bluuebunny/crossref_metadata_2025_split huggingface dataset:
The perceptions of health professionals of the implementation of Recovery-oriented health services: a case study analysis
Authors: Hungerford Catherine , Kench Patricia 
Published: December 2013

Purpose
– Recovery approaches to healthcare are now an important feature of the mental health policies and plans of many western countries. However, there are continuing challenges to the operationalisation of these approaches. The purpose of this paper is to consider how to overcome these challenges, using insights gained from health managers and practitioners who have been involved in the process of implementation.

Design/methodology/approach
– The analysis is undertaken through a descriptive single-case embedded study of the implementation of Recovery into a public mental health service in Australia. The unit of analysis that features in this paper is the perceptions of the implementation of Recovery-oriented services, of health managers and practitioners.

Findings
– The analysis suggests that although health service managers followed many of the recommendations that can be found in the research literature to support achievement of Recovery-oriented services, there was a need to go further. For example, practitioners in the case study context were educated about the principles of Recovery and provided with new processes of clinical documentation to support their work, however these practitioners felt they were ill-equipped to address complex issues of practice, including the management of clinical risk and professional accountability issues. This raises questions about the content of the education and training provided, and also about the ongoing support provided to practitioners who work within a Recovery-oriented framework.

Originality/value
– The descriptive single-case embedded study of the implementation of Recovery is the first of its kind in Australia. Findings of the study provide insight for other health service organisations committed to effectively implementing Recovery-oriented services.
A practice placement design facilitating occupational therapy students’ learning
Authors: Bonsaksen Tore , Emil Granå Kjell , Celo Cecilia , Ellingham Brian , Myraunet Ingunn 
Published: December 2013

Purpose
– The purpose of this paper is to describe an addition to the practice placement design for occupational therapy students in Oslo, and to report on the learning experiences related to this modified practice placement design among the participants.

Design/methodology/approach
– Occupational therapy students and practice educators were interviewed in focus groups after having participated in an exploration of the utility of the Assessment of Communication and Interaction Skills during mental health placement. Thematic analysis was applied to the data material.

Findings
– Four themes emerged relating to the students’ learning experiences during practice placement. They were theory-practice integration; the role of supervision; self-awareness of communication; and socialization to the therapist role.

Practical implications
– The practice placement design addition presented in this paper was well received by students and practice educators. It contributed to students’ focussed experience and to their active participation within a community of practice. The program appears to be one way of organizing placement with a potential for making a substantial contribution to occupational therapy students’ learning.

Originality/value
– The study adds to the existing literature in providing an example of a successful addition to the practice placement design, and in the detailed account of the learning experiences among the participants.
Standards in mental health facilities – an in depth case study in Greece using the WHO QualityRights tool
Authors: Nomidou Aikaterini 
Published: December 2013

Purpose
– The purpose of this paper is to assess the quality of healthcare offered by a Greek Public Psychiatric Clinic. Special attention is paid to the degree to which the Clinic promotes human rights, social inclusion, and autonomy.

Design/methodology/approach
– The paper opted for an exploratory study using the open-ended approach of grounded theory, including 21 depth interviews with patients, staff members and patients’ relatives, documentation review and observation by an independent assessment team consisting of the author, a sociologist with mental disabilities, and a psychologist using the World Health Organization QualityRights tool kit which uses the Convention on the Rights of Persons with Disabilities (CRPD) as its frame. The data complemented by a group discussion with employees in another Clinic of the same hospital.

Findings
– The paper provides empirical insights about how the steps taken by the Psychiatric Clinic to address several of the themes drawn from the CRPD require either improvement or initiation to comply fully with the convention's themes, and how this compares unfavorably with the Urology Clinic.

Research limitations/implications
– Sample size and restriction of the data to only one mental health facility limit the generalizibility of the results. Staff who reported professional burnout and cuts in wages may have been be susceptible to recall bias due to current negative mood. Respondent patients may also have failed to disclose their true experiences due to fear of punishment.

Originality/value
– The paper uses a new methodology and instrument to assess current practice in mental health facilities in relation to international human rights standards emanating from the CRPD as well as the degree of parity between mental health and general health services.
Idea avoidance: reflections on a conference and its language
Authors: Richards Larry 
Published: December 2013

Purpose
– This paper aims to offer a personal reflection on the 2012 joint conference of the American Society for Cybernetics and the Bateson Idea Group, “An Ecology of Ideas”. The intent is to raise awareness, through examples, of ideas – and their associated ways of thinking – that the author tends to take for granted in the work as systems theorists as well as in everyday life, yet ideas that confound the very social issues the conferees were trying to address.

Design/methodology/approach
– The thoughts expressed arose after five days of listening to presentations and discussions, both formal and informal. The approach is conversational, with a desire to stimulate further conversation.

Findings
– Certain versions of systems theory – whole systems, purposeful systems, systems theory as ideology – rely on ideas that although written about extensively in philosophical and socio-political works go unchallenged in everyday life. Three of these ideas – hierarchy, purpose, belief – are embedded in the way of talking about, and the language used to formulate, solutions to social problems. The suggestion is to avoid or suspend these ideas so that alternatives can be considered.

Originality/value
– Idea avoidance offers those who study social change and/or those who participate in making it happen a way to escape the stuckness of ideas so ingrained in the everyday ways of thinking that they go unnoticed.
The ethical implications of automated computation in design
Authors: dos Santos Cabral Filho Jose 
Published: December 2013

Purpose– The paper aims to present a framework for discussing ethics and computational design.Design/methodology/approach– The main propositions of computational design are presented, discussed according to different authors and contrasted with cybernetic principles.Findings– The paper finds that with algorithmic and parametric procedures, architects are using computation to reach a hitherto unknown ease of modelling multiple iterations of a design, so they can expand their possible design scenarios and cope with the uncertainties of ill-defined tasks. However, this strategy faces an ethical limitation because they fail to extend this openness to the final segment of the design chain, the user in the act of dwelling.Originality/value– The paper brings a cybernetic perspective for discussing the often-overlooked ethical implications of computational strategies in design.
Falls and fractures: a literature review and Welsh perspective
Authors: Morgan Gareth 
Published: December 2013

Purpose
– This paper has three main elements to it. The first is to present some of the epidemiological considerations of this situation. The second is to describe some of the risk factors and by extension, the interventions that might be helpful. Third, a case study on the Welsh situation will be described.

Design/methodology/approach
– This paper draws from the published literature and combines this with the professional experience of the author in Wales. Epidemiological calculations are presented using readily available data and summarised diagrammatically.

Findings
– Falls and fractures constitute a significant public health challenge due to the number of individuals affected and the seriousness of impacts. Risk factors, such as vitamin D deficiency, are open to modification and interventions such as exercise are also helpful. In Wales, policy could be geared to improving the response to this, such as an expansion of cost saving fracture liaison services.

Originality/value
– This paper draws together a diverse literature to help develop policy in Wales.
Deafblind UK expands operations in Northern Ireland to further reduce isolation and enhance the lives of older deafblind people
Authors: Lamont Becky 
Published: December 2013

Purpose
– The purpose of this paper is to highlight the need for services catering for older deafblind people in Northern Ireland (NI) and how Deafblind UK is responding, supported by funding from the Big Lottery Fund.

Design/methodology/approach
– This paper is designed to provide an overview of deafblindness in NI. Supported by research and case studies, it explains the current situation, highlights the issues of this disability, the unique response required and how Deafblind UK's Connections NI project is meeting these needs.

Findings
– Older deafblind people are a highly vulnerable group yet there was a severe lack of services in the region catering for their specific needs. Based on work elsewhere in the UK and initial feedback, Deafblind UK's Connections NI project has been designed to support older deafblind people in the region to give them control over their life choices and retain independence as far as possible.

Research limitations/implications
– The project was only launched in April 2013 so although results have been achieved by Deafblind UK elsewhere in the country, it could take some time for similar results to be seen in NI, particularly when considering the nature of the work.

Practical implications
– Deafblind UK will work alongside agencies and in the community to raise awareness of deafblindness, helping to create clearer classification of the disability and associated issues, and deliver more targeted services that reach a higher proportion of older deafblind people in the region.

Originality/value
– This paper highlights the lack of services for older deafblind people in NI and how Deafblind UK is uniquely meeting these needs.
The rewards of cooperation: The effects of membership in European regulatory networks
Authors: Maggetti Martino 
Published: December 2013

AbstractNetworks famously epitomize the shift from ‘government’ to ‘governance’ as governing structures for exercising control and coordination besides hierarchies and markets. Their distinctive features are their horizontality, the interdependence among member actors and an interactive decision‐making style. Networks are expected to increase the problem‐solving capacity of political systems in a context of growing social complexity, where political authority is increasingly fragmented across territorial and functional levels. However, very little attention has been given so far to another crucial implication of network governance – that is, the effects of networks on their members. To explore this important question, this article examines the effects of membership in European regulatory networks on two crucial attributes of member agencies, which are in charge of regulating finance, energy, telecommunications and competition: organisational growth and their regulatory powers. Panel analysis applied to data on 118 agencies during a ten‐year period and semi‐structured interviews provide mixed support regarding the expectation of organisational growth while strongly confirming the positive effect of networks on the increase of the regulatory powers attributed to member agencies.
Combined treatment of rapamycin and dietary restriction has a larger effect on the transcriptome and metabolome of liver
Authors: Fok Wilson C. , Bokov Alex , Gelfond Jonathan , Yu Zhen , Zhang Yiqiang , Doderer Mark , Chen Yidong , Javors Martin , Wood William H. , Zhang Yongqing , Becker Kevin G. , Richardson Arlan , Pérez Viviana I. 
Published: December 2013

SummaryRapamycin (Rapa) and dietary restriction (DR) have consistently been shown to increase lifespan. To investigate whether Rapa and DR affect similar pathways in mice, we compared the effects of feeding mice ad libitum (AL), Rapa, DR, or a combination of Rapa and DR (Rapa + DR) on the transcriptome and metabolome of the liver. The principal component analysis shows that Rapa and DR are distinct groups. Over 2500 genes are significantly changed with either Rapa or DR when compared with mice fed AL; more than 80% are unique to DR or Rapa. A similar observation was made when genes were grouped into pathways; two‐thirds of the pathways were uniquely changed by DR or Rapa. The metabolome shows an even greater difference between Rapa and DR; no metabolites in Rapa‐treated mice were changed significantly from AL mice, whereas 173 metabolites were changed in the DR mice. Interestingly, the number of genes significantly changed by Rapa + DR when compared with AL is twice as large as the number of genes significantly altered by either DR or Rapa alone. In summary, the global effects of DR or Rapa on the liver are quite different and a combination of Rapa and DR results in alterations in a large number of genes and metabolites that are not significantly changed by either manipulation alone, suggesting that a combination of DR and Rapa would be more effective in extending longevity than either treatment alone.
Do patients with paranoid and disorganized schizophrenia respond differently to antipsychotic drugs?
Authors: Corves C. , Engel R. R. , Davis J. , Leucht S. 
Published: December 2013

ObjectiveThe aim of this study was to compare the differential response to amisulpride in patients with paranoid versus disorganized schizophrenia.MethodWe reanalyzed the original data from five different randomized drug trials comparing Brief Psychiatric Rating Scale (BPRS) scores in a database containing 427 paranoid and 296 disorganized patients with schizophrenia.ResultsBoth the disorganized and the paranoid group showed a substantial improvement of the BPRS total score within the first 4 weeks. In the paranoid group, mean (±SD) BPRS reduction was 16.9 (±14.6) (t = 24.06, df = 426, P < 0.001) and in the disorganized group 17.0 (±15.9) (t = 18.49, df = 295, P < 0.001). An analysis of covariance (ancova) controlling for BPRS at baseline and the influence of different trial protocols showed significant differences between diagnostic groups (F = 13.47, df = 1, P < 0.001), Cohen's D 0.31 (CI = 0.16–0.46). Paranoid patients improved by 4.8 BPRS points more than disorganized patients (adjusted means 18.90 (CI = 17.33–20.37) for the paranoid and 14.1 (CI = 12.04 – 16.11) for the disorganized group.ConclusionWe conclude that amisulpride is effective in disorganized as well as in paranoid schizophrenia, but that symptom reduction in the disorganized subtype is less pronounced.
Regulatory mutations in the A2M gene are involved in the mastitis susceptibility in dairy cows
Authors: Wang X. G. , Huang J. M. , Feng M. Y. , Ju Z. H. , Wang C. F. , Yang G. W. , Yuan J. D. , Zhong J. F. 
Published: December 2013

SummaryMutations, such as single nucleotide polymorphisms (SNPs), in the 5′‐flanking and microRNA (miRNA) regulatory regions may result in altered gene expression levels and cause diseases. Alpha‐2‐macroglobulin (A2M) has the function of binding host or foreign peptides and particles, and thereby serves as a defense barrier against pathogens in the plasma and tissues of animals. To investigate the functional markers of the A2M gene associated with mastitis, the promoter was characterized and SNPs that affect promoter activity or binding affinity with the target miRNA were identified using the luciferase reporter assay and real‐time quantitative PCR method. Results showed that the core promoter of A2M was found between the bases g.‐2641 and g.‐2479. Four novel SNPs (g.‐724A>G, g.‐665G>A, g.‐535C>G and g.‐520_‐519insA) in the promoter region were completely linked. The activity of the mutant haplotype (GAGA) increased by 177% compared with that of the wild haplotype (AGC‐). Bta‐miR‐2898 was upregulated by 6.25‐fold in the mammary gland tissues of mastitis‐infected cows compared with that of the healthy cows. One SNP (c.4659_4661delC) located in the 3′‐untranslated region of the A2M gene may affect the binding affinity with the target bta‐miR‐2898. Five SNPs exhibited tight linkage. Association analysis showed that the milk somatic cell score for cows with the mutant haplotype (GAGA‐) was lower than that for cows with the wild haplotype. Thus, the mutant type can be used as a potential functional marker for a mastitis resistance breeding program in dairy cows. Our findings provided the molecular basis for A2M transcriptional and post‐transcriptional regulations. A close relationship between regulatory mutations and mastitis susceptibility of cows also was established.
Reduction of gastric cancer mortality by endoscopic and radiographic screening in an isolated island: A retrospective cohort study
Authors: Matsumoto Satohiro , Ishikawa Shizukiyo , Yoshida Yukio 
Published: December 2013

AbstractObjectiveTo evaluate the efficacy of endoscopic and radiographic screening for gastric cancer.DesignA retrospective cohort study.SettingCommunity in an isolated island.ParticipantsThe study involved 186 patients (131 men, 55 women) diagnosed with gastric cancer between 2000 and 2005.InterventionsEndoscopic and radiographic screening.Main outcome measurementsThe odds ratio of death from gastric cancer in participants versus non‐participants of screening, the cumulative survival rate of the gastric cancer patients.ResultsThe odds ratio of death from gastric cancer in the participants versus non‐participants of screening was 0.091 (95% confidence interval (CI) 0.027–0.308; P < 0.0001). The cumulative survival rate of the gastric cancer patients in the screening group was higher than that in the non‐screening group (P < 0.0001). In the endoscopic screening district, the odds ratio of death from gastric cancer among the participants versus non‐participants of endoscopic screening was 0.117 (95% CI 0.013–1.056; P = 0.0525), while in the radiographic screening district, it was 0.086 (95% CI 0.020–0.376; P < 0.0001). The cumulative survival rates were higher in both the screening groups as compared with the non‐screening group (endoscopy, P = 0.0302; radiography, P = 0.0012).ConclusionThe results suggest that both radiographic and endoscopic screening may prevent gastric cancer deaths.
Outreach surgical consulting services in North East Victoria
Authors: Chittleborough Timothy John , Lourensz Kaleb , Elliott Matthew , Thomas Peter , Franzi Stephen 
Published: December 2013

AbstractObjectiveThere is a paucity of data regarding the provision of consultative outreach specialist surgical services to rural areas. This paper aims to describe a model of outreach consultative practice to deliver specialist surgical services to rural communities.DesignAnalysis of prospectively collected data for consultations in a three month period for two surgeons based in Wangaratta.SettingTwo surgeons in regional Victoria based in Wangaratta, North East Victoria, conducting outreach consultations to Beechworth, Benalla, Bright and Mansfield.ParticipantsAll patients seen in consultations over a 3‐month period.Main outcome measuresPatient workload, casemix of presenting complaint, consultation outcome including plan for surgical procedure.ResultsOutreach surgical consulting was associated with a higher proportion of new consultations, and there was trend towards being more likely to result in a surgical procedure than consultations in the base rural centre.ConclusionsOutreach surgical consulting provides surgeons with a larger referral base and provides communities with better access to local specialists. Outreach practice should be encouraged for surgeons in regional centres.
Pre‐operative co‐morbidity and postoperative survival in the elderly: beyond one lunar orbit
Authors: Carlisle J. B. 
Published: December 2013

SummaryMortality is a good measure of killing, but it is a poor measure of cure, palliation or the maintenance of function. Nevertheless, it has remained the primary metric of hospital care for 200 years. This article discusses the factors that contribute to mortality risk and survival trajectories, as well as the increasing recognition that surgery kills for months after the last suture is tied. This article discusses how disparate factors can usefully combine to generate an ‘elderly’ group with a monthly mortality in excess of 1% and a median life expectancy less than 3.5 years. A downloadable spreadsheet is provided that combines risk factors to generate mortality risks and their associated survival curves, emphasising the importance of looking beyond one postoperative month.
Anti‐thyroid antibodies as a predictor of thyroid cancer
Authors: Wong Sze Ling , Grodski Simon , Yeung Meei J. , Serpell Jonathan W. 
Published: December 2013

AbstractBackgroundRecent literature has suggested an association between autoimmune thyroiditis and papillary thyroid cancer. The aims of this study were to evaluate if positive thyroid antibodies are associated with thyroid carcinoma and to examine the role of thyroid antibodies in the management of thyroid nodules.MethodsThis is a database study of all patients undergoing thyroidectomy with recorded preoperative thyroid antibodies (autoantibodies to thyroglobulin and/or thyroid peroxidase) levels from 2010 to 2012. We analysed preoperative thyroid antibody levels, fine needle aspiration cytology (FNAC) results, type of thyroid surgery and final histopathology.ResultsThere were 960 patients who underwent thyroidectomy with recorded preoperative thyroid antibodies. Of 960 patients, 784 had preoperative FNAC of thyroid nodules. Final histopathology showed 758 benign and 202 malignant cases. As expected, there was a strong association between raised thyroid antibodies and lymphocytic thyroiditis on histology (P = 0.0001) (two‐sided probability). Overall, positive thyroid antibodies were not found to be a predictor of thyroid carcinoma (P = 0.161) (two‐sided probability). However, in patients with benign FNAC, positive thyroid antibodies increased the risk of thyroid malignancy (odds ratio 2.16; 95% confidence interval 1.11 to 4.21, P = 0.027) (two‐sided probability).ConclusionPatients with positive thyroid antibodies have a greater risk of malignancy in those with benign FNAC. We recommend routine thyroid antibody assessment in addition to FNAC as part of the assessment of thyroid nodules.