bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heartsink encounters: a qualitative study of end-of-life care in out-of-hours general practice
Authors: Taubert Mark , Nelson Annmarie 
Published: September 2011

Objectives We aimed to establish how prepared GPs who work regular out-of-hours shifts feel when dealing with end-of-life issues in palliative care patients, what they thought about seeing such patients and whether they considered themselves emotionally equipped to do so. Design Semi-structured interviews were conducted with GPs who worked regular out-of-hours shifts. A detailed analysis of transcripts using Interpretative Phenomenological Analysis was undertaken. Setting South Wales. Participants GPs employed by the local health board's out-of-hours service were contacted. Main outcome measures All interview data were analysed systematically and statements that reflected emotional impact and strain were highlighted, coded and interpreted within their context. Results GPs expressed unease and used terms such as ‘heartsink’, when having to deal with palliative care issues out-of-hours. Heartsink in this context referred to the subjective experience of the clinician. Emotional ‘housekeeping’, i.e. looking after oneself after emotionally-charged encounters, was felt to be a very important process and GPs used a range of coping mechanisms, including reflective time, sharing with peers, compartmentalisation and personal empathy to deal with stress. Conclusion The emotional effects of palliative care encounters on out-of-hours GPs should not be underestimated. Our interpretation distinguished the term ‘heartsink’ from its usual context, the ‘heartsink patient’, to a different meaning, that of the imminent palliative care encounter triggering a sensation of heartsink for some out-of-hours doctors. Therefore, the term ‘heartsink encounter’, rather than heartsink patient, seemed more fitting. Pressed services may encourage a culture where discussion or debrief with a colleague after a palliative care encounter is not perceived as a practical option. This may contribute to work-related burnout in this group of doctors and out-of-hours collaboratives need to be aware of this issue, when planning their services.
“I'm Supposed to Be In Charge”: Self-Advocates' Perspectives on Their Self-Determination Support Needs
Authors: Nonnemacher Stacy L , Bambara Linda M 
Published: September 2011

Abstract
In this qualitative interview study, we explored the perceptions of adults with intellectual disability regarding interpersonal or social supports needed to express their own self-determination. Specifically, 10 adults, all members of a self-advocacy group, were asked to discuss their understanding of the term self-determination and ways in which support staff have either supported or inhibited their self-determination. Ten themes characterizing supportive and impeding staff actions were identified. The need for greater exploration of environmental and social influences on self-determination is emphasized.
Gendered Service Delivery: A Masculine and Feminine Perspective on Staff Gender
Authors: Wilson Nathan J , Stancliffe Roger J , Parmenter Trevor R , Shuttleworth Russell P 
Published: September 2011

AbstractDespite acknowledgement that paid caregivers have a significant impact on the lives of people with intellectual disability, the subjective experience of staff gender is rarely considered in research. Qualitative data from a study on the sexual health needs of men and boys with intellectual disability is presented. We designed this study to determine what impact staff gender has on the sexual health needs of men and boys with intellectual disability. Findings suggest that although staff traverse the same geographies of care, they do it in uniquely gendered ways. Staff gender is an important consideration when dealing with sexual health matters and can enhance the type and quality of relationships between people with intellectual disability.
Convergent Validity of the Mullen Scales of Early Learning and the Differential Ability Scales in Children With Autism Spectrum Disorders
Authors: Bishop Somer L , Guthrie Whitney , Coffing Mia , Lord Catherine 
Published: September 2011

Abstract
Despite widespread use of the Mullen Scales of Early Learning (MSEL; E. M. Mullen, 1995) as a cognitive test for children with autism spectrum disorders and other developmental disabilities, the instrument has not been independently validated for use in these populations. Convergent validity of the MSEL and the Differential Ability Scales (DAS; C. D. Elliott, 1990, 2007) was examined in 53 children with autism spectrum disorder and 19 children with nonspectrum diagnoses. Results showed good convergent validity with respect to nonverbal IQ (NVIQ), verbal IQ (VIQ), and NVIQ–VIQ profiles. These findings provide preliminary support for the practice of using MSEL age-equivalents to generate NVIQ and VIQ scores. Establishing convergent validity of cognitive tests is needed before IQs derived from different tests can be conceptualized as a uniform construct.
Effect of Incorporating Adaptive Functioning Scores on the Prevalence of Intellectual Disability
Authors: Obi Obianuju , Van Naarden Braun Kim , Baio Jon , Drews-Botsch Carolyn , Devine Owen , Yeargin-Allsopp Marshalyn 
Published: September 2011

Abstract
Surveillance and epidemiologic research on intellectual disability often do not incorporate adaptive functioning (AF) data. Exclusion of AF data leads to overestimation of the prevalence of intellectual disability, the extent of which is not known. In this study, the authors evaluated the effect of incorporating AF data on overall intellectual disability prevalence according to sociodemographic, economic, and severity characteristics. Between 2002 and 2006, the Metropolitan Atlanta Developmental Disabilities Surveillance Program identified 1,595 8-year-old children who met the study's intellectual disability surveillance-case definition of IQ ≤ 70. AF scores were not available for 9.2% of the case children, specifically those with mild intellectual disability and low socioeconomic backgrounds. Prevalence estimates showed few substantive changes when incorporating AF data. The authors conclude that use of IQ data alone appears to be appropriate for measuring population intellectual disability prevalence.
Changes in Maladaptive Behaviors From Midchildhood to Young Adulthood in Autism Spectrum Disorder
Authors: Anderson Deborah K , Maye Melissa P , Lord Catherine 
Published: September 2011

Abstract
The current study prospectively examined trajectories of change in symptoms of irritability, hyperactivity, and social withdrawal, as well as predictors of such behaviors, for ages 9–18 years for youths with autism spectrum disorder and a comparison group with nonspectrum developmental delays. Children with more severe core features of autism had consistently higher irritability and hyperactivity scores over time than those with broader autism spectrum disorder and nonspectrum delays. Across all diagnoses, behaviors related to hyperactivity showed the greatest improvement. Social withdrawal worsened with age for a substantial proportion of youths with autism spectrum disorder but not for the nonspectrum comparison group. Compared with youths without autism spectrum disorder, children with the disorder showed greater heterogeneity in trajectories for maladaptive behaviors.
A New Functional CYP3A4 Intron 6 Polymorphism Significantly Affects Tacrolimus Pharmacokinetics in Kidney Transplant Recipients
Authors: Elens Laure , Bouamar Rachida , Hesselink Dennis A , Haufroid Vincent , van der Heiden Ilse P , van Gelder Teun , van Schaik Ron HN 
Published: September 2011

BACKGROUNDTacrolimus (Tac) is a potent immunosuppressant with considerable toxicity. Tac pharmacokinetics varies between individuals and thus complicates its use in preventing rejection after kidney transplantation. This variability might be caused by genetic polymorphisms in metabolizing enzymes.METHODSWe used TaqMan analyses to evaluate the impact of a newly discovered CYP3A4 (cytochrome P450, family 3, subfamily A, polypeptide 4) single-nucleotide polymorphism (SNP) (rs35599367C&gt;T; CYP3A4*22) on Tac pharmacokinetics in 185 renal transplant recipients who participated in an international randomized controlled clinical trial (fixed-dose, concentration-controlled study).RESULTSThe overall mean daily-dose requirement to reach the same predose Tac blood concentration was 33% lower for carriers of the T variant allele than for rs35599367CC patients (95% CI, −46% to −20%; P = 0.018). When combined with the *3 genotype of the CYP3A5 (cytochrome P450, family 3, subfamily A, polypeptide 5) gene, the rs35599367C&gt;T SNP was also associated with a risk of supratherapeutic Tac concentrations (&gt;15 μg/L) during the first 3 days after surgery, with an odds ratio of 8.7 for carriers of the CYP3A4 T allele plus CYP3A5*3/*3 (P = 0.027) and 4.2 for the CYP3A4 CC homozygotes plus CYP3A5*3/*3 (P = 0.002), compared with CYP3A4 CC homozygotes having 1 or 2 CYP3A5*1 alleles. The overall increase in the Tac dose-adjusted trough blood concentration was +179% for carriers of the CYP3A4 T allele with CYP3A5*3/*3 (P &lt; 0.001), +101% for CYP3A4 CC homozygotes with CYP3A5*3/*3 (P &lt; 0.001), and +64% for CYP3A4 T allele carriers with CYP3A5*1 (P = 0.020),compared with CYP3A4 CC homozygotes with CYP3A5*1.CONCLUSIONSThe CYP3A4 rs35599367C&gt;T polymorphism is associated with a significantly altered Tac metabolism and therefore increases the risk of supratherapeutic Tac concentrations early after transplantation. Analysis of this CYP3A4*22 SNP may help in identifying patients at risk of Tac overexposure.
Correlation of cortisol in 1-cm hair segment with salivary cortisol in human: hair cortisol as an endogenous biomarker
Authors: Xie Qiaozhen , Gao Wei , Li Jifeng , Qiao Ting , Jin Jing , Deng Huihua , Lu Zuhong 
Published: September 2011

AbstractCortisol level in human hair would be an endogenous biomarker for the retrospective assessment of long-term central hypothalamo-pituitary-adrenal activity. However, no direct evidence supports that blood-related diffusion is a biologically endogenous source of hair cortisol in humans. The present study aims to validate the direct correlation between cortisol in 1-cm hair segments and salivary cortisol in healthy humans.We collected three saliva samples from the same participant at Time 1, Time 2 (1 week later) and Time 3 (2 weeks later), and hair 4 weeks later. Cortisol levels in 1-cm hair segments and saliva were determined with high performance liquid chromatography tandem mass spectrometry.Salivary cortisol at Time 1 was significantly associated with that at Time 2 (r=0.514, p=0.003), but not with that at Time 3 (r=0.187, p=0.305); and the one at Time 2 was significantly associated with that at Time 3 (r=0.380, p=0.032). Hair cortisol was significantly correlated with salivary cortisol at Time 2 (r=0.389, p<0.05) and average salivary cortisol (r=0.383, p<0.05) from three sampling.Our results confirmed that blood-related diffusion mechanism is a biologically endogenous source of hair cortisol.
Simultaneous determination of cyclophosphamide and 4-hydroxycyclophosphamide in human plasma by high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry – application to Chinese systemic lupus erythematosus patients
Authors: Shu Wenying , Wang Xueding , Yang Xiuyan , Liang Liuqin , Li Jiali , Chen Zhuojia , Chen Xiao , Jin Jing , Li Ruiming , Zhao Lizi , Huang Min 
Published: September 2011

AbstractA pharmacogenomics study of cyclophosphamide in systemic lupus erythematosus patients is being conducted in our laboratory in which the plasma concentrations of cyclophosphamide and its active metabolite 4-hydroxycyclophosphamide should be assayed rapidly and sensitively.A rapid, stable and sensitive liquid chromato-graphy/electrospray ionization tandem mass spectrometry method was developed to simultaneously determine cyclophosphamide and 4-hydroxycyclophosphamide in human plasma with ifosfomide as an internal standard. After a protein precipitation with cold acetonitrile and stabilization of 4-hydroxycyclophosphamide by ansyldrazine and extraction with ethyl acetate, separation was performed on a C18 3.5 μm 2.1×50 mm column with mobile phase of acetonitrile and water (50:50, v/v) with 0.1% formic acid at 200 μL/min. The chromatographic run time was 3 min.The linear calibration curves ranged from 5 to 5000 ng/mL for cyclophosphamide and 5–500 ng/mL for 4-hydroxycyclophosphamide. The recoveries of the liquid extraction were 54.5%–58.5% for cyclophosphamide and 103.5%–105.5% for 4-hydroxycyclophosphamide. The lower limit of quantification was 5 ng/mL for both analytes. The intra- and inter-day precision was <15% for quality control samples at 4000, 500, 50 ng/mL for cyclophosphamide and 4-hydroxycyclophosphamide at 400, 100, 20 ng/mL. The method was applied in this pharmacogenomics study in Chinese systemic lupus erythematosus patients treated with low-dose cyclophosphamide.The method was efficient with shorter running time and lower limit of quantification compared to previous reports and has been successfully applied in this pharmacogenomics study.
Natural and artificial ageing of spruce wood as observed by FTIR-ATR and UVRR spectroscopy
Authors: Ganne-Chédeville Christelle , Jääskeläinen Anna-Stiina , Froidevaux Julien , Hughes Mark , Navi Parviz 
Published: September 2011

Abstract
Spruce samples, naturally aged for 200, 400 and 500 years, artificially aged by a hydrothermal treatment (at 180, 160 or 130°C, relative air humidities of 14%, 40%, or 60% and for treatment times between 1 to 50 h), as well as reference samples, were analysed by Fourier transform infrared spectroscopy (FTIR) attenuated total reflection (FTIR-ATR) and ultraviolet resonance Raman (UVRR) spectroscopy. Natural ageing mostly affected the hemicelluloses and lignin, as observed from the FTIR-ATR and UVRR spectra, respectively. The UVRR spectra of the same samples after acetone extraction indicated that lignin was partially degraded and quinone structures were possibly formed. Artificial ageing at 160°C showed a significant change in the lignin structure, a well-known effect in the thermal treatment of wood, whereas treatment at 130°C did not alter the wood structure to any significant extent. Principal component analysis of the UVRR spectra confirmed that the spectra of artificially aged wood up to 160°C are dissimilar to naturally aged wood and which are also dissimilar to unaged wood.
Upgrading of the Management Review on the Basis of the EFQM Excellence Model
Authors: Petrič Anton , Gomišček Boštjan 
Published: September 2011

Upgrading of the Management Review on the Basis of the EFQM Excellence Model
Suppliers in the automotive industry can use for strategical planning a number of different approaches and tools, which can upgrade the quality management systems (ISO 9001, ISO/TS 14696) to achieve the breakthrough power to meet needs in order to achieve a significant role in the automotive supplying chain. One of the very popular and positively accepted tools to achieve continually improving is implementing of the principles of excellence, according to the EFQM model.
On the basis of case studies is in the article analysed and represented a useful value of the implementation of the quality management system audits and management review according to ISO/TS and their positive impact on the development of key indicators of the company TPV d.d. from Novo mesto, which is mounted as a development supplier in the automotive industry. With the implementation of self assessment according to the model of excellence EFQM we demonstrate the added value of the take up of the principles of excellence, according to the present system auditing according to ISO standards and the implementation of management review according to ISO/TS requirements.
We upgraded in the existing management system performing of management review as manager's tool, which came directly from the requirements of standard ISO/TS, on to the level of the fundamental principles of excellence by EFQM model and mark it as one of the more effective managers tools with which you can still effectively introduces the leadership of the continuous improvements and strategically manages the company.
Perceived Factors and Obstacles to Cognitive Schema Change during Economic Crisis
Authors: Arzenšek Ana 
Published: September 2011

Perceived Factors and Obstacles to Cognitive Schema Change during Economic Crisis
The main objective is to present the perceived factors in cognitive schema change as experienced by participants from two Slovenian sectors and to compare them with factors from schema change theory in order to evaluate specific circumstances and obstacles to effective cognitive schema change. 31 interviews with participants from six companies were conducted twice during the 2008 economic crisis. The prevalent perceived antecedents of schema change lie within an organisation and in the business environment. Stimulating factors are also economic and financial crises and personal characteristics. The prevalent obstacles to schema change, as perceived by participants, are stability of current cognitive schemas, personal characteristics of management, and rigidity.
The effects of feeding fresh forage and silage on some nutritional attributes of beef: an overview
Authors: Kalač Pavel 
Published: September 2011

The effects of feeding fresh forage and silage on some nutritional attributes of beef: an overviewConsumers are increasingly concerned with the amount and composition of fat present in foods. The nutritional image of cattle fat has suffered because of the association of a high proportion of saturated fatty acids with coronary heart disease. This is leading to a shift in the way milk and beef are produced. Extensive research data from the last decade show that beef from animals finished on green fodder and silages (except for maize silage) has a lower content of intramuscular fat, but a higher proportion of nutritionally favourable n-3 polyunsaturated fatty acids (PUFAs), ratio n-6:n-3 PUFAs, vitamin E and ß-carotene, than meat from animals fed on grain-based rations. The differences in beef cholesterol content between the feeding systems are not nutritionally significant.
The occurrence of Erysiphe trifolii on Lathyrus pratensis in a foothill area of South Bohemia
Authors: Kobes Milan , Voženílková Bohumila , Šlachta Martin , Frelich Jan 
Published: September 2011

The occurrence of Erysiphe trifolii on Lathyrus pratensis in a foothill area of South BohemiaThe aim of small-site experiments carried out in the foothills of the Šumava Mts. was to determine the effect of the etiological agent powdery mildew (Erysiphe trifolii) on meadow peavine (Lathyrus pratensis). Over three consecutive years, we observed a whitish to grey-white soft cover of mycelium on the meadow peavine during the vegetation period. This characteristic symptom of the disease was observed on the plants during summer and autumn. In a plot trial with permanent grassland we evaluated the following management systems: i) mulched, ii) fallow, iii) mown stands, and iv) pasture stands grazed by cattle. We evaluated the total number of Lathyrus pratensis plants as well as the number of the plants attacked by Erysiphe trifolii. The three-year investigation of Lathyrus pratensis yielded statistical evidence that the most significant growth of the fungal disease was recorded in fallow stands (68.9%), while the lowest occurrence of the disease (4.4%) was found in the pasture stands grazed by cattle.
Deployment of an Agent-based SANET Architecture for Healthcare Services
Authors: Chiu Christopher , Chaczko Zenon 
Published: September 2011

Deployment of an Agent-based SANET Architecture for Healthcare ServicesThis paper describes the adaptation of a computational technique utilizing Extended Kohonen Maps (EKMs) and Rao-Blackwell-Kolmogorov (R-B) Filtering mechanisms for the administration of Sensor-Actuator networks (SANETs). Inspired by the BDI (Belief-Desire-Intention) Agent model from Rao and Georgeff, EKMs perform the quantitative analysis of an algorithmic artificial neural network process by using an indirect-mapping EKM to self-organize, while the Rao-Blackwell filtering mechanism reduces the external noise and interference in the problem set introduced through the self-organization process. Initial results demonstrate that a combinatorial approach to optimization with EKMs and Rao-Blackwell filtering provides an improvement in event trajectory approximation in comparison to standalone cooperative EKM processes to allow responsive event detection and optimization in patient healthcare.
Computationally-Efficient Design of a Dynamic System-Level LTE Simulator
Authors: Muñoz Pablo , de la Bandera Isabel , Ruiz Fernando , Luna-Ramírez Salvador , Barco Raquel , Toril Matías , Lázaro Pedro , Rodríguez Jaime 
Published: September 2011

Computationally-Efficient Design of a Dynamic System-Level LTE SimulatorThe Long-Term Evolution (LTE) is the next generation of current mobile telecommunication networks. LTE has a new flat radio-network architecture and a significant increase in spectrum efficiency. In this paper, a computationally-efficient tool for dynamic system-level LTE simulations is proposed. A physical layer abstraction is performed to predict link-layer performance with a low computational cost. At link layer, there are two important functions designed to increase the network capacity: Link Adaptation and Dynamic Scheduling. Other Radio Resource Management functionalities such as Admission Control and Mobility Management are performed at network layer. The simulator is conceived for large simulated network time to allow evaluation of optimization algorithms for the main network-level functionalities.