bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular Repair of Three Concurrent Mycotic Pseudoaneurysms
Authors: Asai Megumi , Van Houtte Olivier , Sullivan Terry R. , Garrido Mauricio , Pineda Danielle M.
Published: May 2018

Introduction:

Mycotic pseudoaneurysm has traditionally been repaired surgically with excision of the infected artery and revascularization via extra-anatomical or in situ bypass. There have been reports of endovascular repair for high-risk patients for formal surgical repair. We present a case of a patient with 3 large pseudoaneurysms arising from the right subclavian artery, descending thoracic aorta, and right popliteal artery treated with endovascular and hybrid intervention.

Case:

A 74-year-old male with remote history of coronary artery bypass graft and recent sternoclavicular joint abscess developed 3 concurrent pseudoaneurysms arising from the right subclavian artery, distal descending thoracic aorta, and right popliteal artery. He underwent right axillary to common carotid bypass with endovascular stent graft placement in the distal innominate and proximal subclavian artery, and subsequently had thoracic endovascular aortic repair and right popliteal stent graft. Four months later, he presented with hemoptysis due to compression of the lung secondary to the pseudoaneurysm. He underwent right anterior thoracotomy and debridement of the pseudoaneurysm. Patient recovered from the procedure and discharged.

Conclusion:

Endovascular repair of mycotic pseudoaneurysm is an acceptable alternative for high-risk patients. Even when open approach became necessarily, endovascular stent graft decreased blood loss and morbidity.
Fruits and Vegetables Versus Vegetables and Fruits: Rhyme and Reason for Word Order in Health Messages
Authors: Offringa Lisa C. , Stanton Michael V. , Hauser Michelle E. , Gardner Christopher D.
Published: May 2018

Both vegetable and fruit consumption contribute to wellness and disease prevention. Most dietary health messages promote both together and position the word “fruits” before “vegetables.” We examined the word order of the commonly used phrase “fruits and vegetables” through linguistics, psychology, botany, nutrition, health outcomes, and current US intake to determine if the common word order best presents these two foods in health messaging. By comparing the 10 most commonly consumed vegetables versus fruits, we found that vegetables scored higher on the Aggregate Nutrient Density Index and contained fewer calories and more fiber than fruits. Among the “nutrients of public concern” listed in the 2015 Dietary Guidelines for Americans, we determined that vegetables are better sources of these nutrients than fruits, although fruits scored higher in antioxidant content. In observational cohort studies, vegetable and fruit consumption was found to be associated with decreased mortality. Finally, daily intakes of both vegetables and fruits are lower than recommended, but the discrepancy is larger for vegetables—especially among children—suggesting a greater imperative to promote vegetables. For these reasons, future health messages promoting both together should intentionally put “vegetables” first to promote intake and emphasize their importance regarding contribution to health.
In the DNA Exoneration Cases, Eyewitness Memory Was Not the Problem: A Reply to Berkowitz and Frenda (2018) and Wade, Nash, and Lindsay (2018)
Authors: Wixted John T. , Mickes Laura , Fisher Ronald P.
Published: May 2018

The available real-world evidence suggests that, on an initial test, eyewitness memory is often reliable. Ironically, even the DNA exoneration cases—which generally involved nonpristine testing conditions and which are usually construed as an indictment of eyewitness memory—show how reliable an initial test of eyewitness memory can be in the real world. We endorse the use of pristine testing procedures, but their absence does not automatically imply that eyewitness memory is unreliable.
The Primacy Effect in Impression Formation: Some Replications and Extensions
Authors: Sullivan Jessica
Published: May 2018

Individuals described as “fun, witty, and vicious” are typically rated more favorably than those described as “vicious, witty, and fun” despite the semantic equivalence of these statements. This is known as the primacy effect in impression formation. We tested whether these effects emerge from pragmatic inferences about communicative intentions (e.g., that communicators should relay the most important information first). Participants heard a list of descriptors, with the most positive adjective listed either first or last; they also learned either that (a) the list was compiled by a human (licensing the inference that the most important information should be conveyed first) or (b) randomly ordered by a computer (thus blocking such an inference). Across five experiments (total N = 2,882), we found support for a small primacy effect in impression formation, but found no evidence of a pragmatic explanation for primacy effects.
Endothelial nitric oxide synthase genotype is associated with pulmonary hypertension severity in left heart failure patients
Authors: Duarte Julio D. , Kansal Mayank , Desai Ankit A. , Riden Katherine , Arwood Meghan J. , Yacob Alex A. , Stamos Thomas D. , Cavallari Larisa H. , Zamanian Roham T. , Shah Sanjiv J. , Machado Roberto F.
Published: May 2018

The biological mechanisms behind the development of pulmonary hypertension in the setting of left heart failure (HF‐PH), including combined pre‐ and post‐capillary pulmonary hypertension (Cpc‐PH), remains unclear. This study aimed to use candidate polymorphisms in nitric oxide synthase (NOS) genes to explore the role of NOS in HF‐PH. DNA samples from 118 patients with HF‐PH were genotyped for the NOS3 rs1799983 and NOS2 rs3730017 polymorphisms. A multiple regression model was used to compare hemodynamic measurements between genotype groups. Patients with the T/T genotype at rs1799983 possessed a nearly 10 mmHg increased transpulmonary gradient (TPG) compared to those with other genotypes (P = 0.006). This finding was replicated in an independent cohort of 94 HF‐PH patients (P = 0.005). However, when tested in a cohort of 162 pre‐capillary pulmonary arterial hypertension patients, no association was observed. In a combined analysis of both HF‐PH cohorts, mean pulmonary artery pressure (mPAP), diastolic pulmonary gradient (DPG), and CpcPH status were also associated with rs1799983 genotype (P = 0.005, P = 0.03, and P = 0.02, respectively). In patients with HF‐PH, the NOS3 rs1799983 polymorphism is associated with TPG, and potentially mPAP and DPG as well. These findings suggest that endothelial NOS (encoded by NOS3) may be involved in the pulmonary vascular remodeling observed in Cpc‐PH and warrants further study.
Rare variants in RNF213, a susceptibility gene for moyamoya disease, are found in patients with pulmonary hypertension and aggravate hypoxia‐induced pulmonary hypertension in mice
Authors: Kobayashi Hatasu , Kabata Risako , Kinoshita Hideyuki , Morimoto Takaaki , Ono Koh , Takeda Midori , Choi Jungmi , Okuda Hiroko , Liu Wanyang , Harada Kouji H. , Kimura Takeshi , Youssefian Shohab , Koizumi Akio
Published: May 2018

Ring finger 213 (RNF213) is a susceptibility gene for moyamoya disease (MMD), a progressive cerebrovascular disease. Recent studies suggest that RNF213 plays an important role not only in MMD, but also in extracranial vascular diseases, such as pulmonary hypertension (PH). In this study, we undertook genetic screening of RNF213 in patients with PH and performed functional analysis of an RNF213 variant using mouse models. Direct sequencing of the exons in the C‐terminal region of RNF213, where MMD‐associated mutations are highly clustered, and of the entire coding exons of BMPR2 and CAV1, the causative genes for PH, was performed in 27 Japanese patients with PH. Two MMD‐associated rare variants (p.R4810K and p.A4399T) in RNF213 were identified in two patients, three BMPR2 mutations (p.Q92H, p.L198Rfs*4, and p.S930X) were found in three patients, whereas no CAV1 mutations were identified. To test the effect of the RNF213 variants on PH, vascular endothelial cell (EC)‐specific Rnf213 mutant transgenic mice were exposed to hypoxia. Overexpression of the EC‐specific Rnf213 mutant, but neither Rnf213 ablation nor EC‐specific wild‐type Rnf213 overexpression, aggravated the hypoxia‐induced PH phenotype (high right ventricular pressure, right ventricular hypertrophy, and muscularization of pulmonary vessels). Under hypoxia, electron microscopy showed unique EC detachment in pulmonary vessels, and western blots demonstrated a significant reduction in caveolin‐1 (encoded by CAV1), a key molecule involved in EC functions, in lungs of EC‐specific Rnf213 mutant transgenic mice, suggestive of EC dysfunction. RNF213 appears to be a genetic risk factor for PH and could play a role in systemic vasculopathy.
Safety profile of a special butterbur extract from Petasites hybridus in migraine prevention with emphasis on the liver
Authors: Diener HC , Freitag FG , Danesch U
Published: May 2018

Background:

Butterbur supplements are available in the USA and Canada and are commonly used for treating migraines. Petadolex, a special butterbur extract from Petasites hybridus, is a natural herbal product and the only butterbur extract with proven clinical efficacy in migraine prevention. The Complimentary Migraine Guidelines of the AAN mention butterbur as level A recommendation for the prevention of chronic episodic migraine. However, these guidelines have been retired.

Methods:

We review suspected serious liver cases, pyrrolizidine alkaloids, regulatory issues, preclinical and clinical data of the special butterbur extract Petadolex.

Results:

The RUCAM (Roussel Uclaf Causality Assessment Method) test found no probable relationship between the butterbur root extract Petadolex® and cases of serious liver injury. Two cases of non-serious reversible liver enzyme elevations were rated as probably related to Petadolex®. The safety is supported by preclinical data in animals as well as in-vitro toxicology experiments. In addition, Petadolexis free of detectable levels of pyrrolizidine alkaloids.

Conclusion:

There is no evidence that the special butterbur root extract Petadolex poses a substantial risk of liver injury for patients.
Triazolite, NaCu2(N3C2H2)2(NH3)2Cl3·4H2O, a new mineral species containing 1,2,4-triazolate anion, from a guano deposit at Pabellón de Pica, Iquique Province, Chile
Authors: Chukanov Nikita V. , Zubkova Natalia V. , Möhn Gerhard , Pekov Igor V. , Belakovskiy Dmitriy I. , Van Konstantin V. , Britvin Sergey N. , Pushcharovsky Dmitry Y.
Published: May 2018

The new mineral triazolite is found in a guano deposit located on the Pabellón de Pica Mountain, Iquique Province, Tarapacá Region, Chile. Associated minerals are salammoniac, halite, dittmarite, joanneumite, chanabayaite, nitratine, natroxalate and möhnite. Triazolite occurs as deep blue prismatic crystals up to 0.1 mm × 0.15 mm × 0.75 mm and their radial aggregates up to 1.5 mm across. The mineral is brittle. Its Mohs hardness is 2.Dcalc= 2.028 g cm–3. The infrared spectrum shows the presence of 1,2,4-triazolate anion and ammonia and water molecules. Triazolite is optically biaxial (–), α = 1.582(4), β = 1.625(3), γ = 1.625(3) and 2Vmeas= 5(3)°. The chemical composition (electron-microprobe data for Cl, Na, Fe and Cu; H, C, N and S contents were measured by gas chromatography of products of ignition at 1200°C; wt.%) is: Na 4.91, Fe 1.51, Cu 22.06, Cl 19.80, S 1.4, C 7.7, H 4.4, N 24.2, O (calc.) 12.83, total 98.81. The empirical formula is Na1.14(Cu1.86Fe0.14)(Cl2.99S0.23)N9.23C3.43H23.34O4.29. The idealized formula is NaCu2(N3C2H2)2(NH3)2Cl3·4H2O. Triazolite is a metalorganic ammine complex in which 1,2,4-triazolate anion and ammonia molecule are ligands coordinating Cu2+. The crystal structure was solved by direct methods and refined toR= 0.0242 based on 4210 unique reflections withI> 2σ(I). Triazolite is orthorhombic, space groupP212121,a= 19.3575(5),b= 7.15718(19),c= 12.5020(4) Å,V= 1732.09(8) Å3andZ= 4. The eight strongest reflections of the powder X-ray diffraction pattern [d, Å (I,%) (hkl)] are: 10.22 (97) (101), 6.135 (40) (011), 5.696 (17) (301), 5.182 (59) (202), 5.119 (100) (211), 4.854 (19) (400), 3.752 (16) (312, 501), 3.294 (18) (221). Triazolite is named for the presence of 1,2,4-triazolate anion.
Recommendations for managing PD-1 blockade in the context of allogeneic HCT in Hodgkin lymphoma: taming a necessary evil
Authors: Herbaux Charles , Merryman Reid , Devine Steven , Armand Philippe , Houot Roch , Morschhauser Franck , Haverkos Bradley
Published: May 2018

PD-1 blockade is an effective therapy in relapsed/refractory (R/R) classical Hodgkin Lymphoma (cHL) who have relapsed after or are ineligible for autologous hematopoietic cell transplantation (HCT). Although single-agent anti-PD-1 monoclonal antibodies (mAb’s) are associated with high response rates and durable remissions, available results to date suggest that a large majority of patients will eventually progress on therapy. Many of these patients are potential candidates for allogeneic HCT (allo-HCT) after receiving anti-PD-1 mAb’s, and allo-HCT remains for now the only treatment with demonstrated curative potential in this setting. However, initial reports suggested that allo-HCT in this setting may be associated with increased risk of early transplant-related toxicity, likely driven by lingering effects of PD-1 blockade. Furthermore, many patients with R/R cHL who undergo allo-HCT will relapse after transplantation, most often with limited treatment options. Here again, PD-1 blockade appears to yield high response rates, but with an increased risk of attendant immune toxicity. Many questions remain regarding the use of PD-1 blockade before or after allo-HCT, especially in relation to the feasibility, outcome, optimal timing, and method of allo-HCT after PD-1 blockade. Despite the scarcity of prospective data, these questions are unavoidable and must be tackled by clinicians in the routine care of patients with advanced cHL. We provide consensus recommendations of a working group based on available data and experience, in an effort to help guide treatment decisions until more definitive data are obtained.
“Availability of healthcare providers for rural veterans eligible for purchased care under the veterans choice act”
Authors: Ohl Michael E. , Carrell Margaret , Thurman Andrew , Weg Mark Vander , Hudson Teresa , Mengeling Michelle , Vaughan-Sarrazin Mary
Published: May 2018

Background

Military Veterans in the United States are more likely than the general population to live in rural areas, and often have limited geographic access to Veterans Health Administration (VHA) facilities. In an effort to improve access for Veterans living far from VHA facilities, the recently-enacted Veterans Choice Act directed VHA to purchase care from non-VHA providers for Veterans who live more than 40 miles from the nearest VHA facility. To explore potential impacts of these reforms on Veterans and healthcare providers, we identified VHA-users who were eligible for purchased care based on distance to VHA facilities, and quantified the availability of various types of non-VHA healthcare providers in counties where these Veterans lived.

Methods

We combined 2013 administrative data on VHA-users with county-level data on rurality, non-VHA provider availability, population, household income, and population health status.

Results

Most (77.9%) of the 416,338 VHA-users who were eligible for purchased care based on distance lived in rural counties. Approximately 16% of these Veterans lived in primary care shortage areas, while the majority (70.2%) lived in mental health care shortage areas. Most lived in counties that lacked specialized health care providers (e.g. cardiologists, pulmonologists, and neurologists). Counterintuitively, VHA played a greater role in delivering healthcare for the overall adult population in counties that were farther from VHA facilities (30.7 VHA-users / 1000 adults in counties over 40 miles from VHA facilities, vs. 22.4 VHA-users / 1000 adults in counties within 20 miles of VHA facilities, p < 0.01).

Conclusions

Initiatives to purchase care for Veterans living more than 40 miles from VHA facilities may not significantly improve their access to care, as these areas are underserved by non-VHA providers. Non-VHA providers in the predominantly rural areas more than 40 miles from VHA facilities may be asked to assume care for relatively large numbers of Veterans, because VHA has recently cared for a greater proportion of the population in these areas, and these Veterans are now eligible for purchased care.
Enhancing pharmacists’ role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review
Authors: Sakeena M. H. F. , Bennett Alexandra A. , McLachlan Andrew J.
Published: May 2018

Background

Antimicrobial resistance (AMR) is a global health challenge and developing countries are more vulnerable to the adverse health impacts of AMR. Health care workers including pharmacists can play a key role to support the appropriate use of antimicrobials in developing countries and reduce AMR.

Objective

The aim of this review is to investigate the role of pharmacists in the appropriate use of antibiotics and to identify how the pharmacists’ role can be enhanced to combat AMR in developing countries.

Method

The databases MEDLINE, EMBASE, Web of Science and Google Scholar were searched for articles published between 2000 and the end of August 2017 that involved studies on the role of pharmacists in developing countries, the expanded services of pharmacists in patient care in developed countries and pharmacists’ contributions in antimicrobial use in both developed and developing nations.

Key findings

In developing countries pharmacists role in patient care are relatively limited. However, in developed nations, the pharmacists’ role has expanded to provide multifaceted services in patient care resulting in improved health outcomes from clinical services and reduced health care costs. Success stories of pharmacist-led programs in combating AMR demonstrates that appropriately trained pharmacists can be part of the solution to overcome the global challenge of AMR. Pharmacists can provide education to patients enabling them to use antibiotics appropriately. They can also provide guidance to their healthcare colleagues on appropriate antibiotic prescribing.

Conclusions

This review highlights that appropriately trained pharmacists integrated into the health care system can make a significant impact in minimising inappropriate antibiotic use in developing countries. Strengthening and enhancing the pharmacists’ role in developing countries has the potential to positively impact the global issue of AMR.
Genome-based analysis of Carbapenemase-producing Klebsiella pneumoniae isolates from German hospital patients, 2008-2014
Authors: Becker Laura , Kaase Martin , Pfeifer Yvonne , Fuchs Stephan , Reuss Annicka , von Laer Anja , Sin Muna Abu , Korte-Berwanger Miriam , Gatermann Sören , Werner Guido
Published: May 2018

Background

By using whole genome sequence data we aimed at describing a population snapshot of carbapenemase-producing K. pneumoniae isolated from hospitalized patients in Germany between 2008 and 2014.

Methods

We selected a representative subset of 107 carbapenemase-producing K. pneumoniae clinical isolates possessing the four most prevalent carbapenemase types in Germany (KPC-2, KPC-3, OXA-48, NDM-1). Isolates were processed via illumina NGS. Data were analysed using different SNP-based mapping and de-novo assembly approaches. Relevant information was extracted from NGS data (antibiotic resistance determinants, wzi gene/cps type, virulence genes). NGS data from the present study were also compared with 238 genome data from two previous international studies on K. pneumoniae.

Results

NGS-based analyses revealed a preferred prevalence of KPC-2-producing ST258 and KPC-3-producing ST512 isolates. OXA-48, being the most prevalent carbapenemase type in Germany, was associated with various K. pneumoniae strain types; most of them possessing IncL/M plasmid replicons suggesting a preferred dissemination of blaOXA-48 via this well-known plasmid type. Clusters ST15, ST147, ST258, and ST512 demonstrated an intermingled subset structure consisting of German and other European K. pneumoniae isolates. ST23 being the most frequent MLST type in Asia was found only once in Germany. This latter isolate contained an almost complete set of virulence genes and a K1 capsule suggesting occurrence of a hypervirulent ST23 strain producing OXA-48 in Germany.

Conclusions

Our study results suggest prevalence of “classical” K. pneumonaie strain types associated with widely distributed carbapenemase genes such as ST258/KPC-2 or ST512/KPC-3 also in Germany. The finding of a supposed hypervirulent and OXA-48-producing ST23 K. pneumoniae isolates outside Asia is highly worrisome and requires intense molecular surveillance.
Body image in paediatric burns: a review
Authors: King Ian C. C.
Published: May 2018

Burn injuries in children can result in life-long disfigurement. As medical and surgical techniques of burn management improve survival prospects more than ever before, body image adjustment is increasingly a central consideration in the care of burn-injured individuals. An appreciation that both physiological and psychosocial processes underpin such injuries is key to understanding wound healing. Perceptions of idealized body images in Western society challenge children and their families as they grow up with and adapt to disfigurement from burns. Whilst many studies have examined the psychosocial recovery of adults with burn injuries, few have considered the impact on burn-injured children. This paper explores the models of body image and discusses the relevance of these to research and practice in understanding how to manage burns in children.
Managing portal hypertension in patients with liver cirrhosis
Authors: Sauerbruch Tilman , Schierwagen Robert , Trebicka Jonel
Published: May 2018

Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous. Systemic drugs, such as non-selective beta-blockers, statins, or antibiotics, reduce portal hypertension by decreasing intrahepatic resistance or portal tributary blood flow or by blunting inflammatory stimuli inside and outside the liver. Here, the interactions among the gut, liver, and brain are increasingly examined for new therapeutic options. There is no general panacea. The interruption of initiating factors is key. If not possible or if not possible in a timely manner, combined approaches should receive more attention before considering liver transplantation.
Interactive Excel-Based Procedure for Line Balancing
Authors: Wellington John F. , Lewis Stephen A.
Published: May 2018

The assignment of tasks to workstations that results in the assembly of an item or provision of a service is a common topic of discussion in operations management (OM) courses. In this paper, we present an interactive Excel spreadsheet assisted procedure for assigning the required tasks. The procedure actively engages the student in the process and serves as a tool for learning how to effectively and efficiently assign the tasks to a series (line) of connected workstations. The Excel implementation provides more flexibility in selecting tasks than textbook or other Excel based methods that rely on certain priority rules, and is considerably easier to use than math programming models. The procedure and its spreadsheet implementation are illustrated and discussed, with an example.
Case Article—Converting Zip Code Data into Distances: A Case Study for Teaching Business Analytics
Authors: Huggins Eric
Published: May 2018

In this case study, we demonstrate how to convert a column of zip code data into approximate distances from a default zip code using only standard Microsoft (MS) Excel functions and a free zip code database available online. We illustrate one example of analytics that may be applied to these distances with real data. The Case Article discusses our experiences in teaching the case and highlights the positive aspects of it. In the Case Study, we develop a hypothetical scenario in order to convey the value of being able to convert standard zip code data into distances to the students reading the case. Finally, the Case Teaching Note provides guidance regarding classroom discussion as well as specific instructions for developing the MS Excel spreadsheet.

The Case Teaching Note and final product example are available at https://www.informs.org/Publications/Subscribe/Access-Restricted-Materials .
Pareceristas Ad Hoc
Authors: Ekstasis Revista
Published: May 2018

Listagem de Pareceristas Ad Hoc - vol. 6 n.1 (2017)
Repensar o dito humano em sua relação com a psicologia a partir de Martin Heidegger
Authors: Gill Debora
Published: May 2018

Esta pesquisa tem como objetivo apontar os desdobramentos de Martin Heidegger a partir do modo como ele compreende e repensa o dito humano e sua relação com a psicologia, mostrando os limites estabelecidos pelo autor para a concepção de sujeito na ciência moderna, base do pensamento psicológico. Este trabalho terá como foco a obra Seminários de Zollikon (1959-1969/2001), buscando dialogar com outras obras em que a compreensão de humano é trazida de maneira clara, tais como: Ser e tempo (1927/2009) e carta Sobre o humanismo (1947/1973). O texto contará ainda com a conferência Identidade e diferença (1957/1973), abordando o pensamento mais tardio do autor. O artigo apresentado não terá como objetivo fechar uma conclusão, mas apresentar uma nova forma de repensar o humano a partir de Heidegger, desdobrando suas críticas à tradição e possíveis limites que porventura possam surgir em seu pensamento.
Apontamentos acerca de um tratamento da ciência sob a perspectiva da fenomenologia-hermenêutica
Authors: Tolfo Rogério
Published: May 2018

Neste trabalho visamos apontar para a possibilidade de um tratamentodiferenciado no debate sobre a ciência. Em Ser e Tempo, Heidegger realizaapontamentos sobre um tratamento fenomenológico-hermenêutico sobre aciência. Este tratamento da ciência pode ser realizado considerando-se tanto oâmbito da existência inautêntica, quanto da existência autêntica. Nestaperspectiva, veremos que as noções de temporalidade e historicidadedesempenham um papel decisivo.
Editorial
Authors: Guimarães Deborah Moreira
Published: May 2018

Editorial vol. 6 n.2
Repealing the Eighth Amendment
Authors: Nevill Michael , Murphy Clare
Published: May 2018

The Republic of Ireland this month faces a historic referendum on the future of abortion in the country. Michael Nevill and Clare Murphy set out the issues at stake and the implications for the UK
25 years of BJM
Authors: Lavender Dame Tina , Richens Yana
Published: May 2018

After many years spent at the helm of British Journal of Midwifery, Dame Tina Lavender and Yana Richens OBE reflect on what has changed
Back on the ward
Authors: Cliffe Jonathan
Published: May 2018

BJM is not alone in celebrating its 25th birthday this year. Midwife Jonathan Cliffe describes returning to the hospital in which he was born in 1993
Introducing a preterm surveillance clinic to manage high-risk women
Authors: Dyer Ellen , Rowley Amanda , Mannu Una , Hoveyda Fatemeh
Published: May 2018

Preterm birth, or birth before 37 weeks, is a leading cause of morbidity and mortality in babies. Dedicated preterm surveillance clinics have been shown to be an effective way of managing high-risk women. Given the lack of national guidance on the specifics of preterm surveillance, the aim of this article is to discuss the practicalities of establishing a dedicated preterm surveillance clinic; specifically how to identify high-risk women, what surveillance can be offered, how to standardise the transvaginal ultrasound cervical assessment, and suggested management pathways.
Are women empowered to make decisions about the use of antidepressants in pregnancy?
Authors: Randall Lorna , Briscoe Lesley
Published: May 2018

Background

Untreated depression is related to maternal mortality and morbidity. The most frequent treatment is antidepressant medication, but studies have shown that women find decisions about the use of antidepressants in pregnancy difficult and confusing.

Aim

To explain if women are empowered to make decisions around the use of antidepressants in pregnancy.

Methods

A literature review was conducted using CINAHL Complete, Intermid, Proquest and Discover More.

Findings

Information provision was inadequate and women experienced decisional conflict. Women wanted to be involved in a collaborative decision-making process.

Conclusions

Women want to be provided with clear and accurate information and prefer to collaborate when making decisions about antidepressants in pregnancy. More research is needed to explore demographic gaps within population samples, and women's experiences of decision-making about antidepressant usage. Undergraduate and postgraduate health education should include conversation skills training, associated with collaborative discussion and informed choice.
Embedding evidence-based practice within the pre-registration midwifery curriculum
Authors: Spencer Rachael L , Yuill Onje
Published: May 2018

Clinical midwifery skills and understanding are continually changing in line with research evidence and service innovations. Evidence-based midwifery practice is essential to ensuring that the care provided to childbearing women is safe, effective and of the best quality to meet their individual needs. To deliver woman-centred care, evidence from research should be considered in conjunction with clinical experience and women's own preferences. One of the challenges for Higher Education Institutions that offer pre-registration midwifery education is to incorporate evidence-based practice across the curriculum so that student midwives see it as an integral part of their role, rather than as a separate concept. Midwifery students need the knowledge and skills to identify areas of practice in need of investigation, an understanding of how each stage of the research process works, and the skills to critique research studies to ensure that their practice is evidence-based.
Surgical correction of a herniated bladder in a 6-year-old male entire rabbit (Oryctolagus cuniculus)
Authors: Temple Vicki
Published: May 2018

Bladder herniation is an uncommonly reported finding in rabbits. This case describes the anaesthesia, analgesia, surgical correction and perioperative management of the entrapped urinary bladder in a male entire rabbit (Oryctolagus cuniculus) originally presented to the clinician as having an extra-abdominal mass. In this rabbit, calcium excreted in the rabbit's urine caused a thick ‘sludge’ to form within the herniated portion of the bladder, resulting in a firm mass that initially appeared to be a neoplastic lesion. Veterinary surgeons are encouraged to consider bladder herniation and entrapment as a rare but possible differential diagnosis for a subcutaneous caudal abdominal or inguinal mass.
WVS ‘Return to Work’ surgical courses: double benefits
Authors: King Emily
Published: May 2018

‘Return to work’ surgical courses, run by Worldwide Veterinary Service (WVS) in Thailand, have double benefits: providing a valuable service in the local region, while enabling veterinary surgeons who are returning to work after a career break to re-familiarise themselves with surgical skills in a supportive environment.
Physiotherapists' experiences of respiratory compromise in patients with Parkinson's disease: A qualitative study
Authors: Walker Nikki , Cross Jane
Published: May 2018

Background/Aims:

To explore the experiences and perceptions of physiotherapists involved in the care of people with Parkinson's disease and respiratory compromise.

Methods:

This exploratory qualitative study recruited four physiotherapists who participated in a focus group and completed reflective diaries over a 3-month period. Experiences were explored using Interpretative Phenomenological Analysis.

Findings:

The study highlights three key themes: application of professional knowledge, application of clinical decision making and challenges to application of care.

Conclusions:

The results demonstrate sensitive awareness in caring for a dependent and vulnerable population whose key motor signs, compounded by ageing are perceived as influencing the presentation of respiratory compromise. There are descriptions of a reactive response to illness, alongside reflections on the challenges faced when asserting autonomy and recognising where the role of physiotherapy fits within the multidisciplinary team. Sputum clearance is perceived as being a key aspect of this role, although there is uncertainty with regard to the effectiveness and appropriateness of treatment options. Multiple perceived challenges to care provision are highlighted, with key concerns surrounding clinician and patient knowledge levels, maintenance of patient mobility, person-centred care and clarity in the direction of care.
Travelling with children: What the practice nurse needs to know
Authors: Brewer Catherine
Published: May 2018

Travelling with children can require careful planning. Catherine Brewer covers the practical considerations when providing travel advice to families

Travelling with children needs careful planning and consideration. Practice nurses need to ensure that they carry out effective risk assessments to highlight potential health issues for different age categories. Risks will generally differ from adults and some vaccines are not licensed for young infants or children. This needs to be understood by the parents or carers. Areas of particular risk are malaria, food- and water-borne illnesses, rabies, sunburn and the potential for accident. If children become unwell the consequences can be more serious, so understanding when and how to access medical facilities is vital. There is also other practical advice about travelling with children that can be imparted to the parents to try to ensure a healthy and happy experience for all.
Invasive meningococcal disease: Which vaccines protect against it?
Authors: Ford Karen J
Published: May 2018

Invasive meningococcal disease is a rare, but life-threatening cause of meningitis and septicaemia. Karen Ford describes the disease and causative bacteria, and provides a summary of the vaccines used to prevent it

Invasive meningococcal disease is a rare, but life-threatening cause of meningitis and septicaemia. The highest disease rates are seen in infants and in late adolescence. Several vaccines have been licensed to protect against some types of this devastating disease. This article describes invasive meningococcal disease and the causative bacteria, then provides a summary of the UK meningococcal vaccination programme.
Differences between the use of PGDs and PSDs in primary care
Authors: Adsley Rosemary
Published: May 2018

Rosemary Adsley provides an overview of Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) and highlights their similarities and differences

The use of both Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) is commonplace in primary care. This article will provide a brief overview of the two directions and highlight some similarities and differences between them. It will also provide examples of the situations where each type of direction is currently used and discuss some of the benefits that one type of direction may have over another in certain situations.
RESEARCH ROUNDUP
Authors: Winter George
Published: May 2018

George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
Robotics in oral and maxillofacial surgery
Authors: Borumandi F , Cascarini L
Published: May 2018

How trans-oral robotic surgery can treat cancer in the oropharyngyal space
Robotic oesophago-gastric cancer surgery
Authors: Qureshi YA , Mohammadi B
Published: May 2018

A postoperative complications rate of nearly 50% has compelled oesophago-gastric practice to adopt minimally invasive techniques such as robotic surgery
A PERCEPÇÃO DOS VISITANTES DE FERNANDO DE NORONHA (PE): Estudo de Caso do Projeto TAMAR
Authors: Ricardo Javier Hurtado Alvarez , Neto Lourival Dutra , Moreira Jasmine Cardozo
Published: May 2018

Em 1984 o Projeto TAMAR criou uma base em Fernando de Noronha, arquipélago com grande fluxo turístico, onde realiza atividades de conservação, pesquisa científica e educação ambiental em função da preservação das espécies de tartarugas marinhas que ocorrem no Brasil. No Centro de Visitantes do Projeto TAMAR em Fernando de Noronha há um Livro de Sugestões/Reclamações, onde os visitantes podem deixar a sua opinião sobre aspectos gerais da ilha. O objetivo foi verificar, nos 96 comentários deixados em 2016 no Livro de Sugestões/Reclamações, a percepção do visitante e o que pode ser melhorado no Arquipélago, além de classificar os comentários, de forma que possam ser direcionados para as devidas instituições. Como resultados observou-se que podem ser melhorados aspectos referentes à infraestrutura, às prestações de serviços e ao turismo sustentável.
O RESGATE HISTÓRICO NA GASTRONOMIA: Um Elemento de Contribuição ao Fomento Turístico no Extremo Sul Catarinense
Authors: Eltermann Eddy Ervin , Alves Catarina Roese , Oliveira Cleomar de
Published: May 2018

O presente estudo pretende desenvolver a discussão em torno do resgate gastronômico como inspiração para o desenvolvimento da formação cultural. Pretende-se, a partir do olhar histórico, resgatar a cultura de alimentos do Extremo Sul Catarinense, como a minestra, a galinha com polenta, a solda de ovos e o pirão de peixe, essenciais na sobrevivência de algumas famílias e ligados emocionalmente aos cidadãos mais antigos do município. Procurou-se, portanto, a partir de entrevistas, perceber quais os pratos mais importantes da cultura gastronômica local e, promover o debate em torno da necessidade de empreendedores do ramo da gastronomia voltar a oferta-los na região.
TURISMO SUSTENTÁVEL NA COMUNIDADE CHÃ DE JARDIM EM AREIA/PB
Authors: Coelho Mendes Francisco , Medeiros Detmering Priscilla Helen
Published: May 2018

Visando minimizar os impactos socioambientais, socioculturais e econômicos, surgiu o turismo sustentável. Portanto, este estudo tem por objetivo caracterizar como a Associação para o Desenvolvimento Sustentável da Comunidade de Chã de Jardim (ADESCO), em Areia na Paraíba, desenvolve o turismo, e quais as ações e os incentivos que a associação mantém para perpetuar a prática da sustentabilidade na comunidade. A metodologia adotada é do tipo pesquisa qualitativa e descritiva, de caráter exploratório, com base no levantamento bibliográfico, consulta documental e pesquisa de campo (visita técnica e entrevista). Os resultados mostram que a ADESCO, através de ações, estratégias e projetos, ajuda desenvolver o turismo criativo, responsável e sustentável, pensando-se no bem-estar das pessoas, no bem receber o turista, e na sustentabilidade do meio ambiente e dos recursos naturais.
Epidemiología y efectos de los nemátodes gastrointestinales en la recría bovina en el Chaco semiárido salteño
Authors: SUAREZ Victor H. , ARAOZ Virginia , MICHELOUD Juan F. , VIÑABAL Alberto E.
Published: May 2018

El objetivo del presente trabajo fue estudiar la epidemiología y el efecto de los nematodes gastrointestinales (NGI) en la recría bovina en la región del chaco semiárido de Salta. Desde marzo 2016 a febrero 2017 se formaron tres grupos de 20 terneras de recría: GMXD tratamiento cada 45 días con moxidectina (200 μg/kg), GIVM 1 solo tratamiento al inicio del ensayo con ivermectina 3,15% LA (630 μg/kg) y GCON control sin tratamiento. Cada 45 días se realizaron conteos de huevos (hpg) de nematodes y coprocultivos y se registró la ganancia de peso vivo (GPV). Al inicio los hpg fueron bajos ( 102±77) elevándose en el GCON hacia mediados del invierno ( =1049±1040), para luego descender hacia el final del ensayo, luego de un pico a mediados de la primavera ( =667±928). Los hpg del GIVM mostraron solo un descenso parcial (37,3%) postratamiento y el GMXD siempre tuvo valores de hpg muy bajos, mostrando la eficacia de la moxidectina.  Los géneros de nematodes predominantes fueron Haemonchus (47,1%) y Cooperia (45,9%). El efecto de los tratamientos se evidenció desde fines de otoño, mostrando el GMXD una mayor GPV (p<0,04) al final del invierno, comparado con los otros dos grupos. Al final del ensayo, las GPV totales del GMXD (146,5 kg) fueron significativamente (p<0,008) mayores que las del GIVM (111,0 kg) y del GCON (105,2 kg). Estos resultados muestran un pico del hpg a mediados de invierno, a Haemonchus y Cooperia como géneros predominantes y un efecto negativo en la GPV de la recría.
Measuring /s/ variation among younger generations in a migrant settlement in Lima, Peru
Authors: Klee Carol A. , Rogers Brandon M. A. , Caravedo Rocío , Dietz Lindsey
Published: May 2018

This study analyzes the pronunciation of /s/ in the Spanish of young adults in a newer migrant settlement in metropolitan Lima, Peru. The participants have parents and/or grandparents who migrated to Lima primarily from the Andean provinces, where the sibilant pronunciation of /s/ prevails. The study examines a variety of social factors, including migrant generation, family origin, gender, education, occupation, and social networks to determine the factors that correlate with /s/ weakening, which is more prevalent in ClassicLimeñoSpanish than in Andean Spanish (Caravedo 1990; Hundley 1983; Klee and Caravedo 2006). A proportional-odds mixed effects model was used to treat the repeated measurement categorical data on a continuum of acoustical variation ([s]>[h]>Ø) and the advantages of this model are explained. Results indicate that an important social predictor of /s/ variation is migrant generation: there is a progressive weakening in /s/ with each subsequent migrant generation. In addition to the generational effect, higher levels of education correlate with less /s/ weakening. Two variables were more weakly correlated with /s/ pronunciation: gender and social networks. Overall, the results indicate that young adults in this community, especially those of the third-generation, seem to be assimilating to some degree to coastal norms of /s/ weakening, although there is also a possibility that they may be forming their own norm.
Rhotics of Taos, New Mexico Spanish: Variation and Change
Authors: Vigil Donny A.
Published: May 2018

Although some researchers report the normative production of the rhotics in Traditional New Mexico Spanish, others have reported variability, including the presence of an English-like vocalized rhotic. In the present study, 29 speakers of Spanish from Taos, a city in northern New Mexico, were interviewed and the rhotics of their speech were categorized, quantified and analyzed using speech analysis and multivariate statistical analysis software. The results show variation and change when compared to previous reports (both recent and of over a century ago). In spontaneous and elicited speech, ten distinct rhotic variants, subsequently recoded into five categories, were observed and quantified. Moreover, approximant and assibilated variants have notable frequencies and conditioning factors. VARBRUL analyses reveal phonological context, stress, word position, age, and sex as significant conditioning factors.
Advertising Indians
Authors: Oatsvall Neil
Published: May 2018

Mountain Valley Spring Company (Hot Springs, Arkansas), the nation's first coast-to-coast bottled water company, ran an advertisement in 1939 that conflated American Indians and the natural world. While the company thought that it was selling bottled water by drawing upon a local myth that Hernando De Soto visited the area in 1541, in actuality it tapped into darker themes of conquest, exploitation, and co-opting the bodies of indigenous peoples into white American cultural conceptions of nature and health. This article contends that the Mountain Valley advertisement is indicative of many other advertisements at the time that functioned as the last step in normalizing indigenous people's conquest by the United States into dominant U.S. culture. Doing so allowed whites to experience both their conquest and the natural world in new ways by paying homage to the land's seemingly long-gone original inhabitants. The advertisement not only reflected dominant ideas about American Indians in U.S. society but actually helped to metaphysically reconquer peoples who were physically conquered long before.
The Promising and Unchangeable Impact of Education on Life
Authors: Flough Shrew
Published: May 2018

Education and life are entwined because life without education is almost impossible and education without life is definitely impossible. According to Guigno, (2017, May 4th), “Once you stop learning you start dying”. This is very true because as you live, you learn either consciously and unconsciously. The kids of today are geared up to become adult citizens of tomorrow; their growth is parallel to the future of our country which is reflected in the quality of our present educational system. It is widely accepted and recognized that learning is an instrument through which children’s personality and the way they deal with situations of life can be shaped and develop. This shift of thoughts from bookish knowledge to know about life and character development in the educational system has brought about magnificent changes in the lives of students and learners. People have started to see the fact that education is an essential key to a well-rounded development instead of the old mentality of just acquiring a degree and monetary success in life.
Composition, trophic structure and activity patterns of the understory bats of the Bitaco Forest Reserve
Authors: Ferro Muñoz Natalia , Giraldo Alan , Murillo García Oscar Enrique
Published: May 2018

En el presente trabajo se describe la composición y estructura trófica, y se evalúa el efecto de la temperatura ambiental y la precipitación sobre el patrón de actividad nocturna de los murciélagos de sotobosque que habitan que un bosque Andino, para la primera mitad de la noche. Para esto se realizaron siete campañas de muestreo, con una duración de seis noches cada una, en las que se utilizaron diez redes de niebla que operaron entre las 18:00 y 00:00 horas, siendo revisadas cada hora. Además, se registró la temperatura ambiental y la precipitación durante los eventos de muestreo. El ensamblaje de murciélagos de sotobosque del área de estudio estuvo representado principalmente por especies frugívoras, y dentro de este gremio, se registró una menor riqueza de especies nómadas que sedentarias. La actividad de los murciélagos, para la primera mitad de la noche, fue máxima entre las 18:00 y 19:00 horas, disminuyendo hasta alcanzar una actividad mínima entre las 22:00 y 23:00 horas. El modelo más adecuado para explicar la variación en las capturas de murciélagos incluyó sólo el efecto de la temperatura ambiental, la cual afectó positivamente el número de capturas. En conclusión, para el periodo evaluado, la actividad del ensamble de murciélagos de sotobosque en el área de estudio no se relacionó con la precipitación y exhibió relación leve pero significativa con la temperatura ambiental.