bluuebunny/crossref_metadata_2025 huggingface dataset:
Training for in‐home psychiatric disability support workers
Authors: Shepherd Nicole , Meehan Thomas
Published: March 2013

Purpose

Support workers who provide in‐home support to people with psychiatric disability are becoming a significant part of the mental health workforce. Research is needed to establish the optimum level and content of training they need to effectively carry out their role.

Design/methodology/approach

This paper reports on this paper is to draw on the results of a survey of 104 support workers and interviews with 18 support workers and eight managers in Queensland, Australia, who provide in‐home support for people with psychiatric disability. The authors describe the training undertaken by these workers and their perceptions of the adequacy of this training in relation to the challenges of their work.

Findings

The majority of support workers felt they had adequate training, though many expressed the desire to know more about mental illness symptoms, medications and the concept of recovery. Support workers nominated motivating their clients and managing challenging behaviour as the most difficult aspect of the job. Future training offered to these workers needs to focus on increasing knowledge about mental illness and the concept of recovery, and supporting them in their work with clients who have low levels of motivation and/or challenging behaviours. Access to professional supervision may also be of benefit.

Originality/value

This paper adds to knowledge about the training needs of support workers who provide in‐home support to people with psychiatric disability. These findings will be useful for practitioners and decision makers who are considering the training needs of this group.
Wellness coaching: frontline worker training in mental health
Authors: Nelson Abigail , Shockley Carrie
Published: March 2013

Purpose

Mental health frontline workers can and do provide fundamental support in the wellness of people with serious mental illness. The City University of New York offered a non‐credit Certificate in Wellness Coaching to this group. The purpose of this paper is to describe the certificate and the program outcomes.

Design/methodology/approach

Primary data collected through course evaluations, reports, and observations to describe perceptions of personal and professional usefulness and applicability, as well as challenges.

Findings

Participants reported using wellness concepts personally and professionally and perceived personal development in communication and leadership. Participants and faculty identified internal and external supports and barriers to transitioning into the role of wellness coach.

Originality/value

The paper presents a replicable model which taught frontline workers wellness concepts that benefit themselves and consumers and helped participants identify ways to expand capacity within their mental health agencies.
The need of accounting standards for Islamic financial institutions: evidence from AAOIFI
Authors: Mohammed Sarea Adel , Mohd Hanefah Mustafa
Published: March 2013

Purpose

The purpose of this paper is to determine the need of Islamic Accounting Standards – a review of the literature – for Islamic financial institutions (IFIs).

Design/methodology/approach

The basis of the paper was stakeholder theory to analyse the need of accounting standards and to design the conceptual framework as evidenced from Accounting and Auditing Organization for Islamic Financial Institutions (AAOIFI). The evidence reviewed suggests the need for Islamic accounting standards to fill the gap in accounting practice among Islamic financial institutions.

Findings

The AAOIFI accounting standards serve as a guideline that may reflect the unique characteristics of IFIs and become a useful tool to meet the various needs of IFIs. Currently, one of the major challenges facing IFIs lies in the preparation of the financial statements under different accounting standards and which may lead to problems of comparability, reliability and compliance level measurement. This has resulted in a heated debate among scholars which has hitherto translated to the evolving existing literature surrounding the interpretation of the level of compliance with the Islamic accounting standards. The paper concludes with various recommendations for future research, the most important of which is the need for future studies on how AAOIFI accounting standards can be made mandatory in all Muslim countries.

Originality/value

This paper contributes towards a better understanding and acceptability of the need of Islamic Accounting Standards.
The effects of new AAOIFI standards on Sukuk in choosing the most authentic Islamic principles
Authors: Mohamed Naim Asmadi , Yazid Isa Mohamad , Liki Hamid Mohd
Published: March 2013

Purpose

This paper aims to analyse the new standards on Sukuk which was issued by the Accounting and Auditing Organization for Islamic Financial Institution (AAOIFI) as a result of the strong critics posed by Shaykh Taqi in the end of 2007 that 85 percent of Sukuk issuance were not in line with the teachings of Shariah.

Design/methodology/approach

This study reviewed samples of Sukuk prior and after the new AAOIFI pronouncement by focusing on controversial areas such as ownership transfer, pricing and guarantee element. This paper used content analysis approaches to analyse the pronouncement and the samples.

Findings

The findings showed that there were negligible changes on the principle term and condition (PTC) of the Sukuk after the pronouncement, thus it did not have much effect in changing the Shariah Advisors and industry players when deciding more authentic principles and decisions.

Originality/value

Based on the findings, it is acceptable that the advisors tried their very best in making efforts to minimize controversial decisions as to suit current financial practices.
A Qualitative Assessment of Emergency Department Patients' Knowledge, Beliefs, Attitudes, and Acceptance Toward Revised HIV Testing Strategies
Authors: Cowan Ethan , Leider Jason , Velastegui Lorena , Wexler Juliana , Velloza Jennifer , Calderon Yvette
Published: March 2013

Objectives

The objective of this study was to explore emergency department (EDs) patients' knowledge, beliefs, attitudes, and acceptability toward revised human immunodeficiency virus (HIV) testing recommendations.

Methods

Participants were recruited in proportion to the racial, sex, and ethnic makeup of the study ED. Interviewers presented participants with a stimulus followed by questions about opt‐out consent, elimination of separate written consent, and curtailed counseling. Three investigators coded all transcripts using an iterative coding strategy until thematic saturation was achieved.

Results

Thirty‐four semistructured, in‐depth, individual interviews were conducted, including five with patients ages 13 to 17 years and five with Spanish‐speaking patients. Nineteen (56%) participants were women. The mean (±SD) age was 31 (±12) years. Most were Hispanic (38%) or African American/black (44%). Only one (2.9%) participant knew about the revised testing recommendations. Participants believed that opt‐out consent would result in increased testing, but this was confounded by misunderstanding of the consent process: “so the opt‐out is, you basically don't have a choice.” Participants thought eliminating separate written consent was a positive change but that it could result in people being tested without their knowledge. Attitudes diverged over curtailed counseling, but participants felt patients “should have options” for counseling because “everybody isn't the same.”

Conclusions

Emergency department patients were unaware of revised HIV testing recommendations. Most felt that opt‐out consent and elimination of separate written consent were positive changes but could result in a patient being tested without his or her knowledge. The response to curtailed counseling was polarized but participants agreed on the need to accommodate personal preferences. This information may be useful when designing ED‐based HIV testing programs.
Reduction in Observation Unit Length of Stay With Coronary Computed Tomography Angiography Depends on Time of Emergency Department Presentation
Authors: Mahler Simon A. , Hiestand Brian C. , Nwanaji‐Enwerem Jamaji , Goff David C. , Burke Gregory L. , Douglas Case L. , Nicks Bret , Miller Chadwick D.
Published: March 2013

Objectives

Prior studies demonstrating shorter length of stay (LOS) from coronary computed tomography angiography (CCTA) relative to stress testing in emergency department (ED) patients have not considered time of patient presentation. The objectives of this study were to determine whether low‐risk chest pain patients receiving stress testing or CCTA have differences in ED plus observation unit (OU) LOS and if there are disparities in testing modality use, based on the time of patient presentation to the ED.

Methods

The authors examined a cohort of low‐risk chest pain patients evaluated in an ED‐based OU using prospective and retrospective OU registry data. During the study period, stress testing and CCTA were both available from 08:00 to 17:00 hours. CCTA was not available on weekends, and therefore only subjects presenting on weekdays were included. Cox regression analysis was used to model the effect of testing modality (stress testing vs. CCTA) on OU LOS. Separate models were fit based on time of patient presentation to the ED using 4‐hour blocks beginning at midnight. The primary independent variable was testing modality: stress testing or CCTA. Age, sex, and race were included as covariates. Logistic regression was used to model testing modality choice by time period adjusted for age, sex, and race.

Results

Over the study period, 841 subjects presented Monday through Friday. Median LOS was 18.0 hours (interquartile range [IQR] = 11.7 to 22.9 hours). Objective cardiac testing was completed in 788 of 841 (94%) patients, with 496 (63%) receiving stress testing and 292 (37%) receiving CCTA. After age, race, and sex were adjusted for, patients presenting between 08:00 and 11:59 hours not only had a shorter LOS associated with CCTA (p < 0.0001), but also had a greater likelihood of being tested by CCTA (p = 0.001). None of the other time periods had significant differences in LOS or testing modality choice for CCTA relative to stress testing.

Conclusions

In an OU setting with weekday and standard business hours CCTA availability, CCTA testing was associated with shorter LOS among low‐risk chest pain patients only in patients presenting to the ED between 08:00 and 11:59 hours. That time period was also associated with a greater likelihood of being tested by CCTA, suggesting that ED providers may have intuited the inability of CCTA to shorten LOS during other times.
The Value of Signal Peptide‐CUB‐EGF Domain‐containing Protein 1 and Oxidative Stress Parameters in the Diagnosis of Acute Mesenteric Ischemia
Authors: Turkmen Suha , Mentese Seda , Mentese Ahmet , Sumer Aysegul Uzun , Saglam Kutay , Yulug Esin , Turedi Suleyman , Gunduz Abdulkadir
Published: March 2013

Objectives

This study investigated the diagnostic value of signal peptide‐CUB‐EGF domain‐containing protein 1 (SCUBE‐1) and other oxidative stress parameters in the early diagnosis of acute mesenteric ischemia, which has high mortality and morbidity if not identified and treated in the early period.

Methods

Thirty‐six female Sprague‐Dawley rats were used in this randomized, controlled study. Rats were divided into six groups: three control groups (Groups I, III, and V) and three ischemia groups (Groups II, IV, and VI). In the control groups, blood and tissue specimens were sampled at 30 minutes (Group I), 2 hours (Group III), and 6 hours (Group V), following a simple laparotomy. In the ischemia groups, the superior mesenteric artery (SMA) was ligated following laparotomy, and blood and tissue samples were sampled at 30 minutes (Group II), 2 hours (Group IV), and 6 hours (Group VI).

Results

When comparing the ischemia and control groups, the differences in SCUBE‐1, malondialdehyde (MDA), and total antioxidant status (TAS) levels in the 30‐minute period were not significant (p > 0.05); at 2 hours, SCUBE‐1 levels rose rapidly, and although the desired level of significance could not be obtained with Bonferroni correction, the level was significantly higher compared to the control group at the same time interval (for SCUBE‐1, Group III vs. Group IV, p = 0.006). In these periods (30 minutes and 2 hours), only total oxidative status (TOS) and oxidative stress index (OSI) values were significantly higher in the ischemia group compared to the control group (for both, p = 0.004). A pronounced rise in SCUBE‐1 levels was determined with 6‐hour ischemia (for SCUBE‐1, Group V vs. Group VI, p = 0.004). The changes in MDA, TAS, TOS, and OSI levels were not significant (p = 0.025, p = 0.321, p = 0.006, and p = 0.037, respectively).

Conclusions

SCUBE‐1 levels have the potential to be used as a marker of early period injury in acute mesenteric ischemia, although it is impossible to state explicitly that they can be used for early diagnosis. The same can be said for plasma MDA and TAS levels. The authors believe that TOS and OSI levels, however, can be used in early diagnosis and as an injury marker. Moreover, OSI also exhibits a medium‐strong correlation with histopathologic injury.
Allopregnanolone induces a diurnally dependent hyperphagic effect and alters feeding latency and duration in male Wistar rats
Authors: Holmberg E. , Bäckström T. , Johansson M. , Löfgren M. , Haage D.
Published: March 2013

Aim

Gamma‐aminobutyric acid (GABA)‐ergic transmission from the hypothalamus is essential for normal feeding regulation, and hyperphagia can be induced by local application of GABAA‐receptor agonists to different feeding‐associated brain areas. The food intake in rats varies diurnally and that may influence the effect of GABAA‐receptor active compounds. The progesterone metabolite allopregnanolone is a highly potent endogenous positive modulator of the GABAA receptor. Therefore, it is easy to envisage that allopregnanolone would have a hyperphagic effect, but earlier reports in rat have given ambiguous results. However, a contributing factor for the discrepancy may be the time point of the diurnal cycle in which the experiments were performed. The aim of this study was to investigate the effect of allopregnanolone on intake of standard chow in male Wistar rats at different time points of the day.

Methods

Chow intake was measured after acute administration of allopregnanolone, and feeding behaviour was analysed to detect meal patterns.

Results

We found that allopregnanolone increased chow intake by up to four times in the dark part of the 24‐h cycle. The rats ate significantly more, and the effect of allopregnanolone was more prominent in the active (dark) compared with the inactive (light) period. Allopregnanolone also reduced feeding latency and prolonged the meal duration compared with vehicle.

Conclusion

Allopregnanolone seems to act at several levels of feeding regulation, that is, to initiate feeding and to prolong the duration of a meal, thereby increasing the meal size, especially in the dark period of the 24‐h cycle.
Cell heterogeneity in clear cell renal cell carcinoma
Authors: Lopez José I. , Guarch Rosa , Larrinaga Gorka , Corominas‐Cishek Alexandra , Orozco Roberto
Published: March 2013

The aim of this study was to define the histological spectrum, frequency and significance of nonconventional tumour cells in clear cell renal cell carcinomas (CCRCC). Fifty‐one totally sampled CCRCC were studied histologically to evaluate the spectrum of cell morphology variability, its frequency and significance, and their correlation with tumour grade and stage, and other histological parameters of aggressive behaviour like necrosis. Aside from conventional clear/eosinophilic granular cells, three additional cellular types were identified and considered in this study: small clear cells, syncytial cells and rhabdoid cells. Small clear cells were detected in 11 cases (21.5%), syncytial cells in 8 (15.6%) and rhabdoid cells in 5 (9.8%). The presence of syncytial and rhabdoid cells statistically correlated with grade (p = 0.003 and p = 0.006) and stage (p = 0.049 and p = 0.05) in CCRCC. Necrosis correlated with stage (p = 0.018) and grade (p = 0.004), but not with syncytial, rhabdoid or small clear cells. The presence of syncytial and rhabdoid cells in CCRCC is a relatively frequent event that significantly correlates with high‐grade tumours and high stage status.
Treatment of preoperatively diagnosed colorectal adenomas by transanal endoscopic microsurgery: The experience in China
Authors: Han Yi , He Yong‐Gang , Lin Mou‐Bin , Zhang Hao‐Bo , Lv Ke‐Zhi , Zhang Ya‐Jie , Yin Lu
Published: March 2013

Introduction

Colorectal adenoma is a recognized precancerous lesion that has the potential for malignant transformation. Surgical resection of colorectal adenomas is required for exact diagnosis and treatment. The aim of this study is to assess the safety and therapeutic effect of transanal endoscopic microsurgery for preoperatively diagnosed colorectal adenomas.

Methods

From September 2006 to February 2011, 45 patients with preoperatively diagnosed colon and rectal adenomas underwent transanal endoscopic microsurgery. The clinical data of these patients were reviewed.

Results

The mean tumor diameter was 2.2 cm, mean operative time was 65 min, and the mean estimated blood loss was less than 10 mL. There was no conversion to transabdominal procedure. The mean tumor distance from the anal verge was 8.2 cm. Four patients had perforation into the peritoneal cavity during full‐thickness resection; these were repaired by continuous suturing, and there was no postoperative leakage after 1 week of fasting. The surgical margins of specimens were negative in 44 patients. Complications included rectal bleeding in one patient, acute urinary retention in one patient and pulmonary infection in one patient. The mean postoperative hospital stay was 4.5 days. Only one patient experienced incontinence of hard stool 6 months after surgery. The patients were followed up for a median period of 42 months, with four cases of tumor recurrence observed.

Conclusion

Transanal endoscopic microsurgery is a safe and effective technique for excising large adenomas in the mid and upper rectum and in the lower sigmoid colon. It is also an oncologically preferred method for T1 focal carcinomas that develop from villous adenomas.
Green fluorescent protein (GFP) expression patterns in the olfactory epithelium of GFP transgenic cloned Jinhua pigs
Authors: Hirao Atsushi , Kawarasaki Tatsuo , Konno Kenjiro , Enya Satoko , Shibata Masatoshi , Kangawa Akihisa , Kobayashi Eiji
Published: March 2013

Domestic pigs possess a well‐developed sense of smell. However, the morphology of the porcine olfactory epithelium (OE) is poorly understood. Recently, several strains of transgenic cloned pigs that are presumed to ubiquitously express green fluorescent protein (GFP) have been created. Thus, the purpose of this study was to elucidate the features of porcine OE using the tissues of GFP transgenic cloned pigs. Based on observations of Hematoxylin and Eosin staining and measurements of thickness, porcine OE tissue portions were classified into three categories (thick, standard, and thin). Cryosections revealed that the prominent GFP signals were expressed in olfactory sensory neurons (OSN), Bowman's glands, and olfactory nerve. A few GFP‐expressing sustentacular cells were seen; however, the intensity of GFP fluorescence was slight. In the thick portion, numerous GFP‐expressing polygonal OSN that did not possess dendrites were found. In the standard portions, GFP‐expressing cells had longitudinal dendrites. A few GFP‐expressing cells were found in the thin portion. In the thick and standard portions, most of the prominent GFP‐expressing cells were positive for olfactory marker protein. Moreover, double immunofluorescence staining with boiled GFP and Sox2 antibody revealed that GFP expression patterns in OSN are synchronized with Sox2 immunoreactive patterns.
Immunocytochemistry indicates that glycine‐rich beta‐proteins are present in the beta‐layer, while cysteine‐rich beta‐proteins are present in beta‐ and alpha‐layers of snake epidermis
Authors: Alibardi Lorenzo
Published: March 2013

Immunolocalization of glycine‐rich and cysteine–glycine‐medium‐rich beta‐proteins (Beta‐keratins) in snake epidermis indicates a different distribution between beta‐ and alpha‐layers. Acta Zoologica, Stockholm. The epidermis of snakes consists of hard beta‐keratin layers alternated with softer and pliable alpha‐keratin layers. Using Western blot, light and ultrastructural immunolocalization, we have analyzed the distribution of two specific beta‐proteins (formerly beta‐keratins) in the epidermis of snakes. The study indicates that the antibody HgG5, recognizing glycine‐rich beta‐proteins of 12–15 kDa, is poorly or not reactive with the beta‐layer of snake epidermis. This suggests that glycine‐rich proteins similar to those present in lizards are altered during maturation of the beta‐layer. Conversely, a glycine–cysteine‐medium‐rich beta‐protein (HgGC10) of 10–12 kDa is present in beta‐ and alpha‐layers, but it is reduced or disappears in precorneous and suprabasal cells destined to give rise to beta‐ and alpha‐cells. Together with the previous studies on reptilian epidermis, the present results suggest that beta‐proteins rich in glycine mainly accumulate on a scaffold of alpha‐keratin producing a resistant and hydrophobic beta‐layer. Conversely, beta‐proteins lower in glycine but higher in cysteine accumulate on alpha‐keratin filaments present in beta‐ and alpha‐layers producing resistant but more pliable layers.
Sodium tanshinone IIA silate inhibits oxygen‐glucose deprivation/recovery‐induced cardiomyocyte apoptosis via suppression of the NF‐κB/TNF‐α pathway
Authors: Wu Wen‐Yu , Wang Wen‐Yi , Ma Yan‐Ling , Yan Hong , Wang Xin‐Bo , Qin Yin‐Lin , Su Mei , Chen Tao , Wang Yi‐Ping
Published: March 2013

Background and Purpose

Inhibition of apoptosis may attenuate the irreversible injury associated with reperfusion. In the current study, we focused on the cytoprotective effects and the underlying mechanism of sodium tanshinone IIA silate (STS) against damage induced by oxygen‐glucose deprivation/recovery (OGD/R). in H9c2 cardiomyocytes and the underlying mechanisms.

Experimental Approach

We used a model of cardiac ischaemia/reperfusion, OGD/R in H9c2 cardiomyocytes, to assess the cardioprotective effects of STS. Apoptosis of cells was measured with Hoechst 33342‐based fluorescence microscopy, and annexin V‐FITC‐based flow cytometry. Caspase‐3 and caspase‐8 activities and mitochondrial membrane potential were also measured using commercial kits. TNF‐α in the cell culture supernatant fractions were measured with sandwich elisa, and protein levels assayed using Western blot.

Key Results

STS inhibited OGD/R‐induced apoptosis by suppressing JNK‐mediated activation of NF‐κB, TNF‐α expression, activation of caspase‐3 and caspase‐8 and the Bax/Bcl‐2 ratio. Additionally, positive feedback between NF‐κB and TNF‐α and amplification of TNF‐α were inhibited, suggesting that STS plays a protective role against apoptosis in cardiomyocytes, even upon activation of pro‐inflammatory cytokines. Interestingly, the cytoprotective effects of STS on OGD/R‐induced apoptosis and promotion of cell survival were attenuated after inhibition of PI3K.

Conclusion and Implications

The inhibitory effects of STS on TNF‐α and positive feedback signalling of the NF‐κB/TNF‐α pathways may play important roles in myocardial protection against ischaemia/reperfusion. These protective effects of STS are mediated by suppressing JNK activity through activation of the PI3K‐Akt pathway.
Older peoples’ perception of tests used in the assessment and management of COPD and asthma
Authors: McDonald Vanessa M. , Simpson Jodie L. , McElduff Patrick , Gibson Peter G.
Published: March 2013

Objectives

Outcome assessment is an important part of the management of airways disease, yet older adults may have difficulty with the burden of testing. This study evaluated the patient perception of tests used for the assessment of airways disease in older people.

Data Source

Older adults (>55 years) with obstructive airway disease and healthy controls (N = 56) underwent inhaler technique assessment, skin allergy testing, venepuncture, fractional exhaled nitric oxide (FENO) and gas diffusion measurement, exercise testing, sputum induction, and questionnaire assessment. They then completed an assessment burden questionnaire across five domains: difficulty, discomfort, pain, symptoms and test duration.

Results

Test perception was generally favourable. Induced sputum had the greatest test burden perceived as being more difficult (mean 0.83, P = 0.001), associated with more discomfort (mean 1.3, P < 0.001), more painful (0.46, P = 0.019), longer test duration (0.84, P < 0.001) and worsening symptoms (0.55, P = 0.001) than the questionnaires. FENO had a more favourable assessment but was assessed to be difficult to perform. Inhaler technique received the most favourable assessment.

Conclusions

Older adults hold favourable perceptions to a range of tests that they might encounter in the course of their care for airway disease. The newer tests of sputum induction and FENO have some observed difficulties, in particular sputum induction. The results of this study can inform current practice by including details of the test and its associated adverse effects when conducting the test, as well as providing clear explanations of the utility of tests and how the results might aid in patient care.
Prioritizing refugia for freshwater biodiversity conservation in highly seasonal ecosystems
Authors: Hermoso Virgilio , Ward Doug P. , Kennard Mark J.
Published: March 2013

Aim

Refugia play a key ecological role for the persistence of biodiversity in areas subject to natural or human disturbance. Temporary freshwater ecosystems regularly experience dry periods, which constrain the availability of suitable habitats. Current and future threats (e.g. water extraction and climate change) can exacerbate the negative effects of drying conditions. This could compromise the persistence of a large proportion of global freshwater biodiversity, so the identification and protection of refugia seems an urgent task.

Location

Northern Australia.

Methods

We demonstrate a new approach to identify and prioritize the selection of refugia and apply it to the conservation of freshwater fish biodiversity. We identified refugia using estimates of water residency time derived from satellite imagery and used a systematic approach to prioritize areas that provide all the fish species inhabiting the catchment with access to a minimum number of refugia while maximizing the length of stream potentially accessible for recolonization after the dry period. These priority refugia were locked into a broader systematic conservation plan with area‐based targets and direct connectivity. We accounted for current threats during the prioritization process to ensure degraded areas were avoided, thus maximizing the ecological role of priority refugia.

Results

Priority refugia were located in lowland reaches, where the incidence of threats was less prominent in our study area and headwaters in good condition. An additional set of 106 planning units (6500 km2) were required to represent 10% of each species' distribution in the broad conservation plan. A hierarchical management zoning scheme was applied to demonstrate how these key ecological features could be effectively protected from the major threats caused by aquatic invasive species and grazing.

Main conclusions

This new approach to identifying priority refugia and incorporating them into the conservation planning process in a systematic way would help enhance the resilience of freshwater biodiversity in temporary systems.
Musicogenic seizures in Dravet syndrome
Authors: Sanchez‐Carpintero Rocio , Patiño‐Garcia Ana , Urrestarazu Elena
Published: March 2013

Dravet syndrome is an epileptic encephalopathy characterized by multiple types of seizures. We report the first case of musicogenic reflex seizures in a 7‐year‐old male with a mutation in the SCN1A gene causing Dravet syndrome. Reflex seizures have been reported in patients with Dravet syndrome provoked by body temperature elevation, looking at visual patterns, or under intermittent photic stimulation. The case we report widens the spectrum of reflex seizures recorded in patients with Dravet syndrome. Cortical hyperexcitability of genetic origin could explain the tendency of these patients to experience reflex seizures.
Using the Medical Research Council framework to develop a complex intervention to improve delivery of care for young people with Type 1 diabetes
Authors: Eiser C. , Johnson B. , Brierley S. , Ayling K. , Young V. , Bottrell K. , Whitehead V. , Elliott J. , Scott A. , Heller S.
Published: March 2013

Aims

We describe how we have used the development phase of the Medical Research Council (MRC) Guidelines to construct a complex intervention to improve physical and psychological health among young people (16–21 years) with Type 1 diabetes.

Methods

We consulted previous reviews where available and conducted systematic searches of electronic databases to determine physical and mental health among the population, audited medical records, surveyed self‐reported psychological health among our clinic population; and interviewed staff (n = 13), young people (n = 27) and parents (n = 18) about their views of current care.

Results

Our audit (n = 96) confirmed a high HbA1c [86 mmol/mol (10.0%)] and one third (36.1%) reported significant eating problems. Young people did not attend 12% of their clinic appointments. Staff described difficulties communicating with young people who wanted staff to take account of their individual lifestyle when giving information.

Conclusion

Based on the findings of the systematic reviews and our audit, we concluded that there was sufficient evidence to justify development of a model of care specific to this age group. The components of the complex intervention include changes to standard care, an optional 5‐day self‐management course directed at young people and a separate family communication programme. The MRC Guidelines provided a valuable structure to guide development and evaluation of this intervention.
MonitoringrFVIIIprophylaxis dosing using global haemostasis assays
Authors: AL Hawaj M. A. , Martin E. J. , Venitz J. , Barrett J. C. , Kuhn J. G. , Nolte M. E. , Brophy D. F.
Published: March 2013

Secondary factor VIII (FVIII) prophylaxis converts severe haemophiliacs (FVIII:C < 1 IU dL−1) to a moderate phenotype (FVIII:C ≥ 1 IU dL−1), however, plasma FVIII:C is a poor predictor of bleeding risk.

This study used thromboelastography (TEG) and thrombin generation assay (TGA) to quantify coagulation across a 48 hrFVIIIprophylaxis period.

10 severe haemophiliacs with varying clinical bleeding phenotypes received their standardrFVIIIprophylaxis dose and blood samples were obtained over 48 h. Measured parameters included FVIII:C, TEG and TGA at each time point. FVIII:C pharmacokinetics (PK) and correlation between global assay parameters was performed.

The FVIII:C PK parameters were consistent with previous literature. There was significant correlation between FVIII:C and TEGR‐time andaPTT(bothP < 0.001). Significant correlations existed between FVIII:C and TGA peak, ETP and velocity parameters (allP < 0.001). At 24 h the TEG parameters were sub‐therapeutic despite median FVIII:C of 13.0 IU dL−1. TGA was sensitive to FVIII:C below 1 IU dL−1. Those with the severest bleeding phenotype had the lowest TGA parameters.

There was significant correlation between FVIII:C and TEG and TGA. TEG lost sensitivity at 48 h, but not TGA. Prospective studies are needed to determine whether these data can be used to design individualizedrFVIIIprophylaxis regimens.
Another look at follicular lymphoma: immunophenotypic and molecular analyses identify distinct follicular lymphoma subgroups
Authors: Marafioti Teresa , Copie‐Bergman Christiane , Calaminici Maria , Paterson Jennifer C , Shende Vishvesh H , Liu Hongxiang , Baia Maryse , Ramsay Alan D , Agostinelli Claudio , Brière Josette , Clear Andrew , Du Ming‐Qing , Piccaluga Pier Paolo , Masir Noraidah , Nacheva Elizabeth P , Sujobert Pierre , Shanmugam Kandavel , Grogan Thomas M , Brooks Simon P , Khwaja Asim , Ardeshna Kirit , Townsend William , Pileri Stefano A , Haioun Corinne , Linch David , Gribben John G , Gaulard Philippe , Isaacson Peter G
Published: March 2013

Aims

The aim of this study was to analyse the immunophenotypic and molecular features of a large series of follicular lymphomas, focusing in particular on atypical cases that fail to express CD10 and/or bcl‐2. Such cases present diagnostic pitfalls, especially with regard to the differential diagnosis from follicular hyperplasia and marginal zone B‐cell lymphoma. Therefore, we also included an immunohistochemical evaluation of stathmin, which is strongly expressed by germinal centre B cells, as a putative new marker for follicular lymphomas, particularly those with an atypical phenotype.

Methods and results

Two hundred and five follicular lymphomas were investigated with immunohistochemistry and fluorescence in‐situ hybridization (FISH). The use of three distinct anti‐bcl‐2 antibodies together with CD10 expression data and FISH analysis for bcl‐2 and bcl‐6 rearrangements allowed subclassification of follicular lymphoma into four distinct subgroups: (i) CD10‐positive/bcl‐2‐positive, (ii) CD10‐positive/bcl‐2‐negative, (iii) CD10‐negative/bcl‐2‐positive, and (iv) CD10‐negative/bcl‐2‐negative. All cases were bcl‐6‐positive. STMN1 (stathmin) was shown to be helpful in diagnosing bcl‐2‐negative and/or CD10‐negative follicular lymphomas, and in their distinction from marginal zone B‐cell lymphoma.

Conclusions

Combined immunohistological and molecular analyses reveal that follicular lymphomas showing an atypical immunophenotypic and molecular profile exist, and we demonstrate that STMN1 represents a novel useful diagnostic marker for these.
La protección de la mujer en la vejez en el sistema de pensiones español
Authors: Cifre Concha Salvador
Published: March 2013

El caso español confirma la tesis general de que un sistema de carácter contributivo reproduce las desigualdades de género en el reparto de las responsabilidades familiares y en el mercado de trabajo. Las mujeres que han permanecido en el hogar, en general, no tienen derecho a pensiones propias y quedan a expensas de prestaciones de menor importe, como son las pensiones de viudedad (derechos derivados) o las no contributivas. Por otro lado, aquellas que trabajan fuera del hogar acumulan menores derechos que los varones y, por consiguiente, pensiones de jubilación e incapacidad laboral (derechos propios) de menor cuantía. El objetivo de este estudio es examinar los resultados en España de la distribución de las pensiones por sexo, revisar algunas de las políticas de pensiones que se han puesto en práctica en el presente siglo y proponer acciones directas para avanzar en la transición de los derechos derivados a los derechos propios. Se trata de propuestas de impulso de la igualdad de género, entendida como derecho a la igualdad de bienestar derivado de la cobertura de seguridad económica en la vejez.
El sistema de salud de China: entre la privatización y los servicios de salud pública
Authors: Darimont Barbara , Liu Dongmei
Published: March 2013

En los últimos años la política del sistema de salud de China ha sido objeto de numerosas reformas que han conducido con frecuencia a nuevos desafíos, poniendo de relieve la necesidad de una reforma ulterior. Las reformas más recientes tienen por objeto hallar un término medio entre los servicios de salud pública y los seguros privados comerciales. De este modo, China está siguiendo los pasos de los países que reforzaron inicialmente el papel de la privatización en la década de 1990 y a principios del siglo xxi, pero que ahora se están reorientando hacia los servicios de salud pública. Sin embargo, este proceso de reforma constante ha conducido a una falta de transparencia en el funcionamiento del sistema de salud, lo que ha provocado una pérdida de confianza pública. Persiste un grado considerable de incertidumbre con respecto al modo en que evolucionará la situación en China. No obstante, aún podría materializarse un enfoque de financiación dual de los servicios de salud que utilice tanto los recursos financieros provenientes de los impuestos como los seguros sociales; dicho enfoque ofrecería un posible modelo que serviría de orientación para los avances en otros países.
A validation of parafoveal semantic information extraction in reading Chinese
Authors: Zhou Wei , Kliegl Reinhold , Yan Ming
Published: March 2013

Parafoveal semantic processing has recently been well documented in reading Chinese sentences, presumably because of language‐specific features. However, because of a large variation of fixation landing positions on pretarget words, some preview words actually were located in foveal vision when readers' eyes landed close to the end of the pretarget words. None of the previous studies has completely ruled out a possibility that the semantic preview effects might mainly arise from these foveally processed preview words. This case, whether previously observed positive evidence for parafoveal semantic processing can still hold, has been called into question. Using linear mixed models, we demonstrate in this study that semantic preview benefit from word N + 1 decreased if fixation on pretarget word N was close to the preview. We argue that parafoveal semantic processing is not a consequence of foveally processed preview words.
Using singular value decomposition to investigate degraded Chinese character recognition: evidence from eye movements during reading
Authors: Wang Hsueh‐Cheng , Schotter Elizabeth R. , Angele Bernhard , Yang Jinmian , Simovici Dan , Pomplun Marc , Rayner Keith
Published: March 2013

Previous research indicates that removing initial strokes from Chinese characters makes them harder to read than removing final or internal ones. In the present study, we examined the contribution of important components to character configuration via singular value decomposition. The results indicated that when the least important segments, which did not seriously alter the configuration (contour) of the character, were deleted, subjects read as fast as when no segments were deleted. When the most important segments, which are located in the left side of a character and written first, were deleted, reading speed was greatly slowed. These results suggest that singular value decomposition, which has no information about stroke writing order, can identify the most important strokes for Chinese character identification. Furthermore, they also suggest that contour may be correlated with stroke writing order.
The Case Study as a Research Strategy
Authors: Fridlund Bengt
Published: March 2013

A research strategy seldom used in the caring sciences is the case study. A case study is an empirical in‐depth inquiry about an individual, family, group or organization. It is preferable when ‘how’ and ‘why’ questions are asked. The case study is mainly used to explain those causal links in real‐life intervention that are too complex for either the survey or experimental strategies. Like other research strategies, its design includes questions or propositions, units of analysis, the logic linking the data to the questions or propositions, and the interpretations of the outcomes. A case study can be reported as a single case or as a compilation of a series of cases. In conclusion, a case study is a simple and excellent way for a care professional to present him or herself to the scientific world.
Elderly Persons' Social Network and Need for Social Support after their First Myocardial Infarction
Authors: Hildingh Cathrine , Segesten Kerstin , Fridlund Bengt
Published: March 2013

Social network and social support are phenomena suggested to be of importance to successful recovery from myocardial infarction. However, very few studies have been carried out, especially among the elderly, focusing on their social network and its ability to provide adequate support after myocardial infarction. The aim of this study was to examine elderly persons' social network and need for social support three months after their first myocardial infarction. The sample consisted of 128 persons between 65 and 94 years of age who answered a questionnaire. The results showed that the subjects, even the oldest ones, had an available social network and that they were satisfied with the support it provided. There was an increased need for social support after the myocardial infarction, especially for emotional support and appraisal, but also for instrumental aid and information. Despite these positive results indicating that elderly persons with myocardial infarction have a social network, whose members provide them with support, there may be a need for support also from persons outside this network. Assessment of social network characteristics and the need for social support as well as the provision of adequate information about additional support networks are important tasks for all health professionals.
Reliability and Validity of The Norwegian Version of The Nowotny Hope Scale
Authors: Rustøen Tone , Moum Torbjørn
Published: March 2013

The purpose of the present study was to assess the reliability and validity of the Norwegian version of the Nowotny Hope Scale as applied to cancer patients. The questionnaire was first translated into Norwegian following internationally accepted guidelines. The scale was tested on a sample consisting of 131 newly diagnosed cancer patients. The findings supported the internal consistency of the instrument as a whole (alpha = 0.89) and of the six subscales: confidence (alpha = 0.85), relates to others (alpha = 0.75), future is possible (alpha = 0.80), spiritual beliefs (alpha = 0.94), active involvement (alpha = 0.53) and comes from within (alpha = 0.80). Stability over time was provided by a satisfactory 3–4‐week test—retest correlation (r = 0.81). The validity was confirmed by the judgement of an expert and by a principal components analysis with orthogonal rotation. The result of the factor analysis was somewhat different from the original findings in an American sample. The results obtained in this study are promising and indicate that the Nowotny Hope Scale can be used to measure hope in newly diagnosed Norwegian cancer patients.
Health Motives and Life Values
Authors: Lindholm Lisbet
Published: March 2013

The aim of this study was to investigate the health motives of young people, i.e. the things that give health meaning. The investigation was carried out as two studies among Finland—Swedish young people aged 13–19. A questionnaire with open questions framed with a multidimensional perspective on health was filled in by 152 pupils at secondary school, 121 pupils at upper secondary school and 115 pupils at vocational school in study I. A theme interview with 15 young persons was the data assembling method used in study II. The data was analysed using the hermeneutical method. The results revealed that a young person's experience of health and idea of what health is cannot be understood in a deeper sense without understanding the young person's health motives. The health motives can be described at different levels as external, internal and fundamental. The different motives for health form health motive complexes, which are based on an aspiration to avoid something perceived as evil, such as illness and suffering. On the other hand, the motives are based on an aspiration to achieve what is good, such as love and life. The motives mentioned as meaningful for health have to do with the things that are valued in life. Consciousness of life values that last and can give meaning provides an answer to the ‘why’ of health. Humanistic values, existentialistic values, materialistic values or traditionalistic values give the clue to why health is meaningful for a young person. The results also indicated that there are difference in young persons' health motives in different school contexts.
Hospital Nurses' Perceptions of Patient Teaching
Authors: Karlsen Bjørg
Published: March 2013

Patient teaching in general hospitals is becoming increasingly important both due to higher patient turnover and the principles of self‐care. This study focuses on how hospital nurses describe ideals and realities in teaching adult patients in a general hospital, and how they describe the factors affecting their teaching function. The study has a qualitative approach. Fourteen registered nurses, working in a general hospital, are interviewed. The interviews are semistructured. The four stages adapted from Glaser & Strauss' grounded theory approach are used as a support in the elaboration and the analysis of the data. The study shows that the ideals about patient teaching are rather weakly articulated. The realities are, however, more distinctly described. Empirical findings reveal two different ‘teaching processes’ articulated by the informants. Both processes are novel and different from the traditional teaching process mentioned in the literature. Which processes the nurses are applying in the clinic seem to depend on the objective and content of the patient teaching. This evidence has so far not been reported in previous studies. Regarding the factors affecting their patient teaching, the nurses emphasize the following three; The nurses' qualifications, training in the teaching function and the organizational setting.
Male Nurses—Reasons for Entering and Experiences of Being in the Profession
Authors: Soerlie Venke , Talseth Anne‐Grethe , Norberg Astrid
Published: March 2013

In order to illuminate male nurse teachers' and nurse students' reasons for choosing to become nurses, and their experiences and positions within the profession, all 13 males among a total of 184 nurse teachers and students at one nursing school in Norway were interviewed twice with a 10‐year interval between the interviews. In a personal interview in 1984 all the interviewees emphasized that their desire to become nurses was connected with a wish to act in a woman's role and expressed feminine values. The interviewees' fathers disapproved while their mothers approved with their choices to become nurses. The subjects thought that female nurses did not accept that they were bedside nurses, and exerted pressure on them to adopt roles within nursing that were perceived to be male; i.e. teachers, or administrators. In a telephone interview in 1994 they were asked about their experiences and positions within the profession. Eight interviewees had worked as nurses within psychiatric care and ten had current senior positions. They stated that the most positive thing in the profession was the contact with the patients and meaning so much to someone. All said they would have made the same choice today and become nurses.