bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying the actual/potential person distinction to reproductive torts
Authors: Walker Samuel E.P.
Published: July 2014

As technology has advanced, the level of control that can be exercised over the reproductive process has increased. These advances have resulted in a number of claims in tort law relating to pregnancy and birth. The three reproductive torts considered here are ‘wrongful conception’, ‘wrongful birth’ and ‘wrongful life’. This article will consider the theoretical underpinnings upon which these torts rest and will suggest that the potential/actual person distinction is crucial to these reproductive torts because potential persons should not be able to make claims in tort based on alternative conditions that could never have been. This is because actions (or omissions) prior to birth determine the preconditions for existence. Thus, only actual persons (i.e. those who exist at the time of the action or omission) should be able to bring claims in tort. The analysis will conclude by arguing that no child should be permitted to bring a claim under any form of reproductive tort. The term reproductive torts originates with Nicolette Priaulx's work and encompasses all three terms: wrongful life, wrongful birth and wrongful conception. While these are distinct terms and all fall within negligence for the purposes of this analysis ‘reproductive torts’ is a useful term to identify these particular claims.
Plus ça change, plus c’est la même chose
Authors: Manning Joanna M.
Published: July 2014

In 2005, cover for treatment injury replaced medical misadventure in New Zealand’s accident compensation scheme. The mischief was to remove the need for a claimant to prove a health practitioner’s or organization’s negligence to establish cover. The aim was to provide greater fairness for claimants, faster claims handling and a higher acceptance rate. A disturbing aspect of the case law interpreting the treatment injury criteria is that notions of negligence have crept back into the interpretation of these criteria and are becoming entrenched. The original purpose of the reform is in danger of miscarrying, unless these misguided interpretations are corrected by superior appellate courts. This is not simply a matter of being faithful to the intention of the reform but is necessary to maximize provider trust and cooperation in the claims process in the interests of claimants. A way to do this is to incorporate the concept of ‘preventability’ as defined in the Swedish, Danish and Finnish patient insurance schemes. It may prove impossible to eradicate fault altogether from treatment injury, but vigilance is required so that negligence is kept to a minimum. Negligence concepts might continue to play a role in the interpretation of the statutory exclusion from cover of personal injury that is an ‘ordinary consequence’ of treatment. Another is in relation to Accident Compensation Corporation’s (ACC’s) mandatory duty to report a risk of harm to the public. Any enthusiasm on behalf of ACC and the courts to ‘bring back negligence’ is ironically absent from the latter aspect of the scheme.
Relatives’ participation in everyday care in special care units for persons with dementia
Authors: Helgesen Ann Karin , Athlin Elsy , Larsson Maria
Published: July 2014

Background:

Research concerning relatives’ participation in the everyday care related to persons living in special care units for persons with dementia is limited.

Research questions:

To examine relatives’ participation in their near one’s everyday care, the level of burden experienced and important factors for participation, in this special context.

Design:

The study had a cross-sectional design, and data collection was carried out by means of a study-specific questionnaire.

Participants and context:

A total of 233 relatives from 23 different special care units participated.

Ethical consideration:

The study was approved by the Norwegian Social Science Data Services.

Results:

A great majority of relatives reported that they visited weekly and were the resident’s spokesperson, but seldom really participated in decisions concerning their everyday care. Participation was seldom reported as a burden.

Discussion:

This study indicated that relatives were able to make a difference to their near one’s everyday life and ensure quality of care based on their biographical expertise, intimate knowledge about and emotional bond with the resident. Since knowing the resident is a prerequisite for providing individualised care that is in line with the resident’s preferences, information concerning these issues is of utmost importance.

Conclusion:

This study prompts reflection about what it is to be a spokesperson and whether everyday care is neglected in this role. Even though relatives were satisfied with the care provided, half of them perceived their participation as crucial for the resident’s well-being. This indicated that relatives were able to offer important extras due to their biographical expertise, intimate knowledge about and emotional bond with the resident. Good routines securing that written information about the residents’ life history and preferences is available and used should be implemented in practice.
Self-Perception of Body Weight Status and Weight Control Practices Among Adolescents in Malaysia
Authors: Zainuddin Ahmad Ali , Manickam Mala A. , Baharudin Azli , Omar Azahadi , Cheong Siew Man , Ambak Rashidah , Ahmad Mohamad Hasnan , Ghaffar Suhaila Abdul
Published: July 2014

The prevalence of overweight and obesity among adolescents is rising rapidly in many countries, including Malaysia. This article aims to present the associations between body mass index–based body weight status, body weight perception, and weight control practices among adolescents in Malaysia. The Malaysia School Based Nutrition Survey 2012, which included a body weight perception questionnaire and anthropometric measurements, was conducted on a representative sample of 40 011 students from Standard 4 until Form 5, with a 90.5% response rate. Comparing actual and perceived body weight status, the findings show that 13.8% of adolescents underestimated their weight, 35.0% overestimated, and 51.2% correctly judged their own weight. Significantly more normal weight girls felt they were overweight, whereas significantly more overweight boys perceived themselves as underweight. The overall appropriateness of weight control practices to body weight was 72.6%. Adolescents attempting to lose or gain weight need to have better understanding toward desirable behavioral changes.
Determinants of Dietary Supplements Use among Adolescents in Malaysia
Authors: Sien Yeo Pei , Sahril Norhafizah , Mutalip Mohd Hatta Abdul , Zaki Nor Azian Mohd , Ghaffar Suhaila Abdul
Published: July 2014

Dietary supplements use is relatively widespread in some countries but knowledge of supplements consumption in Malaysia is limited, more so among adolescents. This study aimed to investigate the determinants of dietary supplements use among Malaysian adolescents using multiple logistic regressions analysis. Data from the Malaysia School-based Nutrition Survey 2012 based on a 2-stage stratified sampling was used. The prevalence of vitamin/mineral supplements and food supplements intake among adolescents was 54.1% and 40.2%, respectively. Usage was significantly higher among younger adolescents and among boys. Dietary supplements were also taken mostly by those who thought they were underweight. The most common vitamin/mineral supplements and food supplements consumed were vitamin C and bee products. The main reason for taking supplements was parents’ instruction. These findings can be useful for developing health communications on supplement use targeted to adolescents and their parents.
Prevalence and Correlates of Depression Among Adolescents in Malaysia
Authors: Kaur Jasvindar , Cheong Siew Man , Mahadir Naidu Balkish , Kaur Gurpreet , Manickam Mala A. , Mat Noor Malisa , Ibrahim Nurashikin , Rosman Azriman
Published: July 2014

Depression among adolescents has been recognized as a major public health issue. The objective of this study was to determine the prevalence and correlates of depression among school-going adolescents in Malaysia. Data from the Malaysia Global School-based Health Survey (GSHS) 2012 were analyzed with additional data from the validated DASS21 (Depression, Anxiety, and Stress) questionnaire. The study revealed that 17.7% of respondents had depressive symptoms. Multivariate analysis further showed that feeling lonely (adjusted odds ratio [aOR] = 2.99; 95% CI = 2.57-3.47), Indian ethnicity (aOR = 2.00; 95% CI = 1.63-2.44), using drugs (aOR = 1.85; 95% CI = 1.21-2.82), and being bullied (aOR = 1.79; 95% CI = 1.60-1.99) were significantly associated with depressive symptoms. Lack of parental supervision, alcohol use, and tobacco use were also significant risk factors. Addressing depressive symptoms among adolescents may have implications for managing their risks of being bullied and substance use. This study also highlights the need to further investigate depressive symptoms among adolescents of Indian ethnicity.
Multiple Family Groups for Child Behavior Difficulties
Authors: Gopalan Geetha , Fuss Ashley , Wisdom Jennifer P.
Published: July 2014

Purpose:

The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders has shown promise in engaging child welfare–involved families. This qualitative study examines caregivers’ perceptions of factors that influence retention in MFGs among child welfare–involved families.

Methods:

Twenty-five predominantly Black and Hispanic adult (aged 26–57) female caregivers with child welfare services involvement participated in individual, in-depth interviews. Transcribed interview data were thematically coded, guided by grounded theory methodology. Emergent themes were subsequently organized into a conceptual framework.

Results:

Factors promoting retention included the quality of interaction among group members, group facilitators’ attentive approach with caregivers, supports designed to overcome logistical barriers, and perceptions of MFG activities as fun and helpful. Caregivers’ mental health and personal characteristics as well as children’s behavior also impacted retention.

Conclusions:

Findings suggest MFGs are acceptable for child welfare–involved caregivers. Modifications are suggested to tailor to setting and client characteristics.
Active Implementation Frameworks for Successful Service Delivery
Authors: Metz Allison , Bartley Leah , Ball Heather , Wilson Dawn , Naoom Sandra , Redmond Phil
Published: July 2014

Traditional approaches to disseminating research based programs and innovations for children and families, which rely on practitioners and policy makers to make sense of research on their own, have been found insufficient. There is growing interest in strategies that “make it happen” by actively building the capacity of service providers to implement innovations with high fidelity and good effect. This article provides an overview of the Active Implementation Frameworks (AIFs), a science-based implementation framework, and describes a case study in child welfare, where the AIF was used to facilitate the implementation of research-based and research-informed practices to improve the well-being of children exiting out of home placement to permanency. In this article, we provide descriptive data that suggest AIF is a promising framework for promoting high-fidelity implementation of both research-based models and innovations through the development of active implementation teams.
Potential Conflicting Interests for Surgeons in End-of-Life Care
Authors: Golden Adam G. , Silverman Michael A. , Heller Andrew , Loyal Michael , Cendan Juan
Published: July 2014

Thirty-day mortality represents a variable that is commonly used to measure the quality of surgical care. The definition of 30-day mortality and the application of a risk adjustment to its measurement may vary among different organizations comparing physician quality. In the midst of this confusion, conflicting interests arise for surgeons who must weigh the potential benefit of surgical interventions to individual patients versus the potential loss of access by future patients should 30-day mortality ratings be adversely affected. Similarly, surgeons may become adversely impacted by the lack of compensation from avoiding “high-risk” cases, but might face a more severe financial impact if they have a higher mortality rating compared to their peers.
Effect of 5% Lidocaine Medicated Plaster on Pain Intensity and Paroxysms in Classical Trigeminal Neuralgia
Authors: Tamburin Stefano , Schweiger Vittorio , Magrinelli Francesca , Brugnoli Maria Paola , Zanette Giampietro , Polati Enrico
Published: July 2014

Objective: Trigeminal neuralgia (TN) is a neuropathic pain condition affecting one or more branches of the trigeminal nerve. It is characterized by unilateral, sudden, shock-like, and brief painful attacks, which follow the distribution of trigeminal nerve branches, and with no other accompanying sensorimotor or autonomic signs and symptoms. Current guidelines stipulate which therapies represent first-, second-, and third-line treatments for TN, but there is a consistent mismatch between the therapeutic guidelines and the patient’s preferences and expectations. Case Summary: We report on 2 patients with classical TN in whom conventional drugs for TN were not tolerated. In these patients, treatment with 5% lidocaine medicated plaster (LMP) resulted in reduction of pain intensity and the number of pain paroxysms. Discussion: LMP is known to block the sodium channels on peripheral nerves and may cause a selective and partial block of Aδ and C fibers. According to the TN ignition hypothesis, blockage of peripheral afferents by LMP may reduce pain paroxysms. The effect of LMP may outlast the pharmacokinetics of the drug by reducing pain amplification mechanisms in the central nervous system. LMP has limited or no systemic side effects. Conclusions: LMP may be an effective and well-tolerated treatment option for TN in those patients who do not tolerate or who refuse other therapies. Future randomized controlled studies should better address this issue.
Analysis of friction in surface textured components of reciprocating mechanism
Authors: Kligerman Y , Shinkarenko A
Published: July 2014

A model is presented to study the effects of inertia forces, squeeze film action and pressure boundary conditions on the friction force between a laser surface textured (LST) reciprocating components. The focus of the present paper is analysis of friction between LST piston ring and cylinder liner. The pressure distribution, the clearance and the friction force between the piston ring and the cylinder liner surfaces are obtained from a simultaneous solution of the Reynolds equation and the equation of motion. Two different approaches for analysis of the friction force are presented: “Real engine simulation” – based on a complete dynamic force equilibrium that takes into account the inertia forces and the squeeze film effects due to the piston ring mass and radial motion, respectively, while the pressure boundary conditions for the Reynolds equation represent realistic time variation in the cylinder pressure during the engine cycle; “Approximate solution” – based on a quasi-static force equilibrium that neglects inertia and squeeze film effects while applying constant ambient pressure as boundary condition. It is shown that the instantaneous friction force is much less sensitive to the real time variation of the cylinder pressure during the engine cycle than the clearance and that the approximate solution can be valid mainly for evaluating average friction values. The instantaneous clearance and friction obtained from the approximate solution may be quite different from the accurate ones.
Disclosure of disease status among employed multiple sclerosis patients: Association with negative work events and accommodations
Authors: Frndak Seth E , Kordovski Victoria M , Cookfair Diane , Rodgers Jonathan D , Weinstock-Guttman Bianca , Benedict Ralph HB
Published: July 2014

Background:

Unemployment is common in multiple sclerosis (MS) and detrimental to quality of life. Studies suggest disclosure of diagnosis is an adaptive strategy for patients. However, the role of cognitive deficits and psychiatric symptoms in disclosure are not well studied.

Objective:

The goals of this paper were to (a) determine clinical factors most predictive of disclosure, and (b) measure the effects of disclosure on workplace problems and accommodations in employed patients.

Methods:

We studied two overlapping cohorts: a cross-sectional sample ( n = 143) to determine outcomes associated with disclosure, and a longitudinal sample ( n = 103) compared at four time points over one year on reported problems and accommodations. A case study of six patients, disclosing during monitoring, was also included.

Results:

Disclosure was associated with greater physical disability but not cognitive impairment. Logistic regression predicting disclosure status retained physical disability, accommodations and years of employment ( p < 0.0001). Disclosed patients reported more work problems and accommodations over time. The case study revealed that reasons for disclosing are multifaceted, including connection to employer, decreased mobility and problems at work.

Conclusion:

Although cognitive impairment is linked to unemployment, it does not appear to inform disclosure decisions. Early disclosure may help maintain employment if followed by appropriate accommodations.
JC virus antibody status in a pediatric multiple sclerosis cohort: Prevalence, conversion rate and influence on disease severity
Authors: Huppke Peter , Hummel Hanna , Ellenberger David , Pfeifenbring Sabine , Stark Wiebke , Huppke Brenda , Brück Wolfgang , Gärtner Jutta
Published: July 2014

Background:

Because of the emergence of novel therapies for multiple sclerosis (MS) and the associated increased risk of progressive multifocal leukoencephalopathy, John Cunningham (JC) virus infection has become a focus of interest for neurologists. However, little is known about JC virus infection in pediatric MS to date.

Objective:

We aimed to analyze the prevalence of anti-JC virus antibodies, the conversion rate and the influence of the anti-JC virus antibody status on the clinical course in a large pediatric MS cohort.

Methods:

Anti-JC virus antibodies were analyzed in serum samples within six months of disease onset and during the course of the disease. Clinical data were extracted from a pediatric MS databank.

Results:

A total of 51.6% of 256 patients were found to be positive for anti-JC virus antibodies at onset of disease. No correlation between antibody status and clinical course was seen. Analyzing 693 follow-up serum samples revealed high titer stability, and an annual conversion rate of 4.37% was seen.

Conclusion:

No evidence was found that seropositivity for anti-JC virus antibodies influences the clinical course. Surprisingly, seroprevalence for anti-JC virus antibodies was more than twice as high as anticipated in this age group, raising the question of whether the infection increases the risk of MS development.
Pregnancy health problems and low birth weight associated with maternal insecure attachment style
Authors: Sabuncuoglu Osman , Basgul Alin
Published: July 2014

We aimed to determine the association between attachment style and health problems during pregnancy, as well as perinatal health variables. In 122 mothers who were 2–18 months postpartum, hot flushes, vaginal discharge, back pain, breast tenderness, hair changes, and psychological problems were shown to be associated with insecure attachment as measured by the Adult Attachment Style Questionnaires. Babies born to mothers with insecure attachment were more likely to have a low birth weight. It is vital to increase awareness of insecure attachment style as a risk factor among perinatal health care providers to optimize services.
Emotional reactions to unequal payment: The impact of meritocratic ideology and salary negotiability
Authors: Maitner Angela T.
Published: July 2014

People respond to low-status inequality with feelings of anger and shame. This work investigates the impact of meritocracy beliefs and implied salary negotiability on individuals’ emotional reactions within a stable status hierarchy. When an unequal system appears negotiable, believing that hard work pays off may decrease anger felt in response to inequality. However, learning that a system is non-negotiable violates expectations associated with meritocratic beliefs, and may therefore increase negative emotion. In two experiments investigating participants’ emotional reactions to payment systems, the more participants endorsed meritocratic ideologies, the less anger they felt when unequal treatment appeared negotiable. Experiment 2 showed that endorsement of meritocracy beliefs increased negative emotions when individuals learned that the unequal payment was non-negotiable. Taken together, this work suggests that it is important to consider beliefs about individual agency alongside system parameters establishing opportunities for individual mobility to understand emotional reactions to unequal treatment.
Clinical Assessment of Fluid Balance is Incomplete for Colorectal Surgical Patients
Authors: Tolstrup J. , Brandstrup B.
Published: July 2014

Background and Aims:

Fluid balance for the surgical patient has been proven very important for the postoperative outcome and development of complications. The aim of this study was to evaluate, for the first time in modern times, the accordance between nurse-based fluid charting (cumulated fluid balance) and body weight change for general surgical patients.

Material and Methods:

This was a descriptive study with prospectively collected data from two clinical randomized multicenter trials. A total of 113 patients from American Society of Anesthesiology group I–III undergoing elective colorectal surgery were included. Cumulated fluid balance and body weight change were charted preoperatively and daily at the same time during a postoperative period of 6 days. Differences were calculated by subtracting cumulated fluid balance from body weight change (1 g = 1 mL), and agreement was assessed by making Bland–Altman plots as well as Pearson correlations.

Results:

From day 1 to 4, the mean difference between cumulated fluid balance and body weight change was below 0.4 kg/L. On day 5 and 6, the discrepancies increased with mean differences of, respectively, 1.2 kg/L (p < 0.002*) and 2 kg/L (p < 0.0001*). Bland–Altman plots showed increasingly poor agreement for all postoperative days with wide limits of agreement, ranging from more than 6 kg/L to almost 10 kg/L. Pearson correlations were moderate to strong at all times ranging from 0.437 (day 1) to 0.758 (day 4).

Conclusions:

The accordance between cumulated fluid balance and body weight change for colorectal surgical patients is relatively good for the first four postoperative days, however, with large uncertainty, whereas on the fifth and sixth postoperative day, the discrepancy is statistically and clinically significant. The fluid chart cannot stand alone in interpretation of the patient’s fluid balance; body weight and clinical judgment is indispensable.
Effects of exercise on central aortic pressure before and after treatment with renin–angiotensin system blockade in patients with hypertension
Authors: Lacy Peter S , Brunel Patrick , Baschiera Fabio , Botha Jaco , Williams Bryan
Published: July 2014

Introduction:

Brachial blood pressure increases with exercise and an excessive rise predicts increased cardiovascular risk. Measurement of brachial blood pressure alone may exaggerate the true blood pressure elevation due to exercise-induced change to pressure amplification. Whether blood pressure-lowering treatment modulates pressure amplification during exercise is unknown.

Methods:

Thirty-two participants with stage 1–2 hypertension (mean age 59.2 years) received eight weeks’ blood pressure lowering with either aliskiren (300mg, n=16) or valsartan (320mg, n=16). Brachial and central aortic pressure (CASP) were measured non-invasively during treadmill exercise (Bruce protocol) at baseline, after eight weeks’ treatment and 48 hours following treatment withdrawal.

Results:

The rise in brachial blood pressure with exercise exceeded the rise in CASP, indicative of enhanced pressure amplification. Eight weeks’ treatment elicited similar reductions in brachial blood pressure and CASP which did not differ between rest and peak exercise ( p>0.05). The exercise-induced increase in systolic pressure amplification did not differ between baseline and following eight weeks’ treatment ( p>0.05). These effects remained unchanged following treatment withdrawal.

Conclusion:

Blood pressure lowering does not directly influence the relationship between aortic and brachial pressure either at rest or during exercise in patients with hypertension, other than through proportionate lowering of both pressures. These effects remained unchanged 48 hours after a simulated missed medication dose.
The influences of capital market munificence on new-venture alliance formation in emerging industries
Authors: Hoehn-Weiss Manuela N , Barden Jeffrey Q
Published: July 2014

How do public capital markets influence alliance formation by new ventures? Resource dependency logic suggests that new ventures form fewer alliances when public capital markets are munificent because public investors demand less management control than do alliance partners. In contrast, according to the strategic behavior view, public capital market munificence can also motivate alliance formation because such munificence can enhance the returns that new-venture managers expect from using alliances. We seek to reconcile these two conflicting views of reinforcing versus attenuating effects of public capital market munificence on alliance formation. In this study of new Internet ventures, we find evidence that public capital market munificence increases alliance formation, which provides support for the reinforcing effect. However, availability of other resource alternatives—venture capital and product markets—decreases the positive influence of public capital market munificence on alliance formation. Thus, a contingency perspective in which resource dependency-based motivations moderate strategic motivations best explains the influence of capital market munificence on new ventures’ alliance formation behavior.
Diversity Issues
Authors: Byrd Marilyn Y.
Published: July 2014

The Problem

Social identity diversity is a concept that links an individual to the social world and to other contexts where interactions occur. However, issues that emerge from social identity diversity may not necessarily be viewed as mono-causal, or based on a single form of difference. Because some individuals may experience simultaneously multiple forms of difference that causes oppression, frameworks are needed to critically analyze how these individuals navigate the complexities of their social identities to gain acceptance, satisfaction, and high levels of performance.

The Solution

Intersectionality will be used as an analytical tool to highlight multiple, interlocking forms of societal oppression experienced by historically marginalized groups and to serve as a means of making sense of these experiences.

Key Stakeholders

Human resource development (HRD) scholars and practitioners who are committed to social justice advocacy.
Reading leadership through Hegel’s master/slave dialectic: Towards a theory of the powerlessness of the powerful
Authors: Harding Nancy
Published: July 2014

This paper develops a theory of the subjectivity of the leader through the philosophical lens of Hegel’s master/slave dialectic and its recent interpretation by the philosopher Judith Butler. This is used to analyse the working life history of a man who rose from poverty to a leadership position in a large company and eventually to running his own successful business. Hegel’s dialectic is foundational to much Western thought, but in this paper, I rashly update it by inserting a leader in between the master, whose approval the leader needs if s/he is to sustain self-hood, and the follower, who becomes a tool that the leader uses when trying to gain that elusive approval. The analysis follows the structure of Butler’s reading of the Dialectic and develops understanding of the norms that govern how leaders should act and the persons they should be. Hard work has become for leaders an ethical endeavour, but they grieve the sacrifice of leisure. They enjoy a frisson of erotic pleasure at their power over others but feel guilt as a result. They must prove their leadership skills by ensuring their followers are perfect employees but at the same time must prove their followers are poor workers who need their continued leadership. This leads to the conclusion that the leader is someone who is both powerful and powerless. This analysis is intended not to demonize leaders, but to show the harm that follows the emphasis on leadership as a desirable and necessary organizational function.
Funny turns in children
Authors: Peet Danielle , Barrett George , Burkill Catherine , Rainsbury James
Published: July 2014

Funny turns in children are common and usually triggered by a benign cause. There is a wide range of possible pathologies underlying these episodes. Many children will only be looked after by their GP but some complex cases may be managed by a number of different specialities including general paediatrics, paediatric neurology, paediatric cardiology and the ear, nose and throat department. This article aims to outline a primary care approach to a child presenting with a funny turn to enable appropriate reassurance or referral to the appropriate specialty.
A Quality Assurance Initiative Targeting Radiation Exposure to Neuroscience Patients in the Intensive Care Unit
Authors: Chan Sheila , Josephson S. Andrew , Rosow Laura , Smith Wade S.
Published: July 2014

Background:

Patients admitted to an intensive care unit (ICU) with a primary neurologic disorder often receive multiple radiation-based diagnostic studies of the head and neck. Although radiation exposure puts them at risk of intracranial and neck tumors, the amount of radiation received is largely unknown.

Methods:

We sought to accurately collect cumulative radiation exposure data from radiation-based studies in a retrospective cohort of patients admitted to the neuroscience ICU (NICU) at a single institution. Radiation doses of studies were converted to estimated effective doses in mSv via literature-published formulas. To impact ordering practices, we piloted an educational initiative on patient radiation exposure to a cohort of physicians caring for patients with a diagnosis of acute subarachnoid hemorrhage. Patients were randomized to have radiation exposure data posted at the bedside for physician viewing.

Results:

We identified 641 patients from July 2010 to March 2011 who had received at least 1 computed tomography-based study of the head. Patients received on average 18.4 mSv of radiation from head and neck imaging. Patients with subarachnoid hemorrhage received the highest average levels of radiation exposure (37.1 mSv). Attributable risk of carcinogenesis was estimated to be low. A pilot educational initiative did not reduce the total estimated effective dose per patient.

Conclusions:

Accurate reporting of estimated effective doses for NICU patients is feasible and can be provided to ordering physicians to assist with clinical decision making and potentially lower exposure risk. Further strategies are needed to reduce unnecessary radiation exposure at the physician ordering level.
Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain
Authors: Smith Jonathan A , Osborn Mike
Published: July 2014

Interpretative phenomenological analysis (IPA) is a qualitative approach which aims to provide detailed examinations of personal lived experience. It produces an account of lived experience in its own terms rather than one prescribed by pre-existing theoretical preconceptions and it recognises that this is an interpretative endeavour as humans are sense-making organisms. It is explicitly idiographic in its commitment to examining the detailed experience of each case in turn, prior to the move to more general claims. IPA is a particularly useful methodology for examining topics which are complex, ambiguous and emotionally laden. Pain is a prime exemplar of such a phenomenon: elusive, involving complex psycho-somatic interactions and difficult to articulate. In addition to the 1998 article, published in this Special Issue, two further papers are suggested that the interested reader might wish to look out for.
The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment
Authors: Chemaly Roy F. , Simmons Sarah , Dale Charles , Ghantoji Shashank S. , Rodriguez Maria , Gubb Julie , Stachowiak Julie , Stibich Mark
Published: July 2014

The role of the environment in harboring and transmitting multidrug-resistant organisms has become clearer due to a series of publications linking environmental contamination with increased risk of hospital-associated infections. The incidence of antimicrobial resistance is also increasing, leading to higher morbidity and mortality associated with hospital-associated infections. The purpose of this review is to evaluate the evidence supporting the existing methods of environmental control of organisms: environmental disinfection, contact precautions, and hand hygiene. These methods have been routinely employed, but transmission of multidrug-resistant organisms continues to occur in healthcare facilities throughout the country and worldwide. Several new technologies have entered the healthcare market that have the potential to close this gap and enhance the containment of multidrug-resistant organisms: improved chemical disinfection, environmental monitoring, molecular epidemiology, self-cleaning surfaces, and automated disinfection systems. A review of the existing literature regarding these interventions is provided. Overall, the role of the environment is still underestimated and new techniques may be required to mitigate the role that environmental transmission plays in acquisition of multidrug-resistant organisms.
Characterization of the sleep–wake cycle of the Neotropical rodent Proechimys guyannensis
Authors: da Silva José Cláudio , de Matos Barbosa Pimenta Gabriela , Andersen Monica Levy , Schoorlemmer Gerhardus Hermanus Maria , Tufik Sérgio , Cavalheiro Esper Abrão
Published: July 2014

Objectives:

To better understand the sleep–wake cycle characteristics in the female Neotropical rodent Proechimys guyannensis related to comparative neurobiology.

Methods:

Surface neocortical and hippocampal electrodes were chronically implanted in the brains of female Wistar and Proechimys animals. In addition, electrodes for the study of muscle activity were implanted into the neck muscle of both species. After surgical recovery and a period of adaptation, animals were continuously registered for periods as long as 48 h.

Results:

In both the light and dark phases of the cycle, significant differences in some electrographic patterns were observed between the Proechimys and Wistar animals. Although Proechimys has nocturnal activities and a pattern of polyphasic sleep similar to Wistar rats, the analysis of its sleep-wakefulness cycle indicates that the Neotropical rodent sleeps less with consequent longer periods of wakefulness when compared to Wistar rats.

Conclusions:

Together with previous findings of different neuroanatomical, neurophysiologic and behavioral characteristics, this study allow us to better understand adaptive differences of the Neotropical rodent Proechimys.
Abnormal Origin of the Right Pulmonary Artery From Ascending Aorta (Hemitruncus Arteriosus)
Authors: Haywood L. Julian , Chakryan Yervand , Kim Diana , Boltzer Tin , Rivas Gregory , Shavelle David
Published: July 2014

Hemitruncus arteriosus is a rare congenital deformity that results in early infant mortality. Persistence into adulthood is very unusual and is associated with pulmonary hypertension. We report a case in an adult male with the associated clinical issues.
Preparation and properties of biomimetic superhydrophobic composite coating
Authors: Yu H. B. , Li R. F.
Published: July 2014

A nanosilica (SiO2)/polyurethane (PU) micro-nanocomposite coating with similar surface structure as a lotus leaf was prepared using a simple spraying process. The formation mechanism and structural characteristics of the coating were analysed. The coating surface was also characterised via scanning electron microscopy. The influence of the contents of SiO2, PU, and organosilicon on the coating surface structure and contact angle was studied. The results showed that the coating surface had a similar micro-nanostructure as the lotus leaf surface. When the content of organosilicon was greater than 15%, the water contact angle of the coating and sliding angle were 158 and 3°, respectively. This SiO2/PU micro-nanocomposite coating had superhydrophobic properties and repeated use performance.
Controllable preparation of Ni nanoparticles for catalysis of coiled carbon fibers growth
Authors: Jian Xian , Zhou Zuowan , Wu Sixin , Chen Lei , Zeng Qing , Wang Chao
Published: July 2014

The mass preparation of high-purity coiled carbon fibers (CCFs) remains challenging due to the high complexity and low controllability of reaction. In this work, a controllable growth of Ni particles was fulfilled by liquid phase reduction of nickel sulfate with hydrazine hydrate. The impacts of the reaction temperature, NaOH concentration, and reaction time on the particle size and purity were investigated. The as-deposited Ni particles were characterized by scanning electron microscopy and X-ray diffraction. In addition, these Ni particles were also applied in preparing high-purity CCFs both on graphite and ceramic substrates. The diameter of the as-grown carbon microcoil was about 500 nm, and the related growth mechanism was discussed.
Whole-genome bisulfite sequencing of multiple individuals reveals complementary roles of promoter and gene body methylation in transcriptional regulation
Authors: Lou Shaoke , Lee Heung-Man , Qin Hao , Li Jing-Woei , Gao Zhibo , Liu Xin , Chan Landon L , KL Lam Vincent , So Wing-Yee , Wang Ying , Lok Si , Wang Jun , Ma Ronald CW , Tsui Stephen Kwok-Wing , Chan Juliana CN , Chan Ting-Fung , Yip Kevin Y
Published: July 2014

Background

DNA methylation is an important type of epigenetic modification involved in gene regulation. Although strong DNA methylation at promoters is widely recognized to be associated with transcriptional repression, many aspects of DNA methylation remain not fully understood, including the quantitative relationships between DNA methylation and expression levels, and the individual roles of promoter and gene body methylation.

Results

Here we present an integrated analysis of whole-genome bisulfite sequencing and RNA sequencing data from human samples and cell lines. We find that while promoter methylation inversely correlates with gene expression as generally observed, the repressive effect is clear only on genes with a very high DNA methylation level. By means of statistical modeling, we find that DNA methylation is indicative of the expression class of a gene in general, but gene body methylation is a better indicator than promoter methylation. These findings are general in that a model constructed from a sample or cell line could accurately fit the unseen data from another. We further find that promoter and gene body methylation have minimal redundancy, and either one is sufficient to signify low expression. Finally, we obtain increased modeling power by integrating histone modification data with the DNA methylation data, showing that neither type of information fully subsumes the other.

Conclusion

Our results suggest that DNA methylation outside promoters also plays critical roles in gene regulation. Future studies on gene regulatory mechanisms and disease-associated differential methylation should pay more attention to DNA methylation at gene bodies and other non-promoter regions.
A dynamic network of estrogen receptors in murine lymphocytes: fine-tuning the immune response
Authors: Schneider Andrea E , Kárpáti Éva , Schuszter Kitti , Tóth Eszter A , Kiss Endre , Kulcsár Margit , László Glória , Matko Janos
Published: July 2014

The actual level of circulating estrogen (17β-estradiol, E2) has a serious impact on regulation of diverse immune cell functions, where their classical cytoplasmic receptors, ERα and ERβ, act as nuclear transcriptional regulators of multiple target genes. There is growing evidence, however, for rapid, “non-nuclear” regulatory effects of E2 on lymphocytes. Such effects are likely mediated by putative membrane-associated receptor(s) (mER), but the mechanistic details and the involved signaling pathways still remained largely unknown because of their complexity. Here, we show that in lymphocytes, mERs can signalize themselves, and upon ligation, they are able to coordinate translocation of other E2Rs to the PM. Our data firmly imply existence of a complex, dynamic network of at least seven ER forms in murine lymphocytes: cytoplasmic and membrane-linked forms of ERα, ERβ, or GPR30 and a mER that can receive extracellular E2 signals. The latter mERs are likely palmitoylated, as they are enriched in lipid-raft microdomains, and their E2 binding is also cholesterol dependent. The data also support that ligation of mERs can induce rapid regulatory signals to lymphocytes and then internalize and let the E2 liberate in lysosomes. In addition, they can dynamically control the cell-surface linkage of other cytoplasmic ERs. As demonstrated by the differential effects of mER or cytoplasmic ER ligation on the proliferation of activated T and B lymphocytes, such a dynamic E2R network can be considered as a tool to manage accommodation/fine-tuning of lymphocytes to rapidly changing hormone levels.
Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program
Authors: Ko Naomi Y. , Darnell Julie S. , Calhoun Elizabeth , Freund Karen M. , Wells Kristin J. , Shapiro Charles L. , Dudley Donald J. , Patierno Steven R. , Fiscella Kevin , Raich Peter , Battaglia Tracy A.
Published: July 2014

Purpose

Poor and underserved women face barriers in receiving timely and appropriate breast cancer care. Patient navigators help individuals overcome these barriers, but little is known about whether patient navigation improves quality of care. The purpose of this study is to examine whether navigated women with breast cancer are more likely to receive recommended standard breast cancer care.

Patients and Methods

Women with breast cancer who participated in the national Patient Navigation Research Program were examined to determine whether the care they received included the following: initiation of antiestrogen therapy in patients with hormone receptor–positive breast cancer; initiation of postlumpectomy radiation therapy; and initiation of chemotherapy in women younger than age 70 years with triple-negative tumors more than 1 cm. This is a secondary analysis of a multicenter quasi-experimental study funded by the National Cancer Institute to evaluate patient navigation. Multiple logistic regression was performed to compare differences in receipt of care between navigated and non-navigated participants.

Results

Among participants eligible for antiestrogen therapy, navigated participants (n = 380) had a statistically significant higher likelihood of receiving antiestrogen therapy compared with non-navigated controls (n = 381; odds ratio [OR], 1.73; P = .004) in a multivariable analysis. Among the participants eligible for radiation therapy after lumpectomy, navigated participants (n = 255) were no more likely to receive radiation (OR, 1.42; P = .22) than control participants (n = 297).

Conclusion

We demonstrate that navigated participants were more likely than non-navigated participants to receive antiestrogen therapy. Future studies are required to determine the full impact patient navigation may have on ensuring that vulnerable populations receive quality care.
International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer
Authors: Wildiers Hans , Heeren Pieter , Puts Martine , Topinkova Eva , Janssen-Heijnen Maryska L.G. , Extermann Martine , Falandry Claire , Artz Andrew , Brain Etienne , Colloca Giuseppe , Flamaing Johan , Karnakis Theodora , Kenis Cindy , Audisio Riccardo A. , Mohile Supriya , Repetto Lazzaro , Van Leeuwen Barbara , Milisen Koen , Hurria Arti
Published: July 2014

Purpose

To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer.

Methods

SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care.

Results

GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another.

Conclusion

There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base.
Breast and Ovarian Cancer in the Older Woman
Authors: Tew William P. , Muss Hyman B. , Kimmick Gretchen G. , Von Gruenigen Vivian E. , Lichtman Stuart M.
Published: July 2014

Nearly half of all women diagnosed with breast or ovarian cancer are age 65 years or older with the number of women diagnosed expected to increase as the population ages and life expectancy improves. Older women are less likely to be offered standard cancer treatments, are more likely to develop higher toxicity, and have higher mortality. Chronologic age should not be the only factor used for making treatment decisions. Functional dependence, organ function, comorbidity, polypharmacy, social support, cognitive and/or psychosocial factors, overall life expectancy, and patient's goals of care are equally vital and should be assessed before and during treatment. In this review, current evidence and treatment guidelines for older women with breast or ovarian cancer are outlined.