bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a Community-Based Participatory Research Consortium From the Perspective of Academics and Community Service Providers Focused on Child Health and Well-Being
Authors: Pivik Jayne R. , Goelman Hillel
Published: March 2011

A process evaluation of a consortium of academic researchers and community-based service providers focused on the health and well-being of children and families provides empirical and practice-based evidence of those factors important for community-based participatory research (CBPR). This study draws on quantitative ratings of 33 factors associated with CBPR as well as open-ended questions addressing the benefits, facilitators, barriers, and recommendations for collaboration. Eight distinct but related studies are represented by 10 academic and 9 community researchers. Even though contextual considerations were identified between the academic and community partners, in large part because of their focus, organizational mandate and particular expertise, key factors for facilitating collaboration were found across groups. Both community and academic partners reported the following as very important for positive collaborations: trust and mutual respect; adequate time; shared commitment, decision making, and goals; a memorandum of understanding or partnership agreement; clear communication; involvement of community partners in the interpretation of the data and information dissemination; and regular meetings. The results are compared to current models of collaboration across different contexts and highlight factors important for CBPR with community service providers.
Luhmann’s system theory in social work: Criticism and reflections
Authors: Kihlström Anita
Published: March 2011

• Summary: In this article Luhmann’s functionalist systems theory is examined and its relevance to social work questioned. What does the theory focus on? How does it understand the individual? What kind of communication does it involve? The answers draw on the theory of communicative action and the Swedish welfare model.

• Findings: When using Luhmann’s systems theory social work will be reduced to an instrumental process. It implies that neither ethical nor moral arguments from outside will be able to influence the work. However, a citizen-oriented social service has to be attentive to the difficulties confronting individuals in their daily life. But, the communication model used in this theory limits the role of the individual by reducing mutual dialogues to one-sided information, supported by codes. This attitude is in opposition to demands for recognition and social support. Thus, Luhmann’s systems theory needs to be carefully considered when used in modern social work.

• Applications: The analysis will increase and update the knowledge of some limitations with Luhmann’s functionalist systems theory used in social work
Measuring social workers’ judgements: Why and how to use the factorial survey approach in the study of professional judgements
Authors: Wallander Lisa
Published: March 2011

• Summary: The factorial survey approach, which was first introduced in the social sciences around the beginning of the 1980s, constitutes an advanced method for measuring human judgements of people or social situations. At the general level, this quasi-experimental approach involves presenting respondents with vignettes (fictive descriptions), in which selected characteristics describing the vignette ‘person’ or ‘situation’ are simultaneously manipulated. The aim of this article is to present a conceptual and an analytical framework for factorial survey studies of professional judgements in social work.

• Findings: In the first part of the article, I develop and discuss the proposition that this approach may be used in order to study the contents of professional judgements about the diagnosis and treatment of clients. The ‘contents’ is discussed in terms of knowledge assumptions that practitioners explicitly and tacitly use as a basis for their professional judgements. Second, I outline a strategy for modelling social workers’ judgements. This modelling strategy proceeds from the possibilities afforded by multilevel regression analysis.

• Applications: Findings from analyses of factorial survey data may reveal both professional agreement and disagreement in practitioners’ judgements. While results that reveal high levels of disagreement in judgements about what constitutes a particular diagnosis or about which intervention is the most suitable for a particular client may raise questions as regards the ‘professionalism’ of practitioners’ judgements, results that reveal professional agreement in diagnostic and treatment assumptions may be transformed into hypotheses that can be tested further in research.
Social work as a practice of freedom
Authors: Hyslop Ian
Published: March 2011

• Summary: In the second decade of the 21st century, the development of social work is of vital moment. For the past 30 years the social space within which social workers practise has been reduced via the managerial technologies of the neoliberal era. At a time when the parameters of practice are increasingly constrained it is incumbent upon us to critically reconsider the notion that social work is aligned with social justice and human emancipation. In order to champion the voice of social work it is first necessary to examine what it is that this voice has to say: to reflect upon the possibilities intrinsic to social work.

• Findings: The following discussion examines the emergence of social work as a child of modernity and the heritage of the Enlightenment. It is contended that the development of social work has mirrored contradictions inherent to modernity. It is argued that social work is characterized by a particular interstitial positioning that offers a unique experience of these contradictions. The conflicted nature of practice can generate resilient action for both workers and clients, and potentially facilitates processes of resistance and change, individually and socio-politically.

• Applications: An appreciation of the epistemic possibilities of social work may help inform a commitment to emancipatory practice. Recognition of the unique vision that social work has to offer represents the unrealized potential of the social work project. The development of effective organization and advocacy to this end remains the challenge for theory, practice, and education in the coming decade.
Pragmatism and the prospects of sociological theory
Authors: Holmwood John
Published: March 2011

The paper addresses the recent turn to pragmatism within sociological theory, arguing that, in crucial respects, the ‘new’ pragmatism is at odds with the animating thrust of the ‘old’ pragmatism associated with James, Dewey and Mead. Two tendencies in the new pragmatism are discussed, namely ‘the universal pragmatics’ associated with general theory (Habermas) and the displacement of explanation in favour of edification (Rorty). Each position fails to recognize the unifying role played by ‘problem-solving’ in the original pragmatist approach, and this, in turn, is argued to provide a more satisfactory way of resolving some dilemmas of contemporary sociological theory.
‘Wide-awake learning’
Authors: Booth Alan
Published: March 2011

This article reviews the development of integrative learning and argues that it has an important role to play in broader conceptions of the undergraduate curriculum recently advanced in the UK. It suggests that such a focus might also provide arts and humanities educators with a hopeful prospect in difficult times: a means by which the distinctive value and potential of these subjects might be articulated and promoted. Interviews with humanities students and lecturer case-studies from a UK initiative in integrative learning are used to ground the argument advanced and provide illustrative examples of practice.
Toward professional integration in the humanities
Authors: Anderson Lisa Marie
Published: March 2011

This article is both an argument for and an example of portraiture, a methodology for conducting and presenting qualitative research which, though familiar to many social scientists and educational researchers, remains relatively unknown within the humanities. The author details one kind of practice within the scholarship of teaching and learning — a study of a transformational learning experience — that calls for the framework of the research portrait, and suggests further possibilities for this framework, particularly within area studies, cultural studies, and world languages and literatures. Numerous advantages of portraiture are demonstrated and discussed, including the de-marginalization of the research subject, the facilitation of interdisciplinary practice, and the further integration of the teacher—researcher’s professional responsibilities and identities.
Gendering English Studies
Authors: Wallace Diana
Published: March 2011

This article addresses the silences and anxieties provoked by the gendering of English Studies as a subject taught by men to women. I reflect on my own experience as a female student and lecturer within a subject that has been ‘professionalized’ by males. The geographical and social context within which I teach — the South Wales Valleys, a post-industrial, post-Devolution area with high male unemployment — offers particular challenges in relation to the teaching of women’s writing. The few male students who take such modules often find their gender made ‘visible’ in ways which can provoke a range of behaviours suggesting anxieties about gender and class in relation to ‘English’.
Masculinity studies
Authors: Pinto Samantha
Published: March 2011

This reflective article interrogates the role of masculinity studies in the women’s and gender studies’ classroom by looking at the work of American film icon Marlon Brando. Brando and his risky masculinity in the film represents a locale of ‘dangerous desires’ which reveal deep conflict in student perceptions of men, women, and gender.
A Case Study of Anorexia Nervosa and Obsessive Personality Disorder Using Third-Generation Behavioral Therapies
Authors: Martín-Murcia Francisco , Cangas Díaz Adolfo J. , Pardo Gonzalez Luisa
Published: March 2011

This article presents a case study of anorexia nervosa and obsessive personality disorder as a means of describing the main therapeutic interventions in the framework of “third-generation” therapies. The sessions were videotaped by independent observers. The particulars of the therapeutic relationship (based on functional analytic psychotherapy) and the contextual strategies (based on acceptance and commitment therapy) used are analyzed here. This case highlights progressive positive changes in social behavior, including congruence of values and vital actions, resolution of the eating disorder, greater openness to experience, and decreased pervasive thoughts. The discussion associates these changes with the types of intervention specific to this therapeutic approach.
Show us the sound! Aesthetic leadership of symphony orchestra conductors
Authors: Koivunen Niina , Wennes Grete
Published: March 2011

We describe the leadership activities of symphony orchestra conductors with an aesthetic analysis. In contrast to a popular understanding of a conductor as an individual hero, we depict leadership as an ongoing relational process between the conductor and the musicians. Drawing on our field studies of four symphony orchestras and the literatures of music organizations, organizational aesthetics and aesthetic leadership, we develop three dimensions to study the leadership of conductors: relational listening, aesthetic judgment and kinaesthetic empathy. Our analysis contributes to leadership theory by emphasizing the importance of aesthetic elements, processes, embodiment and work practices.
Leading questions: If ‘Total Place’, ‘Big Society’ and local leadership are the answers: What’s the question?
Authors: Grint Keith , Holt Clare
Published: March 2011

This paper concerns the apparent decentralization of decision-making in the UK that has accompanied the new coalition government. In particular, we are interested in the rise of Prime Minister Cameron’s public services initiative: ‘Big Society’, and one of its antecedents, ‘Total Place’. We suggest that while these remain sites of political contest, they provide an opportunity for rethinking why the leadership of change might be linked to a change of leadership. In effect, if these approaches are the answer to the problem of providing public services in an age of austerity, then we need to start the analysis by asking what the questions to these answers are. To unravel this point we briefly explain the background to these developments and then consider six questions that might help explain why the local nature of leadership matters. These questions are: what kind of problem are we looking at? What is the purpose of this organization? How does power operate in this place? Why is the local nature of knowledge critical? Is time a problem or an opportunity? And, finally, what kind of local space is this? We conclude by suggesting that the nature of local leadership matters because it constitutes similar problems differently.
The role of pharmacotherapy in mild to moderate chronic obstructive pulmonary disease
Authors: Raghavan Natya , Guenette Jordan A. , O’Donnell Denis E.
Published: March 2011

Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide and most of those afflicted have mild to moderate disease as measured by spirometry. There is mounting evidence that even mild airway obstruction is associated with activity-related dyspnea, exercise limitation, impaired quality of life, increased hospitalization and mortality. As our understanding of the complex, heterogeneous pathophysiology and clinical consequences of milder COPD continues to grow, there is increasing interest in the potential impact of therapeutic interventions beyond smoking cessation. Unfortunately, few clinical trials have included patients with mild to moderate disease and the evidence base for pharmacological treatment in this subpopulation is currently lacking. Recent short-term mechanistic studies confirm that reversal of airway smooth muscle cholinergic tone consistently improves respiratory mechanics during rest and exercise in mild COPD but long-term clinical benefits remain to be evaluated. Secondary analysis of large, prospective studies designed to evaluate the efficacy of long-acting bronchodilators, inhaled corticosteroids and combination therapy indicate that patients with moderate COPD achieve comparable benefits to those with advanced disease. In the absence of evidence-based guidelines for the management of milder COPD, treatment choices are driven mainly by clinical presentation: for those with persistent and troublesome activity-related dyspnea a trial of inhaled bronchodilator therapy is justified; for those with a propensity for recurrent infective exacerbations, consideration of additional anti-inflammatory treatment seems reasonable. In this paper, we review the current knowledge base and emerging paradigm for the pharmacological treatment of mild to moderate COPD.
Proton-pump inhibitors for the treatment of functional dyspepsia
Authors: Suzuki Hidekazu , Okada Sawako , Hibi Toshifumi
Published: March 2011

In the Rome III classification, functional dyspepsia (FD) has been further subcategorized into two different syndromes, namely, epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). Acid-related pathophysiology seems to be mainly responsible for EPS, and antisecretory agents such as proton-pump inhibitors (PPIs) seem to be effective mainly against EPS. However, recent information as to the relationship between initial duodenal acid sensitization in the early postprandial phase and delayed gastric emptying in the later postprandial phase would suggest the amelioration of PDS by antisecretory agents. In the present review, we summarized the recent literature on the direct and indirect effect of PPIs in FD (including not only Rome III, but also Rome II criteria). The effects of PPIs against FD are heterogeneous, depending on the protocol of the clinical studies, and the inclusion criteria of each randomized controlled trial (primary care or tertiary care population). As the placebo effects cannot be ignored in this disease, a placebo-controlled study would be necessary, at least for the evaluation of the effect of each agent on symptom relief in patients with FD. Further studies directly comparing PPIs with suitable placebos in terms of their effects in reducing the symptoms of endoscopically confirmed, Rome III-based FD are awaited.
Internet Hotel Reservations: Recent Changes and Trends in the Enforcement of Click Wrap and Browse Wrap “Terms and Conditions/Terms of Use”
Authors: Wilson Robert H.
Published: March 2011

“Click wrap” and “browse wrap” agreements attempt to add additional terms and conditions to the online hotel reservation contract made by a guest. If the terms are enforced by a court, they will provide some advantages to the hotel in the event of litigation involving the guest. Provisions might include choice of forum, choice of law, mandatory arbitration, limitation on types of damages, limitation of class actions, waiver of liability, liquidated damages, and restrictions on legal fees; and they may become part of the Internet-based contract when a guest reserves a room. Before enforcing the additional terms, however, a court must first determine that mutual assent to the additional provisions exists between the parties. Click wrap agreements will be routinely enforced by the courts, as the guest is required to click an icon that states, “I agree to the additional terms and conditions.” In a browse wrap agreement, the hotel Internet site has a link, usually found at the bottom of the webpage and in small print, that is accessible to the guest by clicking the link. The guest may or may not choose to view the additional terms and conditions prior to making the reservation, and the guest may not even be aware that the additional terms and conditions exist. Courts will only enforce terms and conditions of a browse wrap agreement if they are able to determine that mutual assent is present and that the guest is aware or should have been aware of the additional terms.
Effects of Gender and Expertise on Consumers’ Motivation to Read Online Hotel Reviews
Authors: Kim Ellen Eun Kyoo , Mattila Anna S. , Baloglu Seyhmus
Published: March 2011

Electronic word of mouth (eWOM) communication, such as the online hotel review, is receiving increasing attention from marketing managers in the hotel industry, primarily because consumers are making considerable use of online forums and often do not book without seeking online advice on restaurants, tourist destinations, or hotels. This study of a convenience sample of 781 travelers in Las Vegas found three chief motivating factors for consumers to seek eWOM, namely, convenience and quality, risk reduction, and social reassurance. The analysis found distinct differences between the sexes regarding their motivating factors, and levels of expertise also influenced consumers’ motivations to read online reviews. Women, for instance, are more likely to read reviews for the purpose of convenience and quality and for risk reduction. Men’s use of the online reviews depended on their level of expertise.
Concussions Involving 7 or More Days Out in the National Football League
Authors: Casson Ira R. , Viano David C. , Powell John W. , Pellman Elliot J.
Published: March 2011

Background:

Positions, signs, symptoms, and medical management of National Football League players with concussions involving 7 or more days out (7+) from play were compared for two 6-year study periods (2002-2007 vs 1996-2001).

Hypothesis:

More players were held out 7+ days in the 2002-2007 period without significant difference in concussion signs and symptoms.

Study Design:

Cohort.

Methods:

From 1996 through 2007, National Football League team physicians reported concussion signs and symptoms, medical action taken, and follow-up management.

Results:

During the 2002-2007 period, 143 (16.7%) and 33 (3.86%) concussed players were out 7+ days and 21+ days, respectively, compared with 73 (8.2%) and 7 (0.79%) in the 1996-2001 period, a significant difference ( z = 5.39, P < .01). The positions with the highest fraction of 7+ days out were the quarterback (24.5% vs 16.1%), linebacker (19.7% vs 4.6%), and wide receiver (19.5% vs 8.2%) in the later versus earlier period. The player positions with the highest odds for being out 7+ days were quarterback (odds ratio = 1.80 vs 4.02), linebacker (odds ratio = 1.28 vs 0.65), and wide receiver (odds ratio = 1.25 vs 1.15). The highest incidence of 7+ days out occurred after passing plays (32.2% vs 37.0%), followed by kickoffs (18.9% vs 21.9%). The majority of players with 7+ days out were removed from the game on the day of injury (74.8% vs 72.6%); a smaller fraction were returned to play on the day of injury in the later 6 years (3.5% vs 6.8%).

Conclusions:

The positions with the highest odds for being out 7+ days with concussion were quarterbacks, linebackers, and wide receivers. In the more recent 6-year period, more players were managed conservatively by being held out 7+ days, even though the signs and symptoms of their concussions were similar to those in the earlier period.
Partial Triceps Disruption
Authors: Foulk David M. , Galloway Marc T.
Published: March 2011

Partial triceps tendon disruptions are a rare injury that can lead to debilitating outcomes if misdiagnosed or managed inappropriately. The clinician should have a high index of suspicion when the mechanism involves a fall onto an outstretched arm and there is resultant elbow extension weakness along with pain and swelling. The most common location of rupture is at the tendon-osseous junction. This case report illustrates a partial triceps tendon disruption with involvement of, primarily, the medial head and the superficial expansion. Physical examination displayed weakness with resisted elbow extension in a flexed position over 90°. Radiographs revealed a tiny fleck of bone proximal to the olecranon, but this drastically underestimated the extent of injury upon surgical exploration. Magnetic resonance imaging is essential to ascertain the percentage involvement of the tendon; it can be used for patient education and subsequently to determine treatment recommendations. Although excellent at finding associated pathology, it may misjudge the size of the tear. As such, physicians must consider associated comorbidities and patient characteristics when formulating treatment plans.
Treatment of a Symptomatic Forearm Muscle Herniation With a Mesh Graft
Authors: Sanders Brett S. , Bruce Jeremy , Robertson Jason
Published: March 2011

Symptomatic muscle herniations are an unusual cause of upper extremity pain in the athlete that is rarely reported in the literature. Out of 18 reported cases of upper extremity herniations, only 3 were caused by strenuous exertion. This article describes a successful repair of a 21-year-old rock climber’s ventral forearm herniation with polypropylene mesh.
Seeking Confirmation in Times of Doubt
Authors: Sawicki Vanessa , Wegener Duane T. , Clark Jason K. , Fabrigar Leandre R. , Smith Steven M. , Bengal Steven T.
Published: March 2011

Strong attitudes exert greater influence on social perceptions, judgments, and behaviors. Some research indicates that strong attitudes are associated with exposure to attitude-confirming information. However, we believe that uncertain attitudes might produce strong selective exposure to attitude-consistent information, especially when available information is unfamiliar. In three experiments, participants reported attitude favorability, reported attitude confidence (Study 1A and 2) or completed a doubt-priming manipulation (Study 1B), and selected information supporting or opposing an issue. When chosen information was relatively unfamiliar (in all three studies), uncertainty led to more attitude-consistent exposure than certainty did. However, when chosen information was more familiar (in Study 2), the pattern of effects was significantly reversed: Certainty led to more attitude-consistent exposure than did uncertainty. This finding suggests that under certain conditions, uncertainty can motivate people to seek attitude-confirming information, thereby creating a motivational basis for weak attitudes to have strong influences on information seeking.
A new approach for modelling and control of two-wheel anti-lock brake systems
Authors: Mirzaeinejad H , Mirzaei M
Published: March 2011

Anti-lock brake system is designed to actively improve the vehicle safety during hard braking. In this article, optimization-based braking pressure control laws for the front and rear wheels are analytically designed based on a non-linear two-axle vehicle model. The integral feedback technique is also appended to the design method to increase the robustness of the controller in the presence of modelling uncertainties. In order to achieve the maximum braking force for each wheel at any time during braking, a new reference wheel slip model is presented to be tracked by the controller. In this model, the variations of tyre normal load and tyre/road condition are considered in finding the optimum slip of each wheel. The derived control laws are evaluated and their main features are discussed. Finally, the effectiveness of the proposed controller in tracking the new reference model is investigated and the obtained results are compared with the prevalent research results. The simulation studies demonstrate that the designed controller can successfully cope with the strong non-linearity and uncertainty existing in a vehicle dynamics model. Also, the vehicle stopping distance is remarkably reduced by the proposed approach.
Evolution of the Inhalation of Vapors and Aerosols in the Care of Asthma and Other Respiratory Diseases
Authors: Op’t Holt Timothy B.
Published: March 2011

The inhalation of vapors or smoke to treat respiratory ailments dates back to India, 4,000 years ago when those afflicted would smoke the leaves of Atropa Belladona, the source of atropine, for cough. In 1849, the inhalation of aerosolized spa waters was introduced. Thereafter, pneumatic and steam-powered nebulizers aerosolized a variety of substances for bronchospasm and treatment of tuberculosis. Nebulizers with control over particle size evolved in the mid-1900s. The problem with small respirable volumes and waste to the environment with nebulizers led to development of more efficient nebulizers. The pressurized metered dose inhaler (pMDI, 1956), overcame several disadvantages of predicate nebulizers. The evolution away from chloroflourocarbon (CFC) propellants to hydroflouroalkane propellants eliminates the harmful environmental effects of CFCs. Valved holding chambers improve aerosol penetration and deposition. Dry powder inhalers (DPI), are a mainstay of aerosol therapy as they are convenient and several contain a month’s supply of medication.
Knowledge and Awareness of Symptoms, Triggers, and Treatment Among Older Adults With Asthma and/or Chronic Obstructive Pulmonary Disease
Authors: Shendell Derek G. , Foster Christine , Sexton June , Roden Jeninne , Yamamoto Naomichi , Kelly Sarah W. , Chandler with Leslie , Venables Michelle , Williams Samantha , Burr Stacey , Wagenleitner Veronica , Anderson Nicole ,   Students of Respiratory Therapy
Published: March 2011

Asthma can be controlled through proper clinical and environmental management and education; however, public health and allied health professionals, such as respiratory therapists, have not typically been trained in environmental engineering and building safety concepts critical to addressing indoor environmental asthma and allergy triggers. The population is growing and aging: low- to middle-income seniors are working and living longer, and incidence and prevalence of chronic respiratory diseases continue increasing. The authors conducted a community-based participatory research pilot project with a cross-sectional repeated measures design in Visalia, California. This paper presents the study process, the impact of asthma and allergy on quality of life, and the environment- and health-related data collected via 3 baseline knowledge and awareness questionnaires and the technician walk-through survey on the home environment and asthma triggers. Participants were confirmed at baseline as having 1 or more physician-diagnosed respiratory diseases: asthma, bronchitis, chronic obstructive pulmonary disease. Questionnaires were administered to recruited consenting participants meeting selection criteria (n, 34; convenience sample) at community locations. At baseline, 12 agreed to comprehensive home visits: 9 of whom completed first visits, of which 6 completed second visits. One baseline questionnaire was repeated at first seasonal home visits; 2 of 6 participants completed it again at second seasonal home visits. Participants completing home visits (eg, receiving education from local asthma coalition members) increased clinical asthma management knowledge and awareness. Results suggested areas for improvement in future asthma education initiatives targeting older adults living independently, regarding indoor environmental triggers and underlying safety and health conditions.
Asthma Diagnosis, Knowledge and Awareness among Recreational Endurance Athletes
Authors: Shendell Derek G. , Alexander Melannie S. , Lorentzson Lauren , Kelly Sarah W. , Zimmerman Ralph (Chip) D. , Goodfellow Lynda T.
Published: March 2011

Objective: Limited research exists on recreational-level competitors regarding asthma and/or comorbidity. The present purpose was to conduct a study in conjunction with the 2008 ING Georgia Marathon and Half-Marathon in Atlanta.

Methods: The authors conducted an online secure survey in winter 2008 using PsychData, using previously validated questions from other research and national surveys. Data were summarized from participating recreational athletes on sociodemographic attributes; training locations; participant and family member diagnosis of asthma; and participant knowledge and awareness of signs, symptoms, and management.

Results: There were 1151 participants (99.4%) who provided informed consent and then answered the survey (more than 10% of initially registered athletes); 7 athletes (0.6%) did not consent. There were complete data for 1138 participants (98%). Most participants were women (56.2%), white (88.2%), and of a relatively higher socioeconomic status than the general population. Most participants (96.2%) were running either a full marathon (29.8%) or half-marathon (66.4%), as opposed to walking or participating as a wheelchair athlete. About 1 in 8 participants (12.1%) reported physician-diagnosed asthma. Clinically, whereas 84.6% correctly knew that an asthma action plan can prevent hospitalizations due to asthma, only 18% reported that they had such a plan. Moreover, only 24.8% had ever been asked to demonstrate medication use (controller and/or rescue inhaler), and only 2 people performed daily peak flow measurements.

Conclusions: In a study of physically active white adults of higher socioeconomic status, 12.1% reported asthma. As such, this study identified the need for potential improvements in asthma management via written asthma action plans and demonstration of peak flow monitoring and medication use.
Single-cell phospho-specific flow cytometric analysis demonstrates biochemical and functional heterogeneity in human hematopoietic stem and progenitor compartments
Authors: Gibbs Kenneth D. , Gilbert Penney M. , Sachs Karen , Zhao Feifei , Blau Helen M. , Weissman Irving L. , Nolan Garry P. , Majeti Ravindra
Published: March 2011

The low frequency of hematopoietic stem and progenitor cells (HSPCs) in human BM has precluded analysis of the direct biochemical effects elicited by cytokines in these populations, and their functional consequences. Here, single-cell phospho-specific flow cytometry was used to define the signaling networks active in 5 previously defined human HSPC subsets. This analysis revealed that the currently defined HSC compartment is composed of biochemically distinct subsets with the ability to respond rapidly and directly in vitro to a broader array of cytokines than previously appreciated, including G-CSF. The G-CSF response was physiologically relevant—driving cell-cycle entry and increased proliferation in a subset of single cells within the HSC compartment. The heterogeneity in the single-cell signaling and proliferation responses prompted subfractionation of the adult BM HSC compartment by expression of CD114 (G-CSF receptor). Xenotransplantation assays revealed that HSC activity is significantly enriched in the CD114neg/lo compartment, and almost completely absent in the CD114pos subfraction. The single-cell analyses used here can be adapted for further refinement of HSPC surface immunophenotypes, and for examining the direct regulatory effects of other factors on the homeostasis of stem and progenitor populations in normal or diseased states.
Evolution of major milk proteins in Mus musculus and Mus spretus mouse species: a genoproteomic analysis
Authors: Boumahrou Nisrine , Bevilacqua Claudia , Beauvallet Christian , Miranda Guy , Andrei Sanda , Rebours Emmanuelle , Panthier Jean-Jacques , Bellier Sylvain , Martin Patrice
Published: March 2011

Background

Due to their high level of genotypic and phenotypic variability,Mus spretusstrains were introduced in laboratories to investigate the genetic determinism of complex phenotypes including quantitative trait loci.Mus spretusdiverged fromMus musculusaround 2.5 million years ago and exhibits on average a single nucleotide polymorphism (SNP) in every 100 base pairs when compared with any of the classical laboratory strains. A genoproteomic approach was used to assess polymorphism of the major milk proteins between SEG/Pas and C57BL/6J, two inbred strains of mice representative ofMus spretusandMus musculusspecies, respectively.

Results

The milk protein concentration was dramatically reduced in the SEG/Pas strain by comparison with the C57BL/6J strain (34 ± 9 g/Lvs. 125 ± 12 g/L, respectively). Nine major proteins were identified in both milks using RP-HPLC, bi-dimensional electrophoresis and MALDI-Tof mass spectrometry. Two caseins (β and αs1) and the whey acidic protein (WAP), showed distinct chromatographic and electrophoresis behaviours. These differences were partly explained by the occurrence of amino acid substitutions and splicing variants revealed by cDNA sequencing. A total of 34 SNPs were identified in the coding and 3'untranslated regions of the SEG/PasCsn1s1(11),Csn2(7) andWap(8) genes. In addition, a 3 nucleotide deletion leading to the loss of a serine residue at position 93 was found in the SEG/PasWapgene.

Conclusion

SNP frequencies found in three milk protein-encoding genes betweenMus spretusandMus musculusis twice the values previously reported at the whole genome level. However, the protein structure and post-translational modifications seem not to be affected by SNPs characterized in our study. Splicing mechanisms (cryptic splice site usage, exon skipping, error-prone junction sequence), already identified in casein genes from other species, likely explain the existence of multiple αs1-casein isoforms both in SEG/Pas and C57BL/6J strains. Finally, we propose a possible mechanism by which the hallmark tandem duplication of a 18-nt exon (14 copies) may have occurred in the mouse genome.
Should patients with abnormal liver function tests in primary care be tested for chronic viral hepatitis: cost minimisation analysis based on a comprehensively tested cohort
Authors: Arnold David T , Bentham Louise M , Jacob Ruth P , Lilford Richard J , Girling Alan J
Published: March 2011

Background

Liver function tests (LFTs) are ordered in large numbers in primary care, and the Birmingham and Lambeth Liver Evaluation Testing Strategies (BALLETS) study was set up to assess their usefulness in patients with no pre-existing or self-evident liver disease. All patients were tested for chronic viral hepatitis thereby providing an opportunity to compare various strategies for detection of this serious treatable disease.

Methods

This study uses data from the BALLETS cohort to compare various testing strategies for viral hepatitis in patients who had received an abnormal LFT result. The aim was to inform a strategy for identification of patients with chronic viral hepatitis. We used a cost-minimisation analysis to define a base case and then calculated the incremental cost per case detected to inform a strategy that could guide testing for chronic viral hepatitis.

Results

Of the 1,236 study patients with an abnormal LFT, 13 had chronic viral hepatitis (nine hepatitis B and four hepatitis C). The strategy advocated by the current guidelines (repeating the LFT with a view to testing for specific disease if it remained abnormal) was less efficient (more expensive per case detected) than a simple policy of testing all patients for viral hepatitis without repeating LFTs. A more selective strategy of viral testing all patients for viral hepatitis if they were born in countries where viral hepatitis was prevalent provided high efficiency with little loss of sensitivity. A notably high alanine aminotransferase (ALT) level (greater than twice the upper limit of normal) on the initial ALT test had high predictive value, but was insensitive, missing half the cases of viral infection.

Conclusions

Based on this analysis and on widely accepted clinical principles, a "fast and frugal" heuristic was produced to guide general practitioners with respect to diagnosing cases of viral hepatitis in asymptomatic patients with abnormal LFTs. It recommends testing all patients where a clear clinical indication of infection is present (e.g. evidence of intravenous drug use), followed by testing all patients who originated from countries where viral hepatitis is prevalent, and finally testing those who have a notably raised ALT level (more than twice the upper limit of normal). Patients not picked up by this efficient algorithm had a risk of chronic viral hepatitis that is lower than the general population.
Confirmed local endemicity and putative high transmission of Schistosoma mansoni in the Sesse Islands, Lake Victoria, Uganda
Authors: Standley Claire J , Adriko Moses , Besigye Fred , Kabatereine Narcis B , Stothard Russell J
Published: March 2011

The Sesse Islands, in the Ugandan portion of Lake Victoria, have long been considered a low transmission zone for intestinal schistosomiasis. Based on observations of high prevalence of Schistosoma mansoni infection in the northern-most islands of this archipelago, a follow-up survey was conducted to ascertain whether transmission was endemic to this island group, combining parasitological and malacological surveys. Prevalence of intestinal schistosomiasis was again observed to be high, as was intensity of infections which, combined with low reported incidence of treatment, suggests that chemotherapy-based control initiatives are not being maximally effective in this region as high levels of population movement between islands and districts are confounding. The local disease transmission was confirmed by the observations of high abundance of Biomphalaria, as well as field-caught snails shedding S. mansoni cercariae. DNA sequencing of 12 cercariae revealed common mitochondrial cox 1 haplotypes, as well as, novel ones, consistent with the high genetic diversity of this parasite in Lake Victoria. Intestinal schistosomiasis is firmly endemic in parts of the Sesse Islands and more broadly, this island group provides an insight into the future challenges to be faced by the Ugandan National Control Programme in regularly reaching these rather remote, inaccessible and largely itinerant communities.
Extracorporeal cell therapy of septic shock patients with donor granulocytes: a pilot study
Authors: Altrichter Jens , Sauer Martin , Kaftan Katharina , Birken Thomas , Gloger Doris , Gloger Martin , Henschel Jörg , Hickstein Heiko , Klar Ernst , Koball Sebastian , Pertschy Annette , Nöldge-Schomburg Gabriele , Vagts Dierk A , Mitzner Steffen R
Published: March 2011

Introduction

Neutrophil granulocytes are the first defense line in bacterial infections. However, granulocytes are also responsible for severe local tissue impairment. In order to use donor granulocytes, but at the same time to avoid local side effects, we developed an extracorporeal immune support system. This first-in-man study investigated whether an extracorporeal plasma treatment with a granulocyte bioreactor is tolerable in patients with septic shock. A further intention was to find suitable efficacy end-points for subsequent controlled trials.

Methods

The trial was conducted as a prospective uncontrolled clinical phase I/II study with 28-day follow-up at three university hospital intensive care units. Ten consecutive patients (five men, five women, mean age 60.3 ± 13.9 standard deviation (SD) years) with septic shock with mean ICU entrance scores of Acute Physiology and Chronic Health Evaluation (APACHE) II of 29.9 ± 7.2 and of Simplified Acute Physiology Score (SAPS) II of 66.2 ± 19.5 were treated twice within 72 hours for a mean of 342 ± 64 minutes/treatment with an extracorporeal bioreactor containing 1.41 ± 0.43 × 10E10 granulocytes from healthy donors. On average, 9.8 ± 2.3 liters separated plasma were treated by the therapeutic donor cells. Patients were followed up for 28 days.

Results

Tolerance and technical safety during treatment, single organ functions pre/post treatment, and hospital survival were monitored. The extracorporeal treatments were well tolerated. During the treatments, the bacterial endotoxin concentration showed significant reduction. Furthermore, noradrenaline dosage could be significantly reduced while mean arterial pressure was stable. Also, C-reactive protein, procalcitonin, and human leukocyte antigen DR (HLA-DR) showed significant improvement. Four patients died in the hospital on days 6, 9, 18 and 40. Six patients could be discharged.

Conclusions

The extracorporeal treatment with donor granulocytes appeared to be well tolerated and showed promising efficacy results, encouraging further studies.

Trial registration

ClinicalTrials.gov Identifier: NCT00818597
Editorial: One small molecule: a new way to treat the flu?
Authors: Young Howard
Published: March 2011

DMXAA, a small molecule undergoing clinical trials for solid tumors, is now shown to have in vivo anti-viral activity.
When things go wrong: a practical guide to dealing with complaints
Authors: Hodgson Richard , Mendis Santhushi , Storey Sandra
Published: March 2011

Complaints inevitably accompany clinical care. This article explores complaints primarily in the context of the UK National Health Service complaints system. However, much of the content will apply to other settings, such as the independent sector. The infrequent but serious ramifications of complaints are also considered, including retraining and suspension. The article is written from a medical perspective but considers the roles of other professionals, the organisation and the complainant.
Peer reviewing made easy
Authors: Halder Neel , Ramsay Rosalind , Tyrer Peter , Casey Patricia
Published: March 2011

Peer review in scientific journals has existed for over 200 years. This process is currently the accepted way of assessing scientific manuscripts prior to publication for most journals. Despite this, little has been written about the process of peer reviewing, with hardly anything specific to psychiatric journals. This article answers fundamental questions related to peer reviewing and includes practical tips to writing reviews. It will be helpful for those keen on improving their knowledge about the peer-review process. It will not only benefit those who are reviewers or thinking about becoming reviewers, but also authors, who can use the information to improve their chances of publication.
Management of acute agitation in psychosis: an evidence-based approach in the USA
Authors: Schleifer Justin J.
Published: March 2011

Agitation in psychiatric settings, particularly in psychosis, presents a staggering challenge for clinicians, who must both manage the patient's acute symptoms and simultaneously make an accurate diagnosis. Too often, the management of the former confounds the latter. Patients are very often sedated medically, which masks their underlying condition, rendering accurate diagnosis delayed and inherently difficult. Significant data are available regarding both pharmacological and non-pharmacological interventions for agitation that maximise symptom control while minimising confounding side-effects. In this article, a review of the historical evolution of agitation management in psychotic illness is presented, followed by an evidence-based clinical guideline for managing agitation in psychosis in the USA.
Body dysmorphic disorder
Authors: Ross Jennifer , Gowers Simon
Published: March 2011

Body dysmorphic disorder is a distressing and often disabling condition characterised by a preoccupation with imagined or slight physical defects in appearance. It has been recognised as a mental disorder for many years (and named body dysmorphic disorder since 1980), but epidemiological studies and clinical trials have been few. To a large extent, the disorder has been ignored by the mental health community, who often fail to elicit the diagnosis. This article reviews the diagnostic criteria for the disorder, its validity and its relationship to other disorders such as obsessive-compulsive disorder, anorexia nervosa, social phobia and somatisation disorders. The course of the illness, its aetiology and treatment approaches are discussed. As research is growing alongside an increase in patient presentations, body dysmorphic disorder requires a coherent response from healthcare services.
Why psychiatry should engage with the media
Authors: Bithell Claire
Published: March 2011

Psychiatry receives less media coverage than general medicine, and the coverage it does receive is four times as likely to be negatively framed. In addition, coverage of mental health problems is often negative in tone and mental health research tends to be underrepresented in the media. As the media is likely to be a key source of information for the general public about mental health and psychiatry, this is worrying. There are opportunities, however, to change this landscape; the UK national news media are keen to cover more stories about mental health problems and to feature more psychiatrists' comments in their coverage. By engaging with the media, psychiatrists have the chance to create better-informed media narrative.
Psychological services for women giving birth in a large Irish tertiary referral maternity unit
Authors: McAuliffe Aileen , Russell Noirin E. , Fenton Joanne
Published: March 2011

Aims and method

To investigate whether women were being asked about their current and previous mental health, and where risk factors for perinatal mental health problems were identified, to determine whether appropriate referral occurred. Individual case-note review was performed on women where present or past mental health problems were indicated.

Results

In two-thirds of women where a history of mental health problems was indicated at the booking clinic this was not addressed in their obstetric case notes. Of the women who reported being depressed, nearly a third had no reference to this in their obstetric case notes and only 40% were referred to the Mental Health Liaison Clinic (MHLC). Two-thirds of the women who indicated a history of postnatal depression had no further comments documented in their obstetric case notes. One case of bipolar affective disorder and one case of puerperal psychosis were identified on booking questionnaires and neither had any comments documented in the obstetric case notes. In total 16% of women who reported a history of mental health problems were referred to the MHLC.

Clinical implications

More robust procedures for the identification and management of perinatal mental health risk need to be implemented.