bluuebunny/crossref_metadata_2025 huggingface dataset:
Translation and Cross-Cultural Adaptation of the Brazilian Version of the International Knee Documentation Committee Subjective Knee Form
Authors: Metsavaht Leonardo , Leporace Gustavo , Riberto Marcelo , de Mello Sposito Maria Matilde , Batista Luiz Alberto
Published: May 2010

Background: The perception of improvement by a patient has assumed a central role in functional evaluation after a variety of knee problems. One of the instruments most used in clinical research is the International Knee Documentation Committee (IKDC) Subjective Knee Form because its psychometric properties are considered to be excellent. Nonetheless, this questionnaire was originally developed for use in the English language. Therefore, to use this questionnaire in the Brazilian population, it is essential to translate and validate it.

Purpose: The aim of this study was to translate the IKDC Subjective Knee Form into a Brazilian version and to test its validity and reproducibility.

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

Methods: The translation of the original IKDC Subjective Knee Form into a Brazilian version was accomplished in accordance with the American Orthopaedic Society for Sports Medicine guidelines and was tested in 32 patients with knee pathologic conditions to develop the first Brazilian version. To test validity and reproducibility, 117 patients with several knee complaints completed the Brazilian IKDC Subjective Knee Form, the Short Form 36 (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lysholm score. From these patients, 85 were retested within a week to achieve reproducibility. The validation was addressed by correlating the Brazilian IKDC Subjective Knee Form to the other outcome measures. The reproducibility was tested by measuring internal consistency, test-retest reliability, and agreement.

Results: The Brazilian IKDC Subjective Knee Form was highly related to the physical component summary of the SF-36, the Lysholm score, and the WOMAC, and weakly related to the mental component summary of SF-36 ( r = .79, .89, .85, and .51, respectively). The internal consistency was strong, with a Cronbach α value of .928 and .935 in the test and retest assessment, respectively. The test-retest reliability proved to be excellent, with a high value of the intraclass correlation coefficient (.988), as well as the agreement, demonstrated by the low differences between the means of the test and retest, and the short limit of agreement, observed in the Altman-Bland and survival-agreement plots.

Conclusion: The results of this study provide evidence that the Brazilian IKDC Subjective Knee Form has psychometric properties similar to the original version. In addition, it was a reliable evaluation instrument for patients with knee-related problems.
Influences of Physical Environment on Corridor Walking Among Assisted Living Residents
Authors: Lu Zhipeng , Rodiek Susan D. , Shepley Mardelle M. , Duffy Michael
Published: May 2010

Walking has multiple physical and psychological benefits for older people. This study explores corridor walking behaviors and perceptions of corridor walkability in assisted living residents. Focus groups were conducted with 50 residents in six assisted living facilities in Texas. The data were analyzed by the constant comparative method. The findings revealed three types of corridor walking: walking to destination, walking for exercise, and walking for interaction. Residents’ perception of corridor walkability was related to the themes of safety, comfort/convenience, and aesthetics. Qualities of design elements that residents used to judge corridor walkability included continuity and graspability of handrails, coverage of carpeted floor, availability of seating, appropriate size of the corridor (i.e., width and length) and the elevator, appropriate locations of activity spaces and restrooms, and presence of artwork, window views, and plants. The findings provide insights to environmental interventions that may promote walking among sedentary residents.
Low Citrulline in Leigh Disease: Still a Biomarker of Maternally Inherited Leigh Syndrome
Authors: Debray François-Guillaume , Lambert Marie , Allard Pierre , Mitchell Grant A.
Published: May 2010

Two siblings presented with encephalopathy, lactic acidosis, and hypocitrullinemia. Muscle and liver biopsies were considered for respiratory chain studies, but because of hypocitrullinemia, molecular analysis for maternally inherited Leigh syndrome was first performed, revealing in both siblings the mitochondrial DNA T8993G mutation (95% heteroplasmy), allowing to avoid tissue biopsies. Hypocitrullinemia, an occasional finding in mitochondrial diseases, has been specifically associated with T8993G mutation. However, only few patients have been reported, and the prevalence of hypocitrullinemia in 8993 mitochondrial DNA mutations is unknown. In a small series of 16 Leigh syndrome patients, sensitivity and specificity of hypocitrullinemia (≤12 μmol/L) for 8993 mitochondrial DNA mutations were 66% and 85%, respectively. Although studies in larger cohorts are necessary, we suggest considering T8993G mutation early in the diagnostic evaluation of infantile mitochondrial diseases with hypocitrullinemia, which minimizes the need for invasive procedures associated with a small but nonnegligible risk of complications and incorrect diagnosis.
Transient Leukoencephalopathy Associated With X-Linked Charcot-Marie-Tooth Disease
Authors: Rosser Tena , Muir Jason , Panigrahy Ashok , Baldwin Erin E. , Boles Richard G.
Published: May 2010

X-linked hereditary demyelinating neuropathy (Charcot-Marie-Tooth 1X) accounts for 10% to 20% of all hereditary demyelinating neuropathies and is caused by mutations in the GJB1 gene, which codes for connexin 32. Connexin 32 is a gap junction protein widely expressed in Schwann cells as well as oligodendrocytes. Transient leukoencephalopathy has been reported in children and adults with Charcot-Marie-Tooth 1X. The case of a previously healthy 10-year-old boy who presented with fluctuating neurological deficits is reviewed. His brain magnetic resonance imaging scans showed abnormal restricted diffusion and mild hyperintense T2-weighted and fluid attenuation inversion recovery abnormalities in the splenium of the corpus callosum and the posterior cerebral white matter in a bilaterally symmetric distribution. A family history of Charcot-Marie-Tooth disease was revealed late in his presentation, and genetic testing identified a mutation in the GJB1 gene that has not previously been associated with central nervous system involvement.
Student-Directed Transition Planning: Increasing Student Knowledge and Self-Efficacy in the Transition Planning Process
Authors: Woods Lee L. , Sylvester Lorraine , Martin James E.
Published: May 2010

This study examined the effectiveness of a new school to adult life transition planning lesson package titled Student-Directed Transition Planning. The Student-Directed Transition Planning lessons teach transition terms and concepts to provide a means to increase self-determination skills and student participation in transition IEP (Individualized Education Program) meeting discussions. An experimental pre—post design utilizing random assignment of secondary-aged students with IEPs determined differences between intervention and control groups in knowledge of transition terms and concepts, and self-efficacy perceptions of the transition planning process. Study results indicated that students receiving Student-Directed Transition Planning instruction experienced a statistically significant knowledge gain, and an increase in perceived self-efficacy in 7 out of 10 transition planning process indicators.
Learning Disability Documentation Decision Making at the Postsecondary Level
Authors: Madaus Joseph W. , Banerjee Manju , Hamblet Elizabeth C.
Published: May 2010

Students with learning disabilities (LD) transitioning from secondary school to postsecondary education must submit documentation verifying the existence of a disability and that describes a current and substantial limitation to learning. Preparing acceptable documentation can be a challenge for secondary personnel because of differing laws at the secondary and postsecondary levels and because of variation in the type of data required by each school. This study presents the results of a survey of 183 postsecondary disability service providers related to frequently required components of LD documentation. Although a clear diagnosis of LD was required by most respondents, there was variation in regard to other key components. Implications and suggestions for secondary transition practice are presented.
Effects of a 21st-Century Curriculum on Students’ Information Technology and Transition Skills
Authors: Vreeburg Izzo Margo , Yurick Amanda , Nagaraja Haikady N. , Novak Jeanne A.
Published: May 2010

A pretest—posttest control group experimental design was used to evaluate the effectiveness of EnvisionIT, a 10-unit web-based curriculum designed to teach secondary students information technology (IT) skills in the context of transition-planning activities. Fifteen high schools were stratified by socioeconomic status and randomly assigned to the EnvisionIT experimental condition or a control condition in which students received traditional instruction. Pre- and posttest data for 287 students—119 (41%) of whom had disabilities—were analyzed using hierarchical linear modeling. Findings indicated that students in the experimental group made significantly greater gains in IT literacy than students in the control group. Students in the experimental group also showed greater gains in several transition skills, including goal setting, knowledge of how to find jobs, and information about college. Results support the conclusion that the EnvisionIT curriculum produces improvements in students’ acquisition of the 21st-century skills needed for success in today’s high tech world.
Reconsidering the Culture and Violence Connection: Strategies of Action in the Rural South
Authors: Lee Matthew R. , Ousey Graham C.
Published: May 2010

Crime scholars have long conceptualized culture as a set of values that violence is used to defend or reinforce (i.e., honor). This analysis moves beyond this framework by conceptualizing culture as a toolkit providing strategies of action that individuals use to negotiate social situations. Qualitative data obtained from participant responses to vignettes describing potential conflict situations are analyzed to explore the merit of the cultural toolkit framework as it pertains to the “southern culture of violence” thesis. Contrary to the traditional culture as values model, these data indicate that interpersonal violence is a situationally viable response for diverse groups of people, including males and females, Blacks and Whites, the young and the older. The interplay between culture and social structure is also apparent. Although culture provides individuals with a toolkit, structural factors provide situations in which individuals must decide which cultural tools are most appropriately used. Violence is most viable when individuals feel that the police cannot be relied on and when they perceive that there is an imminent or potentially recurring threat to their family or themselves. Rarely is violent action justified to achieve overarching values, although values are clearly part of the toolkit that informs social action. Participants also frequently report that some segments of their community would consider violence to be an appropriate response even when they personally disagree with that assessment. This highlights the role of agency, where individual lines of action may be constructed independently from perceived community expectations, another major point of departure from the values model.
Does Parenting Shield Youth From Exposure to Violence During Adolescence? A 5-Year Longitudinal Test in a High-Poverty Sample of Minority Youth
Authors: Spano Richard , Rivera Craig , Bolland John M.
Published: May 2010

Five waves of longitudinal data collected from 349 African American youth living in extreme poverty were used to determine if parental monitoring shielded youth from exposure to violence during adolescence. Semiparametric group— based modeling was used to identify trajectories of parental monitoring and exposure to violence from T1 to T5. Results from these analyses revealed (a) about 52% of youth had a trajectory of hypervigilant parental monitoring and (b) two out of the five distinct trajectories of exposure to violence were low and/or declining over the 5-year time period. Multivariate findings indicated that (a) youth with a trajectory of hypervigilant parenting were 109% more likely to have middle-declining exposure to violence, but hypervigilant parenting was unrelated to stable and low exposure to violence T1 to T5. The theoretical and policy implications of these findings as well as areas for future research are also discussed.
Merchandise Exports and Job Quality, Evidence From the States
Authors: Adkisson Richard V. , Saucedo Eduardo
Published: May 2010

This article examines the relationship between state exports and job quality across the 50 American states. An occupational distribution index is calculated and used as a proxy for state job quality. An 8-year data panel is used to estimate the impacts of exports and several control variables on the magnitude of the occupational distribution index. The article finds a nonlinear relationship between exports and job quality. Beyond some level, further increases in exports seem to have a negative impact on state job quality. Cursory attention is paid to state-by-state trends in the occupational distribution index. Secondary findings based on the model provide further insight into economic development strategies.
Cleaning Up the Mess: Redevelopment of Urban Brownfields
Authors: Hula Richard C. , Bromley-Trujillo Rebecca
Published: May 2010

This article explores the impact of a brownfield redevelopment initiative in the state of Michigan. Although such programs are often perceived as having a positive impact, there is remarkably little evidence beyond anecdotal examples to support such claims. The reported analysis is based on a 5-year project to create a database capable of assessing the impact of the Michigan program. Findings indicate that a viable market for brownfield redevelopment has been created since the change in Michigan brownfield law. On average, brownfield sites have shown a decline in quality over time; however, many sites demonstrated significant improvement.
Building Bridges to the Middle Class: The Role of Community-Based Organizations in Asian American Wealth Accumulation
Authors: Patraporn R. Varisa , Pfeiffer Deirdre , Ong Paul
Published: May 2010

Despite the increasing provision of social and financial services by community-based organizations (CBOs), few studies focus on the roles that Asian American—serving CBOs play in helping their economically and culturally diverse communities accumulate wealth. The authors explore this overlooked sector by interviewing key informants in 30 mostly Asian American asset-building organizations nationwide. Participating CBOs respond to the financial needs of their diverse communities primarily in three ways: (a) adapting programs for the underserved, (b) facilitating access to the mainstream, and (c) preserving existing assets. Unlike mainstream banks, they use a comprehensive asset-building framework premised on extensive technical assistance and culturally congruent programming. The interviewed organizations face a variety of challenges in implementing programs-namely, maintaining financial solvency and working with limited capacity—issues that they struggle to overcome through forming collaborations and partnerships, earned income strategies, obtaining certification, and cross-training.
Catching Up: The Role of State Science and Technology Policy in Open Innovation
Authors: Mayer Heike
Published: May 2010

This article examines the impact of the emerging model of open innovation on state public policy, particularly the practice of technology-based economic development in weak research and development (R&D) states. Open innovation describes the nascent practice of firms using knowledge created outside their boundaries and also marketing ideas they would not commercialize themselves. Firms engaging in open innovation thrive on knowledge spillovers, and weak R&D regions could benefit from this model through the creation of Marshallian externalities. It is therefore interesting to ask whether weak R&D states take advantage of this model. This case study analysis shows that states involved in the Experimental Program to Stimulate Competitive Research partially support the emerging open innovation paradigm. All states have science and technology strategies and actively support and invest in their higher education infrastructure. They show variation in their support for university—industry partnerships, entrepreneurship, capital access, commercialization, and technology transfer. None of the states, however, uses the open innovation framework explicitly.
Practices of Arab American Patients With Type 2 Diabetes Mellitus During Ramadan
Authors: Pinelli Nicole R. , Jaber Linda A.
Published: May 2010

Aims: To examine practices and complications among Arab Americans observing fasting during Ramadan. Methods: Adults with type 2 diabetes mellitus, of native Arab ancestry, and observing fasting were invited to complete an interview. Changes made to behavioral characteristics or diabetes management during Ramadan and consequences of fasting were assessed. Results: Twenty-seven patients (60.1 ± 9.8 years, 51.9% male) participated. Majority reported exercising less frequently during Ramadan. Modifications in home blood glucose monitoring (HBGM) were observed in 48% of patients, of these 25% and 17% decreased frequency or had not tested at all, respectively. Consultation with providers prior to Ramadan was reported by 67%. Education regarding medications, risks of fasting, indications to break fasting, meal plans, and exercise were not provided in the majority. Therapeutic changes were made in 50% and 46% of insulin and oral medication users, respectively. Excessive thirst was the most commonly reported symptom. The overall frequency of hypoglycemia and hyperglycemia was low. One patient stopped fasting during Ramadan due to uncontrolled hyperglycemia. Hospitalization or emergency room visits were not reported. Conclusions: Lack of patient education prior to Ramadan may contribute to the suboptimal practices reported. Pharmacists may be able to ensure safe fasting practices among Arab Americans by providing patient-specific education.
Music Teacher Education Students as Cross-Age Reading Tutors in an After-School Setting
Authors: Madsen Clifford K.
Published: May 2010

A class of music teacher education students ( N = 18) served as tutors in a cross-age reading program for fourth and fifth grade students enrolled in an after-school program. The qualitative study progressed in several phases: (a) Two experts with over 60 years collective teaching experience at the elementary school level were asked to recommend the “best book available for a cross-age tutoring project that would have the greatest appeal for this age category of student.” The selected book was The Pinballs by award-winning children’s author, Betsy Byars (Byars, 1977). (b) College-age tutors were asked to read the book, write a reaction to its content and give their opinion concerning how it could be used by classroom teachers. (c) Tutors were randomly paired with after-school children who were mostly identified as being low in reading skills and/or reading fluency. (d) Each dyad participated in a one-on-one session once a week for 30 to 50 minutes lasting for 10 weeks. (e) At the end of the 10 week period, each child was asked to write a short paragraph describing their reading experience. (f) Similarly, each college student was asked to write a lengthier description of their experiences. During the study, these college tutors were under the daily supervision of the regular after-school elementary teacher who supervised the entire program. Additionally, a university music education faculty member met weekly with the elementary teacher to discuss the project. This feedback loop provided an important aspect of the study.
The Communication Patterns Questionnaire-Short Form: A Review and Assessment
Authors: Futris Ted G. , Campbell Kelly , Nielsen Robert B. , Burwell Stephanie R.
Published: May 2010

The Communication Patterns Questionnaire—Short Form (CPQ-SF) is an 11-item self-assessment of spouses’ perceptions of marital interactions. A cited reference review of the CPQ-SF literature revealed no formal assessment of its psychometric properties and that researchers are imprecise in their use, reporting, and referencing of the measure. Toward improving the use of the CPQ-SF in research and practice, the factor structure and psychometric properties of this scale were examined with data collected from a diverse sample of 477 married individuals. Three latent constructs were identified: criticize/defend, discuss/avoid, and positive interaction patterns. Suggestions for a more precise use of the CPQ-SF in research and practice conclude the article.
Clinical Pharmacology of Dronedarone: Implications for the Therapy of Atrial Fibrillation
Authors: Dorian Paul
Published: May 2010

Dronedarone, a recently approved antiarrhythmic agent, is a chemical analog of amiodarone. It has an approximately 15% bioavailability, with plasma concentrations markedly increasing after a high-fat meal; it is recommended to be taken with food. The primary metabolic clearance pathway for dronedarone is via the hepatic enzyme system (primarily cytochrome P450 3A4 [CYP3A4]); the half-life of dronedarone is 27 to 31 hours. Strong CYP3A4 inhibitors, such as ketoconazole, are associated with a marked increase in dronedarone maximum concentration and are thus contraindicated; inducers of CYP3A4 will conversely decrease dronedarone exposure. Dronedarone is a substrate for P-glycoprotein (P-gp) and will lead to an increase in concentration of P-gp substrates such as digoxin. Dronedarone will cause a small increase in creatinine concentrations, without a change in glomerular filtration rate (GFR). Gender, renal dysfunction, weight, and age have little effect on the pharmacokinetics of dronedarone, and dose adjustment for these variables is not required.
Evaluation of Antihypertensive Therapy Among Ischemic Stroke Survivors: Impact of Ischemic Heart Disease
Authors: Hassan Yahaya , Aziz Noorizan Abd , Al-Jabi Samah W. , Looi Irene , Zyoud Sa'ed H.
Published: May 2010

Background: Hypertension and ischemic heart disease (IHD) are among the most prevalent modifiable risk factors for stroke. Clinical trial evidence suggests that antihypertensive medications are recommended for prevention of recurrent ischemic stroke in hypertensive and normotensive patients. Objectives: The objectives of this study were to analyze and evaluate the utilization of antihypertensive medication for acute ischemic stroke (AIS) or transient ischemic attack (TIA) survivors in relation to recent recommendations and guidelines and to compare their use among patients with or without IHD. Methods: This was a retrospective cohort study of all patients with AIS/TIA attending the hospital from July 1, 2008 to December 31, 2008. Demographic data, clinical characteristics, different classes of antihypertensive medications, and different antihypertensive combinations prescribed to AIS/TIA survivors were analyzed among patients with and without IHD. Statistical Package for Social Sciences (SPSS) program version 15 was used for data analysis. Results: In all, 383 AIS/TIA survivors were studied, of which 66 (19.5%) had a documented history of IHD. Three quarters (n = 260; 76.9%) of AIS or TIA survivors received antihypertensive medication, mostly as monotherapy, at discharge. The majority of patients (n = 201, 59.5%) were prescribed angiotensin-converting enzyme inhibitors (ACEIs). Patients with IHD were significantly prescribed more β-blockers than patients without IHD (P = .003). A history of hypertension, a history of diabetes mellitus, and age were significantly associated with prescription of antihypertensive medications at discharge (P < .001, P < .001, and P < .001, respectively). Conclusion: Patterns of antihypertensive therapy were commonly but not adequately consistent with international guidelines. Screening stroke survivors for blood pressure control, initiating appropriate antihypertensive medications, and decreasing the number of untreated patients might help reduce the risk of recurrent strokes and increase survival.
Review: Update on Newer Antihypertensive Medicines and Interventions
Authors: Wu Katherine C. , Gerstenblith Gary
Published: May 2010

The incidence and prevalence of systemic hypertension are reaching global epidemic proportions. Despite a diverse pharmacologic armamentarium of agents to treat high blood pressure, suboptimal control remains a significant problem in as many as 43% of patients and this rate has not significantly improved over the past 2 decades. There are a variety of factors contributing to this including patient nonadherence due to complex drug regimens and medication side effects, undertreatment, and treatment resistance. There, thus, remains a need to develop novel agents and approaches to antihypertensive therapy that facilitate attainment of optimal blood pressure levels. This monograph will review a number of new pharmacologic targets and interventions as well as a novel method of drug delivery to patients.
Dronedarone Therapy in Atrial Fibrillation: A Summary of Recent Controlled Trials
Authors: Duray Gabor Z. , Schmitt Jörn , Hohnloser Stefan H.
Published: May 2010

Dronedarone is a new multichannel blocker, structurally related to amiodarone but free of iodine and less lipophilic and so expected to be free of iodine-related organ toxicity and tissue accumulation. The drug was developed for the treatment of atrial fibrillation (AF). The phase II Dronedarone Atrial FibrillatioN study after Electrical cardioversion (DAFNE) study established 400 mg twice-daily dosing (bid) as the standard dose for dronedarone in the maintenance of sinus rhythm. In the pivotal phase III European Trial In Atrial Fibrillation Or Flutter Patients Receiving Dronedarone For The Maintenance of Sinus Rhythm/ American-Australian-African Trial With Dronedarone In Atrial Fibrillation/flutter Patients For The Maintenance of Sinus Rhythm (EURIDIS/ADONIS) studies in patients with paroxysmal/persistent AF and atrial flutter, dronedarone significantly prolonged the mean time to first AF/flutter recurrence. Although dronedarone proved to be safe in these AF studies, a trial in patients with severe congestive heart failure was prematurely stopped because of excess mortality in the dronedarone relative to the control group. This finding prompted the conduct of a large randomized study in more than 4600 patients with nonpermanent AF, which used the primary end point of time to first cardiovascular (CV) hospitalization or death. Dronedarone significantly reduced the incidence of the primary as well as several secondary end points among which CV mortality was the most significant one. The results of this development program led to the approval of dronedarone for use in patients with AF in several jurisdictions. This article provides a short summary of the most important findings during the clinical development of dronedarone.
Effects of Statins on Progression of Carotid Atherosclerosis as Measured By Carotid Intimal—Medial Thickness: A Meta-Analysis of Randomized Controlled Trials
Authors: Bedi Updesh Singh , Singh Mukesh , Singh Param Puneet , Bhuriya Rohit , Bahekar Amol , Molnar Janos , Khosla Sandeep , Arora Rohit
Published: May 2010

Background: Carotid intimal—medial thickness (CIMT) as measured by B-mode ultrasonography is a surrogate marker for carotid atherosclerosis. Studies have found conflicting results for the effect of statins on carotid atherosclerosis progression by measuring CIMT. Hence, this meta-analysis was conducted to evaluate the impact of statin therapy on CIMT progression. Methods: A systematic search using PubMed, EMBASE, and Cochrane library databases was performed. Heterogeneity of the studies was analyzed by the Cochran Q statistics. The significance of common treatment effect was assessed by computing common mean difference between the control and treatment groups. A 2-sided alpha error of less than 0.05 was considered to be statistically significant. Results: In all, 11 trials (N = 3806) fulfilled the criteria for inclusion in the analysis. The study population included 67.2% males and 22.8% females. The mean age was 58.7 years. Treatment with statins (mean treatment duration of 25.6 months) resulted in a significant reduction in the mean low-density lipoprotein ([LDL]; mg/dL, before treatment 168.6 ± 33.3, after treatment 102.33 ± 27.9, P < .05). No significant changes in the levels of LDL cholesterol were noted in the control group. A total of 7 trials showed regression and 4 trials showed slowing of progression of CIMT. Pooled analysis of all 11 trials showed that there was a statistically significant benefit with statin therapy in slowing down the progression of CIMT and the common mean difference between statin therapy arm and placebo arm was -0.040 (CI: -0.052--0.028; P value < .001). Conclusions: Statins therapy slows down the progression of carotid atherosclerosis as measured by CIMT, indicating benefits at subclinical stage of the disease process.
Multicenter study for environmental and biological monitoring of occupational exposure to cyclophosphamide in Japan
Authors: Sugiura Shinichi , Nakanishi Hirokazu , Asano Mika , Hashida Tohru , Tanimura Manabu , Hama Toshihiro , Nabeshima Toshitaka
Published: May 2010

Purpose. A multicenter field survey of environmental contamination and exposure of healthcare professionals to anticancer drugs were performed.

Setting. Three university hospitals, one cancer specialty hospital and two corporate hospitals from across Japan.

Method. The environmental contamination with cyclophosphamide (CP) was investigated. A wipe examination was performed at six sites apiece in two divisions. The urinary excretion of the CP over 24 h was determined. The subjects of the survey included physicians, pharmacists, and nurses, for a total of seven at each facility irrespective of job title. The wipe samples were collected at 12 sites within two divisions at each facility. For the exposure survey, the total urine volume was determined, and a portion of the urine sample was then collected from each participants at each facility. Urine was collected for 24 h. The samples were determined by using the GC-MS method.

Results. Wipe examination: contamination with CP was identified at 50% of the sites. The concentration was high (CP > 1.00 ng/cm2) in the general environment in two hospitals and in the safety cabinet in one hospital. In the survey for the exposure of staff to anticancer drugs, 276 samples were obtained from 41 healthcare professionals. CP was detected in 90 samples obtained from 23 subjects. The amount of exposure was greatly different among the facilities. The urinary excretion of CP per subject was between 2.7 and 462.8 ng/24 h. The range of urinary excretion for each hospital was between 4.6 and 211.2 ng/24 h.
Anesthesia Management of a Patient With a Ventricular Assist Device for Noncardiac Surgery
Authors: Riha Hynek , Netuka Ivan , Kotulak Tomas , Maly Jiri , Pindak Marian , Sedlacek Jiri , Lomova Jitka
Published: May 2010

Congestive heart failure represents a severe health condition with unfavourable long-term prognosis despite all the progress in pharmacological therapy of heart failure. Another therapeutic option is represented by mechanical cardiac support devices. Ventricular assist devices (VAD) constitute largest subgroup of these devices. Patients supported with VAD carry many considerations which are important for successful perioperative management of these patients for noncardiac surgery.

The general perioperative considerations include consultation with VAD management personnel, detailed assessment of end-organ dysfunction before surgery, appropriate antibiotic prophylaxis, deactivation of implantable cardioverter-defibrillator for the time of surgical procedure, and the choice between general and regional anesthesia. Intraoperative monitoring depends primarily on the type of blood flow generated by VAD. For devices generating pulsatile blood flow, standard monitoring arrangements are needed. In the patients supported by devices which provide nonpulsatile blood flow, pulse oximetry and noninvasive blood pressure measurement are not reliable monitoring methods, and placement of intra-arterial catheter is warranted. In all the patients supported with VAD, transesophageal echocardiography is extremely useful method for monitoring the function of VAD itself, and in the case of univentricular VAD for monitoring the function of nonsupported cardiac ventricle.

The most important issue in hemodynamic management of the patients with VAD is avoiding hypovolemia because it can cause inadequate VAD output with resulting low cardiac output and hypotension. All the patients with VAD need some degree of anticoagulation, and for noncardiac surgery the question of interrupting or decreasing the level of anticoagulation should be discussed among members of the caring team.
Left Ventricular Assist Devices: An Evolving State of the Art
Authors: Leff Jonathan D. , Shore-Lesserson Linda
Published: May 2010

Heart failure is a disease of increasing prevalence around the world. The treatment options for patients suffering from this ailment range from pharmacologic to surgical. Heart failure, however, continues to harbor a dismal prognosis despite conventional treatments. The high mortality rate among this patient population has spawned interest in alternative therapies. Mechanical circulatory support has emerged as a treatment option for patients with refractory heart failure. Over the past years a number of studies have highlighted the effectiveness of left ventricular assist devices (LVAD’s) in improving patient’s outcomes. The technologies that support these devices have evolved and provide new opportunities to manage patients suffering from this debilitating disease. Heart transplantation continues to generate the most reproducible survival benefit to patients with advanced heart failure, but is limited by a lack of donors. It is therefore the goal of mechanical assist therapy to improve patient survival and quality of life in heart failure in light of the limitations of heart transplantation. In this article we examine the evolving utility of LVAD’s in the treatment of heart failure.
Central Nervous System Protection in Cardiac Surgery
Authors: Reich David L.
Published: May 2010

Neurological dysfunction and stroke following cardiac surgery and thoracic surgery requiring hypothermic circulatory arrest is a well-defined problem. The original studies in CABG patients identified risk factors, such as prior stroke and lower educational level. There is older evidence suggesting that higher perfusion pressures during cardiopulmonary bypass are helpful. Hyperthermia during rewarming on cardiopulmonary bypass and postoperative hyperthermia have been associated with adverse cognitive outcomes. Glucose management intraoperatively remains controversial, but most now advocate for moderate glucose control using insulin, if required. The subset of patients having thoracic aortic surgery requiring periods of aortic discontinuity are particularly problematic. A cerebral protection strategy should be determined, and this may include hypothermic circulatory arrest, selective cerebral perfusion, or retrograde cerebral perfusion. All of these techniques have been associated with good surgical outcomes, but there is little information on cognitive outcomes of thoracic aortic surgery.
Characterization and Management of Cardiac Tumors
Authors: Castillo Javier G. , Silvay George
Published: May 2010

Cardiac tumors are infrequent clinical entities with an autopsy frequency ranging from 0.001% to 0.030%. The occurrence of metastatic cardiac tumors has been reported a 100-fold more commonly than primary lesions. Three quarters of primary cardiac tumors are benign; approximately half of these are cardiac myxomas, and the rest are lipomas, papillary fibroelastomas, and rhabdomyomas. Among malignant primary cardiac tumors, the most reported are those histopathologically considered as undifferentiated, followed by angiosarcomas and leiomyosarcomas. Traditionally, cardiac tumors have been identified as curious autopsy findings resulting in a literature paucity of large clinical series, therefore, providing knowledge mostly based on case report collection. However, recent technological advances in noninvasive imaging modalities such as echocardiography and cardiac magnetic resonance imaging (MRI) have resulted in a rapid acquisition of real-time heart images with high spatial and temporal resolution and an excellent tissue characterization of the tumor. This consequent earlier, more frequent, and more complete assessment of cardiac tumors before significant symptoms develop has challenged cardiologists, cardiac anesthesiologists, and surgeons to create a tailored referral pattern and approach.
Endothelial Dysfunction in the Perioperative Setting
Authors: Riedel Bernhard , Schier Robert
Published: May 2010

Although perioperative macrovascular events (eg, myocardial infarction, stroke) are readily evident, their absolute incidence remains relatively low. In contrast, microvascular dysfunction and its role in perioperative morbidity is not easily measured. Microvascular dysfunction is likely to have a greater impact on noncardiovascular complications (eg, wound healing and end-organ failure), through impaired perfusion, than that which is readily appreciated. Inflammation and oxidative stress, such as that induced by surgical trauma, disrupts endothelial homeostasis thereby decreasing the bioavailability of nitric oxide. This predisposes blood vessels to vasoconstriction, inflammation, leukocyte adhesion, thrombosis—factors that contribute to perioperative cardiovascular events at both macrovascular and microvascular level. Current clinical strategies applicable to the perioperative setting that improve microvascular health include preoperative exercise therapy, pharmacologic interventions (eg, statins, newer β-blockers) and attempts to stimulate mobilization and homing of bone marrow—derived endothelial progenitor cells. Many of these strategies are still in their infancy and large prospective trials that investigate the impact of these therapeutic options on postoperative outcome are eagerly awaited.
An Update on Obstetric Anesthesia
Authors: Beilin Yaakov
Published: May 2010

Many women in the United States receive analgesia for labor and delivery. The ideal labor analgesic technique would confer complete pain relief without side effects. The analgesic technique would not cause any lower extremity motor blockade nor interfere with the progress or course of labor and would be sufficiently flexible to produce anesthesia for instrumental or cesarean deliveries. Furthermore, the baby would be vigorous at birth. Modern obstetric analgesia techniques and medications achieve these goals. This article reviews current labor analgesia techniques and medications used during labor and delivery.
Physiology and Pharmacology of Myocardial Preconditioning
Authors: Raphael Jacob
Published: May 2010

Perioperative myocardial ischemia and infarction are not only major sources of morbidity and mortality in patients undergoing surgery but also important causes of prolonged hospital stay and resource utilization. Ischemic and pharmacological preconditioning and postconditioning have been known for more than two decades to provide protection against myocardial ischemia and reperfusion and limit myocardial infarct size in many experimental animal models, as well as in clinical studies (1-3). This paper will review the physiology and pharmacology of ischemic and drug-induced preconditioning and postconditioning of the myocardium with special emphasis on the mechanisms by which volatile anesthetics provide myocardial protection. Insights gained from animal and clinical studies will be presented and reviewed and recommendations for the use of perioperative anesthetics and medications will be given.
Comparison of Tracheal and Esophageal Compliance Curves in Human Cadaveric Subjects
Authors: Russo M. , Schaner D. , Osborn I.
Published: May 2010

We sought to derive compliance curves of the trachea and esophagus. 16 fresh human cadavers were intubated tracheally and esophageally and cuff pressures measured at equal air volumes. Tracheal compliance was statistically less than esophageal compliance for volumes of 1, 2, and 3 mL of air, (p = 0.002, p = 0.008, and p = 0.006, respectively) but not so for volumes beyond that. This physical property is therefore not robust enough for detecting esophageal intubation.
Acute Respiratory Distress Syndrome: New Classification
Authors: Moroz Viktor , Goloubev Arkady , Kuzovlev Artem N.
Published: May 2010

The article deals with acute respiratory distress-syndrome new classification which was developed at the V.A. Negovsky Research Institute of General Reanimatology (Moscow, Russia). This classification makes it possible to timely diagnose early stages of acute respiratory distress-syndrome by means of transpulmonary thermodilution method.
Comparative Toxic Effect of Nitrogen Mustards (HN-1, HN-2, and HN-3) and Sulfur Mustard on Hematological and Biochemical Variables and Their Protection by DRDE-07 and Its Analogues
Authors: Sharma Manoj , Vijayaraghavan R. , Agrawal Om Prakash
Published: May 2010

The chemical warfare agents sulfur mustard (SM) and nitrogen mustards (HN-1, HN-2, and HN-3) are highly reactive vesicants. The study was planned to investigate the protective efficacy of amifostine, DRDE-07 and their analogues, and few conventional antidotes (30 minutes pretreatment) against dermally applied SM and nitrogen mustards in preventing hematological and biochemical changes in mice. Mustard agents (1.0 median lethal dose [LD50]) induced a significant decrease in the body weight and spleen weight. A significant decrease in the white blood cell (WBC) count and an increase in serum transaminases and alkaline phosphatases (ALPs) were observed. A significant decrease in reduced (GSH) and oxidized glutathione (GSSG) and an increase in thiobarbituric acid reactive substances were also observed. All the mustard agents increased DNA fragmentation. The effects of SM were significantly ameliorated by DRDE-07 analogues, and with nitrogen mustards the protection was partial. Overall, DRDE-30 (propyl analogue) followed by DRDE-35 (butyl analogue) are favored as safer and better compounds.
‘Macho’ managers and organizational heroes: competing masculinities in popular films
Authors: Panayiotou Alexia
Published: May 2010

This article works with the visual narrative of several popular films to critically analyse how masculinity is constructed in the cinematic workplace, focusing on the representations of managers and the interplay between the practice of management and the practice of gender. Using a performative-practice approach, the article focuses on the ‘saying and doing’ of gender in the films chosen and shows that organizations in film are a testing ground for competing forms of masculinity; in fact, one type—the ‘organizational hero’—may offer a type of resistance to prevailing cultural paradigms, so that Hollywood films present both a propagation of dominant patriarchal discourses and a space for challenging these discourses.
Successful Weight Loss Maintenance and a Shift in Identity
Authors: Epiphaniou Eleni , Ogden Jane
Published: May 2010

The present qualitative study aims to explore the experiences of dieters who successfully maintain their weight loss with a focus on the transition in perception of self from their heaviest to their current reduced weight. Ten successful women from a slimming club who had lost at least 10 per cent of their weight for a minimum of one year participated in the study. The results showed an identity shift from a previous restrained self towards a liberated individual, regarding their social interactions, dietary habits, emotional regulation and self-appraisal. The results are discussed in terms of the process of reinvention and the impact of stigma on an obese person’s self-identity.
Post-traumatic Growth among Cardiac Outpatients
Authors: Leung Yvonne W. , Gravely-Witte Shannon , Macpherson Alison , Irvine Jane , Stewart Donna E. , Grace Sherry L.
Published: May 2010

This study evaluated the sociodemographic, clinical and behavioral correlates of post-traumatic growth (PTG) in coronary artery disease (CAD) patients, and the degree of PTG compared to other patient groups. Using a prospective design, 1497 CAD outpatients completed a survey assessing potential PTG correlates. A total of 1268 responded to a nine-month follow-up survey assessing PTG. Significant PTG correlates were being younger, non-white, having lower income, functional status, and depressive symptoms, greater social support, and positive illness perceptions. The degree of PTG was equivalent to that of cardiac patients in other countries, but was lower than that of breast cancer and multiple sclerosis patients.
Emotional Exhaustion, Absenteeism, and Turnover Intentions in Childcare Teachers
Authors: Carson Russell L. , Baumgartner Jennifer J. , Matthews Russell A. , Tsouloupas Costas N.
Published: May 2010

Drawing on Salmon’s (2001) unifying theory of the beneficial effects of physical exercise, we examined physical activity behaviors as an important, but understudied, buffer against experiences of emotional exhaustion, absenteeism, and turnover intentions in 189 childcare teachers. Structural equation modeling revealed that workplace and leisure-time physical activity were negatively related to emotional exhaustion, which in turn, was positively related to teacher migration and attrition intentions. Post-hoc analyses revealed indirect (mediated) effects between physical activity behaviors and teacher turnover intentions via emotional exhaustion. This theoretically driven model fit the data better than an alternative model whereby emotional exhaustion predicts physical activity behaviors.
The Impact of Information Order on Intentions to Undergo Predictive Genetic Testing
Authors: Morrison Val , Henderson Bethan J. , Taylor Caroline , A'Ch Dafydd Nonn , Unwin Abbie
Published: May 2010

As predictive genetic testing availability increases so does our need to understand factors associated with test uptake. This study tests whether the order positive and negative information about genetic testing for breast cancer is presented in affects intention to take a genetic test. Eighty-four women were randomly allocated into three groups: (1) positive then negative information; (2) negative then positive information; and (3) a control group. A significant effect was found in relation to perceived risk, attitudes towards genetic testing, perceived disadvantages of testing and intention. Our findings point to a primacy effect, whereby information presented first has the greatest effect.
Identifying Parents’ Perceptions about Physical Activity
Authors: Hamilton Kyra , White Katherine M.
Published: May 2010

Drawing on the belief-based framework of the Theory of Planned Behaviour, this study employs qualitative methodology involving individual and group interviews to examine the beliefs associated with regular physical activity performance among parents of young children ( N = 40). The data were analysed using thematic content analysis. A range of advantages (e.g. improves parenting practices), disadvantages (e.g. interferes with commitments), barriers (e.g. time), and facilitators (e.g. social support) to performing physical activity are identified. Normative pressures are also identified as affecting parents’ activity behaviour. These identified beliefs can be used to inform interventions to challenge inactivity among this at-risk group.