bluuebunny/crossref_metadata_2025 huggingface dataset:
Goal Setting With Type 2 Diabetes
Authors: Fleming Susan E. , Boyd Angela , Ballejos Miriam , Kynast-Gales Susan A. , Malemute Charlene L. , Armstrong Shultz Jill , Vandermause Roxanne K.
Published: October 2013

Purpose

The purpose of this study was to explicate and interpret common experiences of diabetes educators (DEs) with patient goal setting for patients with type 2 diabetes in diabetes education.

Methods

Transcripts (n = 10) from semi-structured interviews were analyzed using a hermeneutic phenomenological approach to more deeply explore the accounts of DEs’ goal setting with patients with type 2 diabetes.

Results

The overarching pattern that emerged was “Striking a Balance,” which subsumed 4 subthemes: Applying Theoretical-Practical Principles When Setting Goals, Identifying Idealistic-Realistic Expectations, Creating Patient-Educator–Centered Plans, and Readying-Living With Goal Setting. The pattern, “Striking a Balance,” revealed a common meaning of DEs as experiences requiring balance and nuance in goal setting with patients.

Implications

The results of this study combined with the tenets of the self-determination theory can provide the DEs with real-life exemplars and a theoretical framework to encourage their patients to self-manage, increase intrinsic motivation, and improve adherence related to their lifestyle changes and glycemic control. DEs, as facilitators of change, can implement these changes with flexible and reciprocal activities with their patients. The DEs owned these activities and they are: “building the bond,” “sharing the session,” “readying for change,” “sending them home,” and “bringing them back.”
Neoliberal settler colonialism, Canada and the tar sands
Authors: Preston Jen
Published: October 2013

The Canadian government commenced the treaty-making process with the Indigenous peoples of the Athabasca region in 1870, motivated by the Geological Survey of Canada’s reports that petroleum existed in the area. This, in addition to the discovery of gold in the Klondike region, spurred an influx of unregulated settlement and resource extraction in the north. The trajectory of this history has continued to bring the Canadian settler state – and its oil industry stakeholders – into negotiation with indigenous Nations over the Athabasca tar sands. Currently contested is Enbridge Inc.’s Northern Gateway project, which aims to move oil from the Edmonton, Alberta area by way of two massive pipelines covering 1,170km to Kitimat, British Columbia, where it would then be transported to Asia-Pacific markets by super-tankers. This paper examines the widespread criticism of the project from Indigenous and environmental groups, as well as responses to these objections by public/private partnerships between Enbridge, federal and provincial governments and their national security and counter-terrorism forces. It argues that recognising and naming contemporary forms of white settler colonialism, including these types of neoliberal partnerships, is required for new relations to become possible.
The legacy of Hillsborough: liberating truth, challenging power
Authors: Scraton Phil
Published: October 2013

In April 1989, ninety-six men, women and children, supporters of Liverpool Football Club, died in a severe crush at an FA Cup semi-final at Hillsborough Stadium, Sheffield. Hundreds were injured and thousands traumatised. Within hours, the causes and circumstances of the disaster were contested. While a judicial inquiry found serious institutional failures in the policing and management of the capacity crowd, no criminal prosecutions resulted, and the inquests returned ‘accidental death’ verdicts. Immediately, the authorities claimed that drunken, violent fans had caused the fatal crush. Denied legitimacy, survivors’ accounts revealed a different story criticising the parlous state of the stadium, inadequate stewarding, negligent policing, failures in the emergency response and flawed processes of inquiry and investigation. Reflecting on two decades of research and contemporaneous interviews with bereaved families and survivors, this article contrasts the official discourse with those alternative accounts – the ‘view from below’. It demonstrates the influence of powerful institutional interests on the inquiries and investigations. It maps the breakthrough to full documentary disclosure following the appointment of the Hillsborough Independent Panel, its research and key findings published in September 2012. The campaigns by families and survivors were vindicated and the fans, including those who died, were exonerated. The process is discussed as an alternative method for liberating truth, securing acknowledgement and pursuing justice.
Black Feminist Me: Answering the Question ‘Who Do I Think I Am’
Authors: Dotson Kristie
Published: October 2013

In this paper, I offer a partial picture of my conceptual location as a US black feminist, professional philosopher and, by doing so, illustrate one of the ways Africana philosophy is being shaped and engaged. I offer a portrait of my conceptual location by identifying a value shared by some ‘anti-theory’ black feminists and some Africana professional philosophers in the US that ultimately recommends a consistent engagement in black feminist/philosophical praxis.
The effects of exposure to titanium dioxide nanoparticles during lactation period on learning and memory of rat offspring
Authors: Mohammadipour Abbas , Hosseini Mahmoud , Fazel Alireza , Haghir Hossein , Rafatpanah Houshang , Pourganji Masoume , Bideskan Alireza Ebrahimzadeh
Published: October 2013

Nanoscale titanium dioxide (TiO2), which is massively produced and widely used in living environment, seems to have a potential risk on human health. The central nervous system (CNS) is the potential susceptible target of nanoparticles, but the studies on this aspect are limited so far. The aim of this study was to evaluate the effects of exposure to TiO2 nanoparticles during lactation period on learning and memory of offspring. Lactating Wistar rats were exposed to TiO2 nanoparticles (100 mg/kg; gavage) for 21 days. The Morris water maze and passive avoidance tests showed that the exposure to TiO2 nanoparticles could significantly impair the memory and learning in the offspring. Therefore, the application of TiO2 nanoparticles and the effects of their exposure, especially during developmental period on human brain should be cautious.
The protective effect of propylthiouracil against hepatotoxicity induced by chromium in adult mice
Authors: Ben Hamida Fatma , Troudi Afef , Sefi Madiha , Boudawara Tahia , Zeghal Najiba
Published: October 2013

Environmental and occupational exposure to chromium compounds, especially hexavalent chromium (Cr(VI)), is widely recognized as potentially hepatotoxic in humans and animals. Its toxicity is associated with overproduction of free radicals, which induces oxidative damage. This study focused on the possible protective effect of propylthiouracil (PTU) against potassium dichromate (K2Cr2O7). Female mice were divided into four groups (groups I–IV) with seven animals in each group. Group I served as a control, which received tap water; group II received K2Cr2O7 alone (75 mg kg−1 body weight (b.w.)) via drinking water; group III received both K2Cr2O7 via drinking water and PTU by intramuscular injection at a dose 2.5 mg/100 g−1 b.w. twice a week, and group IV received PTU alone twice a week for 30 days. Exposure of mice to Cr promoted oxidative stress with an increase in malondialdehyde, protein carbonyl, and advanced oxidation protein product levels. Nonenzymatic antioxidants such as glutathione, nonprotein thiol, vitamin C levels and enzymatic antioxidant activities such as glutathione peroxidase and superoxide dismutase were decreased, while catalase activity was increased. Biomarkers of liver injury such as aspartate and alanine transaminases, lactate dehydrogenase activities, bilirubin, albumin, and glucose levels were increased, while triglyceride and cholesterol levels decreased. Coadministration of PTU restored the above-mentioned parameters to near-normal values. The histological findings confirmed the biochemical results.
In vitro assessment of cytogenetic and oxidative effects of α-pinene
Authors: Türkez Hasan , Aydın Elanur
Published: October 2013

α-Pinene (α-pinene), a bicyclic monoterpene, is present in the oils of many species of coniferous trees, most notably the pine, and is known for its diverse biological properties such as antimicrobial, anti-inflammatory, antiproliferative and antioxidant. However, there are limited data on the cytogenetic and antioxidant effects of α-pinene in cultured human blood cells ( n = 5) for the first time. The purpose of this study was to investigate the genetic, oxidative, and cytotoxic effects of α-pinene in cultured human blood cells ( n = 5) for the first time. Human blood cells were treated with α-pinene (0 to 200 mg/L) for 24 and 48 h, and then cytotoxicity was detected by lactate dehydrogenase (LDH) release and (3-(4,5-dimethyl-thiazol-2-yl) 2,5-diphenyltetrazolium bromide) (MTT) assay, while DNA damage was also analyzed by micronucleus (MN) assay, chromosomal aberration (CA) assay and 8-oxo-2-deoxyguanosine (8-OH-dG). In addition, biochemical parameters (total antioxidant capacity (TAC) and total oxidative stress (TOS)) were examined to determine oxidative effects. The results of LDH and MTT assays showed that α-pinene (at 200 mg/L) decreased cell viability. In our in vitro test systems, it was observed that α-pinene did not cause any statistically important changes in the rates of studied genotoxicity endpoints but dose-dependent alterations were observed in TAC and TOS levels. α-Pinene treatment caused increases in TAC levels (at 25 and 50 mg/L) and decreases in TOS levels (only at 200 mg/L) on human lymphocytes. In conclusion, the findings of the present study confirm for the first time that α-pinene could be a significant source of natural antioxidant compound that may have beneficial health effects.
Serum prolidase activity, oxidative stress, and antioxidant enzyme levels in patients with renal cell carcinoma
Authors: Pirinççi Necip , Kaba Mehmet , Geçit İlhan , Güneş Mustafa , Yüksel Mehmet Bilgehan , Tanık Serhat , Arslan Ayşe , Demir Halit
Published: October 2013

Objectives:

Prolidase is a member of the matrix metalloproteinase family. It plays a vital role in collagen turnover, matrix remodeling, and cell growth. Reactive oxygen species (ROS) have been implicated in the pathogenesis of various diseases, including cancers. Oxidative stress can cause tumor angiogenesis and may be carcinogenic. However, the relationship between antioxidant capacity and various cancers has been researched in several clinical trials. In our study, we aimed to identify serum prolidase activity, oxidative stress, and antioxidant enzyme levels in patients with renal tumors and to evaluate their relationships with each other.

Materials and Methods:

A total of 37 male patients with renal cell cancer and with a mean age of 56.28 ± 3.1 were included in the study. The control group comprising 36 male patients (mean age 56.31 ± 2.9) was randomly selected among the volunteers. Serum samples for measurement of superoxide dismutase (SOD), glutathione peroxidase (GSHPx), glutathione-S-transferase (GST), malondialdehyde (MDA), glutathione (GSH), and prolidase levels were kept at −20°C until they were used.

Results:

Serum prolidase activity and MDA levels were significantly higher in renal cancer patients than in controls (all, p < 0.05), while SOD, GSHPx, and GST levels were significantly lower ( p < 0.05).

Conclusion:

Our results indicate that increased prolidase seems to be related to increased oxidative stress along with decreased antioxidant levels in renal cancer.
Les 30 ans du BMS
Authors: Degenne Alain
Published: October 2013

BMS’s 30 Years: The author expresses his commitment to the use of empirical data in sociology. As in any scientific endeavor, he stresses the importance of instrumentation and methods. He commends the role played by the BMS for the past 30 years and wants it to continue its mission.
Thirty Years of Survey Methodology / Thirty Years of BMS
Authors: de Leeuw Edith D.
Published: October 2013

This article presents an overview of the history of survey methodology and survey statistics based on an analysis of BMS issues since the start in October 1983. The author, member of the BMS Scientific Committee, discusses the changes in modes of data collection, the changing emphasis on different error sources in surveys, and trends in analysis and analysis tools. She reflects on recent developments in mixed-mode and Internet surveys, and ends with some thoughts on the future.
Je me souviens, je me souviens pas très bien,… 30 ans du BMS
Authors: Schiltz Marie-Ange
Published: October 2013

I Remember, I Don't Really Remember That Well… 30 Years of the BMS: The author, member of the BMS Editorial Board from the beginning, goes back over how she first got involved with the BMS and describes how – with graphs, tables and statistics – the journal has evolved since then.
Celebrating 30 Years of BMS and Its Cooperation with RC33 and SAGE
Authors: Blasius Jörg
Published: October 2013

The author, former President of RC33 and organizers of several RC33 congresses, tells his story of association with the BMS and SAGE Publications.
“Unequal Pay for Equal Work”
Authors: Stanberry Kurt , Aven Forrest
Published: October 2013

The purpose of this article is to demonstrate, through the use of empirical evidence, the continued existence of gender-based compensation inequities in the United States. This is confirmed in an analysis of data collected by the authors showing women workers are paid less than men even when holding jobs with the same titles. Similar findings have been reported in a number of other recent studies. There appears to be grounds to conclude that the difference in pay cannot be totally and satisfactorily explained by factors such as experience or education. While inequities exist, whether continued paycheck inequality proves intentional discrimination remains unclear. However, to address the problem, remedial action is recommended in the form of the passage of new statutory law and the expansion of existing common law.
Everything is Different, Nothing is Changed
Authors: Ortiz Mario R.
Published: October 2013

Sciencing and living the art of humanbecoming are a commitment to a specific ontology housed in the humanbecoming paradigm. This article is a reflection on Parse’s unique humanbecoming paradigm and its postulates: illimitability, paradox, freedom, and mystery. It is important to interpret these postulates in ways that are personally unique, as all persons live humanbecoming in the emerging now in the endless sea of nows.
Living on the Edge
Authors: PetersonLund Robin R.
Published: October 2013

A comprehensive review of the literature of the universal experience of living on the edge is discussed. Literature was reviewed from biology, criminology, ecology, economics, ethics, finance, fine arts, historical biography, medicine, nursing, philosophy, physiology, psychology, sociology, and theology. Three themes emerged with this literature review: living on the edge as a sacred place one travels to or where one lives, living on the edge as a choice in taking risks and surviving danger, and living on the edge as engaging with health experiences in which persons and nurses coparticipate. Living on the edge is a visionary quest into a new frontier that holds illimitable possibilities that transform the world. The literature is discussed according to theoretical and research findings.
The Ambiguities of Loyalty
Authors: Condon Barbara Backer
Published: October 2013

Loyalty is a complex notion. Recognizing moments of loyalty in nursing can encourage pride in the profession and thereby assist in elevating nursing as a profession. If nurses can appreciate the complexities involved in loyalty, this knowing might assist them in understanding personal struggles with loyalty when they arise and may also help in the understandings-misunderstandings that can occur when a breach of loyalty is felt. In this column, this complexity is discussed. Loyalty as a part of living quality is also highlighted in that loyalty is always choosing value priorities in cocreating living quality. Furthermore, the principles of humanbecoming are used as a guide to teaching-learning as well as recognizing loyalty in the nursing profession.
Nursing Leadership
Authors: Clarke Pamela N. , Hassmiller Susan
Published: October 2013

The column presents a scholarly dialogue about nursing’s role in interprofessional education, practice, and collaboration. Susan Hassmiller, PhD, RN, FAAN, is the Robert Wood Johnson Foundation (RWJF) senior adviser for nursing. In this role, she shapes and leads the foundation’s strategies to address nurse and nurse faculty shortages and ensures that RWJF’s commitments in nursing have a broad and lasting national impact. In partnership with AARP, Hassmiller directs the foundation’s Future of Nursing: Campaign for Action. This effort, active in 50 states plus the District of Columbia, strives to implement the recommendations of the Institute of Medicine’s 2011 report, The Future of Nursing: Leading Change, Advancing Health, for which Hassmiller served as the study director.
Humanbecoming
Authors: Karnick Paula M.
Published: October 2013

All that I believe and every interaction I have is written in Dr. Ortiz’s column. Humanbecoming is a paradigm, a way of living nursing and life. It is something I cherish. Read and savor this wonderful story.
Contemporary Women’s Adaptation to Motherhood
Authors: Aber Cynthia , Weiss Marianne , Fawcett Jacqueline
Published: October 2013

A better understanding of the process of adaptation to motherhood should enhance nurses’ ability to prepare women for the transition to motherhood and to provide care following childbirth. Knowledge about women’s adaptation to motherhood was developed primarily from the 1960s to the 1990s. Cesarean birthing was a special focus of research throughout the late 1970s and the 1980s, followed by functional status, and more recently, depression and stress associated with birth and postpartum. Adaptation to motherhood in the context of the early 21st century has received limited attention in nursing research, creating an assumption that the process of adaptation is universal and context-free rather than evolving within the life and societal context of women across generations. Although becoming and being a mother has been described as a normative transition rather than a stressor by some, knowledge development about adaptation to motherhood also has been constrained by the limited use of a unified perspective of transition as a process of adaptation. Therefore, the purposes of this exploratory study were to describe contemporary women’s physical, emotional, functional, and social adaptation to motherhood and to examine the relations of selected demographic and perinatal variables to adaptation to motherhood in the first 3 to 6 weeks of the postpartum.
The Bear and the Canyon
Authors: Sullivan-Marx Eileen M.
Published: October 2013

Using Carper’s fundamental patterns of knowing in nursing as a framework, the author reflects upon and intertwines experiences as a nurse leader and experiences in nature that called for resilience and courage.
A Legacy Building Model for Holistic Nursing
Authors: Lange Bernadette , Zahourek Rothlyn P. , Mariano Carla
Published: October 2013

This pilot project was an effort to record the historical roots, development, and legacy of holistic nursing through the visionary spirit of four older American Holistic Nurses Association (AHNA) members. The aim was twofold: (a) to capture the holistic nursing career experiences of elder AHNA members and (b) to begin to create a Legacy Building Model for Holistic Nursing. The narratives will help initiate an ongoing, systematic method for the collection of historical data and serve as a perpetual archive of knowledge and inspiration for present and future holistic nurses. An aesthetic inquiry approach was used to conduct in-depth interviews with four older AHNA members who have made significant contributions to holistic nursing. The narratives provide a rich description of their personal and professional evolution as holistic nurses. The narratives are presented in an aesthetic format of the art forms of snapshot, pastiche, and collage rather than traditional presentations of research findings. A synopsis of the narratives is a dialogue between the three authors and provides insight for how a Legacy Model can guide our future. Considerations for practice, education, and research are discussed based on the words of wisdom from the fours older holistic nurses.
Detecting Mood Disorder in Resource-Limited Primary Care Settings: Comparison of a self-administered screening tool to general practitioner assessment
Authors: Vöhringer Paul A , Jimenez Mirtha I , Igor Mirko A , Fores Gonzalo A , Correa Matias O , Sullivan Matthew C , Holtzman Niki S , Whitham Elizabeth A , Barroilhet Sergio A , Alvear Katherine , Logvinenko Tanya , Kent David M , Ghaemi Nassir S
Published: October 2013

Objectives

Although efficacious treatments for mood disorders are available in primary care, under-diagnosis is associated with under-treatment and poorer outcomes. This study compares the accuracy of self-administered screening tests with routine general practitioner (GP) assessment for detection of current mood disorder.

Methods

197 consecutive patients attending primary care centres in Santiago, Chile enrolled in this cross-sectional study, filling out the Patients Health Questionnaire-9 (PHQ-9) for depression and the Mood Disorder Questionnaire (MDQ) for bipolar disorder, after routine GP assessment. Diagnostic accuracy of these self-administered tools was compared with GP assessment, with gold standard diagnosis established by a structured diagnostic interview with trained clinicians (SCID-I).

Results

The sample was 75% female, with a mean age of 48.5 (SD 16.8); 37% had a current mood disorder (positive SCID-I result for depression or bipolar disorder). Sensitivity of the screening instruments (SI) was substantially higher than GP assessment (SI: 0.8, [95% CI 0.71, 0.81], versus GP: 0.2, [95% CI 0.12, 0.25]: p-value < 0.0001), without sacrifice in specificity (SI: 0.9, [95% CI 0.86, 0.96], versus GP: 0.9, [95% CI 0.88, 0.97]: p-value = 0.7). This led to improvement in both positive predictive value (SI: 0.8, [95% CI 0.82, 0.90], versus GP: 0.6, [95% CI 0.50, 0.64]: p-value < 0.001) and negative predictive value (SI: 0.9, [95% CI 0.78, 0.91] versus GP: 0.7, [95% CI 0.56, 0.72]: p-value < 0.01).

Conclusion

Self-administered screening tools are more accurate than GP assessment in detecting current mood disorder in low-income primary care. Such screening tests may improve detection of current mood disorder if implemented in primary care settings.
New validated multiresidue analysis of six 4-hydroxy-coumarin anticoagulant rodenticides in hen eggs
Authors: Shimshoni Jakob Avi , Soback Stefan , Cuneah Olga , Shlosberg Alan , Britzi Malka
Published: October 2013

Anticoagulant rodenticides are frequently a cause of poisoning of domestic animals, wildlife, and human beings. A toxicosis in 6,000 laying hens caused by the malicious addition of unknown amounts of coumatetralyl bait as well as the insecticides aldicarb, methomyl, and imidacloprid in the drinking water, was investigated in the current study. In order to determine a possible carryover of coumatetralyl into eggs, a rapid and reliable analytical method was developed and fully validated for the simultaneous detection of 6 anticoagulant rodenticides (warfarin, coumatetralyl, coumachlor, bromadiolone, difenacoum, and brodifacoum) in yolk and albumen using high-performance liquid chromatography (HPLC) with fluorescence detection. The method developed was reproducible, sensitive, accurate, and linear within the range of 0.01–1 mg/kg, which is the concentration range of bromadiolone and warfarin found in yolk in previously reported studies. The coefficient of variations of within and between days was 1.0–8.5% for yolk and 0.6–3.8% for albumen, while recoveries from spiked albumen and yolk samples were all in the range of 79–99% and 51–95%, respectively. Limits of detection in yolk were 0.01 mg/kg for warfarin and 0.003 mg/kg for the remaining compounds; in albumen, the limit of detection was 0.003 mg/kg for warfarin, coumatetralyl, and coumachlor, and 0.0015 mg/kg for difenacoum and brodifacoum. The application of the validated method revealed the presence of coumatetralyl in the yolk only at levels of 0.0057 mg/kg and 0.0052 mg/kg on the second and fourth day of the poisoning. In conclusion, the HPLC method demonstrated suitability for application in official analysis of anticoagulants in hen eggs.
Pulmonary alveolar microlithiasis with concurrent pleural mesothelioma in a dog
Authors: de Brot Simone , Hilbe Monika
Published: October 2013

Pulmonary alveolar microlithiasis (PAM) is a rare pulmonary disorder characterized by the accumulation of calcium phosphate microliths within the alveoli, with only a few cases described in animals. A 10-year-old female Bulldog was euthanized due to history of dyspnea and recurrent pleural and pericardial effusions. At necropsy, numerous multifocal to coalescent protruding nodules of 1–5 mm in diameter were scattered throughout the thoracic serosal surfaces. Moreover, lungs showed a diffuse pale gray color and had a generalized fine grainy consistency. Histological investigations revealed abundant intra-alveolar laminated microliths that stained positive with periodic acid–Schiff and von Kossa stains. The pulmonary interstitium showed multifocal, mild to moderate thickening, due to collagen deposition and mild hyperplasia of type 2 pneumocytes. The pulmonary lesion was not associated with any inflammatory response, and mineral deposition was not observed in any other organ or tissue. In addition, pulmonary, pericardial, and pleural surfaces were extensively infiltrated by an epithelioid mesothelioma. Immunohistochemical staining revealed neoplastic cells that strongly coexpressed vimentin and cytokeratin, supporting the diagnosis of mesothelioma. An overview of PAM, including pathogenesis and histological characteristics, are discussed in relation to the concurrent pleural mesothelioma. The potential cause and effect relationship between the 2 conditions could neither be established nor ruled out.
A survey of fish viruses isolated from wild marine fishes from the coastal waters of southern Korea
Authors: Kim Wi-Sik , Choi Shin-Young , Kim Do-Hyung , Oh Myung-Joo
Published: October 2013

A survey was conducted to investigate viral infection in 253 wild marine fishes harvested in the southern coastal area of Korea from 2010 to 2012. The fish that were captured by local anglers were randomly bought and sampled for virus examination. The samples were tested for presence of virus by virus isolation with FHM, FSP, and BF-2 cells and molecular methods (polymerase chain reaction and sequencing). Of the 253 fish sampled, 9 fish were infected with virus. Aquabirnaviruses (ABVs), Viral hemorrhagic septicemia virus (VHSV), and Red seabream iridovirus (RSIV) were detected in 7, 1, and 1 fish, respectively. Molecular phylogenies demonstrated the detected viruses (ABV, VHSV, and RSIV) were more closely related to viruses reported of the same type from Korea and Japan than from other countries, suggesting these viruses may be indigenous to Korean and Japanese coastal waters.
Syrian hamsters (Mesocricetus auratus) with simultaneous intestinal Giardia sp., Spironucleus sp., and trichomonad infections
Authors: Sheppard Barbara J. , Stockdale Walden Heather D. , Kondo Hirotaka
Published: October 2013

A commercial facility producing hamsters with a history of infection by dwarf tapeworm ( Hymenolepis nana) submitted 15 animals for necropsy and postmortem parasitological and microscopic examination. No tapeworms were detected grossly or microscopically. Fecal examination including gastrointestinal mucosal smears demonstrated mixed intestinal bacteria and low numbers of Giardia sp. Histologic examination of small intestine demonstrated filling of the small intestinal crypts by large numbers of 7–9 µm × 3 µm, rod to crescent or teardrop-shaped flagellates consistent with Spironucleus sp. These organisms had two 1-µm, basophilic, oval nuclei and multiple superficial flagella-like structures. Much larger 10–15 µm × 8–10 µm, oval to pear-shaped organisms were also present in lower numbers and usually located with the crypts. These larger flagellates had multiple flagella and a basophilic rod-shaped nucleus. The larger flagellates included Giardia sp., which had an intimate interface with the surface of the mucosal epithelium, bilaterally symmetry, and binucleation. Lower numbers of trichomonads were also present and were distinguished by an undulating surface membrane and a single nucleus. The mucosa was hyperplastic and moderately inflamed. Although the tapeworm infection was resolved, diagnosis of multiple intestinal flagellates by fecal examination is complicated by the varying sensitivity and diagnostic accuracy of different types of fecal analysis for different flagellate types. Key differences in the morphology and location of the different types of flagellates as observed by histology of intestinal tissues provide important additional diagnostic information to distinguish trichomonads, Spironucleus sp., and Giardia sp.
High-Dose Neuroleptics and Neuroleptic Rotation for Agitated Delirium Near the End of Life
Authors: Bascom Paul B. , Bordley Jessica L. , Lawton Andrew J.
Published: October 2013

Reason for the study:

Agitated delirium presents unique challenges for hospice and palliative care clinicians. Haloperidol, the recommended neuroleptic, may be ineffective at low dose, or poorly tolerated at higher doses.

Main Findings:

This article reports on two patients with refractory agitated delirium. Both developed extrapyramidal symptoms from haloperidol and required rotation to an alternate neuroleptic. Patient #1 received 2000 mg/day oral chlorpromazine. Patient #2 received greater than 200 mg/day sublingual olanzapine. Control of agitation was achieved, though the doses were substantially higher than has previously reported in the literature. Each patient experienced considerable sedation, though this was an acceptable side effect for the family. Each patient was transferred from the acute care hospital to a location of family preference. There they died within a week of transfer.

Conclusions:

Agitated delirium is a palliative care emergency. High doses of neuroleptic medications, with rotation to an alternate neuroleptic when side effects occur with standard haloperidol, may effectively palliate agitated delirium. This remedy can provide the patient with a peaceful dying in a place of their choosing.
Clofarabine-induced kidney toxicity
Authors: Jhaveri Kenar D , Chidella Shailaja , Allen Steven L , Fishbane Steven
Published: October 2013

Clofarabine is a purine nucleoside analog indicated for treatment of relapsed or refractory acute lymphoblastic leukaemia in children. The drug is also increasingly used, outside of its FDA approved indication, for treatment of relapsed or refractory acute myeloid leukemia in adults. It acts by inhibiting DNA synthesis, the enzyme ribonucleotide reductase and repair and activation of mitochondrial repair processes. We describe a case of a 48-year-old male with refractory acute myeloid leukemia with acute kidney injury associated with clofarabine treatment. We conducted a review of the literature and utilized the Food and Drug Administration Adverse Event Reporting System to identify spontaneous reporting of renal adverse events with this drug in 29 other cases. Since clofarabine inhibits ribonucleotide reductase, we postulate by extrapolation from the animal studies that collapsing glomerulopathy or severe tubular injury or a combination of both may be the mechanism of acute kidney injury observed with this agent. This would be consistent with the observed severe acute kidney injury and proteinuria in humans.
Rye flour enriched with arabinoxylans in rye bread making
Authors: Buksa Krzysztof , Nowotna Anna , Ziobro Rafał , Gambuś Halina
Published: October 2013

The aim of the study was to investigate physical and chemical properties of preparations of water soluble arabinoxylans (arabinoxylan-enriched flour) obtained by industrial method and their derivatives (obtained by hydrolysis and cross-linking of aranbinoxylans), as well as their impact on baking properties of rye flours. Additionally, these results were compared with highly purified arabinoxylans prepared by laboratory method and well characterized in the literature. Flour enriched with arabinoxylans was obtained by industrial method involving air separation of flour particles. It was characterized by 8.6% arabinoxylan content, lack of insoluble material and substantial residue (67%) of starch and dextrins. The addition of all industrial method preparations in amount of 10% (i.e. approx. 1% water soluble arabinoxylans), to rye flours resulted in an increase in water absorption, bread volume and decrease in hardness of the bread crumb and the effect was especially strong in the case of flour type 720. Due to the easiness of isolation procedure, industrial method preparation could be advised as an improver for rye bread making.
Network Influences on Dissemination of Evidence-Based Guidelines in State Tobacco Control Programs
Authors: Luke Douglas A. , Wald Lana M. , Carothers Bobbi J. , Bach Laura E. , Harris Jenine K.
Published: October 2013

Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention’s Best Practices for Comprehensive Tobacco Control Programs, are effectively and efficiently disseminated to intended stakeholders. To determine the organizational and network predictors of dissemination among state tobacco control programs, interviews with members of tobacco control networks across eight states were conducted between August 2009 and September 2010. Measures included partner attributes (e.g., agency type) and relationships among network members (frequency of contact, extent of collaboration, and dissemination of Best Practices). Exponential random graph modeling was used to examine attribute and structural predictors of collaboration and dissemination among partners in each network. Although density and centralization of dissemination ties varied across states, network analyses revealed a consistent prediction pattern across all eight states. State tobacco control dissemination networks were less dense but more centralized compared with organizational contact and collaboration networks. Tobacco control partners in each state were more likely to disseminate the Best Practices guidelines if they also had existing contact and collaboration relationships with one another. Evidence-based guidelines in public health need to be efficiently and broadly disseminated if we hope to translate science into practice. This study suggests that funders, advocacy groups, and public health agencies can take advantage of existing public health organizational relationships to support the communication and dissemination of evidence-based practices and policies.
Modeling the Impact of Simulated Educational Interventions on the Use and Abuse of Pharmaceutical Opioids in the United States
Authors: Wakeland Wayne , Nielsen Alexandra , Schmidt Teresa D. , McCarty Dennis , Webster Lynn R. , Fitzgerald John , Haddox J. David
Published: October 2013

Three educational interventions were simulated in a system dynamics model of the medical use, trafficking, and nonmedical use of pharmaceutical opioids. The study relied on secondary data obtained in the literature for the period of 1995 to 2008 as well as expert panel recommendations regarding model parameters and structure. The behavior of the resulting systems-level model was tested for fit against reference behavior data. After the base model was tested, logic to represent three educational interventions was added and the impact of each intervention on simulated overdose deaths was evaluated over a 7-year evaluation period, 2008 to 2015. Principal findings were that a prescriber education intervention not only reduced total overdose deaths in the model but also reduced the total number of persons who receive opioid analgesic therapy, medical user education not only reduced overdose deaths among medical users but also resulted in increased deaths from nonmedical use, and a “popularity” intervention sharply reduced overdose deaths among nonmedical users while having no effect on medical use. System dynamics modeling shows promise for evaluating potential interventions to ameliorate the adverse outcomes associated with the complex system surrounding the use of opioid analgesics to treat pain.
Dynamic Simulation of Crime Perpetration and Reporting to Examine Community Intervention Strategies
Authors: Yonas Michael A. , Burke Jessica G. , Brown Shawn T. , Borrebach Jeffrey D. , Garland Richard , Burke Donald S. , Grefenstette John J.
Published: October 2013

Objective. To develop a conceptual computational agent-based model (ABM) to explore community-wide versus spatially focused crime reporting interventions to reduce community crime perpetrated by youth. Method. Agents within the model represent individual residents and interact on a two-dimensional grid representing an abstract nonempirically grounded community setting. Juvenile agents are assigned initial random probabilities of perpetrating a crime and adults are assigned random probabilities of witnessing and reporting crimes. The agents’ behavioral probabilities modify depending on the individual’s experience with criminal behavior and punishment, and exposure to community crime interventions. Cost-effectiveness analyses assessed the impact of activating different percentages of adults to increase reporting and reduce community crime activity. Community-wide interventions were compared with spatially focused interventions, in which activated adults were focused in areas of highest crime prevalence. Results. The ABM suggests that both community-wide and spatially focused interventions can be effective in reducing overall offenses, but their relative effectiveness may depend on the intensity and cost of the interventions. Although spatially focused intervention yielded localized reductions in crimes, such interventions were shown to move crime to nearby communities. Community-wide interventions can achieve larger reductions in overall community crime offenses than spatially focused interventions, as long as sufficient resources are available. Conclusion. The ABM demonstrates that community-wide and spatially focused crime strategies produce unique intervention dynamics influencing juvenile crime behaviors through the decisions and actions of community adults. It shows how such models might be used to investigate community-supported crime intervention programs by integrating community input and expertise and provides a simulated setting for assessing dimensions of cost comparison and intervention effect sustainability. ABM illustrates how intervention models might be used to investigate community-supported crime intervention programs.
Modeling Social Dimensions of Oral Health Among Older Adults in Urban Environments
Authors: Metcalf Sara S. , Northridge Mary E. , Widener Michael J. , Chakraborty Bibhas , Marshall Stephen E. , Lamster Ira B.
Published: October 2013

In both developed and developing countries, population aging has attained unprecedented levels. Public health strategies to deliver services in community-based settings are key to enhancing the utilization of preventive care and reducing costs for this segment of the population. Motivated by concerns of inadequate access to oral health care by older adults in urban environments, this article presents a portfolio of systems science models that have been developed on the basis of observations from the ElderSmile preventive screening program operated in northern Manhattan, New York City, by the Columbia University College of Dental Medicine. Using the methodology of system dynamics, models are developed to explore how interpersonal relationships influence older adults’ participation in oral health promotion. Feedback mechanisms involving word of mouth about preventive screening opportunities are represented in relation to stocks that change continuously via flows, as well as agents whose states of health care utilization change discretely using stochastic transitions. Agent-based implementations illustrate how social networks and geographic information systems are integrated into dynamic models to reflect heterogeneous and proximity-based patterns of communication and participation in the ElderSmile program. The systems science approach builds shared knowledge among an interdisciplinary research team about the dynamics of access to opportunities for oral health promotion. Using “what if” scenarios to model the effects of program enhancements and policy changes, resources may be effectively leveraged to improve access to preventive and treatment services. Furthermore, since oral health and general health are inextricably linked, the integration of services may improve outcomes and lower costs.
Evaluating the Effectiveness of Contact Tracing on Tuberculosis Outcomes in Saskatchewan Using Individual-Based Modeling
Authors: Tian Yuan , Osgood Nathaniel D. , Al-Azem Assaad , Hoeppner Vernon H.
Published: October 2013

Tuberculosis (TB) is a potentially fatal disease spread by an airborne pathogen infecting approximately one third of the globe. For decades, contact tracing (CT) has served a key role in the control of TB and many other notifiable communicable diseases. Unfortunately, CT is a labor-intensive and time-consuming process and is often conducted by a small and overworked nursing staff. To help improve the effectiveness of CT, we introduce a detailed, individual-based model of CT for the Canadian province of Saskatchewan. The model captures the detailed operation of TB CT, including loss to follow-up, and prophylactic and case treatment. This representation is used to assess the impact on active TB cases and TB infection prevalence of differential scoping, speed, prioritization of the CT process, and reduced loss to follow-up. Scenario results are broadly consistent with—but provide many additional insights beyond—our previously reported findings using an aggregate model. In the context of a stylized northern community, findings suggest that age- and ethnicity-prioritized schemes could improve CT effectiveness compared to unprioritized schemes by dramatically reducing TB infection and preventing on average roughly 11% ( p < .0001) of active TB cases over a period of 20 years. Reducing loss to follow-up to 10% could yield 5.4% ( p = .02) TB cases prevented on average with lower prevalence of TB infection, but improving the CT speed does not yield significant improvement in TB outcomes. Finally, although the work emphasized the value of social network analysis, we found that caution should be exercised in directly translating social network analysis–observed associations into prioritization recommendations.
Reconciling Statistical and Systems Science Approaches to Public Health
Authors: Ip Edward H. , Rahmandad Hazhir , Shoham David A. , Hammond Ross , Huang Terry T.-K. , Wang Youfa , Mabry Patricia L.
Published: October 2013

Although systems science has emerged as a set of innovative approaches to study complex phenomena, many topically focused researchers including clinicians and scientists working in public health are somewhat befuddled by this methodology that at times appears to be radically different from analytic methods, such as statistical modeling, to which the researchers are accustomed. There also appears to be conflicts between complex systems approaches and traditional statistical methodologies, both in terms of their underlying strategies and the languages they use. We argue that the conflicts are resolvable, and the sooner the better for the field. In this article, we show how statistical and systems science approaches can be reconciled, and how together they can advance solutions to complex problems. We do this by comparing the methods within a theoretical framework based on the work of population biologist Richard Levins. We present different types of models as representing different tradeoffs among the four desiderata of generality, realism, fit, and precision.
Facebook Advertisements for Inexpensive Participant Recruitment Among Women in Early Pregnancy
Authors: Arcia Adriana
Published: October 2013

Facebook advertisements were used to recruit nulliparous women in the first 20 weeks of pregnancy for an online survey about their childbirth preferences. A campaign of ads was targeted to women, aged 18 to 44 years, residing in the United States. The ads were viewed 10,577,381 times by 7,248,985 unique Facebook users over 18 weeks in 2011. The ad campaign yielded 6,094 clicks by 5,963 unique users at a mean cost of $0.63 per click and a unique click-through rate of 0.08%. Of those who clicked through to the study site, 18% ( n = 1,075) consented to participate. The participant pool was reduced to 344 women after application of strict eligibility criteria. Participants represented 43 states and the District of Columbia, their mean age was 20.9 years ( Mdn = 19.0, SD = 4.0), and their mean weeks’ gestation was 11.5 ( SD = 5.8). The campaign cost was $3,821.81 or $11.11 per eligible participant.
Analysis of friction, wear and oxidation behaviour of X40CrMoV5/Fe360B steel couple in an open-sliding contact
Authors: Baccouch Z , Mnif R , Elleuch R , Richard C
Published: October 2013

In hot-forming processes, the interface tool/product is important for the quality of the finished product surfaces. Consequently, it is important to better understand the phenomena, namely, oxidation, which occurs at the interface between tool and sheet in this kind of process. It is in this context that an experimental program was conducted to analyse friction, wear and oxidation behaviours on the tribological performance of the combination of tool and sheet. A high-temperature pin-on-disc tribometer, with an original open-sliding contact, was used. Pins, representing tools are X40CrMoV5 high-alloyed steel, and discs, representing drawing products, are Fe360B steel plates (EN 10025–S235JRG2). The friction and wear study of the combination was carried out at temperatures ranging from ambient (room temperature) to 800℃ and within a normal load range of 35–140 N. Regarding oxidation effect and wear mechanisms, they are examined and characterized by scanning electron microscope and energy-dispersive X-ray spectrometer. As for the experimental results, they showed that the increase in temperature involves the decrease in the friction coefficient due to the oxide scales for all the tests. Pre-oxidized discs are also tested. It was found that the wear process is characterized by an adhesive wear with a transfer of oxides on the pins.