bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression in multiple sclerosis: A long-term longitudinal study
Authors: Koch Marcus W , Patten Scott , Berzins Sandy , Zhornitsky Simon , Greenfield Jamie , Wall Winona , Metz Luanne M 
Published: May 2014

Background: Depression is a common comorbidity in multiple sclerosis (MS), but little is known about its long-term prognosis. Depression in the general population is usually episodic with relatively short-lasting depressive episodes. In this study we investigate the long-term prognosis of depression in MS. Methods: Using data from a large longitudinal observational study and from the Calgary MS clinic database, we investigated changes in Center for Epidemiological Studies Depression Scale (CESD) scores in MS patients over four years of follow-up. We used logistic regression to investigate the association of the factors sex, age, disease duration, Expanded Disability Status Scale (EDSS), depression at baseline, and antidepressant use with depression at each year of follow-up. Results: CESD scores remained largely stable, or decreased slightly over four years of follow-up, whereas EDSS scores steadily increased. Depression at baseline was the strongest predictor of depression at follow-up; the other factors were not or not consistently associated with depression at follow-up. As expected, antidepressant use was associated with a greater risk of depression at follow-up. Starting and stopping antidepressant treatment during follow-up was not associated with the risk of depression at follow-up or with significant change in CESD scores. Conclusion: In contrast to depression in the general population, depression in MS is largely chronic, which suggests a different pathophysiology.
Translocation t(2;11) in CLL cells results in CXCR4/MAML2 fusion oncogene
Authors: Acunzo Mario , Romano Giulia , Wernicke Dorothee , Balatti Veronica , Rassenti Laura Z. , dell’Aquila Marie , Kipps Thomas J. , Pekarsky Yuri , Croce Carlo M. 
Published: May 2014

Key Points
A new translocation t(2;11)(q22.1;q21) that involves CXCR4 and MAML2 has been described and characterized in CLL.
Long-axis rotation: a missing degree of freedom in avian bipedal locomotion
Authors: Kambic Robert E. , Roberts Thomas J. , Gatesy Stephen M. 
Published: May 2014

AbstractGround-dwelling birds are typically characterized as erect bipeds having hind limbs that operate parasagittally. Consequently, most previous research has emphasized flexion/extension angles and moments as calculated from a lateral perspective. Three-dimensional motion analyses have documented non-planar limb movements, but the skeletal kinematics underlying changes in foot orientation and transverse position remain unclear. In particular, long-axis rotation of the proximal limb segments is extremely difficult to measure with topical markers. Here we present six degree of freedom skeletal kinematic data from maneuvering guineafowl acquired by marker-based XROMM (X-ray Reconstruction of Moving Morphology). Translations and rotations of the hips, knees, ankles, and pelvis were derived from animated bone models using explicit joint coordinate systems. We distinguished sidesteps, sidestep yaws, crossover yaws, sidestep turns, and crossover turns, but birds often performed a sequence of blended partial maneuvers. Long-axis rotation of the femur (up to 38°) modulated the foot's transverse position. Long-axis rotation of the tibiotarsus (up to 65°) also affected medio-lateral positioning, but primarily served to either reorient a swing phase foot or yaw the body about a stance phase foot. Tarsometatarsal long-axis rotation was minimal, as was hip, knee, and ankle abduction/adduction. Despite having superficially hinge-like joints, birds coordinate substantial long-axis rotations of the hips and knees to execute complex 3-D maneuvers while striking a diversity of non-planar poses.
Ambient noise causes independent changes in distinct spectro-temporal features of echolocation calls in horseshoe bats
Authors: Hage Steffen R. , Jiang Tinglei , Berquist Sean , Feng Jiang , Metzner Walter 
Published: May 2014

Abstract
One of the most efficient mechanisms to optimize signal-to-noise ratios is the Lombard effect - an involuntary rise in call amplitude due to ambient noise. It is often accompanied by changes in the spectro-temporal composition of calls. We examined the effects of broadband-filtered noise on the spectro-temporal composition of horseshoe bat echolocation calls, which consist of a constant-frequency component and an initial and terminal frequency-modulated portion. We find that the frequency-modulated components became larger for almost all noise conditions, whereas the bandwidth of the constant-frequency component increased only when broadband-filtered noise was centered on or above the calls' dominant or fundamental frequency. This indicates that ambient noise modifies the associated acoustic parameters of the Lombard-effect, such as spectro-temporal features, independently and could significantly affect the bat's ability to detect and locate targets. Our findings may be of significance in evaluating the impact of environmental noise on echolocation behavior in bats.
Structure of Stable Telluradiphosphirane Bearing Bulky Ferrocenyl Ligands
Authors: Sasamori Takahiro , Suzuki Yuko , Sakagami Michiyasu , Miyake Hideaki , Tokitoh Norihiro 
Published: May 2014

Abstract
Chalcogenation reactions of 1,2-bis(ferrocenyl)diphosphene, Fc*P=PFc* (Fc*: 2,5-bis(3,5-di-t-butylphenyl)ferrocenyl), with elemental sulfur (S8) and tellurium afforded the corresponding thia- and telluradiphosphirane derivatives as stable crystalline compounds, respectively. The sterically demanding ferrocenyl group would afford sufficient crystallinity and stability to the heterocyclic compounds; the structures of these three-membered ring heterocycles were revealed by X-ray crystallographic analysis.
A comparative analysis of pain management by midwives
Authors: Ziyane Isabella S , Sikhondze Nomvuselelo 
Published: May 2014

The study was set up to investigate the management of labour pain by midwives and traditional birth attendants. A qualitative research methodology was used to seek the views of 50 midwives and 60 traditional birth attendants on pain management during labour. Data were analyzed manually using themes that emerged from the study. The results revealed that pain was generally regarded as a normal physiological response to labour and was given little attention. Midwives identified pharmacological and nonpharmacological methods of relieving pain. Traditional birth attendants identified the use of herbs, baths, adopting the most comfortable position, as well as being with a companion as the ideal methods of pain management. Challenges experienced by midwives were lack of resources to effectively deliver quality care and poor referral system, socio-cultural issues and absence of a policy guideline to safeguard practice. Traditional birth attendants experienced challenges relating to poor recognition by the modern health care sector and poor referral system to modern maternity care facilities. Recommendations were made to educational institutions to stream line their curriculum to take into consideration sociocultural aspects of childbearing. A recommendation related to policy makers was to design institutional guidelines, which set out a national strategy for safe motherhood and maternity care.
Does maternal age affect pregnancy outcome?: a study in Tanzania
Authors: Muganyizi Projestine S , Kidanto Hussein L , Massawe Siriel , Moshiro Candida 
Published: May 2014

The objective was to estimate the effect of teenage and elderly maternal age on the incidence of labour interventions and perinatal outcome in Muhimbili National hospital, Tanzania. Included were all nulliparous mothers aged 12–50 years (n=43 167) who gave birth to singleton babies at the hospital during 1999–2005. Recorded data from the electronic database was analyzed. Bivariate and multiple logistic regression analyses were performed to estimate the effect of teenage (12–19 years) and elderly age (35–50 years) on pregnancy risk factors and as outcome variables with reference to the traditional low risk age group (20–34 years). Overall teenagers had the lowest incidence of risk factors. Compared to the low risk age group mothers teenagers were at increased risk for low birth weight (OR 1.4; 95% CI 1.11–1.68) but lower odds for blood loss, caesarean delivery and use of oxytocin. Elderly mothers had higher risk for low birth weight (OR 1.4; 95% CI 1.12–1.78) and caesarean delivery (OR 2.69; 95% CI 2.20–3.30). The elderly age mothers also had significantly more blood loss in excess of 500ml which was a result of the high caesarean section rate. Teenagers, unlike the elderly mothers group, have no increased risks for labour and delivery complications that demand higher level facilities with comprehensive obstetric care services.
Clinical competence of nursing graduates in Kenya
Authors: Chege Margaret Njambi , Kabiru Ephantus W , Karani Anna , Derese Ansellme 
Published: May 2014

The objective was to compare the clinical competence of nurse graduates of two curricula tracts. At the time of the study Kenya Medical Training College (KMTC) had an innovative skillslab-integrated curriculum for Kenya registered community health nurses trained in Nairobi and a traditional lecture-based curriculum for those trained elsewhere. 288 nurse graduates were recruited for the study. Two clinical skills were randomly selected for evidence-based performance. Indicators of competence were identified through Delphi study. Approval to conduct the study was obtained from Ministries of Health and Education and joint University of Nairobi, Kenyatta National Hospital Ethics and Research Committee. Data were collected through evidence-based performance, in-depth interviews and focus group discussions (FGDs). Data input and analysis were done using Excel Version 2003-97. There was significant difference (_2=65.988, p<0.001) in performance between graduates of the two methodologies. Those of the skillslab-based curriculum were described as critical thinkers. Those of the control group were described as better ward managers. The skillslab graduates consistently scored higher in all indicators of competence and across the components of nursing expertise.
Misoprostol for safe motherhood: one tablet, two life-saving indications
Authors: Grossman Amy , Graves Alisha , Rwamushaija Emmanuel , Park Calandra 
Published: May 2014

Misoprostol is a safe, acceptable, feasible, and effective alternative for both postpartum hemorrhage (PPH) and the treatment of incomplete abortion and miscarriage when no other interventions are available, which is often the case in resource-challenged regions. This article reviews the use of misoprostol for these two leading causes of maternal death globally and presents data on the implementation of misoprostol for PPH in Zanzibar as a case study. An evaluation was conducted to assess the uptake of misoprostol in public facilities in Zanzibar through a record review at nine facilities on various indicators from April 2008 to March 2009. For comparison, pre-intervention data were also collected from the same nine facilities for the 12 months preceding the PPH management trainings in April 2008. Following the introduction of misoprostol for PPH, the need for additional interventions among PPH cases significantly declined. The post-intervention period showed significantly fewer blood transfusions, PPH referrals, and PPH-related maternal deaths. Among PPH cases, the need for blood transfusion decreased from 30 (19.2%) in the pre-intervention period to 7 (2.4%) in the postintervention period. Rates of PPH-related referrals and maternal deaths also declined from 7.7% pre-intervention to 3.1% postintervention (P<0.05). Misoprostol has the potential to make an immediate impact on the number of maternal deaths resulting from PPH and treatment of incomplete abortion and miscarriage.
Quality assurance through the external examiner system
Authors: Mogobe Keitshokile Dintle 
Published: May 2014

This paper focuses on the findings of an external examiner in five universities, in different countries in Southern Africa over nine years. The aim is to share information with fellow nurse academics who are concerned with issues of quality in nursing education, so that they could appreciate the challenges associated with the process with a view to improving the system. Participant observation and documentary analysis were used to collect data during the period. The findings are presented through the steps of the external examining process: recruitment and appointments, signing of contracts, review of curriculum materials and examination questions, onsite visits and reviews of students’ scripts, external examiners’ meetings and report writing. The benefits for both the host institution and the external examiners are discussed. The following challenges were found: time and financial constraints, absence of written terms of reference, lack of induction sessions for new external examiners, lack of templates for report writing and stipulated dates for submission of reports. The following were recommended given the findings of this study: timely appointment of external examiners, establishing a regional register of external examiners, producing a handbook for first time examiners and induction of new external examiners, comprehensive involvement of the external examiner, establishing a mechanism for effective monitoring and implementation of external examiner's recommendations and panel discussions.
Report on health screening of blood pressure, blood sugar and body mass index in hospital staff in Cameroon, Africa
Authors: Gobte Nkwan Jacob , Meyer Dorothy J , Njecko Boniface Takwe 
Published: May 2014

Introduction: In Africa, there is increasing attention on non-communicable diseases in response to a shifting of disease burden from infectious diseases to chronic illnesses, especially hypertension, diabetes and obesity. As part of the World Health Week, health screening was offered to all staff at Banso Baptist hospital to promote their awareness of their personal health and obtain a baseline assessment of the general health of the staff. Methods: A health screening was held for all hospital staff which included measurements of blood pressure, blood sugar and body mass index. Demographic data were collected and limited to age, gender and staff position/activity. Results: Almost 60% of the staff participated in the screening with 5.8% having an elevated blood pressure and 2.8% an elevated blood sugar. the percent of overweight/obesity was 55.9% with women significantly more obese than men (p=0.0001). Discussion: Overweight and obesity were higher in the staff than expected with the women's percentage concerning. without interventions, there is the potential of increasing numbers of staff eventually developing hypertension, diabetes and other chronic illnesses. Prevention efforts have the potential to maintain staff wellness and productivity as well as preventing chronic illnesses.
Why do women attend and continue cardiac rehabilitation?
Authors: Higginson Ray 
Published: May 2014

Cardiac rehabilitation is a multidisciplinary intervention, designed to improve the life of the post-myocardial infarction (MI) patient and reduce his/her morbidity and mortality. Although the benefits apply equally to women and men, research shows that patient nonattendance particularly among the elderly female population is an important problem. This qualitative study (which forms par t of a much larger doctoral study) explores some of the factors that influence women's decisions to attend cardiac rehabilitation after an MI. Using a feminist grounded theory research approach, ten female post-MI patients were inter viewed about their cardiac rehabilitation. Preliminary analysis suggests that women choosing to attend claim that it increases their self-confidence, understanding of their condition and feeling of empowerment. They perceive themselves to be ‘restored’ to a functional level they had had before their MI. Information gained from this study could be used to inform the development of gender-specific cardiac rehabilitation programmes.
Assessing exercise intensity in cardiac rehabilitation: the use of a Polar heart rate monitor
Authors: Bethell Hugh , Letford Sandra , Evans Julia , Turner Sally , Maskell Joe , Culliford David 
Published: May 2014

Objective: To assess the accuracy of a Polar heart rate monitor in measuring heart rate in exercising cardiac rehabilitation patients. Design: Simultaneous heart rate recordings comparing results from the Polar monitor with those from Holter monitoring and intermittent pulse rate as measured by radial artery palpation. Setting: Exercise sessions in a community-based cardiac rehabilitation centre. Patients: Twenty phase III cardiac rehabilitation patients recovering from an acute cardiac event. Main outcome measures: Comparison of heart rates recorded by the two systems and by pulse rate measurement. Results: The Polar monitor gave results very similar to those from Holter monitoring. Intermittent pulse rate measurement gave a limited and less accurate view of the intensity of the exercise session. Conclusion: The Polar heart rate monitor gives accurate readings during cardiac rehabilitation exercise sessions at low cost. It is a useful tool which allows assessment of exercise intensity which is not available from intermittent radial pulse rate measurement.
Atrial fibrillation: an update on care provision
Authors: Chalkley Sarah 
Published: May 2014

Atrial fibrillation (AF) is the most common cardiac arrhythmia, increasing mortality and impairing quality of life (Khaykin, 2007). The publication of chapter 8 of the National Service Framework for Coronary Heart Disease (DH, 2005), and the National Institute for Health and Clinical Excellence guidelines (NICE, 2006) have highlighted the importance of individualized case management in the treatment of AF. This article will summarize recommendations in the management of AF in relation to the NSF and NICE guidelines and assess the implications for practice. The associated symptoms, risk factors and classification of each type of AF will be defined. Different investigations will be discussed in relation to symptoms of AF, highlighting treatment options specific to each presentation. Consistent and effective management of AF can have a significant impact on an individual’s quality of life and be cost-effective for health care providers.
Cholesterol and the menopause: Dietary recommendations for improved patient care
Authors: Williams Christine 
Published: May 2014

For postmenopausal women and those undergoing menopause, the risk of developing cardiovascular disease is significantly elevated. Changes to cholesterol and lipid profiles in women at this time can lead to a number of deleterious effects including abdominal fat deposition, reduced glucose tolerance, and increased blood pressure. As a result, cardiovascular disease has become the leading cause of morbidity and mortality in postmenopausal women, accounting for nearly 50% of all female deaths in developed countries. In response to the current situation, a panel of women’s health and nutrition experts have developed a new, six-step plan of dietary recommendations to support cholesterol management during the menopause. The importance of developing such recommendations has been supported by research demonstrating that nearly half of women surveyed stated that they would prefer to take control of their menopausal symptoms through alterations to their diet and lifestyle rather than by medication.
Rehabilitation for patients with chronic heart failure: How do we deliver it to all?
Authors: Burgess Janet , Whitfield James 
Published: May 2014

The Community Hear t Failure Team based in South West Essex identified a need to provide cardiac rehabilitation for patients with stable chronic heart failure (CHF) as these patients were excluded from the standard cardiac rehabilitation programme. The aim was to assess whether a home-based programme could provide similar outcomes to a group programme and provide demonstrable improvements in physical and or psychological health, providing a better quality of life to patients with stable CHF. Patients were assessed before and after the programmes using 6 minute walk test, deltoid muscle strength, Hospital Anxiety and Depression (HAD) scale and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). A total of 18 patients completed the programmes, 6 on the home programme and 12 on the group programmes. Results from physical measures were positive and all patients reported improvements, however results from the HAD Scale and the MLHFQ were equivocal. From this small scale study, the home-based programme appears to be as beneficial as a group-based programme and when run concurrently with the group programme will enable the Community Hear t Failure Team to offer patients the most appropriate programme to meet their needs.
Physical self-efficacy, anxiety and depression following a 6-week cardiac rehabilitation programme
Authors: Barker Alexis , Tsakirides Costas , Carroll Sean , Ingle Lee 
Published: May 2014

Aim: To conduct a preliminary study to evaluate gender differences in psychological health status and physical activity (PA) levels in male and female patients following completion of 6 weeks of phase III cardiac rehabilitation (CR). Methods: Cardiac patients who had completed structured hospital-based CR were invited to participate in the study. Patients completed three questionnaires which evaluated current and past PA levels, physical self-efficacy, and anxiety and depression. Results: Sixteen male participants (mean age 55±8 years), and six females (mean age 55±7 years) were recruited. Males were significantly more active (12±9 hours of total PA per week) than females (8±4 hours of PA per week; P=0.018). Females with social support during exercise engaged in more weekly PA than those who exercise alone (P<0.05). Conversely, males performed more PA alone (14±9 hours) than with others (11±9 hours; P<0.05). Patients (males and females) who exercised in groups had higher physical self-efficacy than those that engaged in exercise alone (P<0.05). The HADS scores revealed that overall males and females were not anxious or depressed (depression sub-score: 3.0±2.4 versus 1.7±2.8; P=0.33; anxiety sub-score: 5.7±2.3 vs 4.3±3.5; P=0.37). A signifi cant gender by exercise environment (exercise alone or undertaken some group exercise) interaction was evident (P=0.045) for depression, but not for anxiety (P=0.122). Conclusion: These preliminary results indicate that gender differences in psychological well-being and physical activity status may exist following standardized short-term phase III cardiac rehabilitation. We recommend that CR services should consider the differing needs of both males and females.
Minimizing the risk of infection in patients with central venous catheters
Authors: Poole Debbie 
Published: May 2014

Central venous catheters (CVCs) are increasingly commonplace in health care and provide an integral part of medical management in the acutely ill patient. They are in frequent use in the cardiac setting for haemodynamic monitoring, administration of drugs and intravenous fluids and for venous blood sampling. CVCs pose a serious risk of infection with potentially lethal consequences. The resulting infection has implications for increased length of stay and financial costs as well as the physical and emotional effects on the patient. Nursing practice in the care of these invasive devices must be in line with evidence-based guidelines ensuring optimum safe practice to prevent complications from sepsis.