bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Locus Ceruleus and Olfactory Bulb Stimulation on Rat Olfactory Tubercle Neuron Activity
Authors: Inokuchi Akira , Boran Thomas V. , Kimmelman Charles P. , Snow James B.
Published: November 2015

The effects of electrical stimulation of the olfactory bulb and the locus ceruleus on olfactory tubercle neurons were examined in rat models. Ipsilateral stimulation of the olfactory bulb produced excitation in 31% of olfactory tubercle neurons tested and inhibition in 17%. Twenty‐two percent of the olfactory tubercle neurons were excited, whereas 9% were inhibited by ipsilateral stimulation of the locus ceruleus. Contralateral stimulation of the locus ceruleus produced similar responses in the same neuron entities. A negative‐positive evoked potential was recorded in the olfactory tubercle after ipsilateral and contralateral stimulation of the locus ceruleus. Thirty‐three percent of the olfactory tubercle neurons that responded orthodromically or antidromically to stimulation of the olfactory bulb were excited by ipsilateral stimulation of the locus ceruleus. In contrast, only 10% responded with excitation to ipsilateral stimulation of the locus ceruleus among the olfactory tubercle neurons that were unresponsive to stimulation of the olfactory bulb. These findings suggest that olfactory tubercle neurons that receive input from or sending output to the olfactory bulb are influenced by the noradrenergic system of the locus ceruleus. A possible role of the olfactory tubercle in olfactory transduction will also be discussed.
Abnormal Oculovestibular Response
Authors: Meyerhoff William L.
Published: November 2015

In normal Individuals, the visual and vestibular systems interact through a common subcortical center located near the vestibular nuclei. When the patient is healthy, this Interaction allows appropriate integration of what might otherwise be conflicting information regarding environmental motion and moving within the environment. In patients with active peripheral vestibular lesions, such as those seen in Meniere's disease, this delicate Interaction loses effectiveness. In such patients, optokinetic stimuli are capable of precipitating episodes of incapacitating vertigo with its associated vegetative symptoms (abnormal oculovestibular response—AOVR). Since the brainstem is unable to accommodate for active peripheral lesions, suffering may be prolonged for many years. Vestibular nerve section, however, converts this active lesion to a static peripheral lesion, allowing for brainstem compensation and cessation of optokinetic‐induced vertiginous symptoms.
Deep Spread Patterns in CT Staging of T2–4 Squamous Cell Laryngeal Carcinoma
Authors: Isaacs John H. , Mancuso Anthony A. , Mendenhall William M. , Parsons James T.
Published: November 2015

In addition to clinical examination and less sophisticated radiographic techniques, high‐resolution computerized tomography (CT) can help to stage squamous cell carcinoma of the larynx. This study was undertaken to identify findings on CT scans that might predict the likelihood of radiation therapy (RT) alone, controlling the primary site disease without significant irradiation‐related complications. Of 30 patients with T2–4 cancers of the larynx, 13 were classified as favorable and 17 were classified as unfavorable candidates for RT based on the CT criteria of transglottic spread, more than 25% pre‐epiglottic space involvement, extensive paralaryngeal space spread, or cartilage involvement. Seven of 17 (41%) unfavorable patients had local recurrences, two are alive with cancer, three patients are dead of disease (DOD), and five had significant complication, but there was no evidence of recurrent cancer. In the favorable group, there were two local recurrences (15%), one distant metastasis, one patient is DOD, and one had a significant complication, but no recurrent cancer. These data may be used to more adequately select and inform patients with T2–4 squamous cell carcinoma of the larynx before RT.
Comparison of speech perception abilities in deaf children with hearing aids or cochlear implants
Authors: Miyamoto Richard T. , Osberger Mary Joe , Robbins Amy M. , Myres Wendy A. , Kessler Kathy , Pope Molly L.
Published: November 2015

The speech perception abilities of deaf children with a single‐ or multi‐channel cochlear implant are compared with those of deaf children who derive substantial benefit from conventional hearing aids. The children with hearing aids have unaided pure‐tone thresholds ranging from 90‐ to 110‐dB HL through at least 2000 Hz, and aided thresholds of 30‐ to 60‐dB HL. The group data show that the speech perception scores of the subjects with hearing aids were significantly higher than those of the subjects with implants on a range of speech perception measures. Although a few subjects with implants achieved scores as high as those who used hearing aids, the majority did not. Even though the children with implants receive substantial benefit from their devices, they continue to have limited auditory perception abilities relative to their peers who derive benefit from conventional hearing aids. The data highlight the importance of establishing hearing aid benefit in potential candidates for implant.
Preservation of facial contour during parotidectomy
Authors: Nosan David K. , Ochi James W. , Davidson Terence M.
Published: November 2015

Parotid surgery often leaves a facial contour deformity. Free abdominal dermal‐fat grafts were used to preserve the facial contour of nine patients undergoing parotid surgery. This procedure is simple to perform and provides an improved cosmetic result without significantly increasing operative time or lengthening hospitalization. No troublesome fat absorption occurred postoperatively. The dermal‐fat graft also serves as a barrier to regenerating neurons, thereby preventing postoperative gustatory sweating.
A rare cause of nasal obstruction: A solitary neurofibroma
Authors: Annino Donald J. , Domanowski Gerard F. , Vaughan Charles W.
Published: November 2015

This case represents a peripheral nerve sheath tumor as a cause of nasal obstruction. Nerve sheath tumors are relatively uncommon; however, most otolaryngologists will encounter them. These tumors develop from cranial and spinal nerve roots and from peripheral nerves. In total, approximately 25% to 44% of nerve sheath tumors occur in the head and neck region. Although the most important are cranial nerve tumors—the majority being acoustic neuromas arising from the vestibular nerve—they may also develop in the nasal cavity.
Laser cordectomy for T1 glottic carcinoma: A 10‐year experience and videostroboscopic findings
Authors: Casiano Roy R. , Cooper Jonathan D. , Lundy Donna S. , Chandler James R.
Published: November 2015

Fifty‐three patients underwent laser cordectomy for T1 glottic squamous cell carcinoma between January 1980 and December 1989—sixteen after having undergone unsuccessful radiation and thirty‐seven who had no previous treatment. There was a 51% five‐year cure rate in the irradiated group vs. 62% in the nonirradiated group. Extension of tumor to the anterior commissure resulted in a higher failure rate. Patients experienced an overall 5‐year cure rate of 98% after surgical or radiation salvage of unsuccessful laser cordectomies. Six patients had preoperative and postoperative videostrobolaryngoscopy. The most common postoperative problem with voice was a breathiness that did not resolve in any of the patients. All patients had absent or moderately reduced amplitude and mucosal wave patterns and imcomplete glottic closure proportional to the amount of cordal tissue removed. Despite its seemingly poor results in carefully selected patients, laser cordectomy is still indicated without compromising the ultimate oncologic results. Advantages over radiation therapy or conservation laryngeal surgery include a short treatment time, requiring only an outpatient surgical procedure at the time of the initial diagnostic and/or staging laryngoscopy, and the avoidance of potential radiation side effects or surgical complications. However, patients should be advised the possibility of persistent postoperative breathy dysphonia, in addition to the possibility of further treatment to effect a long‐term cure.
Histiocytic Non‐Hodgkin's Lymphoma of Waldeyer's Ring
Authors: Kirsch Jeffrey P. , Miller Robert H. , Blair Paul A.
Published: November 2015

The most common extranodal site for non‐Hodgkin's lymphoma in the head and neck is the lymphoid tissue of Waldeyer's ring. Diffuse histiocytic non‐Hodgkin's lymphoma is the most frequent type occurring at all head and neck extranodal sites. The rarity of histiocytic lymphoma in the areas comprising Waldeyer's ring tends to make assembly of a large series of patients for retrospective study quite difficult. Of the 804 patients treated for malignancies in Waldeyer's ring during the years 1948 to 1985 at the Charity Hospital of Louisiana, 26 had lesions classified as histiocytic non‐Hodgkin's lymphoma. We present, to our knowledge, the largest series of diffuse histiocytic lymphomas involving Waldeyer's ring.
Is Human Galvanically Induced Triceps Surae Electromyogram a Vestibulospinal Reflex Response?
Authors: Storper Ian S. , Honrubia Vicente
Published: November 2015

Interest in understanding the human vestibulospinal reflex has increased enormously over the past three decades, because this reflex is the primary effector of maintenance of posture and balance. On a posture platform, forces exerted by the triceps surae (TS) and tibialis anterior muscles are measured to calculate center of mass sway. We wished to determine whether the TS response is a direct component of the vestibulospinal reflex. Ten healthy human beings were stimulated with sinusoidal galvanic currents delivered over their mastoid processes. Sway response on a posture platform and TS electromyogram (EMG) were recorded for the following conditions: (1) standing unrestrained; (2) standing completely restrained above the leg; and (3) sitting unrestrained. Results were similar for all subjects. Computer‐aided analysis for case 1 reveals that TS EMG and horizontal body sway responses are generated at the same frequency as the stimulating current, with a phase lag of 90 degrees. For case 2, body sway response and any component of the TS EMG over the unstimulated condition were absent in all subjects. For case 3, body sway persisted, but no TS EMG above the unstimulated condition was recorded. As the TS EMG disappears when the standing subject is restrained from swaying or in the unrestrained seated subject, we conclude that the TS EMG response is compensatory to motion of more superior portions of the musculoskeletal system; it is not part of the vestibulospinal reflex.
Prolongation of Secondary Critical Ischemia Time of Experimental Skin Flaps Using UW Solution as a Normothermic Perfusate
Authors: Babajanian Michel , Zhang Wen X. , Aviv Jonathan E. , Weinberg Hubert , Biller Hugh F. , Urken Mark L.
Published: November 2015

A myriad of investigations have been published on the pharmacologic manipulation of flaps to enhance tolerance to ischemia. We recently reported a threefold increase in ischemic tolerance of the rat abdominal skin flap pedicle after 6 hours of primary ischemia and 12 hours of reperfusion. Flaps underwent normothermic perfusion washout with lactated Ringer's or U.W. solution, a newly developed organ preservation medium. Perfusion washouts were performed at one of three different points in the protocol: (1) onset of primary ischemia; (2) onset of secondary ischemia; or (3) 2 hours after onset of secondary ischemia. The last group was used to simulate the clinical situation in which flaps are discovered and salvage procedures instituted at a delayed time interval. This is the longest normothermic ischemic interval reported. We undertook the present study to determine the utility of the U.W solution in prolonging the tolerance of the flap to a second ischemic insult after a period of reperfusion. Seventy‐five unilateral rat abdominal skin flaps were raised. Secondary ischemia was produced by placing a microvascular clamp across the inferior epigastric pedicle. Flap survival was assessed at 1 week postoperatively. While none of the nonperfused flaps survived 8 hours of secondary ischemia, at least 50% of the U.W. perfused flaps survived an average of 14 hours of secondary ischemia. Lactated Ringer's perfusion washout only modestly increased the ischemic tolerance. Perfusion washout in the secondary ischemic phase improved the ischemic tolerance to a significantly greater degree than in the primary ischemic interval.
Otologic Neurotologic Manifestations of HIV‐Related Disease
Authors: Linstrom Christopher J. , Pincus Robert L. , Leavitt Eric B. , Urbina Mariana C.
Published: November 2015

Human Immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS), has reached worldwide epidemic proportions and is Increasing. Otologists, neurotologlsts, and audiologists practicing in metropolitan centers in North America can expect to encounter patients with HIV‐related illnesses, including patients with AIDS‐related complex (ARC) and AIDS. Five representative cases are presented: Chronic otitis media, facial palsy, Gradenigo's syndrome with facial paralysis, otosyphilis, and Kaposi sarcoma of the mastoid. The common link in all cases was HIV Infection. This presentation discusses the management of several HIV‐infected patients with otologic and neurotologic findings. HIV Infection has extended to all parts of North America. The worldwide incidence is Increasing. As the epidemic continues to unfold, new challenges to both the diagnosis and treatment of otologic and neurotologic disease in HIV‐positive patients will confront the audiologist and otolaryngologist. Recommendations for the safety of the examining audiologist and treating physician are given.
Indications, Evaluation, Complications, and Results of Functional Endoscopic Sinus Surgery in 200 Patients
Authors: Smith Lane F. , Brindley Paul C.
Published: November 2015

Functional endoscopic sinus surgery (FESS) is a new and exciting treatment for chronic sinus disease. Our knowledge of the surgery continues to expand. A retrospective and prospective review of 200 patients undergoing FESS was undertaken at the Houston Ear, Nose, and Throat Clinic. Parameters studied included patient symptoms, medical history, medical therapy, and radiologic findings. Also reviewed were length of hospitalization, complications, and postoperative symptoms. Nasal obstruction was the most common preoperative symptom. Anterior ethmoid and ostiomeatal complex disease were the most common preoperative CT scan findings. More than 84% of the surgeries were performed on an outpatient basis. Minor complications developed in 8% of the patients, and only one major complication occurred (0.05%). With a mean followup of 17 months, 88% of the patients were symptom‐free or Improved; however, 41.5% still required some medical therapy. FESS can safely be performed while the patient is under general anesthesia. Partial middle turblnectomy is a safe and recommended procedure; no cases of atrophic rhinitis occurred. We conclude that FESS is a highly successful treatment for chronic sinus disease (p < 0.01) and that a strong patient history for sinus symptoms is the most Important Indication for FESS.
Evaluation of patients with acoustic neuroma with dynamic posturography
Authors: Levine Samuel C. , Muckle Robert P. , Anderson John H.
Published: November 2015

The purpose of the present work was to consider the use of posture tests in patients who had known acoustic tumors. The results suggest that it might be possible to determine whether the tumor is on the inferior or superior branch of the vestibular nerve. This would have clinical significance for planning a surgical approach to the tumor. (OTOLARYNGOL HEAD NECK SURG 1993;109:392‐8.)
Clinical guideline development for otitis media: A report on methodology
Authors: Magit Anthony E. , Stool Sylvan E.
Published: November 2015

Clinical guideline development is a major emphasis of recent health policy efforts. Interest in clinical guidelines is the result of multiple factors, including economic pressures and the desire to achieve a baseline level of practice in clinical settings. Guidelines have always been of fundamental importance in medicine. This article will discuss the place clinical guidelines have in contemporary practice and the difficulties encountered in the process of developing a meaningful guideline for managing otitis media with effusion. (OTOLARYNGOL HEAD NECK SURG 1993;109:478‐81.)
Contralateral suppression of otoacoustic emissions: An index of the function of the medial olivocochlear system
Authors: Berlin Charles I. , Hood Linda J. , Hurley Annette , Wen Han
Published: November 2015

We can now distinguish, in part, between nerve deafness and hair cell deafness through the use of otoacoustic emissions. We can also assess the efferent system by carefully quantifying the effects of contralateral stimulation on these same otoacoustic emissions. The suppression of transient evoked emissions by continuous contralateral white noise is an ostensibly small effect of 2 or 3 dB when studied over a 20‐msec window. However, when subjected to microstructural analysis, the effect can exceed 6 to 8 dB in the zones from 10 to 20 msec after the stimulus has subsided. Temporal and spectral analyses reveal robust effects of contralateral lateral stimulation, although in any given normal subject it may be difficult to separate middle ear effects from efferent effects. Evidence is strong that the efferent effect is mediated in part by cholinergic — primarily nicotinic — receptors in the outer hair cell. However, a unique type of patient, who shows nearly normal pure‐tone audiograms and absent ABRs, shows virtually no contralateral suppression of transient evoked emissions. Some other patients, with symptoms of Charcot‐Marie‐Tooth disease, may paradoxically show extremely poor audiograms, but perfectly normal evoked emissions along with absent contralateral suppression. The ABR, along with middle ear muscle reflexes and masking level differences, are all absent in these patients; we therefore think they have a disorder that desynchronizes most of their primary auditory nerve fibers and thereby disconnects them from any efferent activity or masking cancellation. The existence of such an auditory disorder, characterized by severe dysfunction in speech comprehension — especially when listening in noise—suggests that what appears to be a “central auditory imperception” might stem instead from a systemic peripheral primary neuropathy.
Intratympanic gentamicin in bilateral meniere's disease
Authors: Pyykkö Ilmari , Ishizaki Hisayoshi , Kaasinen Susanna , Aalto Heikki
Published: November 2015

Treatment of bilateral Meniere's disease is a delicate task. Streptomycin has demonstrated its ability to successfully control the vertigo attacks, but in some cases it results in oscillopsia and transforms the periodic attacks to permanent instability. If the site of the active labyrinth can be determined, a more specific treatment can be tried. We have treated 14 patients with intractable bilateral Meniere's disease with intratympanic gentamicin (Garamycin, 40 mg/ml) administered initially in either 1, 2, 3, or 4 injections. The patients were tested at frequent intervals and followed up for 2 years. The work capacity, severity of vertigo, and gait difficulties were scored before treatment and during each test occasion. The postural stability was evaluated on a force platform and sway velocity was analyzed. Before treatment, moderate or severe reduction of work capacity was experienced by all of the subjects, which correlated to severity of vertigo and gait problems. Two years after treatment, the vertigo attacks were eliminated in 11 subjects and controlled in three subjects. The work capacity of three subjects was still moderately or severely reduced. This reduction depended on gait disturbance and Tumarkin attacks. The average postural stability returned to pretreatment level 2 years after the treatment was begun. The outcome of the caloric responses did not correlate with the outcome of the treatment. Hearing was not significantly affected by the treatment. Intratympanic gentamicin treatment is a relatively safe and effective way to treat bilateral Meniere's disease when the symptoms can be localized to one ear.
Evaluation of Distraction Osteogenesis by Scanning Electron Microscopy
Authors: Ganey Timothy M. , Klotch Douglas W. , Slater‐Haase Alicia Sue , Sasse Joachim
Published: November 2015

A model of bifocal distraction osteogenesis in the canine model was used to assess and quantitate the mineral content of the newly forming bone within the canine mandible. A 2‐cm defect was created in the body of the mandible, and after a posterior osteotomy, the transport disk was advanced at 0.25 mm per 8 hours for 21 days and then held in rigid fixation for an additional week. As a control for this study, three additional dogs underwent the same procedure with the exception that the transport disk was not advanced. Electron dispersive spectroscopy analysis was performed on the newly formed regenerate bone and compared with areas of existing cortical bone of both the transport disk and the mandible. In the control model, special note was made of the pericortical callus at the osteotomy site as well as of the regenerative bone that filled the 2‐cm defect in the body of the mandible. Calcium/phosphorous ratios were used to assess the composition of the mineralized regions of the mandible. The regenerate bone that filled the defect and the mineralized callus surrounding the site of osteoclasis in the control mandible were significantly different in composition when compared with the regenerate bone that formed during distraction osteogenesis. This suggests that distraction osteogenesis may effect an initial matrix production that is more similar in composition to the mature cortical bone from which it was derived than does periosteal regeneration and filling of an osseous defect.
Islam and Utilisation Policies for Environmental Resources
Authors: Kula Erhun
Published: November 2015

During the last three decades or so academics from a variety of disciplines have been taking part in a wide range of outlets to explore whether religion in general, and Judaeo-Christian faith in particular is really responsible for the misuse of environmental resources. Unfortunately, Islam, as a major World religion, has been largely absent from these debates. This paper looks at the importance of nature in the main sources of Islamic instruction with a view to finding out about the importance of good environmental conduct in Muslim countries where the pressure on environmental resources has been growing.
Economic Efficiency, the Role of Law, and the Old Testament
Authors: Maughan C.W. , Copp S.F.
Published: November 2015

Laws and rules, spiritual and temporal, implicit and explicit, are public goods. They set out the expected standards of behaviour in a society. Since laws and rules are public goods, and not private goods, they tend to be under-supplied by individuals in the marketplace. They are therefore usually supplied and enforced by a group, or by some governor(s) of a group, and will reflect the values of that group. The Mosaic laws were supplied by God to the tribes of Israel and subsequently adopted in whole or in part by many Western countries as the basis for their values. These values became embedded in the legal systems of those countries and affected the institutions and practices that facilitated the development of the market economies associated with those countries. Economics developed from inductive and deductive observations of these early market economies, and led to the formulation of the economic model and to the development of the modern concept of economic efficiency. Since economic efficiency presupposes the laws, rules, institutions and practices that were in place when the observations were made, it is possible to hypothesise that there is a logical link between the Biblical Mosaic laws and economic efficiency. This paper sets out to identify and explain the ‘basic’ economic model and an amplified model that we call the ‘extended’ economic model. It analyses the rules and laws that are implicit in these models, and then compares the Mosaic laws with those implied by the models. The paper concludes that there is evidence of a considerable congruence between the two sets of laws.
The sea is rising… but not onto the policy agenda: A multiple streams approach to understanding sea level rise policies
Authors: Yusuf Juita-Elena (Wie) , Neill Katharine , John Burton St , Ash Ivan K , Mahar Kaitrin
Published: November 2015

There has been little policy effort to address sea level rise in coastal states in the US. It is important to examine, at the state level, how the multitude of different (and changing) actors with different preferences and perspectives contribute to such inertia. This study examines state-level legislative inaction with regards to sea level rise. Using Kingdon's multiple streams framework, we draw a picture of the policy landscape in Virginia as one where the problem of sea level rise is perceived as a low priority, with little consensus on achievable policy solutions, and is politically controversial. We find that policy inertia in Virginia is a result of (1) fractious viewpoints regarding sea level rise as a problem, (2) a lack of clear consensus on policy solutions, and (3) conflicting perspectives of the role of the state.
Lament for a network? Cities and networked climate governance in Canada
Authors: Gordon David J.
Published: November 2015

There is substantial evidence that the global governance of climate change must pass through cities. While formal networks offer cities a means of generating effects that extend beyond their own borders, it remains unclear as to whether such networks can address collective action barriers and implementation gaps. City-networks, after all, are limited in their efforts to govern and must rely on information, service provision, and soft forms of coercion if they are to steer their members past these considerable challenges. This article contributes to extant efforts to assess their ability to do so by addressing two gaps in the literature. First, the article focuses on the Partners for Climate Protection (PCP), a city-network that has received little attention to date. Second, through analysis of two Canadian cities (Toronto and Winnipeg), the article provides an empirical illustration of the limitations of network authority and influence, and offers some thoughts on what this means for networked urban climate governance in Canada and beyond.
An in Vitro Assessment of a Monitor for Continuous Inline Measurement of PO2, PCO2 and pH during Cardiopulmonary Bypass
Authors: Alston R Peter , Trew Arthur
Published: November 2015

The Gas STAT is a monitor which continuously measures PO2. PCO2 and pH inline during cardiopulmonary bypass. Using an in vitro model, the monitor's accuracy was compared to standard blood gas analysis over a range of PO2 (2·0–66·7 kPa), PCO2 (2·7–12·0 kPa) and pH (7–8). Its stability as affected by time, temperature, flow and haematocrit and the presence of halothane, enflurane, isoflurane and sodium nitroprusside was examined. Good correlations were found between the monitor and standard blood gas analysis for PO2 (r = 0·999, P < 0·001) and PCO2 (r = 0·996, P < 0·001). However, large and unpredictable systematic errors occurred. It was stable under all conditions examined, except that in one sensor there was a statistically significant decline in PCO2 measurement with time (P < 0·005) and the PCO2 readings were affected by temperature (P < 0·021). The monitor provides useful information for blood gas management during cardiopulmonary bypass, but should not be used without recourse to standard blood gas analysis.
Motivational interviewing increases physical activity and self-efficacy in people living in the community after hip fracture: a randomized controlled trial
Authors: O’Halloran Paul D , Shields Nora , Blackstock Felicity , Wintle Elizabeth , Taylor Nicholas F
Published: November 2015

Objective:

To investigate if motivational interviewing improved physical activity, self-efficacy, quality of life, mobility and mental health in people living in the community after hip fracture.

Design:

Single-blind randomized controlled trial.

Setting:

Community.

Participants:

A total of 30 adults after hip fracture who had been discharged from rehabilitation to independent living in the community and allocated to a control group ( n = 14) or an intervention group ( n = 16).

Intervention:

All participants received usual care. The intervention group also received eight weekly sessions of motivational interviewing as additional input, with the control group having no additional matching input.

Main outcomes:

The primary outcome was physical activity levels as measured by an accelerometer (steps taken per day, time spent walking per day, and time spent sitting or lying each day). Secondary outcomes included self-efficacy (confidence about walking and not falling), health-related quality of life, mobility and mental health.

Results:

Relative to usual care, the motivational interviewing group took significantly more steps per day (mean = 1237 steps, 95% confidence interval (CI) 12 to 2463), walked for longer per day (mean = 14.4 minutes, 95% CI 0.6 to 28.8), had improved self-efficacy evidenced by being more confident about walking (mean = 1.6 units out of 10, 95% CI 0.3 to 2.9) and not falling (mean = 1.1 units out of 10, 95% CI 0.3 to 1.9) and improved health-related quality of life and mental health.

Conclusion:

This study provides preliminary evidence that motivational interviewing can result in clinically meaningful improvements in physical activity and psychosocial outcomes for people recovering from hip fracture.
A cost-effectiveness study of person-centered integrated heart failure and palliative home care: Based on a randomized controlled trial
Authors: Sahlen Klas-Göran , Boman Kurt , Brännström Margareta
Published: November 2015

Background:

Previous economic studies of person-centered palliative home care have been conducted mainly among patients with cancer. Studies on cost-effectiveness of advanced home care for patients with severe heart failure are lacking when a diagnosis of heart failure is the only main disease as the inclusion criterion.

Aim:

To assess the cost-effectiveness of a new concept of care called person-centered integrated heart failure and palliative home care.

Design:

A randomized controlled trial was conducted from January 2011 to 2013 at a center in Sweden. Data collection included cost estimates for health care and the patients’ responses to the EQ-5D quality of life instrument.

Setting/participants:

Patients with chronic and severe heart failure were randomly assigned to an intervention ( n = 36) or control ( n = 36) group. The intervention group received the Palliative Advanced Home Care and Heart Failure Care intervention over 6 months. The control group received the same care that is usually provided by a primary health care center or heart failure clinic at the hospital.

Results:

EQ-5D data indicated that the intervention resulted in a gain of 0.25 quality-adjusted life years, and cost analysis showed a significant cost reduction with the Palliative Advanced Home Care and Heart Failure Care intervention. Even if costs for staffing are higher than usual care, this is more than made up for by the reduced need for hospital-based care. This intervention made it possible for the county council to use €50,000 for other needs.

Conclusion:

The Palliative Advanced Home Care and Heart Failure Care working mode saves financial resources and should be regarded as very cost-effective.
Neoplastic Fever
Authors: Johnson Miriam
Published: November 2015

Neoplastic fever, that is fever arising solely as a manifestation of malignancy, is not as common as was thought but still constitutes a troublesome symptom and is difficult to manage. The mechanism of neoplastic fever production involves cytokines such as tumour necrosis factor (TNF), interleukins 1 and 6 (IL-I, IL-6) and interferon (IFN), produced either by host macrophages in response to tumour, or sometimes by the tumour itself. The cytokines stimulate production of prostaglandins which act on the hypothalamus causing a change in the thermostatic set point. This mechanism is similar to that of infective fever.

Paracetamol (acetaminophen) will often only partially lyse neoplastic fever but nonsteroidal anti-inflammatory drugs have been shown to be effective. On the basis of small studies, naproxen has been proposed as a useful test to discriminate between neoplastic and infective fever. If this is so, it must be acting through a pathway hitherto undescribed and specific to neoplastic fever. Other work shows that this group of drugs effectively lyses both types of fever. Therefore larger studies are needed to confirm or refute the “Naproxen test” and neoplastic fever remains a diagnosis of exclusion.

In the future, cytokine antagonists may have a role in managing neoplastic fever, but, until their actions are better understood, nonsteroidal anti-inflammatory drugs remain the medication of choice if standard antipyretics have failed.
The Provision of a Palliative Care Service in a Teaching Hospital and Subsequent Evaluation of That Service
Authors: McQuillan R , Finlay I , Roberts O , Branch C , Forbes K , Spencer MG
Published: November 2015

A survey at a large tertiary referral hospital showed that patients with cancer and HIV disease had poorly controlled symptoms. A palliative care service was introduced, employing a doctor and part-time pharmacist. The doctor was available to see and advise about terminally ill patients. With the pharmacists, an educational programme of meetings, teaching sessions and information leaflets was developed. One year after the introduction of the service a repeat survey all patients with cancer or HIV disease was carried out. Problems on admission were similar in both surveys, but fewer patients' symptom scores deteriorated during their hospital stay. There was a significantly increased use of appropriate opioid analgesics and NSAIDs. Staff were satisfied with the service.
Some Reflections on the Role of Victims in the International Criminal Trial Process
Authors: Henham Ralph
Published: November 2015

The purpose of this paper is to examine the nature and significance of victim participation in international criminal trials through the analysis of relevant substantive and procedural norms of the United Nations International Criminal Tribunals for the Former Yugoslavia and Rwanda (ICTY and ICTR respectively) and the recently created International Criminal Court (ICC) in their broader philosophical, sociological and comparative context. By focusing on the linkage between victims' rights and legitimacy its objective is to consider the case for a reconceptualisation of international criminal trial justice and to speculate upon ways in which this might be achieved.
Macro-social Marketing
Authors: Kennedy Ann-Marie
Published: November 2015

This article provides the theoretical underpinnings for the concept of macro-social marketing. Macro-social marketing seeks to use social marketing techniques in a holistic way to effect systemic change, as opposed to individual level change. The article provides the conceptual roots of the concept derived from systems theory and institutional theory. It starts by explaining what types of macromarketing issues – dubbed here wicked problems – can be approached using macro-social marketing. Systems theory is then used to explain the interconnectedness of wicked problems throughout the social and cultural systems, as well as the material environment and marketing system (Dixon 1984). Subsequent sections apply institutional theory to explain how systemic change can be brought about through the use of macro-social marketing, and discuss change at a broader conceptual level, as well as how this process then trickles down to individual organizations within the marketing system.
Electron Microscopy of Radiating Clubs in Tonsillar Crypts of Swine
Authors: Gilka F.
Published: November 2015

Tonsils of 25 adult swine with inflamed crypts were screened for the presence of radiating clubs, and five were selected for electron microscopic study of pathogenesis of clubs. Radiating clubs in crypts were surrounded by an exudate which principally contained neutrophils. Clubs were present on the outer surface of bacterial microcolonies; they also were present on the outer surface of plant particles wedged in crypts or on the cell walls of these particles near bacterial microcolonies. The study demonstrated development of clubs from an amorphous material derived from bacterial and leukocytic cells and also from precipitated proteins. The amorphous material was shaped into clubs by a protracted phagocytic activity of numerous neutrophilic leukocytes. The lesions with radiating clubs within crypts were not surrounded by granulomatous inflammation due to the intact epithelial lining of crypts, and therefore they differ from the granulomas having clubs around microbial colonies. They could, however, serve as models of pathogenesis of radiating clubs in the purulent core of specific granulomas with radiating clubs.
Telangiectasia of Pembroke Welsh Corgi Dogs
Authors: Moore F. M. , Thornton G. W.
Published: November 2015

Multiple vascular lesions involving kidneys and various other organs consisting of cavernous, blood-filled spaces lined by endothelial cells with various amounts of mural collagen are described in eight Pembroke Welsh Corgi dogs. The most common clinical sign associated with this condition is hematuria.
The Discourse of Exploitation and the Exploitation of Discourse
Authors: Rajan Roby
Published: November 2015

Nothing appears more surprising to those who consider human affairs with a philosophical eye than the easiness with which the many are governed by the few, and the implicit submission with which men resign their own sentiments and passions to those of their rulers. When we enquire by what means this wonder is effected, we shall find that, as force is always on the side of the governed, the governors have nothing to support them but opinion. It is therefore on opinion only that government is founded; and this maxim extends to the most despotic and military governments, as well as to the most free and popular.
Emergence of Gay Identity and Gay Social Movements in Developing Countries: The AIDS Crisis as Catalyst
Authors: Roberts Matthew W.
Published: November 2015

Although it is important to acknowledge that the virus affects a wide and growing number of people outside our communities, there is no doubt that it has had an unparalleled impact upon our particular attempts at self-help and organization … yet, at the same time, it has stimulated the growth of many more groups, often bringing lesbians and gay men together for the first time in a particular town or country. In some areas, it has meant the growth of identity and self-respect as lesbian, gay, or bisexual groups have demonstrated their ability to provide care and prevention services to fight the epidemic; sometimes it has even meant governmental recognition and funding.
Face to Face with the Dead Man: Ethical Responsibility, State-Sanctioned Killing, and Empathetic Impossibility
Authors: Molloy Patricia
Published: November 2015

The image of the death house with its polished tiles and gleaming oak chair is fading. I turn my attention to where life is. Although I have decided that I will not be going to death row again, I cannot bear to think that there are some men there now who are facing death alone.

The other man's death calls me into question, as if, by my possible future indifference, I had become the accomplice of the death of the other, who cannot see it; and as if, even before vowing myself to him, I had to answer for this death of the other, and to accompany the Other in his mortal solitude. The Other becomes my neighbour precisely through the way the face summons me, calls for me, begs for me, and in so doing recalls my responsibility, and calls me into question.
Retracing and Redrawing the Boundaries of Events: Postmodern Interferences with International Theory
Authors: Bleiker Roland
Published: November 2015

Recognition of the extraordinary lengths to which one must go to challenge a given structure of intelligibility, to intervene in resident meanings by bringing what is silent and unglimpsed into focus, is an essential step towards opening up possibilities for a politics and ethics of discourse.
The Human Costs of “Giving the Kid Another Chance”
Authors: Brown Waln K. , Miller Timothy P. , Jenkins Richard L. , Rhodes Warren A.
Published: November 2015

This study is based on a 10- to 25-year follow-up of 500 randomly selected cases of juveniles adjudicated delinquent in the juvenile court of Dauphin County, Pennsylvania. Of 243 juveniles adjudicated delinquent in juvenile court on their first referral to juvenile justice, 20% went on to adult prison after the age of 18. Of 233 juveniles not taken to juvenile court on their first referral to juvenile justice, 43% were imprisoned in adult life after the age of 18. Early referral to the juvenile court of juveniles who commit delinquent acts appears to greatly reduce the likelihood that these individuals will go on to prison in adult life.
China Report: AIDS, Law, and Social Control
Authors: Anderson Allen F.
Published: November 2015

China has a growing number of HIV-infected individuals. The vast majority are intravenous drug users from Yunnan Province near the Golden Triangle region, though the infection has been found among prostitutes and in the homosexual community. The Chinese government is approaching the outbreak of AIDS from a public health and a public security perspective. The public security portion of the response employs a philosophy of treatment and resocialization that should facilitate efforts by the Chinese to manage the spread of the AIDS virus.
Sex-Offender Risk Assessment and Disposition Planning: A Review of Empirical and Clinical Findings
Authors: McGrath Robert J.
Published: November 2015

The primary goal of intervention with sex offenders is to protect the community from further sexual aggression. As the availability of jail beds decreases, it is imperative that professionals discriminate between those offenders who must be incarcerated to protect the public and those offenders who can be supervised with reasonable safety in community settings. This article will review the research on variables related to sex offender recidivism which is a critical factor to consider in making these decisions. In addition, criteria for determining an offender's amenability to treatment will be examined and guidelines for formulating disposition plans will be outlined.
Proverbs 29.22–27: Another Unnoticed Alphabetic Acrostic
Authors: Hurowitz Victor Avigdor
Published: November 2015

The books of Proverbs and Ben Sira end with alphabetic acrostics. In my article in Revue Biblique 106 (2000), pp. 1–15, I demonstrate a second alphabetic chapter concluding the ‘Words of the Wise’ (Prov. 24.1–22). The present article reveals yet a third partial acrostic in Prov. 29.22–27 at the end of ‘The Proverbs of Solomon which the Men of Hezekiah King of Judah Copied’. The acrostic and other literary devices in this unit show it is more than a mere collection of original, independent adages. The use of alphabetic acrostics to end three of Proverbs' seven consistent collections has implications for the redaction history of the book.
The Social Roles of Prophets in Early Achaemenid Judah
Authors: Blenkinsopp Joseph
Published: November 2015

Determining the social role of prophets in the Neo-Babylonian and Achaemenid periods is obscured by the use of conventional prophetic formulas (e.g. ‘thus says Yahweh’) applied to discourse quite different from previously accepted prophetic forms of speech. Since literacy was restricted to a very small minority, there is also the problem of audience or readership. Something can nevertheless be learned from an examination of how designations or labels other than nābî' are used in this period, including mal'āk, şōpeh ( meşappeh) and šōmēr. One development that can be traced is the transition from prophet to preacher, from nābî' to mattîp, leading to the emergence of what can be called ‘ecclesiastical literature’. The possibility that such homiletic language (e.g. in Isa. 40–66) may be grounded in a kind of proto-synagogal context is noted. Finally. the political status of the Jewish ethnos after the loss of national independence created a situation favourable to the emergence of sectarianism, and something of this is also detectable in prophetic texts from the early Achaemenid period.
Tolosa-Hunt syndrome: Focus on MRI Diagnosis
Authors: Pascual J , Cerezal L , Canga A , de Arcaya A Alvarez , Polo JM , Berciano J
Published: November 2015

Experience with modern neuroimaging techniques, computed tomography (CT) and magnetic resonance imaging (MRI) scans, in the diagnosis of Tolosa-Hunt syndrome (THS) is reviewed. Conventional CT scan remains normal in about two-thirds of these patients. In the reported 22 patients meeting the IHS criteria for a THS diagnosis on whom an MRI study was performed, MRI revealed a convex enlargement of the symptomatic cavernous sinus by an abnormal tissue isointense with gray matter on short TR/TE images and isohypointense on long TR/TE images. This abnormal tissue markedly increases in signal intensity after contrast injection. MRI seems also to be the ideal technique to follow progressive resolution of the abnormal tissue after steroids. Therefore, normal MRI would probably exclude THS, whereas in the appropriate clinical setting of steroid-responsive painful ophthalmoplegia, MRI showing the cavernous sinus abnormality described here suggests a diagnosis of THS. From these data, we propose that the fourth IHS criterion for THS diagnosis, “Exclusion of other causative lesions by neuroimaging and (not compulsory) carotid angiogram” should be changed to “Finding by MRI of specific cavernous sinus abnormalities (with the characteristics described herein) which slowly resolve with steroid treatment”.
SUNCT Syndrome versus Idiopathic Stabbing Headache (Jabs and Jolts Syndrome)
Authors: Pareja JA , Kruszewski P , Caminero AB
Published: November 2015

Both SUNCT syndrome and idiopathic stabbing headache (ISH) (jabs and jolts syndrome) have to be considered when encountering shortlasting headaches. Since there are no specific tests for these headaches, the differential diagnosis depends entirely upon assessment of the clinical features. These headaches are generally easily distinguishable clinically. There seem to be symptomatic forms of SUNCT.
Investigating the Utility of the Film War Zone in the Prevention of Street Harassment
Authors: Darnell Doyanne A. , Cook Sarah L.
Published: November 2015

Street harassment, the act of sexual harassment by strangers in public, is a common experience shared by many women. This paper reports the first experimental evaluation of the impact of a popular documentary-style film, War Zone, on men's attitudes toward street harassment and empathy for women who experience it. The sample was an ethnically diverse group of undergraduate men attending an urban university ( N = 98). Given the film's primary focus on women's perspectives and the relation of street harassment to rape, we predicted the film would decrease acceptance of street harassment and increase empathy toward women who experience street harassment. We did not find support for these main effects. Hostility toward women, however, was negatively related to cognitive empathy and feelings of distress following the film, and hostility toward women moderated the effect of film condition on distress. Peer acceptance predicted greater self-acceptance of street harassment. Implications for future street harassment research and prevention strategies are discussed.