bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between low renal function and tooth loss over 5 years
Authors: Yoshihara Akihiro , Iwasaki Masanori , Miyazaki Hideo , Nakamura Kazutoshi
Published: November 2012

Objectives

This longitudinal study evaluated the relationship between low renal function and tooth loss in elderly subjects.

Material and methods

Subjects comprised 406 female subjects (55–74 years old) who agreed to participate in a baseline examination and a follow‐up examination after 5 years. Serum cystatin C levels were used to assess renal function. Multiple logistic regression analysis was used to evaluate the relationship between tooth loss and change in serum cystatin C levels over 5 years. Tooth loss over 5 years (0: no, 1: yes) was used as the dependent variable. Seven variables were used as independent variables, including change in serum cystatin C levels over 5 years.

Results

Results of multiple logistic regression analysis showed that cystatin C change over 5 years, age, number of remaining teeth at baseline, number of sites with ≥4 mm clinical attachment level at baseline and serum 25‐hydroxyvitamin D levels at baseline were significantly associated with tooth loss. The odds ratio for tooth loss with cystatin C change over 5 years was 7.70 (p = 0.029).

Conclusion

This study indicates a relationship between serum cystatin C levels and number of missing teeth, and thus suggests that low renal function is associated with tooth loss.
Patient perceptions of patient‐centred care: empirical test of a theoretical model
Authors: Rathert Cheryl , Williams Eric S. , McCaughey Deirdre , Ishqaidef Ghadir
Published: November 2012

Aim

Patient perception measures are gaining increasing interest among scholars and practitioners. The aim of this study was to empirically examine a conceptual model of patient‐centred care using patient perception survey data.

Background

Patient‐centred care is one of the Institute of Medicine's objectives for improving health care in the 21st century. Patient interviews conducted by the Picker Institute/Commonwealth Fund in the 1980s resulted in a theoretical model and survey questions with dimensions and attributes patients defined as patient‐centered.

Method

The present study used survey data from patients with overnight visits at 142 U.S. hospitals.

Results

Regression analysis found significant support for the theoretical model. Perceptions of emotional support had the strongest relationship with overall care ratings. Coordination of care, and physical comfort were strongly related as well.

Conclusion

Understanding how patients experience their care can help improve understanding of what patients believe is patient‐centred, and of how care processes relate to important patient outcomes.
A fractal dimensional approach to successful evaluation of apical healing
Authors: Huang C. C. , Chen J. C. , Chang Y. C. , Jeng J. H. , Chen C. M.
Published: November 2012

Aim

To evaluate whether the initial healing of apical radiolucencies 1 year after root canal treatment could be quantitatively identified by the change in fractal dimension (FD) values for the eventually completely healed cases.

Methodology

Twenty‐six patients with successful root canal treatment were recruited. All teeth were associated with complete healing either before or at 1 year following treatment (six of 26) or still undergoing healing at 1 year after treatment but completely healed thereafter (20 of 26). Two radiographs were selected for the same patient, one taken before treatment and the other taken 1 year after treatment. Eight regions of interests (ROIs) were selected from each radiograph, two as the experimental group located close to the infected root apex, two as the control group in the healthy bone and the other four in the healthy bone ensuring the image quality.

Results

Based on the FD values of the four ROIs in the healthy bone, the two radiographs were confirmed to have been taken with similar projection angles and exposure. The FD values were shown to significantly increase (P = 0.006) and decrease (P = 0.000) around the root apex and the neighbouring region of the apical lesion, respectively.

Conclusion

Changes in fractal dimension values may serve as a necessary condition to quantitatively indicate the initial healing status 1 year after root canal treatment.
Effects of cell salvage on erythrocyte 2,3‐disphosphoglycerate and G‐6‐PD levels and phosphatidylserine expression
Authors: Che J. , Tian M. , Ding G. , Huai Q. , Dong P. , Li Y. , Li S.
Published: November 2012

Introduction

The aim of this study was to investigate the contribution of the perioperative cell salvage process to the changes in erythrocyte 2,3‐disphosphoglycerate (2,3‐DPG) and glucose‐6‐phosphate dehydrogenase (G‐6‐PD) levels and phosphatidylserine (PS) expression using a self‐control study comparing washed blood with venous blood.

Methods

Thirty patients undergoing elective heart and blood vessel surgery were enrolled. Blood was collected and processed using a Fresenius continuous autotransfusion system device. 2,3‐DPG and G‐6‐PD activities, as well as PS expression, from both venous and washed red blood cells (RBC) were measured. We also compared these indicators among washed RBC at 6 h, washed RBC at 0 h, and venous RBC.

Results

2,3‐DPG and G‐6‐PD activities in washed blood at 0 h were significantly higher than in venous RBC (2,3‐DPG, venous vs. washed blood P < 0.05; G‐6‐PD, venous vs. washed blood P < 0.05). Flow cytometry results showed no differences between venous blood and washed RBC at 0 h (n = 23, P > 0.05). 2,3‐DPG activity in washed RBC that were allowed to stand for 6 h decreased compared with that in venous blood (venous vs. washed blood at 6 h P < 0.01), whereas no significant difference was observed in G‐6‐PD activity (venous. vs. washed blood at 6 h P > 0.05).

Conclusion

Compared with venous RBC, washed RBC from intraoperative cell salvage exhibited good oxygen‐carrying and antioxidant capacities. However, the oxygen‐carrying capacity of washed RBC that were allowed to stand for 6 h was not as good as that of venous RBC. Thus, we suggest that washed RBC that were left to stand for more than 6 h should not be reinfused.
Sifting, sorting and saturating data in a grounded theory study of information use by practice nurses: A worked example
Authors: Hoare Karen J , Mills Jane , Francis Karen
Published: November 2012

The terminology used to analyse data in a grounded theory study can be confusing. Different grounded theorists use a variety of terms which all have similar meanings. In the following study, we use terms adopted by Charmaz including: initial, focused and axial coding. Initial codes are used to analyse data with an emphasis on identifying gerunds, a verb acting as a noun. If initial codes are relevant to the developing theory, they are grouped with similar codes into categories. Categories become saturated when there are no new codes identified in the data. Axial codes are used to link categories together into a grounded theory process. Memo writing accompanies this data sifting and sorting. The following article explains how one initial code became a category providing a worked example of the grounded theory method of constant comparative analysis. The interplay between coding and categorization is facilitated by the constant comparative method.
Family factors affecting on withdrawal of life‐sustaining treatment in Korea
Authors: Jo Kae‐Hwa , An Gyeong‐Ju , Han Kyung Su
Published: November 2012

The purpose of this study was to identify the family factors affecting on withdrawal of life‐sustaining treatment in Korea on the basis of Olson's Circumplex Model. A descriptive study was conducted with 364 Korean adults who had experienced a family member with cancer being hospitalized at least 1 month prior in Korea. Data were analysed by using the Pearson's correlation coefficient and multiple regressions with SPSS/WIN 15.0 program. The mean score of The mean score of withdrawal of life‐sustaining treatment appeared low. Significant bivariate correlations were found among withdrawal of life‐sustaining treatment, family cohesion and family communication. Family factors predicting withdrawal of life‐sustaining treatment were family cohesion and family communication. This study demonstrated that balanced families with optimal family cohesion and communication are predicted to easily accept withdrawal of life‐sustaining treatment for their family member at the terminal stage in Korea.
The impact of education and media on contraceptive use in Bangladesh: A multivariate analysis
Authors: Goni Abdul , Rahman Mahfuzar
Published: November 2012

In this paper, an attempt is made to show the impact of education and media on contraceptive use and also to identify the factors that associated with the current use of contraception and continuing of contraception. To reach our goal, Bangladesh Demographic and Health Survey (BDHS 2007) data were used. Findings of this study reveal that education, age of the respondents, religion, media exposure, area of residence and if they belong to any of the non‐governmental organizations (Grameen Bank, Bangladesh Rural Advancement Committee, ASA, Mother's club, etc.) have significant contribution to current use of contraception and continuing of contraception. Media, particularly TV, and education play the leading role regarding this issue, whereas the others have an indirect relationship. Multivariate analyses showed that contraceptive use were higher among educated women and those women who watch TV at least once a week as compared with their respective counterpart. The results indicate urgent need to give emphasis on education, ensuring electronic media exposure, head‐to‐head communication programme, institutional‐based family planning education and necessary information to learn about the impact of overpopulation for the people all over the country.
Implementation of clinical pharmacy services at a university hospital in Jordan
Authors: Al-azzam Sayer I , Shara Mohd , Alzoubi Karem H , Almahasneh Fatimah A , Iflaifel Mais H
Published: November 2012

Objective

Clinical pharmacy services are still in the early stages of implementation in the Middle East. This study assessed the implementation of clinical pharmacy services at a major university hospital.

Methods

All recommendations and services provided by clinical pharmacists were recorded for a period of 7 months.

Key findings

During the study period a total of 3026 patients were followed up and 10 783 recommendations and services were provided. The physicians' rate of acceptance of clinical pharmacists' recommendations was 69.4%.

Conclusion

The implementation of clinical pharmacy services in this setting was successful and should positively impact patient care.
Progress in pelvic anatomy from the viewpoint of radical prostatectomy
Authors: Hinata Nobuyuki , Sejima Takehiro , Takenaka Atsushi
Published: November 2012

The procedure of radical prostatectomy has changed rapidly since the introduction of laparoscopic and robotic surgery, which allows for clear, highly magnified visualization. The da Vinci surgical system enables three‐dimensional visualization and makes use of instruments with seven degrees of freedom. Since its introduction, the use of robot‐assisted radical prostatectomy has spread rapidly worldwide. However, adaptation to changes in surgical techniques using knowledge of classical pelvic anatomy has been difficult. In this report, we reviewed the progress in knowledge of pelvic anatomy, particularly regarding the cavernous nerves, prostatic fascia, Denonvilliers' fascia, endopelvic fascia, bladder neck and apex of the prostate, with regard to radical prostatectomy.
Foetal and neonatal outcomes in first‐trimester pregnant women exposed to abdominal or lumbar radiodiagnostic procedures without administration of radionucleotides
Authors: Choi J. S. , Han J. Y. , Ahn H. K. , Ryu H. M. , Kim M. Y. , Chung J. H. , An G. H. , Nava‐Ocampo A. A.
Published: November 2012

Background/Aim

Little is known about exposures to low radiation doses in the first trimester of pregnancy and deterministic adverse effects in the offspring, and risks are extrapolated from catastrophic events or from exposures to radiotherapy. The study aimed to assess the foetal and neonatal outcomes of pregnant women exposed to radiodiagnostic procedures with abdominal or lumbar irradiation.

Methods

In a prospective cohort design, we studied the foetal and neonatal outcomes in 115 singleton pregnant women who required abdominal or lumbar radiodiagnostic procedures without the administration of radionucleotides, and in 527 age‐matched (±2 years) control pregnant women.

Results

In the exposed group, lumbar spine radiography (33.9%), plain abdominal radiography (16.5%) and upper gastrointestinal tract radiography with abdominal irradiation (15.7%) were the most common radiodiagnostic procedures. Major congenital malformations were identified in two (1.9%) babies born in the exposed group and in two (0.4%) babies born in the control group (odds ratio = 4.7; 95% confidence interval 0.7–33.6; P = 0.15). The rest of the foetal and neonatal outcomes was similar in the two groups except by a marginally higher rate of admissions to the neonatal intensive care unit among babies born to exposed women (odds ratio = 2.9; 95% confidence interval 1.0–9.4; P = 0.06).

Conclusion

Our results indicate that X‐ray and computed tomography scan exposure involving abdominal irradiation without the administration of radionucleotides is not associated with adverse foetal and neonatal deterministic outcomes. Efforts are required to reduce the use of radiodiagnostic procedures for general check‐ups in childbearing age women.
Human cord blood γδ T cells expressing public Vγ2 chains dominate the response to bisphosphonate plus interleukin‐15
Authors: Cairo Cristiana , Sagnia Bertrand , Cappelli Giulia , Colizzi Vittorio , Leke Rose G. F. , Leke Robert J. , Pauza C. David
Published: November 2012

Compared with adults, the circulating Vγ2Vδ2 T‐cell population in cord blood is present at low levels and does not show the strong bias for Vγ2‐Jγ1.2 rearrangements. These features may be a result of limited exposure to stimulatory phosphoantigens, lack of T‐cell‐derived interleukin‐2 (IL‐2) or both. In cord blood mononuclear cell cultures, a single round of stimulation, using aminobisphosphonates to elevate phosphoantigen levels, resulted in expansion of adult‐like Vγ2 chains and accumulation of memory cells with cytotoxic potential. Selection was similar using IL‐2 or myeloid‐derived IL‐15. The Vγ2Vδ2 T cells present in neonates are capable of generating potent immune responses even when relying on IL‐15.
A deleterious effect associated with UNH159 is attenuated in twin embryos of an inbred line of blue tilapia Oreochromis aureus
Authors: Shirak A. , Palti Y. , Bern O. , Kocher T. D. , Gootwine E. , Seroussi E. , Hulata G. , Ron M. , Avtalion R. R.
Published: November 2012

Offspring of a highly inbred gynogenetic line of Oreochromis aureus displayed 12‐fold increase in twinning rate compared to the outbred population. Asymmetric conjoined twins, which consist of a normal embryo attached to a malformed‐atrophic twin, were frequently encountered in both gynogenetic (90·7%) and outbred (38·2%) embryos. The monozygotic origin of these twins was determined using five microsatellite markers. Progeny of heterozygous parents for the microsatellite UNH159 were separated into sub‐sets of twins and normal full‐sibs. Consistent with previous reports, the normal embryo sub‐set exhibited elimination of both types of homozygotes for the UNH159 genetic marker at 2–8 days after fertilization. Unexpectedly, this elimination was less frequent in twins. The UNH159 marker as well as RNA‐binding motif protein, X‐linked (rbmx), SRY‐box containing gene 3 (sox3) and alpha‐thalassemia/mental retardation syndrome X‐linked (atrx) genes were mapped to linkage group 2. These gene orthologues are all located on the mammalian X chromosome and atrx is necessary for the X‐chromosome inactivation.
Lack of taxonomic information from parietal spine size invalidates subspecies in the Atlantic hookear sculpin Artediellus atlanticus
Authors: Rees D. , Byrkjedal I.
Published: November 2012

An analysis of 107 individuals of Atlantic hookear sculpin Artediellus atlanticus from the Barents Sea–Svalbard region and from north‐east Greenland shows that the state of the parietal spines, although not randomly distributed geographically, occurs sympatrically. They do not diagnostically describe populations. They are therefore inept for subspecies delimitation into Artediellus atlanticus atlanticus, Artediellus atlanticus corniger and Artediellus atlanticus europaeus. Sympatric occurrence of parietal spine states called for a molecular approach to look for differences at a species level. Sequencing the mitochondrial genes, cytochrome oxidase c subunit I (coI) and cytochrome b (cytb), shows no difference between individuals with different parietal spine size. Thus, there is no evidence of the spine states representing species‐level variation. The study shows that parietal spine size has no taxonomic information for this species. The patterns of variation in parietal spine size differ to some degree between the sexes.
Frequent baked egg ingestion was not associated with change in rate of decline in egg skin prick test in children with challenge confirmed egg allergy
Authors: Tey D. , Dharmage S. C. , Robinson M. N. , Allen K. J. , Gurrin L. C. , Tang M. L. K.
Published: November 2012

Background

It is controversial whether egg‐allergic children should strictly avoid all forms of egg, or if regular ingestion of baked egg will either delay or hasten the resolution of egg allergy.

Objective

This is the first study to examine the relationship between frequency of baked egg ingestion and rate of decline in egg skin prick test size in egg‐allergic children.

Methodology

This was a retrospective clinical cohort study. All children with challenge‐proven egg allergy who attended the Royal Children's Hospital Allergy Department 1996–2005 and had at least two egg skin prick tests performed in this period were included (n = 125). Frequency of baked egg ingestion was assessed by telephone questionnaire as follows: (a) frequent (> once per week), (b) regular (> once every 3 months, up to ≤ once per week) or (c) strict avoidance (≤ once every 3 months). The relationship between frequency of baked egg ingestion and rate of decline in egg skin prick test size was examined by multiple linear regression, adjusting for potential confounders.

Results

Mean rate of decline in egg skin prick test size in all children was 0.7 mm/year (95% CI 0.5–1.0 mm/year). There was no evidence (P = 0.57) that the rate of decline in egg skin prick test size differed between children who undertook frequent ingestion (n = 21, mean 0.4 mm/year, 95% CI −0.3–1.2 mm/year), regular ingestion (n = 37, mean 0.9 mm/year, 95% CI 0.4–1.4 mm/year) or strict avoidance (n = 67, mean 0.7 mm/year, 95% CI 0.4–1.1 mm/year) of baked egg.

Conclusions

Compared with strict dietary avoidance, frequent consumption of baked egg was not associated with a different rate of decline in egg skin prick test size in egg‐allergic children.

Clinical Relevance

Given that dietary restrictions can adversely impact on the family, it is reasonable to consider liberalizing baked egg in the diet of egg‐allergic children.
Effects of hydrofluoric acid dissolution on organo–mineral associations in Cambisols and Andosols of Réunion
Authors: de Junet A. , Basile‐Doelsch I. , Borschneck D. , Masion A. , Miche H. , Marol C. , Balesdent J.
Published: November 2012

Interactions between organic matter (OM) and mineral phases represent a fundamental mechanism of carbon (C) sequestration in soils. They result in the formation of organo–mineral associations, which prevent rapid OM biodegradation. The density‐separation technique enables effective isolation of different types of organo–mineral associations in soil. However, analyses of OM in these organo–mineral associations are limited because the C contents are very small (<10 mg OM g−1 of soil) and mineral phases complicate direct studies of OM. Previous studies have shown that hydrofluoric acid (HF) dissolution is an effective treatment for OM analysis since the mineral phases are dissolved and C is concentrated in the extract. Nonetheless, few studies on the effects of HF dissolution have been directly carried out on organo–mineral associations. The main objectives of this study were to determine the effects of HF dissolution on organo–mineral associations and to establish the best HF treatment conditions for OM analysis. We chose two specific tropical soils, an hydric Andosol and an haplic Cambisol (Réunion), that varied in their mineralogy. After densimetric separation, we tested three HF concentrations and four contact times. Mineral removal was 94% for both soils at the most concentrated HF treatments. Aluminium and silicon compounds were largely dissolved after the first treatment, while iron‐rich residue accumulated after repeated HF treatments. XRD analyses confirmed the rapid dissolution of halloysite, gibbsite and quartz and the persistence of iron oxides. For the organo–mineral associations of the Cambisol, HF treatments did not enable us to obtain a usable signal with 13C NMR. For the organo–mineral associations of the Andosol, a four‐times extraction over 2 hours with 5% HF allowed us to acquire an effective signal with 13C NMR for OM qualitative analyses. However, a new compound made of aluminium and fluorine appeared with the 10% HF treatments for both soils. In order to compare and analyse the OM present in organo–mineral associations of these two soil types, we thus recommend using four 2‐hour treatments with 5% HF.
Patterns of soil organic carbon, glomalin and structural stability in abandoned Mediterranean terraced lands
Authors: Emran M. , Gispert M. , Pardini G.
Published: November 2012

Soil carbon (C) storage potential has received considerable attention for its role in climate change mitigation, and much research work has been devoted to studying the effect of land‐use change, including land abandonment, on carbon dynamics. A comparative analysis of soil organic carbon (SOC), easily extractable Bradford‐reactive soil protein (EE‐BRSP) and Bradford‐reactive soil protein (BRSP) was carried out at monthly intervals in a land‐use sequence including cultivated soils, forest soils, shrubs and pasture in northeast Spain. In general, greater seasonal variations of both EE‐BRSP and BRSP were found in soils with less carbon storage capacity. Turnover of glomalin into more stable C forms was associated with a small EE‐BRSP:BRSP ratio in better structured soils and BRSP was related to organic carbon, suggesting positive contributions to both the recalcitrant carbon pool and soil structure. This effect seemed to be more pronounced in August when more BRSP was found, probably because of high temperature and dry soils in which glomalin may react to preserve residual adsorbed water and provide better protection in soil microsites. The role of glomalin was further enhanced by the structural stability of aggregates (WSA) investigated in two aggregate fractions (0.25–2.00 and 2.00–5.60 mm), indicating its beneficial effect in aggregation and carbon storage potential. BRSP, SOC and WSA increased significantly (P < 0.001) along the transect and abandonment sequence; the largest WSA values were generally greater in summer in both aggregate fractions. However, values in cultivated soils were always smaller than in soils under shrubs and pasture. Similarly, soils with a smaller carbon pool had the largest proportion of carbon loss as CO2‐C when land use changes from vines to pasture. The role of aggregates in protecting organic carbon against mineralization was therefore postulated and highlighted the importance of soil monitoring after land abandonment.
Influence of non‐crystalline minerals in the total amount, resilience and molecular composition of the organic matter in volcanic ash soils (Tenerife Island, Spain)
Authors: Hernández Z. , Almendros G. , Carral P. , Álvarez A. , Knicker H. , Pérez‐Trujillo J. P.
Published: November 2012

The influence of short‐range ordered minerals, especially allophane or ferrihydrite, in the total amount, resilience and molecular structure of the soil organic matter (SOM) was determined in a series of volcanic ash soils from Tenerife Island (Spain), with a range of amorphous minerals, organic carbon (C) and clay minerals. Up to 120 main analytical descriptors of the SOM were processed by uni‐ and multivariate statistical analyses. Short‐range ordered minerals were estimated from the (Alo + ½ Feo) index, organo‐metallic complexes were calculated from the Alp:Alo ratio and crystalline minerals were determined by X‐ray diffraction. The humic acids (HAs) were isolated, purified and analysed by visible, infrared and 13C nuclear magnetic resonance spectroscopy and analytical pyrolysis. In addition, CO2 release curves from whole soil samples were used to obtain indices of SOM resilience. The results revealed that the amount and resilience of the SOM depended on the presence of short‐range ordered minerals: the greater the content of non‐crystalline minerals, the greater the C stabilization. However, no significant relationships were found between these amorphous minerals and aromatic compounds, which are indicators of resilience in HAs. Conversely, certain molecular characteristics of the HAs, such as the optical density at 465 nm, the concentration of quinone‐type fungal pigments, the yields of carbohydrate‐derivatives and N‐compounds, highlighted the role of allophane‐sized nanoparticles in the protection of microbial metabolites produced during the decomposition, and are also likely to provide active sites for soil C stabilization at the colloidal scale.
Using FRET to analyse signals controlling cell adhesion and migration
Authors: KEMP‐O'BRIEN K. , PARSONS M.
Published: November 2012

Cell adhesion and migration are dynamic, complex processes that require tight temporal control of signalling cascades at defined subcellular sites to occur. Decades of research have used biochemical methods to identify numerous signalling pathways that are involved in the coordination of adhesion, membrane protrusion and contractility that all contribute to migration. However, understanding the way in which these signals are controlled within discrete sites in individual cells undergoing migration is essential to enable a clearer understanding of how these pathways are integrated during motility. Recent advances in the generation of fluorescent protein variants have enabled the development of probes to analyse localized changes in protein conformation, activation or interactions in single cells using microscopy. Many of these probes are based on the use of fluorescence resonance energy transfer that permits precise determination of interacting species based on the emission or lifetime properties of the fluorophores involved. Here, we provide an overview of some of the recent studies that have developed such probes and examples of how these biosensors have been used to further our understanding of cell migration signalling.
Measures of Indigenous social capital and their relationship with well‐being
Authors: Biddle Nicholas
Published: November 2012

Objective:  To provide the first estimates of a comprehensive measure of social capital for the Indigenous population and to link the indicators to well‐being.

Design:  Observational study‐based.

Setting:  Household survey.

Participants:  Nationally representative sample of 7823 Indigenous Australians aged 15 years and over who were usual residents of private dwellings.

Main outcome measure:  Whether or not the respondent felt happy in the last 4 weeks all or most of the time (happiness), and whether or not they felt so sad that nothing could cheer them up at least a little bit of the time over the same period (sadness).

Results:  There were no consistent differences in social capital measures between Indigenous men and women, nor were there consistent differences between the remote and non‐remote population. High levels of social capital were, however, associated with higher subjective well‐being.

Conclusion:  Social capital is both an indicator and determinant of well‐being. It was possible to derive an index of social capital for Indigenous Australians that had a strong positive association with self‐reported happiness and a negative association with self‐reported sadness. However, the analysis also showed that there are a set of related domains of social capital, rather than there being a single underlying concept.
Understanding drivers of rural and remote health outcomes: A conceptual framework in action
Authors: Bourke Lisa , Humphreys John S. , Wakerman John , Taylor Judy
Published: November 2012

Objective

To demonstrate the usefulness of a conceptual framework to increase the understanding of rural and remote health by applying it to specific rural and remote health scenarios.

Design

A conceptual framework was applied to two case studies illustrative of key issues in rural health to reflect different contexts, issues and responses.

Results

Application of the framework to both case studies highlighted that changes in rural and remote health are diverse. While power was a key element of the framework, the interaction of all framework components underpinned changes.

Conclusion

The framework facilitated understanding of change in these rural scenarios and demonstrated that improvement in rural health requires change at both the local and structural levels.
Unintentional paediatric poisoning in rural Victoria: Incidence and admission rates
Authors: Cheng Daryl Ray , Ip Christopher Chi Kit
Published: November 2012

Objective

Unintentional paediatric poisoning is one of the leading causes of childhood emergency department presentations in Australia. This study aimed to assess the incidence and hospital admission rates of unintentional paediatric poisonings in rural Victoria.

Design setting and participants

A retrospective audit of all paediatric poisonings in an 86‐bed rural Victorian hospital over the period 2000–2010 was conducted. The paediatric age group was classified as 0–14 years per the National Injury Prevention and Safety Promotion Plan. Poisonings were classified according to the International Classification of Diseases, 10th revision, diagnostic codes ranging from T36‐T65.

Results

To our knowledge, this is the first article providing a snapshot of paediatric poisoning in rural Victoria. Fifty‐seven cases met eligibility criteria and were analysed. Medicines were the predominant poisoning agent (75.4%), with the predominant agent being paracetamol. More than half of cases (61.3%) were admitted for hospitalisation, with four having complications requiring further intervention or patient transfer. This was significantly higher than previous data and could be due to lack of specialty staff and equipment, differing attitudes of medical staff and longer travel distances. The average length of stay in hospital was 1.31 days. Poisoning by chemicals and agents was low, despite increased availability of farm chemicals. A small proportion of cases were due to venom‐related poisonings.

Conclusion

Although rates of paediatric poisoning seem to be lower in this particular rural setting, admission rates continue to be significantly higher than comparative urban figures. Further research and education is needed to gain a better understanding of this important public health topic
‘Hear our stories’: Child‐rearing practices of a remote Australian Aboriginal community
Authors: Byers Lyn , Kulitja Selina , Lowell Anne , Kruske Sue
Published: November 2012

Objective

Little is known about Australian Aboriginal world views related to child rearing and child development. The aim of this qualitative study was to provide an opportunity for remote Aboriginal families in Central Australia to share what they felt was important for non‐Aboriginal people, working in the same setting, to know about their parenting methods.

Design, setting and participants

A descriptive study was carried out in a remote Central Australian community by an Aboriginal and non‐Aboriginal researcher, working in partnership, combining ethnographic and participatory approaches. Eight families with children under five were primary participants. Data were collected through participant observation and informal conversational interviews.

Findings

Three main interlinked themes were identified through this research: ‘fitting in’ (integration of children into community life), ‘growing up’ (children's development) and ‘staying strong’ (children's autonomy within a communal social structure). In this community, the development of independence and self‐reliance within a closely nurturing environment are paramount. Children are taught responsibilities and obligations through interaction in community life from birth. Children's growth and development is not linked to chronological time scales. Rather, children are encouraged and praised for their social and emotional maturity as well as physical development, regardless of the age at which milestones are achieved.

Conclusions

This descriptive study provided an opportunity for Aboriginal people in one remote community to share their perspectives about child rearing and child development. It provides some insights into positive child‐rearing practices and perspectives which can assist non‐Aboriginal service providers to work more effectively with Aboriginal families.
Networked remote area dental services: A viable, sustainable approach to oral health care in challenging environments
Authors: Dyson Kate , Kruger Estie , Tennant Marc
Published: November 2012

Objective

This study examines the cost effectiveness of a model of remote area oral health service.

Design

Retrospective financial analysis.

Setting

Rural and remote primary health services.

Participants

Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost‐effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study.

Main Outcome Measured

Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision.

Results and Conclusion

The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost‐saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care.
Building Consent: Hegemony, ‘Conceptions of the World’ and the Role of Evangelicals in Global Politics
Authors: Murray Kyle , Worth Owen
Published: November 2012

Since Robert Cox's early interventions in the 1980s, the work of Gramsci has been openly applied to the arena of international politics, often superimposed on to the wider concepts of ‘world order’ and ‘transnational class’ formation. While this has produced a great deal of commendable scholarly work, it has equally produced a growing number of critics who have voiced concerns over the viability and feasibility of applying Gramsci's key concepts to the realm of the international. Rather than revisiting these charges, we argue that one of the main problems associated with the ‘neo-Gramscian’ interpretations of international relations (IR) is that they have tended to develop an ontology of their own and have not pursued a re-reading of Gramsci's actual work to explore a fresh opening towards applying Gramsci to the international. We argue that by re-exploring Gramsci's understanding of ‘conceptions of the world’ and by re-examining Gramsci's concept of hegemony, a greater scope can be achieved for understanding power relations within global politics. We demonstrate the potential for this by tentatively looking at the role of increasingly popular global evangelical religious groups in the fashioning of hegemonic consent across diverse parts of civil society, arguing that it is such bottom-up studies of societal consent that are required in order for Gramscian theory and research to move beyond their current ontological applications.
On the autonomy and homogeneity of Canadian English
Authors: DOLLINGER STEFAN , CLARKE SANDRA
Published: November 2012

ABSTRACT:  This introduction to the symposium approaches the themes of autonomy and homogeneity in Canadian English from a historical perspective. We trace the debates on these topics back to the late 19th century and relate them to changing public attitudes toward Canadian linguistic autonomy over time. We review the scholarly evidence on autonomy and homogeneity and outline the evolving interpretations of these themes from earlier research to that of the present day. While much linguistic research in the 1980s and 1990s approached linguistic change in Canadian English in terms of “Americanization”, subsequent work has shown that a more nuanced interpretation is in order. We end with a brief review of the six papers in this symposium, in terms of our two themes: four deal with questions of homogeneity and heterogeneity, while two primarily address issues of linguistic autonomy and heteronomy. These papers reveal both common ground and diverging assessment of the data, which attests to a lively field of inquiry.
What's Race Got to Do with It? Responses to Consumer Discrimination
Authors: Evett Sophia R. , Hakstian Anne‐Marie G. , Williams Jerome D. , Henderson Geraldine R.
Published: November 2012

Consumer discrimination occurs when sales clerks and other store employees, including security personnel, treat customers differently because of their race or ethnicity. The goal of the present research was to examine how participants perceived a case of consumer discrimination and what actions they felt the victim should take. Based on Robinson's theory of perceptual segregation, we examined whether the perceptions and responses of white participants differed from those of people of color. We also drew on the liberation psychology tenets of conscientization and de‐ideologization with particular emphasis on taking the perspective of the oppressed, by measuring participants’ level of perceived societal discrimination. These two individual difference variables (participant race and perceived societal discrimination) significantly predicted participants’ perceptions of the situation and their emotional responses, which, in turn, mediated how they thought the customer should respond.
Retrospective Comparison of Minimally Invasive Plate Osteosynthesis and Open Reduction and Internal Fixation of Radius‐Ulna Fractures in Dogs
Authors: Pozzi Antonio , Hudson Caleb C. , Gauthier Christopher M. , Lewis Daniel D.
Published: November 2012

Objective

To compare the efficacy of reduction, time to union, and clinical outcome of radius and ulna fractures stabilized using either minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF).

Study Design

Retrospective, case‐controlled study.

Animals

Dogs with radius and ulna fractures stabilized with plates applied usingMIPO(n = 15) orORIF(n = 15).

Methods

Dogs in each stabilization group were matched for type and location of fracture, age, and body weight. Outcome measures including surgical time, fracture alignment, gap width, plate length, plate bridging and span ratio, working length and screw density, and time to union were compared between the groups using an unpaired t‐test. Statistical significance was set atP< .05.

Results

All fractures obtained radiographic union although infection developed in 1 dog in each stabilization group. Dogs treated withMIPOhad a significant longer plate working length and lesser screw‐density (P< .05). No statistical difference was found in operating time, postoperative alignment, gap width, or time to union (MIPO: 51.9 ± 18.4 days;ORIF: 49.5 ± 26.5 days).

Conclusions

Radius and ulna fractures managed withMIPOhad similar alignment, reduction, and time to union as fractures managed withORIF. Future prospective clinical studies are warranted and should assess healing more frequently and in a standardized manner to compareMIPOtoORIFin a larger population of dogs.
Viremic profiles in asymptomatic and symptomatic chikungunya fever: a blood transfusion threat?
Authors: Appassakij Hatsadee , Khuntikij Paiwon , Kemapunmanus Marisa , Wutthanarungsan Rochana , Silpapojakul Khachornsakdi
Published: November 2012

Background

The presence of a chikungunya virus (CHIKV) outbreak could have an impact on transfusion safety when there are a large number of infected persons during an epidemic. Serosurveys have found that 3% to 28% of infected persons remain asymptomatic and are potential disseminators of transfusion‐associated chikungunya. However, the viremic profiles of asymptomatic chikungunya patients, the major determinant of the transfusion risk, are unknown.

Study Design and Methods

Data on CHIKV viremic profiles were obtained from a case‐control study carried out in a chikungunya‐affected area during the 2009 epidemic in Songkhla, Thailand. CHIKV‐infected individuals were classified based on a combination of the patient's history and clinical and laboratory findings.

Results

There were 134 laboratory‐proven CHIKV‐infected cases, of whom 122 (91.0%) were symptomatic and 12 (9.0%) were asymptomatic. The viremic levels in the symptomatic infected individuals peaked on the first 3 days and lasted up to 8 days as defined by viral isolates. CHIKV genomic products were detected as late as Day 17 of illness. The viral loads observed in the symptomatic individuals (median, 5.6 × 105 plaque‐forming units per milliliter [pfu/mL]; range, 1.3 × 101‐2.9 × 108 pfu/mL) were higher than but not significantly different from those observed in the viremic asymptomatic individuals (median, 3.4 × 103 pfu/mL; range, 8.4 × 101‐2.9 × 105 pfu/mL [p = 0.22, Wilcoxon test]).

Conclusion

CHIKV infection is highly symptomatic and is associated with high‐titred viremia. The viremic levels in asymptomatic CHIKV‐infected individuals were in the range known to be capable of transmitting the disease to experimental animals. Asymptomatic CHIKV viremia individuals could be potential disseminators of transfusion‐associated chikungunya.
Patients with sickle cell anemia on simple chronic transfusion protocol show sex differences for hemodynamic and hematologic responses to transfusion
Authors: Detterich Jon A. , Sangkatumvong Suvimol , Kato Roberta , Dongelyan Ani , Bush Adam , Khoo Michael , Meiselman Herbert J. , Coates Thomas D. , Wood John C.
Published: November 2012

Background

Chronic transfusion therapy (CTT) is a mainstay for stroke prophylaxis in sickle cell anemia, but its effects on hemodynamics are poorly characterized. Transfusion improves oxygen‐carrying capacity, reducing demands for high cardiac output, while decreasing hemoglobin (Hb)S%, reticulocyte count, and hemolysis. We hypothesized that transfusion would improve oxygen‐carrying capacity, but that would be counteracted by a decrease in cardiac output due to increased hematocrit (Hct) and vascular resistance, leaving oxygen delivery unchanged.

Study Design and Methods

To test this hypothesis, we examined patients on CTT immediately before transfusion and again 12 to 120 hours after transfusion, using echocardiography and near infrared spectroscopy.

Results

Comparable increases in Hb and Hct and decreases in reticulocyte count and HbS with transfusion were observed in all patients, but males had a larger rebound of HbS%, reticulocyte count, and free Hb levels between transfusions. In males, transfusion decreased heart rate by 12%, stroke volume by 15%, and cardiac index by 24% while estimates for pulmonary and systemic vascular resistance increased, culminating in 6% decrease in oxygen delivery. In contrast, stroke volume and cardiac index and systemic and pulmonary vascular resistance did not change in women after transfusion, such that oxygen delivery improved 17%.

Conclusion

In our sample population, males exhibit a paradoxical reduction in oxygen delivery in response to transfusion because the increase in vascular resistance is larger than the increase in oxygen capacity. This may result from an inability to adequately suppress their HbS% between transfusion cycles.
Justice, Charity, and Disaster Relief: What, If Anything, Is Owed to Haiti, Japan, and New Zealand?
Authors: Valentini Laura
Published: November 2012

Whenever fellow humans suffer due to natural catastrophes, we have a duty to help them. This duty is not only acknowledged in moral theory but also expressed in ordinary people's reactions to phenomena such as tsunamis, hurricanes, and earthquakes. Despite being widely acknowledged, this duty is also widely disputed: some believe it is a matter of justice, others a matter of charity. Although central to debates in international political theory, the distinction between justice and charity is hardly ever systematically drawn. To fill this gap in the literature, I consider three accounts of this distinction— the “agent‐based,” the “recipient‐based,” and the “mixed” view—and argue that they are all unsatisfactory. I then offer a fourth alternative, the “autonomy” view, which successfully overcomes the difficulties affecting its rivals. I conclude by considering the implications of this view for the moral grounds of disaster relief in earthquake‐stricken Haiti, New Zealand, and Japan.
Do Primaries Improve Electoral Performance? Clientelism and Intra‐Party Conflict in Ghana
Authors: Ichino Nahomi , Nathan Noah L.
Published: November 2012

We consider the effect of legislative primaries on the electoral performance of political parties in a new democracy. While existing literature suggests that primaries may either hurt a party by selecting extremist candidates or improve performance by selecting high valence candidates or improving a party’s image, these mechanisms may not apply where clientelism is prevalent. A theory of primaries built instead on a logic of clientelism with intra‐party conflict suggests different effects of legislative primaries for ruling and opposition parties, as well as spillover effects for presidential elections. Using matching with an original dataset on Ghana, we find evidence of a primary bonus for the opposition party and a primary penalty for the ruling party in the legislative election, while legislative primaries improve performance in the presidential election in some constituencies for both parties.
“No One Ever Showed Me Nothing”: Skill and Self‐Making among Trinidadian Garment Workers
Authors: Prentice Rebecca
Published: November 2012

This article examines the relationship between skill acquisition and the constitution of economic selfhood in Trinidad. Drawing on ethnographic fieldwork among garment workers in a context of industrial decline, I show how their formal, informal, and illicit means of acquiring sewing skills are inextricably linked to the fragmented and unstable economic opportunities available to them. Learning to sew means learning to be a flexible economic actor, which helps workers survive but disadvantages them in waged labor relationships. By investigating the role of pleasure in self‐training, I emphasize the neglected importance of emotion for understanding livelihood strategies.