bluuebunny/crossref_metadata_2025_split huggingface dataset:
An evaluation of an alcohol awareness group for learning disabled offenders in a secure setting
Authors: Burns John , Aspinall Charlotte , Matthews Chris 
Published: February 2012

PurposeIndividuals with learning disabilities (LD) who offend are more likely to be dependent on alcohol than those who do not. There is strong evidence to suggest that interventions for alcohol problems can be effective; this paper aims to address this issue.Design/methodology/approachThe pre and post assessment scores from an alcohol awareness group (AAG) were collected from 34 service users with LD or a dual diagnosis of LD and mental health problems. The programme was manual led and included 12 sessions. The data collected were used to evaluate the programme.FindingsClients' level of knowledge and self efficacy increased after programme completion. Post group, those with a lower IQ had gained a greater level of alcohol‐related knowledge compared to those with a higher IQ. Clients with a learning disability alone scored slightly higher than those with a dual diagnosis.Originality/valueThe AAG has been successful in increasing motivation to change drinking behaviour, knowledge of problems related to alcohol, and “safe drinking” practice. These outcomes have been achieved across a wide range of cognitive abilities suggesting that those with an IQ below 60 can also benefit from this type of intervention.
Young people within the criminal justice system: making sense of fitness to plead and mental capacity in practice
Authors: Hepworth Karina 
Published: February 2012

PurposeIncreasing research evidence highlights the importance of recognising a person's learning disability early in their journey through the Criminal Justice System (CJS) and highlights the need for liaison and diversion schemes. This practice paper seeks to raise awareness of the importance of mental capacity and its alignment (or lack there of) with the issue of fitness to plead.Design/methodology/approachThe Law Commission's recent consultation has highlighted the disparity of the Pritchard Test and the Mental Capacity Act 2005, and has considered several provisional proposals for consideration. As a learning disability nurse within a Youth Offending Service, the author encounters young people on court Orders who struggle to understand the criminal justice process. To highlight the significance of this, and its relationship to practice, the paper proposes to discuss a young person's case.FindingsEarly recognition of a person's needs and mental capacity are crucial to ensure the right pathway is taken through the criminal justice system. Whether this be supporting the person to undertake their Order and delivery of an appropriate and understandable intervention or diversion away from the criminal justice system into services. Information sharing and working together are key factors to success.Originality/valueThis paper seeks to highlight the difficulties and dilemmas facing staff working within the criminal justice system in relation to the identification and support needs of people with learning difficulties. Learning disability nurses and those professionals working within learning disability services have a significant part to play in this area of work and can help to ensure that people with learning disabilities do not face double jeopardy and injustice.
Young people's overestimation of peer substance use: an exaggerated phenomenon?
Authors: Pape Hilde 
Published: February 2012

ABSTRACTAims  This paper queries the notion that young people overestimate peer substance use, asking whether there is robust evidence that such misperceptions are widespread and whether the phenomenon may have been exaggerated in the research literature.Method  An examination of the research literature was conducted, focusing mainly on studies published since 2000. Some analyses of relevant data on cannabis use from a Norwegian youth survey were also undertaken.Results  The research in question is characterized by many weaknesses, including low response rates and widespread use of convenience samples, as well as the presence of contextual factors and the use of assessment tools that may have created a bias in favour of ‘demonstrating’ that youth overestimate peer drinking or drug use. Moreover, in some cases, the apparent tendency to hold such misbeliefs may reflect the reality. Further, although most studies conclude that the modal tendency is to overestimate, high levels of underestimation of peer substance use have been reported. There is also suggestive evidence that many youth may have no pre‐existing beliefs when responding to items on the issue. Results from the Norwegian youth survey added to this picture.Conclusion  Young people's tendency to overestimate peer drinking and drug use has been exaggerated, while the uncertainty surrounding the evidence in question has been understated.
Under what conditions is it ethical to offer incentives to encourage drug‐using women to use long‐acting forms of contraception?
Authors: Lucke Jayne C. , Hall Wayne D. 
Published: February 2012

ABSTRACTAims  To stimulate debate by examining ethical issues raised by Project Prevention, a US‐based organization that offers $US300 to addicted individuals who agree to either undergo surgical sterilization or use long‐acting forms of contraception.Method  An analysis of key ethical questions raised by Project Prevention.Results  The important issues for debate are: (i) what are the reproductive rights of drug‐using women; (ii) does a substantial cash incentive undermine the ability of addicted women to make free and informed decisions about long‐term contraception; and (iii) how can we best assist addicted women to access good reproductive health care and obtain treatment for their addiction?Conclusions  We need more research on ways in which small non‐cash incentives for reversible methods of contraception could be used in a morally acceptable and effective way to promote the sexual, reproductive and general health of addicted women.
What is the best pre‐operative risk stratification tool for major adverse cardiac events following elective vascular surgery? A prospective observational cohort study evaluating pre‐operative myocardial ischaemia monitoring and biomarker analysis
Authors: Biccard B. M. , Naidoo P. , de Vasconcellos K. 
Published: February 2012

SummaryAlthough brain natriuretic peptide has been shown to be superior to the revised cardiac risk index for risk stratification of vascular surgical patients, it remains unknown whether it is superior to alternative dynamic risk predictors, such as other pre‐operative biomarkers (C‐reactive protein and troponins) or myocardial ischaemia monitoring. The aim of this prospective observational study was to determine the relative clinical utility of these risk predictors for the prediction of postoperative cardiac events in elective vascular surgical patients. Only pre‐operative troponin elevation (OR 56.8, 95% CI 6.5–496.0, p < 0.001) and brain natriuretic peptide above the optimal discriminatory point (OR 6.0, 95% CI 2.7–12.9, p < 0.001) were independently associated with cardiac events. Both brain natriuretic peptide and troponin risk stratification significantly improved overall net reclassification (74.6% (95% CI 51.6%–97.5%) and 38.5% (95% CI 22.4–54.6%, respectively)); however, troponin stratification decreased the correct classification of patients with cardiac complications (−59%, p < 0.001). Pre‐operative brain natriuretic peptide evaluation was the only clinically useful predictor of postoperative cardiac complications.
An assessment of the accuracy of pulse oximeters
Authors: Milner Q. J. W. , Mathews G. R. 
Published: February 2012

SummaryPeripheral pulse oximetry has become a core monitoring modality in most fields of medicine. Pulse oximeters are used ubiquitously in operating theatres, hospital wards, outpatient clinics and general practice surgeries. This study used a portable spectrometer (Lightman®, The Electrode Co. Ltd., Monmouthshire, UK) to measure the emission spectra of the two light emitting diodes within the pulse oximeter sensor and to determine the accuracy of 847 pulse oximeters currently in use in 29 NHS hospitals in the UK. The standard manufacturing claim of accuracy for pulse oximeters is ± 2–3% over the range of 70–100% SpO2. Eighty‐nine sensors (10.5%) were found to have a functional error of their electrical circuitry that could cause inaccuracy of measurement. Of the remaining 758 sensors, 169 (22.3%) were found to have emission spectra different from the manufacturers’ specification that would cause an inaccuracy in saturation estimation of > 4% in the range of 70–100% saturation. This study has demonstrated that a significant proportion of pulse oximeter sensors may be inaccurate.
Directly measured mucosal pressures produced by the i‐gelTM and laryngeal mask airway SupremeTM in paralysed anaesthetised patients
Authors: Eschertzhuber S. , Brimacombe J. , Kaufmann M. , Keller C. , Tiefenthaler W. 
Published: February 2012

SummaryThe i‐gelTM and LMA SupremeTM are extraglottic airway devices with non‐inflatable and inflatable cuffs, respectively. We hypothesised that directly measured mucosal pressures would differ between these devices in anesthetised paralysed patients. Thirty patients were randomly allocated to receive one of these two devices. Four pressure sensors were attached to all airway devices used to measure mucosal pressure at the base of the tongue, the distal oropharynx, the hypopharynx and the pyriform fossa. At these four places, median (IQR [range]) i‐gel mucosal pressures were 8.0 (2.7–10.7 [0–26.7]), 5.0 (2.7–7 [1.0–37.3]), 9.3 (2.7–13.3 [0–22.7] and 8.0 (2.7–10.7 [0–25.3]) cmH2O, respectively, and for the LMA Supreme, these were 5.0 (0.5–8.0 [0–33]), 4.0 (1.3–9.3 [0–24]), 10.7 (4–17.3 [0–26.7]) and 8.0 (0–10.7 [0–36]) cmH2O, respectively. Mucosal pressures were low and similar for both devices. The LMA Supreme mucosal pressures were higher in the hypopharynx than in the distal oropharynx (p = 0.04) and base of the tongue (p = 0.011). There were no pressure differences between the locations for the i‐gel.
Susceptibility of the pilot balloon of the disposable laryngeal mask airway to puncture during laser therapy
Authors: Chilcott A. , Lister T. S. , Geary P. M. , Wright P. A. 
Published: February 2012

SummaryThe tube of the laryngeal mask airway is frequently protected by foil during ablative laser procedures. The pilot balloon, however, is often left exposed. The effect of firing seven different cutaneous lasers at the pilot balloon of a disposable laryngeal mask airway was examined to assess its susceptibility to accidental laser strikes. The time taken for each laser to penetrate the pilot balloon was calculated from an average of five laser strikes. The carbon dioxide and erbium YAG lasers punctured the pilot balloon in a mean (SD) of 0.07 (0.02) s and 0.7 (0.1) s, respectively, with the neodymium YAG laser the next quickest to puncture at 3.3 (1.0) s. All other lasers punctured the pilot balloon in less than 15 s. These data suggest that protection of the pilot balloon of the LMA is necessary when using carbon dioxide and erbium YAG lasers.
The effect of posture and anaesthetic technique on the surgical pleth index
Authors: Ilies C. , Ludwigs J. , Gruenewald M. , Thee C. , Hanf J. , Hanss R. , Steinfath M. , Bein B. 
Published: February 2012

SummaryThe surgical pleth index has been shown to correlate with surrogate variables of nociception during general anaesthesia, and it has been suggested to be of use as a depth of anaesthesia monitor. However, little is known about confounding factors. As the main determining variables are based on both central and peripheral autonomic regulatory mechanisms, we hypothesised that changing a patient`s posture may produce a marked effect. We studied the effects of posture change in 45 patients who were randomly assigned to receive general (n = 15) or spinal anaesthesia with (n = 15) or without sedation (n = 15), as well as 15 awake volunteers. Mean (SD) values of the surgical pleth index after adoption of the lithotomy position were reduced from 57 (22) to 21 (6) under general anaesthesia, 63 (15) to 31 (9) under spinal anaesthesia alone, and 52 (14) to 22 (8) under spinal anaesthesia with sedation (all p < 0.01). In healthy volunteers, the surgical pleth index increased from 37 (13) to 57 (11) (p < 0.01) after 30° head‐up tilt and was reduced from 35 (11) to 25 (11) after head‐down tilt (p < 0.05). Change in posture has a marked effect on the surgical pleth index which lasts for at least 45 min, and this must be considered when interpreting the displayed values.
The effect of aspirin in transfusion‐related acute lung injury in critically ill patients*
Authors: Tuinman P. R. , Vlaar A. P. , Binnenkade J. M. , Juffermans N. P. 
Published: February 2012

SummaryAspirin has been found to improve outcomes in an animal model of transfusion‐related acute lung injury. We examined the association of aspirin use before admission to the intensive care unit and the development of transfusion‐related acute lung injury in critically ill patients. We performed a post‐hoc analysis of a nested case‐control study that had been undertaken in a tertiary referral hospital. Transfusion‐related acute lung injury cases were matched with controls (transfused patients not developing lung injury). Of these 218 patients, 66 used aspirin (30%). Use of aspirin did not alter the risk of transfusion‐related acute lung injury after transfusion of platelets (OR 1.06, CI 0.59–1.91, p = 0.85), plasma (OR 1.06, 95% CI 0.59–1.92, p = 0.84), or red blood cells (OR 1.09, 95% CI 0.61–1.94, p = 0.77). Adjustment for confounding variables using propensity scoring also did not affect the risk of acquiring transfusion‐related acute lung injury (p = 0.66). In conclusion, aspirin did not protect against transfusion‐related lung injury in this cohort of critically ill patients.
Spatio‐temporal patterns of habitat use in voles and shrews modified by density, season and predators
Authors: Sundell Janne , Church Christina , Ovaskainen Otso 
Published: February 2012

Summary1. Although the intrinsic habitat preferences of a species can be considered to be fixed, the realized habitat use depends on the prevailing abiotic and biotic conditions. Often the core habitats are occupied by dense and stable populations, while marginal habitats become occupied only at times of high density. In a community of interacting species, habitat uses of different species become inter‐related, for example an increased density of a strong competitor forcing a weaker competitor to use more marginal habitats.2. We studied the spatio‐temporal distribution patterns of three common small mammal species, the bank vole Myodes glareolus; the field vole Microtus agrestis; and the common shrew Sorex araneus, in a 4‐year trapping study carried out on six large islands, each containing a mixture of three main habitat types (forest, field and clear‐cut). We experimentally released least weasels (Mustela n. nivalis) to some of the islands to see how the focal species respond to increased predation pressure.3. Both vole species were largely restricted to their core habitats (bank voles to forests and field voles to fields) at times of low population density. With increasing density, the relative habitat use of both species increased in the clear‐cut areas. The common shrew was a generalist in its habitat use at all population densities.4. The release of the weasels changed the habitat use of all study species.5. The vole species showed a stronger aggregated pattern than the common shrew, especially at low population density. The vole aggregations remained in the same localities between seasons, except in the case of bank voles after the weasels were released.6. Bank voles and field voles avoided each other at high density.7. We conclude that intrinsically differential habitat requirements and flexibility to modify habitat use facilitate the coexistence of the two competing vole species in mosaic landscapes consisting of boreal forests and open habitats.
The role of phylogeny in desert rodent community assembly
Authors: Brown James H. 
Published: February 2012

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[ Many landscapes span communities of varying degrees of biological complexity. Across such a gradient, diversity begets diversity. Increased environmental heterogeneity in the Mojave Desert increases the diversity of rodent consumers, in particular by allowing species that are phylogenetically more similar to coexist in more species rich communities. ]Stevens, R.D., Gavilanez, M.M., Tello, J.S. & Ray, D.A. (2012) Phylogenetic structure illuminates the mechanistic role of environmental heterogeneity in community organization. Journal of Animal Ecology, 81, 455–462.Recent advances in molecular genetics and phylogenetic reconstruction have the potential to transform ecology by providing new insights into the historical evolution of ecological communities. This study by Stevens and collaborators complements decades of previous research on desert rodents, by combining data from a field study and a phylogenetic tree for Mojave Desert rodents to address patterns and processes of community assembly. The number of coexisting rodent species is positively correlated, and the average phylogenetic distance among these species is negatively correlated with perennial plant species richness. As rodent species diversity increases along a gradient of increasing environmental heterogeneity, communities are composed of increasingly related species: there is a consistent pattern of phylogenetic structure from over‐dispersed through random to clumped. I discuss this pattern in the light of complementary results of previous studies. This paper is noteworthy for calling attention to still unanswered questions about how the historical events of speciation, colonization, extinction, and trait evolution and their relationship to past climates and vegetation have given rise to current patterns of community organization.
Taiwanese translation and psychometric testing of the revised illness perception questionnaire for patients with traumatic injury
Authors: Chaboyer Wendy , Lee Bih‐O , Wallis Marianne , Chien Chi‐Sheng 
Published: February 2012

Aims.  The purpose of this study was to undertake a cross‐cultural adaptation, translation and psychometric analysis of the Illness Perception Questionnaire Revised for patients with traumatic injury in Taiwan.Background.  Illness representations are the cognitive understandings and emotional responses individuals develop, which help to determine their responses to health threats.Methods.  This methodological study involved four phases. First, two subscales, identity and causes were modified. Second, translation and back translation was undertaken by four translators, moderated by an expert committee. Third, ten patients with traumatic injury pilot tested the feasibility and readability of the Chinese Illness Perception Questionnaire Revised (Trauma), and three professionals assessed the scale for content validity, resulting in minor modifications. Finally, 173 patients with traumatic injury were recruited to the main study and completed the Chinese Illness Perception Questionnaire Revised (Trauma). Item analysis, factor analysis, Cronbach’s alpha and split‐half reliability were used to the psychometric properties of the Chinese Illness Perception Questionnaire Revised (Trauma).Results.  Eight items were removed from the scale as a result of the item analysis. The factor analysis demonstrated a six‐factor structure explained 60·3% of the total item variance in the scale, which was very similar to the original scale. The Cronbach’s alphas ranged from 0·69–0·80 for each subscale, and the split‐half reliability coefficients were from 0·70–0·82.Conclusion.  The Chinese Illness Perception Questionnaire Revised (Trauma) had good psychometric properties.Relevance to clinical practice.  Translation of the instrument into Chinese extends its utility to the traumatic injury population. Awareness of patients’ illness representations can help clinicians provide appropriate interventions to patients.
A cross‐cultural study of students’ approaches to professional dilemmas: sticks or ripples
Authors: Ho Ming‐Jung , Lin Chi‐Wei , Chiu Yu‐Ting , Lingard Lorelei , Ginsburg Shiphra 
Published: February 2012

Medical Education 2012:

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: 245–256Context  Medical educators internationally are faced with the challenge of teaching and assessing professionalism in their students. Some studies have drawn attention to contextual factors that influence students’ responses to professional dilemmas. Although culture is a significant contextual factor, no research has examined student responses to professional dilemmas across different cultures.Methods  Semi‐structured interviews inquiring into reactions towards, and reasoning about, five video clips depicting students facing professional dilemmas were conducted with 24 final‐year medical students in Taiwan. The interviews were transcribed and analysed according to the theoretical framework used in prior Canadian studies using the same videos and interview questions.Results  The framework from previous Canadian research, including the components of principles, affect and implications, was generally applicable to the decision making of Taiwanese students, with some distinctions. Taiwanese students cited a few more avowed principles. Taiwanese students emphasised an additional unavowed principle that pertained to following the advice of more senior trainees. In addition to implications for patients, team members or themselves, Taiwanese students considered the impact of their responses on multiple relationships, including those with patients’ families and alumni residents. Cultural norms were also cited by Taiwanese students.Conclusions  Medical educators must acknowledge students’ reasoning in professionally challenging situations and guide students to balance considerations of principles, implications, affects and cultural norms. The prominence of Confucian relationalism in this study, exhibited by students’ considerations of the rippling effects of their behaviours on all their social relationships, calls for further cross‐cultural studies on medical professionalism to move the field beyond a Western individualist focus.