bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional outcomes of outpatient balance training following total knee replacement in patients with knee osteoarthritis: a randomized controlled trial
Authors: Liao Chun-De , Lin Li-Fong , Huang Yi-Ching , Huang Shih-Wei , Chou Lin-Chuan , Liou Tsan-Hon
Published: January 2015

Objective:

To evaluate whether balance training after total knee replacement surgery improves functional outcomes and to determine whether postoperative balance is associated with mobility.

Design:

A prospective intervention study and randomized controlled trial with an intention-to-treat analysis.

Setting:

The rehabilitation center of a university-based teaching hospital.

Participants:

A total of 130 patients with knee osteoarthritis who had undergone total knee replacement surgery were recruited to attend an outpatient rehabilitation program. They were randomly allocated to additional balance rehabilitation and functional rehabilitation groups.

Interventions:

During the eight-week outpatient rehabilitation program, both groups received general functional training. Patients in the balance rehabilitation group received an additional balance-based rehabilitation program.

Primary outcome measures:

The functional reach test, single-leg stance test, 10-m walk test, Timed Up and Go Test, timed chair-stand test, stair-climb test, and Western Ontario and McMaster Universities Osteoarthritis Index were measured at baseline, eight weeks (T1), and 32 weeks (T2).

Results:

The balance rehabilitation group patients demonstrated significant improvement in the results of the functional reach test at T1 (37.6 ±7.8 cm) and T2 (39.3 ±9.7 cm) compared with the baseline assessment (11.5 ±2.9 cm) and Timed Up and Go Test at T1 (8.9 ±1.2 seconds) and T2 (8.0 ±1.9 seconds) compared with the baseline assessment (12.5 ±1.8 seconds). Moreover, the balance rehabilitation group patients exhibited significantly greater improvements in balance and mobility than did the functional rehabilitation group patients (all P < 0.001). Furthermore, improved balance was significantly associated with improved mobility at T2.

Conclusion:

Postoperative outpatient rehabilitation with balance training improves the balance, mobility, and functional outcomes in patients with knee osteoarthritis after total knee replacement.
Respiratory muscle training on pulmonary and swallowing function in patients with Huntington’s disease: a pilot randomised controlled trial
Authors: Reyes Alvaro , Cruickshank Travis , Nosaka Kazunori , Ziman Mel
Published: January 2015

Objective:

To examine the effects of 4-month of respiratory muscle training on pulmonary and swallowing function, exercise capacity and dyspnoea in manifest patients with Huntington’s disease.

Design:

A pilot randomised controlled trial.

Setting:

Home based training program.

Participants:

Eighteen manifest Huntington’s disease patients with a positive genetic test and clinically verified disease expression, were randomly assigned to control group ( n=9) and training group ( n=9).

Intervention:

Both groups received home-based inspiratory (5 sets of 5 repetitions) and expiratory (5 sets of 5 repetitions) muscle training 6 times a week for 4 months. The control group used a fixed resistance of 9 centimeters of water, and the training group used a progressively increased resistance from 30% to 75% of each patient’s maximum respiratory pressure.

Main measures:

Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, six minutes walk test, dyspnoea, water-swallowing test and swallow quality of life questionnaire were assessed before, at 2 and 4 months after training.

Results:

The magnitude of increases in maximum inspiratory ( d=2.9) and expiratory pressures ( d=1.5), forced vital capacity ( d=0.8), forced expiratory volume in 1 second ( d=0.9) and peak expiratory flow ( d=0.8) was substantially greater for the training group in comparison to the control group. Changes in swallowing function, dyspnoea and exercise capacity were small ( d≤0.5) for both groups without substantial differences between groups.

Conclusions:

A home-based respiratory muscle training program appeared to be beneficial to improve pulmonary function in manifest Huntington’s disease patients but provided small effects on swallowing function, dyspnoea and exercise capacity.
Does adding a dietician to the liaison team after discharge of geriatric patients improve nutritional outcome: a randomised controlled trial
Authors: Beck A , Andersen UT , Leedo E , Jensen LL , Martins K , Quvang M , Rask KØ , Vedelspang A , Rønholt F
Published: January 2015

Objectives:

The objective was to test whether adding a dietician to a discharge Liaison-Team after discharge of geriatric patients improves nutritional status, muscle strength and patient relevant outcomes.

Design:

Twelve-week randomized controlled trial.

Setting and subjects:

Geriatric patients (70 + years and at nutritional risk) at discharge.

Interventions:

Participants were randomly allocated to receive discharge Liaison-Team vs. discharge Liaison-Team in cooperation with a dietician. The dietician performed a total of three home visits with the aim of developing and implementing an individual nutritional care plan. The first visit took place at the day of discharge together with the discharge Liaison-Team while the remaining visits took place approximately three and eight weeks after discharge and were performed by a dietician alone.

Main measures:

Nutritional status (weight, and dietary intake), muscle strength (hand grip strength, chair-stand), functional status (mobility, and activities of daily living), quality of life, use of social services, re-/hospitalization and mortality.

Results:

Seventy-one patients were included (34 in the intervention group), and 63 (89 %) completed the second data collection after 12 weeks (31 in the intervention group). Odds ratios for hospitalization and mortality 6 months after discharge were 0.367 (0.129; 1.042) and 0.323 (0.060; 1.724). Nutritional status improved and some positive tendencies in favour of the intervention group were observed for patient relevant outcomes, i.e. activities of daily living, and quality of life. Almost 100 % of the intervention group received three home visits by a dietician.

Conclusion:

Adding a dietician to the discharge Liaison-Team after discharge of geriatric patients can improve nutritional status and may reduce the number of times hospitalized within 6 months. A larger study is necessary to see a significant effect on other patient relevant outcomes.
A feasibility and pilot randomized controlled trial of the “Timing it Right Stroke Family Support Program”
Authors: Cameron Jill I , Naglie Gary , Green Theresa L , Gignac Monique AM , Bayley Mark , Huijbregts Maria , Silver Frank L , Czerwonka Anna
Published: January 2015

Objective:

Examine feasibility of conducting a randomized controlled trial of the Timing it Right Stroke Family Support Program (TIRSFSP) and collect pilot data.

Design:

Multi-site mixed method randomized controlled trial.

Setting:

Acute and community care in three Canadian cities.

Subjects:

Caregivers were family members or friends providing care to individuals who experienced their first stroke.

Intervention:

The TIRSFSP offered in two formats, self-directed by the caregiver or stroke support person-directed over time, were compared to standard care.

Main measures:

Caregivers completed baseline and follow-up measures 1, 3 and 6 months post-stroke including Centre for Epidemiological Studies Depression, Positive Affect, Social Support, and Mastery Scales. We completed in-depth qualitative interviews with caregivers and maintained intervention records describing support provided to each caregiver.

Results:

Thirty-one caregivers received standard care ( n=10), self-directed ( n=10), or stroke support person-directed ( n=11) interventions. We retained 77% of the sample through 6-months. Key areas of support derived from intervention records ( n=11) related to caregiver wellbeing, caregiving strategies, patient wellbeing, community re-integration, and service delivery. Compared to standard care, caregivers receiving the stroke support person-directed intervention reported improvements in perceived support (estimate 3.1, P=.04) and mastery (estimate .35, P=.06). Qualitative caregiver interviews ( n=19) reflected the complex interaction between caregiver needs, preferences and available options when reporting on level of satisfaction.

Conclusions:

Preliminary findings suggest the research design is feasible, caregivers’ needs are complex, and the support intervention may enhance caregivers’ perceived support and mastery. The intervention will be tested further in a large scale trial.
Linking Sexually Objectifying Work Environments Among Waitresses to Psychological and Job-Related Outcomes
Authors: Szymanski Dawn M. , Feltman Chandra E.
Published: January 2015

The purpose of our study was to examine the relationships between experiences of working in sexually objectifying environments (SOEs) and psychological and job-related outcomes in a sample of 253 waitresses working in U.S. restaurants. Supporting our hypotheses, results indicated that SOEs were significantly positively correlated with waitresses’ experiences of interpersonal sexual objectification at work, internalization of cultural standards of beauty, and depression as well as negatively correlated with job satisfaction. Contrary to our hypotheses, SOEs were not directly related to self-objectification, body shame, self-esteem, or health habits. Furthermore, our findings revealed support for a theorized five-chain serial mediation model in which SOEs were related to job satisfaction both directly and indirectly via classic objectification theory processes (i.e., interpersonal experiences of sexual objectification in the restaurant environment, self-objectification, body shame, and depression). Finally, a direct positive link was found between interpersonal experiences of sexual objectification and depression. Our findings underscore the need to implement both individual- and system-level interventions to combat the existence of SOEs and the negative effects they may have on women.
Embryotoxicity of nitrophenols to the early life stages of zebrafish (Danio rerio)
Authors: Ceylan Zeynep , Şişman Turgay , Yazıcı Zehra , Altıkat Aysun Özen
Published: January 2015

The nitrophenols (NPs) are water-soluble compounds. These compounds pose a significant health threat since they are priority environmental pollutants. In this study, 2-Nitrophenol (2NP) and 2,4-dinitrophenol (DNP) were examined for embryo and early life stage toxicity in zebrafish ( Danio rerio). Acute toxicity and teratogenicity of 2NP and DNP were tested for 4 days using zebrafish embryos. The typical lesions observed were no somite formation, incomplete eye and head development, tail curvature, weak pigmentation (≤48 hours postfertilization (hpf)), kyphosis, scoliosis, yolk sac deformity, and nonpigmentation (72 hpf). Also, embryo and larval mortality increased and hatching success decreased. The severity of abnormalities and mortalities were concentration- and compound-dependent. Of the compounds tested, 2,4-DNP was found to be highly toxic to the fish embryos following exposure. The median lethal concentrations and median effective concentrations for 2NP are 18.7 mg/L and 7.9 mg/L, respectively; the corresponding values for DNP are 9.65 mg/L and 3.05 mg/L for 48 h. The chorda deformity was the most sensitive endpoint measured. It is suggested that the embryotoxicity may be mediated by an oxidative phosphorylation uncoupling mechanism. This article is the first to describe the teratogenicity and embryotoxicity of two NPs to the early life stages of zebrafish.
Genotoxicity in primary human peripheral lymphocytes after exposure to lithium titanate nanoparticles in vitro
Authors: Akbaba Giray B , Turkez Hasan , Sönmez Erdal , Tatar Abdulgani , Yilmaz Mehmet
Published: January 2015

Lithium titanate (Li2TiO3) nanoparticles (LTT NPs; <100 nm) are widely used in battery technology, porcelain enamels, and ceramic insulating bodies. With the increased applications of LTT NPs, the concerns about their potential human toxicity effects and their environmental impact were also increased. However, toxicity data for LTT NPs relating to human health are very limited. Therefore, the purpose of this study was to evaluate whether LTT NPs are able to induce genetic damage in human peripheral lymphocytes in vitro when taking into consideration that DNA damage plays an important role in carcinogenesis. With this aim, the chromosome aberrations (CA), sister chromatid exchanges (SCE), and micronucleus (MN) assays were used as genotoxicity end points. Human peripheral lymphocytes obtained from five healthy male volunteers were exposed to LTT NPs at final dispersed concentrations ranging from 0 to 1000 μg/mL for 72 h at 37°C. The obtained results indicated that LTT NPs compound did not induce DNA damage in human peripheral lymphocytes as depicted by CA/cell, SCE/cell, and MN/1000 cell values in all concentrations tested. In summary, our results revealed that exposure to LTT NPs is not capable of inducing DNA lesions in human peripheral lymphocytes for the first time.
Effects of carnosine, taurine, and betaine pretreatments on diethylnitrosamine-induced oxidative stress and tissue injury in rat liver
Authors: Başaran-Küçükgergin C , Bingül İ , Tekkeşin M Soluk , Olgaç V , Doğru-Abbasoğlu S , Uysal M
Published: January 2015

Several chemicals such as N-diethylnitrosamine (DEN) promote hepatocellular cancer in rodents and induce hepatocyte injury. DEN affects the initiation stage of carcinogenesis together with enhanced cell proliferation accompanied by hepatocellular necrosis. DEN-induced hepatocellular necrosis is reported to be related to enhanced generation of reactive oxygen species. Carnosine (CAR), taurine (TAU), and betaine (BET) are known to have powerful antioxidant properties. We aimed to investigate the effects of CAR, TAU, and BET pretreatments on DEN-induced oxidative stress and liver injury in male rats. Rats were given CAR (2 g L−1 in drinking water), TAU (2.5% in chow), and BET (2.5% in chow) for 6 weeks and DEN (200 mg kg−1 intraperitoneally) was given 2 days before the end of this period. Serum alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and γ-glutamyl transferase activities were determined and a histopathologic evaluation was performed on the liver tissue. Oxidative stress was detected in the liver by measuring malondialdehyde, diene conjugate, protein carbonyl and nitrotyrosine levels, glutathione and glutathione peroxidase levels, and superoxide dismutase and glutathione transferase activities. Pretreatments with CAR, TAU, and BET decreased liver prooxidant status without remarkable changes in antioxidant parameters in DEN-treated rats. Pretreatments with TAU and BET, but not CAR, were also found to be effective to reduce liver damage in DEN-treated rats. In conclusion, TAU, BET, and possibly CAR may have an ameliorating effect on DEN-induced hepatic injury by reducing oxidative stress in rats.
Prevalence of Epileptiform Discharges in Healthy Infants
Authors: Bihege Christelle J. , Langer Thorsten , Jenke Andreas C. W. , Bast Thomas , Borusiak Peter
Published: January 2015

Most studies on epileptiform discharges in young children were performed using analog electroencephalographic (EEG) recording systems and a limited numbers of electrodes that might have a lower detection rate for epileptiform discharges than modern digital recording systems. Knowing the prevalence of epileptiform discharges in healthy children is critical for a valid interpretation of findings in patients with a suspected epileptic disorder. We reviewed EEG recordings of 393 otherwise healthy children aged 12 to 60 months using digital EEG recording with respect to epileptiform discharges. We found epileptiform discharges in 3 children aged 12, 34 and 55 months resulting in a prevalence of epileptiform discharges in our cohort of 0.76% (95% confidence interval 0.0% to 1.62%). The prevalence of epileptiform discharges in children younger than 5 years is by far lower than in older children, and the digital findings are in accordance with previous data of conventional EEG.
Determination of biological performance, dimensional stability, mechanical and thermal properties of wood–plastic composites produced from recycled chromated copper arsenate-treated wood
Authors: Tascioglu Cihat , Tufan Mursit , Yalcin Mesut , Sen Selim
Published: January 2015

The aim of this study was to investigate the dimensional stability, mechanical and biological performance and thermal degradation of wood–plastic composites made from high-density polyethylene and recycled wood treated with chromated copper arsenate (CCA), a commonly used wood preservative chemical. Virgin pine wood samples were also prepared with and without a coupling agent and used as the control group. Samples of CCA-treated Scots pine ( Pinus sylvestris L.) with varying wood content were produced by adding different ratios of the coupling agent. The recycled CCA-treated wood-filled composites exhibited better flexural and tensile strength properties and dimensional stability than the control group, whilst their impact strength was less. Biological test values showed improved durability against termites and fungus with the recycled CCA-treated wood-filled composites. In addition, the leaching of heavy metals was significantly diminished when the coupling agent was utilized at a level of 5% (w/w), thus presenting a much lower impact on the environment.
Reframing the Study of Policy Implementation
Authors: Werts Amanda Bell , Brewer Curtis A.
Published: January 2015

This policy implementation study examines the experiences of four elementary school principals using photomethods. We employ Rancière and Merleau-Ponty’s theorizations on democracy and making sense to understand the lived policy experiences of school principals and these individual’s potential for practicing democratic politics. At its heart, implementation by local actors is a political undertaking. Our results indicate implementation is a spatially inhabited practice involving negotiation and strategy, where local actor’s experiences moderate and appropriate policy. Thus, we point out that attention to these spatially inhabited practices requires a fundamental shift in the frameworks and methodologies deployed in the investigation of policy implementation.
Collective Bargaining Agreement Provisions in the Wake of Ohio Teacher Evaluation System Legislation
Authors: Ingle William Kyle , Willis Chris , Fritz James
Published: January 2015

Guided by Honig and Hatch’s conceptualization of bridging and buffering, we analyzed the first teacher collective bargaining agreements negotiated after the enactment of the Ohio Teacher Evaluation System to understand how state law has shaped provisions for teacher evaluation, compensation, reductions in force (RIF), transfers, and contract renewal. We found surprising variation in provisions across districts. Most notable was how districts defined comparable evaluations in making RIF decisions. Bridging districts provided the greatest protections for the most accomplished teachers, regardless of seniority. In contrast, buffering districts have RIF provisions based on seniority.
Democratic Engagement in District Reform
Authors: Marsh Julie A. , Strunk Katharine O. , Bush-Mecenas Susan C. , Huguet Alice
Published: January 2015

This article examines parent engagement in a Los Angeles portfolio district reform. Based on data from a 3-year study, we use the lens of democratic theory to examine the design and implementation of mechanisms seeking parent input in the selection of plans to operate low-performing and new schools. We find that despite significant efforts to move toward a more deliberative model over time, the process remained primarily interest-based in most cases, due in large part to structural constraints, limited access to information, and mistrust. The article concludes with implications for policy, practice, and research.
Principals as Political Agents in The Implementation of IDEA’s Least Restrictive Environment Mandate
Authors: O’Laughlin Laura , Lindle Jane Clark
Published: January 2015

This study focused on federal policy for education of students with disabilities. Assuming that principals occupy a pivotal policy implementation role, this analysis centered on selected elementary principals’ discourse about Least Restrictive Environment (LRE) clause in the federal Individuals With Disabilities Education Act (IDEA). The study used a vertical discourse analysis looking from federal policy documents and case law through state and local guidance documents and finally into principals’ responses to open-ended interviews. These principals exhibited caution in their attempts to interpret LRE. They enforced a distance between regular and special education, ultimately yielding their political agency to others.
Culture, Politics, and Policy Interpretation
Authors: Chase Megan M.
Published: January 2015

Understanding how educational practitioners make sense of and subsequently implement policy has been an increasingly important objective of the K-12 research community. This study extends this research into higher education via an in-depth case study of an urban public 2-year technical college. Drawing on sensemaking theory and critical policy analysis, five primary factors are discussed that significantly influence policy interpretation. These factors include common fixtures within higher education, such as institutional identity and self-interest, and other factors, such as national narratives and perceptions of the target population. The findings also suggest that policy interpretation can influence whether a policy improves equity or maintains the status quo. Finally, by highlighting the roles of race and power within this social context, this study identifies critical implications for how policy can be successfully implemented or, as in this case, resisted and opportunistically disregarded.
Critical Theory and the Limits of Academic Economics: Resolving the Political in Piketty’s Capital in the Twenty-First Century
Authors: Krier Daniel , Amidon Kevin S.
Published: January 2015

This essay assesses the central arguments of Piketty’s Capital in the Twenty-First Century. We note Piketty’s limited engagement with and active distancing from the writings of Marx. Piketty’s location within the disciplinary boundaries of academic economics seems to have profoundly shaped his surprisingly apolitical analysis. Engagement with the political dimensions of capital is further constrained to increase the book’s influence upon policy. We analyze important limitations to Piketty’s work that result from these disciplinary constraints. Important politically implicated concepts, problems, and approaches that relate to Piketty’s substantial empirical work are: labor process studies, research on speculative capitalism, and literature highlighting institutional and political determinants among varieties of capitalism.
Older Persons’ Views and Experience of Elder Abuse in South Western Nigeria
Authors: Cadmus Eniola Olubukola , Owoaje Eme Theodora , Akinyemi Oluwaseun Oladapo
Published: January 2015

Objectives: Conventionally, existing information on elder abuse has been institution based, professionally driven, and in high-income countries. This study addresses the prevailing gap in knowledge through direct consultation of older persons in the community about their perceptions of elder abuse. Method: Eight focus group discussions were carried out among males and females aged 60 years and above in a rural and an urban community in south western Nigeria. Data were transcribed and analyzed based on emergent themes. Results: Findings from the study show that the perception of abuse by the respondents included the standard typologies except sexual abuse as well as societal issues such as disrespect and lack of recognition. Discussion: Our study revealed a high level of awareness and experience of elder abuse among the participants in both communities. Effective social welfare and health services aided by targeted government policies are needed to improve the quality of life of the elderly.
Professional Service Use for a Serious Personal Problem
Authors: Woodward Amanda Toler , Chatters Linda M. , Taylor Harry Owen , Taylor Robert Joseph
Published: January 2015

Objectives: Examines combinations of professionals visited for a serious personal problem. Method: The sample includes those aged 55 and above ( N = 862) from the National Survey of American Life (NSAL). Latent class analysis was used to identify groups of respondents based on types of professionals visited. Multinomial logistic regression was used to identify factors associated with group membership. Results: Classes included health provider plus clergy, physician plus mental health provider, and limited provider use. Whites were more likely than African Americans to fall into the health provider plus clergy and physician plus mental health provider classes. Those with physical and emotional problems were more likely to be in the health provider plus clergy and physician plus mental health provider classes, respectively. Discussion: Most respondents were in the limited provider use class suggesting that for many problems, minimal professional help is utilized. Physicians and clergy were important across all three classes.
Friction of outer rotor affecting friction torque characteristics in an internal gear pump
Authors: Inaguma Yoshiharu
Published: January 2015

This article presents the friction torque in an internal gear pump and the friction force between an outer circumference of an outer rotor and a body, which causes a significant loss, has been investigated. When in use at a high pressure, the pump has a large friction torque due to the friction force acting on the outer rotor circumference. This friction force is caused by imbalanced force acting on the outer rotor. As well as by a positioning suction and a delivery port, the force can be reduced by setting a suction pressure recess in a section of the outer rotor circumference. In this study, through the measurement of the friction torque in an actual pump and the pressure distribution on the outer circumference of the outer rotor, it is investigated how the suction pressure recess can change the force acting on the outer rotor. The actual internal gear pump without the suction pressure recess has a large friction torque, and it corresponds to a large force on the outer rotor, which is calculated from the pressure distributions on the inside and outside of the outer rotor. In addition, on the basis of the measured friction torque of the test pump and the force acting on the outer rotor, calculated using the results of the pressure distribution, the coefficient of friction between the outer rotor circumference and the body can be estimated.
Bio-inspired control research of a novel lower extremity exoskeleton with a series-parallel mechanism
Authors: Pan Dalei , Gao Feng , Miao Yunjie , Cao Rui
Published: January 2015

This paper proposes a switch-type and parameter self-tuning fuzzy-PID/PID controller for a novel lower extremity exoskeleton with a series-parallel mechanism according to the features of human level walking gait. The novel exoskeleton mechanism was described, the biological characteristics of human legs during the walking cycle were analyzed and a mapping from the positions of human lower extremity joints to the exoskeleton joints was established. Then the schematic of the exoskeleton control strategy was discussed and illustrated. The co-simulation method of ADAMS and MATLAB/SIMULINK was adopted and the fuzzy-PID/PID controller was designed. A 1-DOF rotation control was simulated by both the fuzzy-PID/PID controller and a conventional PID controller for comparison. Finally, the exoskeleton level walking gait was co-simulated by using the bio-inspired control strategy. The results show that the controller can provide a fast, stable and precise control for the exoskeleton system.
Troubling Times for Young People and Families With Troubles – Responding to Truancy, Rioting and Families Struggling With Adversity
Authors: Arthur Raymond
Published: January 2015

The Big Society was one of the UK Prime Minister’s flagship policy ideas prior to his election in 2010 and has since become part of the UK coalition government’s legislative programme. A key aspect of the Big Society is to mend ‘societally Broken Britain’ by supporting families, as ‘strong families are the foundation of a bigger, stronger society’. However, in the aftermath of the riots of August 2011 in London and other parts of England, the UK Prime Minister, David Cameron, has suggested that parents of children who regularly truant need to be confronted and challenged and has proposed penalizing parents of truanting children by cutting their benefits. This article considers whether withholding benefits from families is an effective means of tackling antisocial behaviour or does this plan represent an ideological view of welfare recipients as being irresponsible and a commitment to the penalization of the socially excluded? This article will consider whether the Big Society truly offers the prospect of a new approach to young people and families deemed to be ‘in trouble’ or whether the August 2011 riots created the environment for justifying cuts in public spending by shifting responsibility for crime and crime control from the criminal justice system onto vulnerable young people and low-income families.
Ethical and methodological issues in qualitative health research involving children
Authors: Huang Xiaoyan , O’Connor Margaret , Ke Li-Shan , Lee Susan
Published: January 2015

Background:

The right of children to have their voice heard has been accepted by researchers, and there are increasing numbers of qualitative health studies involving children. The ethical and methodological issues of including children in research have caused worldwide concerns, and many researchers have published articles sharing their own experiences.

Objectives:

To systematically review and synthesise experts’ opinions and experiences about ethical and methodological issues of including children in research, as well as related solution strategies.

Research design:

The research design was a systematic review of opinion-based evidence, based on the guidelines by Joanna Briggs Institute.

Methods:

A search of five computerised databases has been conducted in April 2014 and 2271 articles were found. After screening the titles, abstracts, full texts and appraising the quality, 30 articles were finally included in the review. A meta-aggregative approach was applied in the data analysis and synthesis process.

Ethical considerations:

Ethical approval is not needed as it is a systematic review of published literature.

Results:

Six themes were identified, including evaluating potential risks and benefits, gaining access, obtaining informed consent/assent, protecting confidentiality and privacy, building rapport and collecting rich data. The similarities and differences between research involving children and that involving adults were indicated.

Conclusion:

All potential incentives should be justified when designing the study. Further studies need to research how to evaluate individual capacity of children and how to balance protecting children’s right to participate and their interests in the research. Cultural differences related to researching children in different regions should also be studied.
Nurses’ perceptions of professional dignity in hospital settings
Authors: Sabatino Laura , Kangasniemi Mari Katariina , Rocco Gennaro , Alvaro Rosaria , Stievano Alessandro
Published: January 2015

Background:

The concept of dignity can be divided into two main attributes: absolute dignity that calls for recognition of an inner worth of persons and social dignity that can be changeable and can be lost as a result of different social factors and moral behaviours. In this light, the nursing profession has a professional dignity that is to be continually constructed and re-constructed and involves both main attributes of dignity.

Objectives:

The purpose of this study was to determine how nurses described nursing’s professional dignity in internal medicine and surgery departments in hospital settings.

Research design:

The research design was qualitative.

Ethical considerations:

This study was approved by the ethics committees of the healthcare organizations involved. All the participants were provided with information about the purpose and the nature of the study.

Participants:

A total of 124 nurses participated in this study.

Method:

The data were collected using 20 focus group sessions in different parts of Italy. The data were analysed by means of a conventional inductive content analysis starting from the information retrieved in order to extract meaning units and sorting the arising phenomena into conceptually meaningful categories and themes.

Results:

Nursing’s professional dignity was deeply embedded in the innermost part of individuals. Regarding the social part of dignity, a great importance was put on the values that compose nursing’s professional identity, the socio-historical background and the evolution of nursing in the area considered. The social part of dignity was also linked to collaboration with physicians and with healthcare assistants who were thought to have a central role in easing work strain. Equally important, though, was the relationship with peers and senior nurses.

Conclusion:

The organizational environments under scrutiny with their low staffing levels, overload of work and hierarchical interactions did not promote respect for the dignity of nurses. To understand these professional values, it is pivotal to comprehend the role of different health professions in their cultural milieu and the evolution of the nursing profession in diverse countries.
Fear, danger and aggression in a Norwegian locked psychiatric ward
Authors: Terkelsen Toril Borch , Larsen Inger Beate
Published: January 2015

Background:

Fear and aggression are often reported among professionals working in locked psychiatric wards and also among the patients in the same wards. Such situations often lead to coercive intervention. In order to prevent coercion, we need to understand what happens in dangerous situations and how patients and professionals interpret them.

Research questions:

What happens when dangerous situations occur in a ward? How do professionals and patients interpret these situations and what is ethically at stake?

Research design:

Participant observation and interviews.

Participants:

A total of 12 patients and 22 professionals participated.

Ethical considerations:

This study has been accepted by the Regional Committee for Medical and Health Research Ethics in Norway.

Findings:

(a) Both atmosphere and material surroundings were interweaved within dangerous situations, (b) the professionals applied stereotypes when interpreting dangerous situations and (c) the professionals and the patients had different interpretations of what triggered dangerous situations.

Discussion:

The discussion centres on how care ethics and a dialogical practice might contribute towards combating difficult situations and the ways in which change is an ongoing ethical process of becoming.

Conclusion:

The ethics of care and a dialogical approach are suggested as ethical frameworks for preventing fear, danger and aggression in psychiatric wards. Both frameworks can be understood as patient-driven, including the relational and contextual perspectives. It means a shift from professionally driven processes to patient-driven dialogue.
The meaning of vulnerability to older persons
Authors: Sarvimäki Anneli , Stenbock-Hult Bettina
Published: January 2015

Background:

Vulnerability is an important concept in nursing and nursing ethics. Vulnerability and ageing have generally been associated with frailty, which gives a limited view of both vulnerability and ageing.

Objective:

The aim of this study was to illuminate the meaning of vulnerability to older persons themselves.

Research design:

A qualitative design based on interpretive description was adopted. The data were collected by interviews that were analysed by qualitative content analysis as interplay between analysis, interpretation and meaning construction.

Participants and research context:

In total, 14 older persons aged 70–96 years were interviewed, 2 men and 12 women. Some of the participants lived in their own homes, some in service houses and some in nursing homes.

Ethical considerations:

The ethical principles of informed consent, confidentiality and non-identification were respected.

Findings:

The core meaning was a deeper sense of vulnerability as you grow old. This was expressed in six themes: Being easily harmed, Becoming an old person, Being an old person in society, Reactions when being violated and hurt, Protection and Vulnerability as strength.

Discussion and conclusion:

The themes include frailty and threats to the dignity of older persons and also capacity to feel and develop. The results showed that although the frailty perspective dominated, vulnerability also had positive meanings for the older persons.
Confidentiality in participatory research
Authors: Petrova Elmira , Dewing Jan , Camilleri Michelle
Published: January 2015

Aim:

This article presents key ethical challenges that were encountered when conducting a participatory qualitative research project with a very specific, small group of nurses, in this case with practice development nurses in Malta.

Background:

With the small number of nurses employed in practice development roles in Malta, there are numerous difficulties of maintaining confidentiality. Poorly constructed interventions by the researcher could have resulted in detrimental effects to research participants and the overall trustworthiness of the research. Generally, ethical guidelines for research exist to reinforce validity of research; however, there is not an established consensus on how these strategies can be utilised in some types of qualitative field work.

Research design:

The researcher used an exploratory case study methodology. The sample consisted of 10 participants who were interviewed twice using face-to-face interviews, over a period of 2 months.

Ethical considerations:

The study was ethically reviewed by the University Research Ethics Committee and the Faculty Research Ethics Committee, University of Malta. The participants referred to in this article have been given adequate information about the study and their consent has been obtained.

Discussion:

Numerous strategies for ensuring confidentiality during recruitment of the participants, during data collection, during transcription and data analysis and during dissemination of research results assisted the researcher in responding to potential and actual ethical issues.

Conclusion:

This article emphasises the main strategies that can be used to respond to ethical challenges when researching with a small easily identifiable group. The learning discussed here may be relevant to or even transferable to other similar research studies or research contexts. These methods fostered a greater credibility throughout the research process and predisposed the participants to greater trust, and thus, they disclosed their experiences and speak more freely, thus enhancing the quality of the study.
Comparison of the Treatments of Patients With Cancer in Their Last 6 Months Between ICU and Cancer Center
Authors: Rao Jie , Fu Qiang , Wu Qiansheng , Yu Shiying
Published: January 2015

Purpose:

To investigate the treatments of patients with cancer in their last 6 months of life in intensive care unit (ICU) and Cancer Center.

Method:

A prospective study was conducted on patients with cancer who died between January 2010 and July 2013 in the ICU and the Cancer Center (55 and 161 cases, respectively) of Tongji Hospital, Wuhan, China. The differences were compared by Chi-square test or Fisher test.

Results:

The differences in the treatments of patients with cancer between 2 groups were statistically significant. The proportion of patients with cancer who accepted blood transfusion (except albumin) was significantly higher in the ICU than in the Cancer Center.

Conclusion:

Patients with cancer in the ICU were more likely to receive active treatments and less palliative and hospice care at the end of life than patients in the Cancer Center.
Malignant Bowel Obstruction in Patients With Recurrent Ovarian Cancer
Authors: Tran Elizabeth , Spiceland Clayton , Sandhu Nicole P. , Jatoi Aminah
Published: January 2015

We sought to report incidence, risk factors, and survival related to bowel obstruction in 311 ovarian cancer patients with recurrent disease. A total of 68 (22%) had a documented bowel obstruction during their cancer course, and 49 (16%) developed it after cancer recurrence. Surprisingly, 142 (45%) fit into an “unknown” category (3+ months of data lacking from last contact/death). No risk factors were identified; management included surgery (n = 21), conservative measures (n = 21), and other (n = 7). Documented bowel obstruction was not associated with a statistically significant reduction in survival after cancer recurrence. In conclusion, although bowel obstruction occurs in only a subgroup of patients with ovarian cancer and does not appear to detract from survival after cancer recurrence, limited end-of-life information may be resulting in an underestimation of incidence.
Sequential Assessments of the Eastern Cooperative Oncology Group Performance Scale Enhance Prognostic Value in Patients With Terminally Ill Cancer Receiving Palliative Care
Authors: Peng Meng-Ting , Liu Chien-Ting , Hung Yu-Shin , Kao Chen-Yi , Chang Pei-Hung , Yeh Kun-Yun , Wang Hung-Ming , Lin Yung-Chang , Chou Wen-Chi
Published: January 2015

This study aimed to assess the utility of the Eastern Cooperative Oncology Group (ECOG) performance scale assessments on days 1 and 8 of palliative care, as well as scale change between these assessments, as prognostic tools for patients with terminally ill cancer. A total of 2392 patients with terminally ill cancer who received palliative care between January 2006 and December 2011 at a single medical center were analyzed. Our study showed that the ECOG scale is a useful prognostic tool to predict life expectancy in patients with terminally ill cancer. The ECOG scale assessments at different time points under palliative care were independent predictors for overall survival. The combined ECOG scale assessments on days 1 and 8 predicted survival more precisely than using day 1 ECOG scale assessment alone.
Reflection in Strategic Management Education
Authors: Albert Sylvie , Grzeda Maurice
Published: January 2015

Critiques of Masters in Business Administration strategic management education have centered on the failure to adequately integrate two core orientations of the strategic management process, that is, analysis and implementation. Thus, attempts to measure assurance of learning in strategic management capstone courses will inevitably reveal gaps in the degree of deep learning that has occurred in a business program. In this article, we argue that a linear or serial approach to case analysis is a prime culprit in contributing to weaknesses in deep learning and critical thinking. This approach encourages weak reflections, lack of innovation in generating strategic options, and poor implementation planning. We analyze various contemporary approaches to strategic management education in relation to deep learning outcomes and, relying on Bloom’s taxonomy, we propose an alternate, reflection-based framework for teaching strategic management culminating in a discussion on its implications for teaching and practice.
Lessons From Medicare Coverage of Colonoscopy and Prostate-Specific Antigen Test
Authors: Xu Wendy Yi , Dowd Bryan
Published: January 2015

Under the 1997 Balanced Budget Act, Medicare expanded coverage of colonoscopy and prostate-specific antigen tests from diagnostic and surveillance tests to preventive screenings. The preventive tests now are covered with no deductibles or copayments. Reducing out-of-pocket costs increases premiums, resulting in a subsidy to beneficiaries who use the service by nonusers, and by taxpayers who shoulder the bulk of Medicare’s costs. Using Medicare fee-for-service claims and the Medicare Current Beneficiary Survey, we estimate the behavioral and financial consequences of these Balanced Budget Act coverage expansions. We find that fee-for-service Medicare-covered colonoscopies increased by 3.5 percentage points after the coverage expansion, and prostate-specific antigen tests increased by 6.8 percentage points. Beneficiaries with lower incomes, less education, and those lacking a usual source of care or supplemental insurance were less likely to use these tests. Therefore, they generally received much smaller net benefits from the coverage of colonoscopies than more advantaged beneficiaries.
Successful Rescue of an Adult With Refractory Anaphylactic Shock and Abdominal Compartment Syndrome With Venoarterial Extracorporeal Membrane Oxygenation and Bedside Laparotomy
Authors: Weiss Gregory Michael , Fandrick Ashley D. , Sidebotham David
Published: January 2015

The incidence of life-threatening anaphylactic reactions related to anesthesia is approximately 1 in 6000 anesthetics administered, and is associated with mortality as high as 5%. In such cases the use of extracorporeal membrane oxygenation (ECMO) in the setting of refractory shock following anaphylaxis may be life saving. Abdominal compartment syndrome (ACS) itself and in this case complicating ECMO support, is a potentially devastating complication of high-volume resuscitation. Decompressive laparotomy is the treatment of choice for ACS. We present a patient treated with venoarterial ECMO for refractory shock following anaphylaxis who developed ACS that was successfully treated with urgent decompressive laparotomy performed in the intensive care unit. This case report highlights the role of abdominal compartment syndrome as a rare but potentially fatal cause of low circuit flow in ECMO-supported patients and proposes a stepwise approach to decision making in this setting. Urgent decompressive laparotomy is potentially lifesaving in this circumstance, and should be urgently considered once other causes of low ECMO flow have been excluded.
Loving work: Drawing attention to pleasure and pain in the body of the cultural worker
Authors: Hope Sophie , Richards Jenny
Published: January 2015

In this article, we present our current research into the body and mind at work, with a particular focus on experiences and implications of enjoyment and love of work within the culture sector. This research is developed through the project Manual Labours that explores the historical conditioning between the body and mind in the so-called immaterial labour conditions. The project aims to identify positive and negative affective labour and the role that physical relationships to work can have in helping conceptualise current working conditions. The enjoyment of work leads to complex differentiations between work and life. This article explores the implications of exploitative labour conditions as self-employed or salaried passionate workers are internalising and developing a sense of ‘un-alienated’ ownership over their wage labour.