bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracellular Calcium Plays a Critical Role in the Microcystin-LR-Elicited Neurotoxicity Through PLC/IP3 Pathway
Authors: Cai Fei , Liu Jue , Li Cairong , Wang Jianghua
Published: September 2015

Neurotoxicity of microcystin-leucine-arginine (MCLR) has been widely reported. However, the mechanism is not fully understood. Using primary hippocampal neurons, we tested the hypothesis that MCLR-triggered activation in intracellular free calcium concentration ([Ca2+]i) induces the death of neurons. Microcystin-leucine-arginine inhibited cell viability at a range of 0.1 to 30 μmol/L and caused a dose-dependent increase in [Ca2+]i. This increase in [Ca2+]i was observed in Ca2+-free media and blocked by an endoplasmic reticulum Ca2+ pump inhibitor, suggesting intracellular Ca2+ release. Moreover, pretreatment of hippocampal neurons with intracellular Ca2+ chelator (O,O′-bis (2-aminophenyl) ethyleneglycol-N,N,N′,N′-tetraacetic acid, tetraacetoxy-methyl ester) and inositol 1,4,5-trisphosphate receptor antagonist (2-aminoethoxydiphenyl borate) could block both the Ca2+ mobilization and the neuronal death following MCLR exposure. In contrast, the ryanodine receptor inhibitor (dantrolene) did not ameliorate the effect of MCLR. In conclusion, MCLR disrupts [Ca2+]i homeostasis in neurons by releasing Ca2+ from intracellular stores, and this increase in [Ca2+]i may be a key determinant in the mechanism underlying MCLR-induced neurotoxicity.
Home Is Where You Park It
Authors: Wehman-Brown Grover
Published: September 2015

Living in an automobile is an increasingly common but underexamined experience in the United States. The car provides shelter against the elements of outdoors, but living in the automobile requires a complex set of practices over dispersed space in order to meet basic bodily and social needs. Using accounts of car dwelling found in survival guides, news reports, blogs, and day-in-the-life videos, this article analyzes some of the fundamental tensions between stillness and mobility, private and public, and home and homeless evidenced in the place-making practices of car dwelling. In analyzing the relationship between material arrangements, practices of spatial and social regulation, and identity formation, I argue that while car dwelling cannot be linked to one specific identity or experience. Relying on Doreen Massey’s concept of ‘practicing place’ this article shows how the complex negotiations of place-making expose multiple routes to theorize nonnormative uses of space and materiality and to develop more equitable access to resources.
What are the legal implications of ignoring hospital policies and procedures?
Authors: Whyman Jeanette
Published: September 2015

Hospital policies and procedures are designed to help prevent patients being harmed during the course of their treatment. The same principles apply as they do in business: by implementing a process-driven approach to ensuring that every component of the product is manufactured to the highest possible specification, customer satisfaction and safety can be secured. The more safety conscious the business, such as aerospace engineering, the tighter the procedures and controls. Hospitals should be no different; they are dealing with life and death and, as such, straightforward, fully tested procedures that are put in place to eliminate medical negligence mistakes should not be ignored. So why, as medical negligence lawyers, do we still see failures by both hospitals and health professionals to follow well-established procedures resulting in serious harm to patients? And particularly when such failures can and do lead to legal sanctions resulting not only in the loss of reputation and livelihood but also, in extreme cases, to liberty? In this article, which is a personal view, I explore some of the reasons why some medical practitioners fail to follow procedures and policies and outline the sanctions, both civil and criminal, for that failure.
Exploring the predictors of home telehealth uptake by elderly Australian healthcare consumers
Authors: Russell TG , Gillespie N , Hartley N , Theodoros D , Hill A , Gray L
Published: September 2015

Background

Despite the significant access and cost-saving potential of telehealth, the uptake of telehealth services in Australia has been sporadic. Understanding the factors that drive the uptake of home-telehealth services from the consumer perspective has received scant attention in the literature.

Aim

The aim of this study was to explore how a comprehensive set of factors may influence the intention of older Australians to adopt home telehealth services.

Methods

A survey of 306 Australians aged between 50 and 68 years was conducted to examine the influence of six categories of predictors on the intention of older Australians to adopt home telehealth: (a) demographics, (b) health status and usage, (c) mobility and ease of access to healthcare, (d) technology usage and anxiety with technology, (e) telehealth attitudes, and (f) personality traits.

Results

Hierarchical regression analysis revealed that significant predictors were: trust in telehealth (β = 0.35); the technology acceptance model (β = 0.27); healthcare habits (β = −0.20); dissatisfaction with traditional healthcare (β = 0.19) and online behaviors (β = 0.09). The model explained 63% of the variance in intention to adopt home telehealth.

Conclusion

This study is the first of its kind in Australia and provides valuable insight into the factors which impact consumer’s intention to adopt telehealth services.
Men’s perceived barriers to help seeking for depression: Longitudinal findings relative to symptom onset and duration
Authors: Rice Simon M , Aucote Helen M , Parker Alexandra G , Alvarez-Jimenez Mario , Filia Kate M , Amminger G Paul
Published: September 2015

Men’s help seeking for depression continues to gain focussed research and clinical attention. In this study, 125 men ( M = 39.02 years) provided data on perceived barriers to mental health help seeking, and self-reported depression at baseline, and 15 weeks. Longitudinal depression caseness was used to investigate group differences in perceived barriers to help seeking. Those experiencing unremitting depression reported the highest perceived help-seeking barriers. This finding was consistent over all domains of help-seeking barriers, and it was independent of previous mental health help-seeking efforts. Findings are discussed in the broader context of men’s mental health and health psychology.
Alcohol consumption increases bias to shoot at Middle Eastern but not White targets
Authors: Schofield Timothy P. , Unkelbach Christian , Denson Thomas F.
Published: September 2015

Alcohol has been implicated in intergroup aggression and hostility. The effect of consuming alcohol relative to a placebo on hostile cognitive biases toward a social category typically stereotyped as threatening and hostile (i.e., Middle Eastern men) was tested. Undergraduates ( N = 81) consumed either an intoxicating dose of alcohol (BrAC = .05% by vol.) or placebo. Then, they played a shooter game in which they were asked to shoot at targets holding guns, but not at targets holding harmless objects. Half of the targets were White and half were Middle Eastern. As predicted, alcohol consumption, relative to a placebo, increased participants’ bias to shoot Middle Eastern targets, but did not affect the shooter bias against White targets. Findings suggest that alcohol may heighten aggressive biases toward outgroups stereotyped as threatening and hostile.
Morality stereotyping as a basis of women’s in-group favoritism: An implicit approach
Authors: Leach Colin Wayne , Carraro Luciana , Garcia Randi L. , Kang Jessica J.
Published: September 2015

Four studies used three different implicit methods (the BriefIAT, Affect Misattribution Procedure, and Lexical Decision Task) to measure women’s gender stereotypes of violence, strength, competence, trustworthiness, and sociability. Analyses of response latencies in Study 1 ( N = 100) showed that these stereotypes were based more in in-group favoritism than out-group derogation. Consistent with recent evidence that morality is central to the positive evaluation of in-groups, it was the implicit stereotype of women as more trustworthy that best predicted their implicit in-group favoritism across studies, r(249) = .27. Only by examining such specific stereotype content could we assess the moral stereotype of trustworthiness as distinctly tied to in-group favoritism. Alternative analyses of the two global dimensions of group evaluation (i.e., agency/competence and communion/warmth) obscured differences between the more specific stereotypes. Implications for theory and research on stereotype content, as well as the group favoritism of disadvantaged groups, are discussed.
Modernity and the embedding of economic expansion
Authors: Halperin Sandra
Published: September 2015

The nationally embedded and relatively broad-based economies characteristic of developed industrial countries are usually seen as the incarnation of a modern economy. These economies are largely internally oriented and are based, to a relatively great extent, on production and services based on local and national needs. Their provenance is generally assumed to have been processes of development that began in the sixteenth century and that, in the nineteenth century, accelerated with the expansion of industrial production and the growth of global trade. This article challenges that assumption. It argues that today’s modern economies represent, not the culmination of long-term processes, but a recurring phenomenon within capitalism. It argues that, in the history of capitalism, there have been phases of nationally embedded and global free market capitalism – periods when capital is relatively more, and relatively less, free from the regulation of nation state. Today’s nationally embedded economies represent, not a further point along a unilinear developmental trajectory, but a return to features of the moral economies that characterized both European and non-European societies before the nineteenth century.
Categorical answer modes provide superior validity to open answers when asking for level of physical activity: A cross-sectional study
Authors: Olsson Sven J.G. , Ekblom Örjan , Andersson Eva , Börjesson Mats , Kallings Lena V.
Published: September 2015

Aims: Physical activity (PA) used as prevention and treatment of disease has created a need for effective tools for measuring patients’ PA level. Our aim was therefore to assess the validity of two PA questions and their three associated answer modes. Methods: Data on PA according to the PA questions and Actigraph GT3X+ accelerometers, aerobic fitness ( VO2max), cardiovascular biomarkers, and self-rated general health were collected in 365 Swedish adults (21–66 years). The PA questions ask about weekly PA via categories (Categorical), an open-ended answer (Open), or specified day by day (Table). Results: The Categorical mode, compared with the Open mode, correlated (Spearman’s rho) significantly more strongly ( p<0.05) with accelerometer PA (0.31 vs. 0.18) and VO2max (0.27 vs. 0.06), and the level of BMI (–0.20 vs. –0.02), waist circumference (–0.22 vs. –0.03), diastolic blood pressure (–0.16 vs. 0.08), glucose (–0.18 vs. 0.04), triglycerides (–0.31 vs. –0.07), and general health (0.35 vs. 0.19). The validity of the Categorical and Table modes were similar regarding VO2max and accelerometry, but the Categorical mode exhibited more significant and stronger correlations with cardiovascular biomarkers. The capacity of the PA questions to identify insufficiently physically active individuals ranged from 0.57 to 0.76 for sensitivity and from 0.47 to 0.79 for specificity. Conclusions: The Categorical mode exhibits the strongest validity and Open mode the weakest. The PA questions may be used on a population level, or as a tool for determining patents’ appropriateness for treatment.
Mental problems and their socio-demographic determinants in young schoolchildren in Sweden, a country with high gender and income equality
Authors: Stenmark Helena , Bergström Erik , Hägglöf Bruno , Öhman Ann , Petersen Solveig
Published: September 2015

Aims: Mental problems and their potential socio-demographic determinants were investigated in young schoolchildren in Sweden, a high-income country in the top of income- and gender-equality rankings. Methods: Cross-sectional study of 1465 schoolchildren in grades 3 and 6. Mental health was measured by the Child Behavior Checklist and the Youth Self Report (Total problems and 14 specific problem areas). Potential socio-demographic determinants were sex, parental education and occupation, family structure, and immigrant status. Results: Mental problems were present in 14% of the sixth graders and in 7% of the third graders. In grade 3, the mean total problem score was lower in girls than in boys, but the prevalence of problems at a subclinical/clinical level did not differ by sex. Furthermore, in nine to 13 of the 14 specific problem areas, problems were equally distributed by sex, parental education, parental occupation, immigrant status, and family structure. In grade 6, both the total mean score and the overall odds of subclinical/clinical problems were similar in girls and boys. Likewise, in all the specific problem areas, problems were evenly distributed by parental education and occupation, and only independently associated with immigrant status and family structure in one problem area. In five specific problem areas, boys had higher odds of problems than girls. Conclusions: This study shows that also in a relatively wealthy and equal country such as Sweden, mental problems are a significant child public health issue. The association between socio-demographic background and mental problems seems to be rather weak, but differ dependent on the type of mental problem in focus.
Comorbidity and work disability among employees with diabetes: Associations with risk factors in a pooled analysis of three cohort studies
Authors: Ervasti Jenni , Kivimäki Mika , Dray-Spira Rosemary , Head Jenny , Goldberg Marcel , Pentti Jaana , Jokela Markus , Vahtera Jussi , Zins Marie , Virtanen Marianna
Published: September 2015

Aims: Among employees with diabetes, comorbidity may considerably deteriorate working capacity. We examined how socioeconomic status, lifestyle factors and job strain were related to work disability in individuals with diabetes with and without comorbidity. Methods: In this pooled analysis of individual-participant data from occupational cohorts from Finland (Finnish Public Sector Study FPS), UK (Whitehall II) and France (GAZEL), 1925 employees with diabetes were followed on average for 4 years. Participants were categorized into four groups, according to their baseline comorbidity status and subsequent work disability, as: non-comorbid diabetes with no/low work disability; comorbid diabetes with no/low work disability; non-comorbid diabetes with moderate/high work disability; and comorbid diabetes with moderate/high work disability. The risk of work disability was assessed with multinomial regression, using Group 1 (the first listed above) as the reference group. Results: Participants with low socioeconomic status had increased odds for higher work disability, irrespective of comorbidity (OR = 3.12; 95% CI 2.25–4.33, among participants with no comorbidity, and OR = 2.61; 95% CI 1.93–3.51 among those with comorbidity). Obesity was cross-sectionally associated with comorbidity (OR = 1.95; 95% CI 1.35–2.83 for comorbidity without disability), and this association was particularly pronounced among those whom became work disabled (OR = 2.61; 95% CI 1.89–3.60 for comorbidity with disability). Job strain was associated with high/moderate work disability, only among participants with comorbidity (OR = 1.63; 95% CI 1.14–2.34). Conclusions: Pooled data from three cohort studies showed that low socioeconomic status, obesity, and job strain are linked to both comorbidity and increased work disability in employees with diabetes.
Becoming an ‘autonomous writer’: Epistemic stance displays and membership categorization in the writing conference
Authors: Mayes Patricia
Published: September 2015

Although the members’ categories associated with institutional settings may seem obvious, more can be said about the actions that make them noticeable and persistent across contexts. This study investigates how epistemic stance displays make the standardized relational pair ‘teacher–student’ relevant during writing conferences in a US university. Analysis of the interaction between teachers and their students shows that teachers tended to display more knowledgeable stances concerning writing and institutional practices, whereas students displayed knowledgeable stances with respect to their own papers, indexing the immediate relevance of the ‘teacher–student’ relational pair and a tension between authority and autonomy. Further analysis reveals that participants also mentioned past and future writing activities, thus indexing the persistence of the ‘teacher–student’ pair as well as the emergence of the category ‘autonomous writer’. Additionally, participants’ orientation to the more general ‘writer–reader’ pair also functioned to index the persistent and emergent aspects of these categories.
Easy and Informative: Using Confidence-Weighted True–False Items for Knowledge Tests in Psychology Courses
Authors: Dutke Stephan , Barenberg Jonathan
Published: September 2015

We introduce a specific type of item for knowledge tests, confidence-weighted true–false (CTF) items, and review experiences of its application in psychology courses. A CTF item is a statement about the learning content to which students respond whether the statement is true or false, and they rate their confidence level. Previous studies using CTF items were reviewed and data from 21 additional psychology courses ( N = 1879 teacher candidates) revealed that CTF items were successfully applied to measure learning performance at the cognitive and metacognitive level. Furthermore, examples are presented demonstrating that the indices of metacognitive monitoring that can be derived from these items provide useful additional information about the effects of teaching and testing methods.
A Short Test for the Assessment of Basic Knowledge in Psychology
Authors: Peter Johannes , Leichner Nikolas , Mayer Anne-Kathrin , Krampen Günter
Published: September 2015

This paper reports the development of a fixed-choice test for the assessment of basic knowledge in psychology, for use with undergraduate as well as graduate students. Test content is selected based on a core concepts approach and includes a sample of concepts which are indexed most frequently in common introductory psychology textbooks. In a pilot study ( n = 67 psychology students), a 21 item-version of the test was developed. Empirical results from two additional studies using psychology students ( n = 173 and n = 112) show that the test can differentiate between students with varying progress in their studies and show a significant correlation of test scores with academic achievement in psychology.
The Contours of Green Human Resource Development
Authors: Scully-Russ Ellen
Published: September 2015

The Problem

Despite growing interest in the role of human resource development (HRD) in creating responsible and sustainable organizations, there is limited discussion on HRD’s potential contribution to new interdisciplinary approaches to creating a more sustainable connection between the environment and society, herein called the greening of society. Greening involves an entire community and its stakeholders, and not just the business organizations that garner attention in the HRD literature.

The Solution

This article introduces the issue by offering a conceptual framework for understanding HRD’s role in greening efforts. The article calls for the development of new HRD concepts, models, and empirical research to help address the mounting environmental challenges and risks to society. It also introduces the articles that launch a preliminary response to this call.

The Stakeholders

This article provides scholars, researchers including environmental researchers, and scholar-practitioners with current thinking around the notion of building responsible and sustainable environmental and social sustainability organizations and society. In addition, this article may be of interest to those concerned about environmental and social sustainability.
Communicating Climate Change Risk and Enabling Pro-Environmental Behavioral Change Through Human Resource Development
Authors: Sadler-Smith Eugene
Published: September 2015

The Problem

Climate change is the most pressing environmental issue of our times. The majority of reputable scientists are in agreement that it threatens dangerous and irreversible impacts on the whole-Earth system. The mitigation of its potential effects requires immediate, substantial, and sustained actions.

The Solution

This article proposes two ways in which human resource development (HRD) can contribute: first, through individual learning and development interventions; second, through organizational development and change. Furthermore, it is argued that organizational culture and individual agency have the potential to reciprocally enable or constrain pro-environmental behavioral change; hence to be effective, green HRD requires interventions both at the individual and the organizational levels.

The Stakeholders

HRD scholars, researchers, and practitioners may also be of interest to others involved in environmental sustainability and critical management studies.
Using a Calendar and Explanatory Instructions to Aid Within-household Selection in Mail Surveys
Authors: Stange Mathew , Smyth Jolene D. , Olson Kristen
Published: September 2015

Although researchers can easily select probability samples of addresses using the U.S. Postal Service’s Delivery Sequence File, randomly selecting respondents within households for surveys remains challenging. Researchers often place within-household selection instructions, such as the next or last birthday methods, in survey cover letters to select respondents. Studies show that up to 30% of selections are inaccurate and samples tend not to represent key demographics. This article tests two design elements—a calendar and explanatory wording of selection instructions in cover letters—to aid and motivate households to carry out selection procedures accurately. We empirically examine these elements in two mail surveys of Nebraskans—the 2012 Nebraska Annual Social Indicators Survey and 2013 Nebraska Trees and Forest Survey. We find that neither the calendar nor the explanatory wording adversely affected response rates but that neither improved the representativeness of the completed samples and that the calendar actually reduced selection accuracy.
All Means All
Authors: Shogren Karrie A. , McCart Amy B. , Lyon Kristin J. , Sailor Wayne S.
Published: September 2015

The Schoolwide Integrated Framework for Transformation (SWIFT) Center identified six schools, nominated and screened by leaders in the field of inclusive education and school reform using a systematic process, and conducted in-depth analyses of these schools to build knowledge and inform implementation of inclusive schoolwide reform. The present study synthesizes findings across five lines of inquiry (classroom practices, teacher and administrator perspectives, student perspectives, family and community perspectives, and supports for students with the most significant needs) that were part of the SWIFT Center’s analysis of these schools. The primary themes are organized around (a) how inclusion is defined and practiced, (b) perspectives of inclusion from key stakeholders, and (c) exemplars of inclusive practices. Implications for future research and practice are described.
Fostering Family–School and Community–School Partnerships in Inclusive Schools
Authors: Haines Shana J. , Gross Judith M. S. , Blue-Banning Martha , Francis Grace L. , Turnbull Ann P.
Published: September 2015

Partnerships between school staff, families, and community members are vital for ensuring the success of all students in inclusive schools. This article reports the results of a synthesis of two original studies: one study that examined the perspectives of family members and another study that examined the perspectives of community partners in developing partnerships with school staff at six inclusive knowledge development sites located in five geographic regions within the United States. The current synthesis study analyzes the original studies’ overlapping themes to inform concentrated efforts aimed at strengthening family and community partnerships in inclusive schools. Themes of this synthesis study include positive, inviting, and inclusive school culture; strong administrative leadership driven by a clear vision of inclusion; attributes of trusting partnerships; and opportunities for reciprocal partnerships and involvement. Implications for practice and research are discussed.
Development of Critical Thinking Through Aesthetic Experience
Authors: Raikou Natassa
Published: September 2015

This article addresses an application performed in tertiary education—a department of pedagogical and educational sciences—of a contemporary method, Transformative Learning through Aesthetic Experience. The method is based on the use of art and aims to reinforce and promote the development of critical thinking within educational settings. Furthermore, the article focuses on exploring possible changes in the learners’ assumptions that are connected to the application of the method, especially regarding the duration and amplitude of these changes. Through a qualitative elaboration of the research findings, we found that the application of the specific method is effective within the training of teachers’ framework.
Reflexive work and the duality of self-leadership
Authors: Pina e Cunha Miguel , Pacheco Mafalda , Castanheira Filipa , Rego Arménio
Published: September 2015

The concept of self-leadership is known and accepted, but still under-researched. By considering the reflexive work involved in the process of self-leadership, we seek to understand what factors are relevant for managers to be effective in a sustainable and productive way. We ask how managers engage in self-leadership. Empirically, we find that self-leadership is a process that can be translated into the capability of handling and sustaining four dualities: challenge and routine; self and others; nonwork and work; mind and body.
Dispreferred responses when texting: Delaying that ‘no’ response
Authors: Rendle-Short Johanna
Published: September 2015

Socially, people find it difficult to say ‘no’ to requests or invitations. In spoken interaction (face-to-face), we orient to this difficulty through the design of our responses. An agreement response (preferred) is characteristically said straightaway with minimal gap between request and response. A disagreement response (dispreferred) is characteristically delayed through silence and by prefacing the disagreement turn with tokens such as ‘well’, ‘uhm’ and ‘uh’ or with accounts as to why the recipient cannot accept the request or invitation. The question for this article concerns what occurs when requests or invitations are made via texting. The results from 329 texting interactions showed that if responses to a request or invitation were delayed by more than 1 minute, it was much more likely be a ‘no’ rather than a ‘yes’ response ( p < 0.001). In other words, preferred responses were sent quickly; dispreferred responses were delayed. Understanding texting as social interaction is increasingly important as the range of communicative options continues to widen (e.g. Facebook, Short Message Service (SMS), Multimedia Messaging Service (MMS), Instant Messaging (IM), email). This study shows preference organisation similarities between spoken interaction and texting with texters orienting to social norms concerning delayed responses. Further research is needed to understand in what contexts a person might choose one communicative medium over another.
Calculating evidence-based renal replacement therapy – Introducing an excel-based calculator to improve prescribing and delivery in renal replacement therapy – A before and after study
Authors: Cottle Daniel , Mousdale Stephen , Waqar-Uddin Haroon , Tully Redmond , Taylor Benjamin
Published: September 2015

Background

Transferring the theoretical aspect of continuous renal replacement therapy to the bedside and delivering a given “dose” can be difficult. In research, the “dose” of renal replacement therapy is given as effluent flow rate in ml kg−1 h−1. Unfortunately, most machines require other information when they are initiating therapy, including blood flow rate, pre-blood pump flow rate, dialysate flow rate, etc. This can lead to confusion, resulting in patients receiving inappropriate doses of renal replacement therapy. Our aim was to design an excel calculator which would personalise patient's treatment, deliver an effective, evidence-based dose of renal replacement therapy without large variations in practice and prolong filter life. Our calculator prescribes a haemodialfiltration dose of 25 ml kg−1 h−1 whilst limiting the filtration fraction to 15%.

Methods

We compared the episodes of renal replacement therapy received by a historical group of patients, by retrieving their data stored on the haemofiltration machines, to a group where the calculator was used. In the second group, the data were gathered prospectively.

Results

The median delivered dose reduced from 41.0 ml kg−1 h−1 to 26.8 ml kg−1 h−1 with reduced variability that was significantly closer to the aim of 25 ml kg−1.h−1 ( p < 0.0001). The median treatment time increased from 8.5 h to 22.2 h ( p = 0.00001).

Conclusion

Our calculator significantly reduces variation in prescriptions of continuous veno-venous haemodiafiltration and provides an evidence-based dose. It is easy to use and provides personal care for patients whilst optimizing continuous veno-venous haemodiafiltration delivery and treatment times.
Pituitary apoplexy in pregnancy: A case series and literature review
Authors: Grand'Maison Sophie , Weber Florence , Bédard Marie-Josée , Mahone Michele , Godbout Ariane
Published: September 2015

Background

Severe headache during pregnancy is a challenging condition that may rarely imply endocrine disturbances. Rapid recognition of pituitary apoplexy is needed to improve pregnancy outcome.

Objective

To review and compare maternal and fetal outcomes after pituitary apoplexy.

Methods

Four cases of pituitary apoplexy during pregnancy in our centre are reported and literature review covering the past 54 years was performed.

Results

In the four cases presented and the 33 reported in the literature, most women presented with severe headaches and systemic symptoms. Overall, 42% were treated surgically, 31% received bromocriptine or cabergoline and 61% were given hormone replacement. No major obstetrical complication was reported and all babies were healthy.

Conclusion

Pituitary apoplexy is a rare cause of sudden and severe headache during pregnancy. Rapid identification of this condition with potentially associated endocrine disturbances is important to ensure maternal and fetal well-being. A multidisciplinary team approach seems to reduce morbidity and mortality.
Percutaneous mitral commisurotomy during pregnancy – A report of two cases performed in a United Kingdom tertiary centre and a review of the literature
Authors: Kapoor Dipanwita , Choudhary Ferrah , Smith William HT , Wallace Suzanne
Published: September 2015

We report two cases of severe mitral stenosis where percutaneous mitral commisurotomy was performed within pregnancy. The first case involves an emergency procedure for a new diagnosis of severe mitral stenosis in a woman presenting with pulmonary oedema at 27 weeks’ gestation. The second case is of a woman known to have mitral stenosis who underwent a semi-elective procedure for deterioration in symptoms. This procedure is not commonly performed in the United Kingdom because of low incidence of rheumatic heart disease. In addition, percutaneous mitral commisurotomy during pregnancy is rarely performed in the United Kingdom because of the improved healthcare system where majority of the women with moderate to severe mitral stenosis (even asymptomatic) will undergo planned interventions (percutaneous mitral commisurotomy or mitral valve surgery) before contemplating pregnancy. These cases highlight both the acute and chronic presentations of mitral stenosis and the impact pregnancy has on this condition. In addition, these cases show the importance of retaining skills in performing percutaneous mitral commisurotomy within our United Kingdom cardiologists.
Thrombocytopenic syndromes in pregnancy
Authors: Yan Matthew , Malinowski Ann K , Shehata Nadine
Published: September 2015

The physiological changes in pregnancy result in platelet counts that are lower than in nonpregnant women. Consequently, thrombocytopenia is a common finding occurring in 7–12% of pregnant women. Gestational thrombocytopenia, the most common cause of low platelet counts, tends to be mild in most women and does not affect maternal, fetal or neonatal outcomes. Gestational thrombocytopenia needs to be distinguished from other less common causes of isolated thrombocytopenia, such as immune thrombocytopenia, which affects approximately 3% of thrombocytopenic pregnant women and can lead to neonatal thrombocytopenia. Hypertensive disorders of pregnancy and thrombotic microangiopathies are both associated with thrombocytopenia. They share a considerable number of similar characteristics and are associated with significant maternal and neonatal morbidity and rarely mortality. Accurate identification of the aetiology of thrombocytopenia and appropriate management are integral to optimizing the pregnancy, delivery and neonatal outcomes of this population. Clinical cases are described to illustrate the various aetiologies of thrombocytopenia in pregnancy and their treatment.
Cross-Cultural Adaptation and Validation of the Lower Extremity Measure Into German
Authors: Goldhahn Sabine , Käch Kurt , Frei Hans Curd , Rudin Mark , Leimbacher Melanie , Platz Andreas
Published: September 2015

Introduction:

The Lower Extremity Measure (LEM) was developed to provide a specific instrument to detect changes in physical function in patients with hip fracture. Of 29 questions, 3 have a valid “not applicable” answer option. The goal of this study was to validate the LEM in German and to determine the added value to the physical functioning (pf) subscale of the Short Form 36 (SF-36).

Materials and Methods:

The LEM was translated according to published guidelines and administered to patients with hip fracture (31 A1-A3 and 31 B1-B3) shortly after surgery (baseline), at 3 months (3M), and for reliability testing at 3 months plus 1 week (3M+). The reproducibility, internal consistency, floor and ceiling effects, construct validity, and responsiveness of the German LEM were assessed.

Results:

A total of 106 patients completed the LEM and SF-36 (mean age 75.5; 67% women) at baseline (mean of 4.9 days after operation), and 88 completed both questionnaires at both the 3M and 3M+ assessments. At each assessment time point, between 6% and 23% of the patients answered 7 questions as “not applicable.” Reproducibility and internal consistency were high (intraclass correlation coefficient = 0.93; Cronbach's α = .96). No floor effect (0%) and a minor ceiling effect (7.87%) were found for the total LEM score. The strongest correlation was found between the LEM and the SF-36 subscale pf (Spearman ρ = .93). Responsiveness was similar for the SF-36 pf subscale and the LEM when using effect size (SF-36 pf 0.71 vs LEM 0.72) and better for the LEM when using standardized response mean (SF-36 pf 0.65 vs LEM 0.76).

Discussion:

The German LEM is a reliable, valid, and responsive measure for the self-assessment of patients after hip fracture surgery. As a number of questions are not applicable to elderly patients, the added value of this lengthy questionnaire in these often frail, sometimes cognitively impaired patients is still open for debate.
Older Patients Are Immunocompromised by Cytokine Depletion and Loss of Innate Immune Function After HIP Fracture Surgery
Authors: Sutherland Alasdair G. , Cook Alistair , Miller Clare , Duncan Linda , Yuecel Raif , Heys Steven D. , Hutchison James D. , Liversidge Janet
Published: September 2015

Purpose/Introduction:

We have examined the immune status of elderly patients who underwent surgery for a hip fracture, an injury associated with poor postoperative outcomes, to identify specific immune defects.

Methods:

In a cohort observational study, 16 patients undergoing surgery for hip fractures had immune function evaluation prior to surgery, and then at 3 and 7 days postoperatively, using flow cytometry for phenotype and for monocyte and granulocyte phagocytic function and respiratory burst. Serum samples were stored and batch analyzed using a human cytokine 25-plex panel.

Results:

We report significant loss of innate immune function, related specifically to reduced granulocyte numbers by day 7 ( P < .0001, flow cytometry; P < .05 white blood cells), and although granulocyte ability to take up opsonized Escherichia coli was increased ( P < .05), the ability of those cells to generate a respiratory burst was reduced at days 3 and 7 ( P < .05). Monocyte respiratory burst was also significantly reduced ( P < .05). Serum cytokine levels indicated very poor T-cell function.

Conclusion:

We have demonstrated that the antimicrobial immune response is profoundly reduced after surgery in elderly patients with hip fractures. The effect was sustained up to 7 days postoperatively, identifying these patients as particularly vulnerable to bacterial infections.
A Survey of Medical Students’ Knowledge and Attitudes Toward Complementary and Alternative Medicine in Urmia, Iran
Authors: Sadeghi Mahshid , Rabiepoor Soheila , Forough Aida Sefidani , Jabbari Shiva , Shahabi Shahram
Published: September 2015

Personal beliefs of medical students may interfere with their tendency for learning Complementary and Alternative Medicine concepts. This study aimed to investigate the knowledge and attitudes of medical students toward complementary and alternative medicine in Urmia, Iran. A structured questionnaire was used as data collection instrument. One hundred questionnaires were returned. Thirty-one percent of students reported use of alternative medicine for at least once. Iranian Traditional Medicine was the main type of alternative medicine used by medical students (93.5%). Neuromuscular disorders were the main indication of alternative medicine use among students (34.4%). Ninety percent of participants demonstrated competent knowledge about acupuncture while the lowest scores belonged to homeopathy (12%). Study results showed that 49% of medical students had positive attitudes and demonstrated a willingness to receive training on the subject. Thus, there appears a necessity to integrate complementary and alternative medicine into the medical curriculum, by taking expectations and feedbacks of medical students into consideration.
Distal Insertions of the Biceps Femoris
Authors: Branch Eric A. , Anz Adam W.
Published: September 2015

Background:

Avulsion of the biceps femoris from the fibula and proximal tibia is encountered in clinical practice. While the anatomy of the primary posterolateral corner structures has been qualitatively and quantitatively described, a quantitative analysis regarding the insertions of the biceps femoris on the fibula and proximal tibia is lacking.

Purpose:

To quantitatively assess the insertions of the biceps femoris, fibular collateral ligament (FCL), and anterolateral ligament (ALL) on the fibula and proximal tibia as well as establish relationships among these structures and to pertinent surgical anatomy.

Study Design:

Descriptive laboratory study.

Methods:

Dissections were performed on 12 nonpaired, fresh-frozen cadaveric specimens identifying the biceps femoris, FCL, and ALL, and their insertions on the proximal tibia and fibula. The footprint areas, orientations, and distances from relevant osseous landmarks were measured using a 3-dimensional coordinate measurement device.

Results:

Dissection produced 6 easily identifiable and reproducible anatomic footprints. Tibial footprints included the insertion of the ALL and an insertion of the biceps femoris (TBF). Fibular footprints included the insertion of the FCL, a distal insertion of the biceps femoris (DBF), a medial footprint of the biceps femoris (MBF), and a proximal footprint of the biceps femoris (PBF). The mean area of these footprints (95% CI) was as follows: ALL, 53.0 mm2 (38.4-67.6); TBF, 93.9 mm2 (72.0-115.8); FCL, 86.8 mm2 (72.3-101.2); DBF, 119 mm2 (91.1-146.9); MBF, 46.8 mm2 (29.0-64.5); and PBF, 215 mm2 (192.4-237.5). The mean distance (95% CI) from the Gerdy tubercle to the center of the ALL footprint was 24.3 mm (21.6-27.0) and to the center of the TBF was 22.5 mm (21.0-24.0). The center of the DBF was 8.68 mm (7.0-10.3) from the anterior border of the fibula, the center of the FCL was 14.6 mm (12.5-16.7) from the anterior border of the fibula and 20.7 mm (19.0-22.4) from the tip of the fibular styloid, and the center of the PBF was 8.96 mm (8.2-9.7) from the tip of the fibular styloid.

Conclusion:

A tibial footprint, distal fibular footprint, medial fibular footprint, and proximal fibular footprint were all consistent components of the insertion of the biceps femoris. Consistent relationships existed between the biceps femoris and insertions of the ALL and FCL.

Clinical Relevance:

The size of these footprints and distances from pertinent surgical landmarks will guide repairs of biceps femoris avulsion injuries.
Orthopaedic Injuries in Equestrian Sports
Authors: Young Jason David , Gelbs Jared Craig , Zhu David Shiyu , Gallacher Stacey Elisa , Sutton Karen Michelle , Blaine Theodore Alton
Published: September 2015

Background:

Despite the common nature of orthopaedic injuries in equestrian sports, there is no published review to specifically characterize orthopaedic injuries in equestrian athletes.

Purpose:

To characterize orthopaedic injury patterns in equine sports–related injuries and their treatment.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

This review was performed through a PubMed, EMBASE, and Scopus query (from 1978 to June 2014) in the English literature using search terms “(equine-related OR equestrian-related OR horse-related OR equestrian OR equestrians) AND (injury OR injuries).” Only full-text studies reporting on orthopaedic injury patterns pertinent to equestrian sports in the United States (US) and the United Kingdom (UK) were included. Orthopaedic injuries were defined as those resulting in a fracture or dislocation. In all, 182 studies were excluded, leaving a total of 27 studies for evaluation. The studies included were analyzed for demographic and epidemiological data for orthopaedic injuries, including fractures and dislocations. Cranial and facial injuries were excluded from analysis.

Results:

The majority of those injured in the US were female (64.5%). The leading cause of injury in the US was falling from a horse. The use of protective equipment seemed to vary widely, with helmet use ranging from less than 6% up to 66.7%. In the UK, fractures were found to account for 17.4% of reported injures, compared with 33.6% of injuries in the US. The majority of fractures in US riders occurred in the upper extremities (50.7%).

Conclusion:

This review helps characterize the epidemiology of equestrian injuries based on currently available data.
The Quantifiable-Body Discourse
Authors: Robinson Brandon Andrew
Published: September 2015

The majority of gay men are now meeting online; however, little is understood about how body presentations in cyberspace affect gay men’s intimate contacts. In this article, I develop the concept of the quantifiable-body discourse to illuminate how a dating Web site’s infrastructure measures the body, impacting how gay men interact with one another. Through in-depth interviews and analyzing profiles on a top gay personal Web site, I show how gay men numerically discuss and compare bodies online. Bolstered by Connell’s concepts of hegemonic masculinity and cathexis, I reveal how this quantification of bodies leads to the valuing and desiring of fit bodies and discriminating against fat bodies in cyberspace and off-line. I also illuminate how dating and “hookup” Web sites perpetuate hegemonic norms around bodies, beauty, and biopower.
Playing the “Immigrant Card”
Authors: Lippard Cameron D.
Published: September 2015

Polls measuring attitudes on immigration suggest that Americans generally agree that immigration is good for the United States. However, these same polls suggest that Americans support strict border enforcement and racial profiling to curtail illegal immigration. These same mixed responses about immigration also characterize southern views, particularly in new immigrant destinations. Drawing on 180 in-depth interviews from southern college students, this article uses color-blind racism and racist nativism theories to examine immigration rhetoric. Results suggest that respondents fear immigrants “taking over,” racializing the immigration debate to only focus on Mexican immigrants. They also conflate their views of blacks and Mexican immigrants, suggesting these two groups are essentially the same. However, they deflect being blatantly racist nativist by camouflaging their comments with color-blind frames. Many note that the mistreatment of immigrants is “fair” in comparison with their immigrant ancestors, and because immigrants are here “illegally.” These findings advance color-blind rhetoric research beyond the black-white dichotomy by focusing on non-white immigrants. It also demonstrates that researchers should consider how at least respondents in new southern immigrant destinations intertwine various color-blind and racist nativist devices to shape immigration attitudes.
Vestibular Function and Activities of Daily Living
Authors: Harun Aisha , Semenov Yevgeniy R. , Agrawal Yuri
Published: September 2015

Objective: Vestibular dysfunction increases with age and is associated with mobility difficulties and fall risk in older individuals. We evaluated whether vestibular function influences the ability to perform activities of daily living (ADLs). Method: We analyzed the 1999 to 2004 National Health and Nutrition Examination Survey of adults aged older than 40 years ( N = 5,017). Vestibular function was assessed with the Modified Romberg test. We evaluated the association between vestibular function and difficulty level in performing specific basic and instrumental ADLs, and total number of ADL impairments. Results: Vestibular dysfunction was associated with significantly higher odds of difficulty with nine ADLs, most strongly with difficulty managing finances (odds ratio [ OR] = 2.64, 95% confidence interval [CI] = [1.18, 5.90]). In addition, vestibular dysfunction was associated with a significantly greater number of ADL impairments (β = .21, 95% CI = [0.09, 0.33]). This effect size was comparable with the influence of heavy smoking (β = .21, 95% CI = [0.06, 0.36]) and hypertension (β = .10, 95% CI = [0.02, 0.18]) on the number of ADL impairments. Conclusion: Vestibular dysfunction significantly influences ADL difficulty, most strongly with a cognitive rather than mobility-based task. These findings underscore the importance of vestibular inputs for both cognitive and physical daily activities.
HUS and the case for complement
Authors: Conway Edward M.
Published: September 2015

Hemolytic-uremic syndrome (HUS) is a thrombotic microangiopathy that is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure. Excess complement activation underlies atypical HUS and is evident in Shiga toxin–induced HUS (STEC-HUS). This Spotlight focuses on new knowledge of the role of Escherichia coli–derived toxins and polyphosphate in modulating complement and coagulation, and how they affect disease progression and response to treatment. Such new insights may impact on current and future choices of therapies for STEC-HUS.