bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEVELOPING THE EUROPEAN CORE CURRICULUM IN RENAL TECHNOLOGY
Authors: James R. 
Published: July 2012

ABSTRACTWorking within the multi‐professional team, renal technicians play a greater part in the functioning of renal units than in other less technical areas of care. The role of the renal technician has been changing and, is now one that often combines technical, scientific and clinical knowledge in utilizing technology so that the long‐term outcomes of the patient are optimised and complications reduced. Therefore a sound knowledge base is vital in ensuring patients' safety.Whilst still centered on the traditional engineering functions such as equipment repair and maintenance, the curriculum is structured to give a broad overview of renal related physiology, chemistry, treatment modalities and technology. The inclusion of these more clinical aspects in the curriculum reflects the change in the technician's role to a more science‐based approach.
MEANING OF ILLNESS AND ILLNESS REPRESENTATIONS, CRUCIAL FACTORS TO INTEGRAL CARE
Authors: Vélez E. , Ramasco M. 
Published: July 2012

SUMMARYIntroduction — A comprehensive study of end‐stage renal disease (ESRD) and haemodialysis (HD) must include the sociocultural dimension of illness and the experience of patients from their own perspective. It is critical for the caring team to know how the disease is lived and reinterpreted by the patient, as this knowledge could improve nursing staff/patient interaction. The meaning of their experience is also an influential factor on the caring methods utilised by the patient.Framework — The Theory of Representations and Explanatory Model of Illness was utilised in the study.Methodology — A narrative qualitative methodology, grounded in a constructivist paradigm was used. Twelve patients were interviewed. The interviews were audio taped and transcribed verbatim.Results — Results revealed that patients have a range of beliefs about their illness and their treatment. Regarding identity, symptoms that arise at the outset of illness are not suspected of relating to renal failure. The inevitability of haemodialysis convinces patients of the presence of illness, opening a wide range of metaphors and symbolic representations.Conclusions — Representations of ESRD and HD conform to a multidimensional corpus where different elements of scientific order and common sense converge and interact, such as beliefs and fears. All of these contribute to the meaning of this illness and its treatment. The attributed meaning is dynamic being continually elaborated based on illness outcomes, adaptation to treatment, particular events and the sociocultural environment.
DIALYSIS: PROLONGING LIFE OR PROLONGING DYING? ETHICAL, LEGAL AND PROFESSIONAL CONSIDERATIONS FOR END OF LIFE DECISION MAKING
Authors: White Y. , Fitzpatrick G. 
Published: July 2012

SUMMARYThere are over 7,000 people on dialysis in Australia and this is predicted to increase due to the ageing population and the high incidence of diabetes mellitus. Discontinuation of dialysis is the second most frequent cause of death in dialysis patients in Australia. Risk factors for the discontinuation of dialysis include: co‐morbidities (especially diabetes mellitus) and being older. Because the decision to discontinue dialysis is a major life choice, collaborative decision making should be encouraged, and the patient needs assurances of the continuation of care and kindness, a palliative care plan, and the alleviation of suffering. Patients decide to discontinue dialysis because of an unacceptable quality of life, depression and a chronic failure to thrive. Health professionals need to support end of life decision making using an ethical decision framework. A review of current literature was undertaken and revealed a paucity of information in regard to palliation in those with end stage renal disease who had discontinued dialysis. The fear of dying, pain, suffering, and abandonment that a patient and/or their family may perceive as being associated with death may create barriers to decisions to discontinue with dialysis treatments. Therefore health care personnel should provide information with honesty to allow patients to predict their quality of life and death. Support for the patient and family during the dying period should be multi‐disciplinary, with clear and timely communication between all members of the team.
CLIENT ATTITUDES TOWARDS HOME DIALYSIS THERAPY
Authors: Polaschek N. 
Published: July 2012

ABSTRACTBackground — There are many studies about the professional problem of renal patient non‐compliance and a number describing the experience of living on dialysis. To date studies have not examined client attitudes toward their therapy.Objectives — This paper reports a study seeking to describe characteristic attitudes towards their treatment regimen among a group living on home dialysis.Methods — The study used a critical interpretive methodology, enabling a distinction between the professional viewpoint and the renal client perspective. Twenty home dialysis clients from one renal service in New Zealand were interviewed for an hour each in November 2004 and January 2005. Texts of the taped interviews were analysed to discover the client perspective towards their therapy in this group.Results — During the initial period of adjustment to treatment many participants discovered their need for treatment by experimenting with the therapeutic prescription. They then used what they had learned about the therapy to alter their treatment regimen in order to maintain, as far as possible, their normal lifestyle. After modifying their therapeutic prescription to suit themselves, participants' motivation to continue meeting the ongoing demands of the treatment regimen was influenced by their perception of their individual life situation, including their relationships, work and personal attitudes towards life.Discussion — Health professionals have interpreted renal client behaviour in relation to their therapy in terms of compliance, because effectiveness of treatment depends on their cooperation. From a client perspective their attitudes are better understood in terms of negotiation. Renal clients do not simply follow professional advice but, through a process of negotiation, seek to integrate therapy into their pattern of regular activities to maintain their normal lifestyle. Renal clients' motivation to meet the ongoing demands of treatment is not related solely to their health status, but is also affected by their general life situation. Understanding client attitudes towards therapy enables nurses to better support people living on dialysis.
QUALITY OF LIFE RESEARCH: A VALUABLE TOOL FOR NEPHROLOGY NURSES
Authors: Tobita I. , Hyde C. 
Published: July 2012

ABSTRACTFindings from quality of life research provide nurses with valuable information for planning care. However, the instrument for measuring quality of life has to be carefully selected to ensure that it assesses accurately the impact on the patients' lives. The research tools reviewed in this article (QLI‐H, and KDQOLTM) are well‐established instruments that have contributed significantly to understanding issues surrounding quality of life in the end‐stage renal disease population. This understanding will lead to improved patient care in the field of nephrology nursing practice.
EDUCATIONAL INFORMATION FOR PATIENTS AND CAREGIVERS IN PAEDIATRIC KIDNEY TRANSPLANT
Authors: Madrid Tornay E. 
Published: July 2012

SUMMARYThe aim is to offer, via the use of a manual, information to the parents and kidney‐transplanted children, which offers hope to all with advice and explanation of procedures, and in this way, to better inform the recipients. The guide offers information to kidney‐transplanted children and their caregivers, with clear instructions, simple vocabularies and attractive drawings or illustrations.With this guide, children and youngsters learn measurements of self‐care, know the details of diet, recognize their physical limits and are informed about their necessary medication in order that the medication can be taken with minimal side effects. The parents find information to take care of a child who is transplanted and so has a second opportunity to enjoy life.This permits high hopes that self‐confidence and self‐esteem will be built up from advice and better information about how to get the best treatment. The quality of life recovered by the children and family is the best reward that can be given to the anonymous donors, who through the transplant, offer a possible reality for those patients who benefit from the chance to live again.
A HAEMODIALYSIS EXERCISE PROGRAMME USING NOVEL EXERCISE EQUIPMENT: A PILOT STUDY
Authors: Bennett Paul N , Breugelmans Leo , Agius Megan , Simpson‐gore Kathy , Barnard Bob 
Published: July 2012

ABSTRACTAim — This study explored whether an exercise programme for haemodialysis patients, including the use of a purpose built dialysis exercise machine, would improve quality of life (QoL), nutrition, physical function and biochemical indices.Methods — Intervention was a 6 month individualised exercise programme, which was continued up to 12 months.QoL, and biochemical indices were measured at 6 months and nutrition was measured at 12 months. Physical function was measured at 4, 8 and 12 months.Results — N=22. Improvement in physical function tests was found for the sit to stand (p = 0.005), step in place (p = 0.005) and arm curl (p = 0.05) tests from baseline to 4 months. We showed a decreased in serum phosphate (0.19mmol/L p=0.008), no change in other nutritional parameters and an increase in urea reduction ratio (1.6% p=0.019) in the exercising group. The QoL health and physical functioning domain improved with increased significance (+3.5 p=0.055).Conclusions — The development of a structured exercise programme can improve quality of life, physical functioning, PO4 levels and urea clearances of dialysis patients.
TAKING CARE OF THE CAREGIVER: SUPPORT GROUPS FOR NEPHROLOGY NURSES
Authors: Chayu Tami , Zur Fruma , Kreitler Shulamith 
Published: July 2012

ABSTRACTThe purpose of the study was to examine the need for support groups in nephrology nurses (NN) in Israel. A questionnaire with 10 questions and demographic background information was administered to nephrology nurses in different hospitals and different parts of the country. Out of 350 distributed questionnaires, 305 nurses responded. The findings showed that there is a need for support groups among NN in Israel.Conclusions — It is necessary to organise support groups for nurses in every dialysis unit.
Auditory Expectation: The Information Dynamics of Music Perception and Cognition
Authors: Pearce Marcus T. , Wiggins Geraint A. 
Published: July 2012

AbstractFollowing in a psychological and musicological tradition beginning with Leonard Meyer, and continuing through David Huron, we present a functional, cognitive account of the phenomenon of expectation in music, grounded in computational, probabilistic modeling. We summarize a range of evidence for this approach, from psychology, neuroscience, musicology, linguistics, and creativity studies, and argue that simulating expectation is an important part of understanding a broad range of human faculties, in music and beyond.
Observation of Public Health Risk Behaviours, Risk Communication and Hand Hygiene at Kansas and Missouri Petting Zoos – 2010–2011
Authors: Erdozain G. , KuKanich K. , Chapman B. , Powell D. 
Published: July 2012

SummaryOutbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This study details an observational study of hand hygiene tool availability and recommendations; frequency of risky behaviour; and handwashing attempts by visitors in Kansas (9) and Missouri (4), USA, petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal‐contact areas in 10/13 and 8/13 petting zoos, respectively. Risky behaviours were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviours were as follows: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal‐contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal‐contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal‐contact areas, 37% (n = 214) of individuals attempted some type of hand hygiene, with male adults, female adults and children attempting at similar rates (32%, 40% and 37%, respectively). Visitors were 4.8× more likely to wash their hands when a staff member was present within or at the exit to the animal‐contact area (136/231, 59%) than when no staff member was present (78/343, 23%; P < 0.001, OR = 4.863, 95% CI = 3.380–6.998). Visitors at zoos with a fence as a partial barrier to human–animal contact were 2.3× more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; P < 0.001, OR = 2.339, 95% CI = 1.454–3.763). Inconsistencies existed in tool availability, signage and supervision of animal contact. Risk communication was poor, with few petting zoos outlining risks associated with animal contact, or providing recommendations for precautions to be taken to reduce these risks.
Rescuer fatigue under the 2010 ERC guidelines, and its effect on cardiopulmonary resuscitation (CPR) performance
Authors: McDonald Catherine H , Heggie James , Jones Christopher M , Thorne Christopher J , Hulme Jonathan 
Published: August 2012

BackgroundUpdated life-support guidelines were published by the European Resuscitation Council (ERC) in 2010, increasing the required depth and rate of chest compression delivery. This study sought to determine the impact of these guidelines on rescuer fatigue and cardiopulmonary resuscitation (CPR) performance.Methods62 Health science students performed 5 min of conventional CPR in accordance with the 2010 ERC guidelines. A SkillReporter manikin was used to objectively assess temporal change in determinants of CPR quality. Participants subjectively reported their end-fatigue levels, using a visual analogue scale, and the point at which they believed fatigue was affecting CPR delivery.Results49 (79%) participants reported that fatigue affected their CPR performance, at an average of 167 s. End fatigue averaged 49.5/100 (range 0–95). The proportion of chest compressions delivered correctly decreased from 52% in min 1 to 39% in min 5, approaching significance (p=0.071). A significant decline in chest compressions reaching the recommended depth occurred between the first (53%) and fifth (38%) min (p=0.012). Almost half this decline (6%) was between the first and second minutes of CPR. Neither chest compression rate, nor rescue breath volume, were affected by rescuer fatigue.ConclusionFatigue affects chest compression delivery within the second minute of CPR under the 2010 ERC guidelines, and is poorly judged by rescuers. Rescuers should, therefore, be encouraged to interchange after 2 min of CPR delivery. Team leaders should be advised to not rely on rescuers to self-report fatigue, and should, instead, monitor for its effects.
A widespread decrease in productivity of sockeye salmon (Oncorhynchus nerka) populations in western North America
Authors: Peterman Randall M. , Dorner Brigitte 
Published: July 2012

We used data on 64 stocks of sockeye salmon ( Oncorhynchus nerka ) from British Columbia (B.C.), Washington, and Alaska to determine whether recent decreases in abundance and productivity observed for Fraser River, B.C., sockeye have occurred more widely. We found that decreasing time trends in productivity have occurred across a large geographic area ranging from Washington, B.C., southeast Alaska, and up through the Yakutat peninsula, Alaska, but not in central and western Alaska. Furthermore, a pattern of predominantly shared trends across southern stocks and opposite trends between them and stocks from western Alaska was present in the past (1950–1985), but correlations have intensified since then. The spatial extent of declining productivity of sockeye salmon has important implications for management as well as research into potential causes of the declines. Further research should focus on mechanisms that operate at large, multiregional spatial scales, and (or) in marine areas where numerous correlated sockeye stocks overlap.
Delineating genetic groupings in continuously distributed species across largely homogeneous landscapes: a study of American black bears (Ursus americanus) in Ontario, Canada
Authors: Pelletier A. , Obbard M.E. , Mills K. , Howe E.J. , Burrows F.G. , White B.N. , Kyle C.J. 
Published: August 2012

There is a crucial need to understand the genetic consequences of landscape modifications on continuous populations that could become fragmented, and to evaluate the degree of differentiation of isolated populations that were historically part of the core. Using 15 microsatellite loci, we evaluated the genetic structure of American black bears ( Ursus americanus Pallas, 1780) across a vast, contiguous Ontario landscape (>1 × 106km2) that largely represents their pre-European settlement distribution. Because geographic barriers are absent, we predicted that isolation by distance would drive genetic structure. We identified three genetic clusters (Northwest, Southeast, and Bruce Peninsula) that were less differentiated than when assessed with mtDNA, suggesting the influence of male-biased dispersal on large-scale genetic differentiation. Isolation by distance (r = 0.552, P = 0.001) was supported by a weak, clinal variation between Northwest and Southeast, illustrating the challenges to delineate populations in wide-ranging taxa. The Bruce Peninsula cluster, confined to a small area under strong anthropogenic pressures, was more differentiated from neighbouring clusters (FST > 0.13, P < 0.0001), with a genetic diversity corresponding to disjunct populations of black bears. Our results could be used in landscape genetics models to project the evolution of population differentiation based on upcoming landscape modifications in northern regions of North America.
LOT
Authors: Gilad Yossi , Herzberg Amir 
Published: August 2012

We present LOT, a lightweight plug and play secure tunneling protocol deployed at network gateways. Two communicating gateways, A and B, running LOT would automatically detect each other and establish an efficient tunnel, securing communication between them. LOT tunnels allow A to discard spoofed packets that specify source addresses in B’s network and vice versa. This helps to mitigate many attacks, including DNS poisoning, network scans, and most notably (Distributed) Denial of Service (DoS).
LOT tunnels provide several additional defenses against DoS attacks. Specifically, since packets received from LOT-protected networks cannot be spoofed, LOT gateways implement quotas, identifying and blocking packet floods from specific networks. Furthermore, a receiving LOT gateway (e.g., B) can send the quota assigned to each tunnel to the peer gateway (A), which can then enforce near-source quotas, reducing waste and congestion by filtering excessive traffic before it leaves the source network. Similarly, LOT tunnels facilitate near-source filtering, where the sending gateway discards packets based on filtering rules defined by the destination gateway. LOT gateways also implement an intergateway congestion detection mechanism, allowing sending gateways to detect when their packets get dropped before reaching the destination gateway and to perform appropriate near-source filtering to block the congesting traffic; this helps against DoS attacks on the backbone connecting the two gateways.
LOT is practical: it is easy to manage (plug and play, requires no coordination between gateways), deployed incrementally at edge gateways (not at hosts and core routers), and has negligible overhead in terms of bandwidth and processing, as we validate experimentally. LOT storage requirements are also modest.
Long-term Outcomes of 1,263 Patients with Mycosis Fungoides and Sézary Syndrome from 1982 to 2009
Authors: Talpur Rakhshandra , Singh Lotika , Daulat Seema , Liu Ping , Seyfer Sarah , Trynosky Tanya , Wei Wei , Duvic Madeleine 
Published: August 2012

AbstractPurpose: The purpose of this prospectively collected single center study cohort of 1,263 patients with mycosis fungoides (MF)/Sézary syndrome (SS) is to evaluate the significance of stage and risk of disease progression from initial presentation and to examine other prognostic factors.Patients and Methods: The prognostic variables effecting overall survival (OS) were examined in a unique prospective cohort of 1,263 patients with MF and SS seen by one investigator at MD Anderson Cancer Center (Houston, TX) from 1982 to 2009. Kaplan–Meier estimates were used to determine median OS, progression-free survival (PFS), and disease-specific survival (DSS). Cox proportional hazards regression model assessed prognostic factors.Results: Mean age at diagnosis was 55.33 years. Early mycosis fungoides (stage IA–IIA) represented 71.5% (903 of 1,263) and advanced (stage IIB–IVB) 28.5% (360 of 1,263) patients. Progression to a higher stage occurred in 147 patients (11.6%) of whom 112 (12%) were early and 35 (9.7%) advanced. Death from disease occurred in 102 of 1,263 (8.1%) patients. Median OS was 24.44 years, PFS was 16 years, and median DSS was not reached. OS and PFS were significantly better for early-stage patients with patches (T1a/T2a) than with patches/plaques (T1b/T2b). The PFS analyzed in 1,241 patients found that only 337 (27.2%) had disease progression or had died from disease. Risk factors associated with progression or deaths were advanced age, plaque stage, lactate dehydrogenase (LDH) level, and tumor area.Conclusions: Improved outcome of MF/SS, reflected by OS and PFS for all stages, may result from earlier diagnosis, new therapies, and aggressive treatment of infections. Clin Cancer Res; 18(18); 5051–60. ©2012 AACR.