bluuebunny/crossref_metadata_2025_split huggingface dataset:
The challenges of improving discharge planning in Sweden and the UK: different but the same
Authors: LUNDH ULLA , WILLIAMS SION 
Published: December 2007

Summary

Discharge of older people from hospital has been an area of concern for over 20 years.
The present emphasis on rapid throughput of patients in acute care settings is likely to exacerbate existing problems.
Improving current practice will mean addressing a number of complex issues to do with communication between agencies and professions.
Despite different welfare systems, many of the challenges of discharge planning are shared in different countries.
This paper describes attempts to involve patients and carers in discharge planning in Sweden and the UK and identifies a number of areas which require attention if the ideals of patient and carer empowerment are to be achieved.
The Total Health Care Audit System: a systematic methodology for clinical practice evaluation and development in NHS provider organizations
Authors: Miles Andrew , Bentley Paul , Price Nicholas , Polychronis Andreas , Grey Joseph , Asbridge Jonathan 
Published: December 2007

AbstractWriting in Medical Education in 1982, Fowkes (1982) noted the lack of general agreement within the medical profession on methods of audit, a deficiency previously articulated by Shaw (1980) and later emphasized by McIntyre (1985). More recently, a study by Black & Thompson (1993) of consultant and junior medical staff in four London district general hospitals revealed that ‘many doctors did not understand how to undertake audit’, and major research by both Hopkins (1993, 1994) and Buttery et al. (1994) described a multiplicity of methodological deficiencies in the general approaches to audit adopted by clinicians since the promulgation of the White Paper definition in 1989. Soundness of methodological approach is fundamental to securing the success of clinical audit within Provider organizations and is thus central to the generation of measurable improvements in the quality of clinical care being delivered to patients. It is therefore disturbing that methodological deficiencies may still be observed in general approaches to audit (Buttery et al. 1994), with no author yet recommending a formal system for critical inquiry into clinical practice. It was the recognition of the unsatisfactory nature of this situation which led us to develop a system aimed at assessing, in a critical fashion, the quality of the totality of care dispensed within NHS provider organizations. The system is presented here for the first time.
Professionals perceptions of psychotropic medication in residential facilities for individuals with mental retardation
Authors: Singh N. N. , Ellis C. R. , Donatelli L S. , Williams D. E. , Ricketts R. W. , Goza A. B. , Perlman N. , Everly D. E. , Best A. M. , Singh Y. N. 
Published: December 2007

AbstractProfessional staff in four state facilities for individuals with mental retardation were surveyed to determine their perceptions, knowledge and opinions regarding the use of psychotropic medication. A large majority of the 377 respondents indicated that the physicians in their facilities were primarily responsible for medication‐related decisions. Under ideal conditions, however, all professional staff and parents were seen as having a greater influence in the decision‐making process. Aggression, delusions and hallucinations, self‐injury, other psychiatric disorders, and anxiety were rated as disorders most likely to result in medication therapy. Behaviour modification was viewed as a suitable alternative to drug treatment for acting out and aggression. The professionals indicated that behavioural observation was the most influential assessment technique in current usage, followed by global impressions and informal diaries. Over 80% of the respondents perceived their preservice and inservice training on issues related to the use of psychotropic medication to treat behaviour problems as inadequate, with 96% of them desiring continuing education. These findings were compared to data from similar studies of populations with other disabilities, and suggestions for modifications in the current decision‐making processes related to the use of psychotropic medication in institutionalized individuals with mental retardation are discussed.
Visual acuity and accommodation in infants and young children with Down's syndrome
Authors: Woodhouse J. M. , Pakeman V. H. , Saunders K. J. , Parker M. , Fraser W. I. , Lobo S. , Sastry P. 
Published: December 2007

AbstractAccommodation and visual acuity were measured in 53 children with Down's syndrome aged between 12 weeks and 57 months. Results were compared With data for 136 control (typically developing) children aged between 4 weeks and 48 months. Whereas the control children accommodated accurately on near targets, accommodation was defective in 92% of the children with Down's syndrome, and there was no change in accommodative ability with age. On the other hand, visual acuity lay within normal limits for the younger children. Children over the age of 2 years showed a below‐normal visual acuity, which is not explained either by refractive error or by the effect of poor accommodation. The data suggest a sudden change in the rate of development of visual acuity which may be associated with physiological changes in the visual cortex. Previously reported defects of accommodation and visual acuity in older children and adults with Down's syndrome are confirmed by our findings in infants and young children.
The cloning, expression and sequence analysis of a second Porphyromonas gingivalis gene that codes for a protein involved in hemagglutination
Authors: Progulske‐Fox A. , Tumwasorn S. , Lépine G. , Whitlock J. , Savett D. , Ferretti J. J. , Banas J. A. 
Published: December 2007

Progulske‐Fox A, Tumwasorn S, Lepine G, Whitlock J, Savett D, Ferretti JJ, Banas JA. The cloning, expression and sequence analysis of a second Porphyromonas gingivalis gene that codes for a protein involved in hemagglutination.It has been suggested that Porphyromonas gingivalis may possess more than one hemagglutinin. We have previously reported the cloning of a gene (hagA) that encodes a hemagglutinin. In this study we report the cloning, characterization, and sequencing of a second gene (hagB) that encodes a protein that also appears to be involved in hemagglutination. Antiserum to the clone (ST 7) was found to inhibit hemagglutination by P. gingivalis 381, and hemagglutinating inhibition activity of anti‐P. gingivalis antiserum was reduced by adsorption of the antiserum with cells of clone ST 7. Restriction mapping and Southern analysis indicates there is little or no DNA homology between this cloned 4.8‐kb Hind DNA fragment and a cloned hemagglutinin gene we have previously described. Minicell analysis of the cloned P. gingivalis chromosomal DNA fragment revealed that the major gene product is a 49‐kDa protein. Immunoaffinity chromotography using purified rabbit immunoglobulin G against the cloned protein resulted in the purification of a major reactive 49‐ to 50‐kDa protein from a P. gingivalis cell lysate. Nucleotide sequence analysis revealed the hagB open reading frame to be 1053 nucleotides in length with a mol% G+C of 59.9% coding for a protein of 350 residues with a calculated molecular weight of 39.375 kDa. This protein was also determined to be basic and hydrophilic and to contain a potential signal peptide. Comparison of both the nucleotide and derived amino acid sequences with computer‐based databases did not reveal any significant homologies between hagB and any other previously sequenced genes.
Sulphur dioxide in foods:– chemical interactions
Authors: WEDZICHA B. L. 
Published: December 2007

SUMMARySulphur dioxide is a versatile food additive which has extensive chemical reactivity. The components of food, and biological systems in general, which may react with this additive include proteins, coenzymes and enzyme cofactors and prosthetic groups. Enzymic browning in cut fruits and vegetables is inhibited by reaction of sulphite ion with quinone intermediates. Inhibition ofnonenzymic browning in a wide range of foods, including beverages and dehydrated products, takes place by inactivation of carbonyl intermediates. Sulphite ion is detoxified in man by sulphite oxidase whilst one of the known products of reaction between hydrogen sulphite ion and intermediates in nonenzymic browning is metabolically inert.
Food acquisition during the African drought of 1983–1984: A study of Kenyan herders
Authors: Sperling Louise 
Published: December 2007

In 1983 and 1984, drought spread across the northern rangelands of Kenya and herders in lowland Samburu lost substantial portions of their livestock. Food aid arrived when 50 to 75% of the cattle had already died, and after poorer pastoralists were hungry enough to sell their remaining productive animals. No pastoralists died of the immediate effects of the drought, but many were so impoverished that their longer‐term prospects for remaining as herders look dim.This essay discusses the timing and content of famine relief as it applies both to Samburu and other food‐stressed areas. It focuses on the process of food acquisition during the northern Kenyan drought itself. The more “indigenous” food strategies of herding, hunting and gathering offered limited benefits. Equally, however, commercial channels for procuring food proved inadequate. Herders could not reliably sell animals to obtain cash for purchased food, nor were the grain and sugar staples always available even when cash was on hand. Lacking means to provide for themselves, Samburu came to depend on varied kinds of handouts.
The Relief Operation in Puno District, Peru, after the 1986 Floods of Lake Titicaca
Authors: SZTORCH L. , GICQUEL V. , DESENCLOS J. C. 
Published: December 2007

The 1985‐86 rainy season in Peru was disastrous due to very high precipitation. Because of the unusual level of floods in the Lake Titicaca area and the increasing number of affected people, the Peruvian Government established an emergency relief plan and appealed for international aid. At that time the situation was already very critical. The lack of preparedness made the implementation of the relief operation difficult. Our paper describes the intervention of a French N.G.O. (Médecins Sans Trontières), requested by the Peruvian authorities. The early phase of the relief programme and its methodology are described. Problems within this relief programme and the further long‐term development action that should be undertaken are discussed.Au Pérou, la saison des pluies 85–86 a été catastrophique par l'importance des précipitations. Au cours des premiers mois de l'année 1986, devant l'ampleur inhabituelle des inondations dans la région du lac Titicaca et le nombre sans cesse croissant de sinistrés, le gouvernement pbruvien décide de mettre en route un plan national de secours d'urgence enfaisant appel à l'aide internationale. Mais la réponse est déjá tardive et le manque de mesures préventives fait que l'organisation des secours se heurte à un grand nombre de difficultés. Notre étude se situe dans le cadre de l'intervention d'une organisation non gouvernementale européenne, sollicitée par le gouvernement péruvien pour une collaboration dans la phase des premiers secours à cette population. Les problémes posés lors de cette opération et la suite à donner à l'assistance a moyen et a long terme sont discutés.
Displacements and Reconstruction: The Case of West Beirut – Lebanon
Authors: EL‐MASRI SOUHEIL 
Published: December 2007

This paper focusses on the housing conditions of the displaced people who were forced to move to West Beirut due to the conflict in Lebanon which started in 1975. With the lack of any emergency housing provision, people have adopted two ways to shelter their families; either by occupying vacant buildings or by squatting on unused land (land squatting).The study is based on fieldwork undertaken in order to gain a deeper insight into the displaced people's housing conditions. The results of the survey analysis are believed to be common to other displaced people, as has been verified by comparison with the available information in newspaper reports, unpublished documents, and other accounts.The paper concludes with a reconstruction strategy, composed of two policies. First, a short‐term policy which deals with the urgent needs of the people in the place of refuge. Thus mitigation and risk reduction are the aims of this policy. Second, a long‐term policy which concentrates on future housing reconstruction; in which economic development, social integration and cultural identity are the basic features.
The Yellow Fever Epidemic in Western Mali, September—November 1987: Why Did Epidemiological Surveillance Fail?
Authors: KURZ XAVIER 
Published: December 2007

Recent yellow fever epidemics in West Africa have underlined the discrepancy between the official number of cases and deaths and those estimated by a retrospective epidemiological investigation. During the yellow fever epidemic that broke out in western Mali in September 1987, a total of 305 cases and 145 deaths were officially notified, but estimates revealed true figures abut five times higher. This paper attempts to discuss the factors that hindered early case detection and more complete reporting. They were, first, the insufficient training on the clinical diagnosis, the blood sampling method for laboratory confirmation, and the curative treatment of patients (resulting in low utilization of services); second, the lack of an action plan to prepare in advance a quick response to the epidemic, affecting reporting procedures at the peripheral level and active case‐finding during the outbreak; and third, the lack of laboratory facilities for a quick confirmation of the disease.The difficulties experienced during the yellow fever epidemic in Mali demonstrated the importance of a preparedness strategy for epidemic control, based on an integrated approach of epidemiological surveillance within basic health service activities. The need for regional collaboration and for institutionalized funds in the donor community that could be mobilized for epidemic preparedness activities is also emphasized.
Environmental Health and the 1991 Bangladesh Cyclone
Authors: HOQUE BILQIS A. , SACK R. BRADLEY , JAHANGIR ALAM M. , HAZERA NAZRUL , SIDDIQI MIZAN , NAHID ALI 
Published: December 2007

A brief post‐disaster study was undertaken soon after the cyclone of 1991 in Bangladesh to make a preliminary assessment of existing environmental health conditions. Eighty affected people and 26 relief personnel from the affected areas were interviewed. Faecal coliform counts, salinity conductivity and pH values were determined for 43 water samples from tubewells and ponds. The quality of 32 samples of water purifying tablets was also tested.Water scarcity was acute, especially water used for washing and personal hygiene. The situation was made worse by the fact that the surface water sources (ponds) which were commonly used for domestic purposes other than drinking were flooded, highly contaminated and regarded as unusable. The user load on existing tubewells doubled, indicating a significantly increased demand for the tubewell water which is commonly used for drinking purposes only. The majority (63 per cent) of the water purifying tablets were found to have lost potency. Sanitation was very poor in households as well as in field clinics and shelters. Most people, including relief personnel, lacked environmental health knowledge. Suggestions regarding immediate preparations for disaster relief include: restoring water systems (tubewells and ponds), training courses for relief personnel, standardizing of water purifying tablets, promoting appropriate water use and its treatment, maintaining sanitation in clinics and shelters and improving the skills and resources of local people to enable them to cope with the situation.
Early Warning and Response: Why the International Community Failed to Prevent the Genocide
Authors: ADELMAN HOWARD , SUHRKE ASTRI 
Published: December 2007

Western leadership … has proclaimed moral indifference to be its decent Christian right John le Carré (1995, p. 213).The enormity of the genocide in Rwanda demands that it be subjected to searching enquiry and that members of the international community, collectively and individually, examine their own roles in the event.This paper draws extensively on Study II of the Joint Evaluation, and examines the effectiveness of international monitoring (early warning) and management of the Rwanda conflict. It is not intended to explore all the factors which together contributed to the genocide that were or might have been amenable to modification by the international community. The focus is on warning and response beginning with the start of the civil war in 1990, and culminating in an analysis of the international response to the genocide in April–June 1994.
EFFECTS OF 0.1% CYCLOPENTOLATE OR 10% PHENYLEPHRINE ON PUPIL DIAMETER AND ACCOMMODATION
Authors: Mordi J. , Tucker J. , Charman W. N. 
Published: December 2007

Abstracts— The mydriatic and cycloplegic effects of either one drop of 0.1% cyclopentolate or two drops of 10% phenylephrine were studied over a period of up to 6 hours after drug instillation, using 5 subjects aged between 25 and 43 years. The extent of mydriasis was determined from the horizontal diameter of the pupil. Dynamic accommodation responses were monitored with an infra‐red, continuously recording optometer. Static measurements of the accommodation response/stimulus curve were made with a laser optometer.With either drug, dilation of the pupil occurred more rapidly than recovery of normal pupil diameter. Both drugs caused alterations in the dynamic and static accommodation responses. Response times were generally slowed, and the slope of the accommodation response/stimulus curve and the amplitude of accommodation were, reduced. The time course of these changes was broadly similar to that of the pupil dilation. Cyclopentolate hydrochloride was more efficient as a mydriatic but exercised a greater unwanted cycloplegic effect.
Meridional differences in temporal response characteristics
Authors: Styles Tim , Flanagan John G. 
Published: December 2007

It is well established that a large variety of psychophysical factors influence the critical flicker fusion frequency (CFF). Several recent studies have examined the relationship between CFF and retinal location with confounding and contradictory results. The aim of this study was to determine the CFF for a number of stimulus sizes and luminances in an attempt to evaluate the interactive effects of these parameters and the quadrantic variation in temporal sensitivity.Retinal sensitivity gradients were measured along the two major oblique meridians out to an eccentricity of 50 degrees. CFF profiles for the 1.724 and 0.431 degree targets were shown to decrease with increasing eccentricity more rapidly in the inferior nasal quadrant (superior temporal retina). No significant difference between superior and inferior visual field temporal processing was evident.
Errors in distance appreciation and binocular night vision
Authors: Bourdy C. , Cottin F. , Monot A. 
Published: December 2007

Studying binocular vergence in relation to luminance levels, we isolated two types of behaviour which may explain differences in distance appreciation:

Underestimation of distances in subjects with overconvergence in darkness.
Overestimation of distances in subjects with underconvergence in darkness.

Progression towards the limiting value of convergence varies from one individual to another for each mesopic and scotopic luminance level and for different experimental conditions: variable discrepancy between the observation distance and the tonic vergence distance: accommodative or fusional stimuli at varying degrees of eccentricity; mobile stimuli in the observer's peripheral field. The study of bipartition in depth of a given interval for different observation distances confirms the existence of two major categories of individuals, Over‐ or underestimation of the nearer subjective half correlates to the binocular dark convergence capacity of each individual. These findings may explain errors in distance appreciation for road users in night vision.
TNO stereopsis test as an aid to the prevention of amblyopia*
Authors: Walraven Jan , Janzen Piet 
Published: December 2007

In this investigation, carried out under a Youth Health Care postgraduate course in Nijmegen, the stereopsis of a school population of 730 children, aged 4–18 years, was recorded and clinically evaluated. Stereopsis was measured using the TNO test, a random‐dot stereo test especially designed for the early detection of amblyopia. The main aims of this study were to establish the validity of the TNO test as a screening test for amblyopia, obtain information about the variability and age dependence of stereopsis, and to evaluate the efficacy of amblyopia prevention. The most important findings can be summarized as follows:1. All amblyopes are detected by the TNO test's recommended referral criterion of 240 sec arc (binocular threshold parallax in sec arc).2. The red‐green anaglyphs used in the test do not pose problems for individuals with a colour vision deficiency.3. The ability to discriminate depth improves by a factor of two over the age interval 4–12 years.4. A stereoacuity of ≤ 120 sec arc is a good predictor of normal or correctable normal vision, and may therefore help in evaluating the often incomplete results of eye tests of young children.5. Where there is an increased perinatal risk, there is a greater chance of disturbed binocular vision.6. It is estimated that 75% of amblyopes remain amblyopic. possibly because of delayed detection; 60% of the amblyopes in the population examined were not identified before the age of 5 years.
The microbiology of the eye
Authors: Armstrong R. A. 
Published: December 2007

SummaryInfection of the external structures of the eye is one of the commonest types of eye disease worldwide. In addition, although relatively impermeable to microorganisms, infection within the eye can result from trauma, surgery or systemic disease. This article reviews the general biology of viruses, bacteria, fungi and protozoa and the major ocular infections that they cause. In addition, the effectiveness of the various antimicrobial agents in controlling ocular disease is discussed. Because of changes in the normal ocular flora, continuous monitoring of the microbiology of the eye will continue to be important in predicting future types of eye infection. Basic research is also needed into the interactions of microbes at the ocular surface. There is increasing microbial resistance to the antimicrobial agents used to treat ocular infections and hence, new antimicrobial agents will continue to be needed together with new methods of drug delivery to increase the effectiveness of existing antimicrobial agents.