bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional and effective connectivity in EEG alpha and beta bands during intermittent flash stimulation in migraine with and without aura
Authors: de Tommaso Marina , Stramaglia Sebastiano , Marinazzo Daniele , Trotta Gabriele , Pellicoro Mario
Published: February 2013

Objectives:

This research was a case-control study to evaluate functional and effective connectivity patterns in ongoing electroencephalography (EEG) under repetitive photic stimulation in the interictal phase of migraine patients with and without aura compared to nonmigraine controls.

Methods:

EEG was recorded by six scalp electrodes from 19 migraine without aura patients (MO), 19 migraine with aura patients (MA) and 11 healthy subjects (control group (N)). Flash stimuli were presented at 9–27 Hz frequencies. Phase synchronization after Hilbert transform and Granger causality were evaluated filtering the EEG in alpha and beta bands.

Results:

Phase synchronization increased in alpha band in MO, and decreased in beta band in MA, with respect to controls. The intensity of directed interactions in beta band, revealed by Granger causality, increased in MA compared to both MO patients and controls.

Discussion:

There were clear differences in ongoing EEG under visual stimulation, which emerged between the two forms of migraine, probably subtended by increased cortical activation in migraine with aura, and compensatory phenomena of reduced connectivity and functional networks segregation, occurring in patients not experiencing aura symptoms. Further investigation may confirm whether the clinical manifestation of aura symptoms is subtended by a peculiar neuronal connectivity pattern.
Dream-enacting behaviour is associated with impaired sleep and severe headache-related disability in migraine patients
Authors: Suzuki Keisuke , Miyamoto Tomoyuki , Miyamoto Masayuki , Suzuki Shiho , Watanabe Yuka , Takashima Ryotaro , Hirata Koichi
Published: February 2013

Background

Sleep disorders, nightmares and visual hallucinations have been reported in migraine patients, which may suggest the involvement of rapid eye movement (REM) sleep regulation in migraine. However, the relationship between migraine and REM sleep behaviour disorder (RBD) remains unclear.

Methods

To investigate the clinical correlates of dream-enacting behaviours (DEB) in migraine patients, we assessed episodic migraine patients ( n = 161, mean age 33.1 years) and headache-free control subjects ( n = 140, mean age 33.1 years) under 50 years of age in a cross-sectional, case-control study. The Japanese version of the RBD screening questionnaire was used, and subjects scoring 5 or higher were defined as having DEB.

Results

A significantly increased frequency of DEB was observed in migraine patients compared to controls (24.2% vs. 14.3%). Migraine patients with DEB presented higher scores on the Migraine Disability Assessment and Pittsburgh Sleep Quality Index and an increased rate of smoking compared to those without DEB. Duration of migraine and headache frequency and intensity were not different between migraine patients with or without DEB.

Conclusion

DEB was associated with impaired sleep and severe headache-related disability in migraine patients and may reflect brainstem dysfunction and increased brain excitability in migraine patients.
Reshaping social theory from complexity and ecological perspectives
Authors: Smith John , Jenks Chris
Published: February 2013

This article argues that Durkheim’s founding insight – uniquely social phenomena – presents us with both a foundation for the discipline of sociology and the risk that the discipline will become isolated. This, we argue, has happened. Our contention is that the emergent social phenomena need to be understood in relation to, but not reduced to, their biological and psychological substrates. Similarly, there are a number of other characteristics, notably of self-organization, which are distinguishing properties of social phenomena but also of quite different phenomena. The comparison is instructive. We therefore argue for an ecological approach to sociological theory, which has important relationships to the general theories and philosophy of ecology and biology. We explore a number of terminological and conceptual parallels that may inform our understanding of the relation of social theory to these and other disciplines.
Eavesdropping on Bourdieu’s philosophers
Authors: Hage Ghassan
Published: February 2013

While working on an auto-ethnographic account of my deafness and concurrently offering a seminar on the philosophical dimensions of Pierre Bourdieu’s work, I was struck by how permeated my ethnographic language was with the very Bourdieu-ian concepts I was examining. Initially, some of the moments captured in the ethnography played docilely a function of exemplification of Bourdieu’s theories and the philosophies behind them. At times, however, I found that my description of certain states of being/hearing invited a more complex three-way conversation, pointing to some productive tensions between the anthropological, sociological and philosophical dimensions of critical thought.
Investigation of mechanical property for paper honeycomb sandwich composite under different temperature and relative humidity
Authors: Wang Dong-Mei , Wang Jun , Liao Qiang-Hua
Published: February 2013

The influence of temperature and relative humidity on the moisture content of paper honeycomb sandwich panels was studied, and the ideal three-dimensional diagram between the moisture content of paper honeycomb sandwich panels and the temperature and relative humidity was constructed by the GAB model. The evaluation equation of critical stress and plateau stress were obtained. The results indicate that the moisture content of paper honeycomb sandwich panels rises with the increase of relative humidity and declines with the increase of temperature; as the moisture content increases, the critical stress and plateau stress of paper honeycomb sandwich panels decline linearly; with the increase of the moisture content, the energy absorption of paper honeycomb sandwich panels increased firstly and then decreased; the evaluation equation of critical stress and plateau stress can predict the mechanical properties of paper honeycomb sandwich panels in different temperatures and relative humidities.
Post-impact residual high strain rate compressive properties of carbon fiber laminates
Authors: Poveda Ronald L , Gupta Nikhil
Published: February 2013

The purpose of the present study is to investigate the residual high strain rate compressive properties of cross-ply carbon fiber laminates after drop-weight impact. The tested laminate is divided into four quadrants and specimens are extracted from each quadrant for high strain rate compression testing using a split–Hopkinson pressure bar. The testing is conducted in the strain rate range of 1000–1450 s−1. A comparison between pre- and post-impact carbon fiber laminates subjected to high strain rate compression suggested that there is a maximum decrease of 76.1% and 71.6% in the peak stress and absorbed energy of the laminate, respectively, at high strain rate compression. Microscopy was conducted on the failed specimens to determine the failure mode. Extensive delamination observed at the impact point causes significant decrease in compressive strength and energy absorption of the laminate.
Selective flotation of PVC using gelatin and lignin alkali
Authors: Yenial Ünzile , Kangal Olgaç , Güney Ali
Published: February 2013

Recycling has become one of the most important issues as a result of increasing waste mass in present day. This is especially important for polymer wastes as they are hard to degenerate in nature. Today, most of the practical methods used for the recycling of waste mass, such as hand sorting, gravity separation, etc., cannot be performed successfully owing to close densities of polymers. Froth flotation can be used successfully and economically for this purpose. The main objective of this study was to investigate the effect of plasticizer reagents and the success of froth flotation at plastic recycling. In this study, lignin alkali and gelatin were used as plasticizer reagents. The effect of these reagents was searched with the parameters of pH, concentration, conditioning and flotation time. In the case of post-consumed polyethylene terephthalate and polyvinyl chloride (PVC), 98.9% purity of PVC was obtained at optimum conditions.
Observations of Academic Instruction for Students With Significant Intellectual Disability
Authors: Restorff Diane E. , Abery Brian H.
Published: February 2013

As part of the validation process for alternate assessments, 39 classroom observations were conducted to gather data about current practices in providing academic instruction to students with significant intellectual disability. Using a standardized protocol, data were gathered using direct instructional observation, an Individualized Education Program review, and an analysis of student work. We found that teachers lacked age-appropriate materials, and most lessons and work samples required routine and recall responses. When teachers incorporated strategic or extended thinking activities into lessons, students were able to demonstrate their knowledge. The findings are suggested as a snapshot of current practices.
Bilateral Periventricular Nodular Heterotopia With Megalencephaly
Authors: Abe Yu , Kobayashi Satoru , Wakusawa Keisuke , Tanaka Soichiro , Inui Takehiko , Yamamoto Toshiyuki , Kunishima Shinji , Haginoya Kazuhiro
Published: February 2013

Bilateral periventricular nodular heterotopia is a neuronal migration disorder characterized by gray matter cellular rests in the periventricular regions. Megalencephaly has not been reported in children with bilateral periventricular nodular heterotopia. No other disorder with a similar phenotype has been reported. Here we report the case of a 5-year-old Japanese boy with bilateral periventricular nodular heterotopia and megalencephaly. Relative macrocephaly was evident at birth, and bilateral periventricular nodular heterotopia and megalencephaly were noted on magnetic resonance imaging (MRI). However, no hydrocephalus or indication of cerebral cortical dysplasia was seen. A mild intellectual disability was present, but the patient had no history of seizures. Genetic analysis revealed no mutation on the capillary sequences for FLNA, and no pathogenic abnormalities were evident on array comparative genomic hybridization. This case could represent a new disease entity: bilateral periventricular nodular heterotopia with megalencephaly.
Effects of kenaf loading and 3-aminopropyltriethoxysilane coupling agent on the properties of polypropylene/waste tire dust/kenaf composites
Authors: Pang Ailing , Ismail Hanafi
Published: February 2013

The effects of kenaf (KNF) loading and 3-aminopropyltriethoxysilane (APTES) on processing torque, tensile properties and morphological properties of KNF-filled polypropylene (PP)/waste tire dust (WTD) composites were investigated. In this research, PP/WTD served as a matrix and KNF as a filler and the composites were prepared using a Thermo Haake Polydrive internal mixer, where different KNF loadings (0, 5, 10, 15 and 20 parts per hundred parts of resin) were used. The results revealed that the stabilization torque and tensile modulus increased with increasing KNF loading but tensile strength and elongation at break were found to decrease. The composites with APTES exhibited higher stabilization torque, tensile strength and tensile modulus but lower elongation at break than composites without APTES. The presence of APTES had enhanced the interfacial adhesion between PP/WTD matrix and KNF, which had resulted in higher tensile strength and modulus of the composites. These findings were supported by the morphological study on the tensile fractured surfaces of the composites.
Comparison of processing and mechanical properties of polypropylene/recycled acrylonitrile butadiene rubber/rice husk powder composites modified with silane and acetic anhydride compound
Authors: Ragunathan S , Ismail H , Hussin K
Published: February 2013

Polypropylene (PP)/recycled acrylonitrile butadiene rubber (NBRr)/rice husk powder (RHP) composites were fabricated with silane and acetic anhydride (Ac) treatment agent. The in situ formed RHP-filled PP/NBRr composites were prepared by melt mixing technique. The mechanical properties of both the treatment methods were investigated with Instron mechanical analysis and Fourier transform infrared. The results indicated that Ac treatment was found to exhibit better mechanical properties of RHP-filled PP/NBRr composites treated with silane. This was due to good compatibility and stronger interaction between anhydride moieties with PP/NBRr.
Polylactic acid/corn cob eco-composites
Authors: Chun Koay Seong , Husseinsyah Salmah
Published: February 2013

A new organic coupling agent called coconut oil coupling agent (COCA) was produced from coconut oil. The effects of filler content and COCA on mechanical, thermal, and morphological properties of corn cob (CC)-filled polylactic acid (PLA) eco-composites were studied. The results show that the addition of CC decreased the tensile strength and elongation at break but increased the modulus of elasticity of PLA/CC eco-composites. However, the presence of COCA improved the tensile strength, elongation at break, and modulus of elasticity of PLA/CC eco-composites. Meanwhile, the glass transition temperature ( Tg) of PLA/CC eco-composites was increased by increasing the CC content and COCA treatment. The peak crystallization temperature ( Tc) in PLA/CC eco-composites indicated the nucleating effect of CC and the Tc of PLA/CC eco-composites decreased at 40 php of CC content. The addition of CC increased the melting temperature ( Tm) of PLA/CC eco-composites but reduced the crystallinity of PLA/CC eco-composites. The COCA treatment enhanced the mechanical properties and the crystallization process of PLA/CC eco-composites. The Tc and Tm of PLA/CC eco-composites were not significantly affected by COCA treatment. The presence of COCA improved the adhesion and interaction between CC and PLA matrix.
Preparation and properties of several Chinese herbal residue/polylactic acid composites
Authors: Yan-Hong Feng , Xiang-Li Li , Gang Jin , Jin-Ping Qu , He-Zhi He
Published: February 2013

Disposal of Chinese herbal residues (CHRs) during Chinese herbal medicine production and processing has become a problem that requires attention. In this study, CHRs were pretreated by steam explosion or pulverization and composites were prepared by mixing pretreated CHRs with polylactic acid. The mechanical properties of composites of CHRs pretreated by two different methods were compared, the main compositions of CHRs were analyzed, and the morphology of various CHRs and brittle fracture surfaces of composites were observed by scanning electron microscopy. The results show that the mechanical properties of the composites are closely related to the herbal species and pretreatment methods. The mechanical properties of CHR composites pretreated by steam explosion are superior to those pretreated by pulverization. Choosing CHRs with large fiber cell wall–lumen ratio, high lignin and cellulose contents, low contents of hetero cells and hemicellulose are helpful in making composites with good comprehensive performance.
Children’s perceptions of their imaginary companions and the purposes they serve: An exploratory study in the United Kingdom
Authors: Majors Karen
Published: February 2013

Imaginary companions of school age children are a relatively unexplored phenomenon. This article reports on a qualitative study carried out in the UK investigating British children’s perceptions of their imaginary companions. Eight children aged between 5 and 11 years were interviewed. Interpretative Phenomenological Analysis was used to explore individual and cross-case themes. It was found that imaginary companions provided friendship, playmates and entertainment, enabling children to overcome times of boredom and loneliness. They appeared to provide a level of wish fulfilment for some children. Children’s interactions with their imaginary companions provided support when there were problem situations in the children’s lives.
Psychiatric symptoms associated with the mental health defence for serious violent offences in Queensland
Authors: Spencer Jillian , Tie Anthony
Published: February 2013

Objective:

The purpose of this study was to examine which psychiatric symptoms were associated with a defence of unsoundness of mind for serious violent offences.

Method:

The study included psychiatric reports provided by forensic psychiatrists from the High Secure Inpatient Service for patients found to have a mental health defence by the Mental Health Court between June 2004 and June 2009.

Results:

The defence of unsoundness of mind was invariably associated with psychotic symptoms. All reports concluded that the patient was deprived of knowledge of the wrongfulness of the act. Patients found to be additionally deprived of the capacity to understand their actions suffered delusional beliefs about the identity of the victim. The symptoms that resulted in a small number of patients being considered deprived of the capacity to control their actions were mixed, but approximately a third suffered passivity phenomena.

Conclusions:

Psychiatrists should be specific about how the patient’s symptoms link to any deprivation of capacity. Report writers could comment upon the presence or absence of Axis II conditions and the likely impact of any substances in the patient’s system at the time of the offence.
Echocardiographic monitoring for clozapine cardiac toxicity: lessons from real-world experience
Authors: Murch Stuart , Tran Nga , Liew Danny , Petrakis Melissa , Prior David , Castle David
Published: February 2013

Objective:

We aimed to identify the baseline prevalence of cardiac dysfunction in patients commencing clozapine, assess adherence with echocardiographic monitoring recommendations, and evaluate the utility and cost of echocardiographic monitoring for the development of clozapine-associated myocarditis and cardiomyopathy.

Methods:

A retrospective longitudinal cohort study was undertaken of 159 consecutive patients from a major tertiary centre commencing clozapine in the period January 2002 to July 2009.

Results:

Some 73% of patients had a baseline study, and 11% had a six-month follow-up study. Nine patients had abnormal left ventricular function at baseline. Myocarditis was identified in three patients, with all cases occurring within the first month of treatment and suspected on clinical grounds before an echocardiogram was performed. One case of possible cardiomyopathy was identified. The cost of echocardiographic screening in the first year of treatment was estimated at $AUD 209,356 per case of cardiomyopathy detected.

Conclusion:

The prevalence of cardiac dysfunction in patients commencing clozapine is high, and there are challenges in adhering with the recommended protocol for monitoring. Routine echocardiography is not useful in the detection of clozapine-associated myocarditis. Although cardiomyopathy may be identified, it is rare and associated with significant cost. Recommendations for routine echocardiographic monitoring should be re-examined.
The Mood Assessment Program is now on the Australian map
Authors: Parker Gordon , Anonuevo Cesar , Wallace Jacqui , Fletcher Kathryn , Paterson Amelia
Published: February 2013

Objective:

To report on the wide uptake and utility of the freely available Mood Assessment Program (MAP) since its introduction as a tool to assist diagnosis and management of mood disorders.

Method:

By mid-2012, some 16,000 patients had completed the MAP. We analyse data derived from such a sample.

Results:

The majority of patients utilizing this service were referred by general practitioners, psychologists and psychiatrists from within New South Wales (NSW). The great majority across age bands found the MAP easy to complete and judged that it covers issues relating to their mood disorder very well or completely.

Conclusion:

The MAP is available for use Australia-wide with ready referral access for patients of mental health practitioners in general practice, psychiatry, psychology and social work. The online availability of the service makes it ideal for use in areas where access to health services is limited.
Gustav Mahler as Freud’s patient: a note on possible obstacles to communication and understanding
Authors: Starcevic Vladan
Published: February 2013

Objective:

This article examines the meeting between Gustav Mahler and Sigmund Freud from a perspective that takes into account possible obstacles to their interaction.

Conclusions:

Mahler consulted Freud in the context of a marital crisis in 1910. While it appears that a meeting between the two men had some positive effects on Mahler, its long-term impact will never be known because Mahler died only eight months later. This consultation is first examined in the light of a number of its implications and questions for contemporary psychotherapy. The fact that Freud was unable to appreciate music did not seem to interfere with a very focused, ultra-brief intervention for the patient completely devoted to music. On the other hand, Mahler’s series of death-related traumas, a life-long preoccupation with death and fear of death, were apparently unnoticed by Freud, who neglected fear of death as an important intrapsychic force and provided an explanation to Mahler that was in accordance with his theories. The article concludes with a comment on the speculation about the link between creativity on one hand and unsatisfied libido and psychological conflicts on the other.
Multiple Perspectives on Internationalizing the Business School Curriculum: The Why, What, and How
Authors: Mcevoy Glenn M.
Published: February 2013

Internationalization is the incorporation of international contents, materials, activities and understandings into the teaching, research, and public service functions of universities to enhance their relevance in an interdependent world. (Definition adopted at the conference on Internationalizing U.S. Universities: A Time for Leadership, Spokane, WA, June 5–7, 1990)
Political Corruption and Electoral Funding
Authors: Evertsson Nubia
Published: February 2013

The aim of this article is to study the suspect nature of private campaign finance, understood as the donors’ hidden intentions and delayed exchange of reciprocities with incumbents. In particular, I explore whether electoral contributions from private corporations lead to political corruption. On the basis of a cross-national analysis, I find that, first, private financing reduces corruption because the use of this legal mechanism is enough to guarantee that the donors’ interests will be achieved. Second, donors recognize that they have gained influence over policy outcomes, although in the spirit of the electoral laws this is not intended to occur. This increases corruption because incumbents use their positions of power to bend the rules and to adjust regulations and decisions in favor of their financial supporters. This paradox suggests law neutralization.
Predictors of Law Enforcement Agencies’ Perceptions of Partnerships With Parole Agencies
Authors: Kim Bitna , Gerber Jurg , Beto Dan Richard , Lambert Eric G.
Published: February 2013

The current study aimed to enhance the understanding of how law enforcement agencies collaborate with parole agencies and how they view police-parole partnerships. The data were collected through a state-wide survey of all sheriffs’ offices and a random sample of municipal police departments in Texas, the state with the nation’s largest parole population. The primary research question focused on identifying (1) empirically derived and meaningful patterns of police-parole partnerships and (2) the predictors of the perception among law enforcement agencies with regard to partnerships with parole agencies. The main finding was that police agencies who valued partnerships with parole agencies tended to already be involved in collaborations with parole agencies and had an organizational culture which supported working with other agencies.
Natalizumab treatment decreases serum IgM and IgG levels in multiple sclerosis patients
Authors: Selter Rebecca C , Biberacher Viola , Grummel Verena , Buck Dorothea , Eienbröker Christian , Oertel Wolfgang H , Berthele Achim , Tackenberg Björn , Hemmer Bernhard
Published: February 2013

Background:

Treatment with natalizumab, a humanized monoclonal antibody against alpha4beta1 integrin, is associated with an increase in lymphoid progenitor cells and B cells in peripheral blood.

Objective:

The objective of this study was to examine the impact of natalizumab therapy on serum levels of total IgG, IgA and IgM in patients with multiple sclerosis (MS).

Methods:

In two independent cross-sectional patient cohorts, serum levels of IgG, IgA and IgM were compared between patients treated with natalizumab and those not receiving natalizumab. Further, serum levels of IgG, IgA and IgM before and during natalizumab treatment were compared in two longitudinal patient cohorts.

Results:

In patients treated with natalizumab, serum IgM and IgG levels were significantly lower compared with therapy naïve patients ( p<0.0001). IgM levels significantly decreased after initiation of natalizumab treatment in both longitudinal patient cohorts ( p<0.01). Moreover, patients treated with natalizumab showed a time-dependent decrease in IgM levels during the first 2 years of treatment.

Conclusion:

Natalizumab treatment leads to a significant decrease in serum IgM and IgG levels in patients with MS. IgM levels decrease with treatment duration during the first 2 years of treatment. These findings might support the hypothesis that natalizumab interferes with homing of B cells, possibly leading to impaired differentiation into plasma cells and subsequently disturbed immunoglobulin synthesis.
Learning and cognitive fatigue trajectories in multiple sclerosis defined using a burst measurement design
Authors: Holtzer Roee , Foley Frederick , D’Orio Vanessa , Spat Jessica , Shuman Melissa , Wang Cuiling
Published: February 2013

Background:

Compromised learning and cognitive fatigue are critical clinical features in multiple sclerosis.

Objectives:

This study was designed to determine the effect of repeated exposures within and across study visits on performance measures of learning and cognitive fatigue in relapsing–remitting multiple sclerosis (RRMS).

Methods:

Thirty patients with RRMS and 30 controls were recruited. Using a burst measurement design (i.e. repeated assessments within and across study visits) the oral version of the Symbol Digit Modalities Test (SDMT) was administered three times during the baseline and two consecutive monthly follow-up visits for a total of nine test administrations. Learning was assessed within and across study visits whereas cognitive fatigue was assessed during the course of each test administration that was divided into three 30-second intervals.

Results:

Linear mixed-effect models revealed compromised learning within (95% CI: 2.6355 to 3.9867) and across (95% CI: 1.3250 to 3.1861) visits and worse cognitive fatigue (95% CI: −2.1761 to −0.1720) in patients with RRMS compared with controls. Among patients with RRMS, worse self-rated cognitive dysfunction predicted poor learning within (95% CI: −0.1112 to −0.0020) and across (95% CI: −0.0724 to −0.0106) visits.

Conclusions:

Burst design is optimal to study learning and cognitive fatigue. This methodology, using the SDMT or other time-efficient tests as outcome measures, can be successfully implemented in longitudinal studies and clinical trials.
Phoneme discrimination of an unrelated language: Evidence for a narrow transfer but not a broad-based bilingual advantage
Authors: Patihis Lawrence , Oh Janet S. , Mogilner Tayopa
Published: February 2013

This study examines monolingual and multilingual individuals’ discrimination of stop consonants in a language to which they had never been exposed: Korean. If bilingualism leads to increased flexibility in phonological categorization, we may see a broad-based bilingual advantage for phoneme discrimination. Using a Korean phoneme discrimination task, we compared 56 adults in four groups: monolingual English, bilingual Spanish, bilingual Armenian, and trilingual. Findings indicate that Spanish–English bilingual individuals scored no better than English monolinguals, and lower than Armenian–English bilingual individuals. In this case, the advantage from early childhood non-English exposure or current bilingualism was found to be specific only to languages with similar phonemic categories. This supports a narrow first/second language to third language transfer view of phoneme discrimination skills.
An evaluation of factors influencing feeding in babies with a cleft palate with and without a cleft lip
Authors: Martin Vanessa , Greatrex-White Sheila
Published: February 2013

The objective of this article was to determine the impact of different bottles and teats for feeding babies with a cleft palate (with and without a cleft lip) on weight velocity, feeding behaviour, and maternal self-esteem. A mixed methods study incorporating the use of diaries to record feeding patterns of babies and levels of professional support received was used. Growth was assessed by converting weights into standard deviation scores and using the differences to express weight velocity over a six-week period. Visual analogue scales were used to assess mothers’ perceptions of their children and themselves. The Edinburgh Postnatal Depression Score (EPDS) was used to identify maternal depression. The study demonstrated that the most significant effect on weight was determined by cleft type. Babies with isolated clefts of the hard and soft palate experienced greater feeding problems and suffered the biggest weight losses. This remained significant independently of the type of bottle/teat used. Poor weight gain was also associated with a mother’s low perception of herself and her child, and her tendency towards depression. The study highlights the importance of the early assessment of babies’ feeding skills and regular follow-up and support from trained and experienced nurse specialists.
Older adult and family member perspectives of the decision-making process involved in moving to assisted living
Authors: Koenig Terry L , Lee Jung Hee , Macmillan Kelley R , Fields Noelle L , Spano Richard
Published: February 2013

The decision to move into assisted living (AL) can be viewed as a life-changing process for older adults and their families; and each may possess differing views of this process. This qualitative study examined the AL decision-making process as described by twenty-two older adult and family member dyads. Participants described emotional and logistical components related to the AL moving decision. Further, fifteen of twenty-two dyads expressed conflicting or differing views of the AL moving decision. Our discussion examines the need for future studies to explore the impact of family and older adult disagreements on the older adult’s AL adjustment; the necessity for community-based agencies and AL settings to provide social services over the duration of the decision-making process; and the importance of employing social workers skilled in family practice in the AL setting.
Exploring a metamorphosis: Identity formation for an emerging conductor
Authors: Ponchione Cayenna
Published: February 2013

Exploring the manner in which professional identity formation in emerging conductors is entangled with the cultural context of orchestras, I focus on the amorphous evolution from a student identity to that of a professional, illuminating some underlying social conditions of the ever-elusive profession of conducting. Prevailing assumptions about professionalism and orchestral practice are addressed, and I consider the implications of these issues for emerging conductors of the twenty-first century. Although one’s own status as a professional musician can be a delicate subject indeed, in this article I reflect on a period of time during the early years of my conducting career: a transition bracketed by distinctive moments of identity formation. In doing so I offer not an ethnography, but a particular experience – one that transformed my conception of orchestral music-making from a product-centric approach to one that is practice-inspired.
A diabetic patient treated for hypertension develops tremors and twitches
Authors: Gandhi Nirav Y , Shakher Jayadave
Published: February 2013

Objective:

To report an unusual but known cause of hypomagnesaemia-induced hypocalcaemia and review the relevant literature.

Methods:

We present the clinical and laboratory findings in a case of hypomagnesaemia induced-hypocalcaemia, and discuss the underlying mechanisms in light of the available literature.

Results:

After admission our patient described typical features of magnesium deficiency such as weakness, tremors and muscle twitches. He also had clinical signs of hypocalcaemia such as a pronounced carpal pedal spasm. Blood results revealed that he had low calcium and magnesium. This was further confirmed by another set of blood results. His vitamin D levels were normal at 25.2 pg/mL and 27.3 pg/mL. His parathyroid hormone was at 18.5 pg/mL (12–72). His urea and electrolytes were normal with sodium of 137 mmol/l, potassium of 3.8 mmol/l, creatinine of 93 mL/minute, and liver function tests in the normal range. Hypomagnesaemia is a common finding and has been reported to be present in nearly 12% of hospitalised patients. From a review of published reports, it is seen that most cases of hypomagnesaemia are due to gastrointestinal or renal losses, but it is also seen with excess alcohol consumption. Drugs such as proton pump inhibitors and, although not often reported, thiazide diuretics are known to cause hypomagnesaemia. The patient was on Indapamide for his hypertension. With replacement therapy, both his ion levels returned back to normal.

Conclusion:

Hypomagnesaemia is often usually associated with multiple biochemical abnormalities. The increasing use of diuretics and the introduction of potent preparations present a considerable risk for hypomagnesaemia induced-hypocalcaemia.
The ties that bind us: Kymlicka on culture and education
Authors: Peña-Rangel David
Published: February 2013

Most societies today are culturally diverse. Increasingly, minority groups are demanding recognition and self-governing rights to protect their ways of life against that of the majority. These demands represent a serious challenge for the state: how is it to balance between the equally legitimate claims of the many cultures inhabiting its territories, all the while promoting a set of common practices and democratic institutions? In several influential publications, Will Kymlicka has offered persuasive answers to those questions. This article examines his theory, with particular emphasis on the distinction he draws between what he calls national minorities and polyethnic (or immigrant) groups. Given his hierarchical structuring of both groups, this article attempts to show that Kymlicka falls into somewhat contradictory positions, especially evident when considering the implications of his theory on how education is structured within multicultural states.
BAUS Section of Endourology national Ureteroscopy audit: setting the standards for revalidation
Authors: Mangera A , Parys B
Published: February 2013

Objective:

Ureteroscopic stone treatment is one of endourology’s ‘signature’ procedures. With a view to forthcoming revalidation demands and improving outcomes, there was a need for the British Association of Urological Surgeons (BAUS) Section of Endourology and its individual members to know how commonly, competently and successfully this procedure is performed.

Methods:

All surgeons belonging to the BAUS Section of Endourology undertaking ureteroscopy (URS) for stone treatment in the United Kingdom were invited to take part in a two-week prospective audit with the instructions to input all URS performed for stone disease in that period on a standardised proforma.

Results:

In total, 143 procedures were reported over two weeks. Peri-operative practices varied in the use of on the day pre-operative imaging, stent usage and treatment modality. Overall stone free rates for all URS was 78% with a complications rate of 4%.

Conclusion:

This is the first study of its kind to have highlighted the demographics of patients undergoing URS in the UK and provides surgeons with information on practices around the country. It also provides realistic outcomes from real-life practice which, if taken forward to a registry, may be incorporated into revalidation.
Urinary function and health-related quality of life of patients after laparoscopic radical prostatectomy: two methods of assessment for 112 patients with up to six years of follow-up
Authors: Kass-Iliyya Antoine , Vasdev Nikhil , Soomro Naeem , Durkan Garrett C
Published: February 2013

Background:

Wide variation exists between methods of assessment of urinary function following laparoscopic radical prostatectomy (LRP).

Objective:

To assess post-operative urinary function and quality of life (QOL) after LRP using validated questionnaires and compare these results with subjective assessments obtained during outpatient consultations.

Design, setting and participants:

Between January 2004 and December 2009, 200 men with organ-confined prostate cancer underwent LRP at our centre. Post-operative urinary function and QOL were evaluated using validated questionnaires (ICIQ-MLUTS and FACT-P). Data regarding urinary function, which were collected at the outpatient clinic (OPC), were also available for these 112 patients.

Outcome measurements and statistical analysis:

Objective post-operative urinary function obtained from validated questionnaires using univariate and multivariate logistic regression models to evaluate the impact of urinary symptoms on QOL.

Results and limitations:

Based on the validated questionnaires, 75% (75/112) of patients had low incontinence scores (0 to 8/24) at a mean follow-up of 37 months. On subjective assessment at the OPC, 82% (92/112) of patients were considered dry (pad free). The majority of patients had a high QOL score (109–156), indicating good quality of life. Urinary symptoms’ severity was significantly correlated with QOL, where severe symptoms were associated with lower QOL. A literature search revealed wide discrepancies in the assessment of functional outcomes following LRP rendering comparison between studies extremely difficult.

Conclusions:

The functional outcomes of LRP vary depending on the assessment used. There continues to be a lack of congruity between the methodologies used in the literature and few studies published have used validated questionnaires.
Patient reported outcomes of abobotulinumtoxinA injection treatment for idiopathic detrusor overactivity: a pragmatic approach to management in secondary care
Authors: Irwin P , Somov P , Ekwueme K
Published: February 2013

Aims:

To evaluate the medium and long-term results of abobotulinumtoxinA (aboBTX-A) injection treatment in the management of refractory overactive bladder (OAB) symptoms owing to idiopathic detrusor overactivity.

Methods:

Prospective data were collected from consecutive patients who underwent intravesical injection of 250 units of aboBTX-A under general anaesthetic for OAB symptoms that were refractory to antimuscarinic therapy. Overactive bladder symptom scores (OABSS), Likhart quality of life (QoL) indices and post-void residual volumes (PVR) were compared before and 6 weeks after treatment. The Wilcoxon Signed Ranks test was used to compare changes in OABSS, QoL and PVR from baseline scores.

Results:

Seventy-three patients received 93 aboBTX-A injection treatments over a 5-year period. Overall, OABSS and QoL improved by a mean of 3.7 + 4.17 ( p<0.001) and 2.1 + 2.06 ( p<0.001), respectively. An improvement in the combined OABSS and QoL scores of two or more points was observed following 68 (70.8%) procedures. De novo self-catheterisation was required following 16 procedures (16.8%) but was discontinued by 3 months in nine cases. In patients undergoing repeat injection treatment, the mean (+ SD) duration of symptomatic relief (until the resumption of antimuscarinic therapy) was 12.3 + 9.8 months, while the mean (+ SD) interval between injection treatments was 26.7 ± 14.3 months.

Conclusion:

AbobotulinumtoxinA injection treatment, employing a dose of 250 units per treatment, confers results that compare very favourably with those reported for onobotulinumtoxinA.
In Vivo Kinematics of the Talocrural and Subtalar Joints With Functional Ankle Instability During Weight-Bearing Ankle Internal Rotation
Authors: Kobayashi Takumi , No Yumi , Yoneta Kei , Sadakiyo Masashi , Gamada Kazuyoshi
Published: February 2013

Functional ankle instability (FAI) may involve abnormal kinematics. However, reliable quantitative data for kinematics of FAI have not been reported. The objective of this study was to determine if the abnormal kinematics exist in the talocrural and subtalar joints in patients with FAI. Five male subjects with unilateral FAI (a mean age of 33.4 ± 13.2 years) were enrolled. All subjects were examined with stress radiography and found to have no mechanical ankle instability (MAI). Lateral radiography at weight-bearing ankle internal rotation of 0° and 20° was taken with the ankle at 30° dorsiflexion and 30° plantar flexion. Patients underwent computed tomography scan at 1.0 mm slice pitch spanning distal one third of the lower leg and the distal end of the calcaneus. Three-dimensional (3D) kinematics of the talocrural and subtalar joints as well as the ankle joint complex (AJC) were determined using a 3D-to-2D registration technique using a 3D-to-2D registration technique with 3D bone models and plain radiography. FAI joints in ankle dorsiflexion demonstrated significantly greater subtalar internal rotation from 0° to 20° internal rotation. No statistical differences in plantar flexion were detected in talocrural, subtalar or ankle joint complex kinematics between the FAI and contralateral healthy joints. During ankle internal rotation in dorsiflexion, FAI joints demonstrated greater subtalar internal rotation. The FAI joints without mechanical instability presented abnormal kinematics. This suggests that abnormal kinematics of the FAI joints may contribute to chronic instability. FAI joints may involve unrecognized abnormal subtalar kinematics during internal rotation in ankle dorsiflexion which may contribute to chronic instability and frequent feelings of instability.

Level of Evidence: Diagnostic, Level IV, Cross-sectional
Instability Resistance Training Across the Exercise Continuum
Authors: Behm David G. , Colado Sanchez Juan Carlos
Published: February 2013

Context:

Instability resistance training (IRT; unstable surfaces and devices to strengthen the core or trunk muscles) is popular in fitness training facilities.

Objective:

To examine contradictory IRT recommendations for health enthusiasts and rehabilitation.

Data Sources:

A literature search was performed using MEDLINE, SPORT Discus, ScienceDirect, Web of Science, and Google Scholar databases from 1990 to 2012.

Study Selection:

Databases were searched using key terms, including “balance,” “stability,” “instability,” “resistance training,” “core,” “trunk,” and “functional performance.” Additionally, relevant articles were extracted from reference lists.

Data Extraction:

To be included, research questions addressed the effect of balance or IRT on performance, healthy and active participants, and physiologic or performance outcome measures and had to be published in English in a peer-reviewed journal.

Results:

There is a dichotomy of opinions on the effectiveness and application of instability devices and conditions for health and performance training. Balance training without resistance has been shown to improve not only balance but functional performance as well. IRT studies document similar training adaptations as stable resistance training programs with recreationally active individuals. Similar progressions with lower resistance may improve balance and stability, increase core activation, and improve motor control.

Conclusion:

IRT is highly recommended for youth, elderly, recreationally active individuals, and highly trained enthusiasts.
Does design matter? Systematic evaluation of the impact of analytical choices on effect estimates in observational studies
Authors: Madigan David , Ryan Patrick B. , Schuemie Martijn
Published: February 2013

Background:

Clinical studies that use observational databases, such as administrative claims and electronic health records, to evaluate the effects of medical products have become commonplace. These studies begin by selecting a particular study design, such as a case control, cohort, or self-controlled design, and different authors can and do choose different designs for the same clinical question. Furthermore, published papers invariably report the study design but do not discuss the rationale for the specific choice. Studies of the same clinical question with different designs, however, can generate different results, sometimes with strikingly different implications. Even within a specific study design, authors make many different analytic choices and these too can profoundly impact results. In this paper, we systematically study heterogeneity due to the type of study design and due to analytic choices within study design.

Methods and findings:

We conducted our analysis in 10 observational healthcare databases but mostly present our results in the context of the GE Centricity EMR database, an electronic health record database containing data for 11.2 million lives. We considered the impact of three different study design choices on estimates of associations between bisphosphonates and four particular health outcomes for which there is no evidence of an association. We show that applying alternative study designs can yield discrepant results, in terms of direction and significance of association. We also highlight that while traditional univariate sensitivity analysis may not show substantial variation, systematic assessment of all analytical choices within a study design can yield inconsistent results ranging from statistically significant decreased risk to statistically significant increased risk. Our findings show that clinical studies using observational databases can be sensitive both to study design choices and to specific analytic choices within study design.

Conclusion:

More attention is needed to consider how design choices may be impacting results and, when possible, investigators should examine a wide array of possible choices to confirm that significant findings are consistently identified.
Benign prostatic hyperplasia
Authors: Parnham Arie , Haq Ahsanul
Published: February 2013

Male Lower Urinary Tract symptoms (LUTs) and Benign Prostatic Hyperplasia (BPH) provide a significant proportion of the core urologists workload, and will continue to do so for the foreseeable future with an increasingly elderly population. This review sets out to provide an overview of the current understanding around BPH and male LUTs as well as investigations and treatment options.