bluuebunny/crossref_metadata_2025 huggingface dataset:
Carotid Plaque, Carotid Intima-Media Thickness, and Coronary Calcification Equally Discriminate Prevalent Cardiovascular Disease in Kidney Disease
Authors: Adeseun Gbemisola A. , Xie Dawei , Wang Xin , Joffe Marshall M. , Mohler III Emile R. , Townsend Raymond R. , Budoff Matthew , Rosas Sylvia E.
Published: September 2012

Background: Despite the significant morbidity and mortality attributable to cardiovascular disease (CVD), risk stratification remains an important challenge in the chronic kidney disease (CKD) population. We examined the discriminative ability of noninvasive measures of atherosclerosis, including carotid intima-media thickness (cIMT), carotid plaque, coronary artery calcification (CAC) and ascending and descending thoracic aorta calcification (TCAC), and Framingham risk score (FRS) to predict self-reported prevalent CVD. Methods and Results: Participants were enrolled in the cIMT ancillary study of the Chronic Renal Insufficiency Cohort (CRIC) study and also had all of the above measures within an 18-month period. CVD was present in 21% of study participants. C-statistics were used to ascertain the discriminatory power of each measure of atherosclerosis. The study population (n = 220) was 64% male; 51% black and 45% white. The proportion of individuals with estimated glomerular filtration rate ≥60, 45–59, 30–44, and <30 ml/min/1.73 m2 was 21, 41, 28, and 11%, respectively. In multivariable analyses adjusting for demographic factors, we failed to find a difference between CAC, carotid plaque, and cIMT as predictors of self-reported prevalent CVD (C-statistic 0.70, 95% CI: 0.62–0.78; C-statistic 0.68, 95% CI: 0.60–0.75, and C-statistic 0.64, CI: 0.56–0.72, respectively). CAC was statistically better than FRS. FRS was the weakest discriminator of self-reported prevalent CVD (C-statistic 0.58). Conclusions: There was a significant burden of atherosclerosis among individuals with CKD, ascertained by several different imaging modalities. We were unable to find a difference in the ability of CAC, carotid plaque, and cIMT to predict self-reported prevalent CVD.
Irregular Rhythm Adversely Influences Calcium Handling in Ventricular Myocardium
Authors: Ling Liang-han , Khammy Ouda , Byrne Melissa , Amirahmadi Fatemah , Foster Anna , Li Gefeng , Zhang Linda , Remedios Cris dos , Chen Chen , Kaye David M.
Published: September 2012

Background—

Despite adequate rate control, the combination of atrial fibrillation with heart failure (HF) has been shown, in a number of studies, to hasten HF progression. In this context, we aimed to test the hypothesis that an irregular ventricular rhythm causes an alteration in ventricular cardiomyocyte excitation–contraction coupling which contributes to the progression of HF.

Methods and Results—

We investigated the effects of electrical field stimulation (average frequency 2 Hz) in an irregular versus regular drive train pattern on the expression of calcium-handling genes and proteins in rat ventricular myocytes. The effect of rhythm on intracellular calcium transients was examined using Fura-2AM fluorescence spectroscopy. In conjunction, calcium-handling protein expression was examined in left ventricular samples obtained from end-stage HF patients, in patients with either persistent atrial fibrillation or sinus rhythm. Compared with regularly paced ventricular cardiomyocytes, in cells paced irregularly for 24 hours, there was a significant reduction in the expression of sarcoplasmic reticulum calcium (Ca
2+
) ATPase together with reduced serine-16 phosphorylation of phospholamban. These findings were accompanied by a 59% reduction (
P
<0.01) in the peak Ca2+ transient in irregulary paced myocytes compared with those with regular pacing. Consistent with these observations, we observed a 54% (
P
<0.05) decrease in sarcoplasmic reticulum Ca
2+
ATPase protein expression and an 85% (
P
<0.01) reduction in the extent of phosphorylation of phospholamban in the left ventricular myocardium of HF patients in atrial fibrillation compared with those in sinus rhythm.

Conclusions—

Together, these data demonstrate that ventricular rhythmicity contributes significantly to excitation–contraction coupling by altering the expression and activity of key calcium-handling proteins. These data suggest that control of rhythm may be of benefit in patients with HF.
Randomised controlled trial of group cognitive behaviour therapy versus brief intervention for depression in cardiac patients
Authors: Turner Alyna , Hambridge John , Baker Amanda , Bowman Jenny , McElduff Patrick
Published: September 2012

Objective:

To determine whether a six-session group cognitive behaviour therapy (CBT) programme results in a greater reduction in depression symptoms than a brief intervention alone in cardiac patients with clinically significant symptoms of depression.

Method:

Fifty-seven community dwelling cardiac patients scoring >13 on the Beck Depression Inventory-II (BDI-II) received a single-session brief intervention. They were then block randomised to either six sessions of group CBT ( n = 25) or no further intervention (BI; n = 32). All were re-assessed at 2, 6 and 12 months. Differences between treatment groups in the primary (BDI-II) and secondary [rates of depression; anxiety symptoms, as measured by the Hospital Anxiety and Depression Scale-Anxiety (HADS-A)] outcomes were examined using generalised linear mixed models with a random intercept term for the individual.

Results:

Significant improvements were seen for the total group from baseline to 12 months on BDI-II and HADS-A scores. However, no differences were found between the CBT and BI conditions on change in BDI-II score, rates of major depressive episode or HADS-A score. Post hoc analysis on the total group found 12-month symptom non-remission was associated with higher baseline BDI-II score ( p = 0.03), more visits to health professionals 12 months prior to baseline ( p = 0.05) and a greater likelihood of either drinking alcohol over recommended levels or smoking at baseline ( p = 0.01).

Conclusions:

Group CBT of up to six sessions did not result in greater reductions in depression or anxiety symptoms compared with a single-session brief intervention. Further work should focus on the efficacy and role of brief interventions, and addressing smoking and alcohol misuse in cardiac patients with depression.
Shopping for Old and New Wine
Authors: Murdock Nancy L. , Nilsson Johanna E. , Duan Changming
Published: September 2012

With this rejoinder, we address some of the concerns and questions raised by Ridley and Mollen (2012) and Hill (2012). Specially, we reflect upon Ridley and Mollen’s commentary about whether the three theories in this major contribution can be deemed emergent or whether they are simply old thought in new packages. We also address Hill’s question regarding the theories chosen and her concerns about why so few counseling psychologists are involved in creating theories. Finally, in response to these thoughtful commentaries, we also briefly discuss our views on theory building and scientific development in the field of counseling psychology.
Variations between Organisations and Localities in Government Funding of Third-sector Activity: Evidence from the National Survey of Third-sector Organisations in England
Authors: Clifford David , Geyne-Rahme Frida , Mohan John
Published: September 2012

This paper uses data from the national survey of third-sector organisations in England to show, for the first time, important variations between organisations and localities in government funding of third-sector activity. It shows that organisations serving the personally or socially disadvantaged are most likely to be publicly funded and that deprived neighbourhoods and local authorities have the highest share of publicly funded organisations. Further, at the neighbourhood scale there is evidence for an interaction effect between kind of organisation and area deprivation, such that organisations working in deprived areas with disadvantaged groups are particularly likely to receive some public funding. These results have particular resonance at a time when many third-sector organisations are faced with cuts in their public funding. They also have relevance to theoretical work on the relationship between government and the voluntary sector.
Fiddling with the pacemaker: Twiddler’s syndrome in a parkinsonian patient
Authors: Grapsa J , Koa-Wing M , Fox KF
Published: September 2012

We describe the case report of an 86-year-old Afro-Caribbean parkinsonian gentleman with intermittent Mobitz II heart block and syncope who received a DDD pacemaker. Due to Parkinson’s syndrome, the patient rotated the atrial lead around the pacemaker, causing the famous "Twiddler’s syndrome", a rare clinical issue which can easily be diagnosed with a simple chest X-ray.
Behavioural, neurochemical and neuroendocrine effects of the endogenous β-carboline harmane in fear-conditioned rats
Authors: Smith Karen L , Ford Gemma K , Jessop David S , Finn David P
Published: September 2012

The putative endogenous imidazoline binding site ligand harmane enhances neuronal activation in response to psychological stress and alters behaviour in animal models of anxiety and antidepressant efficacy. However, the neurobiological mechanisms underlying harmane’s psychotropic effects are poorly understood. We investigated the effects of intraperitoneal injection of harmane (2.5 and 10 mg/kg) on fear-conditioned behaviour, hypothalamo-pituitary-adrenal axis activity, and monoaminergic activity within specific fear-associated areas of the rat brain. Harmane had no significant effect on the duration of contextually induced freezing or 22 kHz ultrasonic vocalisations and did not alter the contextually induced suppression of motor activity, including rearing. Harmane reduced the duration of rearing and tended to increase freezing in non-fear-conditioned controls, suggesting potential sedative effects. Harmane increased plasma ACTH and corticosterone concentrations, and serotonin (in hypothalamus, amygdaloid cortex, prefrontal cortex and hippocampus) and noradrenaline (prefrontal cortex) content, irrespective of fear-conditioning. Furthermore, harmane reduced dopamine and serotonin turnover in the PFC and hypothalamus, and serotonin turnover in the amygdaloid cortex in both fear-conditioned and non-fear-conditioned rats. In contrast, harmane increased dopamine and noradrenaline content and reduced dopamine turnover in the amygdala of fear-conditioned rats only, suggesting differential effects on catecholaminergic transmission in the presence and absence of fear. The precise mechanism(s) mediating these effects of harmane remain to be determined but may involve its inhibitory action on monoamine oxidases. These findings support a role for harmane as a neuromodulator, altering behaviour, brain neurochemistry and neuroendocrine function.
An Accommodations Model for the Secondary Inclusive Classroom
Authors: Scanlon David , Baker Diana
Published: September 2012

Despite expectations for accommodations in inclusive classrooms, little guidance for effective practice is available. Most accommodations policies and evidence-based practices address assessments. High school regular and special educators collaborated in focus groups to articulate a model based on their practices and perceptions of best practice. The model addresses classroom accommodations identification, provision, and evaluation. The model is particularly appropriate for cotaught classrooms with high enrollments of students with high incidence disabilities.
Cases of organophosphate poisoning treated with high-dose of atropine in an intensive care unit and the novel treatment approaches
Authors: Karakus Ali , Celik Muhammet Murat , Karcioglu Murat , Tuzcu Kasim , Erden Ersin Sukru , Zeren Cem
Published: September 2012

Organophosphate poisoning is a life-threatening condition, which is being responsible for the symptoms due to cholinergic effects. Clinical status and blood levels of cholinesterase are used its diagnosis. While atropine and pralidoxime (PAM) appear as essential medications, hemofiltration treatments and lipid solutions have been widely studied in recent years. In this study, the importance of high-dose atropine therapy and early intervention and novel treatment approaches are discussed. Records of a total of 25 patients treated for organophosphate poisoning in the intensive care unit (ICU) between April 2007 and December 2011 were evaluated retrospectively. Of the 25 patients, 14 (56%) were male and 11 (44%) were female with a mean age of 34.8 ± 17.66 years (range: 14–77 years). The patients were most frequently admitted in June ( n = 4) and July ( n = 4) (16%). Of the 25 patients, 22 patients (88%) were poisoned by oral intake, two (8%) by inhalation, and one (4%) by dermal route. Of them, 20 patients (80%) took organophosphates intentionally for suicidal purposes, while five (20%) cases poisoned due to accidental exposure. The scores of Glasgow Coma Scale of nine patients (36%) were below 8 point upon admission to hospital. The highest dose of atropine given was 100 mg intravenously on admission and 100 mg/h/day during follow-up. The total dose given was 11.6 g/12 days. A total of 11 patients (44%) were on mechanical ventilation for a mean duration of 5.73 ± 4.83 days. The mean duration of ICU stay was 6.52 ± 4.80 days. Of all, 23 patients (92%) were discharged in good clinical condition and one patient (4%) was referred to another hospital. This study suggests that atropine can be administered until secretions disappear and intensive care should be exerted in follow-up of these patients. In addition, in case of necessity for high doses, sufficient amounts of atropine and PAM should be available in hospitals.
Audit of Domperidone Use as a Galactogogue at an Australian Tertiary Teaching Hospital
Authors: Grzeskowiak Luke E. , Lim Sze Wen , Thomas Alicia E. , Ritchie Usha , Gordon Andrea L.
Published: September 2012

Background:

Domperidone is often used to promote lactation among women who have difficulty breastfeeding.

Objective:

To examine prescribing and dispensing practices of domperidone at the Women’s and Children’s Hospital (WCH), Adelaide.

Methods:

A retrospective audit of domperidone dispensing among women with singleton pregnancies who delivered at the WCH between January 2000 and July 2010 was undertaken. Women dispensed domperidone were identified using WCH pharmacy dispensing records. Maternal and infant clinical data were obtained from the WCH Perinatal Statistics Collection. An audit of paper-based medical records was undertaken for a random sample of 261 mother-child pairs to collect prescribing and additional clinical data.

Results:

From 2000 to 2010, 1605 women were dispensed domperidone. There was a steady increase in the percentage of women dispensed domperidone, from < 0.5% in 2000 to > 5% of total WCH pregnancies in 2010. Among women dispensed domperidone, the percentage of women who received > 1 dispensing remained consistent (20%) over time, as did the median number of days (12) from delivery to first dispensing. Multiparous women were more likely to receive domperidone within 3 days following delivery compared to primiparous women (8% vs 4%; P < .01). Most women (80%) received directions to take domperidone according to a standard tapering dosing regimen over 12 days. Notably, 60% of women had no documentation of being assessed by a lactation consultant.

Conclusion:

From 2000 to 2010, there was a considerable increase in domperidone dispensing. With a lack of clinical evidence to guide use, current practice appears to be based on anecdotal evidence.
Analysis of high-speed milling dynamic stability through sound pressure, machining force and tool displacement measurements
Authors: Polli Milton Luiz , Weingaertner Walter Lindolfo , Schroeter Rolf Bertrand , Gomes Jefferson de Oliveira
Published: September 2012

High-speed milling is a manufacturing process that has great economical potential owing to high material removal rate, accuracy and quality of machined workpieces. However, chatter might arise especially in situations where there is lack of dynamic stiffness of the system composed by the machine tool, the cutting tool and the workpiece. This work analyses the dynamic stability of the high-speed end milling process. The evaluation of stability is based on sound pressure, machining force and tool displacements measured during the process. In order to investigate the transition from stable cutting to cutting with chatter, the experimentally measured tool displacements are used as input data into a computer simulation to estimate the chip thickness variation during the process. It was found that for unstable cuts, the tool shaft motions are elliptical, process dynamics are dominated by power at the chatter frequency and other vibration modes of the system can resonate with the harmonics of the chatter frequency. Through the computational simulation of the estimated chip thickness variation, it was possible to observe the transition from stable cutting to cutting with chatter, the phase differences between undulations left by subsequent teeth and their consequences in machining forces.
Online tool wear prediction based on partial least square regression and Monte Carlo cross validation
Authors: Wang Guo F , Qian Lei
Published: September 2012

Tool wear prediction is paramount for guaranteeing the quality of the workpiece and improving lifetime of the cutter. However, the multicollinearity between the extracted features deteriorates the prediction accuracy. To overcome this, a partial least square regression-based method is proposed. The main characteristic of partial least square regression is that the regression analysis is realized in the principle component space so that multicollinearity between the input variables can be avoided. To testify the correctness of the proposed method, the milling experiment is preceded and the dynamic cutting force is collected to depict the variation of the tool wear. Moreover, Monte Carlo cross validation is adopted to improve the robustness of partial least square regression. The analysis and comparison between the partial least square regression model and the multiple linear regression model shows that the presented method can get more accurate results.
Potentiating patient participation: the ‘Homeward Bound’ psychoeducation programme for depression in old age
Authors: O’ Dwyer Sarah , Burke David , Malusa Linda
Published: September 2012

Objectives:

The aims of this paper are to briefly describe the need for psychoeducation for older adults with depression, the nature of the existing resources, the need for an alternative resource and the development and context of the St. Vincent’s Hospital Psychogeriatrics Mental Health Service (SVHMHS) ‘Homeward Bound’ psychoeducation programme using an education-workbook for older adults with depression and their carers.

Conclusions:

‘Homeward Bound’ is a psychoeducation programme designed for older adults with depression and their carers to actively engage in a collaborative process that will improve patient adherence, hasten recovery, maximize carer support and enhance patient outcomes and satisfaction. We believe this can be achieved by utilizing the education-workbook designed by the SVHMHS multidisciplinary team.
Diagnostic processes in mental health: GPs and psychiatrists reading from the same book but on a different page
Authors: Lampe Lisa , Shadbolt Narelle , Starcevic Vladan , Boyce Philip , Brakoulias Vlasios , Hitching Rita , Viswasam Kirupamani , Walter Garry , Malhi Gin
Published: September 2012

Objective:

To explore the clinical reasoning processes underpinning diagnostic and management decision-making in treating patients presenting with psychological distress in general practice.

Method:

Practising GPs were invited to attend small-group workshops in which two case histories were presented. Discussion was GP-facilitated and recorded for thematic analysis. GPs provided demographic data, completed personality and attitudinal questionnaires, and answered a series of multiple-choice questions embedded in the cases.

Results:

GPs recognize the possibility of psychiatric disorders early in the clinical reasoning process, but are cautious about applying definitive diagnoses. GPs perceive that patients may be resistant to a psychiatric diagnosis and instead emphasize the need to build rapport and explore and exclude physical comorbidities. GPs see patients with a broad spectrum of distress, illness and impairment, in whom the initial presentation of psychological symptoms is often poorly differentiated and somatically focused, requiring elucidation over time. GPs therefore adopt a longitudinal strategy for diagnosis rather than investing heavily in cross-sectional assessment.

Conclusion:

GPs appear cognizant of possible psychiatric disorders and management strategies, but employ diagnostic strategies and decision-making processes that, in addition to experience and expertise, likely reflect key differences between the primary care and specialist practice settings.
Use of ultra-brief pulse electroconvulsive therapy to treat severe postnatal mood disorder
Authors: Levy Yael , Austin Marie-Paule , Halliday Graeme
Published: September 2012

Objective:

To describe the use of ultra-brief electroconvulsive therapy (ECT) in three postnatal women with severe, treatment resistant depression. The indications and evidence for the use of ECT in the treatment of postnatal depression are discussed.

Method:

We present a case series and review relevant literature.

Results:

Three patients with severe episodes of depression postnatally, not responding to medication, presented to a private mother-baby inpatient unit. All three patients had significant suicidal ideation and two underwent involuntary treatment in public hospitals during the course of their presenting illnesses. They were treated with right unilateral ultra-brief ECT and a range of medications. All women began to respond within 3–6 treatments and no significant cognitive side effects were observed.

Conclusions:

Our findings suggest that right unilateral ultra-brief ECT is a useful treatment modality for severe and treatment resistant depression in the postnatal period. ECT is a useful option in women who have experienced significant medication side effects, or for those whose severity of illness necessitates rapid symptom resolution. Ultra-brief ECT caused minimal clinically observable side effects, which may assist mothers to resume care of their infants more rapidly.
Prevalence of parents within an adult mental health service: Census results 2008–2011
Authors: Howe Deb , Batchelor Samantha , Bochynska Kataryzna
Published: September 2012

Objective:

The objective of this article is to determine the prevalence of parents of children (aged 0–17 years) within a mental health service system and gather contextual data regarding this population.

Method:

The study uses a census approach. The Census is conducted annually across Central Coast Adult Mental Health Services, NSW, Australia. All five community mental health teams and four acute inpatient units within the service participate, with each team completing Census forms for active clients identified as parents on Census day. The Census form collects data on parents and children including demographic data, parental diagnosis, parental contact and risk factors.

Results:

Consecutive data shows 25–28% of active clients are parents. Annually, at least 400 children are identified; approximately 60% reside permanently with their parent with a mental illness.

Conclusions:

The Census is a valuable tool to determine the prevalence of parenthood. Moreover, it collects contextual data on this population. Data show an emerging relationship between parental diagnosis and parental contact. A picture of level of risk across the system has also been highlighted. Results add to the evidence regarding parental mental illness and circumstances of these families. The data clearly articulate a large need for interventions for children of parents with a mental illness (COPMI) within this population, given the high proportion of children who permanently reside with their parent with a mental illness.
Pilot study of a sensory room in an acute inpatient psychiatric unit
Authors: Novak Theresa , Scanlan Justin , McCaul Damien , MacDonald Nathan , Clarke Timothy
Published: September 2012

Objective:

The use of sensory rooms (also known as comfort rooms) to reduce seclusion rates has generated a great deal of interest. This study examined the outcomes associated with the introduction of a sensory room in an acute inpatient psychiatric unit.

Method:

Consumers rated distress and staff rated a variety of disturbed behaviours before and after each use of the room. Items used during each episode were recorded.

Results:

Use of the room was associated with significant reductions in distress and improvements in a range of disturbed behaviours. Those individuals who used the weighted blanket reported significantly greater reductions in distress and clinician-rated anxiety than those who did not. No changes were noted in rates of seclusion or aggression.

Conclusions:

The sensory room was an effective intervention to ameliorate distress and disturbed behaviour, although this did not translate into reductions in overall rates of seclusion or aggression. Weighted blankets appear to be particularly useful.
Acute Lung Injury and Acute Respiratory Distress Syndrome Requiring Tracheal Intubation and Mechanical Ventilation in the Intensive Care Unit
Authors: Johnson Robert F. , Gustin Jillian
Published: September 2012

A case of acute lung injury (ALI) progressing to acute respiratory distress syndrome (ARDS) requiring tracheal intubation and mechanical ventilation (ETMV) is presented. The palliative medicine service was asked to address concerns expressed by the patient's spouse reflecting uncertainty regarding outcome expectations. Acknowledging and confronting the uncertainties of a critical illness is an essential component of patient-centered communication. Addressing and managing uncertainty for the case scenario requires consideration of both short- and long-term outcomes including mortality, ventilator independence, and adverse effects on quality of life for survivors. In this paper, ALI/ARDS requiring ETMV in the ICU was used as a focal point for preparing a prognostic assessment incorporating these issues. This assessment was based on a review of recently published literature regarding mortality and ventilator independence of survivors for adult patients receiving ETMV for ALI/ARDS in the ICU. In the studies reviewed, long-term survival reported at 60 days to 1 year was 50-73% with greater than 84% of the survivors in each study breathing independently. Selected articles discussing outcomes other than mortality or recovery of respiratory function, particularly quality of life implications for ALI/ARDS survivors, were also reviewed. A case of of ALI/ARDS requiring ETMV in the ICU is used to illustrate the situation of an incapacitated critically ill patient where the outcome is uncertain. Patient-centered communication should acknowledge and address this uncertainty. Managing uncertainty consists of effectively expressing a carefully formulated prognostic assessment and using sound communication principles to alleviate the distress associated with the uncertain outcome probabilities.
Bioactive compounds and phenolic-linked functionality of powdered tropical fruit residues
Authors: Correia Roberta TP , Borges Kátia C , Medeiros Maria F , Genovese Maria I
Published: September 2012

Tropical fruit residues consisting of seeds, peels and residual pulp generated as by-products of fruit processing industry were investigated for bioactive compounds, the in vitro antioxidant capacity as well as alpha-glucosidase and alpha-amylase inhibitory activities. Cyanidin, quercetin, ellagic acid (EA) and proanthocyanidins were found in acerola, jambolan, pitanga and cajá-umbu residue powders. Acerola powder had the highest phenolic content (8839.33 mg catechin equivalents (CE)/100 g) and also high-ascorbic acid (AA) concentration (2748.03 mg/100 g), followed by jambolan and pitanga. The greatest 1,1-Diphenyl-2-picrylhydrazyl (DPPH) inhibition was observed for jambolan (436.76 mmol Trolox eq/g) followed by pitanga (206.68 mmol Trolox eq/g) and acerola (192.60 mmol Trolox eq/g), while acerola had the highest ferric reducing antioxidant power (FRAP) assay result (7.87 mmol Trolox eq/g). All fruit powders exhibited enzymatic inhibition against alpha-amylase (IC50 ranging from 3.40 to 49.5 mg CE/mL) and alpha-glucosidase (IC50 ranging from 1.15 to 2.37 mg CE/mL). Therefore, acerola, jambolan and pitanga dried residues are promising natural ingredients for food and nutraceutical manufacturers, due to their rich bioactive compound content.
Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management
Authors: Warren Narelle , Canaway Rachel , Unantenne Nalika , Manderson Lenore
Published: September 2012

The chronicity of chronic disease, and its associated uncertainties and fluctuations in health status, pain and/or discomfort, often leaves those so diagnosed feeling that they have lost control. Treatment can exacerbate this sense of loss of control, as people surrender to the expertise of their biomedical providers and interventions. In principle, self-management aims to return control to the individual, but its promotion is as much motivated by cost-containment as patient autonomy, and is advocated in an environment largely shaped by policy makers and biomedical providers. In this article, we examine how Australians with type 2 diabetes and/or cardiovascular disease supplement medical with complementary and alternative medical (CAM) care. Drawing on in-depth interviews with 69 participants collected in 2009–2010, we illustrate how people rely on medical providers and pharmaceuticals to manage their diabetes, but concurrently consulted with CAM practitioners and used non-biomedical therapies to enhance well-being. In explaining this, participants framed CAM use in the context of reclaiming relative personal and bodily control.
A simplified control system for a daylight-matched LED lamp
Authors: Gilman JM , Miller ME , Grimaila MR
Published: September 2012

Energy-conscious facility designs strive to include natural daylight in workspaces. However, the correlated colour temperature (CCT) and spectral content of daylight varies throughout the day while existent electric lamps produce light with a fixed CCT, resulting in mixed-illumination environments. A prototype LED lamp, with a simple control concept and a novel pulse-width modulation drive circuit, is proposed. This white light over a broad range of CCT values while maintaining a stable colour quality fidelity score with respect to a standard daylight source having an equivalent CCT. This range of CCTs is obtained without requiring computations for spectral approximation, resulting in a simplified control system.
Cryptococcal Antigen Screening and Preemptive Therapy in Patients Initiating Antiretroviral Therapy in Resource-Limited Settings
Authors: Jarvis Joseph N. , Govender Nelesh , Chiller Tom , Park Benjamin J. , Longley Nicky , Meintjes Graeme , Bekker Linda-Gail , Wood Robin , Lawn Stephen D. , Harrison Thomas S.
Published: September 2012

HIV-associated cryptococcal meningitis (CM) is estimated to cause over half a million deaths annually in Africa. Many of these deaths are preventable. Screening patients for subclinical cryptococcal infection at the time of entry into antiretroviral therapy programs using cryptococcal antigen (CRAG) immunoassays is highly effective in identifying patients at risk of developing CM, allowing these patients to then be targeted with “preemptive” therapy to prevent the development of severe disease. Such CRAG screening programs are currently being implemented in a number of countries; however, a strong evidence base and clear guidance on how to manage patients with subclinical cryptococcal infection identified by screening are lacking. We review the available evidence and propose a treatment algorithm for the management of patients with asymptomatic cryptococcal antigenemia.
Decentralizing risk: The role of the voluntary and community sector in the management of offenders
Authors: Mythen Gabe , Walklate Sandra , Kemshall Hazel
Published: September 2012

This paper considers the rise of third sector agencies as key criminal justice providers within the context of the marketization of probation and other crime management responses. We posit that the ‘rehabilitation revolution’ has significant implications for the voluntary and community sector in particular and criminal justice provision in general. Pointing towards incremental colonization of the third sector by criminal justice concerns, we trace the creeping discourse of economic risk, exemplified by the commodification of provision, increased contractualization of services and the application of cost–benefit measures. We argue that government policy is being driven by a behavioural economics of risk that attempts to ‘nudge’ the sector in discrete directions through the use of incentivization, market competition and steers toward entrepreneurship. In such a context, the position of marginal groups with high needs but potentially poorer outcomes may be perilous, consigning high risk and ‘at-risk’ groups to further exclusion.
Overcoming intolerance to young people’s conduct: Implications from the unintended consequences of policy in the UK
Authors: Bannister Jon , Kearns Ade
Published: September 2012

This paper takes the opportunity to reflect upon the trajectory and consequences of the anti-social behaviour policy framework in the United Kingdom (UK) from its inception to date. It contends that despite, and paradoxically because of, the interventions launched to confront anti-social behaviours, perceptions of these behaviours have remained stubborn to improvement. In effect, anti-social behaviour policy has fed negative stereotypes of youth and positioned young people as a metaphor for deeper social malaise. The paper suggests a theoretical framework for understanding the mechanisms through which this perverse consequence has been realized. This task is facilitated conceptually through an exploration of the meaning of tolerance and the considerations that inform (in)tolerant assessments by citizens. Further, we progress to consider evidence of the interplay between these assessments and forces impacting upon social (dis)connectedness in the UK. This enables us to demonstrate how the anti-social behaviour policy suite underpins the intolerance of youth.
The mandatory life sentence for murder: An argument for judicial discretion in England
Authors: Fitz-Gibbon Kate
Published: September 2012

In 1965, alongside the abolition of capital punishment, a mandatory life sentence for murder was implemented in England and Wales. The mandatory life sentence served as a signal to the public that the criminal justice system would still implement the most severe sanction of life imprisonment in cases of murder. Nearly 50 years later, this article examines whether the imposition of a mandatory life sentence for murder is still in the best interests of justice or whether English homicide law would be better served by a discretionary sentencing system. In doing so, the article considers debates surrounding the political and public need for a mandatory life sentence for murder by drawing upon interviews conducted with 29 members of the English criminal justice system. This research concludes that a discretionary sentencing framework is required to adequately respond to the many contexts within which the crime of murder is committed.
How to Define Emotions Scientifically
Authors: Scarantino Andrea
Published: September 2012

The central contention of this article is that the classificatory scheme of contemporary affective science, with its traditional categories of emotion, anger, fear, and so on, is no longer suitable to the needs of affective science. Unlike psychological constructionists, who have urged the transition from a discrete to a dimensional approach in the study of affective phenomena, I argue that we can stick to a discrete approach as long as we accept that traditional emotion categories will have to be transformed in order to do any scientific work. I conclude by articulating some general rules for turning traditional emotion categories into suitable scientific tools.
Toward a Working Definition of Emotion
Authors: Mulligan Kevin , Scherer Klaus R.
Published: September 2012

A definition of emotion common to the affective sciences is an urgent desideratum. Lack of such a definition is a constant source of numerous misunderstandings and a series of mostly fruitless debates. There is little hope that there ever will be agreement on a common definition of emotion, given the sacred traditions of the disciplines involved and the egos of the scholars working in these disciplines. Our aim here is more modest. We propose a list of elements for a working definition of emotion and discuss the justification for the inclusion of elements from our respective perspectives (philosophy and psychology). This working partial definition may at least serve as a litmus test to examine theories of emotion, old and new, across disciplinary boundaries.
A Neuroscientist’s Perspective on Debates about the Nature of Emotion
Authors: LeDoux Joseph
Published: September 2012

The target articles by Dixon (2012), Scarantino (2012), and Mulligan and Scherer (2012) explore the nature of emotion from philosophical and psychological perspectives. I discuss how neuroscience can also contribute to debates about the nature of emotion. I focus on the aspects of emotion that usually fall within the topic of basic emotions, but conclude that we may need to revise how we conceive and study these kinds of emotional states in relation to the brain.
Some Further Thoughts on Emotions and Natural Kinds
Authors: Scarantino Andrea
Published: September 2012

In this brief reply, which cannot do justice to all of the valuable points my commentators have raised, I defend the view that the notion of natural kind I have introduced satisfies the ontological independence criterion and is in keeping with the commitments of realism. I also further clarify the scope of my argument against basic emotion theory, and reiterate that we should stop looking for universal theories of discrete emotions.
“Emotion”: One Word, Many Concepts
Authors: Dixon Thomas
Published: September 2012

The target articles and commentaries reveal considerable support for the view that the term “emotion” names neither a natural kind nor a coherent psychological category. This brief response revisits a couple of historical points about the meanings of “emotion,” as well as the ancient debate between Stoicism and Christianity.
Regulatory Challenges for Cartilage Repair Technologies
Authors: McGowan Kevin B. , Stiegman Glenn
Published: September 2012

In the United States, few Food and Drug Administration (FDA)–approved options exist for the treatment of focal cartilage and osteochondral lesions. Developers of products for cartilage repair face many challenges to obtain marketing approval from the FDA. The objective of this review is to discuss the necessary steps for FDA application and approval for a new cartilage repair product. FDA Guidance Documents, FDA Panel Meetings, scientific organization recommendations, and clinicaltrials.gov were reviewed to demonstrate the current thinking of FDA and the scientific community on the regulatory process for cartilage repair therapies. Cartilage repair therapies can receive market approval from FDA as medical devices, drugs, or biologics, and the specific classification of product can affect the nonclinical, clinical, and regulatory strategy to bring the product to market. Recent FDA guidance gives an outline of the required elements to bring a cartilage repair product to market, although these standards are often very general. As a result, companies have to carefully craft their study patient population, comparator group, and clinical endpoint to best showcase their product’s attributes. In addition, regulatory strategy and manufacturing process validation need to be considered early in the clinical study process to allow for timely product approval following the completion of clinical study. Although the path to regulatory approval for a cartilage repair therapy is challenging and time-consuming, proper clinical trial planning and attention to the details can eventually save companies time and money by bringing a product to the market in the most expeditious process possible.
Traditional Medicinal Plants
Authors: Karunamoorthi Kaliyaperumal , Jegajeevanram Kaliyaperumal , Vijayalakshmi Jegajeevanram , Mengistie Embialle
Published: September 2012

Despite recent scientific advancement and globalization, the system of traditional medicine and complementary/alternative medicine is considered as a primary health care modality in the resource-constrained health care settings. Herbal medicinal system has been postulated and established through empirical observation and trial and error experiments since time immemorial to maintain good health and alleviate ailments and diseases. Earlier, the importance of traditional medicinal plants and phytotherapy have often been disregarded and undervalued. Presently revitalization and renewed interest on traditional medicinal plants has been observed among the public and scientific community. However, several daunting challenges need to be flagged effectively and immediately for the promotion of traditional medicinal plants. The collaborative efforts of ethnobotanists, anthropologists, pharmacists, and physicians could be a workable strategy to evaluate and validate the usage of traditional medicinal plants with the modern scientific methods and innovative techniques. Furthermore, conducting clinical trials to assess their efficacy and human safety is imperative and inevitable.
Assessing the Nutritional Health Outcomes of African American Women with HIV and Substance Abuse Disorders Using a Socioecological Approach
Authors: Mahadevan Meena , Ruzsilla John
Published: September 2012

It is well established that poor nutritional status leaves HIV-positive substance abusers especially vulnerable to an increased risk of opportunistic infections and other illnesses. Socioecological frameworks have been useful for identifying multiple influences on health risks, leading to the development and evaluation of promising community-based interventions for diseases such as cancer and diabetes. This article presents a conceptual model, based on the socioecological approach, to examine the mechanisms and pathways by which the various contextual factors unique to HIV-positive African American women with substance abuse disorders intersect to impact their nutritional health outcomes. The mediating effects of the interpersonal, environmental, and psychological factors on the direct links between disease symptomology, demographic and socioeconomic variables, and nutritional health are emphasized. The long-term goal is to provide the empirical foundation necessary to design targeted interventions that meet the unique personal, social, and familial needs of this population with multiple vulnerabilities.
Microstructure and properties of Fe–Cr–C hardfacing alloys reinforced with TiC–TiB2
Authors: Liu H Y , Yu F B , Meng Q S , Chen S P , Wang H
Published: September 2012

Different amounts of TiB2 powder were added to flux cores of wear resistant hardfacing flux cored wires for the preparation of new flux cored wires. Fe–Cr–C hardfacing alloys reinforced with TiB2 were produced by arc hardfacing. The microstructure, hardness and wear resistance behaviour of the hardfacing alloys were investigated using an optical micrograph, scanning electron micrograph (SEM), X-ray diffractometer, macrohardness tester, microhardness tester and abrasive wear tester. The results showed that, among the hardfacing alloys, a new hard phase, i.e. TiC–TiB2 composite compound particles, was formed and dispersed in the primary carbides and matrix structures. The TiC–TiB2 reinforced Fe–Cr–C hardfacing alloys imparted greater hardness and better wear resistance. The presence of TiC–TiB2 hard phase particles is the main reason for the improvement in hardness and wear resistance of Fe–Cr–C hardfacing alloys.
Changes in human gut flora with age: an Indian familial study
Authors: Marathe Nachiket , Shetty Sudarshan , Lanjekar Vikram , Ranade Dilip , Shouche Yogesh
Published: September 2012

Background

The gut micro flora plays vital role in health status of the host. The majority of microbes residing in the gut have a profound influence on human physiology and nutrition. Different human ethnic groups vary in genetic makeup as well as the environmental conditions they live in. The gut flora changes with genetic makeup and environmental factors and hence it is necessary to understand the composition of gut flora of different ethnic groups. Indian population is different in physiology from western population (YY paradox) and thus the gut flora in Indian population is likely to differ from the extensively studied gut flora in western population. In this study we have investigated the gut flora of two Indian families, each with three individuals belonging to successive generations and living under the same roof.

Results

Denaturation gradient gel electrophoresis analysis showed age-dependant variation in gut microflora amongst the individuals within a family. Different bacterial genera were dominant in the individual of varying age in clone library analysis. Obligate anaerobes isolated from individuals within a family showed age related differences in isolation pattern, with 27% (6 out of 22) of the isolates being potential novel species based on 16S rRNA gene sequence. In qPCR a consistent decrease in Firmicutes number and increase in Bacteroidetes number with increasing age was observed in our subjects, this pattern of change in Firmicutes / Bacteroidetes ratio with age is different than previously reported in European population.

Conclusion

There is change in gut flora with age amongst the individuals within a family. The isolation of high percent of novel bacterial species and the pattern of change in Firmicutes /Bacteroidetes ratio with age suggests that the composition of gut flora in Indian individuals may be different than the western population. Thus, further extensive study is needed to define the gut flora in Indian population.