bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Outcome of Arthroscopic Repair with Concomitant Manipulation in Rotator Cuff Tears with Stiff Shoulder
Authors: Cho Nam Su , Rhee Yong Girl
Published: June 2008

Background

Little has been reported on treatment of rotator cuff tears with shoulder stiffness.

Hypothesis

Rotator cuff tears with shoulder stiffness will show worse clinical results than will tears without stiffness. Those with stiffness are expected to take longer time in pain reduction and recovery of range of motion.

Study Design

Case control study; Level of evidence, 3.

Methods

Among patients who underwent arthroscopic rotator cuff repairs, 15 cases with preoperative shoulder stiffness (group A) and 30 without shoulder stiffness (group B) were enrolled in this study. Preoperative mean forward flexion was 118.3° in group A and 163.4° in group B, whereas external rotation at the side was 34.6° and 55.0°, respectively. The mean follow-up period of group A was 29.8 months (range, 19.5-73.9 months) and 32.4 months (range, 16–0.6 months) in group B.

Results

The mean visual analog scale during motion at the last follow-up was 0.75 in group A and 0.76 in group B ( P = .942). The mean University of California at Los Angeles score was, respectively, 33.1 and 33.2 points ( P = .561). Forward flexion was 166.7° in group A and 170.2° in group B, whereas external rotation at the side was 48.8° and 53.4°, respectively ( P = .157 and .384, respectively). However, the 2 groups showed a significant difference in forward flexion until 1 year postoperatively as group A recovered more slowly ( P = .021). Both groups showed significant differences in external rotation at the side, internal rotation to the back, and cross-body adduction until 6 weeks postoperatively ( P = .009, P < .001, and P = .026, respectively).

Conclusion

Pain, range of motion, muscle strength, and function all significantly improved after arthroscopic rotator cuff repair, regardless of the presence of shoulder stiffness. Patients with full-thickness rotator cuff tears and stiffness of the shoulder can be treated with a single surgery and concomitant manipulation with overall good results. Although final outcomes were as good as those in patients without stiffness, the return of range of motion took longer in those patients undergoing manipulation for stiffness of the shoulder.
Sports Participation after Shoulder Replacement Surgery
Authors: McCarty Eric C. , Marx Robert G. , Maerz Deb , Altchek David , Warren Russell F.
Published: June 2008

Background

Return to sports after total hip or knee replacement surgery has been extensively described. However, the return to general sporting activities after shoulder replacement surgery has not been well documented. With improved implant survivorship, patient expectation of function is high.

Purpose

The purpose of this study was to assess the outcome and ability of patients returning to sports after shoulder replacement surgery.

Study Design

Case series; Level of evidence, 4.

Methods

Seventy-five patients (86 shoulder replacements) who participated in sports or recreational activities before surgery were followed for a minimum of 2 years. Their preoperative and postoperative sports participation and level of competition were assessed. The frequency of their activity, modifications in activity, and length of time it took to resume sports participation after the operation were all reviewed.

Results

The mean age at follow-up was 65.5 years (range, 24-88). The average follow-up was 3.7 years (range, 2-9.4). Sixty-four percent of the patients stated that one of the reasons they had the surgery performed was participation in sports. Thirty-four of 48 of these patients (71 %) demonstrated an improvement in their ability to play their sport and 50% increased their frequency of participation postoperatively. Softball athletes demonstrated the least favorable return; only 2 of 10 patients returned. Swimming, tennis, and golf were the most popular sports; participants in these sports showed the most favorable improvement and actual return. The mean time to partial return to sports was 3.6 months, and 5.8 months to full participation.

Conclusion

Patients are able to successfully return to sports after shoulder arthroplasty. Many returned with improved performance and increased frequency in participation in a timely manner.
Kinematic Evaluation of the Modified Weaver-Dunn Acromioclavicular Joint Reconstruction
Authors: LaPrade Robert F. , Wickum Daren J. , Griffith Chad J. , Ludewig Paula M.
Published: June 2008

Background

Few reconstructive methods to treat displaced acromioclavicular separations have been evaluated using kinematic data.

Hypothesis

The modified Weaver-Dunn reconstruction restores intact acromioclavicular joint motion during passive scapular plane abduction.

Study Design

Controlled laboratory study.

Methods

Acromioclavicular joint motion was recorded during passive humeral elevation in 3 states: an intact shoulder, an “injured” state in which the acromioclavicular and coracoclavicular ligaments were transected, and finally in a reconstructed state using a modified Weaver-Dunn reconstruction. Measurements were taken with an electromagnetic motion analysis system attached to rigid pins placed in the clavicle, scapula, humerus, and sternum during passive scapular plane humeral elevation.

Results

Total translatory motion of the acromioclavicular joint in the cut state was significantly greater than both the intact and reconstructed states in the medial/lateral (intact, 4.3 mm; cut, 7.9 mm; reconstructed, 2.6 mm), anterior/posterior (intact, 4.8 mm; cut, 6.1 mm; reconstructed, 4.9 mm), and superior/inferior (intact, 4.1 mm; cut, 8.0 mm; reconstructed, 4.8 mm) directions. The maximum and minimum positions of the reconstructed state were significantly more anterior and inferior than in the intact state. A significant increase in acromioclavicular axial rotation was also found between the intact and cut state.

Conclusion

The modified Weaver-Dunn reconstruction was found to restore motion of the acromioclavicular joint to near-intact values, but created a more anterior and inferior position of the clavicle with respect to the acromion.

Clinical Relevance

These kinematic data support the modified Weaver-Dunn reconstruction as a kinematically sound procedure to treat displaced acromioclavicular joint injuries.
Short-Term Effects of a Self-Management Intervention on Health Status of Housebound Older Adults With Arthritis
Authors: Laforest Sophie , Nour Kareen , Gignac Monique , Gauvin Lise , Parisien Manon , Poirier Marie-Christine
Published: June 2008

This study examines the impact of a self-management intervention for housebound adults with arthritis and presence of moderating variables. A total of 113 adults with a mean age of 77.7 years and diagnosed with osteoarthritis (62%) or rheumatoid arthritis (38%) were randomized to intervention ( n = 65) and control groups ( n = 48). Information on health, self-efficacy, outcome expectations, and health behaviors was collected (a) at baseline, (b) 2 months later, and (c) following the intervention. Multilevel analysis reveals that experimental group participants reported significantly fewer functional limitations and less helplessness than control participants postintervention. A trend for improved coping effectiveness was observed ( p = .06). Greater improvements in outcome expectations and physical behaviors were associated with greater decreases in helplessness. Larger improvements in outcome expectations were associated with greater decreases in functional limitations. A structured self-management intervention can have a positive impact on the health status of housebound adults with arthritis.
Satisfaction Among Current Doctoral Students in Special Education
Authors: Wasburn-Moses Leah
Published: June 2008

Despite the growing demand for professionals with doctoral degrees in special education, doctoral programs are not producing enough graduates to fulfill this need. Although large attrition rates exist in doctoral study across discipline, very little is known about the attrition or satisfaction of doctoral students in special education. This article reports the results of a nationwide satisfaction survey of 619 students from 78 doctoral programs. Findings indicate that students appear generally satisfied with their programs. However, areas of concern include program structure, overall workload, and quality of preparation in research. Implications for doctoral programs are presented.
A Comparison of Outcomes Associated With Two Key Law-Enforcement Grant Programs
Authors: Lilley David , Boba Rachel
Published: June 2008

Local Law Enforcement Block Grants (LLEBG) have recently been expanded under a new name to become the central federal funding stream for local law enforcement agencies, whereas programs facilitated by the Office of Community-Oriented Policing Services (COPS) have been greatly reduced. However, little is known about crime reduction and arrest-related outcomes associated with multipurpose law enforcement block grants. This study examined data from 11,559 jurisdictions throughout the United States to identify outcomes that were associated with the LLEBG program. Findings indicated that LLEBG's were associated with crime reductions that were similar in size to those of COPS hiring grants. However, the effects of LLEBG on patterns of arrest were opposite from those associated with COPS hiring grants. Given the differential outcomes associated each grant, there may be utility in retaining both COPS and LLEBG programs.
Cesarean Delivery as a Barrier for Breastfeeding Initiation: The Puerto Rican Experience
Authors: Pérez-Ríos Naydi , Ramos-Valencia Gilberto , Ortiz Ana Patricia
Published: June 2008

The study's objective was to examine the relationship between cesarean section delivery and the initiation of breastfeeding in a representative sample of 1695 Puerto Rican women aged 15 to 49 years, who delivered their last healthy singleton child in Puerto Rico between 1990 and 1996. Secondary analysis of data collected in the population-based cross-sectional study Puerto Rico Reproductive Health Survey was performed. Bivariate and multivariate logistic regression analyses were used to examine the crude and covariate adjusted association between type of childbirth and initiation of breastfeeding. Overall, 36% of all births were performed by cesarean section, while initiation of breastfeeding was achieved by 61.5% of the women. Cesarean section was negatively related to breastfeeding initiation in multivariable logistic regression models (odds ratio = .64; 95% CI = 0.51-0.81) after controlling for confounding variables. Intervention programs that aim to promote breastfeeding and that provide special assistance to women undergoing this procedure should be developed.
Phenomenology in Pediatric Cancer Nursing Research
Authors: Fochtman Dianne
Published: June 2008

What does it mean to have cancer as a child or adolescent? To understand this, researchers must study the illness from the child's point of view and listen to these children's descriptions of their “lived world.” Phenomenology is a qualitative research methodology that can be used to discover and interpret meaning. To use phenomenology congruently, the philosophical background must be understood as well as the adaptation of the philosophical basis to research in the caring sciences. Only when clinicians truly understand the meaning of this illness to the child can they design nursing interventions to ease suffering and increase quality of life in children and adolescents with cancer.
Antibiotics in 30 Minutes or Less for Febrile Neutropenic Patients: A Quality Control Measure in a New Hospital
Authors: Corey Amy L. , Snyder Stacy
Published: June 2008

Infections are the most common complication in patients receiving treatment for cancer with neutropenia being the primary risk factor for the development of an infection. In the neutropenic patient, bacteremia remains a significant cause of mortality. Although the literature reports that prompt empiric antibiotic therapy to prevent death caused by virulent organisms is the standard of care, the literature fails to identify what prompt antibiotic administration means. Door/fever-to-patient antibiotic delivery was evaluated as a quality control measure in a new children's hospital. Initially, door/fever-to-patient time was significantly delayed. Collaboration between pharmacy, hospital bed control, medical, and nursing staff resulted in many changes in practice by all groups. As a result, the goal for prompt antibiotic delivery of thirty minutes or less is now achievable.
Talking With Others Who “Just Know”: Perceptions of Adolescents With Cancer Who Participate in a Teen Group
Authors: Cassano Jane , Nagel Kim , O'Mara Linda
Published: June 2008

Adolescents with cancer have social support needs that are challenging to meet. A qualitative descriptive study was done using in-person interviews with 11 participants between the ages of 14 and 20. The purpose of the study was to explore and describe adolescent's perceptions of a teen support group. Two main themes emerged: Satisfying Elements and Challenges in the teen group. The subthemes under Satisfying Elements include participants being able to talk to others who “just know,” sharing experiences while having fun as a normal teenager, and giving or receiving inspiration. Subthemes under Challenges as identified by participants include ensuring that activities during teen events meet the needs of all participants and dealing with the death of a group member. Study findings suggest that adolescent's feel supported when they are among others in similar circumstances while engaging in normal activity. Offering this type of group for adolescents with cancer provides them with the ongoing opportunities for connection with their peers that is often needed throughout the treatment journey.
Using Plain Language Skills to Create an Educational Brochure About Sperm Banking for Adolescent and Young Adult Males With Cancer
Authors: Nagel Kim , Wizowski Lindsay , Duckworth JoAnn , Cassano Jane , Hahn Shirley Ann , Neal Michael
Published: June 2008

Writing in plain language makes it easier for patients to read, understand, and make informed decisions about sperm banking. Greater attention to the issue and properly designed educational brochures for use by nurses in oncology and reproductive health is of evident importance but of unknown impact. A multidisciplinary clinical team followed an evidence-based, patient-centered approach to develop “plain language” patient education materials about sperm banking for adolescent and young adult (AYA) males with cancer. A patient education booklet was produced and implemented as part of the planned patient education for AYA male oncology patients at McMaster Children's Hospital, Hamilton Health Sciences, in Hamilton, Ontario, Canada. The patient education booklet for use by health professionals as a teaching tool to facilitate discussion with AYA males has been produced with the hope that it will contribute to better informed decision making regarding sperm banking and increased use of this technology for fertility preservation.
The Role of the Long-Term Follow-up Clinic in Discovering New Emerging Late Effects in Adult Survivors of Childhood Cancer
Authors: Meeske Kathleen A. , Nelson Mary Baron
Published: June 2008

Our understanding of late effects in long-term survivors of childhood cancer is continually evolving as significant numbers of survivors are entering middle to later adulthood. Effects of conventional treatment on premature aging are being recognized, as are long-term effects of newer therapies. Clinicians in long-term follow-up clinics are in a unique position to monitor for recognized late effects and to be alert to signs and symptoms of late effects that have not been previously reported in the pediatric cancer literature. This article presents 2 young adult survivors who displayed subtle signs of impaired cerebral blood flow due to carotid artery stenosis many years after being treated with neck irradiation. When the first patient presented nearly a decade ago in the clinic with symptoms, premature carotid artery disease was not a radiation-related late effect that had been reported previously in survivors of childhood cancer. These cases are used to illustrate the key role of long-term follow-up clinics in identifying new and emerging treatment-related late effects and underscore the importance of lifetime surveillance and the need for collaboration between pediatric and adult health care providers.
Examining the Push—Pull Method of Blood Sampling From Central Venous Access Devices
Authors: Adlard Kathleen
Published: June 2008

The placement of a central venous access device (CVAD) has revolutionized supportive care for pediatric cancer patients. The CVAD is used to administer chemotherapy/biotherapy, blood products, total parenteral nutrition, antibiotics, and many other supportive medications. CVADs also provide the ability to obtain blood samples without the trauma associated with venipuncture. Frequent blood sampling is often needed to monitor the side effects and response of the cancer treatment. Unfortunately, the most common method requires discarding blood (0.5-10 mL, depending on the institution's protocol) with each lab draws, for various reasons. For pediatric oncology patients, this can result in a large volume of blood being discarded and subsequently increase the need for blood transfusions. Repeated exposure to allogeneic (donor) blood products can put this patient population at additional risk for alloimmunization and febrile reactions. The purpose of this study is to test the limits of agreement between laboratory values (chemistry panel 18 and complete blood count) obtained using the push—pull and standard methods of blood sampling from CVADs in pediatric oncology patients.
The Effect of Blakely v. Washington on Upward Departures in a Sentencing Guideline State
Authors: Iannacchione Brian , Ball Jeremy D.
Published: June 2008

The Supreme Court's decision in Blakely v. Washington was a landmark decision, ruling that juries must determine facts before judges can increase sentences above the sentencing guideline maximum—known as upward departures. Because one of the purposes of sentencing guidelines was to reduce discretion—and, thereby, unwarranted disparity—it is hypothesized extralegal factors will have less impact on upward departures after Blakely compared to before Blakely. Upward departures and their determinants were analyzed 27 months before and after Blakely, utilizing a disproportionate stratified random sample. Although the likelihood of upward departures was diminished after Blakely , extralegal factors did not incur differential effects. Both age and gender of the defendant were found to have statistically significant effects ( p < .05) before and after Blakely. Although this study is only an explorative step, it is an important step to start addressing any potential effects of this landmark decision on sentencing reform efforts.
Disability Harassment Observed by Teachers in Special Education
Authors: Holzbauer Jerome J.
Published: June 2008

The occurrence and impact of disability harassment of students in special education apparently have a low priority for official policy makers and education administrators. Literature on policies of generic school bullying, one state's prohibition of pupil harassment, and a federal memorandum of school-based disability harassment are reviewed. The purpose of this preliminary study is to investigate observed occurrences of harassment of students with disabilities based on 15 specific types of harassment conduct and explore potential policy implications of such conduct. Ninety special education teachers from a large public school district reported on their direct observations of harassment of their students. The most frequently reported types that occur “many times” in rank order include epithets, slurs, mimicking, mockery, and staring. Overall, 96.7% of the participants report that they observed more than one incident of these types of school-related disability harassment conduct. Implications, study limitations, and recommendations for research and policy are discussed.
Participants in the Medicaid Buy-In Program, 2000–2004
Authors: Su Liu  , Ireys Henry T. , Thornton Craig
Published: June 2008

The Medicaid Buy-In program, a state Medicaid option since the late 1990s, is designed to encourage adults with disabilities to work by allowing them to buy into Medicaid when their earnings are above the standard Medicaid eligibility limits. This study provides a descriptive profile of enrollment, expenditures, and earnings for Buy-In participants in 27 states between 2000 and 2004. Analyses indicate that younger participants receiving no federal income support when they enroll in the Buy-In program have higher earnings compared with older participants receiving Social Security Disability Insurance payments. The innovative process used in this study to link data from multiple agencies could be adapted for exploring other policy issues related to the employment of individuals with disabilities.
Resolving End-of-Life Ethical Concerns: Important Palliative Care Practice Development Issues for Acute Medicine in Australia
Authors: McGrath Pam , Henderson David
Published: June 2008

Historically palliative care research has focused on issues associated within the hospice and palliative care system. The findings presented in this manuscript reverse this assumption to argue that significant palliative care issues can only be understood if the focus is on the acute care system. Although a major proportion of deaths happen in the acute hospital setting, the acute care clinicians are the gate keepers to the palliative system. In short, understanding the ethical decision making of acute care professionals in relation to end-of-life care can illuminate many important palliative care practice development issues. The findings indicate that all professional groups in this study of an acute medical ward find end-of-life issues the most challenging of all the ethical challenges.
Acupuncture Is Underutilized in Hospice and Palliative Medicine
Authors: Standish Leanna J. , Kozak Leila , Congdon Sean
Published: June 2008

Acupuncture is a complementary and alternative medical modality. A considerable body of acupuncture research has accumulated since 1998. Acupuncture has been integrated into palliative care settings in the United Kingdom but is yet to be widely offered in the United States. The literature was searched to identify clinical trials involving acupuncture, palliative care, hospice, chronic obstructive pulmonary disease, bone marrow, and cancer. Twenty-seven randomized controlled clinical trials of acupuncture were found that reported on conditions common to the hospice and palliative care setting, including dyspnea, nausea and vomiting, pain, and xerostomia, and 23 reported statistically significant results favoring acupuncture use for the conditions investigated. Acupuncture is safe and clinically cost-effective for management of common symptoms in palliative care and hospice patients. Acupuncture has potential as adjunctive care in palliative and end-of-life care, and the evidence warrants its inclusion in reimbursed palliative and end-of-life care in the United States.
Oral Morphine Overdose in a Cancer Patient Antagonized by Prolonged Naloxone Infusion
Authors: Upadhyay Surjya , Jain Roopesh , Chauhan Himanshu , Gupta Deepak , Mishra Seema , Bhatnagar Sushma
Published: June 2008

An 80-year-old male was diagnosed with carcinoma in the lung with multiple bony metastases and had been prescribed pain medications as per World Health Organization analgesic ladder guidelines. However, he was not getting adequate pain relief and there were difficulties in titration of the morphine doses on an outpatient basis. Therefore, he was hospitalized for dose titration of oral morphine and was coprescribed amitriptyline and ranitidine. During the titration of the analgesic dose, he developed severe symptoms of morphine overdose. He was immediately treated with intravenous naloxone. After prolonged infusion of naloxone, he achieved his baseline vital parameters without any permanent sequel to the overdose event. This case report describes the possible causes of oral morphine overdose in the elderly and its successful treatment. To prevent such complications, one has to be very cautious of other factors such as drug interactions, particularly in the elderly.
Family Satisfaction Following the Death of a Loved One in an Inner City MICU
Authors: Kaufer Melanie , Murphy Patricia , Barker Kris , Mosenthal Anne
Published: June 2008

This study examined family satisfaction with end-of-life care in a medical intensive care unit (MICU) before and after a palliative care intervention was implemented there. This intervention consisted of early communication, family meetings, and psychosocial support. Family members of patients who died in the MICU in 2005 and 2006 were contacted 2 to 16 months after the death of their relatives. Trained interviewers used the Family Satisfaction with Care Questionnaire to assess the families' perceptions of the care given to their family members. Minorities comprised 77% of the patient population. Comparison of the levels of family satisfaction in the preintervention and postintervention groups demonstrated that the intervention significantly improved the quality of end-of-life care, particularly through increases in family members' satisfaction with decision making, communication with physicians and nurses, and the death and dying process.
Fatigue in Advanced Cancer: A Prospective Study
Authors: Hauser Katherine , Walsh Declan , Rybicki Lisa A. , Davis Mellar P. , Seyidova-Khoshknabi Dilara
Published: June 2008

Fatigue is a common advanced cancer symptom. Clinical features are not well known. The authors surveyed consecutive patients admitted to a palliative medicine program to identify clinical correlates of fatigue. Data collected included age, sex, performance status, primary site, prior chemotherapy/radiation therapy, and blood transfusions. Visual analogue scales assessed fatigue, quality of life, and ability to perform daily activities. Weight change was estimated. Laboratory results including lactate dehydrogenase and hemoglobin were recorded. Fatigue severity was associated with brain metastases, poor performance status, poor quality of life, and reduced ability to perform activities. Prior radiation therapy was associated with less severe fatigue. Age, sex, and hemoglobin level were not associated with fatigue. Fatigue was universal on referral. Brain metastases and poor quality of life independently predicted severity. Hemoglobin level did not predict fatigue. Further studies are necessary to define the clinical features and relationships of fatigue.
Developing and Financing a Palliative Care Program
Authors: Edens Pat Stanfill , Harvey Catherine D. , Gilden Karen M.
Published: June 2008

Although hospice care to assist the dying is widely available, palliative care, which focuses on living with chronic and life threatening illness and preparing the living for dying, is poorly understood. Only recently, palliative care has been mandated by the Joint Commission on Accreditation of Healthcare Organizations as a necessary intervention for facilities. Defining a palliative care model for the community hospital emphasizes total care for the patient beyond the traditional medical model. No specific Medicare reimbursement exists for palliative care in hospitals, and hospital administrators are generally not supportive of programs where no reimbursement exists. Developing a model palliative care program using a cost aversion financial model to quantify benefits of a palliative care programs is one strategy to address the reimbursement shortcomings.
Management Education in Emerging Economies
Authors: Napier N.K. , Harvey Michael , Usui Kengo
Published: June 2008

Providing management education in countries where poverty is rampant seems a contradiction in terms. Yet it may help the country to develop stronger competitiveness and economic development. The article proposes a tentative framework to show how management education might be implemented in the world's poorest countries. The proposed framework integrates conditions and influences relating to management education, including country environment, with particular emphasis on stage and nature of poverty and openness of educational practices to ideas from outside the country. Finally, the model suggests that outcomes are hard to assess and face many obstacles. The article primarily draws on a decade-long case study within one country in Southeast Asia but also provides observations from other emerging countries in Asia and Africa. The article discusses the challenges of the dream of providing management education—including the length of time and difficulties of infusing concepts and behaviors into developing countries' management education institutions.
Community Context, Personal Contact, and Support for an Anti—Gay Rights Referendum
Authors: Barth Jay , Overby L. Marvin , Huffmon Scott H.
Published: June 2008

Using data from an unusual survey, we gauge factors influencing support for a state anti—gay rights referendum. After controlling for other powerful predictors of attitudes, we find personal contact (especially relevant and voluntary contact) has an important impact on public support, although community context does not. These findings support an integrated notion of interactions with “out” groups, grounded in social categorization theory, that sees community context and interpersonal contact as concentric circles, moving from abstract, detached forms of contact to more pronounced, personal forms. However, even among those with substantial interpersonal contact, support for the referendum was still widespread.
Diverse Disparities
Authors: Beramendi Pablo , Cusack Thomas R.
Published: June 2008

It is widely thought that among the countries in the Organisation for Economic Co-operation and Development (OECD), income inequality has become more widespread over the past decades. The authors show that this image is misleading. The OECD countries remain more diverse in their distributions of labor earnings and disposable income than they are in their distributions of market income. The larger and persistent cross-national variation in the distributions of work-related earnings and disposable income is attributable to the role of political actors (such as unions and political parties) as well as economic institutions. The way in which political parties are able to pursue their goals varies across forms of income. Political parties' capacities to shape the distribution of labor earnings is contingent on the degree of wage-bargaining coordination. In turn, political parties directly affect the distribution of disposable income through their choices about fiscal instruments.
Classification Accuracy of MMPI-2 Validity Scales in the Detection of Pain-Related Malingering
Authors: Bianchini Kevin J. , Etherton Joseph L. , Greve Kevin W. , Heinly Matthew T. , Meyers John E.
Published: June 2008

The purpose of this study was to determine the accuracy of Minnesota Multiphasic Personality Inventory 2nd edition (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) validity indicators in the detection of malingering in clinical patients with chronic pain using a hybrid clinical-known groups/simulator design. The sample consisted of patients without financial incentive ( n = 23), nonmalingering patients with financial incentive ( n = 34), patients definitively determined to be malingering based on published criteria ( n = 32), and college students asked to simulate pain-related disability ( n = 26). The MMPI-2 validity scales differentiated malingerers from nonmalingerers with a high degree of accuracy. Hypochondriasis and Hysteria were also effective. For all variables except Scale L, more extreme scores were associated with higher specificity. This study demonstrates that the MMPI-2 is capable of differentiating intentional exaggeration from the effects on symptom report of chronic pain, genuine psychological disturbance, and concurrent stress associated with pursuing a claim in a medico-legal context.
Self-Reported Use of Different Forms of Aggression in Late Adolescence and Emerging Adulthood
Authors: Verona Edelyn , Sadeh Naomi , Case Steve M. , Reed Americus , Bhattacharjee Amit
Published: June 2008

Two studies investigated the psychometric properties of a self-report measure of commonly recognized forms of aggression (FOA) that could be used to efficiently gather aggression data in large samples. EFA and CFA in Study 1 suggested that a five-factor model (Physical, Property, Verbal, Relational, and Passive—Rational) best represented the data across high school and college students. However, factor analyses in Study 2 using an ethnically diverse university sample revealed a four-factor solution (combining Physical and Property items). As a confirmation of the construct validity of FOA, physical and property aggression were lower, and verbal and passive—rational aggression were higher in college versus high school students. Gender differences were observed across FOA subscales, except relational aggression. FOA subscales correlated as expected with other anger and personality scales. Overall, the data revealed adequate psychometric properties for the FOA and suggest that current category distinctions (e.g., direct—indirect) may not adequately account for different forms of aggression. Researchers may want to reevaluate these categories.
Factors Influencing Booster Seat Use in a Multiethnic Community: Lessons for Program Implementation
Authors: Johnston Brian D. , Bennett Elizabeth , Quan Linda , Gonzalez-Walker Denise , Crispin Beth , Ebel Beth
Published: June 2008

Based on the local incidence and severity of motor vehicle occupant injuries, the authors' community and hospital injury prevention partnership identified child passenger safety for 4-to-8-year-old children as a priority. They designed a booster seat promotion campaign using an integrated social cognition model of health behavior. A series of focus groups were held with low-income African American, Somali, and Vietnamese parents to understand determinants of booster seat use in these communities. Deficits in understanding about the purpose of booster seats were seen in all groups, and concerns about cost and self-efficacy varied in important ways. Although legislation is an important tool in motivating child passenger restraint, most families saw safety as the prime reason to use booster seats with their children. These results illustrate the use of qualitative data to adapt a theory-based intervention to the needs of specific communities.
Identifying and Assessing Interests and Concerns of Priority Populations for Work-Site Programs to Promote Physical Activity
Authors: Phipps Etienne , Madison Nora , Pomerantz Sherry C. , Klein Mary G.
Published: June 2008

The work site has been identified as an ideal context for promoting physical activity. Assessing employee interest, identifying who could most benefit, and understanding impact of work-related barriers on potential participation is key. We conducted focus groups and surveyed the employee population of a large urban hospital. Using the “stages of change” construct, employees were categorized based on their motivation to exercise into exerciser , intender , and nonintender groups. Intenders were significantly more interested in most physical activity programs at work than were exercisers (p < .05). Intenders also found environmental and personal barriers to be more significant deterrents to participation than did exercisers (p < .01). Half of nonintenders reported interest in physical activity programs. Interest in physical activity programs at work is strong for employees who are not currently exercising. Both structural changes to promote safe environments and time allotments through work-related policies may encourage participation, especially for the priority populations of nonexercising employees.
Enabling and Sustaining the Activities of Lay Health Influencers: Lessons From a Community-Based Tobacco Cessation Intervention Study
Authors: Castañeda Heide , Nichter Mark , Nichter Mimi , Muramoto Myra
Published: June 2008

The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. “Social risk” must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a “community of practice” among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.
Evolving Visions of Waterfront Development in Postindustrial Philadelphia: The Formative Role of Elite Ideologies
Authors: McGovern Stephen J.
Published: June 2008

This article seeks to illuminate the role of elite ideologies in understanding how cities have sought to transform their waterfronts during the postindustrial era. A case study of Philadelphia's long-term efforts to develop Penn's Landing, a valuable thirty-five-acre site along the Delaware River at the eastern edge of Center City, reveals how shifting perspectives among mayors, their top advisors, and leading activists with respect to the proper scope of government and the appropriate source of political power have resulted in significant changes in the city's approach to waterfront planning and policy making.
Experiences of Living in a Disrupted Situation as Partner to a Man With Testicular Cancer
Authors: Sandén Inger , Söderhamn Olle
Published: June 2008

New knowledge has been gained about how close relatives reorient themselves and handle their life situation when facing close relatives' illness. The aim of this study was to describe and elucidate narrated experiences of living in a disrupted situation as partner to a patient with testicular cancer. A qualitative single-case design with a conversational interview using a semistructured guide with open-ended questions was implemented. A young woman whose partner had testicular cancer with metastases was interviewed. Narrative analysis of the data with focus on corporeality, spatiality, temporality, and communality revealed three themes that reflected the woman's concerns in different existential dimensions: the limitless self-care, the restricted space, and the shortness of time. The findings may facilitate caregivers' awareness of actual and potential self-care demands of both patients and significant others and can be used in developing structured strategies in helping close relatives to cope and manage as caregivers.
Challenging Roles: Insights Into Issues for Men Caring for Family Members With Mental Illness
Authors: Fraser Cait , Warr Deborah J.
Published: June 2008

Assumptions informing expectations of caring may not reflect the diversity of circumstances in which informal care is provided, and scant attention has been given to the experiences of men providing care to family members. This study reports on qualitative findings from a study that explored these issues among rural men caring for partners or children with a range of mental illnesses. The findings suggest that the primary relationship between carers and care recipients influences the ways in which the men understand and practice their caring roles. Fathers consistently described proactive approaches to caring and were strongly focused on managing the illness condition. There was some complementarity between parenting and caring roles that is likely to explain why they reported a high use of, and satisfaction with, mental health services. Husbands tended to take reactive approaches to caring in which they were more concerned with managing situations that were associated with their partners' illnesses. Husbands reported limited contact with treatment and support services and perceived them as inappropriate to their circumstances. All of the men were presented with complex tensions in their caring roles, and the men's accounts of caring that are presented offer useful insight into the contexts in which men are increasingly taking on caring roles in families and inform efforts to support men in this capacity.
Murine neonates develop vigorous in vivo cytotoxic and Th1/Th2 responses upon exposure to low doses of NIMA-like alloantigens
Authors: Opiela Shannon J. , Levy Robert B. , Adkins Becky
Published: June 2008

Early life exposure to noninherited maternal antigens (NIMAs) may occur via transplacental transfer and/or breast milk. There are indications that early life exposure to NIMAs may lead to lifelong tolerance. However, there is mounting evidence that exposure to NIMAs may also lead to immunologic priming. Understanding how these different responses arise could be critical in transplantation with donor cells expressing NIMAs. We recently reported that murine neonates that received a transplant of low doses of NIMA-like alloantigens develop vigorous memory cytotoxic responses, as assessed by in vitro assays. Here, we demonstrate that robust allospecific cytotoxicity is also manifest in vivo. Importantly, at low doses, NIMA-expressing cells induced the development of in vivo cytotoxicity during the neonatal period. NIMA-exposed neonates also developed vigorous primary and memory allospecific Th1/Th2 responses that exceeded the responses of adults. Overall, we conclude that exposure to low doses of NIMA-like alloantigens induces robust in vivo cytotoxic and Th1/Th2 responses in neonates. These findings suggest that early exposure to low levels of NIMA may lead to long-term immunologic priming of all arms of T-cell adaptive immunity, rather than tolerance.
Antigen-specific T-T interactions regulate CD4 T-cell expansion
Authors: Helft Julie , Jacquet Alexandra , Joncker Nathalie T. , Grandjean Isabelle , Dorothée Guillaume , Kissenpfennig Adrien , Malissen Bernard , Matzinger Polly , Lantz Olivier
Published: June 2008

The regulation of CD4 T-cell numbers during an immune response should take account of the amount of antigen (Ag), the initial frequency of Ag-specific T cells, the mix of naive versus experienced cells, and (ideally) the diversity of the repertoire. Here we describe a novel mechanism of T-cell regulation that potentially deals with all of these parameters. We found that CD4 T cells establish a negative feedback loop by capturing their cognate major histocompatibility class (MHC)/peptide complexes from Ag-presenting cells and presenting them to Ag-experienced CD4 T cells, thereby inhibiting their recruitment into the response while allowing recruitment of naive T cells. The inhibition is Ag specific, begins at day 2 (long before Ag disappearance), and cannot be overcome by providing new Ag-loaded dendritic cells. In this way, CD4 T-cell proliferation is regulated in a functional relationship to the amount of Ag, while allowing naive T cells to generate repertoire variety.
FIP1L1/PDGFRα synergizes with SCF to induce systemic mastocytosis in a murine model of chronic eosinophilic leukemia/hypereosinophilic syndrome
Authors: Yamada Yoshiyuki , Sanchez-Aguilera Abel , Brandt Eric B. , McBride Melissa , Al-Moamen Nabeel J. H. , Finkelman Fred D. , Williams David A. , Cancelas Jose A. , Rothenberg Marc E.
Published: June 2008

Expression of the fusion gene FIP1-like 1/platelet-derived growth factor receptor alpha (FIP1L1/PDGFRα, F/P) and dysregulated c-kit tyrosine kinase activity are associated with systemic mastocytosis (SM) and chronic eosinophilic leukemia (CEL)/hypereosinophilic syndrome (HES). We analyzed SM development and pathogenesis in a murine CEL model induced by F/P in hematopoietic stem cells and progenitors (HSCs/Ps) and T-cell overexpression of IL-5 (F/P-positive CEL mice). These mice had more mast cell (MC) infiltration in the bone marrow (BM), spleen, skin, and small intestine than control mice that received a transplant of IL-5 transgenic HSCs/Ps. Moreover, intestinal MC infiltration induced by F/P expression was severely diminished, but not abolished, in mice injected with neutralizing anti–c-kit antibody, suggesting that endogenous stem cell factor (SCF)/c-kit interaction synergizes with F/P expression to induce SM. F/P-expressing BM HSCs/Ps showed proliferation and MC differentiation in vitro in the absence of cytokines. SCF stimulated greater migration of F/P-expressing MCs than mock vector–transduced MCs. F/P-expressing bone marrow–derived mast cells (BMMCs) survived longer than mock vector control BMMCs in cytokine-deprived conditions. The increased proliferation and survival correlated with increased SCF-induced Akt activation. In summary, F/P synergistically promotes MC development, activation, and survival in vivo and in vitro in response to SCF.
Long-term expansion of effector/memory Vδ2− γδ T cells is a specific blood signature of CMV infection
Authors: Pitard Vincent , Roumanes David , Lafarge Xavier , Couzi Lionel , Garrigue Isabelle , Lafon Marie-Edith , Merville Pierre , Moreau Jean-François , Déchanet-Merville Julie
Published: June 2008

The ability of human γδ T cells to develop immunologic memory is still a matter of debate. We previously demonstrated the involvement of Vδ2− γδ T lymphocytes in the response of immunosuppressed organ recipients to cytomegalovirus (CMV). Here, we demonstrate their ability to mount an adaptive immune response to CMV in immunocompetent subjects. Vδ2− γδ T-cell peripheral blood numbers, repertoire restriction, and cytotoxicity against CMV-infected fibroblasts were markedly increased in CMV-seropositive, compared with CMV-seronegative, healthy persons. Whereas Vδ2− γδ T cells were found as naive cells in CMV− patients, they virtually all exhibited the cytotoxic effector/memory phenotype in CMV+ patients, which is also observed in transplanted patients challenged with CMV. This long-term complete remodeling of the Vδ2− γδ T-cell population by CMV predicts their ability to exhibit an adaptive anti-CMV immune response. Consistent with this, we observed that the secondary response to CMV was associated with a faster γδ T-cell expansion and a better resolution of infection than the primary response. In conclusion, the increased level of effector-memory Vδ2− γδ T cells in the peripheral blood is a specific signature of an adaptive immune response to CMV infection of both immunocompetent and immunosuppressed patients.