bluuebunny/crossref_metadata_2025 huggingface dataset:
Update on the Global Energy Dissipation Rate of Deep-Ocean Low-Frequency Flows by Bottom Boundary Layer
Authors: Huang Chao , Xu Yongsheng
Published: January 2018

The global dissipation caused by bottom boundary layer drag is one of the major pathways for the consumption of kinetic energy in the deep ocean. However, the spatial distribution and global integral of the drag dissipation are still debatable. This paper presents an updated estimate of the dissipation rate, using the barotropic component of surface geostrophic currents and 632 in situ velocity measurements. Also, the seafloor roughness is proposed as a parameter of drag efficiency in the parameterized method. The results provide a map of the drag dissipation rate with a global integral of ~0.26 TW. Approximately 66% of this dissipation occurs in the Southern Ocean, which is consistent with the proportion of wind power input into this region. Building upon the work in previous studies on the bottom boundary layer drag, more long-period observations are used, eliminating the influence of the baroclinic contribution to the surface geostrophic currents in the construction of the bottom velocity, and taking topographic roughness into account. The estimates have implications for the maintenance of density structure in the deep ocean and understanding of the kinetic energy budget.
Gnomons at Meroë and Early Trigonometry
Authors: Depuydt Leo
Published: January 2018

Angles of the sun and shadows at Meroë at significant annual dates are given. Three graffiti in building 950 at Meroë, previously published by Garstang and probably dating to the first century BC or the first century AD, are discussed in the light of their astronomical implications. A new interpretation identifies a gnomon, an instrument that measures shadows, and its significance for the early history of trigonometry is noted. In one instance observation of the summer solstice at Meroë is suggested.
An Insect Study from Egyptian Stored Products in the Liverpool Museum
Authors: Panagiotakopulu Eva
Published: January 2018

A report on insect pests from botanical remains kept at the Liverpool Museum.
The Voice of Authority: Papyrus Leiden I 382
Authors: Ray J. D.
Published: January 2018

Papyrus Leiden I 382 is a demotic administrative letter, probably from the beginning of the Ptolemaic Period. The writer of the letter is clearly a person of importance, who loses no time in reprimanding a temple scribe over a series of matters which have gone amiss. Its intrinsic interest, and the idiomatic language it contains, justify separate publication.
Transfer of Technology to Promote Entrepreneurship in Developing Countries: An Integration and Proposed Framework
Authors: Lado Augustine A. , Vozikis George S.
Published: January 2018

That entrepreneurship is vitally important to the economic development of a nation Is Indubitable. However, divergent approaches to promoting and fostering entrepreneurial development in the developing countries have been suggested. This paper explores the role of technology transfer to promote entrepreneurship in the LDCs. We argue that entrepreneurial development depends, among other things, on the technology content and context, mode of technology transfer, the recipient country's level of economic development, and the absorptive capacity of local firms. Propositions and implications are offered to guide future research and practice in international entreprenuership.
Venture Capitalist and CEO Dismissal
Authors: Bruton Garry , Fried Vance , Hisrich Robert D.
Published: January 2018

This exploratory research utilized a nationwide survey to examine CEO dismissals by boards of directors on which venture capitalists serve. The findings demonstrate that it is a CEO's failure in strategic concerns, rather than operational ones, that typically lead to CEO dismissal. In addition, replacing a CEO typically has a strong positive effect on new venture performance. These performance gains are not significantly different if replacement CEOs are internal or external to the venture.
The Monitoring of Venture Capital Firms
Authors: Robbie Ken , Wright Mike , Chiplin Brian
Published: January 2018

This paper analyzes the monitoring of venture capital firms by their funds providers, which has been hitherto generally neglected by academic researchers. The changing nature of competition in a mature market has introduced increased pressures for the enhanced monitoring of venture capital firms, especially in relation to target returns and reporting requirements. The paper provides evidence on the nature and extent of these monitoring arrangements derived from interviews and a questionnaire survey of leading players in the UK market.
Time and Entrepreneurial Risk Behavior
Authors: Das T. K. , Teng Bing-Sheng
Published: January 2018

Risk and risk behavior form an important segment of the entrepreneurship literature. Entrepreneurial risk behavior has been studied with both trait and cognitive approaches, but the findings do not adequately explain either how entrepreneurs differ from non-entrepreneurs, or how different types of entrepreneurs can be specified in terms of their risk behavior. This paper is an attempt to address these issues by introducing two temporal attributes that we consider significant for understanding risk behavior, given that risk is inherently embedded in time. First, we suggest the notion of risk horizon, differentiating short-range risk from long-range risk. Second, we examine the risk behavior of entrepreneurs in terms of their individual future orientation, in tandem with their risk propensity. We propose a temporal framework that seeks to explain, at once, the different types of risk behavior among entrepreneurs as well as the distinction between entrepreneurs and non-entrepreneurs. The framework is also applied to networking and alliancing activities of entrepreneurs. Finally, a number of propositions are developed to facilitate empirical testing of the insights implicit in the temporal framework of entrepreneurial risk behavior.
Wah Hoi Industrial Company
Authors: Walters Peter G. P. , Sai-Chung Leslie Yip
Published: January 2018

The changing environment faced by Hong Kong-based entrepreneurs undertaking production in southern China provides the broad context for the Wah Hoi case. Since starting production in Guangdong province in 1988, Wah Hoi has grown rapidly. However, in the mid-1990s, the founder and owner of Wah Hoi, Mr. Fred Mok, has to address a number of problems. These include a need to re-evaluate several joint venture agreements; pressures from cost inflation and regulatory changes in China; a tough competitive environment in overseas markets; and policy issues relating to Wah Hoi's international marketing strategy.
Interleukin-18 diagnostically distinguishes and pathogenically promotes human and murine macrophage activation syndrome
Authors: Weiss Eric S. , Girard-Guyonvarc’h Charlotte , Holzinger Dirk , de Jesus Adriana A. , Tariq Zeshan , Picarsic Jennifer , Schiffrin Eduardo J. , Foell Dirk , Grom Alexei A. , Ammann Sandra , Ehl Stephan , Hoshino Tomoaki , Goldbach-Mansky Raphaela , Gabay Cem , Canna Scott W.
Published: January 2018

Key Points

IL-18 distinguishes susceptibility to MAS amongst hyperferritinemic and autoinflammatory diseases. Excess IL-18 in NLRC4 gain-of-function mice derives from intestinal epithelia, and free IL-18 promotes experimental MAS.
Managing Patients With Oligometastatic Non–Small-Cell Lung Cancer
Authors: Stephens Sarah Jo , Moravan Michael J. , Salama Joseph K.
Published: January 2018

Metastatic lung cancer has long been considered incurable, with the goal of treatment being palliation. However, a clinically meaningful number of these patients with limited metastases (approximately 25%) are living long term after definitive treatment to all sites of active disease. These patients with so-called oligometastatic disease likely represent a distinct clinical group who may possess a more indolent biology compared with their more widely metastatic counterparts. Hellman and Weichselbaum proposed the existence of the oligometastatic state, on the basis of the spectrum theory of cancer spread. The literature suggests that an oligometastatic state exists in patients with non–small-cell lung cancer (NSCLC). This observation in the setting of rapidly evolving systemic therapies, including immune checkpoint inhibitors and an increasing number of targeted therapies, represents a unique clinical opportunity. Metastasis-directed therapies to address sites of disease include surgery (metastasectomy) and/or radiation therapy. Available evidence suggests that treating patients with limited or oligometastases may improve outcomes in a meaningful way; however, the majority of the randomized data includes patients with intracranial metastatic disease, and there are limited robust, randomized data available in the setting of NSCLC with only extracranial sites of metastatic disease. Ongoing randomized trials, including NRG-LU002 and the UK Conventional Care Versus Radioablation (Stereotactic Body Radiotherapy) for Extracranial Oligometastases trial, are aimed at evaluating this question further. One of the current limitations of aggressive treatment of oligometastatic NSCLC is the inability to accurately identify these patients before therapy, yet molecular markers, including microRNA profiles, are being investigated as a promising way to identify these patients.
Increases in IGF-1 After Anti–TNF-α Therapy Are Associated With Bone and Muscle Accrual in Pediatric Crohn Disease
Authors: DeBoer Mark D , Lee Arthur M , Herbert Kirabo , Long Jin , Thayu Meena , Griffin Lindsay M , Baldassano Robert N , Denson Lee A , Zemel Babette S , Denburg Michelle R , Herskovitz Rita , Leonard Mary B
Published: January 2018

Context

Low levels of insulinlike growth factor 1 (IGF-1) in pediatric and adolescent Crohn disease (CD) likely contribute to bone and muscle deficits.

Objective

Assess changes in IGF-1 levels and associations with bone and muscle accrual following initiation of anti–tumor necrosis factor α (TNF-α) therapy in pediatric and adolescent CD.

Design and Participants

Participants (n = 75, age 5 to 21 years) with CD were enrolled in a prospective cohort study; 63 completed the 12-month visit.

Main Outcome Measures

IGF-1 levels at baseline and 10 weeks, as well as dual-energy x-ray absorptiometry (DXA) and tibia peripheral quantitative computed tomography (pQCT) measures of bone and muscle at baseline and 12 months after initiation of anti–TNF-α therapy. Outcomes were expressed as sex-specific z scores.

Results

IGF-1 z scores increased from a median (interquartile range) of −1.0 (−1.58 to −0.17) to −0.36 (−1.04 to 0.36) over 10 weeks (P < 0.001). Lesser disease severity and systemic inflammation, as well as greater estradiol z scores (in girls), was significantly associated with greater IGF-1 z scores over time. DXA whole-body bone mineral content, leg lean mass, and total hip and femoral neck bone mineral density (BMD) z scores were low at baseline (P < 0.0001 vs reference data) and increased significantly (P < 0.001) over 12 months. Greater increases in IGF-1 z scores over 10 weeks predicted improvement in DXA bone and muscle outcomes and pQCT trabecular BMD and cortical area. Adjustment for changes in muscle mass markedly attenuated the associations between IGF-1 levels and bone outcomes.

Conclusions

Short-term improvements in IGF-1 z scores predicted recovery of bone and muscle outcomes following initiation of anti–TNF-α therapy in pediatric CD. These data suggest that disease effects on growth hormone metabolism contribute to musculoskeletal deficits in CD.
α-Asarone Alleviated Chronic Constriction Injury–Induced Neuropathic Pain Through Inhibition of Spinal Endoplasmic Reticulum Stress in an Liver X Receptor–Dependent Manner
Authors: Gui Yulong , Li Aiyuan , Zhang Jie , Li Guan , Ruan Xia , Guo Qulian , Zou Wangyuan
Published: January 2018

BACKGROUND:

Neuropathic pain is an intractable and complex disease. Recent studies have shown a close relationship between endoplasmic reticulum (ER) stress and neuropathic pain. Here, we investigated the effect of α-asarone, an ER stress inhibitor, on chronic constriction injury (CCI)–induced neuropathic pain.

METHODS:

Two parts were included in this study. In part 1, rats were assigned to 7 groups: the sham group, the sham + α-asarone 20 mg/kg group, the CCI group, the CCI + vehicle group, the CCI + α-asarone 5 mg/kg group, the CCI + α-asarone 10 mg/kg group, and the CCI + α-asarone 20 mg/kg group. After surgery, the rats were treated with α-asarone or normal saline daily. Pain thresholds were measured, and samples of the L3–6 spinal cord were taken for western blotting and immunofluorescence on day 7. In part 2, rats were intrathecally implanted with PE-10 tubes and divided into 4 groups: the CCI + α-asarone 20 mg/kg group, the CCI + α-asarone 20 mg/kg + vehicle group, the CCI + α-asarone 20 mg/kg + SR9243 group, and the CCI group. Five rats in each group were separated for behavioral tests 1 hour after intrathecal injection. The rest of them were killed for western blotting on day 7.

RESULTS:

In this study, CCI surgery significantly induced mechanical allodynia and thermal hyperalgesia. CCI surgery significantly induced activation of ER stress (PERK-eIF2α, IRE1α, CHOP, and XBP-1s) in rats. However, treatment with 20 mg/kg of α-asarone significantly alleviated CCI-induced activation of ER stress. Behavioral results showed that daily treatment with 20 mg/kg of α-asarone significantly alleviated CCI-induced nociceptive behaviors, on day 7 (mechanical allodynia, P = .016, 95% confidence interval, 0.645–5.811; thermal hyperalgesia, P = .012, 95% confidence interval, 0.860–6.507). Furthermore, α-asarone induced upregulated expression of liver X receptor β (LXRβ) and downstream proteins in the spinal cord. The LXR antagonist SR9243 completely inhibited the anti-ER stress and antinociceptive effects of α-asarone in rats.

CONCLUSIONS:

α-Asarone relieved CCI-induced neuropathic pain in an LXR-dependent manner. α-Asarone may be a potential agent for treatment of neuropathic pain.
Physiological Responses to Overdressing and Exercise-Heat Stress in Trained Runners
Authors: ELY BRETT R. , BLANCHARD LAURIE A. , STEELE JARED R. , FRANCISCO MICHAEL A. , CHEUVRONT SAMUEL N. , MINSON CHRISTOPHER T.
Published: January 2018

Heat acclimation is the best strategy to improve performance in a hot environment. Many athletes seeking the benefits of heat acclimation lack access to a hot environment for exercise and, thus, rely on overdressing to simulate environmental heat stress. It is currently unknown whether this approach produces the requisite thermoregulatory strain necessary for heat acclimation in trained men and women.

Purpose

To compare physiological and cellular responses to exercise in a hot environment (HOT; 40°C, 30% RH) with minimal clothing (clo = 0.87) and in a temperate environment (CLO; 15°C, 50% RH) with overdressing (clo = 1.89) in both men and women.

Methods

HR, rectal temperature (T
re), mean skin temperature (T
sk), sweating rate (SR), and extracellular heat shock protein (eHSP)72 were measured in 13 (7 males, 6 females) well-trained runners (V˙O2max: 58.7 ± 10.7 mL·kg−1·min−1) in response to ~60 min of treadmill running at 50%–60% V˙O2max in HOT and CLO.

Results

T
re increased in both conditions, but the increase was greater in HOT (ΔT
re HOT: 2.6°C ± 0.1°C; CLO 2.0°C ± 0.1°C; P = 0.0003). SR was also higher in HOT (1.41 ± 0.1 L h−1; CLO: 1.16 ± 0.1 L·h−1; P = 0.0001). eHSP72 increased in HOT (% change: 59% ± 11%; P = 0.03) but not in CLO (6% ± 2%; P = 0.31). Mean T
sk and HR were not different between HOT and CLO in men but were higher in HOT for women.

Conclusion

These data support the idea that overdressing during exercise in a temperate environment may produce the high T
re, T
sk, HR, and SR necessary for adaptation, but these responses do not match those in hot, dry environments. It is possible that greater exercise stimulus, warmer environment, or more clothing may be required to allow for a similar level of acclimation.
Case Report: Non-infectious causes of palmoplantar rashes, what to consider
Authors: Advani Rashmi , Arad Danit
Published: January 2018

Background: Palm and sole skin eruptions have a broad differential diagnosis. It is particularly important to recognize common causes as well as their association with certain chemotherapy regimens such as Capecitabine.

Case report: A 79-year-old woman presented with a painful rash on her hands and feet for 1 week. She had metastatic colon cancer and was in her third week of treatment with capecitabine. Her diagnosis was a medication side-effect from chemotherapy. Capecitabine was stopped and she had some clinical improvement over the next two days. She was discharged with oncology follow up for resumption of Capecitabine at a lower dose with improvement in her rash 3 weeks later. 

Discussion: Skin rashes are a commonly encountered complaint in patients in the inpatient and outpatient setting. It is important to maintain a broad differential diagnosis in those with rashes of the palmoplantar surfaces of the hands and feet. Recognizing skin changes as a possible manifestation of underlying malignancy or a medication side-effect is key in appropriate diagnosis and treatment.
Basic midwifery care should be defined rather than devalued
Authors: Price Mary
Published: January 2018

Rupert Fawdry is an obstetrician who obviously values midwives. His editorial (Fawdry, 1994) is plausible and enthusiastic about the possible expansion of the role of midwives in the future. These ‘super-midwives’ could, it seems, only be true practitioners in their own right if they took responsibility for almost any eventuality. Those who did not wish to undertake procedures such as amniocentesis, ventouse extraction or even caesarean sections would not, by implication, be anything more than maternity nurses.
Sickle cell disease: a case to answer?
Authors: Adams Sarah
Published: January 2018

This article considers sickle cell disease, focusing on the disease itself and exploring the way that the British health care system conceptualises the condition and provides care for sufferers. It examines the types of patient who are commonly affected by this condition and whether this influences the way the disease is viewed and treated.
Pain relief in labour: an overview
Authors: Moore Sue
Published: January 2018

This article provides an overview of some of the physiological and psychological factors associated with pain relief in labour, together with some of the issues that midwives should acknowledge when supporting the woman in labour.
Midwives need to find the courage to change
Authors: Kurutac Judith
Published: January 2018

‘This committee must draw the conclusion that the policy of encouraging all women to give birth in hospitals cannot be justified on grounds of safety’ (House of Commons Select Committee statement, March 1992).
Evaluating a research article
Authors: Rees Colin
Published: January 2018

If practice is to be research-based, midwives need to be able to understand a research article quickly and efficiently. This article gives simple guidelines to help you consider some of the main elements involved in critiquing an article.
No place like hospital?
Authors: Campbell Rona , Macfarlane Alison
Published: January 2018

The place of childbirth seems to be changing as reflected by the slow but steady increase in the number of home births. This article examines the reasons behind this trend and discusses an updated review of the scientific evidence on place of birth, Where to be born? the debate and the evidence, which supports the proposals on place of birth made in Changing Childbirth.
Family planning: integral or additional to midwifery education?
Authors: Pacanowski Lynne
Published: January 2018

This article considers the depth of family planning knowledge required by midwives and explores how changes in the ENB 901 curriculum are making family planning courses more appropriate to the needs of individual practitioners.
How much of a problem are visitors on the labour suite?
Authors: Buckley Rosemary
Published: January 2018

Over the last few years, visitors have become a common sight in the labour suite. But has the pendulum swung too far? Overcrowding in rooms, invasion of privacy, rudeness and uncooperativeness have been reported in one maternity unit. What, if anything, can be done about it? This article examines these and other issues surrounding visitors to labour suites.
Service provision for sickle cell disease
Authors: Eboh Winifred , van den Akker Olga
Published: January 2018

This article examines the service provision for clients with sickle cell disease. Neonatal screening programmes for the detection of these disorders are examined, with particular emphasis on the follow-up system for neonates who are found to be carriers of sickle cell and the C haemoglobins.
Statutory regulation: what's in it for midwives?
Authors: Roch Sarah
Published: January 2018

Midwifery legislation is powerful and effective when understood and utilised properly. Midwives must be proactive in promoting good practice in a changing and challenging arena. Being knowledgeable and articulate will enable midwives to control and direct their own practice, education, supervision and research.
The English National Board
Authors: Page Lesley , Thomas Meryl
Published: January 2018

This is a crucial stage in the history of midwifery, when midwives have a unique opportunity to shape the future. The ENB is playing a key role in ensuring that women and their families will be at the centre of midwives' care, and is helping them to develop the skills and knowledge that will help women when their babies are born.
Prenatal cystic fibrosis carrier screening
Authors: Menuuie Moria
Published: January 2018

Each year in the UK around 300 babies are born with the genetic disease cystic fibrosis. In 4 out of 5 births there is no family history of the disorder and the parents of these children understandably ask ‘why us?’ This article outlines different aspects of the disease and the role that midwives play in delivering prescreening information and counseling.
Prevention and treatment of postnatal psychiatric disorders
Authors: Kumar R , Marks Maureen , Jackson Kate
Published: January 2018

This article discusses the aetiology, indicators of risk and possible treatments for postnatal depression. Midwives have a key preventive role in that they are in continuing contact with women who are at risk and are therefore in a position to detect early symptoms and arrange speedy referrals where appropriate.
Medicalisation of childbearing
Authors: Rothwell Heather
Published: January 2018

This article outlines how the medical profession, arising from a male-dominated society, has affected women's experience of childbearing and midwives' practice in the UK. The author offers an explanation of the origins of the present situation and how midwives can start to change it.
Establishing priorities for research: report of a Delphi survey
Authors: Sleep J , Renfrew MJ , Dunn A , Bowler U , Garcia J
Published: January 2018

The conduct of research that is relevant to midwives and to the midwifery profession has risen rapidly within the last 20 years in the UK. This three-round Delphi survey was designed to inform a research agenda which would reflect the issues of current concern within the maternity services.
Nurse-led epistaxis management within the emergency department
Authors: Hakim Navid , Mummadi Sangha Mitra , Jolly Karan , Dawson Julian , Darr Adnan
Published: January 2018

Background:

the incidence of epistaxis has increased secondary to increased life expectancy and morbidities. This study sought to assess the knowledge, practice and opinion relating to adequacy of training of advanced nurse practitioners (ANPs) and staff nurses (SNs) in the emergency department.

Methods:

a national survey was distributed over an 8-week period; this included a 3-point scoring system based on the National Institute for Health and Care Excellence Clinical Knowledge Summaries guidance on epistaxis management to assess overall performance.

Results:

analysis included 109 ANPs and 101 SNs; 12% of ANPs achieved the maximum score, 40% scored 2, 25% scored 1, and 23% scored 0, while 14% of SNs achieved the maximum score, 24% scored 2, 29% scored 1, and 32% scored 0. Overall 88% of respondents advocated further training.

Conclusion:

significant deficits in knowledge regarding epistaxis management were highlighted. Further training could help to empower patients in basic first aid measures, subsequently reducing admissions rates.
Respiratory muscle training
Authors: Chatham Ken
Published: January 2018

This article describes the various forms of respiratory muscle training and discusses the advantages of each approach. Measurements of respiratory muscle strength and endurance are described, and the limitations of each approach outlined. Finally, published data are briefly examined and suggestions for future research and clinical interventions proposed.
Macmillan carers: a practical approach to home care
Authors: Nash Ann
Published: January 2018

This article describes a service development in palliative care which aims to offer practical support and caring skills to patients and their families at home. The concept of home care in the UK distinguishes between health-care and social-care needs and workers are allocated from different departments to provide that care. Such a distinction is not always clear and there is much debate about how needs are split. The continued allocation of funding from separate health and social services resources exacerbates the issue. The Macmillan Carer Scheme, which offers both health and social care to patients and their families, is an important and significant step in the move towards needs-based service development.
Reflective practice: linking theory and practice in palliative care nursing
Authors: Durgahee Taleb
Published: January 2018

Reflection is a method of learning and teaching nursing through critical analysis of experience. In this study the illuminative research approach is used with students on a care of the dying course (at diploma level) to explore the benefits of reflective practice. The study concludes that the nurses showed an increase in critical thinking, listening and observation skills, and awareness of knowledge-in-use as a result of reflective learning and practice.
Care, autonomy and nurse education
Authors: Cook Edward David
Published: January 2018

Paternalism in medicine is giving way to consumerism. When doctors sneeze, nurses catch cold. Consumerism is having an equal affect on nursing. For example, patient autonomy is currently in vogue. A greater emphasis on the needs and wishes of patients is a much needed correction to the times when medical and nursing staff rode roughshod over those in their care. However, the danger is that we go too far and undermine the personal and professional integrity of nurses.
Palliative care and the ethics of resource allocation
Authors: Garrard Eve
Published: January 2018

Resources for health care are scarce, and dividing them fairly is both necessary and difficult. Palliative care has a claim on these resources because it is concerned with improving the quality of life of those who are dying. However, some standard ways of allocating resources, such as the use of Quality Adjusted Life Years (QALYs), do not favour the funding of palliative care. Even if this can be corrected, there are still problems of allocation within palliative care itself: a choice has to be made between funding a complete provision of care for some but not others, or using resources to provide a more basic service for all those who are in need.
Ethical issues in multicentre collaborative research on breathlessness in lung cancer
Authors: Bailey Christopher
Published: January 2018

This article describes, the ethical issues involved in developing a multicentre collaborative research project to evaluate a nurse-led clinic for breathlessness in patients with lung cancer. In this randomized controlled study, the framework of relationships between coordinating researchers and researchers in the collaborating centres, and between researchers in the collaborating centres and research participants, is identified as the focus of ethical attention. The principles of new paradigm and action research are identified as providing a basis for ethical research which focuses on the quality of the interaction between researcher and participant, and some parallels between this project and new paradigm research are explored.
Is there a place for euthanasia in palliative care?
Authors: Goodman Margaret L
Published: January 2018

In the current debate about the legalization of euthanasia the' distinction between giving care and bringing about death is blurred. Alongside this there is an apparent increased commitment to the further development of palliative care. Difficulties arise in palliative care when euthanasia is discussed as there is an inference that a request for euthanasia results from a failure on the part of the carers. Palliative care aims to relieve distress and suffering, but problems arise from unrealistic expectations of what can actually be achieved. There is a need for professionals to emphasize what is possible in relation to palliative care, to acknowledge that there are limitations, and to set realistic and carefully identified goals which are more likely to be achieved than impossible expectations which could induce individuals to consider euthanasia when impossible expectations are not reached. Euthanasia has an impact on the relationships between health-care professionals and their patients which give rise to a potential alteration of the traditional role.
Monitoring pressure sores in a palliative care setting
Authors: Hatcliffe Stella , Dawe Ruth
Published: January 2018

Pressure sore prevention and management represents a major challenge to palliative care nurses. The balance of promoting comfort, providing appropriate care and following patient wishes can lead to dilemmas in decision making. This prospective study set out to gather more in-depth information on the extent and nature of the problem of pressure sores within a hospice. Areas investigated included prevalence and incidence rates, site and stage of sores and associated pain. Assessment using the Waterlow at risk score demonstrated that the majority of patients were within the high or very high risk category. The results have been used to inform practice, influence resource decisions and set a benchmark for future monitoring.
The meaning of hope to palliative care cancer patients
Authors: Flemming Kate
Published: January 2018

This paper describes a phenomenological study which sought to explore the meaning of hope to patients with cancer who are receiving palliative care. A purposive sample of four patients was interviewed using a semi-structured format.

Content analysis of the themes arising from the transcripts identified three specific areas of meaning as influential in maintaining hope; the maintenance of the disease as it existed at the time of interview for the individual, underpinned by a hope for cure; the existence and presence of significant family members, and an anticipated future with them; the maintenance of a positive interest in the individual by health care professionals. All participants identified that loss of control over any of the hope maintaining factors, would cause loss of hope.

Within each description of hope were individual meanings. However, the generic themes described the essence of the phenomenon of hope. The study thus identified the existence of hope, its nature and meaning, for those who participated and is a starting point for further research in this area.
Signposts on the journey: the place of ritual in spiritual care
Authors: Froggatt Katherine
Published: January 2018

An exploration of the nature and function of rituals is undertaken in this paper to consider the importance and relevance of rituals in spiritual care, within the palliative care speciality. Understandings of ritual tend to focus on either their association with religious practices or ritualistic action. However, rituals can still provide a practical and symbolic way to facilitate change for individuals, both within an organisational context and in spiritual journeys within their own lives. Empirical work examining the hospice culture, using a rites of passage framework, illustrates how the presence of rituals within hospice care may be helpful for individuals experiencing the transition from life to death.
Dehydration and the dying patient
Authors: Roberts Anita Louise
Published: January 2018

The management of dehydration in the terminally ill is a complex and emotive issue. Some health care professionals contend that a reduced fluid intake may result in dehydration which is both painful and distressing for the patient. Conversely, others suggest that artificial hydration has not been proven to benefit dying patients and may even add to their distress both physically and psychologically. These benefits and burdens are also of great concern to the relatives of dying patients and the health professionals who care for them. This paper reviews the literature concerning the pathophysiology of dehydration and discusses the effects of dehydration on dying patients.
Problem and management of noisy rattling breathing in dying patients
Authors: Watts Tessa , Jenkins Kathleen , Back Ian
Published: January 2018

Noisy rattling breathing in dying patients is a symptom control problem which has attracted only a fleeting mention within the literature. This study investigated palliative care nurses' feelings about the problem and the management of noisy rattling breathing in dying patients. The aspects studied were based on the literature and multidis-ciplinary team discussion, and included nurses' feelings about the distress caused by noisy rattling breathing, their perceived confidence in providing related nursing care and their thoughts and feelings about the established care options. Data were gathered from a convenience sample of twenty three palliative care nurses by means of a questionnaire. This data was analysed using descriptive statistics. The results revealed that nurses perceived relatives to be particularly distressed by noisy rattling breathing, Several nurses felt that they lacked confidence in providing related nursing care and there was a felt need for clinical guidelines. The limitations of the study are discussed and the conclusion highlights the need for further research into this symptom control problem.
Making nutrition less stressful for people with dementia
Authors: Goss-Hill Beth
Published: January 2018

Dementia presents a range of problems during mealtimes that can make eating stressful. In this article, Beth Goss-Hill describes how simple interventions can play a large part in making mealtimes an enjoyable experience
What Causes to Tune a Condition of Exactly Identical Fault-Masks Behaviors in an LFSR based BIST Methodology
Authors: Ahmad A. , Al Abri D. , Al Busaidi S. S. , Bait-Suwailam M. M.
Published: January 2018

The authors show that in a Built-In Self-Test (BIST) technique, based on linear-feedback shift registers, when the feedback connections in pseudo-random test-sequence generator and signature analyzer are images of each other and corresponds to primitive characteristic polynomial then behaviors of faults masking remains identical. The simulation results of single stuck-at faults show how the use of such feedback connections in pseudo-random test-sequence generator and signature analyzer yields to mask the same faults.
A New Framework For Identifying the Missed Pilgrims In Hajj and Umrah
Authors: AlKhateeb Jawad
Published: January 2018

A new framework recognition system for identifying the missed pilgrims in Hajj and Umrah is presented in this paper. The framework recognition system is based on the Wavelet Probabilistic Neural Network (WPNN) classifier. The entire framework recognition system is capable of identifying the missed pilgrims. The framework recognition systems is developed as an application for mobile phones The proposed framework recognition system is applied to a huge database for pilgrims in the Ministry of Hajj Computer server for matching and identifying the missed pilgrim. The results are superior comparing to the existing systems
Re-UCP Effort Estimation for Web Application Development
Authors: M Kirmani Mudasir
Published: January 2018

Practical effort estimation is very basic and most essential aspect of very organisation to sustain better project management. Accuracy in efforts makes the organisation to surge its business and build motivation among its customers effectively. It was observed that continuous improvement is required for software effort assessment after regular eras.The fundamental point of this examination work is to assess the execution of Re-UCP strategy for estimation of efforts for web application projects. This research work compares the existing effort estimation model results with the Re-UCP effort estimation methods results for web application development projects.
Characteristic and Development of Cow’s Milk Dadih as an Alternate of Buffalo’s Milk Dadih
Authors: Wirawati Chandra Utami
Published: January 2018

Dadih is a product of fermented buffalo milk in a bamboo tube from West Sumatera. The decline of buffalo population in West Sumatera caused dadih scarcity. The demand of dadih is high because it is an integral part of the Minangkabau’s diet and culture. Cow milk can be used as a substitute of buffalo milk for producing dadih, although the product has slightly different characteristics, especially lower total solids. Producing cows milk dadih similar to buffalo milk dadih, fresh cow milk should be concentrated and added with skim milk. Single or combination of lactic acid bacteria from the genus Lactobacillus, Lactococcus, Streptococcus and Bifidobacterium from dadih of buffalo milk or commercial culture can be used as a starter. Based on investment analysis, the prospect of developing cows milk dadih is feasible.
IZMENENIYa KOSTNOY TKANI ChELOVEKA V KOSMIChESKOM POLETE II. NEKOTORYE ZAKONOMERNOSTI I OSOBENNOSTI
Authors: Oganov V S , Bakulin A V , Novikov V E , Murashko L M , Kabitskaya O E
Published: January 2018

There are considered possible mechanisms of some peculiarities of cosmonauts bone tissue changes after space flights 5-7 month duration, that were diagnosed using dual energy X-ray absoptiometry (DEXA). Local osteopenia in spongy bone of the body lower part may be connected with big weight bearing load in 1g conditions. Increasing of mineral content in upper part of the skeleton and hypermineralization of vertebrae body spongy bone, that were showed by computer tomography possible are the secondary effects and are connected with fluid redistribution to cranial direction, including abdomen.
Additional negative gradient of bone mass in bones of lower part of skeleton, that is observed in early period of readaptation (till 1 month) may be explained as result of acceleration of bone remodeling (resorption and formation of bone), as reaction to recover of loading. Individual variability of above mentioned reactions is connected with genetically determined initial bone mass and phenotype of bone metabolism. There are considered possibilities of genetic prediction of osteopenia in discussed conditions.
Vliyanie narusheniya kostnogo metabolizma na sostoyanie tkaney parodonta u muzhchin reproduktivnogo vozrasta s sakharnym diabetom 1 tina i puti korrektsii
Authors: Grigoryan K R , Grigoryan O R , Nikonova T V , Gorelysheva V A , BARER G M
Published: January 2018

The aims of this study were to investigate the influence of alterations in bone metabolism and in hormonal and biochemical parameters on periodontium tissue as well as to estimate the optimal algorithm of investigation and treatment in men with diabetes mellitus type 1.
During the first stage (12 months) the comparative analysis of conditions of pariodontium tissue was conducted in 60 men of childbearing age with diabetes mellitus type 1 and in 25 men of the control group. During the second stage (12 months) the markers of bone metabolism and the conditions of paradontium tissue were studied in 26 men of childbearing age with diabetes mellitus type 1 and in 25 men of the control group.
The marker of bone resorption (CTX) was significantly lower (372,7 pkg/ml versus 473,0 pkg/ml; p= 0,006) and the marker of bone formation (OK) was significantly higher (27,6 ng/ml compared to 21,42 ng/ml; p< 0,005) in the group of patients who received ALPHA D3-TEVA (alfacalcidol 0,75mkg/day) and 2 tab CALCEMIN ADVANCE (calcium 1000 mg, cholecalciferol 400 UI) in comparison with the control group.
Conclusion: the treatment with Calcium and Vitamin D is effective for prevention of bone resorbtion, particularly in jaws.
OSTEOPOROZ U PATsIENTOV S SOMATIChESKOY PATOLOGIEY v zavisimosti ot pola
Authors: VERTKIN A L , MORGUNOV L Yu , NAUMOV A V , POLUPANOVA Yu S , GORULEVA E I , ARININA E N , BANNIKOVA M B , KhALVAShI R Z , RONZIN A V , RUDENKO L V
Published: January 2018

The presence of risk factors for osteoporosis has been found in 87,1% of investigated patients with somatic diseases. Osteoporosis was diagnosed more frequently in males with somatic diseases, than in females with somatic diseases. Moreover, males had lower BMD versus females. The prevalence of osteoporosis depended on age for men, but did not for women. The presence of somatic disease and/or the risk factors for osteoporosis are the most important factors in the development of osteoporosis without any dependence on sex.
PROFILAKTIKA NARUPENI OBMENA KAL'TsIYa I SISTEM EGO REGULYaTsII PRI DLITEL'NOY GIPOKINEZII S UChASTIEM ChELOVEKA
Authors: ORLOV O I
Published: January 2018

In conditions of 120-daily bedrest changes of a metabolism of the calcium, the functions of a bone directed on preservation at a necessary level of a bone material at the maximal economy level in these conditions were studied. The applied preventive complex consisting of xydyphone and special physical trainings, has rendered the expressed influence on a condition of a calcium homeostasis, defined, on the studied parameters, basically, by diphosphonates.
KAChESTVO ZhIZNI PRI OSTEOPOROZE. PROSPEKTIVNOENABLYuDENIE PATsIENTOV, PERENES1PIKh PERELOMPROKSIMAL'NOGO OTDELA BEDRA
Authors: LESNYaK O M , A BAKhTIYaROVA S , GOLOBOROD'KO K. N. , KUZNETsOVA N L
Published: January 2018

The aim of this study was to investigate the quality of life issues among hip fracture patients. This was a comparative prospective study with the 3 years duration of follow-up. Three groups of hospitalized patients aged 50 and older were included. First group consisted of 50 hip fracture patients, second group - 45 patients with myocardial infarction, and the third group included 64 control subjects. There was no age and sex difference between groups. The Short-Form (SF-36) questionnaire was used to assess quality of life.
The mortality rates as well as quality of life parameters were similar in hip fracture and myocardial infarction patients. But hip fracture patients had significantly lower values of Physical functioning and Bodily pain scores (р
ETIOLOGY, PATHOGENESIS, CLINICAL PRESENTATION, DIAGNOSTICSAND TREATMENT OF THE PRIMARY HYPERPARATHYROIDISM
Authors: Dedov I I , Rozhinskaya L Ya , Mokrysheva N G , Vasil'eva T O , Dedov I I , Rozhinskaya L. Y. , Mokrysheva N. G. , Vasilyeva T. O.
Published: January 2018

Primary hyperparathyroidism (PHPT) is a common endocrine disorder that affects bones, urinary tract, cardiovascular system, gastrointestinal tract, and another organs and tissues. The most cases of PHPT are mild forms and those patients have nonspecific symptoms, which require careful diagnostic considerations and choice of treatment.
There is not enough data about prevalence of PHPT, especially it's mild forms, in Russian Federation, and future epidemiological research needs to be done.
Present literature review includes information about etiology, pathogenesis, clinical findings, diagnostic and differential diagnostic, indication for surgery and medical treatment of PHPT. The review is based on data of studies from the different countries and few studies from Endocrine science center.
COMMENTS TO THE PRACTICAL USE OF THE RUSSIAN CLINICALRECOMMENDATIONS FOR OSTEOPOROSIS
Authors: Ershova O. B. , Ershova O. V.
Published: January 2018

Osteoporosis is one of the most socially significant chronic noninfectious diseases. This is due to its high prevalence and medical, social and economic consequences from osteoporotic bone fractures. The problem of osteoporosis is intensively studied in Russia for the past 15 years. Taking into account the peculiarities of the osteoporotic process (gradual, protracted, oligosymptomatic beginning, multifactorial origin, need for prolonged treatment to achieve effectiveness, wide range of drug treatment options etc.) and remaining lack of knowledge and experience of practitioners in view of the swift progress in osteoporosis research, we consider the importance of unity in approach to diagnosis, prophylaxis and treatment of osteoporosis for doctors of all specialities. These prompted Russian experts to develop the first Russian Clinical Recommendations for osteoporosis that were published in 2005 and reviewed in 2009.
Vitamin D i pokazateli kal'tsiy-fosfornogo obmenau detey, prozhivayushchikh v sredney polose Rossii, v periodmaksimal'noy insolyatsii
Authors: Vitebskaya A. V. , Smirnova G. E. , Il'in A. V.
Published: January 2018

Vitamin D deficiency is associated with rickets in children
and osteomalation in adults. Published data support the role
of vitamin D insufficiency in development of autoimmune,
cardiovascular and oncological diseases. The most precise
method to diagnose vitamin D insufficiency is measuring of
25-hydroxyvitamin D (25(OH)-D). We studded the levels of vitamin
D and calcium-phosphate turnover parameters during
the period of maximal insolation in 140 healthy children and
adolescents permanently living in the central area of Russia.
Vitamin D insufficiency (25(OH)-D < 20 ng/ml) was detected
in 38,6%; in 2,9% of them severe vitamin D deficiency was
diagnosed (25(OH)-D < 8 ng/ml). The results correlate with
data on hypovitaminosis D prevalence in countries with the
same geographical latitude. To clarify the real size of required
prophylaxis we need investigation of the same parameters in
winter period while minimal insolation.
Dozozavisimyy effekt vliyaniya potrebleniyakal'tsiya na fosforno-kal'tsievyy i kostnyyobmeny pri beremennosti
Authors: Sudakov D. S. , Zazerskaya I. E. , Galkina O. V. , Bogdanova E. O.
Published: January 2018

The influence of calcium intake during pregnancy on calcium
and phosphorus metabolism, bone turnover and BMD in postpartum
period was investigated in 35 healthy pregnant women.
The control group included 40 healthy women of reproductive
age. In women with the consumption less than 800 mg of calcium
in the III trimester of pregnancy there was decrease of
calcium excretion by the kidney. In both subgroups of pregnant
bone turnover markers showed increased metabolism in bone
tissue in 1,3-1,5 times in comparison with control group. Measurement
of the BMD made on 4-6 day postpartum period. In
the lumbar spine and distal forearm osteopenia was diagnosed
in 2,5 and 1,5 times more frequently than in the control group
(p
ROL' KAL'TsIY-ChUVSTVITEL'NOGO RETsEPTORA V PODDERZhANII SISTEMY KAL'TsIEVOGO GOMEOSTAZA
Authors: Mirnaya S S , Pigarova E A , Belyaeva A V , Mokrysheva N G , Tyul'pakov A N , Rozhinskaya L Ya
Published: January 2018

Calcium-sensing receptor (CaSR), a member of G proteincoupled
receptors family, plays a key role in systemic calcium
homeostasis regulation. It is expressed in a variety of tissues, and
is responsible for maintaining plasma calcium concentration.
In addition, the CaSR is known to regulate some important
cellular processes such as apoptosis and proliferation. CaSR is
a drug target for calcimimetics and calcilytics, agents used for
modification of parathyroid cells function and treatment of some
pathologic conditions. Inactivating or activating mutations of
the CaSR gene cause different disorders of calcium metabolism.
Polymorphic variants of the gene have been described in healthy
populations.