bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpreting rights and duties after mass violence
Authors: Vollhardt Johanna Ray
Published: March 2012

In our age of human rights, there has been an increased focus not only on the rights of people and collectives harmed through mass atrocities and other injustices, but also on the duty to redress this harm. Building on Passini’s (2011) call for an integration of rights and duties through responsibility, I argue that movements in this direction are already underway. This integration follows, for example, from growing recognition of the complexity in victim and perpetrator roles. Another way in which integration of rights and duties in the aftermath of mass violence has occurred is through alternative meanings of ingroup victimization drawn by victim groups throughout the world. Specifically, based on a sense of inclusive victim consciousness, some have expressed and advocated perceived responsibility to ensure rights for other victim groups as well. This phenomenon is an example of the moral inclusion and focus on responsibility that Passini (2011) argues is necessary in our age of human rights. Examples of moral inclusion among victim groups are reviewed and limitations are discussed, as well as conditions that might inhibit or facilitate a sense of moral responsibility to go beyond individual and ingroup rights and protect others from harm and injustice.
Time for Memory: Beyond Spatial Metaphors?
Authors: Murakami Kyoko
Published: March 2012

This article is a continuous dialogue on memory triggered by Brockmeier’s (2010) article. I drift away from the conventionalization of the archive as a spatial metaphor for memory in order to consider the greater possibility of “time” for conceptualizing memory. The concept of time is central to understanding the nature of human experience as a process in which a constant flux of change in organism, cultural and social practices is observed. Two categories of time have been explored, firstly the Aristotelian, physical time for an experimental paradigm, and secondly, the way in which we experience time in terms of autobiographical memory. The second category of time is discussed, drawing on Augustine and Bergson amongst others. Bergson’s notion of duration has been considered as a promising concept for a better understanding of autobiographical memory. Psychological phenomena such as autobiographical memory should embrace not only spatial dimension, but also a temporal dimension, in which a constant flow of irreversible time, where multiplicity, momentarily, dynamic stability and becoming and emergence of novelty can be observed.
The double uncertainty: Trajectories and professional identity in changing contexts
Authors: Marsico Giuseppina
Published: March 2012

People do not live in fixed, immutable contexts; neither are their life-trajectories uniform. On the contrary, people experience discontinuities, breaks and transitions at various points in their lives, including their professional lives. The fundamental requirement for a transition is a social and cultural relocation, accompanied by the challenging, reworking or abandoning of former valid identities, routines and representations of reality. The construct of transition can be usefully applied to the study of professional trajectories, by offering a perspective that takes into account the dynamicity and uncertainty imposed by the change in professional practices, not just on the activities that take place in professional contexts, but also on the definition/redefinition/negotiation of individual professional identity. This paper suggests an intrinsic “dual uncertainty” of both the context and the individual during the change processes of professional trajectories. The paper provides a complementary outlook to the points raised in Daniels’ (2011) article on the mutual shaping of human action and institutional settings. Taking Daniels’ approach as a basis, it is possible to broaden the analysis of professional trajectories within rapidly-changing occupational settings, by adopting a perspective that takes into account the inherent open-ended nature of socio-cultural phenomena, the fluidity of living contexts, the permeability of the boundaries within which transitions take place and trajectories evolve, as well as the impact of these aspects on professional identity and on its role in processes of change.
Contrasting Vygotsky’s and Bakhtin’s approaches to consciousness
Authors: Cornejo Carlos
Published: March 2012

Matusov (2011) sustains that Vygotsky and Bakhtin represent irreconcilable theoretical approaches. In his view, Vygotsky’s model is monologic and universalist, while Bakhtin’s is dialogic and pluralist. Although the two authors differ importantly, one cannot speak of irreconcilability for two main reasons. First, Vygotsky’s approach is much more multifaceted and even contradictory than usually thought. In fact, his concept of sense echoes the Romanticist claim that experience exceeds the limits of language. Second, a dialogical conception of mind is not outside the reach of Hegelian tradition, which, in Matusov interpretation, is where Vygotsky’s approach comes from. I emphasize that Bakhtin’s unit of analysis is the voice—a concept more sociologic than psychological. “Voice” is insensitive to selfhood and should not be taken as synonymous of “person.” Notwithstanding, Vygotsky and Bakhtin share beliefs with respect to the social constitution of the mind that allow including them in the same research program.
A cultural analysis is necessary in understanding intersubjectivity
Authors: Correa-Chávez Maricela , Roberts Amy L D
Published: March 2012

In this commentary we argue that in order to understand how joint understanding arises out of activity, a cultural examination of communication and interaction must be included in the analysis. In their article “The tension between dialogicality and interobjectivity in cooperative activities,” Talamo and Pozzi (2011) argue that intersubjectivity should be thought of as a process that occurs in group interaction and collaboration. We agree with the authors that intersubjectivity is not something that is located inside people’s heads and that intersubjectivity is not “mind reading.” However, we argue that their plan of analysis lacks an examination of the cultural milieu in which both the personal and the social happen. By not bringing a cultural lens to bear in their analysis they have privileged verbal interactions and painted an incomplete picture of the phenomenon. We provide evidence from cultural comparative work on the different ways that joint understanding and joint activity can be viewed culturally to highlight how cultural understandings of communication are key in interaction.
Evidence-based practice and related information literacy skills of nurses in Singapore: An exploratory case study
Authors: Mokhtar Intan Azura , Majid Shaheen , Foo Schubert , Zhang Xue , Theng Yin-Leng , Chang Yun-Ke , Luyt Brendan
Published: March 2012

Increased demand for medical or healthcare services has meant that nurses are to take on a more proactive and independent role intending to patients, providing basic treatment and deciding relevant clinical practice. This, in turn, translates into the need for nurses to be able to translate research and evidence into their practice more efficiently and effectively. Hence, competencies in looking for, evaluating, synthesizing and applying documented information or evidence-based practice becomes crucial. This article presents a quantitative study that involved more than 300 nurses from a large government hospital in Singapore. A self-reporting questionnaire was developed to collect data pertaining to evidence-based practice and activities, including those that demonstrate information literacy competencies. Results seem to suggest that the nurses preferred to use print and human information sources compared to electronic information sources; were not proactive in looking up research or evidence-based information and, instead, preferred such information to be fed to them; and that they perceived they lacked the ability to evaluate research papers or effectively search electronic information related to nursing or evidence-based practice. It was also found that more than 80% of the nurses have not had any training related to evidence-based practice.
Planning and professionalism: Knowledge, judgement and expertise in English planning
Authors: Vigar Geoff
Published: March 2012

Planning has struggled with its identity as a profession. This has made planning systems vulnerable in the face of attacks on their utility. Sue Hendler was a passionate advocate of planning and its claims to professional status. Building on her writing, I argue that planning’s claims to professional status and expertise have validity. Judged against other professions, planners’ claims are of equal status, grounded as they are in the generation and melding of knowledge and knowledge claims and in the exercising of non-routinised judgement in issues pertaining to place and space. Planning practice and education needs to recognise this reality more explicitly.
Dynamic daylight performance data for plants in four-sided atria
Authors: Kim JH , Song KD
Published: March 2012

An atrium creates indoor conditions mimicing outdoor space. One effective method for creating outdoor-like conditions is landscaping using various plants. This study aims to provide building designers with daylight availability data for plants in atria. With the Daysim program, which uses weather data for Incheon, Korea, the daylight autonomies (DAs) of four-sided open-top atria for 112 cases were determined according to the geometry and orientation. The main geometric indices adopted were the aspect ratio (AR) and the plan aspect ratio (PAR). The results show that the DAs for 750 lx and 1000 lx were negligibly affected by the atrium shape, while the DA for 2000 lx was notably affected by the AR. The impacts of the PAR and orientation on the DA for 2000 lx were prominent in atrium wells with ARs of 0.36.
Citizenship education as an educational outcome for young people in care: A phenomenological account
Authors: Spiteri Damian
Published: March 2012

This qualitative study presents a retrospective analysis of how a cohort of young men, who as boys were assigned to residential care in Malta, perceive the citizenship education that they received while ‘in care’ as having empowered them – as boys, adolescents, and eventually as young adults. Rather than focusing on citizenship education that is derived from formal schooling, this study is focused on analysing the meaning that the participants attributed to experiences of daily living at the care home alongside the cooperative activities that were organized for them by the staff so as to enable them to learn about one another, share responsibilities, and develop feelings of group-solidarity among themselves. The study thereby explores whether the participants see themselves as having an increased repertoire of social competencies, including cooperative decision-making and the ability to forge effective interpersonal relationships, as a result of their being in care. Using an ecosystemic approach, it looks into how other related agents of socialization including their schooling also had a bearing on their lives. The study uses interviews and focus groups to give the particpants a ‘voice’ in describing reality as they perceive and understand it. It shows that, to provide meaningful citizenship education to vulnerable, at-risk children and young people, it is important that they are provided with skills and opportunities to share personal stories and events with one another, and to support each other’s growth. Since boys in care can be extremely conscious that they are in care, this implies that effort needs to be made to help them foster greater links with the outside community, particularly with their family, friends and other adults. It is therefore recommended that young people in care are given opportunities to develop greater self-confidence as this would allow them to promote greater cohesion among themselves and empower them to be more agentic and proactive in wider society.
Elementary school philosophy: A response
Authors: Wartenberg Thomas E.
Published: March 2012

This article is a response to criticism of my book Big Ideas for Little Kids. The main topics addressed are: Who is the audience for the book? Can people without formal philosophical training can be good facilitators of elementary school philosophy discussions? Is it important to assess attempts to teach philosophy in elementary school? Should philosophy discussions among schoolchildren aim for consensus or is disagreement an acceptable conclusion? I also discuss specific criticisms of the elementary school philosophy course I present, and discuss the goals of doing philosophy with children. Finally, I suggest how the experience of teaching philosophy to young children using picture books can enrich introductory college courses.
The Effects of Workplace Physical Activity Interventions in Men
Authors: Wong Jason Y. L. , Gilson Nicholas D. , van Uffelen Jannique G. Z. , Brown Wendy J.
Published: March 2012

The workplace is cited as a promising setting for physical activity (PA) promotion, but workplace PA interventions tend not to specifically target men. The aim of this article was to review the literature on workplace PA interventions for men and to identify key issues for future intervention development. Articles targeting PA at the workplace were located through a structured database search. Information on intervention strategies and PA outcomes were extracted. Only 13 studies (10.5%) reviewed focused on men, of which 5 showed significant increases in PA. These studies used generic, multicomponent, health promotion strategies with a variety of timeframes, self-report PA measures, and PA outcomes. The systematic review identified that evidence on the effectiveness of workplace PA interventions for men is equivocal and highlighted methodological concerns. Future research should use reliable and valid measures of PA and interventions that focus specifically on men’s needs and PA preferences.
A Comparative Study of School Effectiveness in Aguablanca, Colombia
Authors: Burgess Michael , Dixon Pauline
Published: March 2012

The principal aim of this article is to describe and document a comparison of public and private school effectiveness in the marginalized (often referred to as slum) district of Aguablanca, in the city of Cali, Colombia. The data suggest that teachers and parents are largely satisfied with the current status of education provision in Aguablanca. However in terms of ‘statistically significant’ differences, stakeholder perception of the private sector exceeds that of the public sector for every given indicator. The research suggests that the authorities reconsider their education strategy in light of the positive perceptions associated with the existing system of provision. While it may be necessary to increase system capacity in order to meet the demand, great care should be taken to protect (and even extend) provision for the poor through the existing programme of private school subsidies.
Just like a TV show: Public criminology and the media coverage of ‘hunt for Britain’s most wanted man’
Authors: Rowe Michael
Published: March 2012

The week-long police search for Raoul Moat in Northumbria in northeast England in the summer of 2010 formed a major news event across rolling 24/7 TV stations and newspapers. It is argued that much of the media coverage borrowed heavily from fictional depictions of crime. The boundaries between fictional and news representation are not only blurred by TV shows and movies that adopt a pseudo-verité style imitative of factual reporting but also, the Moat case suggests, by news media that borrow frameworks and formats from fictional media. The paper explores the role of academic commentary in such coverage and the opportunities that this might present for the development of a robust public criminology. It is argued that a better appreciation of the media framing of such events, as outlined in the first part of the paper, is crucial to the development of effective public criminological interventions in media coverage of high-profile criminal incidents.
Children and young people’s missed health care appointments: reconceptualising ‘Did Not Attend’ to ‘Was Not Brought’ – a review of the evidence for practice
Authors: Powell Catherine , Appleton Jane V.
Published: March 2012

The issue of wastage caused by missed appointments features prominently at a time when cost-saving measures become ever more important in the health care economy. Missed appointments are said to cost the NHS in the region of £600 million per annum. Various strategies are being tried and tested to ensure that people attend their appointments (or are in for domiciliary visits) including texting and phoning reminders. Clearly, attending for health care is generally in a person’s best interests. However, in the UK, if appointments are missed, then the usual outcome is a ‘three (or even two) strikes and you are out’ approach with a notification to the General Practitioner.

In this paper we will argue that the seemingly widespread ‘Did Not Attend’ (DNA) routine described above is not appropriate where children and young people are concerned. The issue here is that the child or young person ‘Was Not Brought’ (WNB) to their appointment, rather than the fact that they DNA. This is important, because not only is access to health care their fundamental right (United Nations Convention on the Rights of the Child, 1989: Article 24), but failure to attend for health care is recognised as a child protection issue within statutory definitions of neglect. Failings in presenting children for health care is also known to feature prominently in cases that have reached the threshold for Serious Case Reviews, and this paper summarises the evidence in this respect. We conclude the paper by suggesting that reconceptualising child and young person DNA as WNB will lead to positive interventions to safeguard and promote the welfare of children that go beyond the missed appointment to a move towards the child-centric practice described in recent key reviews.
Affirmation through disability: one athlete’s personal journey to the London Paralympic Games
Authors: Kavanagh Emma
Published: March 2012

Aims: This article explores the personal narrative of a British Paralympic wheelchair tennis player who experienced a spinal cord injury (SCI) following a motorcycle accident in 2001 that left her paralysed from the waist down. The study responds to the call by Swain and French, 1 ; among others, for alternative accounts of disability that demonstrate how life following impairment need not be empty and meaningless, but can actually reflect a positive, if different, social identity.

Methods: This study draws upon life history data to investigate the journey of one athlete who has managed to achieve international sporting success following a life-changing accident. A pseudonym has not been used for this study as the athlete wanted to be named in the research account and for her story to be shared.

Results: A chronological approach was adopted to map the pre- and post-accident recovery process. The account examines life before the trauma, the impact of the accident, the process of rehabilitation and the journey to athletic accomplishment.

Conclusions: Negative views of disability can be challenged if disability is viewed in the context of positive life narratives. The story of one Paralympian demonstrates how an ‘ordinary’ person has made the most of an extraordinary situation and become a world-class athlete. This paper demonstrates that in contrast to typical discourse in disability studies, becoming disabled or living with a disability need not be a tragedy but may on the contrary enhance life and lead to positive affirmation.
Developing a physical activity legacy from the London 2012 Olympic and Paralympic Games: a policy-led systematic review
Authors: Weed Mike , Coren Esther , Fiore Jo , Wellard Ian , Mansfield Louise , Chatziefstathiou Dikaia , Dowse Suzanne
Published: March 2012

Aims: There is no evidence that previous Olympic Games have raised physical activity levels in adult populations. However, it may be premature to assume that this lack of previous evidence for an inherent effect is an indication that there is no potential to proactively harness the Games to generate a physical activity or sport legacy. Given that the political goal of achieving a physical activity legacy had already been set, the policy-led aim of this systematic review was to examine the processes by which the London 2012 Olympic and Paralympic Games might deliver a physical activity (as opposed to sport) legacy.

Methods: Searches were conducted on five databases: SPORTS DISCUS, CINAHL, PsychINFO, MEDLINE and Web of Knowledge.

Results: There are two key findings: first, that communities that are not positively engaged with hosting the 2012 Games in London are likely to be beyond the reach of any initiatives seeking to harness the Games to develop legacies in any area; second, major events such as London 2012 can, if promoted in the right way, generate a ‘festival effect’ that may have the potential to be harnessed to promote physical activity among the least active. The ‘festival effect’ derives from the promotion of the 2012 Games as a national festival that is bigger than and beyond sport, but that is also rooted in the lives of local and cultural communities, thus creating a strong desire to participate in some way in an event that is both nationally significant and locally or culturally relevant.

Conclusions: Physical activity policy makers and professionals should seek to satisfy this desire to participate through providing physical activity (rather than sport) opportunities presented as fun community events or programmes. The key to generating a physical activity legacy among the least active adults through this process is to de-emphasise the sporting element of the 2012 Games and promote the festival element.
Isolated Tarsal Navicular Fracture Dislocation
Authors: Mathesul Ambarish A. , Sonawane Dhiraj V. , Chouhan Varun K.
Published: March 2012

Injuries to the midtarsal joints are rare. They occur in the form of various combinations such as fracture, fracture subluxation, and fracture dislocation. The largest series of 71 cases has been reported by Main and Jowett in 1975. Isolated tarsal navicular dislocations are rare injuries. Being rare, these injuries remain poorly understood. Only few case reports exist, which describe the probable mechanism of injury and optimal treatment. Of the few case reports, only one describes closed reduction with external fixator and percutaneous fixation as the treatment modality. This case report emphasizes the use of external fixation with pins in the calcaneum and not in talus as described by the earlier report.

Levels of Evidence: Therapeutic, Level IV
The Use of Multimedia as an Adjunct to the Informed Consent Process for Ankle Ligament Reconstruction Surgery
Authors: Batuyong Eldridge , Birks Christopher , Beischer Andrew D.
Published: March 2012

Background. Obtaining “informed consent” is an integral aspect of surgery that can be fraught with difficulty. This study assessed the efficacy of a multimedia education tool in improving patients’ understanding when used as an adjunct to the traditional verbal consent process regarding ankle lateral ligament reconstruction surgery. Methods. A total of 56 patients (28 males and 28 females) were recruited with a mean age of 36 years. A standardized verbal discussion regarding surgical treatment was provided to each patient. Understanding was then assessed using a knowledge questionnaire. Subsequently, each patient observed a multimedia educational program following which the knowledge questionnaire was repeated. Additional supplementary questions were then given regarding the ease of understanding and satisfaction with the 2 methods of education delivery. Results. The patients answered 75% of the questions correctly before the multimedia module compared with 88% after it (P < .001). Patients rated the ease of understanding and the amount of information provided by the module highly (9.5 cm and 9.0 cm on a 10-cm Visual Analogue Scale scale, respectively), and 61% of patients considered that the multimedia tool performed as well as the treating surgeon. Conclusion. Multimedia tools used in sequence after a verbal consent resulted in improved patient understanding of pertinent information regarding ankle lateral ligament reconstruction surgery.

Levels of Evidence: Therapeutic Level II.
Emergency Department Usage and Medical Care Needs of Adolescent Participants in a High-Intensity Wrestling Camp
Authors: Hendrickson Marissa A. , Furnival Ronald M. , Anderson Bruce J. , Renaker Anne M. , Gaillard Philippe R. , Roback Mark G.
Published: March 2012

Background: Thousands of children and adolescents attend high-intensity athletic camps each year; the rate and type of injuries sustained are unknown.

Hypothesis: Participants in a high-intensity athletic camp would have significant, identifiable health care needs associated with injuries and illnesses.

Study Design: Retrospective, observational study.

Methods: Acute medical care for camp participants was primarily provided in an academic medical center emergency department (ED). All participants treated in the ED or by a volunteer camp physician were included in the study. Medical and camp records for camp participants were reviewed and described.

Results: In sum, 263 participants attended the high-intensity wrestling camp in 2009. Seventy-eight (30%) were treated in the ED; median age was 15.8 years. Sixteen were seen more than once, totaling 96 visits. Thirty-four percent of visits included x-ray and 25% laboratory studies. Forty-four percent were skin complaints. One patient had methicillin-resistant Staphylococcus aureus infection; none had positive viral skin cultures. Musculoskeletal or facial trauma occurred in 37%, with 5 fractures. Injury rate was 1.9 per 1000 athlete exposures. Overall, 47% of campers sought medical care during camp; 11 (4.2%) left camp early because of illness or injury. Few wrestlers received follow-up care.

Conclusions: Illnesses and injuries requiring medical attention were common in this high-intensity sports camp. While many ED patients could have been treated in a clinic, 50% required ED medical resources for diagnosis or care.
The Female Athlete Triad
Authors: Nazem Taraneh Gharib , Ackerman Kathryn E.
Published: March 2012

Context:

The female athlete triad (the triad) is an interrelationship of menstrual dysfunction, low energy availability (with or without an eating disorder), and decreased bone mineral density; it is relatively common among young women participating in sports. Diagnosis and treatment of this potentially serious condition is complicated and often requires an interdisciplinary team.

Evidence Acquisition:

Articles from 1981 to present found on PubMed were selected for review of major components of the female athlete triad as well as strategies for diagnosis and treatment of the conditions.

Results:

The main goal in treatment of young female athletes with the triad is a natural return of menses as well as enhancement of bone mineral density. While no specific drug intervention has been shown to consistently improve bone mineral density in this patient population, maximizing energy availability and optimizing vitamin D and calcium intake are recommended.

Conclusions:

Treatment requires a multidisciplinary approach involving health care professionals as well as coaches and family members. Prevention of this condition is important to minimize complications of the female athlete triad.
Pitch Velocity Is a Predictor of Medial Elbow Distraction Forces in the Uninjured High School–Aged Baseball Pitcher
Authors: Hurd Wendy J. , Jazayeri Reza , Mohr Karen , Limpisvasti Orr , ElAttrache Neal S. , Kaufman Kenton R.
Published: March 2012

Background:

Medial elbow injuries are common among baseball pitchers. Easily accessed methods to assess medial elbow stress may be useful in identifying individuals with increased injury risk.

Hypothesis:

Pitch velocity (PV) is positively associated with higher medial elbow adduction moments.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Participants included 26 uninjured high school pitchers, 15 to 18 years in age. Three-dimensional data and PV were collected as athletes threw 10 fastballs for strikes to a regulation-distance target. Variables of interest were the normalized peak internal elbow adduction moment and peak PV. Linear regression was performed to evaluate the influence of PV on the adduction moment.

Results:

For the group, mean PV was 71 mph (range, 58-81 mph), and the adduction moment was 0.558 Nm/Ht × mass (range, 0.378-0.723). PV was positively associated with the adduction moment ( P < 0.01, R2= 0.373).

Conclusions:

Talented young pitchers may be more susceptible to elbow injuries as a consequence of a biomechanical coupling between PV and upper extremity joint moments.

Clinical Relevance:

PV may be measured easily and serve as an indicator of medial elbow stress.
Efficacy and safety of insulin lispro protamine suspension as basal supplementation in patients with type 2 diabetes
Authors: Giugliano Dario , Esposito Katherine
Published: March 2012

The three currently marketed long-acting insulin analogs, glargine, detemir and insulin lispro protamine suspension (ILPS), represent the most significant advances in basal insulin supplementation since the 1940s and 1950s and the introduction of the intermediate-acting NPH (neutral protamine Hagedorn) insulin. As injection of NPH insulin lacks chronic maintenance of a steady-state low-level basal insulin during fasting periods, which can also expose patients to unpredictable nocturnal hypoglycemia, long-acting insulin analogs have been developed to overcome this important limitation of NPH insulin. ILPS is a protamine-based, intermediate-acting insulin formulation of the short-acting analog insulin lispro: its pharmacokinetic and pharmacodynamic characteristics are quite similar to the other basal insulin analogs glargine and detemir. In recent head-to-head randomized controlled trials of insulin-naïve patients with type 2 diabetes, ILPS achieved similar glycemic control compared with glargine or detemir. ILPS administered once daily is an effective and safe way to maintain a steady-state low-level basal insulin during night time, not dissimilar from that currently obtained with a one-day glargine or detemir administration.
Transcutaneous Electrical Nerve Stimulation: Mechanisms, Clinical Application and Evidence
Authors: Johnson Mark
Published: March 2012

• Transcutaneous electrical nerve stimulation (TENS) is a non-invasive, inexpensive, self-administered technique to relieve pain. • There are few side effects and no potential for overdose so patients can titrate the treatment as required. • TENS techniques include conventional TENS, acupuncture-like TENS and intense TENS. In general, conventional TENS is used in the first instance. • The purpose of conventional TENS is to selectively activate large diameter non-noxious afferents (A-beta) to reduce nociceptor cell activity and sensitization at a segmental level in the central nervous system. • Pain relief with conventional TENS is rapid in onset and offset and is maximal when the patient experiences a strong but non-painful paraesthesia beneath the electrodes. Therefore, patients may need to administer TENS throughout the day. • Clinical experience suggests that TENS may be beneficial as an adjunct to pharmacotherapy for acute pain although systematic reviews are conflicting. Clinical experience and systematic reviews suggest that TENS is beneficial for chronic pain.
Neuroimaging of Visceral Pain
Authors: Johns Emily , Tracey Irene
Published: March 2012

• Functional neuroimaging allows conscious reporting by human subjects to be related to changes in brain activation during painful stimulation. • Brain regions thought to be involved in the perception of pain include the primary and secondary somatosensory cortex, the anterior cingulate cortex, the prefrontal cortex, the insula and the thalamus. • There are major similarities in how visceral pain and somatic pain are processed by the brain. • No single brain region has been found to be responsible for visceral pain. • Patients with IBS often activate the same brain regions as healthy controls in response to pain, but with differing intensities. • Functional neuroimaging studies have failed to reach a consensus opinion on how the brain processes pain in Irritable Bowel Syndrome.
Opioids, pain and addiction – practical strategies
Authors: Jovey Roman D
Published: March 2012

Summary points

1. Addiction can occur with the repeated exposure of a biogenetically predisposed person to an addictive substance or behaviour.

2. In the patient with pain on opioid therapy, use the ‘4 Cs’ to diagnose addiction.

3. Screening and risk stratification of all patients considered for opioid therapy is a key element of ‘universal precautions’ in pain management.

4. There are a number of established and new screening tools including the CAGE, Opioid Risk Tool and Screener and Opioid Assessment for Patients with Pain, which can be utilized in the office setting.

5. There are a number of potential ambiguous drug-related behaviours that should trigger a re-evaluation by the clinician.

6. Treating the higher-risk patient with opioids requires more assessment, more structure and more monitoring. Written opioid prescribing agreements and urine drug testing can be helpful strategies.

7. Essential documentation includes the ‘6As’: Analgesia, Activity, Adverse effects, Ambiguous drug behaviours, Affect and Adequate prescription information.
Representations About Discrimination Practices in the Education System Built by Gypsies (Ciganos) in the Lisbon Metropolitan Area (Portugal)
Authors: Mendes Maria Manuela
Published: March 2012

In Portugal, Gypsies (Ciganos) are categorized as ethnical and minority group, and they are particularly vulnerable to poverty and social exclusion. There is no doubt that they are one of the groups that rise more antipathy among the other Portuguese. In what concerns the “social images” built by the dominant society, there is a negative evaluation of the Gypsies and this image has persisted and resisted so far. Therefore, Gypsy identity and culture are considered marginal. However, the historical discrimination against Gypsies and the existence of a scarce interaction with the non-Gypsy society are some interesting results coming out from a qualitative study finished in 2006 about social representations and emotions that emerged in discriminatory contexts related with the educational system. One of the main objectives of this article is to find how Gypsies represent the school, the formal education, and the social agents that intervene in this educational context, like teachers, other school workers, and other students (non-Gypsies). It is possible to notice some discourses that revealed negative perceptions and rejection feelings incorporated by some Gypsies. They feel that they are treated like “inferior” persons and not recognized by the whole society.
A Configuration Model of Organizational Culture
Authors: Dauber Daniel , Fink Gerhard , Yolles Maurice
Published: March 2012

The article proposes a configuration model of organizational culture, which explores dynamic relationships between organizational culture, strategy, structure, and operations of an organization (internal environment) and maps interactions with the external environment (task and legitimization environment). A major feature of the configuration model constitutes its well-defined processes, which connect the elements of the model systematically to each other, such as single- and double-loop learning, operationalization of strategies, legitimization management, and so on. The model is grounded in a large review of literature in different research areas and builds on widely recognized models in the field of organization and culture theory. It constitutes a response to the call for new models, which are able to explain and facilitate the exploration of the empirical complexity that organizations face today. The configuration model of organizational culture is of particular interest to scholars who investigate into cultural phenomena and change over time.
Joint effects of birth outcomes and childhood body mass index on respiratory symptoms
Authors: Wang Wen-Hua , Chen Pau-Chung , Hsieh Wu-Shiun , Lee Yungling Leo
Published: March 2012

Thinness in infancy and higher childhood body mass index (BMI) are risk factors for poor respiratory health. However, few studies have examined the joint effects of birth outcomes and childhood BMI on the occurrence of respiratory symptoms.

A total of 78,011 Taiwanese middle-school children were investigated between 1995 and 1996 in a nationwide International Study of Asthma and Allergies in Childhood (ISAAC) survey, with standardised height/weight measurement. Their survey data was compared successfully with the birth registration dataset.

Childhood BMI was positively associated with all respiratory symptoms, with greater effects and significant risks associated with serious phenotypes in the video questionnaire. Children with a history of low birth weight (LBW), those who were born prematurely (pre-term), or those who were small for gestational age (SGA) were also more likely to have allergic respiratory symptoms. As birthweight and gestational age were not positively associated with childhood BMI, we proposed that LBW, pre-term birth and childhood BMI were independent factors for respiratory symptoms.

LBW, pre-term birth and childhood BMI are all independent risk factors for respiratory symptoms in children. Children with a history of LBW, pre-term birth or SGA and a higher current BMI might have larger respiratory burden.
Sleep apnoea, anxiety, depression and somatoform pain: a community-based high-risk sample
Authors: Hrubos-Strøm Harald , Einvik Gunnar , Nordhus Inger Hilde , Randby Anna , Pallesen Ståle , Moum Torbjørn , Omland Torbjørn , Dammen Toril
Published: March 2012

Community-based studies that measure both psychiatric diagnoses and obstructive sleep apnoea (OSA) are lacking. This study reports current psychiatric disorders in community-dwelling adults at high risk for OSA identified by the Berlin Questionnaire. Furthermore, associations between OSA and current psychiatric disorders, unadjusted and adjusted for putative confounders, are reported.

A subsample of the Akershus Sleep Apnoea Project consisting of 290 adults, aged 30–65 yrs, with positive Berlin Questionnaire screening underwent the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, version IV and polysomnography. Auxiliary analyses of depression are provided.

The median apnoea/hypopnoea index score in the sample was 7.7 (interquartile range 2.4–22.2). Major depressive disorder, current anxiety and somatoform pain disorder were diagnosed in 12.4%, 14.8% and 19.3% of participants, respectively. At least one psychiatric disorder was diagnosed in 110 participants. The odds ratio of participants with OSA having a psychiatric disorder compared with participants without OSA was 0.54 (95% CI 0.33–0.88). A negative association did not exist among Berlin Questionnaire low-risk participants.

In conclusion, more than one-third of participants in a community-based, Berlin Questionnaire high-risk sample were diagnosed with a psychiatric disorder. A negative association between OSA and psychiatric morbidity was found.
The EvA study: aims and strategy
Authors: Ziegler-Heitbrock Loems , Frankenberger Marion , Heimbeck Irene , Burggraf Dorothe , Wjst Matthias , Häussinger Karl , Brightling Chris , Gupta Sumit , Parr David , Subramanian Deepak , Singh Dave , Kolsum Umme , Boschetto Piera , Potena Alfredo , Gorecka Dorota , Nowinski Adam , Barta Imre , Döme Balazs , Strausz Janos , Greulich Timm , Vogelmeier Claus , Bals Robert , Hohlfeld Jens M. , Welte Tobias , Venge Per , Gut Ivo , Boland Anne , Olaso Robert , Hager Jörg , Hiemstra Pieter , Rabe Klaus F. , Unmüßig Martina , Müller-Quernheim Joachim , Prasse Antje
Published: March 2012

The EvA study is a European Union-funded project under the Seventh Framework Programme (FP7), which aims at defining new markers for chronic obstructive pulmonary disease (COPD) and its subtypes. The acronym is derived from emphysemaversusairway disease, indicating that the project targets these two main phenotypes of the disease. The EvA study is based on the concept that emphysema and airway disease are governed by different pathophysiological processes, are driven by different genes and have differential gene expression in the lung. To define these genes, patients and non-COPD controls are recruited for clinical examination, lung function analysis and computed tomography (CT) of the lung. CT scans are used to define the phenotypes based on lung density and airway wall thickness. This is followed by bronchoscopy in order to obtain samples from the airways and the alveoli. These tissue samples, along with blood samples, are then subjected to genome-wide expression and association analysis and markers linked to the phenotypes are identified. The population of the EvA study is different from other COPD study populations, since patients with current oral glucocorticoids, antibiotics and exacerbations or current smokers are excluded, such that the signals detected in the molecular analysis are due to the distinct inflammatory process of emphysema and airway disease in COPD.
The minimal important difference for residual volume in patients with severe emphysema
Authors: Hartman Jorine E. , ten Hacken Nick H.T. , Klooster Karin , Boezen H. Marike , de Greef Mathieu H.G. , Slebos Dirk-Jan
Published: March 2012

Residual volume (RV) measured by body plethysmography is a routine measurement in clinical pulmonary practice and is often an important outcome variable in clinical trials. However, it is not known what size of improvement can be regarded as being important in severe emphysema patients. Therefore, the aim of the study is to establish the minimal important difference (MID) for RV in severe emphysema patients undergoing bronchoscopic lung volume reduction.

91 severe emphysema patients were included. RV and total lung capacity (TLC) were measured by body plethysmography. MID estimates were calculated by anchor-based and distribution-based methods. Forced expiratory volume in 1 s, 6-min walk distance and St George’s Respiratory Questionnaire total score were used as anchors and Cohen’s effect size was used as distribution-based method.

The calculated MID estimates according to the different anchors and methods ranged between -0.31 and -0.43 L for RV, -6.1 and -8.6% for percentage change in RV (RV%) from baseline, and -2.8 and -4.0% for RV/TLC.

These MID estimates are useful for sample size determination in new studies on interventions aimed at reducing RV and for interpreting the results from clinical trials in severe emphysema patients.
Deciphering neo-sex and B chromosome evolution by the draft genome of Drosophila albomicans
Authors: Zhou Qi , Zhu Hong-mei , Huang Quan-fei , Zhao Li , Zhang Guo-jie , Roy Scott W , Vicoso Beatriz , Xuan Zhao-lin , Ruan Jue , Zhang Yue , Zhao Ruo-ping , Ye Chen , Zhang Xiu-qing , Wang Jun , Wang Wen , Bachtrog Doris
Published: March 2012

Background

Drosophila albomicans is a unique model organism for studying both sex chromosome and B chromosome evolution. A pair of its autosomes comprising roughly 40% of the whole genome has fused to the ancient X and Y chromosomes only about 0.12 million years ago, thereby creating the youngest and most gene-rich neo-sex system reported to date. This species also possesses recently derived B chromosomes that show non-Mendelian inheritance and significantly influence fertility.

Methods

We sequenced male flies with B chromosomes at 124.5-fold genome coverage using next-generation sequencing. To characterize neo-Y specific changes and B chromosome sequences, we also sequenced inbred female flies derived from the same strain but without B's at 28.5-fold.

Results

We assembled a female genome and placed 53% of the sequence and 85% of the annotated proteins into specific chromosomes, by comparison with the 12 Drosophila genomes. Despite its very recent origin, the non-recombining neo-Y chromosome shows various signs of degeneration, including a significant enrichment of non-functional genes compared to the neo-X, and an excess of tandem duplications relative to other chromosomes. We also characterized a B-chromosome linked scaffold that contains an actively transcribed unit and shows sequence similarity to the subcentromeric regions of both the ancient X and the neo-X chromosome.

Conclusions

Our results provide novel insights into the very early stages of sex chromosome evolution and B chromosome origination, and suggest an unprecedented connection between the births of these two systems in D. albomicans.
Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study
Authors: Higgins Angela Y , B Doubeni Anna R , Phillips Karon L , Laiyemo Adeyinka O , Briesacher Becky , Tjia Jennifer , Doubeni Chyke A
Published: March 2012

Background

The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians.

Methods

Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main outcome was the percentage of patients screened in 2007. We also examined the percentage of patients offered screening.

Results

Patients of FPs, compared to those of internists, were less likely to have received an FOBT kit or undergone home FOBT, even after accounting for patients' characteristics. Compared to internists, FPs' patients were more likely to have heard of colonoscopy, but were less likely to receive a screening colonoscopy recommendation (18% vs. 27%), or undergo a colonoscopy (43% vs. 46%, adjusted odds ratios [AOR], 95% confidence interval [CI]-- 0.65, 0.51-0.81) or any CRC screening (52% vs. 60%, AOR, CI--0.80, 0.68-0.94). Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%), while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%).

Conclusion

Patients cared for by FPs had a lower rate of screening compared to those cared for by internists, despite equal or higher levels of awareness; a difference that remained statistically significant after accounting for socioeconomic status and access to healthcare. Both groups of patients remained below the national goal of 70 percent.