bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Information Exchange System for Nursing Professionals to Enhance Patient Safety Across Europe
Authors: Stievano Dr. Alessandro , Jurado Máximo González , Rocco Gennaro , Sasso Loredana
Published: November 2009

Purpose: Ensuring safe healthcare services is one of today's most challenging issues, especially in light of the increasing mobility of health professionals and patients. In the last few years, nursing research has contributed to the creation of a culture of safety that is an integral part of clinical care and a cornerstone of healthcare systems.

Organizing Constructs: European institutions continue to discuss methods and tools that would best contribute to ensuring safe and high‐quality care, as well as ensuring access to healthcare services. According to the European Commission between 8% and 12% of patients admitted to hospitals in the European Union member states suffer from adverse events while receiving care, although some of these events are part of the intrinsic risk linked to receiving care. However, most of these adverse events are caused by such avoidable healthcare errors as, for instance, diagnosis mistakes, inability to act on the results of tests, medication errors, failures of healthcare equipment and hospital infections. Nosocomial infections alone are estimated to affect 4.1 million inpatients, that is, about 1 of every 20 inpatients, causing avoidable suffering and mortality, as well as an enormous loss of financial resources (at least €5.48 billion a year).

Conclusions: The Internal Market Information (IMI) System, developed by the European Commission, aims at contributing to patient safety by means of a timely and updated exchange of information among nursing regulatory bodies on the good standing and scope of practice of their registrants. Through the IMI System, the European Federation of Nursing Regulators will improve its electronic database on nurses to allow national nursing regulatory bodies to exchange the information needed to recognize the nurses' educational and professional qualifications and competencies. This process both facilitates the mobility of professionals and ensures high‐quality nursing practice in an even and consistent way across the European Union.

Clinical Relevance: On a national basis, nursing regulatory bodies play an important role in ensuring patient safety through high standards of nursing education and competence, whereas on an international basis, patient safety can assured by a better exchange of information between national regulatory bodies on the good professional standing of nurses.
Intrahousehold Disparities in Women and Men's Experiences of Water Insecurity and Emotional Distress in Urban Bolivia
Authors: Wutich Amber
Published: November 2009

This study is one of the first to examine the links connecting water insecurity, gender, and emotional distress. The article presents quantitative and qualitative analyses of interview data collected from randomly selected pairs of male and female household heads (n =48) living under the same household‐level conditions of water insecurity. The results provide partial confirmation of past findings that women are more likely than men to be burdened with everyday water responsibilities. However, there were no significant differences between men's and women's experiences in household water emergencies (i.e., water shortages and last‐ditch attempts to buy water) and reports on some measures of emotional distress (i.e., worry, annoyance, and anger with family members). The results suggest that intrahousehold gender disparities may be mitigated in times of severe water scarcity. The discussion raises questions about the comparability of men's and women's expressions of emotional distress.
Burned Rice Husk: An Effective Additive for Enhancing the Electromagnetic Properties of MgB2 Superconductor
Authors: Varghese Neson , Vinod Krishnankutty , Shipra  , Sundaresan Athinarayanan , Syamaprasad Upendran
Published: November 2009

We investigated the effect of doping of burned rice husk which contains ultrafine SiO2 and highly reactive carbon, on the crystal lattice and superconducting properties of MgB2 superconductor prepared by an in situ powder in sealed tube method. XRD, TEM, and magnetic measurements confirm the substitution of carbon atoms at boron sites in the MgB2 lattice and the formation of intragrain nanoinclusions in MgB2. From JC (H) characteristics, doped samples show a drastic enhancement of JC compared with pure MgB2. The enhancement of in‐field JC values is due to the flux pinning on lattice defects produced by C substitution and nanoscale inclusions of impurity phases.
Reforms, globalization, and endogenous agricultural structures
Authors: Swinnen Johan F.M.
Published: November 2009

In this article, I draw lessons from two quasi‐natural experiments (the transition process in former Communist countries and the rapid globalization of food chains) on the optimality of farms and agricultural structures more generally. I argue that (a) the farm structures that have emerged from the transition process are much more diverse than expected ex ante; (b) this diversity is to an important extent determined by economic mechanisms which are influenced by initial conditions and reform policies; (c) non‐traditional farm structures have played an important role during transition because they were optimal to address the specific institutional and structural constraints imposed by the transition process; (d) there is more diversity than often argued in the farms that are integrated in global food chains; (e) endogenous institutional (contracting) innovations in food chains may lock existing farm structures in a long‐run institutional framework; and (f) indicators based on farm structures are not a good measure of welfare effects of the globalization of food chains.
Optimal farm size in an uncertain land market: the case of Kyrgyz Republic
Authors: Savastano Sara , Scandizzo Pasquale Lucio
Published: November 2009

This article applies a real options model to the problem of land development. Making use of the 1998–2001 Kyrgyz Household Budget Survey, we show that when the hypothesis of decreasing return to scale holds, the relation between the threshold value of revenue per hectare and the amount of land cultivated is positive. In addition, the relation between the threshold and the amount of land owned is positive in the case of continuous supply of land and negative when there is discontinuous supply of land. The direct consequence is that, in the first case, smaller farms will be more willing to rent land and exercise the option where, in the second case, larger farms will exercise first. The results suggest three main conclusions: (i) the combination of uncertainty and irreversibility is an important factor in land development decisions, (ii) farmer behavior is consistent with the continuous profit maximization model, and (iii) farming unit revenue tends to be positively related to farm size, once uncertainty is properly accounted for.
Introduction to the special issue “small farms: decline or persistence?”
Authors: Bailey A. , Davidova S. , Hazell P.
Published: November 2009

This issue of Agricultural Economics contains articles from a seminar entitled “Small Farms: Decline or Persistence?” held at the University of Kent. This issue includes nine papers selected from more than 50 papers presented at the seminar. Articles published use a range of econometric and simulation methods to provide a suite of case studies. Topics studied range from such fundamental issues as what constitutes a small farm to recent trends in the diversification of small farms and their integration into modern globalized food chains. Several papers emphasize the link between agricultural policy development and the future of small farms.
Stem cell‐mediated natural tissue engineering
Authors: Möllmann H. , Nef H.M. , Voss S. , Troidl C. , Willmer M. , Szardien S. , Rolf A. , Klement M. , Voswinckel R. , Kostin S. , Ghofrani H.A. , Hamm C.W. , Elsässer A.
Published: November 2009

Recently, we demonstrated that a fully differentiated tissue developed on a ventricular septal occluder that had been implanted due to infarct‐related septum rupture. We suggested that this tissue originated from circulating stem cells. The aim of the present study was to evaluate this hypothesis and to investigate the physiological differentiation and transdifferentiation potential of circulating stem cells. We developed an animal model in which a freely floating membrane was inserted into each the left ventricle and the descending aorta. Membranes were removed after pre‐specified intervals of 3 days, and 2, 6 and 12 weeks; the newly developed tissue was evaluated using quantitative RT‐PCR, immunohistochemistry and in situ hybridization. The contribution of stem cells was directly evaluated in another group of animals that were by treated with granulocyte macrophage colony‐stimulating factor (GM‐CSF) early after implantation. We demonstrated the time‐dependent generation of a fully differentiated tissue composed of fibroblasts, myofibroblasts, smooth muscle cells, endothelial cells and new blood vessels. Cells differentiated into early cardiomyocytes on membranes implanted in the left ventricles but not on those implanted in the aortas. Stem cell mobilization with GM‐CSF led to more rapid tissue growth and differentiation. The GM‐CSF effect on cell proliferation outlasted the treat ment period by several weeks. Circulating stem cells contributed to the development of a fully differentiated tissue on membranes placed within the left ventricle or descending aorta under physiological conditions. Early cardiomyocyte generation was identified only on membranes positioned within the left ventricle.
Crevicular fluid glutathione levels in periodontitis and the effect of non‐surgical therapy
Authors: Grant Melissa M. , Brock Gareth R. , Matthews John B. , Chapple Iain L. C.
Published: November 2009

Aim: To quantify reduced and oxidized glutathione (GSH and GSSG) levels in gingival crevicular fluid (GCF) of periodontitis patients pre‐therapy (versus periodontally healthy controls) and ascertain whether successful non‐surgical therapy alters glutathione levels.

Materials and Methods: Thirty‐second GCF samples (6/subject) were collected on Periopaper™ strips from starved, non‐smokers (n=20; mean age 43.6 years) with chronic periodontitis, before and 3 months after non‐surgical therapy, and periodontally healthy, age‐ and gender‐matched controls (n=20). GSH and GSSG levels were determined using reversed‐phase high‐performance liquid chromatography with fluorescence detection.

Results: Lower concentrations of GSH (p<0.01) and GSSG (p<0.05) were detected in GCF from patients (pre‐ and post‐therapy) than controls and treatment had no significant effect. Amounts per 30‐second sample did not differ between patients and controls. However, the amount of GSSG per 30‐second sample decreased in patients after therapy (p<0.05). Consequently, therapy increased the GSH:GSSG ratio (p<0.05) in patients compared with the controls (p=0.8).

Conclusion: These data demonstrate high concentrations of GSH within GCF, which are compromised in chronic periodontitis. While therapy does not appear to fully restore GSH concentrations in GCF, it does restore the redox balance (GSH:GSSG ratio), suggesting that the abnormal redox balance arises secondary to oxidative stress resulting from periodontal inflammation.
Assessment of the validity of HLD (CalMod) in identifying orthodontic treatment need
Authors: Cooke Mary , Gerbert Barbara , Gansky Stuart , Miller Arthur , Nelson Gerald , Orellana Maria
Published: November 2009

Cooke M, Gerbert B, Gansky S, Miller A, Nelson G, Orellana M. Assessment of the validity of HLD (CalMod) in identifying orthodontic treatment need. Community Dent Oral Epidemiol 2010; 38: 50–57. © 2009 John Wiley & Sons A/S

Abstract –  Objective:  The purpose of this study was to assess the validity of the Handicapped Labio‐Lingual Deviation index with California modifications, HLD (CalMod), in identifying handicapping malocclusions.

Methods:  A set of 153 study casts representing all types of malocclusion was utilized in this study. Models were randomly chosen the UCSF Division of Orthodontics clinic. Treatment need was determined by the HLD (CalMod) index and by a panel of 13 orthodontists, conventionally established as the ‘gold standard’. Spearman Rank correlation analysis was used to evaluate the correlation between HLD (CalMod) and the gold standard. The Classification and Regression Tree (CART) modeling was used to determine the HLD (CalMod) cut‐off point of orthodontic treatment need according to the gold standard.

Results:  A Spearman Rank correlation Coefficient of 0.71 demonstrated a moderately high correlation between HLD (CalMod) and the gold standard. The CART modeling determined a value of 18.5 as the cut‐off point of HLD (CalMod) for orthodontic treatment need, considerably lower than the cut‐off point of 26 currently used by Medi‐Cal. At a value of 26 points as the cut‐off HLD (CalMod) displayed a low sensitivity (25.9%) and high specificity (96.8%).With a cut‐off point of 18.5, specificity decreased to 55.6% while sensitivity increased dramatically to 92.9%.

Conclusion:  Our results show that the HLD (CalMod) with a cut‐off point of 26 fails to indentify a considerable percentage of handicapping malocclusions. More studies should be done assessing the efficacy of the HLD (CalMod) in identifying handicapping malocclusion.
The effects of lavender scent on dental patient anxiety levels: a cluster randomised‐controlled trial
Authors: Kritsidima Metaxia , Newton Tim , Asimakopoulou Koula
Published: November 2009

Kritsidima M, Newton T, Asimakopoulou K. The effects of lavender scent on dental patient anxiety levels: a cluster randomized‐controlled trial. Community Dent Oral Epidemiol 2010; 38: 83–87. © 2009 John Wiley & Sons A/S

Abstract –  Objectives:  To review the effect of lavender scent on anticipatory anxiety in dental participants.

Methods:  In a cluster randomized‐controlled trial, patients’ (N = 340) anxiety was assessed while waiting for a scheduled dental appointment, either under the odor of lavender or with no odor. Current anxiety, assessed by the brief State Trait Anxiety Indicator (STAI‐6), and generalized dental anxiety, assessed by the Modified Dental Anxiety Scale (MDAS) were examined.

Results:  Analyses of variance (anovas) showed that although both groups showed similar, moderate levels of generalized dental anxiety (MDAS F(1,338) = 2.17, P > 0.05) the lavender group reported significantly lower current anxiety (STAI: F(1,338) = 74.69, P < 0.001) than the control group.

Conclusions:  Although anxiety about future dental visits seems to be unaffected, lavender scent reduces state anxiety in dental patients.
Safety and efficacy of bortezomib‐based regimens for multiple myeloma patients with renal impairment: a retrospective study of Italian Myeloma Network GIMEMA
Authors: Morabito Fortunato , Gentile Massimo , Ciolli Stefania , Petrucci Maria T. , Galimberti Sara , Mele Giuseppe , Casulli Antonio F. , Mannina Donato , Piro Eugenio , Pinotti Graziella , Palmieri Salvatore , Catalano Lucio , Callea Vincenzo , Offidani Massimo , Musto Pellegrino , Bringhen Sara , Baldini Luca , Tosi Patrizia , Di Raimondo Francesco , Boccadoro Mario , Palumbo Antonio , Cavo Michele
Published: November 2009

Renal impairment (RI) is a severe complication throughout the course of multiple myeloma (MM). Bortezomib has been shown to be highly active in MM patients with RI. We designed this retrospective analysis to investigate the safety and efficacy of bortezomib‐based therapy in 117 MM patients with RI, 14 cases required dialysis. A total of 603 cycles of bortezomib were administered (median number, five cycles/patient). Ten patients required early discontinuation of bortezomib because of WHO grade IV toxicity. The rate of bortezomib discontinuation in cases with severe, moderate and mild RI was 11%, 5% and 0%, respectively (P = NS). Overall, 91 episodes of WHO grade III/IV toxicity were observed. At least a partial response was documented in 83/113 evaluable patients (73%), including complete response (19%) and near complete response (8%). The overall response rate was similar across RI subgroups. Reversal of RI was documented in 41% of patients after a median of 2.3 months (range 0.4–7.9). In three of 14 patients on dialysis, renal replacement therapy was discontinued after 1, 1 and 4 months. The 2‐yr estimate of response duration and overall survival was 70% and 51%, respectively. In conclusion, bortezomib‐based regimens are safe and effective and should be considered as appropriate treatment options for MM patients with any degree of RI.
Mice lacking synapsin III show abnormalities in explicit memory and conditioned fear
Authors: Porton B. , Rodriguiz R. M. , Phillips L. E. , Gilbert J. W. , Feng J. , Greengard P. , Kao H.‐T. , Wetsel W. C.
Published: November 2009

Synapsin III is a neuron‐specific phosphoprotein that plays an important role in synaptic transmission and neural development. While synapsin III is abundant in embryonic brain, expression of the protein in adults is reduced and limited primarily to the hippocampus, olfactory bulb and cerebral cortex. Given the specificity of synapsin III to these brain areas and because it plays a role in neurogenesis in the dentate gyrus, we investigated whether it may affect learning and memory processes in mice. To address this point, synapsin III knockout mice were examined in a general behavioral screen, several tests to assess learning and memory function, and conditioned fear. Mutant animals displayed no anomalies in sensory and motor function or in anxiety‐ and depressive‐like behaviors. Although mutants showed minor alterations in the Morris water maze, they were deficient in object recognition 24 h and 10 days after training and in social transmission of food preference at 20 min and 24 h. In addition, mutants displayed abnormal responses in contextual and cued fear conditioning when tested 1 or 24 h after conditioning. The synapsin III knockout mice also showed aberrant responses in fear‐potentiated startle. As synapsin III protein is decreased in schizophrenic brain and because the mutant mice do not harbor obvious anatomical deficits or neurological disorders, these mutants may represent a unique neurodevelopmental model for dissecting the molecular pathways that are related to certain aspects of schizophrenia and related disorders.
Functional (GT)n polymorphisms in promoter region of N‐methyl‐d‐aspartate receptor 2A subunit (GRIN2A) gene affect hippocampal and amygdala volumes
Authors: Inoue H. , Yamasue H. , Tochigi M. , Suga M. , Iwayama Y. , Abe O. , Yamada H. , Rogers M. A. , Aoki S. , Kato T. , Sasaki T. , Yoshikawa T. , Kasai K.
Published: November 2009

The glutamate system including N‐methyl‐d‐aspartate (NMDA) affects synaptic formation, plasticity and maintenance. Recent studies have shown a variable (GT)n polymorphism in the promoter region of the NMDA subunit gene (GRIN2A) and a length‐dependent inhibition of transcriptional activity by the (GT)n repeat. In the present study, we examined whether the GRIN2A polymorphism is associated with regional brain volume especially in medial temporal lobe structures, in which the NMDA‐dependent synaptic processes have been most extensively studied. Gray matter regions of interest (ROIs) for the bilateral amygdala and hippocampus were outlined manually on the magnetic resonance images of 144 healthy individuals. In addition, voxel‐based morphometry (VBM) was conducted to explore the association of genotype with regional gray matter volume from everywhere in the brain in the same sample. The manually measured hippocampal and amygdala volumes were significantly larger in subjects with short allele carriers (n = 89) than in those with homozygous long alleles (n = 55) when individual differences in intracranial volume were accounted for. The VBM showed no significant association between the genotype and regional gray matter volume in any brain region. These findings suggest that the functional GRIN2A (GT)n polymorphism could weakly but significantly impact on human medial temporal lobe volume in a length‐dependent manner, providing in vivo evidence of the role of the NMDA receptor in human brain development.
The assessment of frailty in older people in acute care
Authors: Hilmer Sarah N , Perera Vidya , Mitchell Sarah , Murnion Bridin P , Dent Jonathan , Bajorek Beata , Matthews Slade , Rolfson Darryl B
Published: November 2009

Aim:  Develop a measure of frailty for older acute inpatients to be performed by non‐geriatricians.

Method:  The Reported Edmonton Frail Scale (REFS) was adapted from the Edmonton Frail Scale for use with Australian acute inpatients. With acute patients aged over 70 years admitted to an Australian teaching hospital, we validated REFS against the Geriatrician's Clinical Impression of Frailty (GCIF), measures of cognition, comorbidity and function, and assessed inter‐rater reliability.

Results:  REFS was moderately correlated with GCIF (n = 105, R = 0.61, P < 0.01), Mini‐Mental State Examination impairment (n = 61, R = 0.49, P < 0.001), Charlson Comorbidity Index (n = 59, R = 0.51, P < 0.001) and Katz Daily Living Scale (n = 59, R = 0.51, P < 0.001). Inter‐rater reliability of REFS administered by two researchers without medical training was excellent (kappa = 0.84, n = 31).

Conclusion:  In this cohort of older acute inpatients, REFS is a valid, reliable test of frailty, and may be a valuable research tool to assess the impact of frailty on prognosis and response to therapy.
Delirium unit: Our experience
Authors: Wong Tin Niam Dorothy Milly , Geddes John AA , Inderjeeth Charles A
Published: November 2009

The optimal model of care for patients with delirium in tertiary institutions is unknown. The aim of this project was to assess whether managing delirious patients in a secure unit could improve quality of care without significantly increasing the cost. We set up a delirium and surveillance unit at a tertiary hospital in Western Australia. The key elements of the unit were to provide a secure environment with staff trained and committed to delirium care. Patient care was based on comprehensive geriatric principles. The activities and outcomes were audited over an initial period after the establishment of the unit and a second audit was conducted following improvements based on the results of the initial audit. Managing patients in a delirium unit improves quality of care of patients and is cost‐effective. The best model appears to be one where there is a dedicated consultant‐led unit with ongoing staff education.
Review article: The use of pelvic examination within the emergency department in the assessment of early pregnancy bleeding
Authors: Isoardi Katherine
Published: November 2009

Early pregnancy bleeding is a common presentation in the emergency setting. Traditionally, its assessment relied on clinical findings, including pelvic examination. However in recent years, ultrasonography and quantitative beta human chorionic gonadotropin assays have gained prominence and are now first‐line in diagnosing early pregnancy bleeding. Accordingly, the role of pelvic examination in the acute setting has been increasingly questioned. This article reviews the evidence for the role of pelvic examination in the assessment of early pregnancy bleeding in the ED. A Medline search was conducted and 43 articles were included in this review. Applicable research is largely observational and of a low level of evidence. However, available data indicate that the role of pelvic examination in the assessment of early pregnancy bleeding is limited, providing that there is prompt access to transvaginal ultrasound examination. Pelvic examination does not provide further diagnostic information over ultrasonography used in conjunction with beta human chorionic gonadotropin assays. The routine use of pelvic examination is not supported by the literature. However, when ultrasonography and beta human chorionic gonadotropin testing are unavailable or the results inconclusive, pelvic examination should be considered. Assessment in these instances must focus on identifying possible life‐threatening conditions, such as ectopic pregnancy, as well as determining the safety of discharge pending definitive assessment. Speculum examination is indicated in those presenting with severe bleeding or hypotension as removal of obstructing endocervical products can be a crucial resuscitative measure.
Paracetamol versus ibuprofen: A randomized controlled trial of outpatient analgesia efficacy for paediatric acute limb fractures
Authors: Shepherd Michael , Aickin Richard
Published: November 2009

Paediatric limb fracture is a common injury that presents frequently to the ED. The primary objective of the present study was to determine whether ibuprofen provides better analgesia than paracetamol for paediatric patients discharged with acute limb fractures. A prospective, randomized controlled study was conducted in a children's ED. Children aged 5–14 years with an acute limb fracture were randomized to be prescribed paracetamol 15 mg/kg/dose every 4 h or ibuprofen 10 mg/kg/dose every 8 h. Objective (child‐reported) pain scores using the ‘Faces’ pain scale were measured over a 48 h period. Child‐reported pain did not differ significantly between the paracetamol and ibuprofen groups (mean pain score paracetamol 2.8 [95% CI 2.4–3.4]vs 2.7 [95% CI 2.1–3.3], P= 0.73). Parent‐reported sleep quality did not differ between the two groups (P= 0.78). Child‐reported pain score decreased over the 48 h of measurement (P < 0.0001). There were no significant differences in side‐effects detected between the two groups. The present study shows that in the outpatient paediatric population, ibuprofen does not provide better analgesia than paracetamol. Pain from an acute fracture can be managed by regular simple oral analgesia and immobilization.
Endovascular management of an axillary arterial injury post shoulder dislocation
Authors: Reid David , Chue Wai‐Leng
Published: November 2009

Axillary arterial injury is a rare complication of non‐recurrent glenohumeral joint dislocation. Previously this type of injury would have required open exploration of the axillary artery with associated risk of iatrogenic injury to the axillary vein or brachial plexus. We present the case of a 75‐year‐old lady, who following a fall in her own home, sustained a dislocation of her right shoulder joint complicated by avulsion of a branch of her axillary artery. We describe the successful endovascular management of the injury using a self‐expanding stent and propose this as the preferred surgical option where the artery is not completely transected.
Prevalence of access block in Australia 2004–2008
Authors: Richardson Drew , Kelly Anne‐Maree , Kerr Debra
Published: November 2009

Objective:  Access block is the inability of ED patients requiring admission to access appropriate inpatient beds in a timely fashion, defined in Australasia as more than 8 h in the ED. The present study describes changes in prevalence of access block in Australia over a 4 year period.

Methods:  Email, telephone and fax survey of ED on six Mondays at 10.00 hours (31 May, 30 August 2004, 18 June, 3 September 2007, 2 June, 2 September 2008). Data collected included point data on the status of patients in the ED at the index time and of recent ED attendance numbers. Results were collated and analysed by state and hospital role delineation.

Results:  Forty‐eight (60%) of 80 eligible ED answered all six surveys. Presentations to the ED the day before rose 15% (P < 0.0001, paired t‐test) in 4 years, and nationally access block patients in the ED rose an average of 27%, and patients waiting to be seen by a doctor 31%. There were differences between states, with hospitals in New South Wales reporting a significant reduction in access block patients (−51%, P= 0.0002), but all other states a significant increase (+45%, P= 0.001). There were differences by role delineation, with non‐paediatric major referral hospitals experiencing the greatest access block, but smaller hospitals experiencing the greatest increase in patients waiting.

Conclusions:  Around one‐third of all patients receiving care in these ED surveys were experiencing access block. There is evidence that flow through New South Wales ED has improved. The data suggest that most hospitals have passed the point of efficiency.
Potential Effectiveness of Pelvic Floor Rehabilitation Treatment for Postradical Prostatectomy Incontinence, Climacturia, and Erectile Dysfunction: A Case Series
Authors: Sighinolfi Maria Chiara , Rivalta Massimo , Mofferdin Alessandro , Micali Salvatore , De Stefani Stefano , Bianchi Giampaolo
Published: November 2009

Introduction

Radical prostatectomy is the treatment of choice for prostate cancer; although novel techniques have significantly reduced its side effects, the procedure can provoke urinary incontinence of various degrees and/or erectile dysfunction.

Aim

We evaluate the effect of a complete pelvic floor rehabilitation program on both incontinence and erectile dysfunction, including climacturia, in a preliminary case series.

Main Outcomes Measures

Pad usage and International Index of Erectile Function (IIEF-15) Questionnaire.

Methods

Three male patients, previously submitted to nerve and bladder neck sparing radical prostatectomy, presented with urinary incontinence, climacturia and erectile dysfunction of new onset. We decided to manage those subjects with a pelvic-floor rehabilitation program consisting of active pelvic-floor muscle exercises, electromyography biofeedback for strength and endurance, electrical stimulation. The whole program lasted 4 months, with weekly sessions, including general advices on lifestyle changes. Pad usage for incontinence and IIEF-15 were used to assess symptoms before and after the procedure.

Results

Before a complete rehabilitation program, pad usage was 1 per day in all the subjects, and the score for erectile function was set at 17 (range 15–20). After the procedure, all the patients experienced a satisfying urinary continence and an improvement in erectile function (mean IIEF score: 22, range 19–24). Similarly, climacturia seems to be subjectively reduced in all the subjects.

Conclusion

Pelvic floor muscles exercises seem to result in an improved urinary continence and erectile function after radical prostatectomy. Since this is the first clinical case series dealing with this topic, our outcomes are encouraging and suggest the potential usefulness of such noninvasive treatment modality.
EVALUATION OF MOLECULAR WEIGHT OF CHITOSAN IN THIN‐LAYER AND SPOUTED BED DRYING
Authors: HALAL CHRISTINE Y. , MOURA JAQUELINE M. , PINTO LUIZ A.A.
Published: November 2009

Chitosan is chitin in deacetylated form and is the main constituent of crustacean exoskeletons. Commercially, chitosan is dried in tray driers, and during the operation, polymerization may occur as the chitosan is composed of carbohydrates. The aim of this work was to analyze chitosan in spouted bed and thin‐layer drying, considering viscosity average molecular weight of the chitosan samples in the process. Results showed that spouted bed‐dried chitosan presented a molecular weight value similar (160 kDa) to that of the raw one (150 kDa). However, when dried on tray dryers, the molecular weight was 300 kDa, indicating that molecule polymerization occurred.

PRACTICAL APPLICATIONS

Chitosan, a deacetylated form of chitin, is considered a functional food. The use of chitosan in various areas is directly related to the molecular weight and degree of deacetylation, which depends on the conditions of chitin deacetylation and chitosan drying. One of the main steps of the chitosan production process is drying. Industrial chitosan is dried in tray dryers; however, it is composed mainly of carbohydrate monomer units capable of undergoing polymerization during the drying operation. The spouted bed dryer is a method that promotes direct particle–fluid contact, with high rates of heat and mass transfer. Also, it presents an alternative to the spray‐dryer in an attempt to obtain dry products with the same quality, at low costs. This work presents the study of chitosan drying in spouted bed and thin layer, in paste form, considering the viscosity average molecular weight of the chitosan samples in the operation.
QUALITY STABILITY ASSESSMENT OF A STRAWBERRY‐GEL PRODUCT DURING STORAGE
Authors: MARTÍN‐ESPARZA M.E. , ESCRICHE I. , PENAGOS L. , MARTÍNEZ‐NAVARRETE N.
Published: November 2009

A strawberry‐gel product was formulated by using osmotic treatment. The osmotic solution (OS) used to dehydrate the fruit was mixed with carrageenan and employed to formulate the gel. In order to prevent a further dehydration of the fruit during product storage, the OS was previously diluted so that its water activity is the same as the dehydrated fruit. Changes in water, soluble solids, citric acid, ascorbic acid and anthocyanin contents, water activity, surface color, mechanical properties and volatile profile during 15 days of storage (5C) were evaluated. The use of the OS increased the nutritive and functional properties of the product. Changes in volatile profile, mechanical properties and color of the strawberry occur mainly in the first 2 days of storage and are not due to the presence of the gel matrix, as they occur also in the samples not placed in gel. The flux of anthocyanins from the fruit to the gel produces redness, giving a more attractive aspect to the formulated product.

PRACTICAL APPLICATIONS

Fruit is still consumed below the recommended values for human health, particularly in developed countries. The development of new fruit based products with a high proportion of fruit and good nutritional and functional properties (such as the one proposed in this study) may be of interest in order to diversify the market supply. These products must be attractive, especially among the young, easy to consume and with a reasonable shelf‐life. Osmotic dehydration may be used to partially decrease fruit water activity obtaining high quality products. However, the osmotic solution is still difficult to manage in some cases. Thus, the use of this by‐product on the fruit‐gel formulation is of great interest to eliminate environmental adverse effects and to increase the nutritive and functional properties of the product.
Identifying Functional Regions in Australia Using Hierarchical Aggregation Techniques
Authors: MITCHELL WILLIAM , WATTS MARTIN
Published: November 2009

This paper continues our work focused on developing a new socio‐economic geography for Australia such that the chosen spatial aggregation of data is based on an analysis of economic behaviour. The underlying hypothesis is that the development of a geographical classification based on underlying economic behaviour will provide new insights into critical issues of regional performance, including unemployment differentials, the impact of industry, infrastructure and changes in local public expenditure on local labour markets. As a precursor to detailed work on the 2006 Census of Population and Housing data, we establish the proof of concept in this paper of the Intramax methodology using 2001 Journey‐to‐Work data from the Australian Bureau of Statistics (ABS) for the state of New South Wales. The functional regionalisation generated by the Intramax method is then tested using ABS labour force data. We compare 2001 ABS Census of Population and Housing data aggregated by the ABS labour force regions to the same data aggregated using our functional regions. The results demonstrate the potential value of this technique for the development of a new geography.
Neurological complications of immune reconstitution in HIV‐infected populations
Authors: Johnson Tory , Nath Avindra
Published: November 2009

The introduction of highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infection has transformed this disease from a fatal infection to a chronic yet manageable condition by restoring immune function. All the same, this restoration of immune response in some may be associated with deterioration in clinical status, which has been termed immune reconstitution inflammatory syndrome (IRIS). This syndrome often occurs in the context of an underlying opportunistic infection and develops after an interval of weeks to months after the initiation of HAART. Occasionally, IRIS may occur in the brain without any opportunistic infection, which presents as a T cell–mediated encephalitis. This paradoxical infiltration of previously immune suppressed patients with T cells represents a diagnostic challenge and a treatment dilemma. Nonetheless, CNS‐IRIS with or without an opportunistic infection can range in severity. Severe cases can be fatal and hence require intervention with steroid treatment. This review discusses the diagnosis, clinical manifestations, risk factors, pathophysiology, and potential treatment strategies of the various forms of IRIS that involve the nervous system.
The progression of pathology in Parkinson's disease
Authors: Halliday Glenda Margaret , McCann Heather
Published: November 2009

To identify the progression of pathology over the entire course of Parkinson's disease, we longitudinally followed a clinical cohort to autopsy and identified three clinicopathological phenotypes that progress at different rates. Typical Parkinson's disease has an initial rapid loss of midbrain dopamine neurons with a slow progression of Lewy body infiltration into the brain (over decades). Dementia intervenes late when Lewy bodies invade the neocortex. Older onset patients (> 70 years old) dement earlier and have much shorter disease durations. Paradoxically, they have far more α‐synuclein‐containing Lewy bodies throughout the brain, and many also have additional age‐related plaque pathology. In contrast, dementia with Lewy bodies has the shortest disease course, with substantive amounts of Lewy bodies and Alzheimer‐type pathologies infiltrating the brain. These data suggest that two age‐related factors influence pathological progression in Parkinson's disease—the age at symptom onset and the degree and type of age‐related Alzheimer‐type pathology.
Medial collateral ligament desmitis of the distal interphalangeal joint in the hindlimb of a horse: treatment with cast immobilisation
Authors: Trope GD , Whitton RC
Published: November 2009

A 12‐year‐old show‐jumping mare was presented for investigation of a chronic hindlimb lameness of 16 weeks duration. Perineural anaesthesia and ultrasonography localised the lesion to the medial collateral ligament of the distal interphalangeal joint of the left hindlimb. Treatment consisted of a heavily padded distal limb cast for 6 weeks, strict box rest and a strictly regulated hand walking program. Serial ultrasonographic examinations were performed throughout the rehabilitation period. Collateral ligament desmitis of the distal interphalangeal joint is a commonly diagnosed condition of the forelimb; however, hindlimb collateral ligament desmitis has been rarely reported. Ultrasonographic examination in this case was an invaluable diagnostic and follow‐up tool. Immobilisation of the foot by means of a heavily padded distal limb cast allowed excellent healing of the ligament and is presented as a novel treatment for collateral ligament desmitis. At the time of writing the mare had returned to her previous level of exercise and was showing no signs of lameness.
Relationship between California Mastitis Test score and ultrasonographic teat measurements in dairy cows
Authors: Seker I , Risvanli A , Yuksel M , Saat N , Ozmen O
Published: November 2009

Objective The majority of published studies about mastitis are related to the control and prevention of mastitis, with particular emphasis on eliminating predisposition factors. The objective of the current study was to determine the role of teat morphology as an important factor in the aetiology of mastitis.

Design Ultrasonographic measurements were taken from 190 teats from 100 dairy cows of different breeds.

Procedure Mastitis in cows was diagnosed by the California Mastitis Test (CMT) and microbiological tests. The data were evaluated in the light of the clinical history of the animals.

Results Main effects of breed on teat diameter at the position of the Furstenberg rosette (FTD) and teat cistern diameter (CD), that of age on FTD and overall teat diameter (OTD), and that of CMT score on CD and OTD were significant (P < 0.05, P < 0.01). Number of lactations, pregnancy, the lactation period and the udder lobe (rear, front) were not found to have a significant effect on any of the measurements. Results showed that CD was significantly smaller (1.44 ± 0.04 cm) (P < 0.01) in CMT‐positive udder lobes than that in CMT‐negative lobes. No difference was detected in canal length, CD, teat wall thickness, OTD or FTD between the CMT‐positive and ‐negative lobes.

Conclusion The occurrence of mastitis could be related to specific ultrasonographic teat measurements (e.g. CD, OTD and FTD) and these may be important in the breeding of cows with a predisposition to mastitis, as well in the evaluation of in‐herd cows in terms of udder/teat deformities.
Reaction Pathways for the Photodegradation of the Organophosphorus Cyanophos in Aqueous Solutions
Authors: Menager Matthieu , Pilichowski Jean François , Sarakha Mohamed
Published: November 2009

Photodegradation in aqueous solutions is an important pathway for many agrochemicals such as pesticides. In the present work, the photochemical transformation of cyanophos (CYA) was investigated in aqueous solutions using UV light within the 254–313 nm range as well as solar light. The study was performed in order to have a deep insight into the mechanistic pathways for the photochemical disappearance of CYA. Upon UV irradiation of an aerated solution of CYA, the degradation quantum yield was found equal to 1.8 × 10−2. It is independent of the excitation wavelength but varies with oxygen concentration. It increased by a factor of 2 from oxygen‐saturated to oxygen‐free solution. Photosensitized experiments were performed using acrylamide and hydroquinone as energy acceptor and energy donor substrates, respectively. They show that both singlet and triplet excited states were involved in the photochemical behavior of CYA. The laser flash photolysis experiments clearly showed the involvement of the triplet excited state which was efficiently quenched by molecular oxygen and acrylamide with the rate constants 1.97 × 109 and 2.71 × 109 mol−1 L s−1, respectively. The photoproducts structures were proposed according to the mass spectral data using the LC/MS technique. The analytical study shows that various processes such as hydrolysis, homolytic bond dissociations and Photo‐Fries process occur.
Psychological Factors in Terrorism and Counterterrorism: Individual, Group, and Organizational Levels of Analysis
Authors: Kruglanski Arie W. , Fishman Shira
Published: November 2009

This article explores psychological factors involved in terrorism and counterterrorism on individual, group, and organizational levels of analysis. On the individual level, we describe attempts to understand terrorist behavior as a form of psychopathology and/or as reflecting a unique constellation of personality traits. We also consider whether there exists a general motivational basis for participating in terrorism. On the group level of analysis, we address the process of shared reality construction, social influence involved in recruitment of new members to terrorist organization, their indoctrination into terrorist ideology, and the use of language in creating terrorism warranting norms. On the organizational level, we consider issues of training, logistics, and cost effectiveness as they apply to the decisions to launch or abstain from terrorist activities. We conclude by considering the implications of our analysis for possible ways and means for countering terrorism.
Using Empathy to Improve Intergroup Attitudes and Relations
Authors: Batson C. Daniel , Ahmad Nadia Y.
Published: November 2009

Recently, social psychologists have given considerable attention to the possibility that empathy can be used to improve intergroup attitudes and relations. For this possibility to bear practical fruit, it is important to know what is meant by empathy because different researchers use the term to refer to different psychological states. It is also important to understand how each of these empathy states might affect intergroup relations by reviewing theory and research on the psychological processes involved, and it is important to consider the limitations of each form of empathy as a source of improved intergroup relations. Finally, it is important to consider the role of different empathy states in existing programs designed to improve intergroup relations, whether in protracted political conflicts, in educational settings, or via media. In this article, we pursue each of these goals.
Linkage disequilibrium estimates of contemporary Ne using highly variable genetic markers: a largely untapped resource for applied conservation and evolution
Authors: Waples Robin S. , Do Chi
Published: November 2009

Genetic methods are routinely used to estimate contemporary effective population size (Ne) in natural populations, but the vast majority of applications have used only the temporal (two‐sample) method. We use simulated data to evaluate how highly polymorphic molecular markers affect precision and bias in the single‐sample method based on linkage disequilibrium (LD). Results of this study are as follows: (1) Low‐frequency alleles upwardly bias , but a simple rule can reduce bias to <about 10% without sacrificing much precision. (2) With datasets routinely available today (10–20 loci with 10 alleles; 50 individuals), precise estimates can be obtained for relatively small populations (Ne < 200), and small populations are not likely to be mistaken for large ones. However, it is very difficult to obtain reliable estimates for large populations. (3) With ‘microsatellite’ data, the LD method has greater precision than the temporal method, unless the latter is based on samples taken many generations apart. Our results indicate the LD method has widespread applicability to conservation (which typically focuses on small populations) and the study of evolutionary processes in local populations. Considerable opportunity exists to extract more information about Ne in nature by wider use of single‐sample estimators and by combining estimates from different methods.
Sexual function in male patients with obstructive sleep apnoea
Authors: Petersen Marian , Kristensen Ellids , Berg Søren , Midgren Bengt
Published: November 2009

Objective:  Our objective was to investigate general and functional aspects of sexuality in male patients with a confirmed diagnosis of obstructive sleep apnoea (OSA) and compare the results with normative data.

Materials and Methods:  We investigated 308 male patients (age 30–69) admitted to a sleep laboratory and receiving a diagnosis of OSA, using questions drawn from two self‐administered questionnaires on sexuality [Fugl‐Meyer Life satisfaction checklist (LiSat) and Brief Sexual Function Inventory (BSFI)].

Results:  We found that both general (Fugl‐Meyer LiSat) and functional (BSFI) aspects of sexuality were worse in patients with (untreated) OSA when compared with normative data. Both aspects were dependent on age, obesity, social factors and concomitant medication but not on the severity of OSA as reflected by the apnoea–hypopnoea index or subjective sleepiness.

Conclusion:  We conclude that although sexual dysfunction is more prevalent in OSA patients than in the general population, it is a complex problem relating more to age, obesity, social factors and comorbidity than to the severity of OSA.

Please cite this paper as: Petersen M, Kristensen E, Berg S, Midgren B. Sexual function in male patients with obstructive sleep apnoea. The Clinical Respiratory Journal 2010; 4: 186–191.