bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiating clinical governance, clinical management and clinical practice
Authors: Brennan Niamh M. , Flynn Maureen A. 
Published: March 2013

PurposeThis paper seeks to review prior definitions of the umbrella term “clinical governance”. The research question is: do clinical governance definitions adequately distinguish between governance, management and practice functions? Three definitions are introduced to replace that umbrella term.Design/methodology/approachContent analysis is applied to analyse 29 definitions of clinical governance from the perspective of the roles and responsibilities of those charged with governance, management and practice.FindingsThe analysis indicates that definitions of the umbrella term “clinical governance” comprise a mixture of activities relating to governance, management and practice which is confusing for those expected to execute those roles.Practical implicationsConsistent with concepts from corporate governance, the paper distinguishes between governance, management and practice. For effective governance, it is important that there be division of duties between governance roles and management and practice roles. These distinctions will help to clarify roles and responsibilities in the execution of clinical activities.Originality/valueDrawing on insights from corporate governance, in particular, the importance of a division of functions between governance roles, and management and practice roles, the paper proposes three new definitions to replace the umbrella term “clinical governance”.
Paediatric tonsillectomy
Authors: Soni‐Jaiswal Archana , Parry Nadiah , Kumar Nirmal 
Published: March 2013

PurposeThe published evidence in support of a tonsillectomy is equivocal relying on historical studies using objective outcome measures. Based on this, NICE have suggested that tonsillectomy is a “low clinical value treatment” and its funding curtailed by PCTs. This paper aims to prospectively evaluate the effect of a tonsillectomy on quality of life (QOL) of children affected by recurrent infective tonsillitis using a qualitative patient reported outcome measure (PROM).Design/methodology/approachParents of children under the age of 16, undergoing a tonsillectomy, were enrolled. Parents completed a paediatric throat disorders outcome (PTDO) test prior to their child's surgery and then six months post‐operatively. Results were analysed using the Mann‐Whitney U test. The power of the study was 0.8 to detect a difference of 10 in a total score of 70.FindingsA total of 63 children participated and an 86 per cent response rate was received at six months. The mean total score improved from 31.29 pre‐op to 7.41 post‐op (p<0.001). The mean score for the first two subgroups remained static but for the remaining 12 sub‐groups significantly improved post‐op.Originality/valueThe study demonstrates that performing tonsillectomies in a carefully selected cohort of children, significantly improves their QOL. It adds to a growing body of evidence that tonsillectomy is not a “low clinical value procedure” and has a substantial impact on the patients' symptoms.
The RADICAL framework for implementing and monitoring healthcare risk management
Authors: Edozien Leroy C. 
Published: March 2013

PurposeThe purpose of this paper is to facilitate an integrative approach to the implementation, monitoring and reporting of risk management in healthcare settings.Design/methodology/approachA framework, identified by the acronym RADICAL, is presented. The underlying principles and the strengths of the framework are described.FindingsThe framework comprises the following domains in an integrated grid: raise awareness, design for safety, involve users, collect and analyse patient safety data, and learn from patient safety incidents.Practical implicationsThe RADICAL framework provides a simple but comprehensive approach to the implementation, monitoring and reporting of healthcare risk management. It is designed to facilitate learning and accountability at both individual and organisational levels, advocating a balance between “person” and “system”. It covers all domains of patient safety while also being flexible to allow local customisation of the content and metrics for each domain.Originality/valueThe RADICAL framework can be used by service providers and commissioners to implement and monitor risk management, and by regulators for monitoring performance. It can also be used in education and training, and to provide information on quality and safety to service users.
A re‐evaluation of the role of rotational forceps: retrospective comparison of maternal and perinatal outcomes following different methods of birth for malposition in the second stage of labour
Authors: Tempest N , Hart A , Walkinshaw S , Hapangama DK 
Published: March 2013

ObjectiveTo compare the outcomes of operative cephalic births by Kielland forceps (KF), rotational ventouse (RV), or primary emergency caesarean section (pEMCS) for malposition in the second stage of labour in modern practise.DesignRetrospective observational study.PopulationData were included from 1291 consecutive full‐term, singleton cephalic births between 2 November 2006 and 30 November 2010 with malposition of the fetal head during the second stage of labour leading to an attempt to deliver by KF, RV or pEMCS.MethodsMaternal and neonatal outcomes of all KF births were compared with other methods of operative birth for malposition in the second stage of labour (RV or pEMCS).Main outcome measuresAchieving a vaginal birth was the primary outcome and fetal (admission to special care baby unit, low cord pH, low Apgar, shoulder dystocia, Erb's palsy) and maternal (massive obstetric haemorrhage—blood loss of >1500 ml, sphincter injury, length of stay in hospital) safety outcomes were also recorded.ResultsWomen were more likely to need caesarean section if RV (22.4%) was selected to assist the birth rather than KF (3.7%; adjusted odds ratio 8.20; 95% confidence interval 4.54–14.79). Births by KF had a rate of adverse maternal and neonatal outcomes comparable to those by RV and pEMCS in the second stage for malposition.ConclusionsOur results suggest that, in experienced hands, assisted vaginal birth by KF is likely to be the most effective and safe method to prevent the ever rising rate of caesarean sections when malposition complicates the second stage of labour.
Ten‐year follow‐up of a randomised controlled trial comparing bipolar endometrial ablation with balloon ablation for heavy menstrual bleeding
Authors: Herman MC , Penninx JPM , Mol BW , Bongers MY 
Published: March 2013

ObjectivePreviously, we have reported that, at both 12 months and 5 years after treatment, bipolar endometrial ablation is superior to balloon ablation in the treatment of heavy menstrual bleeding. In this article, we evaluate the results at 10 years after these interventions.DesignTen‐year follow‐up of a double‐blind randomised controlled trial.SettingA teaching hospital in the Netherlands.PopulationPremenopausal women suffering from heavy menstrual bleeding.MethodA follow‐up questionnaire was sent to women 10 yearsafter randomisation for bipolar ablation and balloon ablation (2 : 1 ratio).Main outcome measuresAmenorrhoea rates, re‐intervention and patient satisfaction.ResultsAt 10 years of follow‐up, the response rate was 69/83 (83%) in the bipolar group and 35/43 (81%) in the balloon group. Amenorrhoea rates were 50/69 (73%) in the bipolar group and 23/35 (66%) in the balloon group [relative risk, 1.1 (95% CI, 0.83–1.5)]. Further treatment following initial ablation was reported in 21 cases, 14 in the bipolar group and nine in the balloon group [relative risk, 0.9 (95% CI, 0.63–1.3)]. Eight of these women required further treatment after 5 years, including two hysterectomies. Patient satisfaction in the bipolar group was 81% (56/69) compared with 77% (27/35) in the balloon group [relative risk, 1.1 (95% CI, 0.82–1.2)].ConclusionTen years after treatment, the superiority of bipolarablation over balloon ablation in the treatment of heavy menstrual bleeding was no longer evident.
Early Traumatic Events in Psychopaths
Authors: Borja Karina , Ostrosky Feggy 
Published: March 2013

AbstractThe relationship between diverse early traumatic events and psychopathy was studied in 194 male inmates. Criminal history transcripts were revised, and clinical interviews were conducted to determine the level of psychopathy using the Psychopathy Checklist‐Revised (PCL‐R) Form, and the Early Trauma Inventory was applied to assess the incidence of abuse before 18 years of age. Psychopathic inmates presented a higher victimization level and were more exposed to certain types of intended abuse than sociopathic inmates, while the sum of events and emotional abuse were associated with the PCL‐R score. Our studies support the influence of early adverse events in the development of psychopathic offenders.
Cattle‐Caused Fatalities in a Province of Western Turkey: 1996–2010 Autopsy Results
Authors: Karbeyaz Kenan , Ayranci Unal , Balci Yasemin , Gunduz Tarik 
Published: March 2013

AbstractCattle‐caused injuries and deaths are much more than predicted. The aim of this research is to determine the prevalence of cattle‐caused fatalities and the factors affecting it in a province of western Turkey. The court files on cattle‐caused fatalities during a 15‐year period between 1996 and 2010 were explored. The proportion of forensic‐qualified deaths from the total of 3753 was 0.9% (35/3753). Most of the cases were between the ages of 18 and 65 (60%). Most deaths occurred in the spring and summer months compared with autumn and winter months (9 and 22 vs. 3 and 1, respectively). The mortality rate was much higher in men compared with women (94.3% and 5.7%, respectively). The majority of deaths were caused by injuries on the chest (71.4%). The reason for most deaths was due to hemopneumothorax and lung injury (71.4%). Predicting the behavior of cattle may not always be possible, as such, it is advisable that one wears protective equipment when dealing with cattle.
Human Versus Animal: Contrasting Decomposition Dynamics of Mammalian Analogues in Experimental Taphonomy
Authors: Stokes Kathryn L. , Forbes Shari L. , Tibbett Mark 
Published: March 2013

AbstractTaphonomic studies regularly employ animal analogues for human decomposition due to ethical restrictions relating to the use of human tissue. However, the validity of using animal analogues in soil decomposition studies is still questioned. This study compared the decomposition of skeletal muscle tissues (SMTs) from human (Homo sapiens),pork (Sus scrofa), beef (Bos taurus), and lamb (Ovis aries) interred in soil microcosms. Fixed interval samples were collected from theSMTfor microbial activity and mass tissue loss determination; samples were also taken from the underlying soil forpH, electrical conductivity, and nutrient (potassium, phosphate, ammonium, and nitrate) analysis. The overall patterns of nutrient fluxes and chemical changes in nonhumanSMTand the underlying soil followed that of humanSMT. Ovine tissue was the most similar to human tissue in many of the measured parameters. Although no single analogue was a precise predictor of human decomposition in soil, all models offered close approximations in decomposition dynamics.
Establishing Likelihood Ratios for Patterned Garment Comparisons from Seam Measurement Data,
Authors: Johnson D. B. , Perlin Victor E. , Rohde Mitchell M. , Thomas Alice C. , Luu Cuong Q. , Chang Jennifer 
Published: March 2013

AbstractIt is often challenging to ascribe an objective measure of confidence for identifications based on surveillance imagery from a crime scene. The present work seeks to address this deficiency in the case of garment comparison evidence by developing a quantitative method for establishing a conservative lower bound on the likelihood ratio (LR) for identifications involving patterned garments. The method is based on statistical analysis of pattern offset measurements taken from a sample of garments of the same type (manufacturer, style, and size) as the seized evidence. The developed analysis framework was demonstrated on different types of garments over a range of modeled surveillance imaging scenarios with variable image quality; the lower bounds on the LRs ranged from approximately 10–1 to over 400–1. The statistical model was tested and validated through a large‐scale empirical study involving both simulated and human observer‐performed garment comparisons.
Accuracy and Usefulness of the AVOXimeter 4000 as Routine Analysis of Carboxyhemoglobin
Authors: Fujihara Junko , Kinoshita Hiroshi , Tanaka Naoko , Yasuda Toshihiro , Takeshita Haruo 
Published: March 2013

AbstractThe measurement of blood carboxyhemoglobin (CO‐Hb) is important to determine the cause of death. The AVOXimeter 4000 (AVOX), a portable CO‐oximeter, has the advantages of a low purchase price and operating cost, ease of operation, and rapid results. Little information is available on the usefulness of AVOX in the forensic sample, and the previous study investigated only six samples. Therefore, in this study, we confirmed the usefulness of the AVOX through a comparison of its results with data previously obtained using the double wavelength spectrophotometric method in autopsies. Regression analysis was performed between CO‐Hb levels measured by the AVOX and those measured by the conventional double wavelength spectrophotometric method in postmortem blood samples: a significant correlation was observed. This study suggests the usefulness of the AVOX to analyze postmortem blood, and the AVOX is suitable for routine forensic analysis and can be applied at the crime scene.
Gastric emptying of solids and its relationship with microalbuminuria in children and adolescents with type 1 diabetes mellitus (儿童与青少年1型糖尿病患者的固体食物胃排空情况以及它与微量白蛋白尿之间的关系)
Authors: Ersoy Betul , Sayit Elvan , Can Sule , Urk Vildan , Batok Dilek , Polat Muzaffer 
Published: March 2013

AbstractBackgroundThe aims of the present study were to determine the frequency of delayed gastric emptying in children and adolescents with type 1 diabetes mellitus (T1DM) and to investigate the relationship between gastric emptying rate and other contributing factors (e.g. serum HbA1c, duration of diabetes and microalbuminuria) in these patients.MethodsThis was a clinical trial evaluating the rate of gastric emptying of solid meals in 33 children and adolescents with T1DM and in 26 healthy peers using a radionuclide method. Three consecutive overnight urine collections were used to calculate the albumin excretion rate.ResultsThere was no significant difference in the gastric half‐emptying time (GE t½) between patients and controls (151.7 ± 154.5 vs 109.8 ± 60.5 min, respectively; P = 0.885) or the frequency of delayed gastric emptying (36.4% vs 30.8%, respectively; P = 0.433). There was a moderately positive correlation between GE t½ and the duration of diabetes (r = 0.380; P = 0.029). There was no correlation between GE t½ and microalbumin levels in T1DM patients. In these patients, the body mass index standard deviation scores were significantly lower than in patients with normal gastric emptying (–0.13 ± 0.87 vs 0.7 ± 1.23, respectively; P = 0.044).ConclusionProgression of delayed gastric emptying is more likely to be related to a longer duration of diabetes than glycemic control in children and adolescents with T1DM. Patients with delayed gastric emptying are thinner compared with patients with a normal rate of gastric emptying; they may also be asymptomatic.
Autophagy is required for trap formation in the nematode‐trapping fungus Arthrobotrys oligospora
Authors: Chen Yuan‐Li , Gao Ying , Zhang Ke‐Qin , Zou Cheng‐Gang 
Published: March 2013

SummaryNematode‐trapping fungi live mainly as saprobes in soil environments. When encountering nematodes, these fungi become ‘carnivorous’ and develop specialized trapping devices to attack their hosts for extracting nutrients, especially nitrogen source. Thus, nematode‐trapping fungi are model organisms for understanding the molecular mechanism of the switch between saprobic and parasitic phases of pathogen life cycles. Arthrobotrys oligospora, one of the best‐studied nematode‐trapping fungi, mainly lives as a saprobe. In the presence of nematodes, A. oligospora enters the parasitic stage by forming adhesive reticulate traps to capture nematodes. In filamentous fungi, autophagy has been shown to be involved in morphogenesis and morphology. In this study, we demonstrate that autophagy is induced by nematodes during the early stage of trap formation in A. oligospora. Disruption of atg8 gene not only abolishes the nematode‐induced autophagy, but also suppresses trap formation and reduces pathogenicity for nematodes. During the early stage of trap formation, the expression of genes involved in amino acid biosynthesis is upregulated and the transcriptional activity of GCN4 is induced in A. oligospora, suggesting that nematodes induce autophagy probably by triggering intracellular amino acid starvation. Autophagy is thus crucial for trap formation in A. oligospora during infection of nematodes.
Sulfur‐oxidizing bacterial populations within cyanobacterial dominated coral disease lesions
Authors: Bourne David G. , van der Zee Marc J. J. , Botté Emmanuelle S. , Sato Yui 
Published: March 2013

SummaryThis study investigated the diversity and quantitative shifts of sulfur‐oxidizing bacteria (SOB) during the onset of black band disease (BBD) in corals using quantitative PCR (qPCR) and cloning approaches targeting the soxB gene, involved in sulfur oxidation. Four Montipora sp. coral colonies identified with lesions previously termed cyanobacterial patches (CP) (comprising microbial communities different from those of BBD lesions), was monitored in situ as CP developed into BBD. The overall abundance of SOB in both CP and BBD lesions were very low and near the detection limit of the qPCR assay, although consistently indicated that SOB populations decreased as the lesions transitioned from CP to BBD. Phylogenetic assessment of retrieved soxB genes showed that SOB in both CP and BBD lesions were dominated by one sequence type, representing > 70% of all soxB gene sequences and affiliated with members of the Rhodobacteraceae within the α‐Proteobacteria. This study represents the first assessment targeting SOB within BBD lesions and clearly shows that SOB are not highly diverse or abundant in this complex microbial mat. The lack of oxidation of reduced sulfur compounds by SOB likely aids the accumulation of high levels of sulfide at the base of the BBD mat, a compound contributing to the pathogenicity of BBD lesions.
Arabinogalactan and fructo‐oligosaccharides have a different fermentation profile in the Simulator of the Human Intestinal Microbial Ecosystem (SHIME®)
Authors: Terpend Kathleen , Possemiers Sam , Daguet David , Marzorati Massimo 
Published: March 2013

SummaryCurrent prebiotics, such as fructo‐oligosaccharides (FOS), are limited in their persistence in the distal colon and are predominantly fermented in the proximal colon. In order to identify a potential alternative, the differences in the fermentation profile of arabinogalactan (AG) and FOS have been assessed in the Simulator of the Human Intestinal Microbial Ecosystem. The effect of each product on the composition and activity of the microbial community was analysed during a 3‐week treatment period at a dose of 5 g day−1. While FOS indeed was mainly fermented in the simulated proximal colon, AG was still available for fermentation in the simulated distal colon as shown by pH profiles, size exclusion chromatography and analyses of specific enzymatic activities. As a consequence, the main effect of the products (increase in propionate and butyrate and decrease in ammonium production) occurred in different intestinal areas. DGGE and qPCR analyses confirmed that the main modulation of the microbiota by the two products occurred in different areas of the gut. AG was associated with a statistically significant increase in the concentration of total bacteria, Bacteroidetes, Faecalibacterium prausnitzii, a delayed bifidogenic effect and a decrease of the pathogenic Clostridium perfringens. FOS led to a strong lactobacillogenic effect.
Site occupancy models in the analysis of environmental DNA presence/absence surveys: a case study of an emerging amphibian pathogen
Authors: Schmidt Benedikt R. , Kéry Marc , Ursenbacher Sylvain , Hyman Oliver J. , Collins James P. 
Published: March 2013

Summary

The use of environmental DNA (eDNA) to detect species in aquatic environments such as ponds and streams is a powerful new technique with many benefits. However, species detection in eDNA‐based surveys is likely to be imperfect, which can lead to underestimation of the distribution of a species.

Site occupancy models account for imperfect detection and can be used to estimate the proportion of sites where a species occurs from presence/absence survey data, making them ideal for the analysis of eDNA‐based surveys. Imperfect detection can result from failure to detect the species during field work (e.g. by water samples) or during laboratory analysis (e.g. by PCR).

To demonstrate the utility of site occupancy models for eDNA surveys, we reanalysed a data set estimating the occurrence of the amphibian chytrid fungus Batrachochytrium dendrobatidis using eDNA. Our reanalysis showed that the previous estimation of species occurrence was low by 5–10%. Detection probability was best explained by an index of the number of hosts (frogs) in ponds.

Per‐visit availability probability in water samples was estimated at 0·45 (95% CRI 0·32, 0·58) and per‐PCR detection probability at 0·85 (95% CRI 0·74, 0·94), and six water samples from a pond were necessary for a cumulative detection probability >95%. A simulation study showed that when using site occupancy analysis, researchers need many fewer samples to reliably estimate presence and absence of species than without use of site occupancy modelling.

Our analyses demonstrate the benefits of site occupancy models as a simple and powerful tool to estimate detection and site occupancy (species prevalence) probabilities despite imperfect detection. As species detection from eDNA becomes more common, adoption of appropriate statistical methods, such as site occupancy models, will become crucial to ensure that reliable inferences are made from eDNA‐based surveys.
Environmental influence on transmitter detection probability in biotelemetry: developing a general model of acoustic transmission
Authors: Gjelland Karl Ø. , Hedger Richard D. 
Published: March 2013

Summary

Environmental factors, such as wind, may have a strong influence on the detection probability and detection rate of acoustic telemetry tags. The effect of environmental factors may obscure biological effects and distort the interpretation of acoustic telemetry data.

This study was undertaken with fish internally tagged with acoustic transmitters containing depth sensors and monitored by an array of automatic receivers. The influence of environmental factors on the hourly detection rate was evaluated using environmental data from a nearby climate station. The signal detection probability was modelled within the framework of general theory of sound propagation in water.

Wind was found to have the strongest influence on the detection rate. Transmitter depth range and rain also contributed significantly to the variation in detection rate.

By modelling the attenuation coefficient as a function of wind speed, we show that the probability of detecting a free‐swimming acoustically tagged animal can be successfully modelled using general sound propagation theory.

The approach of modelling detection probability as a function of the attenuation coefficient offers a wide applicability, as it implies a direct link between detection probability and physical characteristics of the water at the study site. Correcting for varying detection probability is in many cases extremely important to do, since rhythms in biological/behavioural factors are often confounded with environmental variables that influence detection probability (e.g. sea breeze, tide).