bluuebunny/crossref_metadata_2025_split huggingface dataset:
De‐escalation techniques used, and reasons for seclusion and restraint, in a forensic psychiatric hospital
Authors: Kuivalainen Satu , Vehviläinen‐Julkunen Katri , Louheranta Olavi , Putkonen Anu , Repo‐Tiihonen Eila , Tiihonen Jari 
Published: September 2017

AbstractIn Finland, the Mental Health Act determines the legal basis for seclusion and restraint. Restrictive measures are implemented to manage challenging situations and should be used as a last resort in psychiatric inpatient care. In the present study, we examined the reasons for seclusion and restraint, as well as whether any de‐escalation techniques were used to help patients calm down. Seclusion and restraint files from a 4‐year period (1 June 2009–31 May 2013) were retrospectively investigated and analysed by content analysis. Descriptive statistics were calculated. A total of 144 episodes of seclusion and restraint were included to analyse the reasons for seclusion and restraint, and 113 episodes were analysed to examine unsuccessful de‐escalation techniques. The most commonly‐used techniques were one‐to‐one interaction with a patient (n = 74, 65.5% of n = 113) and administration of extra medication (n = 37, 32.7% of n = 113). The reasons for seclusion and restraint were threatening harmful behaviour (n = 51, 35.4% of n = 144), direct harmful behaviour (n = 43, 29.9%), indirect harmful behaviour (n = 42, 29.1%), and other behaviours (n = 8, 5.6%). In general, the same de‐escalation techniques were used with most patients. Most episodes of seclusion or restraint were due to threats of violence or direct violence. Individual means of self‐regulation and patient guidance on these techniques are needed. Additionally, staff should be educated on a diverse range of de‐escalation techniques. Future studies should focus on examining de‐escalation techniques for the prevention of seclusion.
Ulysses in the United Kingdom: Difficulties with a capacity‐based justification for self‐binding in bipolar disorder
Authors: Kane Nuala B. 
Published: September 2017

SummaryThere has been a recent proposal by Gergel and Owen for introduction of legally enforceable self‐binding directives for persons with bipolar affective disorder in the United Kingdom. The model is rooted in presence or absence of decision‐making capacity, and the notion of capacity used is an expansion of the usual notion of capacity, in that it is individualized and diachronic. In this article, I argue that an individualized notion of capacity either lacks a coherent foundation or exposes itself to a situation where epistemological error results in a double standard or unjustified enforcement of the directive. I also raise concern that the diachronic notion of capacity leads to an authenticity type account, which fails to incorporate differences in individual prognosis. I then present a rough sketch of an alternative account, more in keeping with current mental health legislation, which uses an individualized notion of “risk to self” to justify self‐binding directives in bipolar disorder.
Reasoning, evidence, and clinical decision‐making: The great debate moves forward
Authors: Loughlin Michael , Bluhm Robyn , Buetow Stephen , Borgerson Kirstin , Fuller Jonathan 
Published: September 2017

AbstractWhen the editorial to the first philosophy thematic edition of this journal was published in 2010, critical questioning of underlying assumptions, regarding such crucial issues as clinical decision making, practical reasoning, and the nature of evidence in health care, was still derided by some prominent contributors to the literature on medical practice. Things have changed dramatically. Far from being derided or dismissed as a distraction from practical concerns, the discussion of such fundamental questions, and their implications for matters of practical import, is currently the preoccupation of some of the most influential and insightful contributors to the on‐going evidence‐based medicine debate. Discussions focus on practical wisdom, evidence, and value and the relationship between rationality and context. In the debate about clinical practice, we are going to have to be more explicit and rigorous in future in developing and defending our views about what is valuable in human life.
A phase II randomised study to evaluate the efficacy of aprepitant plus palonosetron for preventing delayed‐phase CINV associated with TC therapy in gynaecological cancer
Authors: Sugimori Yayoi , Ota Tsuyoshi , Ujihira Takafumi , Ishiguro Tomonori , Ogishima Daiki 
Published: September 2017

AbstractAimChemotherapy‐induced nausea and vomiting (CINV) is one of the most frequently encountered side effects of cancer treatment. Severe CINV can lead patients to refuse chemotherapy, which ultimately affects cancer outcomes. The development of fairly new antiemetic agents, 5‐hydroxytryptamine‐3 receptor antagonists, palonosetron and neurokinin‐1 receptor antagonists and aprepitant has reduced the risk and incidence of CINV. In this study, we assessed the efficacy of aprepitant plus palonosetron against palonosetron for CINV in patients receiving moderately emetic cancer chemotherapy (paclitaxel and carboplatin combination [TC] therapy).MethodsBetween November 2010 and March 2014, 78 patients with gynecological cancer treated with TC therapy were randomized into two groups: an aprepitant group (administered aprepitant, dexamethasone and palonosetron) and a control group (administered dexamethasone and palonosetron). The primary study endpoint was complete response, defined as the complete absence of emetic events in the delayed phase.ResultsThe complete response rate in the delayed phase differed significantly between the two groups, with 82% in the aprepitant group and 97% in the control group (P = 0.025).ConclusionThe combination of aprepitant and palonosetron appears to be of greater efficacy than palonosetron alone for the prevention of delayed‐phase CINV induced by TC therapy.
Pain relieving and protective effects of Astragalus hydroalcoholic extract in rat arthritis models
Authors: Maresca Mario , Micheli Laura , Cinci Lorenzo , Bilia Anna Rita , Ghelardini Carla , Di Cesare Mannelli Lorenzo 
Published: September 2017

Abstract

Objectives
The evaluation of the pharmacological profile of the dried 50% hydroalcoholic extract (50%HA) of Astragali radix in two different animal models of articular damage resembling osteoarthritis and rheumatoid arthritis.

Methods
Sodium monoiodoacetate (MIA) or complete Freund's adjuvant (CFA) was intra-articular injected (day 0) in the rat tibiotarsal joint to induce damages mimicking osteoarthritis or rheumatoid arthritis. Pain measurements (responses to non-noxious and noxious stimuli, spontaneous pain, articular pain) were assessed on days 7 and 14. On day 14, the tibiotarsal joints were explanted in order to measure the diameter and to assess histological evaluations. Furthermore, the plasmatic concentrations of inflammatory and anti-inflammatory cytokines were measured.

Key findings
A single administration of 50%HA (300 mg/kg per os) significantly reduced both MIA-induced pain and CFA-induced pain (78% and 96% pain relief, respectively). The repeated administration prevented the development of hypersensitivity on day 14. The haematoxylin/eosin staining revealed that 50% HA attenuated joint alterations in MIA-injected rats, and furthermore, the joint inflammatory infiltrate was reduced in both models (by about 50%). In CFA-treated rats, 50%HA lowered the plasmatic levels of the pro-inflammatory cytokines interleukin-1β and tumour necrosis factor-α as well as the joint diameter.

Conclusions
The 50% hydroalcoholic extract of Astragali radix is a valuable candidate for the adjuvant treatment of articular diseases.
Scintigraphic Assessment of Deposition of Radiolabeled Fluticasone Delivered from a Nebulizer and Metered Dose Inhaler in 10 Healthy Dogs
Authors: Chow K.E. , Tyrrell D. , Yang M. , Abraham L.A. , Anderson G.A. , Mansfield C.S. 
Published: September 2017

BackgroundAerosolized medications are increasingly being used to treat respiratory diseases in dogs. No previous studies assessing respiratory tract deposition of radiolabeled aerosols have been performed in conscious dogs.Hypothesis/ObjectivesAssess respiratory tract deposition of radiolabeled, inhalant corticosteroid (fluticasone propionate labeled with 99mTc) delivered from a nebulizer and metered dose inhaler (MDI) to healthy dogs.AnimalsTen healthy Foxhounds.MethodsProspective, randomized, cross‐over pilot study. Initial inhalation method (nebulizer or MDI) was randomly assigned. Treatments were crossed over after a 7‐day washout period. Treatments initially were performed using sedation. Dogs were imaged using 2‐dimensional planar scintigraphy, with respiratory tract deposition quantified by manual region‐of‐interest analysis. Deposition calculated as percentage of delivered dose. Six of 10 dogs were randomly selected and reassessed without sedation.ResultsInhalation method had significant effect on respiratory tract deposition (P = 0.027). Higher deposition was achieved by nebulization with mean deposition of 4.2% (standard deviation [SD], 1.4%; range, 1.9–6.1%); whereas MDI treatment achieved a mean of 2.3% (SD, 1.4%; range, 0.2–4.2%). Nebulization achieved higher respiratory tract deposition than MDI in 7 of 10 dogs. No statistical difference (P = 0.68) was found between mean respiratory tract deposition achieved in dogs when unsedated (3.8%; SD, 1.5%) or sedated (3.6%; SD, 1.7%).Conclusions and Clinical ImportanceStudy confirms respiratory tract deposition of inhalant medications delivered from a nebulizer and MDI in healthy dogs, breathing tidally with and without sedation. Respiratory tract deposition in these dogs was low compared to reported deposition in adult humans, but similar to reported deposition in children.
Does phytoestrogen supplementation improve cognition in humans? A systematic review
Authors: Thaung Zaw Jay Jay , Howe Peter Ranald Charles , Wong Rachel Heloise Xiwen 
Published: September 2017

AbstractRecent evidence indicates that resveratrol, a phytoestrogen, can improve cognitive function in postmenopausal women by enhancing cerebral vasodilator responsiveness. We examine the effects of phytoestrogen supplementation on cognition and compare resveratrol with other phytoestrogens. Databases were searched for reports of randomized controlled trials (RCTs) containing terms describing phytoestrogens together with terms relating to cognition. Effect sizes were determined for changes in cognition. We identified 23 RCTs, 15 with isoflavone and eight with resveratrol or grape formulations. Six soy isoflavone studies showed positive cognitive effects of medium size. Greater benefits were seen in women who were <10 years postmenopausal and supplemented for <6 months. Small‐to‐medium effect–size cognitive benefits of resveratrol were seen in four studies of older adults of mixed gender and in postmenopausal women who took 150–200 mg resveratrol daily for at least 14 weeks. No benefits were seen in three studies using red clover or grape formulations. Supplementation with either soy isoflavone or resveratrol improved executive function and memory domains of cognitively normal older adults in half of the included studies, mostly with medium effect sizes. The cognitive benefit of resveratrol was related to improved cerebral perfusion.
Social marketing approaches to nutrition and physical activity interventions in early care and education centres: a systematic review
Authors: Luecking C. T. , Hennink‐Kaminski H. , Ihekweazu C. , Vaughn A. , Mazzucca S. , Ward D. S. 
Published: September 2017

SummaryIntroductionSocial marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown.MethodsPubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria.ResultsThe review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one‐third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child‐level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used.ConclusionThis review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted.
Can Performance Management Best Practices Help Reduce Crime?
Authors: Pasha Obed 
Published: September 2017

AbstractAs performance management systems gain popularity in police agencies, they are increasingly being criticized for their ineffectiveness at reducing crime and for encouraging abuse of authority. Scholars and practitioners, however, argue that these systems can be effective if they are implemented properly with the use of best practices. This article contributes to this debate by evaluating the impact of performance management systems and associated best practices on improving police performance. An analysis of primary survey data of 308 U.S. police agencies shows that performance management systems are effective tools in helping reduce crime across almost all crime categories. However, the best practices of performance reporting to citizens and providing discretion to officers have no significant impact on crime reduction, while consulting officers in the target‐setting process has a negative impact on police performance.
Agonist‐induced platelet reactivity correlates with bleeding in haemato‐oncological patients
Authors: Batman B. , van Bladel E. R. , van Hamersveld M. , Pasker‐de Jong P. C. M. , Korporaal S. J. A. , Urbanus R. T. , Roest M. , Boven L. A. , Fijnheer R. 
Published: September 2017

Background and objectiveProphylactic platelet transfusions are administered to prevent bleeding in haemato‐oncological patients. However, bleeding still occurs, despite these transfusions. This practice is costly and not without risk. Better predictors of bleeding are needed, and flow cytometric evaluation of platelet function might aid the clinician in identifying patients at risk of bleeding. This evaluation can be performed within the hour and is not hampered by low platelet count. Our objective was to assess a possible correlation between bleeding and platelet function in thrombocytopenic haemato‐oncological patients.Materials and MethodsInclusion was possible for admitted haemato‐oncology patients aged 18 years and above. Furthermore, an expected need for platelet transfusions was necessary. Bleeding was graded according to the WHO bleeding scale. Platelet reactivity to stimulation by either adenosine diphosphate (ADP), cross‐linked collagen‐related peptide (CRP‐xL), PAR1‐ or PAR4‐activating peptide (AP) was measured using flow cytometry.ResultsA total of 114 evaluations were available from 21 consecutive patients. Platelet reactivity in response to stimulation by all four studied agonists was inversely correlated with significant bleeding. Odds ratios (OR) for bleeding were 0·28 for every unit increase in median fluorescence intensity (MFI) [95% confidence interval (CI) 0·11–0·73] for ADP; 0·59 [0·40–0·87] for CRP‐xL; 0·59 [0·37–0·94] for PAR1‐AP; and 0·43 [0·23–0·79] for PAR4‐AP. The platelet count was not correlated with bleeding (OR 0·99 [0·96–1·02]).ConclusionAgonist‐induced platelet reactivity was significantly correlated to bleeding. Platelet function testing could provide a basis for a personalized transfusion regimen, in which platelet transfusions are limited to those at risk of bleeding.
Novel intronic RHD variants identified in serologically D‐negative blood donors
Authors: El Wafi M. , El Housse H. , Zaid N. , Zouine S. , Nourichafi N. , Bouisk K. , Benajiba M. , Habti N. 
Published: September 2017

BackgroundBlood group genotyping is used to predict RhD phenotype in transfusion and obstetric medicine. Prediction of antigen D is based on molecular techniques which targets most common RHD‐specific polymorphism. However, inactive RHD variants can suggest false‐positive RhD phenotype. Their types and frequencies vary among ethnicities. Our study aimed to identify RHD variants among Moroccan blood donors who are serologically D negative.Study Design and MethodsDNA from 53 blood donors who are serologically D negative RhC and/or RhE positive were screened for RHD exon 10 by PCR‐SSP. RHD‐positive samples were further tested by multiplex PCR covering exons 3, 4, 5, 6, 7 and 9 and then sequenced by targeted next‐generation sequencing method. Mutations’ impact on mRNA splicing was predicted using alamut software version 2·0.ResultsPCR‐SSP revealed 9 of 53 (16·9%) RHD‐positive samples. Five of nine samples were positive for all tested exons, two of nine were positive for exon 9, and two of nine were undetermined. Sequencing revealed four novel RHD variants based on six mutations in introns 1, 3, 5 and 6. In silico analysis revealed aberrant splicing of three mutations (RHD c.487‐1024delG, RHD c.487‐256T>G and RHD c.940‐187_940‐188del), while three other mutations (RHD c.149‐682C>A, RHD c.802‐37delA and RHD c.939 + 1151dup) had no effect on splicing compared to wild type.ConclusionsAll identified RHD variants contain at least one mutation that probably affects splicing to generate D‐negative phenotype. Hence, ethnic RhD antigen background must be considered when developing transfusion and obstetric strategies.
Advances in thermoelectric materials research: Looking back and moving forward
Authors: He Jian , Tritt Terry M. 
Published: September 2017

Strategies for efficient thermoelectrics
Thermoelectric materials convert heat into electricity and can provide solid-state cooling for spot-sized refrigeration. One important barrier for adopting these materials beyond niche applications is their low efficiency. He and Tritt review the mechanisms and strategies for improving thermoelectric efficiency. They discuss how to report material performance and highlight the most promising materials. With new materials and strategies for performance enhancement, thermoelectrics are poised to alter the renewable energy landscape.

Science
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eaak9997
Marine Spatial Planning in the North Sea—Are National Policies and Legal Structures Compatible Enough? The Case of Norway and the Netherlands
Authors: Platjouw Froukje Maria 
Published: September 2017

Abstract
Marine spatial planning is an important tool to achieve a more ecosystem-based governance approach to marine ecosystems. Marine ecosystems often transcend national jurisdictional boundaries, so the compatibility of national policies and legal structures are important prerequisites for transboundary marine spatial planning. This article explores marine spatial planning in the North Sea ecosystem and analyses whether national policies and legal structures in the Netherlands and Norway are compatible enough. Both countries have an extensive body of law regulating the different uses of the North Sea and have also developed integrated management approaches for ‘their’ respective parts of the North Sea. The article demonstrates that marine spatial planning in regional sea areas is complicated when national legal frameworks and governance structures and traditions are very different.
Does the Flag Still Follow Trade? Agency, Politicization and External Opportunity Structures in the Post-Lisbon System of eu Diplomacy
Authors: Smith Michael H. 
Published: September 2017

Summary
This article focuses on the past and present of the European Union’s system of diplomacy, and asks whether the changes initiated by the Lisbon Treaty have really transformed that system. The Lisbon Treaty promised to transform the situation in which ‘the flag followed trade’ and give a primary role to the diplomacy of politics and security. Using arguments based on the location of agency, the politicization of economic diplomacy and the logic of external opportunity structures, the article argues that the transformation has not taken place, and that eu external action remains essentially a hybrid construct in which economic diplomacy plays a central role. Such a situation has important implications for eu diplomacy in third countries and for the character of the eu’s diplomatic representation, especially when it comes to the demand expressed in the eu’s 2016 Global Strategy for ‘joined up’ or closely coordinated external action.
Serial Changes in the Joint Space Width and Joint Line Convergence Angle After Closed-Wedge High Tibial Osteotomy
Authors: Park Cheol Hee , Bae Dae Kyung , Kim Kang Il , Lee Jong Whan , Song Sang Jun 
Published: September 2017

Background: There have been little data concerning serial changes in the joint space width (JSW) and joint line convergence angle over the course of follow-up periods after closed-wedge high tibial osteotomy (CWHTO). Purpose: To evaluate serial changes in the JSW and joint line convergence angle after CWHTO. Study Design: Case series; Level of evidence, 4. Methods: A total of 100 computer-assisted CWHTOs with a minimum follow-up period of 3 years (mean, 4.4 years) were analyzed. Clinically, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was evaluated. Radiographically, the mechanical axis was measured preoperatively and postoperatively. The minimal JSW was measured as the shortest distance between the femur and the tibia. The convergence angle was measured as the angle between the tangent to the subchondral plates of the femoral condyle and the tibial plateau. Serial changes in these measurements were analyzed preoperatively; at 3 months, 6 months, 1 year, and 2 years postoperatively; and at the final follow-up. The intraclass correlation coefficients for all measurements were greater than 0.8. Results: The mean WOMAC score improved from 41.4 preoperatively to 14.9 at the final follow-up. The preoperative and postoperative mean mechanical axis was 8.1° varus and 1.6° valgus, respectively. The mean minimal JSW was 2.5, 2.9, 2.9, 3.1, 3.2, and 3.1 mm preoperatively and at 3 months, 6 months, 1 year, 2 years, and the final follow-up, respectively ( P < .001). The mean convergence angle was 4.4°, 3.9°, 4.0°, 4.1°, 4.2°, and 4.3°, respectively, during the same time periods ( P = .068). Conclusion: Cartilage healing, as indicated by the JSW, and clinical improvement were maintained over the minimum 3-year follow-up after CWHTO. Cartilage pressure, as indicated by the convergence angle, remained unchanged after CWHTO.
Social Work Treatment of Sleep Disturbance in a 5-Year-Old Boy: A Single-Case Evaluation
Authors: Brophy Gerard 
Published: September 2017

Objective A social work intervention with sleep disturbance in a family comprising a mother and her 5-year-old son using a behavior-analytic approach. Sleep disturbance is a common childhood problem that can adversely affect family functioning, parental relationship, and child development, but in general, social workers do not deal with the problem. Method Baseline assessment was conducted followed by a descriptive analysis. Intervention techniques included parent training, positive reinforcement, and a behavioral-collaborative approach. Results The child learned to settle when sent to bed and to sleep through the night. The social work intervention was effective in empowering the mother to effect change with her child in the home setting. Conclusion Behavior analysis can be effective in dealing with sleep problems and in providing a framework for antioppressive social work practice.