bluuebunny/crossref_metadata_2025 huggingface dataset:
Implicit Measurements of Sexual Preference in Self-Declared Heterosexual Men: A Pilot Study on the Rate of Androphilia in Italy
Authors: Camperio Ciani Andrea , Battaglia Umberto
Published: May 2014

Introduction

An unambiguous measurement of the rate of nonheterosexuality in the male population (male bisexuality and homosexuality) is essential to estimate the health risks associated with same-sex sexual behavior and to scale social and health programs for these citizens. However, self-reported questionnaires on explicit measures of sexual orientation yield significant underestimations of nonheterosexuality. A necessary prerequisite for nonheterosexual preference is androphilia (sexual–erotic attraction to males), which can be explored through psychological tests.

Aims

This study, using a pilot sample, investigates the possibility to inventory the frequency of male androphilia in the general population through a sexual preference implicit association test (sp-IAT). This test is a classical IAT that is based on an association of pictures and words and is easily portable.

Methods

First we conducted a preliminary validation of the specific IAT protocol on 24 control subjects; then, we examined a sample of 150 adult males in Italy as a pilot study. The subjects responded to the sp-IAT and completed the explicit Kinsey scale questionnaire.

Main Outcome Measures

Kinsey scale scores and D value of sp-IAT for both preliminary and pilot sample.

Results

On the explicit Kinsey scale, 2.7% of the sample declared themselves to be sexually attracted to men, corresponding to previous explicit samplings of the Italian homosexual male population. However, the sp-IAT identified that 11.3% of self-declared gynephilic heterosexuals showed a moderate to strong androphilia with a significant effect size (D) always below −0.2, and another 5.6% of the heterosexual sample showed no preference for females (D between −0.2 and 0).

Conclusion

The Kinsey questionnaire strongly dichotomized the responses as either attracted to females or attracted to men, whereas the sp-IAT showed a wider distribution of responses from gynephilia to androphilia. In conclusion, the sp-IAT could be a novel and unambiguous instrument useful to ascertain androphilia population prevalence as a proxy for possible male nonheterosexuality.
Food protein‐induced enterocolitis syndrome: Pitfalls in the diagnosis
Authors: Guibas George V. , Tsabouri Sophia , Makris Michael , Priftis Kostas N.
Published: May 2014

Food protein‐induced enterocolitis syndrome (FPIES) represents the severe end of the spectrum of gastrointestinal food hypersensitivity; its acute episodes can culminate in severe dehydration and hypovolemic shock, and its chronic form entails considerable morbidity associated with feeding difficulty and failure to thrive. Nevertheless, awareness for this syndrome remains rather low. Many factors hamper the establishment of FPIES diagnosis. Such factors pertain to the pathophysiological mechanism of the syndrome, causal food proteins, clinical manifestations, diagnostic procedures, differential diagnosis considerations, and prevailing perceptions which may require critical appraisal. Throughout this review, we will present and discuss these issues and put the focus on factors that could lead to under‐diagnosis of FPIES, cause numerous acute episodes, and substantially increase the diseases morbidity and financial burden. We will also address other issues that are clinically relevant to FPIES.
A novel P700 redox kinetics probe for rapid, non‐intrusive and whole‐tissue determination of photosystem II functionality, and the stoichiometry of the two photosystems in vivo
Authors: Jia Husen , Dwyer Simon A. , Fan Da‐Yong , Han Yaqin , Badger Murray R. , von Caemmerer Susanne , Chow Wah Soon
Published: May 2014

We sought a rapid, non‐intrusive, whole‐tissue measure of the functional photosystem II (PS II) content in leaves. Summation of electrons, delivered by a single‐turnover flash to P700+ (oxidized PS I primary donor) in continuous background far‐red light, gave a parameter S in absorbance units after taking into account an experimentally determined basal electron flux that affects P700 redox kinetics. S was linearly correlated with the functional PS II content measured by the O2 yield per single‐turnover repetitive flash in Arabidopsis thaliana expressing an antisense construct to the PsbO (manganese‐stabilizing protein in PS II) proteins of PS II (PsbO mutants). The ratio of S to zmax (total PS I content in absorbance units) was comparable to the PS II/PS I reaction‐center ratio in wild‐type A. thaliana and in control Spinacea oleracea. Both S and S/zmax decreased in photoinhibited spinach leaf discs. The whole‐tissue functional PS II content and the PS II/photosystem I (PS I) ratio can be non‐intrusively monitored by S and S/zmax, respectively, using a quick P700 absorbance protocol compatible with modern P700 instruments.
Optical Coherence Tomography for the Study of Polymer and Polymer Matrix Composites
Authors: Liu P. , Groves R. M. , Benedictus R.
Published: May 2014

Based on low‐coherence interferometry, a hybrid optical coherence tomography (OCT) system has been built. It coupled time‐domain OCT (TD‐OCT) and Fourier‐domain OCT (FD‐OCT) into one system. TD‐OCT can take the advantage of a large axial scan range while FD‐OCT has superior performance in fast imaging as no axial scan is needed. The two imaging modalities shared a broad bandwidth light source with a centre wavelength of 1550 nm, which is less scattering and can give better penetration depth in the polymer‐based material than the shorter wavelength used for biomedical applications. 2D translation stages were incorporated in the system to make cross‐sectional and volume imaging available. It can provide larger scan range as well as less image distortion compared with galvo scanners. Finally, we reported on successfully characterized specimens such as polymer coatings and glass‐fibre composites. The cross‐sectional and volumetric images obtained clearly show the microstructure of the materials. The thickness as well as the defects, e.g. microcrack and delamination can be determined.
A single‐center experience of cytomegalovirus infections in Asian pediatric patients undergoing allogeneic hematopoietic stem cell transplant for leukemia in Singapore
Authors: Tan P.L. , Lim L.M. , Khanlian C. , Villegas M.S.
Published: May 2014

Introduction

Cytomegalovirus (CMV) infection remains a significant cause of morbidity and mortality in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) despite improved surveillance and the current preemptive approach. Few data on its prevalence in the Asian pediatric population exist.

Methods

We retrospectively reviewed the prevalence of CMV infections in 33 patients with 37 transplants who received HSCT for leukemia from 1998 to 2008, and who were managed preemptively for infections.

Results

In the 37 transplants, 16 patients (43%) had CMV DNAemia. Of the patients who were CMV seropositive before transplant and received stem cells from seropositive donors (R+/D+), 69% had DNAemia; of those who received stem cells from seronegative donors (R+/D−), 36% had CMV DNAemia. Of the patients who were CMV naïve before transplant and received stem cells from seropositive donors (R−/D+), 25% had CMV DNAemia. In CMV‐seronegative donor–recipient transplants (R−/D−), 20% of patients had CMV DNAemia. The median time to the first episode of CMV DNAemia was 21 (range: 10–107) days after the transplants, and the median duration of CMV DNAemia was 22 (range: 2–315) days. CMV DNAemia recurred in 44% (7 of 16) of these patients. Only 1 patient developed CMV disease (retinitis). No deaths were related to CMV infections.

Conclusions

CMV infection manifesting as DNAemia is a common complication in pediatric patients undergoing allogeneic HSCT for leukemia. Pre‐transplant serostatus predicts reactivation risks; invasive CMV disease is rare using the preemptive approach in our patient population.
Tax man's gloomy message: the rich will get richer
Authors: Marshall Eliot
Published: May 2014

With a massive database of income tax records, a French superstar challenges conventional wisdom on inequality
Draft Genome Sequence of
Burkholderia
sp. Strain MP-1, a Methyl Parathion (MP)-Degrading Bacterium from MP-Contaminated Soil
Authors: Liu Xu-Yun , Luo Xiao-Jing , Li Chun-Xiu , Lai Qi-Liang , Xu Jian-He
Published: May 2014

Burkholderia
sp. strain MP-1 was isolated from pesticide-contaminated soil. Herein, we report the draft genome sequence of strain MP-1, which contains 168 contigs of 8,611,053 bp, with a G+C content of 62.55% and 7,631 protein-coding genes.
A rare presentation of an ancient disease: scurvy presenting as orthostatic hypotension
Authors: Zipursky Jonathan Samuel , Alhashemi Ahmad , Juurlink David
Published: May 2014

A 49-year-old man presented to hospital with severe orthostatic hypotension, gingival dysplasia and a purpuric rash involving his extremities. The orthostatic hypotension failed to respond to fluids and, on the basis of physical examination and dietary history, the patient was given a preliminary diagnosis of scurvy (ascorbic acid deficiency). Serum ascorbic acid levels were undetectable and the orthostasis was resolved within 24 h of ascorbic acid replacement. The pathogenesis of orthostatic hypotension in the setting of scurvy appears to involve impaired catecholamine synthesis and attenuated vasomotor response to α-adrenergic stimulation. We believe that this case describes a rare presentation of scurvy and highlights a previously under-reported connection between scurvy and vasomotor instability.
Invasive pulmonary aspergillosis in a patient presenting with idiopathic systemic capillary leak syndrome
Authors: Hayama Manabu , Shime Nobuaki , Mio Tadashi
Published: May 2014

A 54-year-old man presented to our emergency department with fever and dyspnoea. He required vigorous haemodynamic support and mechanical ventilation for hypotensive distributive shock with hypoalbuminaemia, haemoconcentration, rhabdomyolysis and acute renal failure, consistent with idiopathic systemic capillary leak syndrome. Left lung consolidation and hypoxaemia were observed 6 days after admission. Sputum smear revealed the presence of acute angled branching hyphae, consistent with a diagnosis of invasive pulmonary aspergillosis. Antifungal therapy was administered and mechanical ventilation discontinued on day 66. The patient recovered and was discharged from the hospital on day 185.
A rare cause of dilated bile duct incidentally detected on imaging
Authors: Loh Kah Poh , Nautsch Deborah , Desilets David , Mehendiratta Vaibhav
Published: May 2014

Adenomas involving the extrahepatic bile ducts are rare benign tumours of the biliary tract. Given the asymptomatic nature of these tumours and the natural progression of biliary adenoma to carcinoma including cholangiocarcinoma, early detection is challenging. We present a case of an octogenarian woman with a remote history of gallstones who initially presented to the gastroenterology office for an incidental finding of biliary dilation, and whose subsequent imagings and biopsy suggested common bile adenoma. However, the patient was deemed a poor surgical candidate for pancreaticoduodenectomy, and unfortunately represented 5 months later with findings suggesting cholangiocarcinoma. This case provides a unique opportunity to study the natural progression of biliary adenoma to cholangiocarcinoma.
Primary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device
Authors: Tsang Anderson Chun-On , Leung Kar-ming , Lee Raymond , Lui Wai-man , Leung Gilberto Ka-Kit
Published: May 2014

Background

A post-irradiated carotid pseudoaneurysm at the skull base can cause life-threatening blowout syndrome. Conventional treatments include parent vessel occlusion, endovascular coiling or covered stenting. Use of the Pipeline embolization device (PED) for pseudoaneurysm exclusion at the skull base is not well described.

Objective

To report the clinical and angiographic outcome after using multiple PEDs to treat recently ruptured radiation-induced carotid pseudoaneurysms at the skull base.

Methods

Retrospective review of the clinical and angiographic records of patients who received PEDs as primary treatment for skull base carotid pseudoaneurysm between April 1, 2011 to March 31, 2013.

Results

Seven patients (five men, two women) with a mean age of 58 years (range 47–65) were treated in the study period. Primary treatment with the PED alone, with adjunct coil embolization in two patients, achieved immediate hemostasis in all patients, with no pseudoaneurysm rebleeding after a mean follow-up of 15.3 months (range 4–24 months). One patient had periprocedural cerebral infarction. Delayed internal carotid artery occlusion secondary to in-stent thrombosis occurred in three patients, one of whom had lacunar infarct and two remained asymptomatic.

Conclusions

Endovascular treatment with the PED was effective in excluding skull base post-irradiated carotid pseudoaneurysms and preventing recurrent blowout. However, the risk of ischemic complications in this group of patients was high and our experience did not support the use of flow diverters as a first-line treatment for this condition.
Diel patterns of leaf carbohydrate concentrations differ between seedlings and mature trees of two sympatric oak species
Authors: Baber Ori , Slot Martijn , Celis Gerardo , Kitajima Kaoru
Published: May 2014

A fundamental aspect of the carbon cycle is the exchange of carbon between plants and the atmosphere. It is, therefore, important to understand factors that affect differences in gas exchange and carbon balance within and among species. Concentrations of nonstructural carbohydrates are often used as a proxy for carbon balance. We determined diel patterns of leaf carbohydrate concentrations in relation to irradiance (sun vs. shade) in seedlings and mature trees of two sympatric oak species (Quercus virginiana Mill. and Quercus hemisphaerica Bartram ex Willd.). For seedlings, we also measured leaf gas exchange. Higher sun exposure significantly increased photosynthesis and carbohydrate concentrations in both species. Carbohydrate concentrations of seedling leaves showed strong diel fluctuations, whereas concentrations in mature tree leaves did not. This contrast might be attributed to faster carbohydrate export from leaves of mature trees. The difference in sink strength between seedlings and adults may be related to the decreasing ratio of leaf mass to plant mass with ontogeny, increasing the demand for carbohydrates per unit leaf mass. Seedlings and mature trees are clearly functionally different and care must be taken when extrapolating results from seedling experiments to mature trees.
Study of heterostructures of Cu3BiS3–buffer layer measured by Kelvin probe force microscopy measurements (KPFM)
Authors: Mesa F. , Fajardo D.
Published: May 2014

The interface formed between Cu3BiS3 thin films and the buffer layer is a potentially limiting factor to the performance of solar cells based on Al/Cu3BiS3/buffer heterojunctions. The buffer layers of ZnS and In2S3 were grown by co-evaporation, and tested as an alternative to the traditional CdS deposited by chemical bath deposition. From the Kelvin probe force microscopy measurements, we found the values of the work function of ZnS, In2S3, and CdS, layers deposited into Cu3BiS3. Additionally, different electronic activity was found for different grain boundaries (GBs), from studies under illumination, we also found the net doping concentration and the density of charged GB states for Cu3BiS3 and Cu3BiS3/CdS.
Two esterases from the genus Spodoptera degrade sex pheromones and plant volatiles
Authors: He Peng , Li Zhao-Qun , Liu Cheng-Cheng , Liu Shi-Jing , Dong Shuang-Lin
Published: May 2014

In moths, high temporal sensitivity in perception of sex pheromones and host plant volatiles suggests the existence of mechanisms acting to maintain antennal sensitivity. The antennal enzymes have been long hypothesized to play a central role in the mechanisms, by rapid metabolism of the odorants soon after the fulfillment of the sensillum receptor activation. In the present study, two putative homologous esterases, SexiCXE13 and SlituCXE13, were cloned by RT–PCR and RACE procedures from Spodoptera exigua and Spodoptera litura, respectively. The phylogenetic tree assigned the two genes into the same group with two previously identified male antennal-specific pheromone-degrading enzymes. SexiCXE13 and SlituCXE13 were expressed in High Five cells, and the enzymatic characteristics and substrate specificity were investigated using the purified recombinant enzymes. Both esterases showed high activity to a variety of acetate substrates, including the sex pheromones, their analogs, and some common plant odorants. Our study, for the first time, provides direct biochemical and molecular evidence that the ubiquitously expressed enzyme has the ability to degrade sex pheromones and plant volatiles, and thus this adds new knowledge to the mechanism underlying the sensitivity of moth olfaction.
Quantum gravity: Physics from supergeometries
Authors: Cirilo-Lombardo Diego Julio , Prudêncio Thiago
Published: May 2014

We show that the metric (line element) is the first geometrical object to be associated to a discrete (quantum) structure of the spacetime without necessity of black hole-entropy-area arguments, in sharp contrast with other attempts in the literature. To this end, an emergent metric solution obtained previously in [ Phys. Lett. B661 (2008) 186–191] from a particular non-degenerate Riemannian superspace is introduced. This emergent metric is described by a physical coherent state belonging to the metaplectic group Mp (n) with a Poissonian distribution at lower n (number basis) restoring the classical thermal continuum behavior at large n(n → ∞), or leading to non-classical radiation states, as is conjectured in a quite general basis by means of the Bekenstein–Mukhanov effect. Group-dependent conditions that control the behavior of the macroscopic regime spectrum (thermal or not), as the relationship with the problem of area/entropy of the black hole are presented and discussed.
DYNAMIC MR IMAGING, BIODISTRIBUTION AND PHARMACOKINETICS OF POLYMER SHELLED MICROBUBBLES CONTAINING SPION
Authors: BARREFELT ÅSA , PARADOSSI GAIO , ASEM HEBA , MARGHERITELLI SILVIA , SAGHAFIAN MARYAM , ODDO LETIZIA , MUHAMMED MAMOUN , ASPELIN PETER , HASSAN MOUSTAPHA , BRISMAR TORKEL B.
Published: May 2014

Magnetic Resonance Imaging (MRI) is a noninvasive diagnostic method that provides information on morphological and physiological changes of the internal organs over time. Imaging and measurements can be repeated on the same subject, thereby reducing inter-individual variability effects and hence the number of subjects required. A potential MRI contrast agent consisting of microbubbles embedded with superparamagnetic iron oxide nanoparticles (SPION) in the shell (SPION MBs) was injected intravenously into rats to determine their biodistribution and pharmacokinetics using MR imaging. Agarose phantoms containing SPION MBs were scanned using 3 T MRI to construct a standard curve. Rats were injected with SPION MBs, free SPION or plain MBs and scanned dynamically at 3 T using a clinical MR scanner. The relaxation rate (R2*) was studied over time as a measure of the iron oxide concentrations to enable calculation of the pharmacokinetic parameters. The kinetics of SPION MBs in the liver was fitted to a one-compartment model. Furthermore, the biological fate of SPION MBs was examined via a histological survey of tissue samples using Perls' Prussian blue staining and immunohistochemistry (IHC). 1.2 h after injection of SPION MBs, T2* of the liver had decreased to its minimum. The elimination half-life of SPION MBs was 598.2 ± 97.3 h, while the half-life for SPION was 222.6 ± 26.4 h. Moreover, our study showed that SPION MBs were taken up by the macrophages in the lungs, spleen and liver. MBs labeled with SPION can be used for MR imaging. Moreover, MRI is a reliable and noninvasive tool that can be utilized in pharmacokinetic investigations of future contrast agents using SPION MBs and SPION in the rat.
Antigen-Specific Culture of Memory-like CD8 T Cells for Adoptive Immunotherapy
Authors: Litterman Adam J. , Zellmer David M. , LaRue Rebecca S. , Jameson Stephen C. , Largaespada David A.
Published: May 2014

Cytotoxic T cells typically are expanded ex vivo in culture with IL2 for adoptive immunotherapy. This culture period leads to a differentiated phenotype and acquisition of effector function, as well as a loss of in vivo proliferative capability and antitumor efficacy. Here, we report antigen-specific and polyclonal expansion of cytotoxic T cells in a cocktail of cytokines and small molecules that leads to a memory-like phenotype in mouse and human cells even during extended culture, leading to enhanced in vivo expansion and tumor control in mice. Cancer Immunol Res; 2(9); 839–45. ©2014 AACR.
Capillary Index Score in the Interventional Management of Stroke Trials I and II
Authors: Al-Ali Firas , Tomsick Thomas A. , Connors John J. , Gebel James M. , Elias John J. , Markarian Georges Z. , Al-Ali Zein , Broderick Joseph P.
Published: May 2014

Background and Purpose—

The Capillary Index Score (CIS) is a simple angiography-based scale for assessing viable tissue in the ischemic territory. We retrospectively applied it to Interventional Management of Stroke (IMS) trials I and II to evaluate the predictive value for good outcomes.

Methods—

CIS was calculated from pretreatment diagnostic cerebral angiograms blinded to outcome. IMS I and II diagnostic cerebral angiogram images of sufficient quality were reviewed and CIS calculated for treated subjects with internal carotid artery or M1 occlusion. CIS scoring (0–3) was dichotomized into favorable (
f
CIS; 2 or 3) and poor (
p
CIS; 0 or 1). Modified thrombolysis in cerebral infarction score 2b or 3 was considered good revascularization. CIS and modified thrombolysis in cerebral infarction scores were compared with good outcome, defined as modified Rankin Scale score ≤2 at 90 days.

Results—

Twenty-eight of 161 subjects met the inclusion criteria. Thirteen (46%) had
f
CIS. Good clinical outcome was significantly different between the 2 CIS groups (62% for
f
CIS versus 7% for
p
CIS;
P
=0.004). Good reperfusion correlated to good outcome (
P
=0.04). No significant differences in time to intravenous or intra-arterial treatment were identified between
f
CIS and
p
CIS groups (
P
>0.25).

Conclusions—

A
f
CIS was found in ≈50% of subjects and was a virtual prerequisite for good outcome in this study subgroup of IMS I and II. We call this the 50% barrier.
A catalyst-free growth of aluminum-doped ZnO nanorods by thermal evaporation
Authors: Suhaimi Syahida , Sakrani Samsudi , Dorji Tashi , Ismail Abdul Khamim
Published: May 2014

The growth of Al:ZnO nanorods on a silicon substrate using a low-temperature thermal evaporation method is reported. The samples were fabricated within a horizontal quartz tube under controlled supply of O2 gas where Zn and Al powders were previously mixed and heated at 700°C. This allows the reactant vapors to deposit onto the substrate placed vertically above the source materials. Both the undoped and doped samples were characterized using scanning electron microscopy (SEM), field emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDX), high-resolution transmission electron microscopy (HRTEM) and photoluminescence (PL) measurements. It was observed that randomly oriented nanowires were formed with varying nanostructures as the dopant concentrations were increased from 0.6 at.% to 11.3 at.% with the appearance of ‘pencil-like’ shape at 2.4 at.%, measuring between 260 to 350 nm and 720 nm in diameter and length, respectively. The HRTEM images revealed nanorods fringes of 0.46 nm wide, an equivalent to the lattice constant of ZnO and correspond to the (0001) fringes with regard to the growth direction. The as-prepared Al:ZnO samples exhibited a strong UV emission band located at approximately 389 nm (E

g
 = 3.19 eV) with multiple other low intensity peaks appeared at wavelengths greater than 400 nm contributed by oxygen vacancies. The results showed the importance of Al doping that played an important role on the morphology and optical properties of ZnO nanostructures. This may led to potential nanodevices in sensor and biological applications.
A showcase of future plant biology: moving towards next-generation plant genetics assisted by genome sequencing and systems biology
Authors: Lee Insuk
Published: May 2014

A report on the Cold Spring Harbor Asia conference on Genome Assisted Biology of Crops and Model Plant Systems Meeting, held in Suzhou, China, April 21–25, 2014.
Desiccation resistance reflects patterns of microhabitat choice in a Central-American assemblage of wandering spiders
Authors: Lapinski Witold , Tschapka Marco
Published: May 2014

The lowland rainforest of north-eastern Costa Rica harbours an assemblage of large wandering spider species belonging to three habitat subguilds: 1) semi-aquatic, 2) forest-ground dwelling, and 3) vegetation dwelling species. We hypothesized that desiccation resistance should differ among species preferring different microhabitats and the associated microclimate. Desiccation resistance was assessed 1) by measuring water-loss rates of the spiders under relatively dry experimental conditions, and 2) by recording desiccation susceptibility, i.e., the reactions of the spiders to a relatively dry environment. High water-loss rates and desiccation susceptibility of the semi-aquatic and forest-ground dwelling subguilds clearly mirrored the relatively humid microclimate of the understory. Significantly lower water-loss rates and desiccation susceptibility of the vegetation-dwelling species reflected the highly variable, often dry and hot conditions of the rainforest canopy and forest edge habitats. Vegetation-dwelling wandering spiders are therefore physiologically better adapted to dry conditions than the semi-aquatic and forest-ground dwelling species. The results illustrate the significance of physiological characteristics for explaining species-specific habitat use, and in a larger context also for niche partitioning within a community.
GROWTH OF SME SECTOR AND WAYS OF IMPROVING ACCESS TO FINANCIAL SERVICES IN UZBEKISTAN
Authors: Koraliev Turaboy , Oblomurodov Narzullo
Published: May 2014

Private sector is recognized as the driving force and the engine for economic growth in many countries. It delivers important goods and services, provides jobs, generates revenue for public sector, and creates and maintains infrastructure. SMEs in particular create jobs and lead to more equitable distribution of incomes. In Uzbekistan the share of SMEs in GDP steadily increased from 30% in 2000 to 54% in 2012. The sector accounts for 75% of total employment in the country and it is forecasted that SMEs will add around half a million of new jobs in 2013.Despite these improvements, SMEs’ productivity and competitiveness potential have been affected by regulatory and institutional constraints. Access to adequate financial services is a key component for sustainable growth of the private sector, economic diversification and creation of more and better jobs. Adequate access to finance includes not only bank loans, but also a host of financing instruments that are geared to meet the diverse needs of enterprises and entrepreneurs with different characteristics and profiles. In addition, access to a broader range of efficient and reliable financial services, including electronic payment services, enables enterprises to manage the financial resources available to them more effectively.
How do health workers balance infant feeding and employment?
Authors: Omer-Salim Amal , Olsson Pia
Published: May 2014

Maternity protection is increasingly important for working women worldwide. Most African countries have some maternity protection provisions, but little is known about their utility in practice. This article described how female health workers combined infant feeding and employment. Individual interviews were conducted with 12 female health workers at a hospital in Dar es Salaam, Tanzania. The data was transcribed, translated, and qualitative content analysis applied. Four ways of handling infant feeding and employment emerged: preparing during pregnancy and maternity leave; maximizing breastfeeding during time off work; creating time to breastfeed during the working day; and finding someone else to manage infant feeding during the mother's absence at work. Diverse and flexible workplace and family solutions are needed to cater for employed mothers’ needs. Self-efficacy in handling infant feeding and employment is yet another factor to consider beyond the concepts of time, space/proximity, support and gatekeepers described in the literature.
Accurate and consistent record-keeping using the antenatal card
Authors: Basu Jayati , Seopela Louisa
Published: May 2014

The antenatal card is the vehicle of documentation of antenatal care service provision in South Africa and it provides opportunities for practising preventive medicine. The aim was to evaluate the health professional's performance on documenting antenatal cards. Antenatal clinic cards and obstetric files of 413 women, who delivered at the labour ward of Rahima Moosa Hospital (RMH) during a 1-month period in February, 2008 were reviewed retrospectively. All components of antenatal cards were evaluated. Results of primary clinics and RMH were compared. Poor documentation of the most important parameters such as expected date of delivery, symphysio-fundal height measurement, weight, blood pressure, HIV and CD4 count, fetal growth, problem list, place of delivery, were noted.

Inadequate documentation of the antenatal cards might result in sub-standard antenatal care particularly in a developing country setting, leading to increased maternal and fetal morbidity and mortality. A regular in-service training is necessary.
Evaluating partograph use at two main referral hospitals in Kenya
Authors: Rotich Everlyn , Maina Loise , Njihia Alice , Christensson Kyllike
Published: May 2014

Purpose: To evaluate the use of the partograph as a critical tool in the management of labour in two hospitals in Kenya. Method: Midwives were observed administering partographs to a total of 234 women. This process was evaluated using a structured observation checklist. Results: Every one of the partographs evaluated was incomplete or incorrect in some respect. There was also minimal consideration of the recorded data in determining whether to intervene in the pregnancy. The alert line was crossed for 40 partographs (17.1%) with no intervention being instituted. In 6 cases (2.6%) there was a waiting time of 3–16 hours after crossing of the action line before interventions were carried out. Conclusion: Proper monitoring, recording, and interpretation are important in minimizing unnecessary interventions.
Barriers to health-seeking practices during pregnancy among adolescents in rural Blantyre, Malawi
Authors: Mbiza Christina Ruth , Kazembe Abigail , Simwaka Andrew
Published: May 2014

Background

Very few adolescents in Malawi seek antenatal care on time during pregnancy. The Kroeger model (1993) guided the investigation of factors that hinder adolescents from seeking healthcare advice during pregnancy.

Method

A cross-sectional study was conducted at three health centers in rural Blantyre involving a convenience sample of 240 respondents. Data were analysed using SPSS version 16.0.

Results

Individual factors such as low level of education, inability to make decisions with regards to care, inadequate knowledge, and psychological factors such as shyness, fear, stigma and health service factors such as long distance to the facility, a lack of adolescent friendly services, and inaccessible roads were found to be barriers to seeking healthcare.

Conclusion

Empowering communities and adolescents, establishing and making existing health facilities more adolescent friendly may help adolescents seek healthcare advice in suitable time during pregnancy.
Planning, developing and writing an effective conference abstract
Authors: Albarran John
Published: May 2014

John Albarran gives a step-by-step guide to ensuring the highest standards (and increasing the chance of acceptance) when preparing an abstract for submission.
Women and coronary heart disease: New recommendations
Authors: Albarran John
Published: May 2014

Last month the British Cardiovascular Society launched new guidelines on optimizing women’s heart health. John Albarran discusses the issues surrounding the problems of women and heart disease.
Research Roundup
Authors: Linden Belinda
Published: May 2014

Increased alcohol intake has in the past been linked with sudden cardiac arrhythmias, oft en among people who have no obvious evidence of heart disease. Previous studies have found that a regular moderate to high alcohol intake may increase the risk of developing atrial fi brillation in men but this has not yet been confi rmed in women.
Cognitive behavioural therapy
Authors: Brown Arlene
Published: May 2014

While there are other many other books which discuss cognitive-behavioural therapy (CBT), the strength of this book is its very pragmatic focus on how health professionals can use the technique to help individuals live with a long-term condition. This is particularly relevant today when health care efforts are increasingly directed at supporting people to take more control of their own chronic disease management (CDM).
Considering new models of care
Authors: Stuart-Jones Vicqui
Published: May 2014

Vicqui Stuart-Jones reports on some of the presentations from the annual British Cardiovascular Society annual conference, held in London on 1–3 June 2009
The management of pain in end-stage heart failure
Authors: Hughes Suzy , MacCallum Annie
Published: May 2014

Pain is emerging clinically as an important but overlooked symptom in heart failure. The symptom of pain is poorly described in chronic disease and not a symptom immediately associated with heart failure. Despite this, in studies pain is commonly reported by heart failure patients. Heart failure patients may experience pain from a variety of causes, which may be acute, chronic or in end-stage disease, the concept of ‘Total Pain’ may apply. Treatment can be a challenge as it must take into account any contraindications the patient’s diagnosis or other medications impose. Established pain management may need to be adapted to include a combination of drugs with different modes of action and non pharmacological strategies
Research nurse or nurse researcher?
Authors: Watmough Sarah , Flynn Maria , Wright Angie , Fry Kathryn
Published: May 2014

In part 2 of a series on practical aspects of research, Sarah Watmough, Maria Flynn, Angie Wright and Kathryn Fry consider the role of the nurse in research and examine the differences in roles and responsibilities of the ‘Research Nurse’ and the ‘Nurse Researcher
Practicalities of prescribing and the heart failure specialist nurse
Authors: McHugh Pauline
Published: May 2014

Pauline McHugh is a heart failure specialist nurse and independent prescriber caring for patients in the community. She discussed her experience with Vicqui Stuart-Jones.
Evidence-based treatment for patients with ACS
Authors: Linden Belinda
Published: May 2014

This section presents a synopsis of a selection of recently published articles of interest to those nurses working in the field of cardiovascular nursing. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Effective blood glucose management in patients with diabetes recovering from CABG
Authors: Lehwaldt Daniela
Published: May 2014

Nurses are frequently involved in blood glucose monitoring in patients with diabetes recovering from coronary artery bypass grafting (CABG). The goal is to prevent and limit serious postoperative complications associated with hyperglycaemia (increased blood glucose levels) including sternal and leg wound infections. To achieve this goal it is paramount that hyperglycaemia is detected as early as possible and treated effectively.

Many factors are associated with the development of hyperglycaemia among people with diabetes recovering from CABG. The diabetic state itself, the effects of cardiopulmonary bypass (CPB) and the surgical trauma induced during CABG are all influencing factors. However, hyperglycaemia can also be exacerbated through inconsistent blood glucose control in the immediate postoperative phase. Over the past few years, a large body of evidence has highlighted the advances of intensive blood glucose control on postoperative recovery. Blood glucose management protocols can be used to achieve improved outcomes for diabetic patients recovering from CABG.
The potential role of ivabradine in management of chronic heart failure
Authors: Williams Helen , Curran Rebecca
Published: May 2014

Ivabradine is currently licensed as an anti-anginal agent in the UK, however there is now interest in its potential role in the treatment of chronic heart failure. Ivabradine is a pure heart-rate lowering agent, slowing heart rate without affecting blood pressure or myocardial contractility. Recent data from the SHIFT study has shown that in selected patients ivabradine can reduce heart failure hospital admissions and heart failure-related deaths, although no overall impact on all-cause or cardiovascular mortality was shown. Patients who may benefit are those with NYHA class II–IV heart failure due to left ventricular systolic dysfunction in sinus rhythm with a resting heart rate ≥70 beats per minute, and who are optimized on ACE-inhibitors and beta-blockers, as these drug classes confer a survival benefit which has not been proven with ivabradine

This article considers the evidence so far on ivabradine in heart failure. Contraindications and drug interractions are discussed, as well as practical considerations if it is introduced to heart failure management.
ECG of the month
Authors: Regan Clare
Published: May 2014

Claire Regan presents an ECG for you to analyse. The answer is given on page 349
Patient views on nurse prescribing: what does research tell us?
Authors: Latter Sue
Published: May 2014

Sue Latter reviews the research published so far into patients’ attitudes towards prescribing by nurses.
Cardiorenal syndrome and sudden cardiac death
Authors: Ashton Lisa
Published: May 2014

Chronic kidney disease (CKD) and sudden cardiac death (SCD) syndromes are major public health issues. Patients with CKD are more likely to die from cardiovascular complications than reach end-stage renal disease. End-stage renal disease itself is a primary factor for cardiovascular disease and increased risk of SCD. This article explores pathophysiology, diagnostic tools and current treatment guidelines, raising the question regarding use of ICDs in the prevention of SCD in this patient group. ICD therapy may be beneficial for patients with cardiorenal syndrome, at present this is underutilized and management of risk factors remains the focus of treatment. Further research is required to ascertain the best treatment option for these patients. Early identification and treatment of high-risk patients is paramount and close consultation and cooperation between cardiac and renal specialists is required.
Peripherally-inserted central venous catheters
Authors: Obaid Daniel R , Amerasekera Steve SH
Published: May 2014

Peripherally-inserted central venous catheters (PICCs) are increasingly being used for a variety of the indications that previously required traditional central vascular access devices. They are a safe and cost-effective alternative. However, they do have potentially important associated complications. This review will cover indications for PICCs and insertion techniques, as well as the detection, prevention and management of complications associated with insertion and continued usage.
The attitudes and views of GPs and physicians to prescribing by heart failure nurse specialists
Authors: Shannon Eve , Spence William
Published: May 2014

Aims:

To describe and explore attitudes and views of general medical practitioners (GPs) and physicians regarding prescribing by heart failure nurse specialists (HFNS).

Methods:

This qualitative study employed focus group and one-to-one interviewing. Data were collected in one primary health-care centre and one teaching hospital in the west of Scotland, UK. A convenience sample of 10 GPs and 11 physicians was recruited.

Findings:

GPs and physicians were aware and supportive of HFNS prescribing with both agreeing on its benefits for patient care and other professionals. There was limited awareness of the range of medicines available to the HFNS for prescribing and the associated role preparation. Difference between primary and secondary care data-bases was viewed as a barrier to HFNS prescribing.

Conclusions:

GPs and physicians viewed HFNS prescribing in a positive way and as a natural progression in role expansion. Their need for education about HFNS prescribing was identified.
Life with congenital heart disease and pulmonary hypertension
Authors: Jackson Hayley
Published: May 2014

The Grown-Up Congenital Heart Patients’ Association (GUCH-PA), Pulmonary Hypertension Association and Downs Heart Group are jointly looking into patients’ experiences of services for those with a dual diagnosis, such as Hayley Jackson, who shares her story here.
Atelectasis and the cardiac surgery patient
Authors: Brodie Lyndell
Published: May 2014

Atelectasis (the reduced expansion of alveolar clusters leading to partial or complete lung collapse) is a common postoperative complication in patients undergoing cardiac surgery. As part of the multidisciplinary team, nurses are involved in the treatment of atelectasis at all stages of the patient journey, from the preoperative stage, through their intensive care unit stay, onto the cardiac ward until discharge. This article describes the risk factors for and detection of atelectasis in this patient group, together with prevention and treatment strategies that are currently adopted at various stages of the patient pathway.
ECG of the month
Authors: Regan Claire , Regan Martin
Published: May 2014

Clare Regan and Martin Regan present an ECG for you to analyse. The answer is given on page 394
Incremental shuttle walk test in cardiac rehabilitation
Authors: Grove Tim
Published: May 2014

The incremental shuttle walk test (ISWT) is a low cost, submaximal exercise test, which is commonly used in the assessment of aerobic fitness in a cardiac rehabilitation (CR) setting. This review discusses the practical applications of the ISWT in the context of its validity, repeatability and its predictability in measuring aerobic fitness. The validity of the ISWT test has been shown to have a strong correlation between distances walked to actual measures taken during the ‘gold standard’ treadmill test. However, the overall distance achieved during the ISWT can be influenced by the test/retest familiarity effect, if a practice walk test is not performed. Despite this limitation, the heart rate walking speed index can be applied to measure the true physiological effects of the ISWT in the absence of a practice walk following an exercise intervention. In addition, the results of the ISWT can also provide valuable information for exercise prescription and physical activity guidance along with providing prognostic information for patients requiring heart transplantation.
A balancing act: the challenge of juggling dual roles
Authors: Dunkley Sophie , Tagney Jenny
Published: May 2014

The notion of role-sharing is not a new one, but it can be daunting in the current climate to make the leap. This article looks at the personal perspective of balancing two roles; a clinical ward-based band 5 post alongside a clinical nurse specialist (CNS) band 6 role. Consideration is given to the extent of the CNS role in the complex condition of heart failure, adjusting to this role as well as looking at the challenge of juggling two part-time posts. The roles provided an excellent personal development opportunity, which was well supported clinically by caring for this patient group. As such, it enabled the application of theory learnt in the CNS role into clinical care given on the cardiology ward. Although the role sharing was overall a positive experience, finding time to address identified learning needs and independent working were some of the negative aspects encountered. Ultimately, it provided a ‘taster’ of the CNS role in heart failure, which has now become the focus of professional development and career aspirations for the post holder.
Acute pericarditis: An overview
Authors: Curry Sonia
Published: May 2014

Acute pericarditis is a common cardiovascular condition that may present in primary and secondary care settings. This disorder has multiple causes. However, in developed countries up to 85% of acute pericarditis is caused by viral or idiopathic origins. This article will focus mainly on this aetiology. It is important for health-care professionals involved in the assessment of chest pain and management of this group of patients to have a comprehensive understanding of the condition. This overview discusses the anatomy of the pericardium, the aetiology of acute pericarditis, clinical presentation, diagnostic procedures and treatment strategies associated with this disorder. The European Society of Cardiology Clinical Guidelines on the Diagnosis and Management of Pericardial Diseases (2004) and recent relevant research are used to underpin this article.
Saheli
Authors: Thanki Jo , Nutter Joy
Published: May 2014

Saheli was a women’s group established as a mechanism to utilise partnerships in order to support each other and to facilitate and promote independence. This was in response to an identified gap in the provision of services for minority ethnic womens groups.

Initial evaluation of the group would suggest that such partnerships go beyond individual health care, but can be used to develop strategies and information for health care professionals and to influence purchasers and providers.

As part of the on-going project Jo Thanki, the group’s co-ordinator presents an overview of the early history and influence of Saheli on minority ethnic women in Birmingham.
Daily routines of elderly people with diabetes
Authors: Goldstein Ruth , Daly Heather
Published: May 2014

Diabetes mellitus is a chronic disease suffered by approximately 3% of the adult population. Treatment of the disease may require drug therapy and dietary control. In addition patients’ self-monitoring of the disease, on a daily basis, is fundamental to successful therapy. This paper focuses on the elderly and their monitoring routines. A monitoring regimen which is consistent with patient’s daily routines and places no significant burden either on the patient or their carer must be encouraged. The monitoring equipment used and regimen required should be negotiated with the patient to ensure that compliance with the regimen is adequate to ensure appropriate control of the disease. Practical issues such as the patient’s daily routines, their mental and physical ability, the type of support they receive from formal and informal carers and their general ability to cope with potentially complicated equipment should be addressed alongside the choice of new and more established monitoring equipment.