAT DONDY , SUBHAN BEGINER , MADDUPPA HAWIS H.
Published: December 2014

Prehadi, Sembiring A, Kurniasih EM, Arafat D, Subhan B, Madduppa HH. 2015. DNA barcoding and phylogeneticreconstruction of shark species landed in Muncar fisheries landing site in comparison with Southern Java fishing port. Biodiversitas 16:55-61. Sharks are one of main fisheries commodity that are currently exploited on a large scale because of their high economic value.The identification of sharks has been a difficult one due to the specimenâ€™s similarity in morphology and mostly have had key diagnosticfeatures removed. This study aimed to identify and to review the status of sharks, and also to reconstruct the shark species that werelanded at South Java fishing port using molecular approaches. The DNA amplification was using cytochrome oxidase I mitochondrial oflocus and 600-700 basepairs. A total of seven species from 59 individuals was identified including Alopias pelagicus, Carcharhinusfalciformis, C. sorrah, C. amblyrhynchos, Galeocerdo cuvier, Atelomycterus marmoratus, and Spyrna lewini. The diversity of sharkspecies landed in Muncar during the last 2 years has been decreased. The identified sharks species in this study sites were about 18% ofall Indonesian sharks. The result of this study is expected help the Government to manage shark fisheries in Indonesia.
Defining Information Needs for Public Health Systems and Services Research
Authors: Buehler James
Published: December 2014

Background: People who lead or manage public health agencies have multiple needs
for information in order to do their jobs effectively. In seeking to investigate “what
works” in public health practice, investigators in the field of public health systems
and services research (PHSSR) have largely overlapping information needs but often
require a greater detail, specificity, or comprehensiveness than is routinely available
in public health data systems.PHSSR Data Needs Meeting: On April 24, 2014, the PHSSR
Center of the University of Kentucky and AcademyHealth convened a 1-day meeting of
public health practitioners and PHSSR investigators to identify PHSSR information needs.
Meeting participants considered data needs for three PHSSR domains: the organization of
public health agencies and services, the use of rapidly evolving health information
technologies, and the financing and economic evaluation of public health
activities.Future Data Needs: Identifying data needs in these and other PHSSR domains
requires clarification of research questions, consideration of research methods, a
balance of imagination and practicality, and investments to extend the information
captured in existing administrative, financial, and population health monitoring
systems.
Sistema de apoio à decisão na comunicação de acidentes graves
Authors: Leite António A. Pinho
Published: December 2014

Devido à actividade de produção, manuseamento, armazenagem e transporte de substâncias químicas perigosas numa área industrial, pode ocorrer um grave acidente químico, que pode afectar as empresas vizinhas e a população envolvente. Perante os vários cenários de danos físicos e humanos, o objectivo deste projecto centrou-se no desenvolvimento de uma aplicação de apoio à decisão na comunicação de acidentes graves às autoridades de protecção civil. A aplicação de metodologias, com recurso a software específico, resultaram no desenvolvimento de uma aplicação que visa permitir e facilitar esta tomada de decisões, apoiando a direcção de emergência das empresas a gerir este tipo de comunicações em situações de crise.
Risco de cheia e vulnerabilidade: uma abordagem às inundações urbanas de Belém/Pará/ no Brasil
Authors: Pegado Rosielle Souza , Blanco Claudio José Calvacante , Roehrig Jackson , Caroça Carla , Costa Francisco Da Silva
Published: December 2014

A cidade de Belém cresceu de forma acelerada e descontrolada. Este descontrole sem planeamento gerou problemas de inundação urbana com altos prejuízos. Actualmente procura-se evitar e/ou diminuir estas inundações, investindo em estudos de forma a se conhecer melhor sobre esta problemática e aplicá-los numa gestão de prevenção e controle deste tipo de risco.
Combining observed and contingent travel behavior: the best of both worlds?
Authors: Cruz Luís , Simões Paula , Barata Eduardo
Published: December 2014

Os recursos naturais oferecem uma ampla gama de benefícios para a sociedade. Mas muitos destes recursos podem ser irremediavelmente perdidos. Considerando que os esforços de proteção ambiental envolvem custos de oportunidade, a avaliação económica é essencial para permitir aos decisores conhecer os benefícios líquidos das suas decisões, principalmente no caso de benefícios não incorporados nos preços de mercado.A literatura sobre a avaliação ambiental tem permitido desenvolvimentos significativos. Incidindo sobre os métodos utilizados para avaliar os benefícios relacionados com o uso recreativo de áreas naturais, este trabalho explora o potencial de combinar abordagens com base em preferências reveladas e declaradas. Conclui‑se que esta opção impõe esforços adicionais que no entanto serão compensados pela possibilidade de tirar proveito do melhor destes dois mundos.
Light Weight Tabletop Exercise for Cybersecurity Education
Authors: Ottis Rain
Published: December 2014

It is often difficult to meaningfully convey concepts like security incident management cycle, information sharing, cooperation, as well as the roles of people, processes and technology in cybersecurity courses. Serious gaming can help solve this problem, since it can provide a more immersive and interactive learning experience than traditional methods. This paper presents a light weight tabletop exercise format that has been successfully used in cybersecurity education to demonstrate these and many other concepts to Master level students in two European universities over the past 5 years. The term light weight is chosen to indicate the low work load and resource requirements for the instructor. The paper provides practical guidance on how to develop and execute such exercises. In addition, it lists observations of concepts and recommended discussion points that have been successfully demonstrated in class using this exercise format.
Intrapulmonary Recombinant Factor VIIa for Diffuse Alveolar Hemorrhage in Children
Authors: Park Jeong A. , Kim Byoung-Ju
Published: December 2014

Diffuse alveolar hemorrhage (DAH) is a life-threatening pulmonary complication in patients with hematologic malignancies or autoimmune disorders, and it has a high mortality rate. The current treatment options of corticosteroids, transfusions, and immunosuppressants have been limited and largely unsuccessful, and they can be accompanied by multiple complications. Intrapulmonary administration of recombinant activated factor VII (rFVIIa) has been reported in adults, but there are scarce data on its use in children. The present article reviews our institutional experience with intrapulmonary rFVIIa for the treatment of DAH in children. The study included 6 pediatric patients with acute, bronchoscopically confirmed DAH treated between 2011 and 2013. The median age was 11 years, and patient diagnoses were as follows: acute myeloid leukemia (2 patients), myelodysplastic syndrome (1 patient), hemophagocytic lymphohistiocytosis (1 patient), T-cell lymphoblastic lymphoma (1 patient), and idiopathic pulmonary hemosiderosis (1 patient). These patients were treated with intrapulmonary rFVIIa concurrent with methylprednisolone, fresh-frozen plasma, and maintenance of the platelet count >50 000/mm3. Complete and sustained hemostasis after rFVIIa treatment and an absence of adverse events were observed in all patients. The PaO2/fraction of inspired oxygen ratio increased significantly, and rapid clinical improvements were observed. Two patients who received hematopoietic stem cell transplantation died of subsequent respiratory syncytial virus and Acinetobacter baumannii infections, but the other 4 patients exhibited rapid improvement, were successfully weaned from ventilators, and experienced long-term survival. Our findings indicate that intrapulmonary administration of rFVIIa is an effective and safe treatment option for children with DAH; however, further clinical studies are needed.
Text Message Reminders for Second Dose of Influenza Vaccine: A Randomized Controlled Trial
Authors: Stockwell Melissa S. , Hofstetter Annika M. , DuRivage Nathalie , Barrett Angela , Fernandez Nadira , Vargas Celibell Y. , Camargo Stewin
Published: December 2014

OBJECTIVE:

To determine whether provision of vaccine-health-literacy-promoting information in text message vaccine reminders improves receipt and timeliness of the second dose of influenza vaccine within a season for children in need of 2 doses.

METHODS:

During the 2012–2013 season, families of eligible 6-month through 8-year-old children were recruited at the time of their first influenza vaccination from 3 community clinics in New York City. Children (n = 660) were randomly assigned to “educational” text message, “conventional” text message, and “written reminder-only” arms. At enrollment, all arms received a written reminder with next dose due date. Conventional messages included second dose due date and clinic walk-in hours. Educational messages added information regarding the need for a timely second dose. Receipt of second dose by April 30 was assessed by using χ2 tests. Timeliness was assessed by receipt of second dose by 2 weeks after due date (day 42) using χ2 and over time using a Kaplan-Meier analysis.

RESULTS:

Most families were Latino and publicly insured with no significant between-arm differences between groups. Children in the educational arm were more likely to receive a second dose by April 30 (72.7%) versus conventional (66.7%) versus written reminder-only arm (57.1%; P = .003). They also had more timely receipt by day 42 (P < .001) and over time (P < .001).

CONCLUSIONS:

In this low-income, urban, minority population, embedding health literacy information improved the effectiveness of text message reminders in promoting timely delivery of a second dose of influenza vaccine, compared with conventional text messages and written reminder only.
Race, Ethnicity, and Socioeconomic Status in Research on Child Health
Authors: Cheng Tina L. , Goodman Elizabeth ,   THE COMMITTEE ON PEDIATRIC RESEARCH, Cheng Tina L. , Bogue Clifford W. , Chien Alyna T. , Dean J. Michael , Kharbanda Anupam B. , Peeples Eric S. , Scheindlin Ben
Published: December 2014

This Policy Statement was reaffirmed September 2022.

An extensive literature documents the existence of pervasive and persistent child health, development, and health care disparities by race, ethnicity, and socioeconomic status (SES). Disparities experienced during childhood can result in a wide variety of health and health care outcomes, including adult morbidity and mortality, indicating that it is crucial to examine the influence of disparities across the life course. Studies often collect data on the race, ethnicity, and SES of research participants to be used as covariates or explanatory factors. In the past, these variables have often been assumed to exert their effects through individual or genetically determined biologic mechanisms. However, it is now widely accepted that these variables have important social dimensions that influence health. SES, a multidimensional construct, interacts with and confounds analyses of race and ethnicity. Because SES, race, and ethnicity are often difficult to measure accurately, leading to the potential for misattribution of causality, thoughtful consideration should be given to appropriate measurement, analysis, and interpretation of such factors. Scientists who study child and adolescent health and development should understand the multiple measures used to assess race, ethnicity, and SES, including their validity and shortcomings and potential confounding of race and ethnicity with SES. The American Academy of Pediatrics (AAP) recommends that research on eliminating health and health care disparities related to race, ethnicity, and SES be a priority. Data on race, ethnicity, and SES should be collected in research on child health to improve their definitions and increase understanding of how these factors and their complex interrelationships affect child health. Furthermore, the AAP believes that researchers should consider both biological and social mechanisms of action of race, ethnicity, and SES as they relate to the aims and hypothesis of the specific area of investigation. It is important to measure these variables, but it is not sufficient to use these variables alone as explanatory for differences in disease, morbidity, and outcomes without attention to the social and biologic influences they have on health throughout the life course. The AAP recommends more research, both in the United States and internationally, on measures of race, ethnicity, and SES and how these complex constructs affect health care and health outcomes throughout the life course.