bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum protein concentrations as predictors of serum immunoglobulinGconcentration in neonatal foals
Authors: Hurcombe Samuel D. A. , Matthews Adriel L. , Scott Victoria H. L. , Williams Jarred M. , Kohn Catherine W. , Toribio Ramiro E.
Published: October 2012

Objective

To determine the predictive value of serum concentrations of total protein (sTP), albumin (sAlb), and globulin (sGlob) measured by automated calorimetric assays to estimate serum immunoglobulin G (sIgG) concentrations in neonatal foals and identify failure of transfer of passive immunity when compared to turbidoimmunometric assay determinations of sIgG.

Design

Retrospective and prospective analysis of laboratory data.

Setting

University tertiary care facility.

Animals

Group 1 (retrospective): foals (n= 45) ≤7 days of age in which sIgG, sGlob, sAlb, and sTPconcentrations were measured on an automated chemistry analyzer.

Group 2 (prospective): foals (n= 31) ≤7 days of age with same laboratory data collected used to validate equations generated from group 1 foals.

Interventions

Spearman rank correlations between measured sIgGand serum protein concentrations were performed. When significant correlation was found, sIgGwas estimated using an sGlob simple linear regression and estimated using a sGlob, sTP, and sAlb multiple linear regression. Comparisons between estimated and measured sIgGwas performed usingKruskal‐Wallis testing. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to identify foals with sIgG< 8.0 g/L [<800 mg/dL].

Measurements and Main Results

sIgGwas correlated with sGlob, sTP, and sAlb (ρ = 0.8, 0.6, and –0.3, respectively;P< 0.05). Estimated sIgGand measured sIgGwere not different (P> 0.9). In group 1 foals, the sensitivity, specificity, positive predictive value, and negative predictive value were 73%, 76%, 73%, and 83%, respectively, for sGlob, and 90%, 76%, 75%, and 90%, respectively, for multiple proteins estimated sIgGidentification of failure of transfer of passive immunity. Test qualities were improved in group 2 foals.

Conclusions

Serum protein concentrations may be used to estimate sIgGconcentrations in newborn foals. Further investigation using a larger sample size is needed to validate this methodology of assessing humoral immunity in neonatal foals.
Stratigraphy and chronology of Provo shoreline deposits and lake‐level implications, Late Pleistocene Lake Bonneville, eastern Great Basin, USA
Authors: Miller David M. , Oviatt Charles G. , Mcgeehin John P.
Published: October 2012

The Provo shoreline of Lake Bonneville formed following the Bonneville flood, and, based on previous dating, was formed during a period of overflow from about 17.5 to 15.0 cal. ka. In many places the Provo shoreline consists of a pair of distinct shorelines, one ∼3 m higher than the other. We present data from two cuts through double beaches to show that the upper beach is younger and represents sedimentation after a lake‐level rise. In addition, the lower beach deposits are internally stratified by beds that suggest three more lake‐level rises during its development. The Provo beach complex thus appears to have been built during rising lake levels, which can be explained by rises in the overflow threshold by sequential landslide deposition. Evaluation of beach altitudes demonstrates that the two beach crests throughout the Bonneville basin experienced equivalent rebound from removal of the lake load, and therefore they formed after the rebound associated with the Bonneville flood occurred in early Provo time. However, radiocarbon ages on gastropods collected within the beach deposits suggest both that the sequence of five beach deposits formed from c.18.1 to c. 17.0 cal. ka, and that the Bonneville flood occurred before 18 cal. ka. These ages are discordant with previous dates on shells within offshore sands, and raise questions about the validity of radiocarbon ages for shells in Lake Bonneville as well as about the age of the Bonneville flood and Provo shoreline. The timing for maximum Provo lake depths and its association with climate stages during deglaciation remain unresolved.
Australian and U.S. News Media Portrayal of Sharks and Their Conservation
Authors: Muter Bret A. , Gore Meredith L. , Gledhill Katie S. , Lamont Christopher , Huveneers Charlie
Published: October 2012

Investigation of the social framing of human–shark interactions may provide useful strategies for integrating social, biological, and ecological knowledge into national and international policy discussions about shark conservation. One way to investigate social opinion and forces related to sharks and their conservation is through the media's coverage of sharks. We conducted a content analysis of 300 shark‐related articles published in 20 major Australian and U.S. newspapers from 2000 to 2010. Shark attacks were the emphasis of over half the articles analyzed, and shark conservation was the primary topic of 11% of articles. Significantly more Australian articles than U.S. articles treated shark attacks (χ2 = 3.862; Australian 58% vs. U.S. 47%) and shark conservation issues (χ2 = 6.856; Australian 15% vs. U.S. 11%) as the primary article topic and used politicians as the primary risk messenger (i.e., primary person or authority sourced in the article) (χ2 = 7.493; Australian 8% vs. U.S. 1%). However, significantly more U.S. articles than Australian articles discussed sharks as entertainment (e.g., subjects in movies, books, and television; χ2 = 15.130; U.S. 6% vs. Australian 1%) and used scientists as the primary risk messenger (χ2 = 5.333; U.S. 25% vs. Australian 15%). Despite evidence that many shark species are at risk of extinction, we found that most media coverage emphasized the risks sharks pose to people. To the extent that media reflects social opinion, our results highlight problems for shark conservation. We suggest that conservation professionals purposefully and frequently engage with the media to highlight the rarity of shark attacks, discuss preventative measures water users can take to reduce their vulnerability to shark encounters, and discuss conservation issues related to local and threatened species of sharks. When integrated with biological and ecological data, social‐science data may help generate a more comprehensive perspective and inform conservation practice.

Descripción de Tiburones y su Conservación por Medios Informativos Australianos y Norteamericanos
Diffuse near‐infrared spectroscopy prediction of healing in diabetic foot ulcers: A human study and cost analysis
Authors: Weingarten Michael S. , Samuels Joshua A. , Neidrauer Michael , Mao Xiang , Diaz David , McGuire James , McDaniel Jane , Jenkins Lori , Zubkov Leonid , Papazoglou Elisabeth S.
Published: October 2012

Wound size reduction has been the standard benchmark for determination of efficacy for diabetic ulcer treatments but due to interclinician error and difficulty measuring irregular wound shapes, this method is unreliable with a positive predictive value of less than 60%. Diffuse near‐infrared spectroscopy (DNIRS) uses 70‐MHz modulated light in the diagnostic window (650–900 nm) noninvasively to quantify levels of oxy‐ and deoxy‐hemoglobin in the wound bed, which when measured over time, can show a trend toward or away from healing based on the changes in oxy‐hemoglobin concentration from week to week. In this study, DNIRS was used to monitor 24 human diabetic foot ulcers longitudinally over the course of 20 weekly or biweekly measurement sessions. In just 4 weeks, the DNIRS system has an 82% positive predictive value (sensitivity of 0.9 and specificity of 0.86; p < 0.002). These data indicate that it could be possible to predict healing in 4 weeks using DNIRS, which can provide objective guidance toward the continuation of costly treatments. Discontinuing ineffective treatments after 4 weeks could have potentially saved over $12,600 per patient, based on the treatment regimen of patients in this study.
Maggot excretions affect the human complement system
Authors: Cazander Gwendolyn , Schreurs Marco W. J. , Renwarin Lennaert , Dorresteijn Corry , Hamann Dörte , Jukema Gerrolt. N.
Published: October 2012

The complement system plays an important role in the activation of the inflammatory response to injury, although inappropriate complement activation (CA) can lead to severe tissue damage. Maggot therapy is successfully used to treat infected wounds. In this study, we hypothesized that maggot excretions/secretions influence CA in order to modulate the host's inflammatory response. Therefore, the effect of maggot excretions on CA was investigated in preoperatively and postoperatively obtained sera from patients. Our results show that maggot excretions reduce CA in healthy and postoperatively immune‐activated human sera up to 99.9%, via all pathways. Maggot excretions do not specifically initiate or inhibit CA, but break down complement proteins C3 and C4 in a cation‐independent manner and this effect proves to be temperature tolerant. This study indicates a CA‐reducing substrate that is already successfully used in clinical practice and may explain part of the improved wound healing caused by maggot therapy. Furthermore, the complement activation‐reducing substance present in maggot excretions could provide a novel treatment modality for several diseases, resulting from an (over)active complement system.
Estimation of Protein Requirements According to Nitrogen Balance for Older Hospitalized Adults with Pressure Ulcers According to Wound Severity in Japan
Authors: Iizaka Shinji , Matsuo Junko , Konya Chizuko , Sekine Rie , Sugama Junko , Sanada Hiromi
Published: October 2012

Objectives

To estimate protein requirements in older hospitalized adults with pressure ulcers (PrU) according to systemic conditions and wound severity.

Design

Secondary nitrogen balance study over 3 days.

Setting

Long‐term care facility.

Participants

Twenty‐eight older adults with PrU using a urinary catheter.

Measurements

Nitrogen balance over 3 days was evaluated from habitual nitrogen intake measured using a food weighing record and nitrogen excretion from urine, feces and wound exudate. Nitrogen intake required to maintain nitrogen equilibrium was estimated as an average protein requirement using a linear mixed model.

Results

Nitrogen intake at nitrogen equilibrium was 0.151 gN/kg per day (95% confidence interval = 0.127–0.175 gN/kg per day) for all participants. The amount of protein loss from wound exudate contributed little to total nitrogen excretion. A Charlson comorbidity index of 4 or greater (the median value) was related to lower nitrogen intake at nitrogen equilibrium (P = .005). Severe PrU with heavy exudate amounts and measured wound areas of 7.9 cm2 or greater (the median value) were related to higher nitrogen intake at nitrogen equilibrium in individuals with a Charlson comorbidity index of 3 or less (both P = .04). Larger wound area (correlation coefficient (r) = 0.55, P = .003) and heavier exudate volume (r = 0.53, P = .004) were associated with muscle protein hypercatabolism measured according to 3‐methylhistidine/creatinine ratio.

Conclusion

The average protein requirement is 0.95 g/kg per day for older hospitalized Japanese adults with PrU, but protein requirements depend on an individual's condition and wound severity and range from 0.75 to 1.30 g/kg per day. Severe PrU can require higher protein intakes because of muscle protein hypercatabolism rather than direct loss of protein from wound exudate.
Influence of Hospice on Nursing Home Residents with Advanced Dementia Who Received Medicare‐Skilled Nursing Facility Care Near the End of Life
Authors: Miller Susan C. , Lima Julie C. , Mitchell Susan L.
Published: October 2012

Objectives

To examine differences in outcomes according to hospice status of skilled nursing facility (SNF) care recipients.

Design

Retrospective cohort.

Setting

Three thousand three hundred fifty‐three U.S. nursing homes (NHs).

Participants

Four thousand three hundred forty‐four persons with advanced dementia who died in NHs in 2006 and received SNF care within 90 days of death were studied, 1,086 of these also received hospice before death: 705 after SNF care, and 381 concurrent with SNF care.

Measurements

Treatments, persistent pain and dyspnea, and hospital death.

Results

Decedents with any hospice received fewer medications, injections, feeding tubes, intravenous fluids, and therapy services and more hypnotics than those without hospice (all P < .001). Decedents with hospice after SNF care received fewer antipsychotics and those with hospice concurrent with SNF care received more antipsychotics than those without (all P < .001). Multivariate logistic regressions showed that decedents with hospice after SNF had lower likelihood of persistent dyspnea (adjusted odds ratio (AOR) = 0.63, 95% confidence interval (CI) = 0.45–0.87) and hospital death (AOR = 0.02, 95% = CI 0.01, 0.07) than those without hospice. Decedents with hospice concurrent with SNF care had a higher likelihood of persistent pain (AOR = 1.65, 95% CI = 1.23, 2.19) and a lower likelihood of hospital death (AOR = 0.13, 95% CI = 0.07, 0.26) than those without hospice.

Conclusion

Residents dying with advanced dementia who received SNF care in the last 90 days of life had fewer aggressive treatments and lower odds of hospital death if they also received hospice care at any point during that time. Associations between hospice and persistent pain or dyspnea differed according to whether hospice care was received concurrent with or after SNF care.
Myocardial Infarction After Hip Fracture Repair: A Population‐Based Study
Authors: Huddleston Jeanne M. , Gullerud Rachel E. , Smither Fantley , Huddleston Paul M. , Larson Dirk R. , Phy Michael P. , Melton L. Joseph , Roger Veronique L.
Published: October 2012

Objectives

To quantify the occurrence of myocardial infarction (MI) occurring in the early postoperative period after surgical hip fracture repair and estimate the effect on 1‐year mortality.

Design

A population‐based, historical cohort study of individuals who underwent surgical repair of a hip fracture that used the computerized medical record linkage system of the Rochester Epidemiology Project.

Setting

Academic and community hospitals, outpatient offices, and nursing homes in Olmsted County, Minnesota.

Participants

Over the 15‐year study period (1988–2002), 1,116 elderly adults underwent surgical repair of a hip fracture.

Measurements

At the end of the first 7 days after hip fracture repair, participants were classified into one of three groups: clinically verified MI (cv‐MI), subclinical myocardial ischemia, and no myocardial ischemia. One‐year mortality was compared between these groups. Multivariate models assessed risk factors for early postoperative cv‐MI and 1‐year mortality.

Results

Within the first 7 days after hip fracture repair, 116 (10.4%) participants experienced cv‐MI and 41 (3.7%) subclinical myocardial ischemia. Overall 1‐year mortality was 22%, with no difference between those with subclinical myocardial ischemia and those with no myocardial ischemia. One‐year mortality for those with cv‐MI (35.8%) was significantly higher than for the other two groups. Occurrence of early postoperative cv‐MI, male sex, and history of heart failure or dementia were independently associated with greater 1‐year mortality, whereas prefracture home residence and preoperative higher hemoglobin were protective.

Conclusion

Rates of early postoperative, cv‐MI after hip fracture repair exceed rates after other major orthopedic surgeries and are independently associated with greater 1‐year mortality.
Gait and Cognition: A Complementary Approach to Understanding Brain Function and the Risk of Falling
Authors: Montero‐Odasso Manuel , Verghese Joe , Beauchet Olivier , Hausdorff Jeffrey M.
Published: October 2012

Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults, but increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are interrelated in older adults. Quantifiable alterations in gait in older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single‐ and dual‐task testing and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia. This article reviews the importance of the interrelationship between gait and cognition in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunction and fall risk in older people in clinical practice. To this end, the benefits of dual‐task gait assessments (e.g., walking while performing an attention‐demanding task) as a marker of fall risk are summarized. A potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through nonpharmacological and pharmacological treatments is also presented. Untangling the relationship between early gait disturbances and early cognitive changes may be helpful in identifying older adults at risk of experiencing mobility decline, falls, and progression to dementia.
Palliative and Therapeutic Harmonization: A Model for Appropriate Decision‐Making in Frail Older Adults
Authors: Moorhouse Paige , Mallery Laurie H.
Published: October 2012

Frail older adults face increasingly complex decisions regarding medical care. The Palliative and Therapeutic Harmonization (PATH) model provides a structured approach that places frailty at the forefront of medical and surgical decision‐making in older adults. Preliminary data from the first 150 individuals completing the PATH program shows that the population served is frail (mean Clinical Frailty Score = 6.3), has multiple comorbidities (mean 8), and takes many medications (mean = 9). Ninety‐two percent of participants were able to complete decision‐making for an average of three current or projected health issues, most often (76.7%) with the help of a substitute decision‐maker (SDM). Decisions to proceed with scheduled medical or surgical interventions correlated with baseline frailty level and dementia stage, with participants with a greater degree of frailty (odds ratio (OR) = 3.41, 95% confidence interval (CI) = 1.39–8.38) or more‐advanced stage of dementia (OR = 1.66, 95% CI = 1.06–2.65) being more likely to choose less‐aggressive treatment options. Although the PATH model is in the development stage, further evaluation is ongoing, including a qualitative analysis of the SDM experience of PATH and an assessment of the effectiveness of PATH in long‐term care. The results of these studies will inform the design of a larger randomized controlled trial.
Medical Decision‐Making for Older Adults without Family
Authors: Weiss Barry D. , Berman Elena A. , Howe Carol L. , Fleming Robert B.
Published: October 2012

Each year in the United States, individuals who lack decision‐making capacity because of acute or chronic cognitive impairment are in situations in which important medical decisions must be made for them, but tens of thousands of these individuals have no known family members or designated surrogates available to help with those decisions. Such individuals constitute 16% of patients in intensive care units, 3% of nursing home residents, and a large but unspecified number of individuals in a variety of settings who are facing end‐of‐life decisions. Several approaches are currently used to aid in medical decision‐making for people without families or designated surrogates, including hospital ethics committees, court‐appointed surrogate agents, reliance on advance directives if they are available, and even the use of computer‐based decision systems. These approaches all have limitations and often result in individuals receiving care that would not have been their preference. Additionally, because clinical care teams must wrestle with uncertainty about best approaches to care, lengths of hospital stay for individuals without family are longer, resulting in higher healthcare costs and potentially more‐aggressive interventions than individuals with family experience. This article reviews medical decision‐making for older adults without families or designated surrogates and proposes a solution: “health fiduciaries”—a new type of professional trained and certified to act as a surrogate decision‐maker for individuals who are unable to make decisions for themselves.
Effect of Aging and Human Immunodeficiency Virus Infection on Cognitive Abilities
Authors: Ciccarelli Nicoletta , Fabbiani Massimiliano , Baldonero Eleonora , Fanti Iuri , Cauda Roberto , Giambenedetto Simona Di , Silveri Maria Caterina
Published: October 2012

Objectives

To explore the combined effects of aging and human immunodeficiency virus (HIV) infection on cognitive decay.

Design

Cross‐sectional, single‐cohort study.

Setting

Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.

Participants

One hundred fifty‐three asymptomatic HIV‐positive (HIV+) outpatients (20% aged ≥ 60) and an age‐ and education‐matched control population of 39 HIV‐negative individuals.

Measurements

A neuropsychological investigation was conducted to compare four groups of participants classified on the basis of HIV serostatus and age (<60 vs ≥60). The effects of age and HIV infection on neuropsychological performance were analyzed using a two‐by‐two factorial analysis of variance. Demographic and clinical variables associated with neuropsychological performance were identified using linear regression analysis in the HIV+ population.

Results

HIV infection and aging had significant negative effects on cognitive performance, but no significant interaction was observed between these two factors. Although older HIV+ participants had worse cognitive performance, they showed no distinct cognitive pattern from younger HIV+ participants. Moreover, younger HIV+ participants' performance on memory tasks was qualitatively and quantitatively comparable with that of older HIV− participants, despite the dramatic age difference.

Conclusion

Aging and HIV might be additive factors in the expression of cognitive decline. As the HIV+ population ages, routine neuropsychological examinations could help clinicians better understand and manage the expression of cognitive impairment.
Managing the Exploitation/Exploration Paradox: The Role of a Learning Capability and Innovation Ambidexterity
Authors: Lin Hsing‐Er , McDonough Edward F. , Lin Shu‐Jou , Lin Carol Yeh‐Yun
Published: October 2012

Some researchers have proposed that practices facilitating learning and knowledge transfer are particularly important to innovation. Some of the practices that researchers have studied include how organizations collaborate with other organizations, how organizations promote learning, and how an organization's culture facilitates knowledge transfer and learning. And while some have proposed the importance of combining practices, there has been a distinct lack of empirical studies that have explored how these practices work together to facilitate learning and knowledge transfer that leads to the simultaneous achievement of incremental and radical innovation, what we refer to as innovation ambidexterity (IA). Yet, a firm's ability to combine these practices into a learning capability is an important means of enabling them to foster innovation ambidexterity.

In this study, learning capability is defined as the combination of practices that promote intraorganizational learning among employees, partnerships with other organizations that enable the spread of learning, and an open culture within the organization that promotes and maintains sharing of knowledge. This paper examines the impact of this learning capability on innovation ambidexterity and innovation ambidexterity's effect on business performance. The resource‐based view (RBV) of the firm is used to develop a conceptual foundation for combining these practices. This study empirically examines whether these practices constitute a learning capability by analyzing primary data gathered from 214 Taiwanese owned strategic business unit (SBUs) drawn from several industries where innovation is important.

The results of this study make four important contributions. First, they demonstrate that the combination of these practices has a greater impact on innovation ambidexterity than any one practice individually or when only two practices are combined. Second, the results demonstrate a relationship between innovation ambidexterity and business performance in the form of revenues, profits, and productivity growth relative to competitors. Third, the results suggest that innovation ambidexterity plays a mediating role between learning capability and business performance. That is, learning capability has an indirect impact on business performance by facilitating innovation ambidexterity that in turn fosters business performance. This study also contributes to our understanding of ambidexterity literature in a non‐Western context, i.e., Taiwan.
Population resilience to an extreme drought is influenced by habitat area and fragmentation in the local landscape
Authors: Oliver Tom H. , Brereton Tom , Roy David B.
Published: October 2012

Most studies on the biological impact of climate change have focussed on incremental climate warming, rather than extreme events. Yet responses of species’ populations to climatic extremes may be one of the primary drivers of ecological change. We assess the resilience of individual populations in terms of their sensitivity to‐ and ability to recover from‐ environmental perturbation. We demonstrate the method using a model species, the ringlet butterflyAphantopus hyperantus, and analyse the effects of an extreme drought event using data from 79 British sites over 10 yr. We find that populations crashed most severely in drier regions but, additionally, the landscape structure around sites influenced population responses. Larger and more connected patches of woodland habitat reduced population sensitivity to the drought event and also facilitated faster recovery. Having enough, sufficiently connected habitat appears essential for species’ populations to be resilient to the increased climatic variability predicted under future scenarios.
Positive versus negative effects of an invasive ecosystem engineer on different components of a marine ecosystem
Authors: Gribben Paul E. , Byers James E. , Wright Jeffrey T. , Glasby Tim M.
Published: October 2012

Habitat‐forming invasive species have complex impacts on native communities. Positive above ground and negative below ground impacts are reported, suggesting that habitat‐forming invasive species may affect community components differently. Furthermore, such effects may vary depending on the density of the invader. We determined the responses of community components to different densities of the invasive green alga Caulerpa taxifolia in southeastern Australia. Initially we investigated differences in soft‐sediment faunal communities (above and below ground) across a biomass gradient at two invaded sites. Caulerpa taxifolia biomass was positively associated with the composition and abundance of the epifaunal community, but negatively correlated with the abundance of infauna. To examine the response of common community members in more detail, we caged two species of mollusk (the infaunal bivalve, Anadara trapezia and the epifaunal gastropod, Batillaria australis) across the same biomass gradient to determine lethal and sublethal effects of C. taxifolia biomass on individuals. Survivorship of A. trapezia was low when C. taxifolia was above 300 g m−2. Negative sublethal effects were also density‐dependent with A. trapezia tissue weight being lowest above this same C. taxifolia biomass. The proportion of B. australis surviving was unaffected by C. taxifolia biomass. However, the total number of live B. australis recovered in cages increased as C. taxifolia biomass increased, providing further evidence of positive density dependent effects (in line with the survey data) of C. taxifolia on epifauna. Finally, we removed C. taxifolia from plots of differing C. taxifolia biomass and followed community change for 5 months. Community change following C. taxifolia removal was also density dependent as recovery 5 months post‐removal depended on the initial biomass of C. taxifolia, suggesting a lag in the recovery of communities due to residual environmental effects post‐removal (i.e. hysteresis). We have shown that the effects of a habitat‐forming invasive species are biomass dependent and also affect community components differently, suggesting that, globally, the impact of these types of invaders may be context dependent.
The Australian First‐time Grandparents Study: Time spent with the grandchild and its predictors
Authors: Condon John , Corkindale Carolyn , Luszcz Mary , Gamble Elizabeth
Published: October 2012

Aim:  This paper presents data on the amount of contact a large cohort of first‐time Australian grandparents have with their grandchild, and the amount of child care they provide. It compares these with grandparents' expectations and desired levels.

Method:  Prospective grandparents were assessed on multiple measures before the birth of their grandchild, and at 6, 12, 24 and 36 months thereafter.

Results:  At the 12‐month assessment, grandmothers had approximately 15 hours per week contact, and provided approximately 7.5 hours per week of child care. The corresponding figures for grandfathers were 9.5 hours and 5 hours respectively. Approximately 10% of grandparents reported no contact with their grandchild, and 30–40% reported undertaking no child care. Almost half the grandparents desired more contact than they were actually getting.

Conclusion:  Accurate quantification of contact and care is a prerequisite for investigation of the impact of the transition to grandparenthood on health and well‐being.
A favourable response to surgical intervention and hyperbaric oxygen therapy in pyoderma gangrenosum
Authors: Altunay Ilknur , Kucukunal Asli , Sarikaya Sezgi , Tukenmez Demirci Gulsen
Published: October 2012

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterised with ulcerations. Inflammatory bowel diseases (ulcerative colitis and Crohn's disease) and haematologic diseases (leukaemia, preleukaemia and monoclonal gammopathy) have been reported in about 40–50% of PG patients in whom the treatment of the underlying disease is important for the improvement of the lesions. We herein report a colorectal adenocarcinoma patient with PG, who responded partially to topical treatments and systemic immunosuppressants and healed completely with the aid of surgical wound repair and hyperbaric oxygen therapy.
Skin ulcer caused by venous extravasation of heroin
Authors: Onesti Maria G , Fioramonti Paolo , Fino Pasquale , Massera Diego , Amorosi Vittoria , Scuderi Nicolo
Published: October 2012

The accidental leakage of the compound, in this case heroin, from the veins where it is injected, causes the formation of tissue lesions. Similar mechanisms lead to progressive tissue necrosis, which, if not immediately treated, results in the loss of the relevant function. A 57‐year‐old man presented a skin lesion on the posterior region of the left forearm with extensive necrosis of skin and subcutaneous layer involving the underlying muscle planes, caused by a venous extravasation of heroin that he reports having injected himself. The wound size is 15 × 10 cm; it had a sanious, fibrinous, secreting and smelly bottom. In this period, the patient was subjected to daily focused dressing before debridement of the lesion through a collagenase plus hyaluronic acid ointment: Bionect Start®; (FIDIA Pharmaceutical, Abano, Italy). The therapeutic choice was rewarded with a complete resolution of the wound through a non‐invasive technique and over a short period. Avoiding the hospitalisation of the patient achieved a reduction of risks for him and of the costs for the National Health Service (NHS). The Bionect Start®; (FIDIA Pharmaceutical) as well as allowing the healing of the wound also decreased significantly the pain felt by the patient, the amount of exudate and the bad smell improving in a non‐negligible way his quality of life.
Influence of Zirconia Interfacial Coating on Alumina Fiber‐reinforced Alumina Matrix Composites
Authors: Licciulli Antonio , Chiechi Antonio , Fersini Maurizio , Sanosh Kunjalukkal P. , Balakrishnan Avinash
Published: October 2012

The present study demonstrates an approach for fabricating fiber‐reinforced ceramic matrix composites (CMCs) involving the coating of 2‐dimensional woven alumina fibers with zirconia layer by sol gel, followed by impregnation of these coated fibers with alumina matrix and pressureless sintering. To emphasize the benefits of the zirconia coating on these CMCs, a reference sample without interfacial coating layer was prepared. The zirconia‐coated CMCs showed superior flexural strength and thermal shock resistance compared with their uncoated counterparts. Foreign object damage tests carried out on the ZrO2 coated CMCs at high impact speed showed localized damage without any shattering.
Preparation and Characterization of CIGSe Solar Cells by Ink Printing on Alumina Substrates with Self‐Synthesized Selenide Powders via an Environment‐Friendly and Cost‐Effective Dry Synthesis Route
Authors: Kuo Dong‐Hau , Jhang Cian‐Wei
Published: October 2012

CIGSe solar cells with an ink‐printing absorber layer were prepared on Mo‐coated alumina substrates. The use of alumina substrates can extend the process window to higher temperatures. The inks contained single‐phase CIGSe powder, which was formed by firing different selenide powders of Cu2Se, In2Se3, and Ga2Se3 at 800°C. All these powders were synthesized with an environment‐friendly and cost‐effective powder process. The printed inks were sintered at 600–800°C. The solar cells had power conversion efficiency of 0.50%, an open‐circuit voltage of 27 mV, a short‐circuit current density of 37 mA/cm2, and a fill factor of 0.50.
Multi‐Modal Imaging Technologies in Cardiovascular Risk Assessment
Authors: Casciani Emanuele , De Vincentiis Chiara , Colaiacomo Maria Chiara , Gualdi Gian Franco
Published: October 2012

Atherosclerotic plaques can be responsible for life‐threatening cardiovascular and cerebrovascular events. Some features of the plaque, such as a thin fibrous cap, large necrotic core, macrophage infiltration, neovascularization, and intraplaque hemorrhage, are associated with a major risk of such events and so their assessment is fundamental. Novel imaging techniques, each one with its own strength and drawbacks, can help in the evaluation and quantification of atherosclerosis. An analysis of the recent literature was carried out. The different techniques were compared by evaluating the accuracy of each one in the detection and assessment of the atherosclerotic plaque's features named above.
Recruiting Rural Participants for a Telehealth Intervention on Diabetes Self‐Management
Authors: Miyamoto Sheridan , Henderson Stuart , Young Heather , Ward Deborah , Santillan Vanessa
Published: October 2012

Purpose: Recruiting rural and underserved participants in behavioral health interventions is challenging. Community‐based recruitment approaches are effective, but they are not always feasible in multisite, diverse community interventions. This study evaluates the feasibility of a rapid, multisite approach that uses rural clinic site coordinators to recruit study participants. The approach allows for rural recruitment in areas where researchers may not have developed long‐term collaborative relationships.

Methods: Adults with diabetes were recruited from rural Federally Qualified Health Center (FQHC) clinics. Recruitment feasibility was assessed by analyzing field notes by the project manager and health coaches, and 8 in‐depth, semistructured interviews with clinic site coordinators and champions, followed by thematic analysis of field notes and interviews.

Findings: Forty‐seven rural sites were contacted to obtain the 6 sites that participated in the study. On average, sites took 14 days to commit to study participation. One hundred and twenty‐one participants were acquired from letters mailed to eligible participants and, in some sites, by follow‐up phone calls from site coordinators. Facilitators and deterrents affecting study recruitment fell into 4 broad categories—study design, site, site coordinator, and participant factors.

Conclusion: The rapid multisite approach led to quick and efficient recruitment of clinic sites and participants. Recruitment success was achieved in some, but not all, rural sites. The study highlights the opportunities and challenges of recruiting rural clinics and rural, underserved participants in multisite research. Suggestions are provided for improving recruitment for future interventions.
Montana Primary Care Providers’ Access to and Satisfaction With Pediatric Specialists When Caring for Children With Special Health Care Needs
Authors: Hardy Rose , Vivier Patrick , Rivara Frederick , Melzer Sandford
Published: October 2012

Purpose: Primary care providers (PCPs) of children with special health care needs (CSHCN) in rural areas face challenges in accessing specialty care to support a patient‐centered medical home. This study assessed the practice characteristics and attitudes regarding pediatric specialty care among Montana PCPs of CSHCN.

Methods: We surveyed 433 Montana PCPs identified through a statewide registry. Demographic and practice information was collected, including the proportion of time spent on CSHCN care coordination. A 5‐point Likert scale was used to calculate mean need scores for each pediatric specialty, access to these specialties, and barriers to care. Results were analyzed separately for pediatricians and family physicians, as well as rural and urban providers, using λ2, t tests, and Mann‐Whitney tests.

Results: Of the PCPs surveyed, 386 had a valid address and were currently practicing in Montana, 112 (29%) responded, and 91 provided care to CSHCN (averaged 29% of time spent in CSHCN care coordination). Child psychiatry (4.1) and developmental/behavioral pediatrics (3.7) were identified as the most needed specialties, yet they scored lowest in access to care (2.2 and 2.6, respectively). The most important rated specialist characteristics were quality (4.1), availability (3.5), and communication skills (2.8). Among the top barriers to care, lack of appropriate specialists was identified by 82% of PCPs.

Conclusions: Specialty care delivery for CSHCN in rural areas such as Montana should focus on matching availability with the identified need for specialty services, and ensuring that systems of communication between PCPs and specialists support the care coordination function of PCPs.
Transcending the deregulation debate? Regulation, risk, and the enforcement of health and safety law in theUK
Authors: Tombs Steve , Whyte David
Published: October 2012

This paper considers the context for the development of the concept of responsive regulation, namely the transcending of the deregulation debate. It argues that claims regarding responsive regulation when allied to risk‐based rationales for enforcement can, in fact, allow a “deregulatory” momentum to develop. This argument is grounded with reference to a case study of the regulation of workplace health and safety in theUK, with a particular focus upon the period 2000–2010. The paper casts doubt on the relevance and robustness of the concept of responsive regulation. In a context that might have been fertile ground for developing genuinely responsive regulatory policy, empirically we find the development of policies that are better described as “regulatory degradation.” Thus we argue in this paper that, whatever the intentions of its proponents, there is a logical affinity between responsive regulation, and effective de‐regulation, and that it is this affinity that has provided a convenient political rationale for the emergence of a neo‐liberal regulatory settlement in theUK.
MulticentricT‐cell lymphoma presenting as inferior palpebral swelling in a Standardbred mare
Authors: Rendle DI , Hughes KJ , Farish C , Kessell A
Published: October 2012

A 6‐year‐old Standardbred mare that presented with bilateral palpebral swelling and a left corneal ulcer was diagnosed with a multicentricT‐cell lymphoma. Other clinical findings included submandibular lymphadenopathy and oedema, pharyngeal oedema and rhinitis. Prior to euthanasia the horse developed keratomalacia, the onset of which was coincidental with the use of high doses of topical and systemic corticosteroids. Although an unusual presentation, palpebral swelling should be considered as a clinical sign of lymphoma.
Resolving the Routine Presence of Kyanite, Andalusite and Sillimanite across a Region using Foliation Intersection/Inflection Axes Preserved in Porphyroblasts, Petrographic Observations and Thermobarometry
Authors: ALI Asghar
Published: October 2012

Constraints from P‐T pseudosections (MnNCKFMASH system), foliation intersection/inflection axes preserved in porphyroblasts (FIAs), mineral assemblages and textural relationships for rocks containing all three Al2SiO5 polymorphs indicate a kyanite→ andalusite→ sillimanite sequential formation at different times rather than stable coexistence at the Al2SiO5 triple point. All three Al2SiO5 polymorphs grew in the Chl, Bt, Ms, Grt, St, Pl and Crd bearing Ordovician Clayhole Schist in Balcooma, northeastern Australia separately along a looped P‐T‐t‐D path that swaps from clockwise to anticlockwise in the tectono‐metamorphic history of the region. Kyanite grew during crustal thickening in an Early Silurian Orogenic event followed by decompression/heating, andalusite and fibrolitic sillimanite growth during Early Devonian exhumation.
Icteric acute hepatitis E with no response of immunoglobulin M class anti‐hepatitis E virus antibody
Authors: Takikawa Yasuhiro , Miyamoto Yasuhiro , Onodera Mio , Kuroda Hidekatu , Kasai Kazuhiro , Miyasaka Akio , Takahashi Masaharu , Okamoto Hiroaki , Suzuki Kazuyuki
Published: October 2012

A 68‐year‐old Japanese man developed icteric acute hepatitis during periodic care after undergoing gastrectomy due to early gastric cancer. The routine serological markers for hepatitis A, B and C viruses were all negative. Although the liver enzymes spontaneously recovered without any specific therapy, cholestasis was relatively prolonged and successfully treated with prednisolone. Determination of serum hepatitis E virus (HEV) RNA revealed the transient infection of HEV, and both immunoglobulin (Ig)A and IgG class anti‐HEV antibodies were detected after the disease onset, whereas those were negative when measured 3 weeks prior to the onset. In addition, the titer of serum IgA class antibody was associated with the clinical signs of hepatitis. In contrast, no IgM class antibody was detected throughout the course. This case suggests that screening only with IgM class antibody is not sufficient to detect acute HEV infection.
Opportunities and challenges: over-the-counter codeine supply from the codeine consumer’s perspective†
Authors: Nielsen Suzanne , Cameron Jacqui , Pahoki Sanja
Published: October 2012

Objectives

This study aimed to gain a better understanding on perspectives of over-the-counter (OTC) codeine users and issues relating to codeine dependence in the community pharmacy setting. Examining OTC codeine users' experiences aimed to promote better understanding of OTC codeine dependence, and inform pharmacy practices.

Methods

Utilising a qualitative research methodology we conducted interviews with 20 participants who were OTC codeine users and met DSM IV criteria for codeine dependence.

Key findings

Key themes identified included experience of participants acquiring OTC codeine and participants' interactions with pharmacists. The OTC codeine-dependent participants found it generally easy to access OTC codeine, describing ‘standard’ questioning, minimal intervention from pharmacists and only occasional refusal to supply. A better appearance and presentation was generally linked to easy codeine supply.

Conclusions

The experiences of participants suggest a number of barriers exist to effective intervention for OTC codeine dependence in the community pharmacy setting. Identification of these barriers will provide an opportunity to more effectively target interventions to reduce harm related to OTC codeine products. Increased involvement of pharmacists in OTC codeine sales was associated with help-seeking by codeine users.
Facial emotion expression recognition by children at familial risk for depression: high‐risk boys are oversensitive to sadness
Authors: Lopez‐Duran Nestor L. , Kuhlman Kate R. , George Charles , Kovacs Maria
Published: October 2012

Background:  Offspring of depressed parents are at greatly increased risk for mood disorders. Among potential mechanisms of risk, recent studies have focused on information processing anomalies, such as attention and memory biases, in the offspring of depressed parents. In this study we examined another information processing domain, perceptual sensitivity to emotion cues in facial expressions, as a potential mechanism of risk that characterizes the offspring of depressed parents.

Methods:  The study included 64 children at familial‐risk for depression and 40 low‐risk peers between the ages 7 and 13(Mage = 9.51; SD = 2.27). Participants were presented with pictures of facial expressions that varied in emotional intensity from neutral to full‐intensity sadness or anger (i.e., emotion recognition), or pictures of faces morphing from anger to sadness (emotion discrimination). After each picture was presented, children indicated whether the face showed a specific emotion (i.e., sadness, anger) or no emotion at all (neutral) using a forced choice paradigm. We examined group differences in the intensity of emotion that suggested greater sensitivity to specific emotions.

Results:  In the emotion recognition task, boys (but not girls) at familial‐risk for depression identified sadness at significantly lower levels of emotional intensity than did their low‐risk peers. The high and low‐risk groups did not differ with regard to identification of anger. In the emotion discrimination task, both groups displayed over‐identification of sadness in ambiguous mixed faces but high‐risk youth were less likely to show this labeling bias than their peers.

Conclusion:  Our findings are consistent with the hypothesis that enhanced perceptual sensitivity to subtle traces of sadness in facial expressions may be a potential mechanism of risk among boys at familial‐risk for depression. This enhanced perceptual sensitivity does not appear to be due to biases in the labeling of ambiguous faces.
Commentary: Early father–infant interaction and externalizing behaviors – a response to Ramchandani et al. (2013)
Authors: Shaw Daniel S.
Published: October 2012

Many researchers have attempted to uncover the precise contribution of fathers to childrearing in relation to both young and older children’s development during the past five decades (Lamb, 1975), including during the infancy period (Parke & O’Leary. S, 1975). However, few have been able to isolate precise mechanisms by which specific types of paternal childrearing practices may be linked to specific types of prosocial and problem behavior. The current paper by Ramchandani et al. (2013) breaks new ground in identifying a precise dimension of paternal parenting during early infancy ‐ engagement ‐ and linking it to maternal reports of infant externalizing problem behavior. Importantly, this association was found after accounting for the influence of several child, paternal, and maternal characteristics, including observed maternal sensitivity. Specifically, the authors found that fathers observed to be less engaging with their 3‐month olds were reported by mothers to show fewer disruptive problems 9 months later.