bluuebunny/crossref_metadata_2025 huggingface dataset:
Small and medium-sized enterprise internationalisation strategy and performance in times of market turbulence
Authors: Hilmersson Mikael
Published: September 2013

This article examines the relationship between the strategies utilised by small and medium-sized enterprise (SMEs) for international expansion, and their performance during market turbulence. Analysing the strategy process of firm internationalisation, three main dimensions of this unfolding process are condensed: the scale, scope and speed of firm internationalisation. The influence of these three dimensions on performance during market turbulence is explored using a hypothesised model tested through an integrated dataset combining data pertaining to firm strategy, and performance. The analysis demonstrates that the scope and speed of internationalisation render a positive performance effect, whereas the scale of internationalisation does not. The article contributes to knowledge regarding sustainable and successful internationalisation strategies during times of market turbulence.
Exploring public awareness and perceptions of palliative care: A qualitative study
Authors: McIlfatrick Sonja , Noble Helen , McCorry Noleen K , Roulston Audrey , Hasson Felicity , McLaughlin Dorry , Johnston Gail , Rutherford Lesley , Payne Cathy , Kernohan George , Kelly Sheila , Craig Avril
Published: September 2013

Background:

Research suggests that the public appear to be confused about the meaning of palliative care. Given the ageing population and associated increase in the number of patients requiring palliative care, it is vital to explore the public’s understanding of this concept. Health-promoting palliative care seeks to translate hospice and palliative care ideals into broader public health practice.

Aim:

To explore public perceptions of palliative care and identify strategies to raise awareness.

Design:

An exploratory qualitative approach.

Participants:

Semi-structured telephone interviews were undertaken ( N = 50) with members of the public who volunteered to participate in the study. The interviews focused on knowledge and perceptions of palliative care, expectations of palliative care services and the identification of strategies to raise public awareness of palliative care. The interviews were audio recorded and content analysed.

Results:

Most participants had a general knowledge of palliative care, largely influenced by their own personal experience. They identified that palliative care was about caring for people who were dying and maintaining comfort in the last days of life. Participant’s expectations of services included the following: holistic support, symptom management, good communication and practical support to enable choice and carer support. Key aspects identified for promoting palliative care were the development of understanding and use of the term itself and targeted educational strategies.

Conclusion:

Experience of palliative care generates understanding in the general public who also have ideas for increasing knowledge and awareness. The findings can inform policymakers about strategies to raise public awareness of palliative care.
Conducting Three-Level Cross-Sectional Analyses
Authors: Peugh James L.
Published: September 2013

Applied early adolescent researchers often sample students (Level 1) from within classrooms (Level 2) that are nested within schools (Level 3), resulting in data that requires multilevel modeling analysis to avoid Type 1 errors. Although several articles have been published to assist researchers with analyzing sample data nested at two levels, few articles are available to researchers seeking assistance with three-level data analyses. The purpose of this article is to extend the presentational logic and pedagogical flow employed in previous two-level pedagogical publications to illustrate the relevant issues researchers face, the decisions to be made, and the proper procedures needed, when analyzing cross-sectional three-level data. These procedures are demonstrated with a generated three-level data example based on the Early Childhood Longitudinal Study (ECLS-K) public use dataset. The generated data used in this article, as well as the SPSS, SAS, and Mplus model specification syntax files needed to reproduce all analyses in this article, and additional illustrative examples, are available as supplemental online materials at http://jea.sagepub.com/content/early/recent .
The Composition of the Editorial Boards of General Marketing Journals
Authors: Pan Yue , Zhang Jason Q.
Published: September 2013

Unlike the diversity issues in corporate governance, the diversity in top academic positions (e.g., editorial boards of academic journals in business) is rather underresearched. The editorial boards of academic marketing journals are important gatekeepers and trendsetters in the creation and dissemination of marketing knowledge. Membership on journal editorial boards usually signals scholarly stature and professional advancement. This study examines the composition of editorial boards of general marketing journals, and compares it with what it was like 15 years ago. The study also investigates the impact of the composition of editorial boards on journal quality. We find that women’s participation in editorial boards generally corresponds to their presence in the profession. We also find an overall small representation of board members affiliated with nonacademic institutions. While the presence of women, practitioners, or international members does not have any relationship with journal quality, the presence of scholars affiliated with doctoral programs seems to correlate with journal quality. The number of female and international members on the boards increased, whereas practitioners’ representation dropped from 1997 to 2012.
Altered brain connectivity in patients with psychogenic non-epileptic seizures: A scalp electroencephalography study
Authors: Xue Qing , Wang Zhen-Yu , Xiong Xiu-Chun , Tian Chun-Yang , Wang Yu-Ping , Xu Peng
Published: September 2013

Objective

To determine the role of altered brain connectivity in patients with psychogenic non-epileptic seizures (PNES).

Methods

Patients with PNES and age- and sex-matched healthy control subjects were enrolled. Participants underwent neuropsychological evaluation (anxiety, depression and dissociation) and interictal scalp electroencephalography (EEG). A brain network was constructed. Between-group differences in clustering coefficient and global efficiency were analysed.

Results

Patients with PNES ( n = 15) had significantly decreased clustering coefficients in the gamma band compared with controls ( n = 15). Difference topology revealed that patients with PNES had decreased long linkage between the frontal region and other regions compared with controls. There were no significant between-group differences in global efficiency. Neuropsychological scores were significantly higher in patients than controls, but there were no correlations with network properties.

Conclusion

Altered brain connectivity in patients with PNES suggests an underlying pathophysiological mechanism. EEG and network analysis allow noninvasive exploration of the neurological processes of this disease.
Benefits of a frame-based stereotactic surgical planning system for the treatment of spontaneous intracerebral haematomas
Authors: Dun Zhiping , Zhu Shugan , Jiang Hao
Published: September 2013

Objective

Frame-based stereotactic surgical planning systems (SSPSs) have been used for deep brain stimulation and radioneurosurgery. Here, we evaluated the feasibility, safety and efficacy of using a SSPS to aid spontaneous intracerebral haematoma (ICH) treatment.

Methods

Patients with moderate spontaneous putamen haematomas were randomized into two groups: treatment (group A) and control (group B). In group B, the catheter for evacuating haematomas was inserted into a target point, located at the centre of the haematoma, using conventional frame-based stereotactics; urokinase thrombolysis was subsequently delivered through the catheter. In group A, this procedure was assisted by a SSPS, which designed both the target point and trajectory in the haematoma through virtual reality. Duration of evacuating haematomas and number of urokinase injections was compared between groups.

Results

In total, 65 patients were recruited: in group A ( n = 30), the duration of evacuating haematomas (35.27 ± 9.17 h) was shorter than in group B ( n = 35; 67.77 ± 13.82 h). There were fewer urokinase injections in group A (3.63 ± 1.16) than in group B (6.40 ± 1.29).

Conclusions

The feasibility, efficacy and safety of spontaneous ICH treatment were optimized by the use of a frame-based SSPS.
Waste-to-energy incineration plants as greenhouse gas reducers: A case study of seven Japanese metropolises
Authors: Tabata Tomohiro
Published: September 2013

Municipal solid waste (MSW) incineration is a greenhouse gas (GHG) emitter; however, if GHG reductions, achieved by accounting for waste-to-energy, exceed GHG emissions, incineration can be considered as a net GHG reducer. In Japan, only 24.5% of MSW incineration plants perform energy recovery despite 80% of MSW being incinerated; therefore, there is great potential to extract more energy from MSW. In this study, the factors that should be considered to achieve net GHG reductions from incineration were analysed from a life cycle perspective. These considerations were then applied to the energy supply requirements in seven Japanese metropolises. Firstly, the carbon footprints of approximately 1500 incineration plants in Japan were calculated. Then, the incineration plants with negative carbon footprint values were classified as net GHG reducers. Next, the processes that contribute to the carbon footprint were evaluated, and two processes—plastic burning and electricity savings—were found to have the greatest influence. Based on the results, the energy supply requirements were analysed and discussed for seven metropolises (Sapporo, Tokyo, Nagoya, Osaka, Kobe, Takamatsu and Fukuoka) taking into account the energy demands of households. In Kobe, 16.2% of the electricity demand and 25.0% of the hot water demand could be satisfied by incineration to realise a net GHG reducer, although urban design for energy utilisation would be required.
National Study of Chronic Disease Self-Management
Authors: Ory Marcia G. , Ahn SangNam , Jiang Luohua , Lorig Kate , Ritter Phillip , Laurent Diana D. , Whitelaw Nancy , Smith Matthew Lee
Published: September 2013

Objective: To investigate how the Chronic Disease Self-Management Program (CDSMP) changes health outcomes, lifestyle behaviors, and health care service utilization over a 6 month period. Method: The participants were 1,170 adults enrolled in the National Study of CDSMP in 2010-2012 ( M age = 65.4 years). Six-month assessments were available for 903 participants. Linear mixed models and generalized linear mixed models were used to assess the changes between baseline and 6-month assessment for primary and secondary outcomes among CDSMP participants. Results: Social/role activities limitations, depression, and communication with physicians improved significantly from baseline to 6-month follow-up. Study participants reported significant improvements in more physical activity and less emergency room (ER) visits and hospitalization during that period. Discussion: Nationally, CDSMP not only improves health outcomes and lifestyle behaviors but also decreases costly ER visits and hospitalization. Geriatricians and other primary care providers should be encouraged to refer patients with chronic conditions to such self-management programs.
The effect of waves rupture diaphragm on acceleration loads of projectile
Authors: Liang Shi-chang , Huang Jie , Li Yi , Lan Sheng-wei , Jian He-xiang , Liu Sen
Published: September 2013

The acceleration loads of projectile during launch process of two-stage light gas gun were studied by the developed computational fluid dynamics program. With the usage of LS-DYNA software, the diaphragm rupture pressure was calculated by finite element method. The influence of different waves rupture diaphragm on the maximum acceleration loads of projectile was analyzed, keeping the configurations of gun unchanged. It is found that the maximum acceleration loads can be reduced and the muzzle velocity objective can be achieved by choosing the ruptured wave appropriately and optimizing other operational parameters. Soft launch capability is provided for launching complex lifting configuration models up to hypervelocity.
“Shared learning” for building urban climate resilience – experiences from Asian cities
Authors: Orleans Reed Sarah , Friend Richard , Toan Vu Canh , Thinphanga Pakamas , Sutarto Ratri , Singh Dilip
Published: September 2013

This paper considers how resilience thinking and, in particular, its emphasis on learning has been applied in 10 cities in Vietnam, India, Thailand and Indonesia. Applying a “shared learning” approach in the Asian Cities Climate Change Resilience Network (ACCCRN) has helped to create or strengthen networks, build appreciation for complexity and uncertainty among stakeholders, provide a space for deliberating concepts such as vulnerability and resilience, and build knowledge and capacities for stakeholders to engage and represent their own interests. Shared learning approaches face considerable challenges navigating politicized urban environments, in which the nature and value of existing systems − and therefore the value of building resilience − are contested. This article suggests that deliberate, strategic intervention by facilitators may contribute to more transformative change on behalf of equitable, socially just outcomes – and thus cautions against seeing urban climate vulnerability as a technical challenge, or shared learning as a “toolkit” for building resilience.
Self-Regulatory Depletion Enhances Neural Responses to Rewards and Impairs Top-Down Control
Authors: Wagner Dylan D. , Altman Myra , Boswell Rebecca G. , Kelley William M. , Heatherton Todd F.
Published: September 2013

To be successful at self-regulation, individuals must be able to resist impulses and desires. The strength model of self-regulation suggests that when self-regulatory capacity is depleted, self-control deficits result from a failure to engage top-down control mechanisms. Using functional neuroimaging, we examined changes in brain activity in response to viewing desirable foods among 31 chronic dieters, half of whom completed a task known to result in self-regulatory depletion. Compared with nondepleted dieters, depleted dieters exhibited greater food-cue-related activity in the orbitofrontal cortex, a brain area associated with coding the reward value and liking aspects of desirable foods; they also showed decreased functional connectivity between this area and the inferior frontal gyrus, a region commonly implicated in self-control. These findings suggest that self-regulatory depletion provokes self-control failure by reducing connectivity between brain regions that are involved in cognitive control and those that represent rewards, thereby decreasing the capacity to resist temptations.
Pakistan and Afghanistan, 2014 and Beyond: Not Friends, Not Yet Enemies?
Authors: Zeb Rizwan
Published: September 2013

As the American withdrawal is approaching, the future stability of Afghanistan and its effects on the region are increasingly being debated. The predominant view is that due to the mishandling of the situation by the Americans, post 2014 Afghanistan would be unstable and the whole region especially Pakistan will face the consequences of this failure. A stable and peaceful Afghanistan is in Pakistan’s interest as it will ensure that no more drugs, extremism and refugees pour into the country. Islamabad is of the view that like in 1989, the Americans would once again be leaving Afghanistan without finishing what they have started. This coupled with the increasing Indian influence in Afghanistan brings back the historical fear, which has been the driving force behind its Afghan policy since 1947, of being sandwiched between two hostile neighbours. This article flags five points: first, Islamabad has legitimate security concerns in Afghanistan; second, historically, Pakistan’s security concerns regarding India are a major factor in deciding Pakistan’s position in and about Afghanistan; third, Pakistan supported the Taliban government in Kabul due to its geostrategic and security concerns; fourth, there can be no solution of the Afghanistan problem without Islamabad on board; fifth, the solution to the Afghan problem lies not only in Afghanistan but also around it, in the region; therefore, a regional approach is a must.
Post-2014 Afghanistan: Future Scenarios from Structure and Agency Perspectives
Authors: Wolf Siegfried O.
Published: September 2013

This article aims to outline some potential developments in Afghanistan after the withdrawal of most of the foreign combat troops in 2014 from an agential as well as a structural perspective. To be able to do so, it is necessary to evaluate the performance of the international community in general and NATO’s International Security Assistance Force (ISAF) mission in particular over the last 11 years in Afghanistan as well as the role of the Afghan government under the leadership of President Hamid Karzai. In this context, the article will pay special attention to the most crucial question: how much peace is possible and how will the interlinked puzzle of the state, democracy and its institutions manifest itself? Finally the article shares some thoughts on future scenarios for Afghanistan. Based on the current, rather pessimistic, outlook, it will be argued that major armed conflicts will determine the political landscape.
Fear and loathing in Lesotho: An autoethnographic analysis of sport for development and peace
Authors: Forde Shawn D
Published: September 2013

This paper is an autoethnographic analysis of my experiences working for a year in southern Africa on a sport for development and peace (SDP) project. I reflect on the ways in which some of my day-to-day practices exemplified aspects of whiteness and masculinity. In terms of methodology, I combine literature from autoethnography and arts-based inquiry to argue for the use of drawing as a method of inquiry and a mode of presentation to examine and illustrate my experiences as a young, white, male development worker/“expert”. I present three graphic vignettes that I produced through reflections on my experiences and through reading literature from critical race and development scholars. The ultimate aim with this paper is to put forward a critical counter-narrative that upsets the “white savior” story that is common within development and SDP.
Merogonic stages of Theileria cervi in mule deer (Odocoileus hemionus)
Authors: Wood Jason , Johnson Eileen M. , Allen Kelly E. , Campbell Gregory A. , Rezabek Grant , Bradway Daniel S. , Pittman Louis L. , Little Susan E. , Panciera Roger J.
Published: September 2013

In February 2012, 12 farmed mule deer ( Odocoileus hemionus) were moved from a facility in southwestern Oklahoma to a facility in southeastern Oklahoma that housed 100 farmed white-tailed deer ( Odocoileus virginianus). Between the third and fifth weeks, 9 of the 12 mule deer had died, 4 of which were submitted for necropsy. The deer were heavily infested with Amblyomma americanum (lone star ticks). Hematologic data from 1 deer revealed severe anemia, leukocytosis, and intraerythrocytic hemoparasites consistent with Theileria spp. Microscopically, the liver, lymph nodes, and spleen contained multifocally distributed, enlarged monocytic cells whose cytoplasm was replaced by developing meronts in various stages of merogony. It appears that, upon arrival, the Theileria cervi–naïve mule deer became infested with large numbers of Theileria-infected lone star ticks leading to massive exposure of the mule deer to sporozoites of the protozoan, resulting in an acute hemolytic crisis and fatalities. The merogonic stages of T. cervi are also described. The lack of earlier reports of merogony may be due to the fact that only a single, short-lived, merogonic cycle follows exposure to sporozoites and thus merogonic stages are demonstrable for only a short period. Polymerase chain reaction testing of paraffin-embedded tissue yielded a 507-bp amplicon sequence that was 100% identical with the sequence of T. cervi previously reported from white-tailed deer in Oklahoma and from elk in Wisconsin and Indiana.
Anatomic Comparison of Lateral Transfer of the Long Flexors for Concomitant Peroneal Tears
Authors: Seybold Jeffrey D. , Campbell John T. , Jeng Clifford L. , Myerson Mark S.
Published: September 2013

Background:

Lateral transfers of the flexor hallucis longus (FHL) or flexor digitorum longus (FDL) tendons have been described for treatment of concomitant, irreparable peroneal tears. This study evaluated the anatomic benefits and constraints of lateral FHL and FDL tendon transfers with regard to available tendon length, diameter, and proximity to the posterior neurovascular bundle.

Methods:

In 9 cadaveric specimens, the FHL and FDL tendons were transected through a medial approach distal to the knot of Henry. Each tendon was transferred into a lateral incision, passing the FDL tendon both posterior and anterior to the tibial neurovascular bundle. The tendons were individually secured to the base of the fifth metatarsal with the foot in maximal eversion and dorsiflexion. The length of donor tendon available for fixation at the fifth metatarsal was measured. After the FDL tendon transfer was secured, the posterior neurovascular bundle was examined for signs of compression.

Results:

Average FHL tendon diameter measured 5.1 mm; the FDL measured 4.5 mm. After passage through a bone tunnel, an additional 4.9 cm of FHL tendon remained to suture to itself; only 0.5 cm remained for the posterior and anterior FDL transfers. Transfer of the FHL did not increase muscle bulk within the retrofibular groove. Every FDL transfer posterior to the neurovascular bundle produced obvious visual compression of the tibial nerve with plantar flexion and inversion of the foot.

Conclusion:

Use of the FHL tendon for lateral transfer consistently provided sufficient length of tendon for multiple fixation options and a stronger muscle for transfer. Fixation options for the FDL were limited due to its shorter length. Lateral transfer of the FDL tendon posterior to the neurovascular bundle caused visible compression on the tibial nerve with ankle and hindfoot range of motion.

Clinical Relevance:

This anatomic study confirmed several advantages for the use of the FHL tendon transfer in cases of concomitant peroneal tears.
“I Knew From Day One That I’m Either Gonna Fight This Thing or Be Defeated”
Authors: Kissil Karni , Niño Alba , Ingram Mary , Davey Maureen
Published: September 2013

Few studies have explored how African American parents navigate breast cancer while parenting their school-age children. This focus-group study examined how African American parents cope with the diagnosis and treatment of breast cancer. Three focus groups were conducted with nine African American parents coping with breast cancer. Interviews were analyzed using content analysis. Participants described a variety of coping strategies. Five primary themes emerged: involvement in community of support, relationship with cancer, being the family emotional regulator, highlighting positives, and spirituality. Findings suggest that providers can improve the care of African American breast cancer patients and their families by facilitating patient advocacy, encouraging patients to reach out to various support systems, discussing with patients their children’s functioning, and integrating spirituality into available support programs. Developing more culturally sensitive support groups that promote shared family understanding and open communication among African American parents and their children can facilitate better coping.
The Relationship Between Neutrophil-to-Lymphocyte Ratio and Coronary Collateral Circulation
Authors: Uysal Onur Kadir , Turkoglu Caner , Sahin Durmus Yildiray , Duran Mustafa , Yıldırım Arafat , Elbasan Zafer , Ozkan Bugra , Tekin Kamuran , Kunak Aysegul Ulgen , Yilmaz Yucel , Kaya Mehmet Gungor , Gur Mustafa , Cayli Murat
Published: September 2013

Neutrophil/lymphocyte ratio (NLR) has been proposed as a prognostic marker to determine systemic inflammatory response and atherosclerosis. Our aim was to determine the relationship between NLR and development of coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD). A total of 521 consecutive patients with stable CAD who underwent coronary angiography and documented total occlusion in one of those major coronary arteries were included in this study. Levels of fasting blood glucose, white blood cell, and NLR were significantly higher in patients with poor collateral than in those with good collateral. After multivariate analysis, high level of NLR was an independent predictor of CCC together with levels of fasting blood glucose. The receiver–operating characteristic analysis provided a cutoff value of 2.75 for NLR to predict poor CCC with 65% sensitivity and 68% specificity. We demonstrated an independent association between levels of NLR and development of CCC in patients with stable CAD.
An Analysis of the Barkley Deficits in Executive Functioning Scale in a College Population: Does It Predict Symptoms of ADHD Better Than a Visual-Search Task?
Authors: Dehili Vincent Malik , Prevatt Frances , Coffman Theodora P.
Published: September 2013

Objective: Executive functioning (EF) deficits have been associated with ADHD. However, disagreement exists concerning the extent to which cognitive tests of EF accurately reflect a diagnosis of ADHD. Barkley developed the Barkley Deficits in Executive Functioning Scale (BDEFS) by categorizing the meta-construct of EF into five subdomains. This study investigated the incremental validity of the BDEFS in predicting symptoms of ADHD compared with a visual-search task. We also investigated patterns among the five BDEFS domains. Method: One hundred and sixteen college students completed a visual-search task and the BDEFS and reported on their symptoms of ADHD. Results: (a) BDEFS total scores significantly predicted total ADHD symptoms, whereas the visual-search task failed to predict ADHD symptoms. (b) The BDEFS demonstrated significant correlations with symptoms of ADHD in expected patterns. Conclusion: This study provides evidence of validity for the BDEFS in a college sample.
Effect of single-cat versus multi-cat home history on perceived behavioral stress in domestic cats (Felis silvestrus catus) in an animal shelter
Authors: Broadley Heidi M , McCobb Emily C , Slater Margaret R
Published: September 2013

This study investigates the effect of living with other cats in a prior home on stress levels of cats recently surrendered to an animal shelter. A total of 63 cats was evaluated using a Cat-Stress-Score and an approach test. Cats were categorized in terms of previous home history with or without other cats. No significant difference was found in stress scores between cats from single-cat households and those from multiple-cat households, although single cats that had been in the shelter less than 4 days demonstrated higher stress levels. No significant difference was found between the two groups in terms of approach results. Results of this study suggest that, in traditional individual cage settings, cats that are not accustomed to living with other cats may experience more stress in the initial few days of attempting to adjust to shelter existence. Through the use of such assessments, shelter personnel may develop an increased awareness to the needs of these cats and attempt to provide measures to improve their well-being within the shelter environment.
First report of Dracunculus insignis in two naturally infected cats from the northeastern USA
Authors: Lucio-Forster Araceli , Eberhard Mark L , Cama Vitaliano A , Jenks Mary H , Jones Carroll , Sanders Sara Y , Pongratz Jennifer P , Bowman Dwight D
Published: September 2013

Dracunculiasis is rarely reported in cats, yet over the last few years we have identified two cats with filarioid-like spirurid infections. Case 1 was a 9-year-old cat with pituitary-dependent hyperadrenocorticism from New York tate from which four adult dracunculoid nematodes were isolated from its torso. Based on morphometric characteristics and parasite geographic distribution, the specimens were identified as Dracunculus insignis females; at least one of the females was gravid, suggestive of patent infection. Species identification was confirmed through amplification and sequence analysis of nuclear and mitochondrial loci. Case 2 was a 14-year-old diabetic cat from Massachusetts. Formalin-fixed sections were obtained from a subcutaneous mass excised from the left foreleg. Histopathological examination revealed a large nematode with morphometrical characteristics of Dracunculus, surrounded by lymphocytes and sheets of eosinophils. These two cases appear to be the first published reports of dracunculiasis in domestic cats in the USA, and based on the findings from case 1, D insignis may be the species associated with both infections.
From superstars to devils: The ethical discourse on managerial figures involved in a corporate scandal
Authors: Ailon Galit
Published: September 2013

This article draws upon a growing body of Foucauldian-inspired literature on business ethics. Looking at the media as a prime site of dynamic discursive production in contemporary times, it offers an analysis of the underlying moral sensitivities and ethical frameworks characteristic of reports about the two top managerial figures involved in the Enron scandal: Jeffrey Skilling and Kenneth L. Lay. Analysing Forbes and BusinessWeek articles, the article examines the sudden appearance of these managers as a heightened moral threat, asking what constellations of knowledge and meaning were expressed through the demonization of these once idealized managerial superstars. It shows that while speaking in the name of ethics, the examined discourse also undermines ethics in that it promulgates a largely paradoxical and ethically incapacitating concept of self and logic of action.
Increasing prevalence and incidence rates of multiple sclerosis in Kuwait
Authors: Alroughani R , Ahmed SF , Behbehani R , Khan R , Thussu A , Alexander KJ , Ashkanani A , Nagarajan V , Al-Hashel J
Published: September 2013

Background:

Kuwait was considered as low to intermediate risk area for MS.

Objectives:

To determine the prevalence and incidence rates of MS among Kuwaiti nationals based on 2011 population census.

Methods:

This cross-sectional study was conducted between October 2010 and April 2013 using the newly developed national MS registry in Kuwait. Patients with a diagnosis of MS according to 2010 revised McDonald criteria were identified. The crude, age- and sex-specific prevalence and incidence rates among Kuwaiti patients were calculated.

Results:

1176 MS patients were identified of which 927 (78.8%) were Kuwaitis and 249 (21.2%) were expatriates. Among Kuwaiti patients, female to male ratio was 1.8:1 with a mean age of 35.40 ± 10.99 years. The prevalence rate of MS was 85.05 per 100,000 persons (95% CI: 82.80 – 87.04). There was a peak in prevalence among patients aged 30–39 years. The incidence of MS was 6.88 per 100,000 persons (95% CI 5.52–8.55). Between 2003 and 2011, the incidence increased 3.22 and 2.54 times in women and men respectively.

Conclusion:

Kuwait is considered a high-risk area for MS. The significant increase in prevalence and incidence rates may represent a true increase despite the improvement in case ascertainment and case definition.
The emotional geography of prison life
Authors: Crewe Ben , Warr Jason , Bennett Peter , Smith Alan
Published: September 2013

Accounts of prison life consistently describe a culture of mutual mistrust, fear, aggression and barely submerged violence. Often too, they explain how prisoners adapt to this environment—in men’s prisons, at least—by putting on emotional ‘masks’ or ‘fronts’ of masculine bravado which hide their vulnerabilities and deter the aggression of their peers. This article does not contest the truth of such descriptions, but argues that they provide a partial account of the prison’s emotional world. Most importantly, for current purposes, they fail to describe the way in which prisons have a distinctive kind of emotional geography, with zones in which certain kinds of emotional feelings and displays are more or less acceptable. In this article, we argue that these ‘emotion zones’, which cannot be characterized either as ‘frontstage’ or ‘backstage’ domains, enable the display of a wider range of feelings than elsewhere in the prison. Their existence represents a challenge to depictions of prisons as environments that are unwaveringly sterile, unfailingly aggressive or emotionally undifferentiated.
The pivot points in planning: How the use of contracts influences trust dynamics and vice versa
Authors: de Vries Jasper R , Beunen Raoul , Aarts Noelle , Lokhorst Anne Marike , van Ark Ronald
Published: September 2013

To organize new governance arrangements and to restore trust in spatial planning, contracts are often seen as vital policy instruments. The relations between contracts and trust are regularly studied from various perspectives. In this article, we add to the existing knowledge by exploring a dynamic perspective on the use of contracts over time and the influence thereof on trust dynamics. We conclude that, longitudinally, the use of contracts can play a pivotal role in trust dynamics by influencing the construction of, and actors’ perspective on, the common history of the parties involved and their future expectations in close relation to the changing context. This perspective might help planners to deal with the inevitable dynamics of planning processes and trust.
The Thermostatic Model of Responsiveness in the American States
Authors: Pacheco Julianna
Published: September 2013

Does the thermostatic model exist in the states? Using a unique data set on state spending preferences on education and welfare, I find evidence ofdynamic policy representationanddynamic public responsiveness, but with important qualifications. As state support for spending on education or welfare increases, state expenditures increase, but only for states that are highly professional and, presumably, able to accurately gauge the preferences of residents. In other states, legislators are responding to national policy sentiment instead of specific state opinion. I find no evidence that initiative states are more responsive to state opinion. Empirical evidence for dynamic public responsiveness is more consistent across model specifications. As state expenditures on education or welfare increase, state preferences for additional spending decrease, even after controlling for federal expenditures. Finally, I find that policy representation and public responsiveness in the states are conditional on issue saliency. The results provide a more nuanced understanding about the degree of dynamic representation and responsiveness in the states and the thermostatic model more generally.
HERstory Is OURstory
Authors: Onuora Adwoa Ntozake
Published: September 2013

Narrative representations require that we as researchers-turned-creative-writers engage in processes of meaning making as we story memories relayed to us in conversations with participants. Our efforts to story participants’ lives, however, often result in questions: Can there be a true narrative? And whose story is this, anyway? Using re-created storied dialogue, this article contributes to the larger debate within narrative research methodology around issues of “truth,” representation, and ownership of knowledge. Through the ontological perspectives communicated in an Afro-indigenous Anancy folktale, I offer an indigenous response to these questions. I argue that to decolonize our research paradigms, researchers in the academy must wear a different set of analytical spectacles for understanding the lived experiences of African peoples.
The role of capsule endoscopy in acute gastrointestinal bleeding
Authors: Nadler Moshe , Eliakim Rami
Published: September 2013

Acute gastrointestinal (GI) bleeding is a common cause of hospitalization, resulting in about 400,000 hospital admissions annually, with a mortality rate of 5–10%. It is estimated that 5% of acute GI bleedings are of obscure origin with a normal esophagogastroduodenoscopy and ileocolonoscopy. Capsule endoscopy is the state-of-the-art procedure for inspection of the entire small bowel with a high sensitivity for the detection of causes of bleeding. In recent years, many studies have addressed the sensitivity and outcome of capsule-endoscopy procedures in patients with acute GI bleeding. This review looks at the role of capsule endoscopy in the evaluation of patients with acute GI bleeding from either the upper GI tract or small bowel.
Capsaicinoids in the treatment of neuropathic pain: a review
Authors: Peppin John F. , Pappagallo Marco
Published: September 2013

The treatment of neuropathic pain is difficult. Oral pharmaceuticals have significant side effects, and treatment efficacy tends to be modest. The use of topical analgesics reduces the potential for systemic side effects and allows direct application of medications to the area of pain. The natural spicy substance, capsaicin, has historically been known for its topical use. Capsaicin, once applied to the skin, causes a brief initial sensitization followed by a prolonged desensitization of the local pain nerves. This occurs through stimulation of the transient receptor potential vanilloid-1 (TRPV1) expressing pain nerve fibers. While low-dose capsaicin has not resulted in good efficacy, the larger dose 8% topical capsaicin has had some of the best data currently available in the treatment of post-herpetic neuralgia (PHN) and other neuropathic conditions. This paper discusses the data currently existing for capsaicin 8% in the treatment of PHN. It further reviews data for the low-dose capsaicin products and the current status in the development of other capsaicinoids, e.g. resiniferotoxin, and high-concentration liquid capsaicin.
Revision MTP Arthrodesis for Failed MTP Arthroplasty
Authors: Gross Christopher E. , Hsu Andrew R. , Lin Johnny , Holmes George B. , Lee Simon
Published: September 2013

Introduction. Although the gold standard to address hallux rigidus that fails conservative treatment is an arthrodesis, some surgeons have attempted to use arthroplasty to improve range of motion and to simulate a normal joint. When these implants do fail, a salvage MTP arthrodesis is the only surgical option for these patients. This research aims to outline various methods to arthrodese the MTP joint in salvage situations. Methods. We retrospectively looked at patients who underwent a first-MTP fusion after failure of an implant arthroplasty. All fusions involved either bone allograft or autograft and internal fixation. The patients were assessed clinically, radiographically, and with the Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS MTP-IP) clinical questionnaire preoperatively and postoperatively. Results. In all, 11 patients met the inclusion criteria. The average age of patients at the time of the salvage MTP arthrodesis was 57 years. The interval time between primary surgery and revision arthrodesis was on average 84.2 months. There was a high reoperation rate, with 7 operative procedures occurring per 12 arthrodeses (58%). The average time to radiographic fusion was 6.9 ± 4.8 months; 41.7% of patients had a delayed union (>6 months to fusion). Two patients had symptomatic nonunions (16.7%). All the patients had an improvement in their AOFAS MTP-IP score. Conclusion. Although salvage arthrodeses for failed arthroplasties generally have favorable satisfaction rates and are a powerful tool in treating this painful condition, they are fraught with complications. They unite slower, have a significantly higher reoperation rate, and have lower AOFAS scores than primary fusions.

Levels of Evidence: Therapeutic, Level IV—Case series
Understanding Spirometry in Primary Care
Authors: O’Laughlen Mary C. , Rance Karen , Stout James W.
Published: September 2013

Purpose. Improving the quality of care provided to patients with pulmonary disorders is imperative, but properly performed and correctly interpreted spirometry is typically missing in primary care. There are increasing calls for widespread training efforts to mitigate this deficiency. This article describes why spirometry is needed in primary care and how it is performed and evaluated. Data Sources. The latest spirometry recommendations from the National Heart, Lung, and Blood Institute; the Global Initiative for Chronic Obstructive Lung Disease; the American Thoracic Society/European Respiratory Society; the American College of Physicians; the American College of Chest Physicians; and the US Preventive Services Task Force were consulted. Conclusions. Using spirometry to evaluate lung function is one of the simplest, most common pulmonary function tests. Nurse practitioners (NPs) will undoubtedly encounter these patients in their practice, and having comprehensive knowledge about spirometry will be a great asset to both their patients and health care team. NPs are often in a unique position with spirometry testing as they both perform and interpret the procedure. Implications for Practice. To better serve their patients, NPs need the knowledge to properly perform and correctly interpret spirometry.
Theoretical and Practical Knowledge of Metered-Dose Inhalers and Spacer Device Among Health Care Providers in Riyadh, Saudi Arabia
Authors: Alaki Emadia Mohammed , Donques Aziza Abdullah , Al Ghobain Mohammed
Published: September 2013

Objective. To assess the theoretical and practical knowledge of health care providers (HCPs) in relation to the use of metered-dose inhalers (MDIs) and spacer devices. Methods. A cross-sectional study was conducted in Riyadh, Saudi Arabia, among 52 HCPs using a stratified random sampling technique. A questionnaire was used to assess theoretical knowledge; practical knowledge was assessed by direct demonstration of the use of an MDI and a spacer device. Results. Among the participants, 57% were female. The majority provided education to their patients (92%). Of the HCPs, 36.5% completed the demonstration of holding the spacer with a mask and MDI together and then shaking well 4 to 5 times, 78.8% completed the demonstration of cap removal, 15.4% completed the demonstration of checking for any foreign body in the spacer, 78.8% completed the demonstration of holding the device properly, 69.2% completed the demonstration of inhaling slowly and deeply, 55.8% completed the demonstration of maintaining the seal for 5 to 6 breaths after the MDI is pressed, 26.9% completed the demonstration of “if more puffs of medication are prescribed, complete these puffs,” and 25% completed the demonstration of washing the spacer with warm soapy water. The overall scores were good (16.6%), fair (44.4%), and poor (39%). Conclusion. Most of the HCPs in this study lacked basic knowledge and skills regarding the proper way to instruct their patients to use MDIs and spacer devices. There is a need to establish continuing education programs for HCPs about asthma inhaler knowledge and technique.
Cost Estimation of First-Line Antiretroviral Therapy with Zidovudine/Stavudine as the Nucleoside Backbone in India
Authors: Thuppal Sowmyanarayanan V. , Karthik Rajiv , Abraham Ooriapadical C. , Wanke Christine A. , Mwamburi Mkaya , Terrin Norma , Cohen Joshua T. , Mathai Dilip , Muliyil Jayaprakash , Kang Gagandeep
Published: September 2013

Background:

In India, a zidovudine-based regimen is preferred as the first-line drug treatment for HIV, despite high rates of drug toxicity. This study estimates the treatment costs for HIV.

Methods:

Eligible patients were enrolled from Antiretroviral Therapy Center, Christian Medical College, India. Baseline demographic and clinical characteristics, medical and nonmedical expenditure, and lost income were collected.

Results:

Of 41 patients enrolled and followed for 6 months, HIV treatment toxicity and opportunistic infections were reported by 12 (29%) and 13 (31.7%) patients, respectively. The median total costs, direct costs, and out-of-pocket expenditure were Indian rupees (INR) 9418 (US$181), 8727 (US$168), and 7157 (US$138), respectively. Diagnostic tests accounted for 58% of the expenses. HIV treatment accounted for 34% of the median income earned INR 21 000 (US$404). Expenditure for treatment with toxicity was 44% higher than without toxicity.

Conclusion:

Current treatment is associated with toxicity, increasing treatment costs and imposing a significant economic burden.
Highly electronegative LDL from patients with ST-elevation myocardial infarction triggers platelet activation and aggregation
Authors: Chan Hua-Chen , Ke Liang-Yin , Chu Chih-Sheng , Lee An-Sheng , Shen Ming-Yi , Cruz Miguel A. , Hsu Jing-Fang , Cheng Kai-Hung , Chan Hsiu-Chuan Bonnie , Lu Jonathan , Lai Wen-Ter , Sawamura Tatsuya , Sheu Sheng-Hsiung , Yen Jeng-Hsien , Chen Chu-Huang
Published: September 2013

Key Points

Highly electronegative LDL (L5), which is elevated in patients with STEMI, induces platelet activation and aggregation through LOX-1. L5 may have a role in promoting thrombogenesis that leads to STEMI.
Strong population genetic structuring in an annual fish, Nothobranchius furzeri, suggests multiple savannah refugia in southern Mozambique
Authors: Bartáková Veronika , Reichard Martin , Janko Karel , Polačik Matej , Blažek Radim , Reichwald Kathrin , Cellerino Alessandro , Bryja Josef
Published: September 2013

Background

Intraspecific genetic variation of African fauna has been significantly affected by pronounced climatic fluctuations in Plio-Pleistocene, but, with the exception of large mammals, very limited empirical data on diversity of natural populations are available for savanna-dwelling animals.Nothobranchius furzeriis an annual fish from south-eastern Africa, inhabiting discrete temporary savannah pools outside main river alluvia. Their dispersal is limited and population processes affecting its genetic structure are likely a combination of those affecting terrestrial and aquatic taxa.N. furzeriis a model taxon in ageing research and several populations of known geographical origin are used in laboratory studies. Here, we analysed the genetic structure, diversity, historical demography and temporal patterns of divergence in natural populations ofN. furzeriacross its entire distribution range.

Results

Genetic structure and historical demography ofN. furzeriwere analysed using a combination of mitochondrial (partial cytochromebsequences, 687 bp) and nuclear (13 microsatellites) markers in 693 fish from 36 populations. Genetic markers consistently demonstrated strong population structuring and suggested two main genetic groups associated with river basins. The split was dated to the Pliocene (>2 Mya). The northern group inhabits savannah pools across the basin of the intermittent river Chefu in south-western Mozambique and eastern Zimbabwe. The southern group (from southernmost Mozambique) is subdivided, with the River Limpopo forming a barrier (maximum divergence time 1 Mya). A strong habitat fragmentation (isolated temporary pools) is reflected in significant genetic structuring even between adjacent pools, with a major influence of genetic drift and significant isolation-by-distance. Analysis of historical demography revealed that the expansion of both groups is ongoing, supported by frequent founder effects in marginal parts of the range and evidence of secondary contact between Chefu and Limpopo populations.

Conclusions

We demonstrated: (1) ancient (pre-Pleistocene) divergence between the two mainN. furzerilineages, their recent secondary contact and lack of reproductive isolation; (2) important genetic structuring attributed to the fragmented nature of their environment and isolation-by-distance, suggesting that dispersal is limited, occurs over short distances and is not directly associated with river routes; (3) an apparent role of the River Limpopo as a barrier to dispersal and gene flow.