bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capacity to choose and refuse? A case study
Authors: Guthrie Susan , Roddam Hazel , Panna Sharmin , Fairburn Gordon 
Published: November 2012

PurposeThis paper aims to present the distinctive roles and perspectives of the members of a multidisciplinary team supporting a man with multiple diagnoses who was under Section by the Mental Health Act.Design/methodology/approachThe management of risk for this man with intellectual disability, mental illness and a degenerative neurological condition was particularly complex due to his self‐harming and impulsivity. Each specialist clinician (nurse, speech and language therapist, psychiatrist) reflects on their role as a member of a team approach. The perspective of the man himself is represented, although he was unable to give a consistent descriptive self report.FindingsFor people with mental illness and intellectual disability the capacity to understand and retain information about their condition may be limited and variable. The paper discusses the multiple ethical issues in attempting to preserve a modified autonomy and in decision making around best interests.Practical implicationsSupporting someone with dysphagia presents specific challenges to staff teams due to the everyday and familiar nature of mealtimes. When the person is unable to understand and refuses to comply with guidelines outlining restrictions to mealtime choices, the staff's role in safeguarding is particularly complex. The paper considers how to mitigate against risks to mental and physical health.Originality/valueIn cases of self harm the care team is challenged to respect autonomy and maintain quality of life whilst ensuring safety of the individual. The paper discusses maintaining professional integrity when considering compromise.
Autism spectrum disorders and offending
Authors: Gunasekaran Santhana , Chaplin Eddie 
Published: November 2012

PurposeThis paper seeks to offer a general review of offending and autism spectrum disorders from both the authors' perception of the media portrayal and the current evidence based research.Design/methodology/approachThe authors undertook a review of the current literature relating to autism spectrum disorders and offending and commented on current media reporting to try and offer a balance.FindingsRecent evidence suggests that there is unlikely to be an increased prevalence compared to the general population, but the presence of co‐morbidities may increase the risk of violence.Originality/valueThe paper offers a succinct overview of the current evidence base relating to autism spectrum disorders and offending.
Rapid risk assessment in acute hospital for patients with intellectual disabilities
Authors: Read Stevie , Johnson Tristan 
Published: November 2012

PurposeThere is significant literature to demonstrate that people with intellectual disabilities are at higher risk of premature death, however there is relatively little evidence of research carried out on risk assessment in hospital for this patient group. This paper aims to share the outcomes from a patient safety project conducted in an acute hospital by the Trust's intellectual disabilities team.Design/methodology/approachA project structure was used, supported by the Trust patient safety team through association with the National Institute for Innovation and Improvement: leading improvement in patient safety (LIPS) programme. The aim of the project was to bring together the current evidence, to understand the risk issues for this group and develop a robust risk assessment tool that could be embedded into the care processes in acute hospitals.FindingsA six month pilot concluded that a short assessment in a familiar format was more likely to be used by nurses. Risk assessment on its own does not deliver better and safer care. It must be accompanied by a series of clear, evidence based actions that used together ensure the patients' total safety and care needs are met. This tool is used throughout the Trust and in a number of other hospitals across the eastern region. Its use has contributed to reducing length of stay and improving health outcomes.Research limitations/implicationsThe paper shows the need for further research and data gathering.Originality/valueThis study demonstrates that risk for patients with intellectual disabilities in hospital is complex. Education is essential to underpin new assessment tools for clinical practice.
Energy simulations of a transparent‐insulated office façade retrofit in London, UK
Authors: Liang Wong Ing , Eames Philip , Perera Srinath 
Published: November 2012

PurposeTransparent insulation materials (TIMs) have been developed for application to building facades to reduce heating energy demands of a building. The purpose of this research is to investigate the feasibility of TI‐applications for high‐rise and low‐rise office buildings in London, UK, to reduce heating energy demands in winter and reduce overheating problems in summer.Design/methodology/approachThe energy performance of these office building models was simulated using an energy simulation package, Environmental Systems Performance‐research (ESP‐r), for a full calendar year. The simulations were initially performed for the buildings with conventional wall elements, prior to those with TI‐systems (TI‐walls and TI‐glazing) used to replace the conventional wall elements. Surface temperatures of the conventional wall elements and TI‐systems, air temperature inside the 20 mm wide air gaps in the TI‐wall, dry‐bulb zone temperature and energy demands required for the office zones were predicted.FindingsPeak temperatures of between 50 and 70°C were predicted for the internal surface of the TI‐systems, which clearly demonstrated the large effect of absorption of solar energy flux by the brick wall mass with an absorptivity of 90 percent behind the TIM layer. In the office zones, the magnitude of temperature swings during daytime was reduced, as demonstrated by a 10 to 12 h delay in heat transmission from the external façade to the office zones. Such reduction indicates the overheating problems could be reduced potentially by TI‐applications.Originality/valueThis research presents the scale and scope of design optimisation of TI‐systems with ESP‐r simulations, which is a critical process prior to applications to real buildings.
Global diversity patterns and cross‐taxa convergence in freshwater systems
Authors: Tisseuil Clement , Cornu Jean‐François , Beauchard Olivier , Brosse Sebastien , Darwall William , Holland Robert , Hugueny Bernard , Tedesco Pablo A. , Oberdorff Thierry 
Published: November 2012

Summary

Whereas global patterns and predictors of species diversity are well known for numerous terrestrial taxa, our understanding of freshwater diversity patterns and their predictors is much more limited.
Here, we examine spatial concordance in global diversity patterns for five freshwater taxa (i.e. aquatic mammals, aquatic birds, fishes, crayfish and aquatic amphibians) and investigate the environmental factors driving these patterns at the river drainage basin grain.
We find that species richness and endemism patterns are significantly correlated among taxa. We also show that cross‐taxon congruence patterns are often induced by common responses of taxa to their contemporary and historical environments (i.e. convergent patterns). Apart from some taxa distinctiveness (i.e. fishes), the ‘climate/productivity’ hypothesis is found to explain the greatest variance in species richness and endemism patterns, followed by factors related to the ‘history/dispersion’ and ‘area/environmental heterogeneity’ hypotheses.
As aquatic amphibians display the highest levels of congruency with other taxa, this taxon appears to be a good ‘surrogate’ candidate for developing global freshwater conservation planning at the river drainage basin grain.
Transcriptional response of lignin‐degrading enzymes to 17α‐ethinyloestradiol in two white rots
Authors: Přenosilová L. , Křesinová Z. , Amemori A. Slavíková , Cajthaml T. , Svobodová K. 
Published: November 2012

SummaryFungal, ligninolytic enzymes have attracted a great attention for their bioremediation capabilities. A deficient knowledge of regulation of enzyme production, however, hinders the use of ligninolytic fungi in bioremediation applications. In this work, a transcriptional analyses of laccase and manganese peroxidase (MnP) production by two white rots was combined with determination of pI of the enzymes and the evaluation of 17α‐ethinyloestradiol (EE2) degradation to study regulation mechanisms used by fungi during EE2 degradation. In the cultures of Trametes versicolor the addition of EE2 caused an increase in laccase activity with a maximum of 34.2 ± 6.7 U g−1 of dry mycelia that was observed after 2 days of cultivation. It corresponded to a 4.9 times higher transcription levels of a laccase‐encoding gene (lacB) that were detected in the cultures at the same time. Simultaneously, pI values of the fungal laccases were altered in response to the EE2 treatment. Like T. versicolor, Irpex lacteus was also able to remove 10 mg l−1 EE2 within 3 days of cultivation. While an increase to I. lacteus MnP activity and MnP gene transcription levels was observed at the later phase of the cultivation. It suggests another metabolic role of MnP but EE2 degradation.
Outcomes of child psychiatric treatment
Authors: Lundh A. , Forsman M. , Serlachius E. , Lichtenstein P. , Landén M. 
Published: November 2012

ObjectiveThe aim of this study was to investigate outcomes of child psychiatric outpatient treatment as usual and to identify outcome predictors, with special regard to attention‐deficit/hyperactivity disorder (ADHD), mood disorder, obsessive‐compulsive disorder and conduct disorder.MethodRoutinely collected data from 12 613 outpatients between July 2006 and January 2010 in Stockholm, Sweden were analysed. The outcome measure was change in Children's Global Assessment Scale (CGAS) ratings between first visit and case closure (∆CGAS).ResultsCGAS improved during the course of treatment across all diagnostic groups, ranging from a mean change of 4 (mental retardation) to 16 (suicide attempts). ∆CGAS was two times higher in the mood disorder group compared with the ADHD group. In the mood disorder group, several psychotherapies were associated with better outcome but not medication. In the ADHD group, psychotherapeutic interventions were also associated with better outcome, but those who received treatment with central stimulants received less non‐medical interventions.ConclusionWhereas the functional impairment and the level of improvement in mood disorder corresponded to previous efficacy studies, the ADHD patients were more impaired and improved less after treatment. This should prompt a critical discussion as to whether ADHD patients receive the best available treatment in CAMHS in Stockholm and elsewhere.
Quantitative Reduction of Peripheral CD4+CD25+FOXP3+ Regulatory T cells in Reproductive Failure after Artificial Insemination by Donor Sperm
Authors: Lu Yuechao , Zhang Fan , Zhang Yang , Zeng Bin , Hu Lian , Liao Aihua 
Published: November 2012

ProblemThe objective of this study was to determine whether peripheral Treg‐cell percentages were altered in women with reproductive failure after artificial insemination by donor sperm (AID) and which parameters can best discriminate women with AID failure and normal controls.Method of studyA retrospective case–control study of 20 fertile controls and 20 patients undergoing more than four treatment cycles with negative pregnancy test (Group I), 20 experiencing biochemical pregnancy loss (Group II), and 20 undergoing missed abortion or spontaneous miscarriage (Group III) was performed. The peripheral percentages of CD4+CD25+ and CD4+CD25 +Foxp3+ Treg cells within CD4+ T‐cell population were evaluated at both late follicular and luteal phases of menstrual cycle by flow cytometry.ResultsA significantly decreased percentage of CD4+CD25+Foxp3+ Treg cells was detected at the late follicular phase in all AID failure groups compared with the controls. The percentage of CD4+CD25+Foxp3+ Treg cells at the late follicular phase in the controls was higher than that at the luteal phase. Using receiver operating characteristic curve, we found that CD4+CD25+Foxp3+ Treg‐cell percentage <2% can best discriminate the AID failure and normal controls.ConclusionReduced percentage of peripheral CD4+CD25+ Foxp3+ Treg cells at the late follicular phase was associated with AID failure and can be a potential biomarker for predicting AID‐induced failure.
Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: a meta‐analysis of randomized controlled trials
Authors: Yang Jun , Tong Da Nian , Yao Jing , Chen Wei 
Published: November 2012

AbstractBackgroundThere is no clear answer regarding the use of laparoscopic techniques versus the Lichtenstein method for the treatment of recurrent inguinal hernia.ObjectiveThe aim of this study was to compare the outcomes of laparoscopy versus the Lichtenstein repair by a meta‐analysis of available randomized controlled trials (RCTs).MethodsDatabases, including PubMed, EMBASE, the Cochrane Library, and the Science Citation Index updated to May 2012, were searched. The main outcome measures were wound infections and haematoma, urinary retention, post‐operative chronic pain and recurrence. A meta‐analysis of included RCTs was performed.ResultsFive RCTs, comprising a total of 427 patients, were included. Although most of the analysed outcomes were similar between groups, wound infection rates and post‐operative chronic pain occurred less frequently in the laparoscopic group than in the Lichtenstein group (odds ratio: 0.28, 95% CI: 0.08–0.97; P = 0.05; odds ratio: 0.33, 95% CI: 0.17–0.68; P = 0.002, respectively).ConclusionThe laparoscopic approach to the treatment of recurrent inguinal hernia is superior to the Lichtenstein hernioplasty in some aspects that affect patient satisfaction.
Performance of Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B (REACH‐B) score in classifying treatment eligibility under 2012 Asian Pacific Association for the Study of the Liver (APASL) guideline for chronic hepatitis B patients
Authors: Chen T.‐M. , Chang C.‐C. , Huang P.‐T. , Wen C.‐F. , Lin C.‐C. 
Published: November 2012

SummaryBackgroundREACH‐B [Risk Estimation for Hepatocellular Carcinoma (HCC) in Chronic Hepatitis B] scoring system was developed to predict the risk of HCC in noncirrhotic chronic hepatitis B (CHB) patients.AimTo evaluate the discriminatory performance of REACH‐B scoring system in classifying anti‐viral treatment eligibility of CHB patients according to the 2012 Asian Pacific Association for the Study of the Liver (APASL) treatment guideline.MethodsA total of 904 noncirrhotic CHB were enrolled. Patients' age, gender, liver biochemistry, HBeAg status and HBV DNA levels were recorded.ResultsThe minimum REACH‐B risk score for patients to be eligible for anti‐viral treatment was 7 for HBeAg‐positive and 6 for HBeAg‐negative patients. Among them, increasing REACH‐B score was not significantly associated with eligibility for treatment [adjusted odds ratio (OR): 1.210, 95% confidence interval (CI): 0.979–1.494, P = 0.078] in HBeAg‐positive patients, as shown by logistic regression analysis after adjusting for gender. In HBeAg‐negative patients, REACH‐B score significantly predicted the treatment eligibility (adjusted OR: 1.783, 95% CI: 1.607–1.979, P < 0.001). Discriminatory ability of REACH‐B score to classify eligibility was poor for HBeAg‐positive patients ≥40 years [area under receiver operating characteristic (AUC): 0.664, 95% CI: 0.533–0.795], but good/excellent for HBeAg‐positive patients <40 years (AUC: 0.903; 95% CI: 0.841–0.964), HBeAg‐negative patients ≥45 years (AUC: 0.883; 95% CI: 0.848–0.917) and HBeAg‐negative patients <45 years (AUC: 0.907; 95% CI: 0.874–0.940).ConclusionThe discriminatory performance of the REACH‐B scoring system in classifying anti‐viral treatment eligibility based on the 2012 APASL guideline was good/excellent, except for ≥40 years old HBeAg‐positive patients.
Increased circulating CC chemokine levels in the metabolic syndrome are reduced by low‐dose atorvastatin treatment: evidence from a randomized controlled trial
Authors: Loughrey Brona V. , McGinty Ann , Young Ian S. , McCance David R. , Powell Lesley A. 
Published: November 2012

SummaryObjectiveCentral obesity and insulin resistance are key components of the metabolic syndrome, which is associated with an increased risk of cardiovascular disease. In obesity, CC chemokines, such as monocyte chemotactic protein‐1 (MCP‐1), macrophage inhibitory protein‐1β (MIP‐1β) and eotaxin‐1 and their respective receptors, are critically involved in peripheral monocyte activation and adipose tissue infiltration. The aim of the current study was to examine whether low‐dose atorvastatin (10 mg/d) treatment modulated serum levels of CC chemokines in metabolic syndrome subjects.Materials and MethodsSerum levels of MCP‐1, eotaxin‐1, MIP‐1β, C reactive protein (CRP) and interleukin‐6 (IL‐6) were measured in lean control and metabolic syndrome subjects at baseline, and following a 6‐week randomized placebo‐controlled clinical trial of atorvastatin (10 mg/d). Peripheral CD14+ monocytes were isolated and mRNA levels of MCP‐1, MIP‐1 β and CCR5 determined.ResultsSerum MCP‐1 (P = 0·02), eotaxin‐1 (P = 0·02) and MIP‐1β (P = 0·03), CRP (P < 0·001) and IL‐6 (P = 0·006) were significantly increased in metabolic syndrome in comparison with lean controls. Furthermore, CD14+ peripheral monocyte mRNA expression of the chemokine receptor, CCR5, of which MIP‐1β and eotaxin‐1 are ligands, was increased two‐fold in the metabolic syndrome group (P = 0·03). In addition to the expected improvements in lipid profile, atorvastatin treatment significantly reduced circulating eotaxin‐1 (P < 0·05), MIP‐1β (P < 0·05) levels and CD14+ peripheral monocyte CCR5 mRNA expression (P = 0·02).ConclusionThese results support a model whereby atorvastatin treatment, by inhibiting CD14+ monocyte CCR5 expression, may inhibit monocyte trafficking, reduce chronic inflammation and, thus, lower circulating levels of CC chemokines.
Ethical Considerations in Clinical Trials: A Critique of theICH‐GCP Guideline
Authors: Kaur Sharon , Choy Choong Yeow 
Published: November 2012

AbstractThis article examines issues relating to ethics decision‐making in clinical trials. The overriding concern is to ensure that the well being and the interests of human subjects are adequately safeguarded. In this respect, this article will embark on a critical analysis of theICH‐GCP Guideline. The purpose of such an undertaking is to highlight areas of concern and the shortcomings of the existingICH‐GCP Guideline. Particular emphasis is made on how ethics committees perform their duties and responsibilities in line with the principles outlined in theICH‐GCP Guideline. This article will draw attention to the need for a new approach to addressing the weaknesses of theICH‐GCP Guideline in its present form.
Why Restrictions on the Immigration of Health Workers Are Unjust
Authors: Hidalgo Javier 
Published: November 2012

AbstractSome bioethicists and political philosophers argue that rich states should restrict the immigration of health workers from poor countries in order to prevent harm to people in these countries. In this essay, I argue that restrictions on the immigration of health workers are unjust, even if this immigration results in bad health outcomes for people in poor countries. I contend that negative duties to refrain from interfering with the occupational liberties of health workers outweighs rich states' positive duties to prevent harm to people in sending countries. Furthermore, I defend this claim against the objection that health workers in poor countries acquire special duties to their compatriots that render them liable to coercive interference.
Association between radiographic Wallerian degeneration and neuropathological changes post childhood stroke
Authors: JONES KEVIN C , HAWKINS CYNTHIA , ARMSTRONG DEREK , DEVEBER GABRIELLE , MACGREGOR DAUNE , MOHARIR MAHENDRANATH , ASKALAN RAND 
Published: November 2012

Aim  Wallerian degeneration is a radiological finding thought to reflect corticospinal tract degeneration. This finding on magnetic resonance imaging (MRI) is routinely used as a predictor of poor prognosis in childhood stroke. However, its validity has never been established. Our objective was to correlate Wallerian degeneration seen on MRI with histopathology.Method  We searched the databases of the Department of Pathology and Children’s Stroke registry at the Hospital for Sick Children, Toronto for autopsy specimens exhibiting focal infarcts from children born at term who underwent MRI after a stroke. The specimens were examined for Wallerian degeneration and then correlated with the pre‐mortem MRI findings.Results  Seven children (four females, three males) with a median age of 11 years (1–17y) at the time of stroke met the inclusion criteria for this study. Of the seven children included in the study with ischaemic or haemorrhagic infarcts, six had concordant Wallerian degeneration findings on both MRI and post‐mortem histopathological examination. The median time between stroke and death was 20 days (3–1825d).Interpretation  Our results show for the first time that the radiographic finding of Wallerian degeneration is a valid biomarker of corticospinal tract degeneration in children who have had ischaemic or haemorrhagic stroke.
Habitat use, home range, movements and interactions of introducedLepomis gibbosusand nativeSalmo truttain a small stream of Southern England
Authors: Stakėnas Saulius , Vilizzi Lorenzo , Copp Gordon H. 
Published: November 2012

AbstractRadio telemetry data were analysed to assess the microhabitat use, movement patterns, home range overlap and interspecific interactions of non‐native pumpkinseedLepomis gibbosus(L.) and native brown troutSalmo trutta(L.) in a small English stream located immediately below a commercial angling lake from which pumpkinseed escaped. Although both species favoured pool habitats, brown trout preferred higher velocities and coarser substrata compared with pumpkinseed. Also, some individual brown trout preferred deeper waters than did pumpkinseed. Home range area of brown trout was substantially larger than that of pumpkinseed in spring and summer, and for both species, home range area in autumn was significantly smaller than in the other seasons. Range centre distribution analysis revealed that both species were distributed significantly nonrandomly within the stream during all seasons. There was substantial home range overlap between the two species in all seasons, the greatest being in spring. Overall distances moved were greatest during spring for both species, with brown trout moving greater distances relative to pumpkinseed. However, the absence of mutual attraction or avoidance between the species, as well as the lack of cohesion in preferred habitats and strong territorial fidelity, suggests little or no impact of introduced pumpkinseed on resident brown trout.