bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mutual powerlessness in client participation practices in mental health care
Authors: Broer Tineke , Nieboer Anna P. , Bal Roland 
Published: March 2012

AbstractBackground  Client participation has become a dominant policy goal in many countries including the Netherlands and is a topic much discussed in the literature. The success of client participation is usually measured in terms of the extent to which clients have a say in the participation process. Many articles have concluded that client participation is limited; professionals often still control the participation process and outcomes.Objective  The objective of this study is to gain insight into (i) the practice of client participation within a quality improvement collaborative in mental health care and (ii) the consequences of a Foucauldian conceptualization of power in analysing practices of client participation.Design  We used an ethnographic design consisting of observations of national events and improvement team meetings and interviews with the collaborative’s team members and programme managers.Results  Contrary to many studies on client participation, we found both clients and service providers frequently felt powerless in its practice. Professionals and clients alike struggled with the contributions clients could make to the improvement processes and what functions they should fulfil. Moreover, professionals did not want to exert power upon clients, but ironically just for that reason sometimes struggled with shaping practices of client participation. This mutual powerlessness (partly) disappeared when clients helped to determine and execute specific improvement actions instead of participating in improvement teams.Conclusion  Recognizing that power is inescapable might allow for a more substantive discussion concerning the consequences that power arrangements produce, rather than looking at who is exerting how much power.
Symptom recognition of heart attack and stroke in nine European countries: a representative survey
Authors: Mata Jutta , Frank Ronald , Gigerenzer Gerd 
Published: March 2012

AbstractBackground  Cardiovascular diseases are the number one cause of death and a source of chronic disability.Objectives  To assess recognition of and reaction to symptoms of heart attack and stroke, and how recognition is related to the frequency of consulting physicians and other information sources.Design  Face‐to‐face computer‐assisted personal interviews.Participants  Representative sample of 10 228 persons in Austria, France, Germany, Italy, the Netherlands, Poland, Russia, Spain and UK, aged 14–98.Main Outcome Variables  Recognition of heart attack and stroke symptoms and proper reaction to symptoms.Results  Chest pain was the only heart attack symptom recognized by more than 50% of participants. Eight percent knew no symptoms. Of 14 stroke symptoms, none was recognized by more than 50% of participants; 19% could not identify any symptom. For both heart attack and stroke, Germans and Austrians recognized the largest number of symptoms. Persons in Italy, Poland, Russia and Spain knew only about half as many symptoms as in Germany or Austria. Only 51% of Europeans would call an ambulance when someone suffers a stroke, the fewest (33 and 34%) in Germany and Austria. In most countries, people who consulted their physician more frequently had no better recognition of heart attack or stroke symptoms.Conclusions  The majority of persons in nine European countries recognize few heart attack and stroke symptoms; many do not know how to react. This low level of knowledge constitutes a major health risk and likely leads to delay in treatment, contributing to the high mortality and morbidity from these diseases.
The Swiss Health Literacy Survey: development and psychometric properties of a multidimensional instrument to assess competencies for health
Authors: Wang Jen , Thombs Brett D. , Schmid Margareta R. 
Published: March 2012

AbstractBackground  Growing recognition of the role of citizens and patients in health and health care has placed a spotlight on health literacy and patient education.Objective  To identify specific competencies for health in definitions of health literacy and patient‐centred concepts and empirically test their dimensionality in the general population.Methods  A thorough review of the literature on health literacy, self‐management, patient empowerment, patient education and shared decision making revealed considerable conceptual overlap as competencies for health and identified a corpus of 30 generic competencies for health. A questionnaire containing 127 items covering the 30 competencies was fielded as a telephone interview in German, French and Italian among 1255 respondents randomly selected from the resident population in Switzerland.Findings  Analyses with the software MPlus to model items with mixed response categories showed that the items do not load onto a single factor. Multifactorial models with good fit could be erected for each of five dimensions defined a priori and their corresponding competencies: information and knowledge (four competencies, 17 items), general cognitive skills (four competencies, 17 items), social roles (two competencies, seven items), medical management (four competencies, 27 items) and healthy lifestyle (two competencies, six items). Multiple indicators and multiple causes models identified problematic differential item functioning for only six items belonging to two competencies.Conclusions  The psychometric analyses of this instrument support broader conceptualization of health literacy not as a single competence but rather as a package of competencies for health.
Pseudomonas aeruginosa population structure revisited under environmental focus: impact of water quality and phage pressure
Authors: Selezska Katherina , Kazmierczak Marlon , Müsken Mathias , Garbe Julia , Schobert Max , Häussler Susanne , Wiehlmann Lutz , Rohde Christine , Sikorski Johannes 
Published: March 2012

SummaryPseudomonas aeruginosa attracts research attention as a common opportunistic nosocomial pathogen causing severe health problems in humans. Nevertheless, its primary habitat is the natural environment. Here, we relate the genetic diversity of 381 environmental isolates from rivers in northern Germany to ecological factors such as river system, season of sampling and different levels of water quality. From representatives of 99 environmental clones, also in comparison with 91 clinical isolates, we determined motility phenotypes, virulence factors, biofilm formation, serotype and the resistance to seven environmental P. aeruginosa phages. The integration of genetic, ecological and phenotypic data showed (i) the presence of several extended clonal complexes (ecc) which are non‐uniformly distributed across different water qualities, and (ii) a correlation of the hosts' serotype composition with susceptibility towards distinct groups of environmental phages. For at least one ecc (eccB), we assumed the ecophysiological differences on environmental water adaptation and phage resistance to be so distinct as to reinforce an environmentally driven cladogenic split from the remainder of P. aeruginosa. In summary, we conclude that the majority of the microevolutionary population dynamics of P. aeruginosa were shaped by the natural environment and not by the clinical habitat.
Community analysis of high‐ and low‐nucleic acid‐containing bacteria in NW Mediterranean coastal waters using 16S rDNA pyrosequencing
Authors: Vila‐Costa Maria , Gasol Josep M. , Sharma Shalabh , Moran Mary Ann 
Published: March 2012

SummaryThe ecological significance of the marine bacterial populations distinguishable by flow cytometry on the basis of the fluorescence (FL) of their nucleic acid (NA) content and proxies of cell size (such as side scatter, SSC) remains largely unknown. Some studies have suggested that cells with high NA (HNA) content and high SSC (HS) represent the active members of the community, while the low NA (LNA) cells are inactive members of the same phylogenetic groups. But group‐specific activity measurements and phylogenetic assignment after cell sorting have suggested this is not be the case, particularly in open‐ocean communities. To test the extent to which the different NA subgroups are similar, and consequently the extent to which they likely have similar ecological and biogeochemical roles in the environment, we analysed the phylogenetic composition of three populations after cell sorting [high NA‐high SC (HNA‐HS), high NA‐low SC (HNA‐LS), low NA (LNA)] by 454 pyrosequencing in two contrasting periods of the year in NW Mediterranean coastal waters (BBMO, Blanes Bay Microbial Observatory) where these three populations have recurrent seasonal patterns. Statistical analyses showed that summer and winter samples were significantly different and, importantly, the sorted populations within a sample were composed of different taxa. The majority of taxa were associated with one NA fraction only, and the degree of overlap (i.e. OTUs present simultaneously in 2 fractions) between HNA and LNA and between summer and winter communities was very small. Rhodobacterales, SAR116 and Bacteroidetes contributed primarily to the HNA fraction, whereas other groups such as SAR11 and SAR86 contributed largely to the LNA fractions. Gammaproteobacteria other than SAR86 showed less preference for one particular NA fraction. An increase in diversity was observed from the LNA to the HNA‐HS fraction for both sample dates. Our results suggest that, in Blanes Bay, flow cytometric signatures of natural communities track their phylogenetic composition.
Laparoscopic extraperitoneal colostomy in elective abdominoperineal resection for cancer: a single surgeon experience
Authors: Leroy J. , Diana M. , Callari C. , Barry B. , D’Agostino J. , Wu H.‐S. , Marescaux J. 
Published: March 2012

AbstractAim  Parastomal herniation of end colostomies can be chronically debilitating for patients and a difficult problem to treat. To prevent parastomal hernia (PSH) formation an extraperitoneal colostomy (EPC) approach has been developed in open colorectal surgery and some studies have suggested a potential advantage to this approach. Here we describe our technique of laparoscopic extraperitoneal stoma formation and present our experience to date.Methods  We performed a retrospective analysis of consecutive patients undergoing a laparoscopic abdominoperineal resection between March 1999 and March 2011. We performed the EPC technique as follows: under laparoscopic guidance, a smooth tip instrument was used to gently separate the peritoneum from the posterior aponeurotic plane to create an extraperitoneal tunnel running from the skin incision to the left flank of the abdominal cavity to join the previously dissected paracolic gutter. The colon was exteriorized and the position was checked to ensure the absence of torsion or kinking.Results  Twenty‐two patients underwent a standard laparoscopic abdominoperineal resection with total mesorectal excision. Colostomy was constructed extraperitoneally (EPC) or transperitoneally (TPC) in 12 and 10 patients respectively. There were five complications requiring operative intervention: two stomal necrosis and one surgical site infection in the TPC group and two small bowel occlusions in the EPC group. Four patients from the TPC group developed PSH at 24, 36, 48 and 72 months respectively while there were no cases of PSH in the EPC group.Conclusion  Extraperitoneal laparoscopic colostomy showed a potential reduction of PSH in our series of patients.
Perineal descent does not imply a more severe clinical disorder
Authors: Alves‐Ferreira P. C. , Gurland B. , Zutshi M. , Hull T. 
Published: March 2012

AbstractAim  There is poor consensus in the literature about measuring perineal descent. We aimed to assess symptoms and quality of life in constipated patients with abnormal perineal descent.Method  Constipated patients were categorized into those with obstructed defaecation, colonic inertia, mixed disorders and irritable bowel syndrome constipation types. Anal physiology was performed. KESS score, Irritable Bowel Syndrome Quality of Life and SF‐12 questionnaires were completed. The position of the perineum was measured by defaecography. Patients were divided into two groups according to the position of the perineal descent at rest: group 1 (normal < 3.5 cm) and group 2 (abnormal > 3.5 cm).Results  Fifty‐eight patients were identified, 23 (40%) in group 1 and 35 (60%) in group 2. Patients in group 2 were older (P = 0.007), had a higher body mass index (BMI; P = 0.003), a higher rate of hysterectomy (P = 0.04) and more vaginal deliveries (P = 0.001). Obstructed defaecation was the predominant subtype of constipation. Group 1 had more difficulty in initiating defaecation and group 2 presented more cases with intussusception and enterocele (P = 0.03 for both). Group 2 had a lesser degree of perineal descent between rest and straining. Rectal compliance was greater in group 2 (P = 0.03). Symptoms and quality of life scores were similar between the groups.Conclusion  Radiologically determined excessive perineal descent is not indicative of worse symptoms or quality of life. This radiological finding does not warrant further investigation.
Isolation of two binocular mechanisms for motion in depth: A model and psychophysics1
Authors: SHIOIRI SATOSHI , MATSUMIYA KAZUMICHI , MATSUBARA KAZUYA 
Published: March 2012

AbstractRandom dot patterns (RDPs) have been used to stimulate in isolation either of two binocular mechanisms for motion in depth: interocular velocity difference (IOVD), and changing disparity over time (CDOT). First, we examined how these stimuli isolate either mechanism using models based on motion/disparity energy detection. In the model, the IOVD mechanism calculates the difference in motion signal between the two eyes, and the CDOT mechanism calculates the difference in disparity signal between sequential stereo images. The simulation revealed that uncorrelated (0% correlation) RDPs are useful to isolate either of the two mechanisms, while the contrast‐reversed version (anticorrelation) of RDPs may not. Second, we compared the IOVD model predictions with experimental data from a previous study for motion in depth with various contrasts, displacements and vertical shifts between the two eyes. The simulation showed that the model predicts the general trends of the effects of contrast, displacement and vertical shift shown in the data. This suggests the physiological plausibility of the energy‐based model of motion in depth.
Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case‐control study
Authors: Stedenfeldt M , Pirhonen J , Blix E , Wilsgaard T , Vonen B , Øian P 
Published: March 2012

Please cite this paper as: Stedenfeldt M, Pirhonen J, Blix E, Wilsgaard T, Vonen B, Øian P. Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case‐control study. BJOG 2012;119:724–730.Objectives  To investigate the association between the geometrical properties of episiotomy and obstetric anal sphincter injuries (OASIS) because episiotomies angled at 40–60° are associated with fewer OASIS than episiotomies with more acute angles.Design  Case–control study.Setting  University Hospital of North Norway, Tromsø and Nordland Hospital, Bodø, Norway.Sample  Seventy‐four women who had one vaginal birth and episiotomy. Cases (n = 37) have sustained OASIS at birth, while controls (n = 37) had not. The groups were matched for instrumental delivery.Methods  Two groups of women with history of only one vaginal birth were compared. Episiotomy scar was identified and photographed and relevant measures were taken. Data were analysed using conditional logistic analysis.Main outcome measures  Mean episiotomy angle, length, depth, incision point.Results  The risk of sustaining OASIS decreased by 70% (odds ratio [OR] 0.30; 95% CI 0.14–0.66) for each 5.5‐mm increase in episiotomy depth, decreased by 56% (OR 0.44; 95% CI 0.23–0.86) for each 4.5‐mm increase in the distance from the midline to the incision point of the episiotomy, and decreased by 75% (OR 0.25; 95% CI 0.10–0.61) for each 5.5‐mm increase in episiotomy length. Lastly, there was no difference in mean angle between groups but there was a “U‐shaped” association between angle and OASIS (OR 2.09; 95% CI 1.02–4.28) with an increased risk (OR 9.00; 95% CI 1.1–71.0) of OASIS when the angle was either smaller than 15°or >60°.Conclusion  The present study showed that scarred episiotomies with depth > 16 mm, length > 17 mm, incision point > 9 mm lateral of midpoint and angle range 30–60° are significantly associated with less risk of OASIS. Shrinkage of tissue must be considered.
Pulmonary hypertension and pregnancy—a review of 12 pregnancies in nine women
Authors: Curry RA , Fletcher C , Gelson E , Gatzoulis MA , Woolnough M , Richards N , Swan L , Steer PJ , Johnson MR 
Published: March 2012

Please cite this paper as: Curry R, Fletcher C, Gelson E, Gatzoulis M, Woolnough M, Richards N, Swan L, Steer P, Johnson M. Pulmonary hypertension and pregnancy—a review of 12 pregnancies in nine women. BJOG 2012;119:752–761.Objective  To report outcomes in a recent series of pregnancies in women with pulmonary hypertension (PH).Design  Retrospective case note review.Setting  Tertiary referral unit (Chelsea and Westminster and Royal Brompton Hospitals).Sample  Twelve pregnancies in nine women with PH between 1995 and 2010.Methods  Multidisciplinary review of case records.Main outcome measures  Maternal and neonatal mortality and morbidity.Results  There were two maternal deaths (1995 and 1998), one related to pre‐eclampsia and one to arrhythmia. Maternal morbidity included postpartum haemorrhage (five cases), and one post‐caesarean evacuation of a wound haematoma. There were no perinatal deaths, nine live births and three first‐trimester miscarriages. Mean birthweight was 2197 g, mean gestational age was 34 weeks (range 26–39), and mean birthweight centile was 36 (range 5–60). Five babies required admission to the neonatal intensive care unit, but were all eventually discharged home. All women were delivered by caesarean section (seven elective and two emergency deliveries), under general anaesthetic except for one emergency and one elective caesarean performed under regional block.Conclusions  Maternal and fetal outcomes for women with PH may be improving. However, the risk of maternal mortality remains significant, so that early and effective counselling about contraceptive options and pregnancy risks should continue to play a major role in the management of such women when they reach reproductive maturity.
Sex differences in brain proteomes of neuron‐specific STAT3‐null mice after cerebral ischemia/reperfusion
Authors: Di Domenico Fabio , Casalena Gabriella , Jia Jia , Sultana Rukhsana , Barone Eugenio , Cai Jian , Pierce William M. , Cini Chiara , Mancuso Cesare , Perluigi Marzia , Davis Catherine M. , Alkayed Nabil J. , Butterfield Allan D. 
Published: March 2012

J. Neurochem.(2012)121, 680–692.AbstractSignal transduction and activator of transcription‐3 (STAT3) plays an important role in neuronal survival, regeneration and repair after brain injury. We previously demonstrated that STAT3 is activated in brain after cerebral ischemia specifically in neurons. The effect was sex‐specific and modulated by sex steroids, with higher activation in females than males. In the current study, we used a proteomics approach to identify downstream proteins affected by ischemia in male and female wild‐type (WT) and neuron‐specific STAT3 knockout (KO) mice. We established four comparison groups based on the transgenic condition and the hemisphere analyzed, respectively. Moreover, the sexual variable was taken into account and male and female animals were analyzed independently. Results support a role for STAT3 in metabolic, synaptic, structural and transcriptional responses to cerebral ischemia, indeed the adaptive response to ischemia/reperfusion injury is delayed in neuronal‐specific STAT3 KO mice. The differences observed between males and females emphasize the importance of sex‐specific neuronal survival and repair mechanisms, especially those involving antioxidant and energy‐related activities, often caused by sex hormones.
Molecular systematics of the caracaras and allies (Falconidae: Polyborinae) inferred from mitochondrial and nuclear sequence data
Authors: FUCHS JÉRÔME , JOHNSON JEFF A. , MINDELL DAVID P. 
Published: March 2012

The Polyborinae is the most diverse subfamily of the Falconidae in terms of both morphology and behaviour, and includes falconet‐shaped birds (Spiziapteryx), arboreal omnivores (Daptrius, Ibycter), as well as terrestrial generalists and scavengers (Caracara, Milvago and Phalcoboenus). The Polyborinae are endemic to the New World, with all but one species (Caracara cheriway) being restricted to Central and South America. Using over 7300 bp of mitochondrial and nuclear sequence data, we aim to clarify the taxonomy and biogeography of the Polyborinae. The genus Milvago was unexpectedly found to be polyphyletic, with Chimango Caracara Milvago chimango being related to the genus Phalcoboenus and Yellow‐headed Caracara Milvago chimachima being sister to Daptrius. Furthermore, very low genetic divergence was found among the four species of the genus Phalcoboenus, with the lowest divergence being between White‐throated Caracara Phalcoboenus albogularis and Mountain Caracara Phalcoboenus megalopterus. Our divergence time analyses revealed that the Polyborinae started to diversify in the Miocene, at about 14 Ma, and that the generalist/scavenger behaviour in the Falconidae appeared between 14 and 6.6 Ma. All speciation events within the caracaras occurred during the Pleistocene. This situation differs from the general pattern described for forest birds, in which most diversification events are older, occurring primarily in the Pliocene and Miocene.
Organizing Self‐Organizing Systems
Authors: Chertow Marian , Ehrenfeld John 
Published: March 2012

SummaryIndustrial symbiosis examines cooperative management of resource flows through networks of businesses known in the literature as industrial ecosystems. These industrial ecosystems have previously been portrayed as having characteristics of complex adaptive systems, but with insufficient attention to the internal and external phenomena describing their genesis. Drawing on biological, ecological, organizational, and systems theory, a discontinuous three‐stage model of industrial symbiosis is presented. The model proceeds from a random formative stage involving numerous actors engaging in material and energy exchanges, to conscious recognition and intentional pursuit of network benefits, to institutionalization of beliefs and norms enabling successful collaborative behavior. While there is much variation, with no single path to this outcome, the recognition of benefits is seen as an emergent property characteristic of these self‐organized systems that move beyond the initial stage.