bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescent Men’s Pregnancy Resolution Choices in Relation to an Unintended Pregnancy
Authors: Lohan Maria , Olivari Maria Giulia , Corkindale Carolyn , Milani Luca , Confalonieri Emanuela , Cruise Sharon , O’Halloran Peter , Alderdice Fiona , Hyde Abbey
Published: April 2013

This article investigates adolescent men’s pregnancy resolution choices in Australia, Ireland, and Italy. It addresses two main gaps in the literature: the lack of research on (adolescent) men’s views on unintended pregnancy and pregnancy resolution and the lack of international comparative case studies on men and reproductive choices. Consistent with theories of the transformation of intimacies in society and the growth of individualization, the results suggest that adolescent men are interested in the effect of an unintended pregnancy on their individual biographies as well as the effect on their girlfriend’s health and well-being. However, Australian male adolescents were much more likely to choose abortion than Italian or Irish adolescents, suggesting adolescent males have also internalized country-level debates surrounding abortion. Methodologically, the article demonstrates an innovative approach to data collection using a computer-based interactive drama to facilitate participants’ deliberation and responses. It was shown to engage a large number of adolescent men and is likely to have wider generalizability in developing international comparative research on the topic as well as applications for health promotion.
Prescribing Patterns of Primary Care Physicians and Otolaryngologists in the Management of Laryngeal Disorders
Authors: Cohen Seth M. , Kim Jaewhan , Roy Nelson , Courey Mark
Published: April 2013

Objective

To examine how primary care physicians (PCPs) and otolaryngologists use proton pump inhibitors (PPIs), antibiotics, antihistamines, oral and inhaled steroids, and histamine 2 antagonists in the treatment of laryngeal disorders.

Study Design and Setting

Retrospective analysis of data from a large, national administrative US claims database.

Subjects and Methods

Patients with laryngeal disorders based on ICD‐9‐CM codes from January 1, 2004, to December 31, 2008, seen as an outpatient by a PCP, otolaryngologist, or both and continuously enrolled for 12 months were included. Pharmacy claims, age, gender, geographic location, comorbid conditions, provider type, and laryngeal diagnosis were collected. Random‐effects logistic regression and multinomial logistic regression analyses were performed.

Results

Of approximately 55 million individuals, 135,973 had a laryngeal diagnosis, 12 months post–index date follow‐up, and an outpatient encounter with a PCP, otolaryngologist, or both. Acute laryngitis was one of the most common reasons PCPs prescribed each medication class. Nonspecific dysphonia was the most common reason otolaryngologists prescribed each medication class. Patients seen by a PCP had a higher odds ratio for receiving an antibiotic and antihistamine, and patients seen by an otolaryngologist had a greater odds ratio for receiving a PPI and inhaled steroids. After adjusting for other variables in the model, the probability that a patient seen by a PCP would receive an antibiotic was. 55 and a PPI. 13. If seeing an otolaryngologist, it was. 44 and. 22, respectively.

Conclusion

Differences exist regarding the prescribing patterns of PCPs and otolaryngologists in treating patients with laryngeal disorders.
Gender Differences in Successful NIH Grant Funding in Otolaryngology
Authors: Eloy Jean Anderson , Svider Peter F. , Kovalerchik Olga , Baredes Soly , Kalyoussef Evelyne , Chandrasekhar Sujana S.
Published: April 2013

Objective

To evaluate gender differences in NIH funding among faculty in otolaryngology departments and discuss potential reasons for these differences.

Study Design and Setting

Analysis of NIH funding data available on the online NIH RePORTER system.

Methods

Fiscal year 2011 and 2012 NIH funding awards to principal investigators (PIs) in otolaryngology departments were obtained and used to examine faculty listings from otolaryngology departments for academic rank and gender. The Scopus database was used to determine publication range of these faculty members.

Results

Individual mean NIH awards to men ($362,946 ± $21,247 standard error of mean) were higher than those to women ($287,188 ± $38,029). Male PIs were found to have higher mean NIH funding totals (aggregating grants for PIs with multiple awards) than female PIs ($498,593 vs $359,276). Upon organization by academic rank and years active, men had significantly higher funding levels at both the level of assistant professor and at 10 to 20 years of experience. Of all NIH grants awarded, men had a higher percentage of the more prestigious R‐series grants (76.2%) than did women (63.4%).

Conclusions

Male faculty members have higher NIH funding levels than their female colleagues, a disparity that exists separate from career longevity, as it is true both at the rank of assistant professor and for those with 10 to 20 years of research experience. The larger proportion of R‐series NIH grants awarded to male faculty may contribute to this finding. This discrepancy in percentage and dollars of funding exists despite the increasing percentages of women in higher ranks.
Use of Apneic Oxygenation for the Performance of Pan‐endoscopy
Authors: Rudlof Burkard , Hohenhorst Winfried
Published: April 2013

Objective

To evaluate the efficacy of apneic oxygenation for the performance of pan‐endoscopy.

Study Design

Clinical retrospective study.

Setting

A university teaching hospital in Wuppertal, Germany.

Subjects

Forty‐seven patients who underwent pan‐endoscopy under apneic oxygenation during a period of 1 year.

Methods

After preoxygenation and induction of anesthesia, an 8 French catheter was introduced into the trachea for oxygen supply. Pan‐endoscopy was carried out, as long as there were no signs of desaturation. The data were collected retrospectively from the anesthesia charts.

Results

Apnea was well tolerated up to 45 minutes in most of the patients. In 2 patients, the method was carried out incorrectly, and in 1 obese patient, it was not possible to get an acceptable oxygenation.

Conclusion

With appropriate monitoring, sufficient nitrogen elution, and proper patient selection, we believe that this technique is superior to jet ventilation and intubation for pan‐endoscopy, allowing unimpeded operative visualization.
Hemorrhage after Transoral Robotic‐Assisted Surgery
Authors: Asher Scott A. , White Hilliary N. , Kejner Alexandra E. , Rosenthal Eben L. , Carroll William R. , Magnuson J. Scott
Published: April 2013

Objective

An increasing number of head and neck surgeons have begun using transoral robotic‐assisted surgery. Our objective was to examine the postoperative bleeding complications we have encountered to determine risk factors and to discuss the topic of hemorrhage control.

Study Design

Case series with chart review.

Methods

Medical records were reviewed in 147 consecutive patients undergoing transoral robotic‐assisted surgery for any indication at one tertiary academic medical center between March 2007 and September 2011.

Results

Eleven of 147 (7.5%) patients undergoing transoral robotic‐assisted surgery experienced some degree of postoperative hemorrhage, with 9 patients requiring reoperation for examination and/or control of bleeding. Bleeding occurred at a mean of 11.1 ± 9.2 days after initial operation. Eight of 11 (72%) patients who bled were on antithrombotic medication (anticoagulants or antiplatelet agents) for other medical comorbidities. The postoperative hemorrhage rate in patients taking antithrombotic medication (8/48 patients = 17%) was significantly higher than in those not taking antithrombotics (3/99 patients = 3%), P =. 0057. While the bleeding rate in salvage surgery (3/29 = 10.3%) was slightly higher than in primary surgery (8/118 = 6.8%), this difference did not reach statistical significance.

Conclusion

Potential for postoperative bleeding in association with antithrombotic medications in patients undergoing transoral robotic‐assisted surgery should be recognized. Various effective techniques for management of these patients without robotic assistance were demonstrated.
Long‐term Outcome of Round Window Vibrant SoundBridge Implantation in Extensive Ossicular Chain Defects
Authors: Colletti Liliana , Mandalà Marco , Colletti Vittorio
Published: April 2013

Objective

To evaluate retrospectively the long‐term safety and efficacy of the first 50 patients, all suffering from severe ossicular chain defects and with moderate to severe mixed hearing loss, who received the Vibrant SoundBridge with the floating mass transducer located on the round window membrane. To evaluate differences in outcome versus etiology and age of the patient population.

Study Design

Case series with planned data collection.

Setting

Tertiary referral medical center.

Subjects and Methods

Patients eligible for implantation of the floating mass transducer on the round window membrane ranged in age from 2 months to 74 years with a moderate to severe conductive or mixed hearing loss from different etiologies. For each adult patient, preoperative versus postoperative bone and air conduction thresholds, air‐bone gaps, and speech understanding scores were evaluated at 24‐month follow‐up. At 60‐month follow‐up, data were available from 33 patients. Preoperative and postoperative free‐field auditory brainstem responses were studied in infants and children. Intraoperative and short‐ and long‐term postoperative complications are presented.

Results

There were significant improvements in speech perception and pure‐tone audiometry in adults and auditory brainstem response thresholds in infants immediately after surgery and at follow‐up examinations (12 to 71 months). No significant complications or device extrusions were observed in the present series.

Conclusions

Infants, children, and adults with moderate to severe conductive or mixed hearing loss obtained substantial benefit from implantation of the floating mass transducer on the round window membrane regardless of the etiology of hearing loss and previous surgery.
Salvage Laryngectomy in Patients with Recurrent Laryngeal Cancer in the Setting of Nonoperative Treatment Failure
Authors: Li Mingsi , Lorenz Robert R. , Khan Mumtaz J. , Burkey Brian B. , Adelstein David J. , Greskovich John F. , Koyfman Shlomo A. , Scharpf Joseph
Published: April 2013

Objective

To investigate the effectiveness of salvage partial and total laryngectomy in the treatment of recurrent laryngeal cancer in the setting of initial nonoperative treatment failure and to identify factors influencing long‐term survival.

Study Design

Case series with planned chart review.

Setting

Tertiary medical center.

Subjects and Methods

Patients with recurrent squamous cell carcinoma of the larynx initially treated with either radiation or chemoradiation, who underwent salvage laryngectomy at the Cleveland Clinic Foundation from 1997 to 2011, were identified. The cohort was divided into an early‐stage group and an advanced‐stage group based on initial tumor staging. Survival outcome was evaluated separately in each group against tumor staging, methods of treatment, and nodal status. Secondary endpoints of speech and swallowing were also evaluated.

Results

A total of 100 patients were identified, with 72 patients in the early‐stage group and 28 patients in the advanced‐stage group. The overall postsalvage locoregional control rate was 70%, and the 5‐year disease‐specific survival was 70% and 55.2% in the early and advanced group, respectively (P =. 39). The 5‐year disease‐specific survival was not significant in either group when compared with recurrent staging, initial treatment, salvage treatment, or nodal disease (P = ns). Using voice prostheses, good to excellent speech function was achieved postoperatively in most patients.

Conclusion

Tumor staging, methods of initial and salvage treatment, and nodal disease were not significant predictors of survival. Both salvage partial and total laryngectomy were effective methods in the treatment of recurrent laryngeal cancer in carefully selected patients.
Head and Neck Cancer Stem Cells: The Effect of HPV—An In Vitro and Mouse Study
Authors: Tang Alice L. , Owen John H. , Hauff Samantha J. , Park Jung Je , Papagerakis Silvana , Bradford Carol R. , Carey Thomas E. , Prince Mark E.
Published: April 2013

Objectives

To determine if the behavior of cancer stem cells (CSCs) is affected by human papillomavirus (HPV) status.

Study Design

An in vitro and in vivo analysis of HPV and CSCs.

Setting

University laboratory.

Subjects and Methods

We isolated CSCs from HPV‐positive and HPV‐negative cell lines. Two HPV‐negative cell lines underwent lentiviral transduction of E6/E7. Chemoresistence was determined using colony formation assays. Native HPV‐positive and HPV E6/E7‐transduced cells were compared for lung colonization after tail vein injection in NOD/SCID mice.

Results

The proportion of CSC is not significantly different in HPV‐positive or HPV‐negative head and neck squamous cell carcinoma (HNSCC) cell lines. The HNSCC CSCs are more resistant to cisplatin than the non‐CSCs, but there were no significant differences between HPV‐positive and HPV‐negative cells. The HPV‐negative cancer cells yielded low colony formation after cell sorting. After transduction with HPV E6/E7, increased colony formation was observed in both CSCs and non‐CSCs. Results from tail vein injections yielded no differences in development of lung colonies between HPV E6/E7‐transduced cells and nontransduced cells.

Conclusions

Human papillomavirus status does not correlate with the proportion of CSCs present in HNSCC. The HPV‐positive cells and those transduced with HPV E6/E7 have a greater clonogenicity than HPV‐negative cells. The HNSCC CSCs are more resistant to cisplatin than non‐CSCs. This suggests that common chemotherapeutic agents may shrink tumor bulk by eliminating non‐CSCs, whereas CSCs have mechanisms that facilitate evasion of cell death. Human papillomavirus status does not affect CSC response to cisplatin therapy, suggesting that other factors explain the better outcomes for patients with HPV‐positive cancer.
Microvascular Anastomotic Coupler Assessment in Head and Neck Reconstruction
Authors: Frederick John W. , Sweeny Larissa , Carroll William R. , Rosenthal Eben L.
Published: April 2013

Objective

To assess the advantages of using mechanical anastomotic systems in head and neck free tissue transfer.

Study design

Case series with chart review.

Setting

A university‐based tertiary care center.

Subjects and Methods

A retrospective review of mechanical venous coupler devices in head and neck reconstruction performed between October 2004 and December 2006. A total of 261 venous anastomoses were performed in 234 consecutive patients. Five types of flaps were performed: radial forearm (66%), anterior lateral thigh (12%), fibula (9%), rectus abdominis (8%), and latissimus dorsi (2%). Demographic data were collected, and the outcomes measured were flap survival and microvascular complications.

Results

The size of the venous anastomosis ranged from 1.5 to 4.0 mm, with most being 3.0 mm (56%) followed by 3.5 mm (23%). The most common recipient vein used was a stump off the internal jugular vein (76%) followed by the external jugular vein (17%). Microvascular complications occurred in <5% (n = 11) of patients, with >50% of those being arterial insufficiency (n = 7). Total failures occurred in 3% (n = 7) of patients: 1.5% (n = 4) acute failures (<5 days) and 1.5% (n = 3) late failures. Of the acute failures, causes included venous congestion (n = 1) and arterial insufficiencies (n = 3). The venous coupler used in the failures was 3.0 mm in diameter. Free flap failures resulting from arterial insufficiency involved coupling to the external jugular vein, while the remaining free flap failures (n = 4) used the internal jugular vein.

Conclusion

With an early venous failure rate of 0.38%, mechanical anastomosis is an adequate alternative to hand‐sewn techniques.
“Our Little Patients”
Authors: Hirshbein Laura
Published: April 2013

Perceptions of hospitalization for children shifted from late nineteenth-century care designed to uplift poor children and create better citizens to mid-century attention to children’s emotional and medical needs. In the last few decades, sick children have become objects of sympathy and outpourings of affection. The history of hospitalized children at the University of Michigan demonstrates change over time in involvement of caregivers and families, the role of education during sickness, and the value placed on illness. The hospital provided more than just medical interventions, and its history offers a window to changing ideas about children and society.
Effect of Reamer Design on Posteriorization of the Tibial Tunnel During Endoscopic Transtibial Anterior Cruciate Ligament Reconstruction
Authors: Bhatia Sanjeev , Korth Kyle , Van Thiel Geoffrey S. , Gupta Deepti , Cole Brian J. , Bach Bernard R. , Verma Nikhil N.
Published: April 2013

Background:

It is known that small alterations in tunnel positioning during anterior cruciate ligament (ACL) reconstruction significantly affect ACL length and tensioning patterns as well as alter force vectors and joint kinematics.

Purpose:

To compare the amount of inadvertent posteriorization of the ACL tibial tunnel anatomy during transtibial ACL femoral reaming in the “over-the-top” position with a full femoral reamer versus a half femoral reamer, in comparison to the native tibial ACL footprint. It is hypothesized that the half reamer will result in less distortion of tibial tunnel anatomy and improved anatomic footprint coverage. It is also hypothesized that the true center of the tibial ACL footprint lies more anterior than previously described.

Study Design:

Controlled laboratory study.

Methods:

Eight cadaveric knee specimens were securely fixed to a stationary table at 90° of flexion and neutral rotation. After removal of the anterior capsule and patella, native joint anatomy was precisely recorded with a digitizer accurate to 0.05 mm. Tibial and femoral tunnels were then drilled in the manner of transtibial ACL reconstructions using the optimal tibial starting point of 15.9 mm below the medial plateau and 9.8 mm posteromedial to the medial margin of the tibial tubercle. After the 11-mm tibial tunnel was drilled, femoral tunnels were first drilled with a 10-mm half-fluted reamer, followed by a 10-mm full reamer. Each tibial tunnel’s location and geometry relative to the native ligamentous insertion sites and joint anatomy were digitized.

Results:

Digitized measurements of ACL insertional anatomy demonstrated that the center of the native ACL tibial footprint was 2.0 ± 0.49 mm (range, 1.1-2.7 mm) anterior to the posterior aspect of the lateral meniscus’ anterior horn. Use of the 10-mm full femoral reamer resulted in a tibial-articular aperture that had a posterior edge 4.35 mm more posterior ( P = .049) and extra-anatomic ( P = .006) than the footprint of the 10-mm half femoral reamer.

Conclusion:

Half-fluted reamers may be more advantageous for femoral tunnel reaming with a more oblique transtibial approach, as they result in less posterior tibial tunnel expansion than full reamers, possibly leading to improved graft function. Based on the digitized anatomy, the center of the tibial attachment site is anterior to the posterior aspect of the lateral mensicus’s anterior horn, which has been traditionally described as the anatomic center.

Clinical Relevance:

Use of half-fluted reamers for transtibial femoral tunnel reaming could lead to more anatomic tunnel placement and possibly improved graft mechanics after transtibial single-bundle ACL reconstruction.
Articular Cartilage Evaluation After TruFit Plug Implantation Analyzed by Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC)
Authors: Bekkers Joris E.J. , Bartels Lambertus W. , Vincken Koen L. , Dhert Wouter J.A. , Creemers Laura B. , Saris Daniel B.F.
Published: April 2013

Background:

Quantitative MRI of articular cartilage has rapidly developed in recent years and provides the clinician with a noninvasive tool to determine the biological consequence of an intervention.

Purpose:

To evaluate the quality of intra-articular cartilage, using the dGEMRIC scanning technique, 1 year after TruFit implantation. The hypothesis was that implantation of a TruFit plug does not lead to damage at the opposing articular cartilage.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 13 patients (age, 32 ± 8 years) were evaluated with dGEMRIC at 12 ± 4 months after treatment of an osteochondral lesion by implantation of 1 or multiple TruFit plugs. The dGEMRIC scanning protocol was applied 90 minutes after intravenous Magnevist (0.2 mmol/kg body weight) injection. Different regions of interest (ROIs) were defined: the femur cartilage, cartilage directly surrounding the implanted TruFit plug, the TruFit plug, and the articulating and nonarticulating tibia cartilage. The average dGEMRIC index (T1gd; magnetic resonance imaging relaxation time per ROI) was calculated by a pixel-by-pixel curve fitting using the Levenberg-Marquardt method. Differences between the mean T1gd of the individual ROI for all patients were tested using analysis of variance with post hoc Bonferroni correction. A P value <.05 was considered statistically significant.

Results:

The average T1gd of the TruFit ROI (385 ± 74 ms) was comparable with those in the femur (409 ± 49 ms) and surrounding (392 ± 64 ms) ROIs ( P ≥ .339). The average T1gds for the articulating (578 ± 133 ms) and nonarticulating (516 ± 118 ms) ROIs were higher compared with the femur (409 ± 49 ms), surrounding (392 ± 64 ms), and TruFit (385 ± 74 ms) ROIs ( P < .002), while no difference was observed between the tibia ROIs ( P = .160).

Conclusion:

Implantation of the TruFit plug in osteochondral lesions does not damage the opposing or surrounding surface, and newly formed tissue inside the plug has cartilage-like dGEMRIC characteristics 12 months after implantation. The implantation of synthetic TruFit plugs is safe for the opposing cartilage, an item that is frequently discussed when using such materials to treat focal cartilage defects.
Bone–Patellar Tendon–Bone Autograft Versus Allograft in Outcomes of Anterior Cruciate Ligament Reconstruction
Authors: Kraeutler Matthew J. , Bravman Jonathan T. , McCarty Eric C.
Published: April 2013

Background:

Bone–patellar tendon–bone (BPTB) is a common autograft and allograft source used for anterior cruciate ligament (ACL) reconstruction. Although the failure rate is generally higher for allografts, donor site morbidity and anterior knee pain can be issues with BPTB autografts. Controversy exists regarding the functional outcomes, complications, and knee stability of these grafts, previous comparisons of which have been based on smaller samples of case series.

Purpose:

To compare BPTB autografts to allografts for ACL reconstruction, specifically with regard to patient satisfaction, return to preinjury activity level, and postoperative functional outcomes.

Study Design:

Meta-analysis.

Methods:

A total of 76 studies published between 1998 and 2012, including a total of 5182 patients, were reviewed. It was not required for studies to be comparative in nature. Outcomes evaluated were graft rupture rate, return to preinjury activity level, overall and subjective International Knee Documentation Committee (IKDC), Lysholm, Tegner activity, Cincinnati Knee Rating System, pivot shift, and single-legged hop tests, as well as KT-1000 arthrometer side-to-side difference and presence of anterior knee pain. Summary odds ratios with 95% confidence intervals were calculated to compare BPTB autografts to allografts for each outcome.

Results:

Outcomes on subjective IKDC, Lysholm, Tegner, single-legged hop, and KT-1000 arthrometer were statistically significantly in favor of autografts. Return to preinjury activity level, overall IKDC, pivot shift, and anterior knee pain were significantly in favor of allografts, although allograft BPTB demonstrated a 3-fold increase in rerupture rates compared with autograft (12.7% vs 4.3%). There was no significant difference between the 2 groups for Cincinnati Knee scores.

Conclusion:

Patients undergoing ACL reconstruction with BPTB autografts demonstrate lower rates of graft rupture, lower levels of knee laxity, and improved single-legged hop test results and are more generally satisfied postoperatively compared with patients undergoing reconstruction with allograft BPTB.
Comparison of the Balance Accelerometer Measure and Balance Error Scoring System in Adolescent Concussions in Sports
Authors: Furman Gabriel R. , Lin Chia-Cheng , Bellanca Jennica L. , Marchetti Gregory F. , Collins Michael W. , Whitney Susan L.
Published: April 2013

Background:

High-technology methods demonstrate that balance problems may persist up to 30 days after a concussion, whereas with low-technology methods such as the Balance Error Scoring System (BESS), performance becomes normal after only 3 days based on previously published studies in collegiate and high school athletes.

Purpose:

To compare the National Institutes of Health’s Balance Accelerometer Measure (BAM) with the BESS regarding the ability to detect differences in postural sway between adolescents with sports concussions and age-matched controls.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Forty-three patients with concussions and 27 control participants were tested with the standard BAM protocol, while sway was quantified using the normalized path length (mG/s) of pelvic accelerations in the anterior-posterior direction. The BESS was scored by experts using video recordings.

Results:

The BAM was not able to discriminate between healthy and concussed adolescents, whereas the BESS, especially the tandem stance conditions, was good at discriminating between healthy and concussed adolescents. A total BESS score of 21 or more errors optimally identified patients in the acute concussion group versus healthy participants at 60% sensitivity and 82% specificity.

Conclusion:

The BAM is not as effective as the BESS in identifying abnormal postural control in adolescents with sports concussions. The BESS, a simple and economical method of assessing postural control, was effective in discriminating between young adults with acute concussions and young healthy people, suggesting that the test has value in the assessment of acute concussions.
From Social Alienation to Mental Health through Koinonia via the Median Group
Authors: Schick Helen
Published: April 2013

This is a brief account of eight years work with a mixed psychiatric group, and two years work with a ‘category A’ prison group using Pat de Maré’s Median Group theory and illustrating some of these principles.
Free Association, Group Association and Group Dialogue
Authors: Nitzgen Dieter
Published: April 2013

Based on a talk given in Bozen 2010, the following article was written to give an account of the concepts of free association, group association and group dialogue. According to Foulkes, the advance from psychoanalysis to small group psychotherapy was a step from free association to group association. Pat de Maré conceived the subsequent advance from small group therapy to the group analytic work with median and large groups as a step from group association to group dialogue. The article attempts to elucidate the inherent logic of this development. Special attention is paid to the vicissitudes of interpretation in groups, which are compared to the logic of interpretation as advocated by J. Lacan. The subject of meaning is approached as a crucial issue of group analytic theory and practice. In a final paragraph, the relation between group dialogue and collective consciousness will be explored and the contrasted to Lacan’s notion of the Other.
Median Group® in a Psychiatric Outpatient Service and in a Psychiatric Diagnosis and Treatment Service (SPDC)
Authors: Schoellberger Roberto , Pozzi Laura
Published: April 2013

Outlined is a brief description of two pieces of research into the Median Group experience in an open psychiatric outpatient service and in a closed ward. The first is about the self-definition and well being of 30 patients in three Median Groups, mostly under drug prescription, and 31 patients only under drug prescription. On nine sub scales (five levels each) of SCL (Symptom Check List)-90-R, only the field of somatization shows small differences between the experimental and the control group, whereas in all the others the differences are statistically significant, which means a better quality of life.

The other research has been undertaken by Laura Pozzi, who introduced the Median Group to a closed psychiatric ward of a general hospital. It shows a high level of acceptance within the group, and on the group ward level, a sudden decrease of aggressive episodes has been registered.
Development of reactive artificial liner using recycled materials. 1. Mechanical properties and chemical compatibility
Authors: Chin Johnnie Y , Moon Kyong-Whan , Park Jae K , Park Daniel J
Published: April 2013

There have been several studies showing that volatile organic compounds (VOCs) can diffuse a geomembrane within days and migrate to groundwater and the surrounding environment. To ease the concern of potential pollution of the surrounding environment, an alternative artificial liner consisting of recycled materials is proposed. This composite liner consisted of recycled crumb rubber, organo-clay, silica fume, and epoxy binder. Dimethyl sulfoxide, an environmentally-friendly solvent recycled from paper pulp, was used as a plasticizer. The objective of this study was to determine the best combination of ingredients used at the initial stage and to develop artificial liners suitable for containing VOCs in leachate by comparing various physical properties. A series of screening tests including bending, tearing and elongating was performed to determine the most suitable mixture ratios. Then, more intensive tests were performed with the specimens that had the best physical properties. The new artificial liner demonstrated satisfactory mechanical properties with the minimum elongation and maximum strength after 40 years. Both artificial liners and high-density polyethylene (HDPE) specimens had ~136 kg cm−2 after 4 months of thermal stress while the artificial liner had 40% less elongation at break than HDPE. The artificial liner’s fully developed strength was about ten times stronger than HDPE. This new type of composite material that can be applied on site may provide a new perspective in liner design and alleviate the issue of potential groundwater pollution caused by landfill leachate and highly mobile VOCs which is a matter of much concern.
Waste pricing policies and cost-efficiency in municipal waste services: the case of Flanders
Authors: De Jaeger Simon , Rogge Nicky
Published: April 2013

Major changes in municipal solid waste (MSW)-related services, such as the collection system, often require important initial investments, while the benefits on the output side typically occur over a longer time perspective. However, when analyzing the association between such policy choices and cost efficiency of MSW collection and disposal, the time horizon is often not taken into account. This article advocates the use of the Malmquist Productivity Index approach to measure and analyze cost efficiency changes over time after the introduction of the relative new weight-based waste collection and billing system in Flanders. The results and robustness checks indicate that introducing weight-based pricing does not lead to lower cost efficiency of MSW service provision.
At-Will Employment in the States
Authors: Kim Jungin , Kellough J. Edward
Published: April 2013

This study examines data from a 2010 survey of state agency human resource directors in six states: Colorado, Florida, Georgia, Kansas, Missouri, and South Carolina. The survey was designed to obtain data on the impressions these managers have of the impact of at-will employment in civil service systems. Findings reveal that the managers’ attitudes are mixed, but they are more likely to register agreement with positive assessments of at-will employment than negative assessments. Managers who think that employees can trust their organizations to treat them fairly are more likely than others to express positive views and are somewhat less likely to agree with negative statements. Personnel managers who believe that at-will employment is sometimes used to expand the reach of political patronage are much more likely than others to agree with negative statements characterizing the reform. The respondents’ sex, race/ethnicity, political ideology, private sector experience, and years of experience in the public sector exhibit little apparent impact on attitudes toward at-will employment.
Functional Electrical Stimulation Therapy for Recovery of Reaching and Grasping in Severe Chronic Pediatric Stroke Patients
Authors: Kapadia Naaz M. , Nagai Mary K. , Zivanovic Vera , Bernstein Janet , Woodhouse Janet , Rumney Peter , Popovic Milos R.
Published: April 2013

Stroke affects 2.7 children per 100,000 annually, leaving many of them with lifelong residual impairments despite intensive rehabilitation. In the present study the authors evaluated the effectiveness of 48 hours of transcutaneous functional electrical stimulation therapy for retraining voluntary reaching and grasping in 4 severe chronic pediatric stroke participants. Participants were assessed using the Rehabilitation Engineering Laboratory Hand Function Test, Quality of Upper Extremity Skills Test, Pediatric Evaluation of Disability Inventory, and Assisting Hand Assessment. All participants improved on all measures. The average change scores on selected Rehabilitation Engineering Laboratory Hand Function Test components were 14.5 for object manipulation ( P = .042), 0.78 Nm for instrumented cylinder ( P = .068), and 14 for wooden blocks ( P = .068) and on the grasp component of Quality of Upper Extremity Skills Test was 25.93 ( P = .068). These results provide preliminary evidence that functional electrical stimulation therapy has the potential to improve upper limb function in severe chronic pediatric stroke patients.
Chiari Syndrome and Respiratory Failure
Authors: Kijsirichareanchai Kunut , Limsuwat Chok , Mankongpaisarnrung Charoen , Nantsupawat Nopakoon , Nugent Kenneth
Published: April 2013

Background:

Patients with failed extubation requiring reintubation have increased morbidity and mortality. This situation may reflect the severity of the underlying disorder or may reflect an undiagnosed condition that was not apparent at the time of the initial intubation.

Methods:

Case report and literature review.

Results:

A 49-year-old man developed acute hypercapneic respiratory failure during an episode of community-acquired pneumonia. This patient failed extubation 4 times. Routine neurological evaluation, including computed tomography of the head, was within normal limits. A magnetic resonance imaging revealed a severe Chiari malformation type I. The patient eventually required tracheostomy and prolonged mechanical ventilation. We identified 28 cases with Chiari malformations (CM) in the medical literature, who presented with respiratory failure. The mean age was 29.5 years, 46% of the cases were male, 50% had an associated syringomyelia, and 64% required a decompressive surgery. Twenty-five percent had recurrent symptoms postsurgery.

Conclusions:

Patients with CMs can have repeated extubation failures. Some of these patients have normal neurological examinations and studies and are not identified until they have an MRI study. Clinicians need to consider this possibility in patients who are difficult to wean.
Engendering Racial Perceptions
Authors: Penner Andrew M. , Saperstein Aliya
Published: April 2013

Intersectionality emphasizes that race, class, and gender distinctions are inextricably intertwined, but fully interrogating the co-constitution of these axes of stratification has proven difficult to implement in large-scale quantitative analyses. We address this gap by exploring gender differences in how social status shapes race in the United States. Building on previous research showing that changes in the racial classifications of others are influenced by social status, we use longitudinal data to examine how differences in social class position might affect racial classification differently for women and men. In doing so, we provide further support for the claim that race, class, and gender are not independent axes of stratification; rather they intersect, creating dynamic feedback loops that maintain the complex structure of social inequality in the United States.
Apathy in Patients With Parkinson Disease as a Function of Side of Onset
Authors: Harris Erica , McNamara Patrick , Durso Raymon
Published: April 2013

Background:

In previous studies among patients with Parkinson disease (PD) who were administered the Apathy Evaluation Scale (AES), between 12% and 51% evidenced clinically significant apathy. Although apathy is a risk factor for dementia, its causes and clinical correlates have not been adequately studied. In particular, side of onset of disease, though a likely predictor of apathy and dementia, has not been thoroughly investigated.

Methods:

A total of 30 mid-stage patients with PD and 35 community-dwelling elderly control patients (CPs) were administered the AES (self version) along with a battery of cognitive and neuropsychiatric assessments. Persons close to patients with PD and CPs completed the AES—other (informant) version about the patient or CP. Multiple linear regression analysis examined predictors of apathy severity after controlling for mood, levodopa dosage equivalents (LDEs), gender, age, and disease severity (Hoehn–Yahr [H-Y] stage).

Results:

Patients with right-onset disease more frequently exhibited apathy and evidenced significantly higher total AES scores than left-onset patients with PD or CPs ( P < .03). Of all the patients, 42% with right-onset PD versus 11.1% of the patients with left-onset PD exhibited clinically significant levels of apathy. There were no differences for self versus informant scores for right-onset patients with PD. The AES scores were not correlated with depression, stress, anxiety, LDEs, gender, age, and H-Y stage. There were no gender differences for any AES variables.

Conclusion:

Clinically significant levels of apathy are much more likely to occur in patients with right-onset disease. These patients may be at greater risk of PD-related dementia.
Daily Life Behaviors and Depression Risk Following Stroke
Authors: Jean François A. M. , Swendsen Joel D. , Sibon Igor , Fehér Kristoffer , Husky Mathilde
Published: April 2013

Approximately one-third of stroke survivors have symptoms of depression. A better understanding of the early risk factors implicated in this form of comorbidity may contribute to the development of early prevention strategies and to improving outcomes for this population. The current study uses ecological momentary assessment techniques to identify behavioral risk factors for depression 3 months after stroke. Thirty-six participants completed ambulatory monitoring of daily life circumstances (location, social environment, and activity) 5 times per day during a 1-week period after hospital discharge. Clinician-administered measures of depression were also provided before discharge and 3 months later. Ambulatory monitoring revealed that depression scores at 3 months were lower among individuals with more social interactions but higher among those who reported having sports activities and working in the week following hospital discharge. Daily life behaviors may have important implications for understanding the risk of poststroke depression, and mobile technologies may provide important contributions to their investigation.
Mental Health Service Use Among Depressed, Low-Income Homebound Middle-Aged and Older Adults
Authors: Choi Namkee G. , Kunik Mark E. , Wilson Nancy
Published: April 2013

Objectives: This study examined previous mental health service use among low-income homebound middle-aged and older adults who participated in a study testing the feasibility and efficacy of telehealth problem-solving therapy for depression. Method: The sample consisted of 188 homebound adults aged 50 years or older. Data on mental health service use were collected at baseline. We used multivariable logistic regression analysis to examine correlates of different types of outpatient service use within the preceding 12 months. Results: Of the subjects, 56% reported mental health service use. Of the users, 80% had made at least one primary care mental health visit, 21% had visited a psychiatrist, and 25% had received counseling. Higher depressive symptom severity scores were positively associated with a psychiatrist visit only. Discussion: The need to improve low-income homebound older adults’ access to psychotherapy was clearly evident.
Meclofenamic acid blocks the gap junction communication between the retinal pigment epithelial cells
Authors: Ning N , Wen Y , Li Y , Li J
Published: April 2013

Aim: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage the pain and inflammation. NSAIDs can cause serious side effects, including vision problems. However, the underlying mechanisms are still unclear. Therefore, we aimed to investigate the effect of meclofenamic acid (MFA) on retinal pigment epithelium (RPE). Materials and methods: In our study, we applied image analysis and whole-cell patch clamp recording to directly measure the effect of MFA on the gap junctional coupling between RPE cells. Results: Analysis of Lucifer yellow (LY) transfer revealed that the gap junction communication existed between RPE cells. Functional experiments using the whole-cell configuration of the patch clamp technique showed that a gap junction conductance also existed between this kind of cells. Importantly, MFA largely inhibited the gap junction conductance and induced the uncoupling of RPE cells.

Other NSAIDs, like aspirin and flufenamic acid (FFA), had the same effect. Conclusion: The gap junction functionally existed in RPE cells, which can be blocked by MFA. These findings may explain, at least partially, the vision problems with certain clinically used NSAIDs.
Analgesic effects of mad honey (grayanotoxin) in mice models of acute pain and painful diabetic neuropathy
Authors: Gunduz A , Eraydin I , Turkmen S , Kalkan O F , Turedi S , Eryigit U , Ayar A
Published: April 2013

Objectives:

The aim of this experimental study was to investigate the effects of mad honey (grayanotoxin, GTX), used in complementary medicine for a variety of purposes besides being food, on pain thresholds in normal mice as model for acute pain and diabetic mouse as model for neuropathic pain.

Methods:

Hind paw withdrawal pain threshold to thermal stimulus was measured with a plantar analgesia meter in a mice model using healthy intact animals for acute pain and streptozotocin-induced diabetic animals for chronic neuropathic pain. Time and dose-dependent effects of intraperitoneally (i.p.) administered GTX were investigated in both acute and neuropathic pain.

Results:

In the acute pain model, administration of GTX caused a dose- and time-dependent marked increase in the pain latency values. In diabetic mice, which had markedly increased threshold to pain, GTX (0.1 mg/kg, i.p.) restored the mean pain latencies by decreasing from the pre-GTX treatment values of 3.2 ± 0.6 to 3.0 ± 0.9s at 10 min, 3.2 ± 0.6s at 20 min, 3.4 ± 0.6s at 30 min, 2.6 ± 0.5s at 60 min and 2.4 ± 0.6s ( p < 0.05) at 100 min.

Conclusion:

The results from this experimental study indicate that GTX exhibits significant analgesic activity and has potential benefits against painful diabetic neuropathy. This is compatible with the widespread use of GTX containing mad honey for alleviating pain. Further studies involving long-term applications are needed for a more decisive conclusion regarding the usefulness of GTX as an analgesic, especially in the treatment of painful neuropathy.
The inclusive masculinities of heterosexual men within UK gay sport clubs
Authors: Jarvis Nigel
Published: April 2013

This article focuses on the little known phenomenon of heterosexual men’s participation in gay1 sport clubs. It explores the relationship between straight men joining gay teams in a context of changing masculinities. Through 12 interviews with a diverse range of self-identified straight men living in the UK, the research demonstrates how traditional definitions of masculinity are possibly shifting, as are their attitudes towards sexuality, as a result of their involvement with gay sport organisations. Their experiences and stories reveal how their participation in gay sport settings may contribute to diminished cultural homophobia, in line with other recent studies. Initial stereotypes and perceptions of gay athletes were dismantled, resulting in clear attitudinal shifts toward homosexuality. The men interviewed had no one single conceptualisation of masculinity, and instead showed a more pluralised and inclusive version of masculinity. While their participation in gay clubs can largely be seen as a positive and transgressive act, their involvement still has some limitations.
End-Stage Kidney Disease
Authors: Crawford Gregory B. , Robinson Julie A. , Baker Amy E. Z. , Crail Susan M.
Published: April 2013

This survey examines the quantity, quality, and accessibility of recent research that contributes to the evidence-based implementation of a palliative approach to end-stage kidney disease (ESKD). An electronic search identified published articles (between September2009 and August 2011) relevant to adults with ESKD (n = 1628). Few articles (n = 136) referred to key themes in a palliative approach to care: life-limiting illness, holistic care, and unit of care. Most of the relevant empirical articles used designs that did not allow a causal variable to be identified, and evaluations of interventions were rare. The literature was dispersed and often in journals unlikely to be regularly accessed by renal clinicians. Literature supporting the implementation of a full evidence-based palliative approach to ESKD is expanding but remains limited and is difficult to identify and access.
What Do We Teach in Organizational Behavior? An Analysis of MBA Syllabi
Authors: Brown Kenneth G. , Charlier Steven D. , Rynes Sara L. , Hosmanek Andrew
Published: April 2013

This study examines the syllabi of 241 required organizational behavior (OB) related classes in full-time U.S. MBA programs. Syllabi were coded for information about course title, topics, readings, cases, teaching methods, and learning assessment methods. Results revealed that the most frequent topics listed across courses are leadership and groups or teams. There was considerable diversity in assigned books, readings, and cases, with only a small number of books (2), readings (15), or cases (5) assigned in 10 or more courses within our sample. Assessment of student learning was conducted via (in order of importance for final student grades) testing, individual writing, class participation, group writing, group presentation, and individual presentation. Private, ranked MBA programs were more likely to offer more than one OB-related course, usually management plus leadership, or OB plus leadership. Implications of these findings for OB teaching are discussed, along with suggestions for future research.