bluuebunny/crossref_metadata_2025 huggingface dataset:
Lipid Testing and Lipid-Lowering Therapy in Hospitalized Ischemic Stroke and Transient Ischemic Attack Patients
Authors: Mullard Andrew J. , Reeves Mathew J. , Jacobs Bradley S. , Kothari Rashmi U. , Birbeck Gretchen L. , Maddox Kate , Stoeckle-Roberts Stacey , Wehner Susan ,   Paul Coverdell National Acute Stroke Registry Michigan Prototype Investigators
Published: December 2005

Background and Purpose—

Recent recommendations call for in-hospital initiation of lipid-lowering therapy (LLT) for most ischemic stroke (IS) and transient ischemic attack (TIA) survivors; however, little is known about actual use. This study describes use of and predictors for in-hospital lipid testing and LLT using data from a statewide stroke registry.

Methods—

In 2002, the registry ascertained cases from a stratified sample of 16 hospitals. This study includes only IS and TIA cases discharged alive.

Results—

In 1907 study subjects, 30.2% (27.2% to 33.5%) were on LLT at admission. In 1399 subjects not on LLT at admission, 37.2% (30.2% to 44.9%) underwent lipid testing, and 12.9% (7.2% to 22.1%) received LLT at discharge. Use of testing and LLT varied widely between hospitals (
P
<0.001). In-hospital lipid testing was positively associated with large teaching hospitals (
P
=0.029), and neurologist or neurosurgeon (
P
=0.004); and negatively associated with increasing age (
P
=0.002), being female (
P
=0.020), a previous medical history of atrial fibrillation (
P
=0.002), nonambulatory status (
P
=0.005), and poor prognosis (
P
<0.001). LLT at discharge was positively associated with a previous medical history of dyslipidemia (
P
<0.001), lipid testing (
P
=0.004), and elevated low-density lipoprotein levels (
P
<0.001). Among subjects who were not on LLT at admission but who had Adult Treatment Panel III–based indications for use of LLT, only 31.2% (20.5% to 44.5%) received LLT at discharge.

Conclusions—

Many hospitalized acute IS and TIA patients with indications for LLT are untreated at discharge. Efforts to close treatment gaps in lipid evaluation and treatment require sustained quality improvement efforts and should pay particular attention to high-risk patients.
Prolonged Low-Dose Intravenous Thrombolysis in a Stroke Patient With Distal Basilar Thrombus
Authors: Veltkamp Roland , Jacobi Christian , Kress Bodo , Hacke Werner
Published: December 2005

Background and Purpose—

Patients with high-grade basilar artery stenosis secondary to thromboembolism are at high risk of developing subsequent vessel occlusion. Optimal medical management of this condition is unclear.

Summary of Case—

We present a patient with a small subacute brain stem infarction and filiform distal basilar residual lumen attributable to arterioarterial or cardiogenic embolism. Beginning 3 days after symptom onset, low-dose intravenous thrombolysis with 0.125 mg/kg recombinant tissue plasminogen activator was continuously infused for 48 hours. Follow-up magnetic resonance angiography revealed complete resolution of the embolus. No further cerebral ischemic episodes occurred during 3-month follow-up, and the basilar artery remained patent.

Conclusion—

Our observation suggests a potential for prolonged low-dose intravenous thrombolysis in basilar artery embolism, but further data are needed to judge the effectiveness and risk of this intervention.
Mechanical Thrombolysis in Ischemic Stroke Attributable to Basilar Artery Occlusion as First-Line Treatment
Authors: Bergui Mauro , Stura Guido , Daniele Dino , Cerrato Paolo , Berardino Maurizio , Bradac Gianni Boris
Published: December 2005

Background and Purpose—

To report results of mechanical disruption or retrieval of thrombus as first-line treatment in patients with stroke attributable to occlusion of the basilar artery, in particular regarding efficiency and safety.

Methods—

In 12 consecutive patients with acute stroke attributable to basilar occlusion, mechanical disruption or thrombus retrieval using various loop-shaped tools was tried before eventually starting local intra-arterial thrombolysis with recombinant tissue plasminogen activator (r-tPA). Main inclusion criteria were: National Institutes of Health Stroke Scale score >8 or Glasgow Coma Scale score <12; onset or worsening of symptoms <8 hours; no hemorrhages or large hypodensities on computed tomography scan; and occlusion of the basilar artery matching clinical symptoms. Efficiency included recanalization, procedure time, and r-tPA dose; safety was defined as rate of procedure-related complications. Outcome was evaluated at 3 months.

Results—

Mechanical recanalization was successful in 6 patients. A single brain infarction, possibly attributable to distal embolization, occurred. Three patients had good outcomes. In 5 of 6 remaining patients, the artery was recanalized using r-tPA. A single asymptomatic hemorrhage occurred; 3 patients had good outcomes. Procedure time and r-tPA were significantly less in patients with successful mechanical thrombolysis (43.33 minutes and 13.33 mg versus 112.33 minutes and 55.83 mg, respectively).

Conclusion—

Mechanical recanalization was effective in half of the patients and at least as safe as local intra-arterial thrombolysis. It allowed to save r-tPA and time. Although the low success rate remains a limit, the excellent and quick anatomical recanalization obtained after successful procedures makes this approach promising.
Task-Specific Training With Trunk Restraint on Arm Recovery in Stroke
Authors: Michaelsen Stella Maris , Dannenbaum Ruth , Levin Mindy F.
Published: December 2005

Background and Purpose—

Task-specific training improves functional outcomes after stroke. However, gains may be accompanied by increases in movements compensating for motor impairments. We hypothesized that restriction of compensatory trunk movements may encourage recovery of premorbid movement patterns leading to better functional outcomes. The goal was to determine whether task-specific training with trunk-restraint (TR) produces greater improvements in arm impairment and function than training without TR in patients with chronic hemiparesis.

Methods—

Double-blind randomized control trial of a therapist-supervised home program (3 times per week, 5 weeks) in 30 patients with chronic hemiparesis stratified by arm impairment level (Fugl-Meyer) was performed. Intervention group (TR group) received progressive object-related reach-to-grasp training with prevention of trunk movements. Control group (C) practiced tasks without TR. Main outcome measures were upper limb impairment (Fugl-Meyer Arm Section) and function (TEMPA) and movement kinematics (trunk displacement, elbow extension; Optotrak, 10 trials) of a reach-to-grasp movement. Evaluations were repeated before, immediately after, and 1 month postintervention by blind evaluators.

Results—

TR training led to greater improvements in impairment and function compared with C. Improvements were accompanied by increased active joint range and were greater in initially more severe patients. In these patients, TR decreased trunk movement and increased elbow extension, whereas C had opposite effects (increased compensatory movements). In TR, changes in arm function were correlated with changes in arm and trunk kinematics.

Conclusions—

Treatment should be tailored to arm impairment severity with particular attention to controlling excessive trunk movements if the goal is to improve arm movement quality and function.
Cilostazol Attenuates Gray and White Matter Damage in a Rodent Model of Focal Cerebral Ischemia
Authors: Honda Fumiaki , Imai Hideaki , Ishikawa Makoto , Kubota Chisato , Shimizu Tatsuya , Fukunaga Mari , Saito Nobuhito
Published: December 2005

Background and Purpose—

To evaluate whether delayed treatment with the antiplatelet agent cilostazol reduces the volume of infarction in the gray and white matter in a rodent model of permanent focal cerebral ischemia and to explore the mechanism of the neuroprotective effect in vivo.

Methods—

Cilostazol (30 or 50 mg/kg) or vehicle was administered by gavage 30 minutes and 4 hours after the induction of cerebral ischemia by permanent occlusion of the left middle cerebral artery (MCA). Animals were euthanized 24 hours after MCA occlusion, and the volume of gray matter damage was evaluated by quantitative histopathology. Axonal damage was determined with amyloid precursor protein immunohistochemistry. Dynamic susceptibility contrast MRI was used to assess regional cerebral blood volume (CBV) and cerebral blood flow (CBF).

Results—

Treatment with the higher dose of cilostazol (50 mg/kg) significantly reduced the volume of gray matter damage and axonal damage in the cerebral hemisphere by 45.0% (
P
<0.02) and 42.4% (
P
<0.002), respectively, compared with the control group. Relative CBV in the peri-infarct area after MCA occlusion was significantly increased in the cilostazol-treated group (50 mg/kg) compared with the control group (
P
<0.05). Relative CBF tended to be higher in the cilostazol-treated group compared with the control group.

Conclusions—

Treatment with cilostazol significantly reduced the gray and white matter damage associated with permanent focal ischemia. Cilostazol improved CBV and CBF in the peri-infarct area. The major action of cilostazol is to increase perfusion in the ischemic penumbra.
Validation of Automatically Classified Magnetic Resonance Images for Carotid Plaque Compositional Analysis
Authors: Clarke Sharon E. , Beletsky Vadim , Hammond Robert R. , Hegele Robert A. , Rutt Brian K.
Published: December 2005

Background and Purpose—

MRI may be used for noninvasive assessment of atherosclerotic lesions; however, MRI evaluation of plaque composition requires validation against an accepted reference standard, such as the American Heart Association (AHA) lesion grade, defined by histopathological examination.

Methods—

Forty-eight carotid endarterectomy specimen cross-sections had AHA lesion grade determined histopathologically and were concurrently imaged using combinations of 8 MRI contrast weightings in vitro. A maximum likelihood classification algorithm generated MRI “maps” of plaque components, and an AHA lesion grade was assigned correspondingly. Additional analyses compared classification accuracy obtained with a commonly used set of magnetic resonance contrast weightings [proton density (PDw), T1 (T1w), and partial T2 (T2w)] to accuracy obtained with the combination of PDw, T1w, and diffusion-weighted (Dw) contrast.

Results—

For the 8-contrast combination, the sensitivities for fibrous tissue, necrotic core, calcification, and hemorrhage detection were 83%, 67%, 86%, and 77%, respectively. The corresponding specificities were 81%, 78%, 99%, and 97%. Good agreement (79%) between magnetic resonance and histopathology for AHA classification was achieved. For the PDw, T1w, and Dw combination, the overall classification accuracy was insignificantly different at 78%, whereas the overall classification accuracy using PDw, T1w, and partial T2w contrast weightings was significantly lower at 67%.

Conclusions—

This study provides proof-of-principle that the composition of atherosclerotic plaques determined by automated classification of high-resolution ex vivo MRI accurately reflects lesion composition defined by histopathological examination.
Telemedicine-Guided Carotid and Transcranial Ultrasound
Authors: Mikulik Robert , Alexandrov Andrei V. , Ribo Marc , Garami Zsolt , Porche Nichole A. , Fulep Eva , Grotta James C. , Wojner-Alexandrov Anne W. , Choi John Y.
Published: December 2005

Background and Purpose—

Transcranial Doppler (TCD) and carotid duplex (CD) provide rapid and safe screening for stroke patients but are highly operator dependent. We explored the feasibility of telemedicine (TM)-guided TCD/CD administered by a health care provider inexperienced with ultrasound.

Methods—

Dual video screens transmitted real-time TCD/CD images and sound to a neurosonographer. TM TCD/CD characteristics were compared with an in-person (IP) examination independently obtained on the same patient. We compared carotid stenosis, thrombolysis in brain ischemia (TIBI) flow grades, and the time spent on testing.

Results—

We examined 8 subjects with a median age of 51 (31 to 63 range). IP and TM successfully examined 100% of internal carotid and middle cerebral arteries, 50% versus 44% of anterior cerebral artery, and 100% versus 88% of the basilar arteries, respectively. The median time in minutes IP versus TM was 15 (range 10 to 35) and 30 (15 to 50) for CD (
P
=0.07) and 18 (15 to 30) and 45 (30 to 55) for TCD (
P
=0.002), respectively. TM correctly identified all normal CD/TCD examinations in 7 subjects. In 1 patient, TM identified carotid occlusion but misread TIBI flow grades in both middle cerebral arteries.

Conclusions—

Our pilot study showed the feasibility of TCD/CD by an inexperienced health professional guided by a sonographer via TM. Tests were completed within times comparable to outpatient setting in a vascular laboratory.
Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy
Authors: Steiner Thorsten , Rosand Jonathan , Diringer Michael
Published: December 2005

Background and Purpose—

Life-threatening intracranial hemorrhage, predominantly intracerebral hemorrhage (ICH), is the most serious complication of oral anticoagulant therapy (OAT), with mortality in excess of 50%. Early intervention focuses on rapid correction of coagulopathy in order to prevent continued bleeding.

Summary of Review—

This article reviews the epidemiology of OAT-associated ICH (OAT-ICH), and current treatment options, with the aim of providing a framework for future studies of unresolved questions. A number of acute treatments are available, but all have a significant risk of inducing thrombosis and other side effects, and vary in their rapidity of effect: vitamin K (very slow response time), fresh frozen plasma (slow response time, large volume of fluid required, transfusion-related acute lung injury), prothrombin complex concentrates, and recombinant activated factor VII. Current practice is to administer a combination of vitamin K and either fresh frozen plasma or prothrombin complex concentrates; the occasional use of recombinant activated factor VII has been reported. No prospective study has addressed the efficacy of, or outcomes from, the use of these practices.

Conclusions—

Current management of OAT-ICH is varied and not based on evidence from randomized controlled trials. Well-designed clinical trials are essential if we are to identify the effective acute treatments for OAT-ICH that are urgently needed.
Long-Term Outcome After Stroke
Authors: Haacke Caroline , Althaus Astrid , Spottke Annika , Siebert Uwe , Back Tobias , Dodel Richard
Published: December 2005

Background and Purpose—

As stroke mortality rates decline, individuals are increasingly likely to live with their residual impairments and disabilities. Therefore, the quality of poststroke life is 1 of the pivotal topics that have to be considered beneath the functional outcome. However, data on health-related quality of life (HRQoL) have been infrequently used in stroke trials. The purpose of this study was to examine the long-term outcome (4 years after stroke) of HRQoL and to identify the determinants of HRQoL in stroke survivors.

Methods—

Seventy-seven patients were included who were admitted to the Department of Neurology, Philipps-University Marburg, after experiencing an ischemic stroke, a transient ischemic attack, or a hemorrhagic stroke. All patients were examined by a physician, and assessment was performed using a standardized questionnaire. HRQoL was assessed using the German version of the EuroQoL Index (EQ-5D) and the Health Utility Index 2 and 3 (HUI2/3).

Results—

Four years after stroke, besides physical functioning, neuropsychological sequelae such as depression and cognitive impairment contributed to a reduced HRQoL. In addition, the incidence of incontinence proved to be an important factor for HRQoL. Explained variances in regression analysis models were high (
R
2
=0.802 for HUI and 0.633 for EQ-5D—visual analogue scale) and were based on a few important determinants, including physical state, depression, cognitive impairment, and incontinence.

Conclusion—

Our results underscore the importance of nonmotor symptoms on HRQoL in patients with stroke.
Terrorism and Globalization
Authors: Cooper Barry
Published: December 2005

This chapter relates the material circumstances of globalization to cultural trauma and the spiritual disorder of pneumopathology. Eric Voegelin asserts that the pneumopathological terrorist suffers from a disease in which evil assumes the form of spirituality. Terrorist organizations, such as Aum Shinrikyo in Japan or Osama bin Laden's al-Qaeda, construct an imaginative "second reality" in which the murder of innocents is seen as contributing to a magical transformation of the world. This kind of terrorism replaces pragmatically rational pursuits with pathological spiritual aspirations in which Weapons of Mass Destruction and suicide bombings are both seen as appropriate instruments in an apocalyptic struggle between Good and Evil.
Charlotte Bühler’s Existential-Humanistic Contributions to Child and Adolescent Psychology
Authors: Derobertis Eugene M.
Published: December 2005

Charlotte Malachowski Bühler was a founder of humanistic psychology. This article reviews her theories of child and adolescent development. One purpose is to provide college instructors with material introducing a humanistic theory of development to students of child psychology. Bühler’s ideas are compared to other developmental theories, especially psychoanalytic and behavioral theories. This is followed by a presentation of her ideas as they relate to specific stages of development inherent within her descriptions of human growth prior to adulthood. The article concludes with a summative account of Bühler’s thoughts on the development of the self and some critical remarks regarding her work.
Viktor Frankl—Advocate for Humanity: On his 100th Birthday
Authors: Längle Alfried , Sykes Britt-Mari
Published: December 2005

Viktor Frankl founded the psychotherapeutic school known as Logotherapy and Existential Analysis. Frankl was a medical doctor whose interest in the burgeoning field of psychology and psychoanalysis brought him into contact with the theories of Freud and Adler. Frankl’s familiarity with these two schools of psychotherapy combined with his own philosophical approach to human nature became motivating factors in his desire to reduce “reductionism” and promote a more humanistic approach to the fields of psychology, psychotherapy, and medicine. Frankl dedicated both his life and the better part of his career to the topic of meaning. Frankl’s unique contribution to the field of psychology focuses on the effect that meaning, possibility, freedom, and decision have on an individual’s psychological well-being and development. This article aims to illustrate Frankl’s unique contribution to psychology by providing a brief biography and highlighting the contexts in which Logotherapy as a theory emerged.
Self-Actualization and Society: A New Application for an Old Theory
Authors: Laas Ingrid
Published: December 2005

This article introduces the reader to a descriptive framework that differentiates between psychologically healthy and unhealthy social movements. This work parallels some of Abraham Maslow’s work on individual psychological health. The article explains this connection and explores the possibility of expanding the application of Maslow’s theories of motivation of individuals to the motivations of groups. These ideas are then applied to the democratic uprisings that occurred around the world in the late 20th century. Finally, the evolutionary implications of these ideas are investigated, suggesting it is time to explore the potential of a humanistic science based on Maslow’s work.
Love, Open Awareness, and Authenticity: A Conversation with William Blake and D. W. Winnicott
Authors: Adams Will W.
Published: December 2005

In being loved, we become more open. In being open, we become more authentic. In being authentic, we become more loving and creative. Love, open awareness, and authentic existence are intimately interrelated. They co-arise interdependently and together comprise a coherent structure of well-being, allowing one to be most fully human and most fully and uniquely oneself. Psychology and literature are complementary approaches to understanding the meaning of human existence in our shared life-world. In this spirit, a hermeneutical conversation with William Blake and D. W. Winnicott is presented. Blake’s work and life are read in light of Winnicott’s theory of development and psychotherapy, and Winnicott’s theory is read in light of Blake, thereby illuminating the significant interpermeation of love, openness, and authenticity.
Questioning Constructionism: Toward an Ethics of Finitude
Authors: Brinkmann Svend
Published: December 2005

This article develops an existential-phenomenological critique of the social constructionist movement in psychology, taking its lead from what Kenneth Gergen calls “the most pressing question”: What happens to us when we begin to employ constructionist ideas in our lives? It is suggested that contemporary consumer societies already work according to the logic of social construction and that constructionism already has become many people’s philosophy. Some points of conversion between constructionism and consumerism are pointed out, including a shared focus on identity morphing, aesthetization of life, and a denial of life’s tragic dimensions. As an antidote to this “ethics of infinitude,” this article outlines an existential-phenomenological ethics that starts from certain basic facts of human existence, including human interdependency and mortality. It is argued that nonconstructed moral demands spring from these facts. Social constructionists too easily miss the fact that solidarity, compassion, and care are possible only for finite, vulnerable creatures.
Examination of Parenting Styles of Processing Emotions and Differentiation of Self
Authors: Schwartz Jonathan P. , Thigpen Sally E. , Montgomery Jennifer K.
Published: December 2005

Gottman and associates theorized emotion coaching, parents’ processing of negative emotions with children, as important for children’s later development. Bowen viewed differentiation, the balance between emotional and cognitive reactions to one’s family of origin, as an important developmental process. However, research has not specified parenting methods that foster healthy differentiation. The authors hypothesized adults with emotion-coaching parents have healthier differentiation than those parented with other styles. A total of 254 (129 female, 124 male) participants completed surveys measuring perception of parenting styles and differentiation of self. For male participants, perceiving their parents as having a disapproving style was associated with a poor sense of self. For female participants, high levels of fusion and low levels of emotional cutoff were associated with low emotion-coaching parents and disapproving mothers. Implications and limitations are discussed.
Loss and Depression in Cohabiting and Noncohabiting Custodial Single Parents
Authors: Hilton Jeanne M. , Kopera-Frye Karen
Published: December 2005

Differences in depression and factors that contribute to depression were examined using a sample of 627 divorced mothers and 101 divorced fathers who participated in the National Survey of Families and Households. Findings indicated that custodial mothers had less contact with friends and were more depressed than custodial fathers, regardless of cohabiting status, and noncohabiting mothers had significantly less income than noncohabiting fathers. No group differences were found for income change, role satisfaction, or personal mastery. Regression analysis revealed that household income, income change, household size, contact with friends, personal mastery, and role satisfaction significantly accounted for 42% of the variance in explaining depression. The findings suggest that custodial mothers and fathers are more alike than different in the ways that they experience depression and that role satisfaction and personal mastery are important buffers against depression for both mothers and fathers.
Resilient Sexual Desire in Heterosexual Couples
Authors: McCarthy Barry W. , Ginsberg Rebecca L. , Fucito Lisa M.
Published: December 2005

Inhibited sexual desire (ISD), characterized by low sexual interest and sexual avoidance, is a common problem for heterosexual couples presenting to sex therapy. ISD is multicausal and multidimensional and manifests differently for males and females. Precipitating factors include traumatic sexual experiences, negative self-image, sexual guilt or shame, deviant or variant sexual behavior, relationship difficulties, and a chronic sexual dysfunction. Regardless of whether the male or female experiences ISD, the effect on the couple is that the cycle of positive anticipation, pleasure-oriented intercourse, and a regular rhythm of sexual contact is replaced by anticipatory anxiety, unsuccessful intercourse, self-consciousness, and avoidance. This article outlines a therapeutic plan for establishing resilient sexual desire by emphasizing intimacy, pleasure, satisfaction, and realistic sexual expectations.
Internet Counseling and Its Feasibility for Marriage and Family Counseling
Authors: Pollock Sandra L.
Published: December 2005

This article explores the inevitable phenomenon of online therapy provided by professional counselors. Advantages of Internet counseling are examined from clients’ and counselors’ perspectives. Disadvantages are discussed, particularly in the area of asynchronous communication without the benefit of nonverbal cues. The possibility of providing marriage and family counseling via the Internet is considered. Through perusal and extrapolation of the current literature available on Internet counseling, this article speculates on the potential usefulness of this venue in the 21st century and the need for more research.
Ethical Code for the International Association of Marriage and Family Counseling
Authors:   International Association of Marriage and Family Counseling
Published: December 2005

The Board of Directors of the International Association of Marriage and Family Counselors (IAMFC) requested the Ethics Committee to revise the extant code of ethics. This revised Ethical Code of the IAMFC addresses contemporary practices and concerns in marriage and family counseling. The code follows the basic structure of the recent revision of the American Counseling Association’s Code of Ethics.
Addressing Secrets in Couples Counseling: An Alternative Approach to Informed Consent
Authors: Bass Barry A. , Quimby Julie L.
Published: December 2005

This article presents an alternative approach to informed consent that addresses unique concerns regarding confidentiality in marital and relationship counseling. Professional ethics codes rarely provide therapists with specific guidance on how to respond to clients who wish to keep secrets from their spouse or partner. Moreover, scholars writing about confidentiality frequently offer contradictory advice on how to ethically treat those couples presenting with secrets. This article suggests that regardless of one’s viewpoint on the issue of secret keeping in counseling, therapists best serve couples by advising them at the onset of treatment of the counselor’s policies regarding confidential communication. In addition to discussing issues regarding privacy and confidentiality in couples counseling, this article presents one example of an informed consent document designed to address this important concern.
Uniting Spirituality and Sexual Counseling: Eastern Influences
Authors: Turner Tommy E. , Fox Nancy J. , Center Hayden , Kiser Jerry D.
Published: December 2005

Practitioners who unite sexual counseling and spirituality must examine their personal experiences, values, and beliefs in the spiritual realm and become familiar with the various spiritual contexts of clients. This article provides information about Taoism, Hinduism, and Buddhism—three major Eastern religions that have made significant contributions to the merger of spirituality and sexuality.
Integration in EFT: A Reply to Simon (2004)
Authors: Johnson Susan
Published: December 2005

Simon’s (2004) examination of the integrative nature of emotionally focused therapy (EFT) fails to describe accurately EFT and its promise in therapy integration. EFT is not merely assimilative but moves toward an effective synthesis of key theories. There is a revolution occurring in couple and family therapy. There is a confluence of data on the nature of distress and health in relationships, data on attachment as an explanatory framework, and data on the nature and role of emotion in relationships. We need models characterized by effective synthesis to give us a map to the territory and a way home. Such a synthesis is now possible.
The Psychohistorical Approach in Family Counseling With Mestizo/Latino Immigrants: A Continuum and Synergy of Worldviews
Authors: Arredondo Patricia , Avilés Robert M. Davison , Zalaquett Carlos P. , Grazioso Maria del Pilar , Bordes Veronica , Hita Liza , Lopez Belinda J.
Published: December 2005

In April 2005, the International Association for Marriage and Family Counseling’s yearly Distinguished Speakers series at the American Counseling Association Conference featured a presentation on family counseling with Mestizo/Latino immigrants. A panel composed of Latino counseling professionals representing varied Mestizo backgrounds discussed their personal and professional experiences surrounding the Mestizo/Latino diaspora. This article discusses population definitions, contextual variables, and demographics regarding Mestizos/Latinos, along with life transition issues and ethnic-heritage themes. A psychohistorical approach to family counseling is presented, and illustrative vignettes, including personal anecdotes by the conference presenters/authors, are provided. Recommendations for practice are offered.
When a Spouse Comes Out: As Told From a Straight Spouse’s Point of View
Authors: Duffey Thelma
Published: December 2005

We hear many stories about a spouse, heterosexually married for years, who reveals to a partner that she or he is gay, lesbian, bisexual, or transgender (GLBT). The professional literature has shown considerable interest in the coming-out experience of newly identified GLBT partners. The author is a counselor educator and has been a therapist for more than 15 years. She works with individuals, couples, and families on a myriad of issues, including spousal disclosure of homosexuality. The following story reflects a compilation of experiences encountered in her practice narrated from the perspective of a heterosexual spouse following her husband’s disclosure.
The Role of Measurement Error in Familiar Statistics
Authors: Ree Malcolm James , Carretta Thomas R.
Published: December 2005

Measurement error, or reliability, affects many common applications in statistics, such as correlation, partial correlation, analysis of variance, regression, factor analysis, and others. Despite its importance, the role of measurement error in these familiar statistical applications often receives little or no attention in textbooks and courses on statistics. The purpose of this article is to examine the role of reliability in familiar statistics and to show how ignoring the consequences of (less than perfect) reliability in common statistical techniques can lead to false conclusions and erroneous interpretation.
Coefficient Beta and Hierarchical Item Clustering
Authors: Cooksey Ray W. , Soutar Geoffrey N.
Published: December 2005

Summated scales are widely used in management research to measure constructs such as job satisfaction and organizational commitment. This article suggests that Revelle’s (1979) coefficient beta, implemented in Revelle’s (1978) ICLUST item-clustering procedure, should be used in conjunction with Cronbach’s coefficient alpha measure of internal consistency as criteria for judging the dimensionality and internal homogeneity of summated scales. The approach is demonstrated using ICLUST reanalyses of sample responses to Warr’s (1990) affective well-being scale and O’Brien, Dowling, and Kabanoff’s (1978) job satisfaction scale. Coefficient beta and item clustering are shown to more clearly identify the homogeneity and internal dimensional structure of summated scale constructs than do traditional principal components analyses. Given these benefits, Revelle’s approach is a viable alternative methodology for scale construction in management, organizational, and cross-cultural contexts, especially when researchers need to make defensible choices between using whole scales or subscales.
In vivo disruption of tolerogenic cross-presentation mechanisms uncovers an effective T-cell activation by B-cell lymphomas leading to antitumor immunity
Authors: Horna Pedro , Cuenca Alex , Cheng Fengdong , Brayer Jason , Wang Hong-Wei , Borrello Ivan , Levitsky Hyam , Sotomayor Eduardo M.
Published: December 2005

Bone marrow-derived antigen-presenting cells (APCs) play a central role in the induction of tolerance to tumor antigens expressed by B-cell lymphomas. Here we show that in vivo disruption of this APC-mediated tolerogenic mechanism unveils an intrinsic ability of malignant B cells to efficiently present tumor antigens to antigen-specific CD4+ T cells, resulting in a strong antitumor effect. This intrinsic antigen-presenting ability of malignant B cells is, however, overridden by tolerogenic bone marrow-derived APCs, leading instead to T-cell unresponsiveness and lack of antitumor effect. These results highlight the concept that therapeutic strategies aimed at enhancing the antigen-presenting function of B-cell lymphomas might not succeed unless the tolerogenic mechanisms mediated by bone marrow-derived APCs are disrupted in the first place.
Vaccination of human subjects expands both specific and bystander memory T cells but antibody production remains vaccine specific
Authors: Genova Gianfranco Di , Roddick Joanna , McNicholl Feargal , Stevenson Freda K.
Published: December 2005

Human subjects maintain long-term immunologic memory against infective organisms but the mechanism is unclear. CD4+ T-helper memory (Thmem) cells are pivotal in controlling humoral and cellular responses, therefore their longevity and response to vaccination are critical for maintenance of protective immunity. To probe the dynamics of the Thmem-cell response to antigenic challenge, we investigated subjects following a booster injection with tetanus toxoid (TT). Expansion of TT-specific Thmem cells and cytokine production showed complex kinetics. Strikingly, parallel expansion and cytokine production occurred in pre-existing Thmem cells specific for 2 other common antigens: purified protein derivative of tuberculin and Candida albicans. Bystander expansion occurred in Thmem but not in Thnaive cells. Antibody production against TT peaked approximately 2 weeks after vaccination and gradually declined. However, pre-existing antibody against the other antigens did not change. It appears that although all Thmem cells are readily stimulated to expand, antibody responses are controlled by antigen availability. These findings relate to the maintenance of memory and have consequences for assessments of specific T-cell responses to vaccination.
Placental dermatan sulfate: isolation, anticoagulant activity, and association with heparin cofactor II
Authors: Giri Tusar K. , Tollefsen Douglas M.
Published: December 2005

Pregnancy is associated with hemostatic challenges that may lead to thrombosis. Heparin cofactor II (HCII) is a glycosaminoglycan-dependent thrombin inhibitor present in both maternal and fetal plasma. HCII activity increases during pregnancy, and HCII levels are significantly decreased in women with severe pre-eclampsia. Dermatan sulfate (DS) specifically activates HCII and is abundant in the placenta, but the locations of DS and HCII in the placenta have not been determined. We present evidence that DS is the major anticoagulant glycosaminoglycan in the human placenta at term. DS isolated from human placenta contains disaccharides implicated in activation of HCII and has anticoagulant activity similar to that of mucosal DS. Immunohistochemical studies revealed that DS is associated with fetal blood vessels and stromal regions of placental villi but is notably absent from the syncytiotrophoblast cells in contact with the maternal circulation. HCII colocalizes with DS in the walls of fetal blood vessels and is also present in syncytiotrophoblast cells. Our data suggest that DS is in a position to activate HCII in the fetal blood vessels or in the stroma of placental villi after injury to the syncytiotrophoblast layer and thereby inhibit fibrin generation in the placenta.
Lack of allosterically controlled intramolecular transfer of nitric oxide from the heme to cysteine in the β subunit of hemoglobin
Authors: Huang Kris T. , Azarov Ivan , Basu Swati , Huang Jinming , Kim-Shapiro Daniel B.
Published: December 2005

The SNO-Hb hypothesis holds that heme-bound nitric oxide (NO) present in the β subunits of T-state hemoglobin (Hb) will be transferred to the β-93 cysteine upon conversion to R-state Hb, thereby forming SNO-Hb. A deficiency in the ability of Hb to facilitate this intramolecular transfer has recently been purported to play a role in pulmonary hypertension and sickle cell disease. We prepared deoxygenated Hb samples with small amounts of heme-bound NO and then oxygenated the samples. Electron paramagnetic resonance (EPR) spectroscopy was used to (1) determine the concentration of iron nitrosyl Hb (Fe-NO Hb), (2) show that the NO is evenly distributed among α and β subunits, and (3) show that the Hb undergoes a change in its quaternary state (T to R) upon oxygenation. We did not observe a decrease in the concentration of Fe-NO Hb on oxygenation, which is inconsistent with the prediction of the SNO-Hb hypothesis.
Caffeic acid phenethyl ester decreases acute pneumonitis after irradiation in vitro and in vivo
Authors: Chen Miao-Fen , Keng Peter C , Lin Paul-Yang , Yang Cheng-Ta , Liao Shuen-Kuei , Chen Wen-Cheng
Published: December 2005

Background

Lung cancer is relatively resistant to radiation treatment and radiation pneumonitis is a major obstacle to increasing the radiation dose. We previously showed that Caffeic acid phenethyl ester (CAPE) induces apoptosis and increases radiosensitivity in lung cancer. To determine whether CAPE, an antioxidant and an inhibitor of NF-kappa B, could be a useful adjuvant agent for lung cancer treatment, we examine the effects of CAPE on irradiated normal lung tissue in this study.

Methods

We compared the effects of CAPE on cytotoxicity and intracellular oxidative stress in normal lung fibroblast and a lung cancer cell line. Forin vivoanalysis, whole thorax radiation (single dose 10 Gy and 20 Gy) was delivered to BALB/c male mice with or without CAPE pretreatment. NF- kappaB activation and the expression levels of acute inflammatory cytokines were evaluated in mice after irradiation.

Results

Thein vitrostudies showed that CAPE cause no significant cytotoxicity in normal lung as compared to lung cancer cells. This is probably due to the differential effect on the expression of NF-kappa B between normal and malignant lung cells. The results fromin vivostudy showed that CAPE treatment decreased the expression of inflammatory cytokines including IL-1 alpha and beta, IL-6, TNF-alpha and TGF- beta, after irradiation. Moreover, histological and immunochemical data revealed that CAPE decreased radiation- induced interstitial pneumonitis and TGF-beta expression.

Conclusion

This study suggests that CAPE decreases the cascade of inflammatory responses induced by thoracic irradiation without causing toxicity in normal lung tissue. This provides a rationale for combining CAPE and thoracic radiotherapy for lung cancer treatment in further clinical studies.
Genetic structure of Anopheles gambiae populations on islands in northwestern Lake Victoria, Uganda
Authors: Kayondo Jonathan K , Mukwaya Louis G , Stump Aram , Michel Andrew P , Coulibaly Mamadou B , Besansky Nora J , Collins Frank H
Published: December 2005

Background

Alternative means of malaria control are urgently needed. Evaluating the effectiveness of measures that involve genetic manipulation of vector populations will be facilitated by identifying small, genetically isolated vector populations. The study was designed to use variation in microsatellite markers to look at genetic structure across four Lake Victoria islands and two surrounding mainland populations and for evidence of any restriction to free gene flow.

Methods

Four Islands (from 20–50 km apart) and two surrounding mainland populations (96 km apart) were studied. Samples of indoor resting adult mosquitoes, collected over two consecutive years, were genotyped at microsatellitelocidistributed broadly throughout the genome and analysed for genetic structure, effective migration (Nem) and effective population size (Ne).

Results

Ne estimates showed island populations to consist of smaller demes compared to the mainland ones. Most populations were significantly differentiated geographically, and from one year to the other. Average geographic pair-wiseFST ranged from 0.014–0.105 and several pairs of populations had Ne m < 3. The loci showed broad heterogeneity at capturing or estimating population differences.

Conclusion

These island populations are significantly genetically differentiated. Differences reoccurred over the study period, between the two mainland populations and between each other. This appears to be the product of their separation by water, dynamics of small populations and local adaptation. With further characterisation these islands could become possible sites for applying measures evaluating effectiveness of control by genetic manipulation.
Induction and inhibition of oocyte maturation by EDCs in zebrafish
Authors: Tokumoto Toshinobu , Tokumoto Mika , Nagahama Yoshitaka
Published: December 2005

Background

Oocyte maturation in lower vertebrates is triggered by maturation-inducing hormone (MIH), which acts on unidentified receptors on the oocyte surface and induces the activation of maturation-promoting factor (MPF) in the oocyte cytoplasm. We previously described the induction of oocyte maturation in fish by an endocrine-disrupting chemical (EDC), diethylstilbestrol (DES), a nonsteroidal estrogen.

Methods

In this study, stimulatory and inhibitory effects of EDCs and natural steroids on oocyte maturation were examined in zebrafish. For effective agents, some details about the mechanism in induction or inhibition of maturation were examined. Possible groups of DES interacting with the MIH receptor are discussed based on relative potency of steroids to induce maturation.

Results

Among agents tested, tamoxifen (TAM) and its metabolite 4-hydroxytamoxifen (4-OHT) showed stimulatory activity similar to DES. The time courses of the change in germinal vesicle breakdown and an intracellular molecular event (the synthesis of cyclin B) induced by TAM were indistinguishable from those induced by MIH. In contrast, pentachlorophenol (PCP) had a potent inhibitory effect on MIH-induced oocyte maturation. PCP inhibited not only MIH-induced maturation but also DES- and TAM-induced maturation. Methoxychlor also inhibited maturation when oocytes were pre-treated with this agent.

Conclusion

These results suggest that EDCs act as agonists or antagonists in the induction of oocyte maturation in fish.
Quantification of the virus-host interaction in human T lymphotropic virus I infection
Authors: Asquith Becca , Mosley Angelina J , Heaps Adrian , Tanaka Yuetsu , Taylor Graham P , McLean Angela R , Bangham Charles RM
Published: December 2005

Background

HTLV-I causes the disabling inflammatory disease HAM/TSP: there is no vaccine, no satisfactory treatment and no means of assessing the risk of disease or prognosis in infected people. Like many immunopathological diseases with a viral etiology the outcome of infection is thought to depend on the virus-host immunology interaction. However the dynamic virus-host interaction is complex and current models of HAM/TSP pathogenesis are conflicting. The CD8+ cell response is thought to be a determinant of both HTLV-I proviral load and disease status but its effects can obscure other factors.

Results

We show here that in the absence of CD8+ cells, CD4+ lymphocytes from HAM/TSP patients expressed HTLV-I protein significantly more readily than lymphocytes from asymptomatic carriers of similar proviral load (P = 0.017). A high rate of viral protein expression was significantly associated with a large increase in the prevalence of HAM/TSP (P = 0.031, 89% of cases correctly classified). Additionally, a high rate of Tax expression and a low CD8+ cell efficiency were independently significantly associated with a high proviral load (P = 0.005, P = 0.003 respectively).

Conclusion

These results disentangle the complex relationship between immune surveillance, proviral load, inflammatory disease and viral protein expression and indicate that increased protein expression may play an important role in HAM/TSP pathogenesis. This has important implications for therapy since it suggests that interventions should aim to reduce Tax expression rather than proviral loadper se.
Tracing from Fat Tissue, Liver, and Pancreas: A Neuroanatomical Framework for the Role of the Brain in Type 2 Diabetes
Authors: Kreier Felix , Kap Yolanda S. , Mettenleiter Thomas C. , van Heijningen Caroline , van der Vliet Jan , Kalsbeek Andries , Sauerwein Hans P. , Fliers Eric , Romijn Johannes A. , Buijs Ruud M.
Published: December 2005

The hypothalamus uses hormones and the autonomic nervous system to balance energy fluxes in the body. Here we show that the autonomic nervous system has a distinct organization in different body compartments. The same neurons control intraabdominal organs (intraabdominal fat, liver, and pancreas), whereas sc adipose tissue located outside the abdominal compartment receives input from another set of autonomic neurons. This differentiation persists up to preautonomic neurons in the hypothalamus, including the biological clock, that have a distinct organization depending on the body compartment they command. Moreover, we demonstrate a neuronal feedback from adipose tissue that reaches the brainstem. We propose that this compartment-specific organization offers a neuroanatomical perspective for the regional malfunction of organs in type 2 diabetes, where increased insulin secretion by the pancreas and disturbed glucose metabolism in the liver coincide with an augmented metabolic activity of visceral compared with sc adipose tissue.