bluuebunny/crossref_metadata_2025 huggingface dataset:
A self‐report play skills questionnaire: Technical development
Authors: Sturgess Jennifer , Ziviani Jenny
Published: September 2010

A play skills self‐report questionnaire in game form was administered to 72 children aged between 4 years 10 months and 7 years 6 months. The same questions were answered by a parent and teacher of each child. The aim was to establish how children's perceptions of their play skills differed from those of their parents and teachers. Twenty‐two children were retested after 1 month to examine test‐retest reliability. The influence of age and gender on play self‐report and on parent and teacher report, and the effect of position in the family, were also examined. Results indicated that children's views of their play skills were different from adults. Child and parent absolute agreement was significant toP= 0.05 on 6 questions, and child and teacher on 1. There was a significant positive correlation between means of parent and teacher responses (r= 0.42,P= 0.0025) but not betweeen child and parent or child and teacher. Some consistency over time in the children's own view was found (7 questions showed significant agreement toP= 0.05). There was no significant interaction between age, gender and total score, but a significant gender difference for teacher mean score (z=‐2.31,P= 0.02) was identified. Means of parents with only one child and those with the subject and one younger child were significantly different (t= 3.48, d.f. = 23,P= 0.002). These results suggest that further investigation of methods for children to self‐report their play skills is warranted.
Heart rate response to vestibular stimulation in two children with Down's syndrome: A pilot study
Authors: Edwards Sandra Jan , Yuen Keung
Published: September 2010

This pilot study described the effects of a programmed vestibular stimulation on heart rate change in two children with Down's syndrome exhibiting congenital heart defects. The stimulation programme was applied twice weekly for eight weeks. The total amount of controlled rotary vestibular stimulation provided within each trial was approximately 1.5 minutes, and the average intensity of the stimulation was at a frequency of about 0.5 Hz. Heart rate was recorded before and after each programmed stimulation. The two children responded physiologically to stimulation: their heart rate decreased but remained within normal limits. It appeared that autonomic response as indicated by heart rate change and behavioural cues from the two children provided a safety guide for the amount and intensity of the stimulation.
Reporting qualitative research
Authors: Llewellyn Gwynnyth
Published: September 2010

Hayes' (1996) analysis of common problems and solutions in writing for publication deserves a wide readership. Her paper provides novice and experienced authors with a substantive foundation for successful manuscript preparation. Hayes' primary focus, however, reflects the positivist experimental research tradition, commonly referred to as quantitative research. In this paper, I focus on the research tradition of qualitative inquiry. I note common problems and present possible solutions in reporting qualitative research. My aim is to ease the difficulties that are frequently experienced by authors, reviewers and journal editors in preparing and reviewing qualitative research manuscripts.
Cultural issues from practice
Authors: Fitzgerald Maureen H. , Mullavey‐O'Byrne Colleen , Clemson Lindy
Published: September 2010

This paper addresses cultural issues in occupational therapy practice through a review of the occupational therapy and culture literature and a brief exploration of key issues highlighted in analyses of discussions and critical incidents in transcripts of interviews with 86 occupational therapists. The data, collected in conjunction with the Intercultural Interaction Project, highlights seven important categories of issues from the perspective of therapists: (i) professional values; (ii) family roles and responsibilities; (iii) communication; (iv) social behaviours; (v) gender; (vi) 'sick' role; and (vii) explanatory models. The importance of the therapist's personal and professional values stands out even more strongly in our data than in the occupational therapy literature. This suggests that increased awareness of personal and professional values is one of the most critical issues for the development of culturally competent practitioners and satisfying, successful intercultural interactions. Our work suggests that the development of cultural competency based on issues associated with actual events is 'best practice' for addressing the needs of all clients and practitioners.
Inter‐rater reliability of the original and modified Barthel Index, and a comparison with the Functional Independence Measure
Authors: Fricke Janet , Unsworth Carolyn A.
Published: September 2010

The Barthel Index (BI), the Modified Barthel Index (MBI) and the Functional Independence Measure (FIM) are all widely used by occupational therapists as assessment tools for clinical decision‐making and outcome measurement. All of these tools have demonstrated validity and the BI and the FIM have demonstrated inter‐rater reliability. The MBI has been modified to increase sensitivity; however, there have been no publications on the inter‐rater reliability of this tool following the changes. The purpose of this research was to examine the inter‐rater reliability of two versions of the Barthel Index, and draw some comparisons between this assessment tool and the FIM. Twenty‐five patients with neurological and orthopaedic conditions were assessed by three occupational therapists using the three tools. The method of analysis selected was percentage agreement and intraclass correlation coefficient. The results indicated that both the original and modified versions of the Barthel Index possess good inter‐rater reliability. As all three tools have demonstrated adequate reliability and validity, it is suggested that clinicians select the most sensitive tool that best meets their clinical needs, and use this assessment tool in its standardized format.
Clarifying ambiguity in problem fieldwork placements: Picking up and dealing with problem signals
Authors: Drake Vaile , Irurita Vera
Published: September 2010

Grounded theory methodology was used to explore the experience of fieldwork supervisors dealing with 'problem' students. Seventeen supervisors were interviewed and further data were derived from informal observation and relevant literature. What the participants in this study found difficult was ambiguity or uncertainty about the student's performance and other issues related to the fieldwork placement. The ambiguity was managed by a clarification process that occurred in three phases: the pinpointing phase during the placement, the deciding phase at the end of the placement and the closing phase after the completion of the placement. Ambiguity was evoked in the supervisors when they first picked up signals of potential problems. Discussion focuses on strategies aimed at picking up signals early enough to facilitate the clarifying process and thereby preventing the supervisor's self‐doubt and personal sense of failure.
An application of the model of human occupation to fieldwork supervision and fieldwork issues in NSW
Authors: Mackenzie Lynette
Published: September 2010

Occupational therapists in New South Wales (NSW), both clinicians and academics, find themselves in the position of adapting to the continually increasing demands for sufficient fieldwork opportunities for students. There are now four occupational therapy undergraduate programmes in NSW presenting further challenges for the supply of fieldwork placements. In response to this situation, the NSW Fieldwork Issues Group was formed to address issues arising for all involved. This paper is a result of initial attempts by members of the group to identify and explore the major issues confronting fieldwork supervisors, in order to develop some strategies for managing the changes taking place in NSW. In an effort to clarify the issues involved, a variety of models were considered and the 'model of human occupation' was applied. This paper presents, briefly, the reasons for choosing this model and details its potential application to issues facing fieldwork supervisors in NSW and the implications for fieldwork supervision within the occupational therapy profession as a whole.
The contribution of occupational therapy to the fabric of Australian rural and remote communities
Authors: Millsteed Jeannine
Published: September 2010

Social justice has provided a basis for the underlying values of occupational therapy in Australia. In the 1990s, changes in health issues and delivery of services are causing occupational therapists to reconsider their values and the ways they deliver their services. By any measure, the health status of individuals in rural and remote communities of Australia is poorer that their urban counterparts. The issues associated with the poor health status of these communities will best be addressed through a combined strategic approach by governments, organizations and professional groups, including occupational therapy. Identification of some of the key issues affecting the supply of occupational therapists in rural and remote communities and how they might be addressed are discussed. It is proposed that the development of cohesive national strategies and actions aimed at enhancing the contribution of occupational therapy to rural and remote communities ought to include, among other things, adoption of the primary health care approach, fundamental changes in the education and preparation of practitioners for practice, and identification of competencies and standards for effective rural and remote practice.
First year occupational therapy students: Profile and perceptions
Authors: Fleming Jennifer , Gilbert Jillian , McKenna Kryss , Heath Trevor
Published: September 2010

A class of first year occupational therapy students were surveyed to explore their backgrounds, attitudes to disability and perceptions of the characteristics of a successful occupational therapist, factors underlying their decision to study occupational therapy, and course‐related and career expectations. Of 83 students, most were female, under 20 years of age and from a middle‐class background. Their attitudes towards people with disability were generally positive. Their decision to study occupational therapy was largely made at the end of their formal schooling and was based on altruistic and practical influences. Their expectations of the course appeared accurate and, in terms of their future career, most students expressed a desire to work in either paediatric or adult physical areas. These students will be surveyed again during the course and as graduate therapists to monitor their attitudes and the unfolding of their career paths.
Assessing disability status: The reliability of the Multiple Sclerosis Disability Profile
Authors: Wollin Judy
Published: September 2010

The present study reports on the reliability of the Multiple Sclerosis Disability Profile. Multiple sclerosis (MS) is an enigmatic disease that affects people differently. The Disability Profile is a 68 item assessment instrument with the aim of providing a brief overview of the health status of an individual with MS. Internal consistency was assessed using the split‐half technique and Cronbach's alpha. The findings demonstrated excellent internal consistency. Inter‐rater reliability was assessed using Cohen's kappa. Kappa was computed with four options per item and then again with two options per item of the Disability Profile. The findings indicated that reliability was satisfactory when the responses for each item were reduced from four to two options. The recommendations are that items with poor inter‐rater reliability should be reviewed and a simpler more reliable version of the Disability Profile should be adopted.
Occupational therapists as object users: A critique of Australian practice 1954–1995
Authors: Hocking Clare , Wilcock Ann
Published: September 2010

This research sought to identify the conventions and expectations that guide Australian occupational therapists' use of objects, and to critique these against professional beliefs and values. A history of ideas methodology was used to analyse the content of a sample of issues of theAustralian Occupational Therapy Journal, spanning 42 years. This revealed that therapists have been strongly influenced by mechanistic thinking, with a resultant focus on biomechanical, neurological and functional aspects of object use, which has excluded consideration of the client's subjective experience of using objects and the symbolic meaning of the objects used. The centrality of assistive devices, splints and formal assessments to occupational therapists' identity and professional development is also identified. Current practices are critiqued as inconsistent with respecting clients' dignity and worth.
An examination of the validity of the orrisby Manual Dexterity Test
Authors: Maiden Debra , Dyson Maree
Published: September 2010

This study examines the validity of the Morrisby Manual Dexterity Test (MMDT) to ascertain its effectiveness as a measure of hand function, within a broader Work Capacity Evaluation. This test was developed by the Morrisby Organization of the Educational and Industrial Test Services Ltd, London, in 1966. The MMDT, which aims to measure manual speed and manual skill, was tested on 15 subjects with normal function and 10 subjects known to have disabilities affecting the hands. The scores obtained were compared with results from two other commonly used hand function tests (Purdue Peg Board and Minnesota Rate of Manipulation Test). Subtests of all three tests were appropriately matched so that comparisons were meaningful. The scores from 11 subtests were related to normative data and a percentile score was established. The data were statistically analysed using Pearson correlation coefficients to examine the relationship between performance on the MMDT and the comparison tests. The scores of subjects with normal hand function and subjects with known impairment of hand function were compared on all variables. Construct validity was assessed by using the t‐test to determine whether the MMDT discriminates between the two groups. To ascertain test reliability, test‐retest scores of the MMDT manual speed and manual skill tests were compared. The findings suggest that the MMDT is a reliable but not a valid test instrument and is of questionable value in predicting hand function performance, particularly in relation to manual skill.
Impact of refugee trauma on children's occupational role as school students*
Authors: Driver Cathryn , Beltran Ruth O.
Published: September 2010

Current literature identifies a lack of knowledge and understanding of the long‐term responses to extreme trauma in children, particularly from an occupational therapy perspective. Five school children participated in the present study to explore and describe a child's occupational performance as a school student following their experience of refugee trauma. The study used semi‐structured, indepth interviews with the children, parents and teachers. The interviews were combined with participant observation within various school environments. The results indicate that a child's student role performance can be affected by the experience of refugee trauma. Effects were manifested in various ways, such as poor academic performance, gross motor problems and difficulty interacting with peers. It is critical that occupational therapists recognize their potential contribution in meeting the needs of children from politically troubled countries who have experienced trauma. Opportunities to work with these children are suggested, as are avenues for further research.
Improved feeding ability in adults with acquired brain damage: Two case studies
Authors: Yuen Hon Keung , D'Amico Mariana
Published: September 2010

Severe feeding difficulties exhibited by persons with acquired brain damage are a major concern for occupational therapists working in postacute rehabilitation settings. Clients with feeding difficulties may exhibit increased risks of life‐threatening situations, such as aspiration, and demand an enormous amount of supervision. In the present paper, two cases are presented to illustrate the use of a combination of an applied behaviour analysis approach with utensil adaptation or cognitive retraining to enhance independent self feeding. In the first case, the applied behaviour analysis approach of shaping procedure followed by the provision of adaptive utensils is used to improve self‐feeding compliance of a man with severe ataxia. In the second case, the applied behaviour analysis approach of paced‐prompting and the cognitive retraining approach of the re‐auditorization technique are used to improve the mealtime behaviour of a woman whose lack of self‐monitoring skills were severely affecting her safety in self feeding.
Preparing students for their first fieldwork placement using on‐campus practicums
Authors: Cook Catherine , Cusick Anne
Published: September 2010

The present study describes and evaluates a programme that aimed to help students make best use of the scarce professional resource of fieldwork placements, in particular the first placement. The placement used a model of self‐directed learning as a foundation principle. An on‐campus clinical practicum programme was developed following a needs analysis to facilitate attainment of clinical competencies that were a prerequisite to placement commencement. Student self ratings of comfort in doing specific tasks before and after the practicum programme were obtained. Student and supervisor ratings of performance in specific tasks after placement were also made. In addition, supervisors were asked to rate the level of self‐directedness of students. Results demonstrate the positive impact of the programme in preparing students for their first placement. Supervisors identified high levels of performance on specified tasks and a view that the students were more self directed than other novice students they had supervised. Recommendations are made for the continuation and further development of the practicum programme.
Seed germination and dispersal strategy of Trillium apetalon (Trilliaceae): a typical temperate woodland perennial in Japan
Authors: SUZUKI KOJIRO , KAWANO SHOICHI
Published: September 2010

Seed dispersal and germination mechanisms of Trillium apetalon Makino were investigated in field populations and under experimental conditions. Seeds mature in mid‐June in lowland populations, and in late July to early August in montane to subalpine populations. In the field, seed dispersal and germination proceed in distinct phases. Mature seeds, each with a large soft seed elaiosome, are dispersed by ants. Following dispersal, the radicle elongates first, but the cotyledon is still covered with the seed coat. The first true leaf (plumule) develops, and then the cotylendon (d) disappears. Subsequently, the first radicle (b) disappears, but a single new root (bl) is formed, with an old radicle trace (f). Finally, the first radicle disappears completely and then a single root is formed. Approximately 70% of all seeds produced germinated in the field. Approximately half germinated in the autumn following dispersal and approximately 20% of the remaining seeds germinated in early summer, but a few remaining seeds germinated in late summer of the succeeding year, more than a year and half after seed dispersal. Light conditions did not affect germination, but seeds lost their viability under dry storage conditions. In the field, litter cover may be important because it moderates temperature and retains moisture. The hydrocarbons contained in the seed elaiosome obviously play a role, attracting ants for seed dispersal.
The cost of being a caring mother: the ignored factor in the reproduction of marine invertebrates
Authors: Fernández M. , Bock C. , Pörtner H.‐O.
Published: September 2010

Investment in reproduction ranges from gamete production to active parental care, and marine invertebrates span this range. However, the cost of parental care has not yet been systematically quantified, nor incorporated into life history studies of marine invertebrates, in contrast to most other animal taxa. Since oxygen is a limiting factor in egg masses of marine invertebrates, we studied patterns of oxygen partial pressure over time in embryo masses of Brachyuran crabs, and correlated these results with the cost of providing oxygen to the embryos. We found that: (1) oxygen is limiting in the embryo masses, (2) female crabs show an active brooding behaviour that we think helps to provide oxygen to the embryo mass, and (3) there is a substantial parental investment associated with brooding behaviours. Oxygen limitation and parental investment seem to be associated in many taxa of marine invertebrates, and we suggest that oxygen provision to the embryos may be a critical factor determining parental investment in this group.
SHORT COMMUNICATION: Normal aerobic bacterial conjunctival flora in the Crab‐eating raccoon (Procyon cancrivorus) and Coati (Nasua nasua) housed in captivity in pernambuco and paraiba (Northeast, Brazil)
Authors: Spinelli Taciana P. , Oliveira‐Filho Edmilson F. , Silva Davi , Mota Rinaldo , Sá F. B.
Published: September 2010

Objective To determine the normal aerobic bacterial conjunctival population of the Coatis and the Crab‐eating raccoons housed in captivity in the Pernambuco and Paraiba states of Brazil.

Animals studied Ten healthy Coatis and 10 healthy Crab‐eating raccoons were selected for this study. Animals are from three zoos situated at the Pernambuco and Paraiba States in the north‐east of Brazil.

Procedures After ophthalmologic examination, swabs from healthy animals were carefully collected in order to avoid contamination. Samples were identified and submitted to the laboratory. Swabs were plated for culture on ovine blood agar (8%) and agar Levine and incubated at 37 °C and observed 24 and 48 h.

Results Staphylococcusspp. was the most common microorganism isolated from conjunctival sac.Shigellaspp. comprised the Gram‐negative genera isolated.Escherichia coliwere isolated from the right eye of one Coati that had no growth at contralateral eye. Nine eyes from coatis and 10 from Crab‐eating raccoons had no microorganisms isolated.

Conclusion Our results were in accordance with previous studies indicatingStaphylococcussp., followed byCorynebacteriumspp. as the most common inhabitant of the eyes of most mammalian species.
B‐mode ultrasonography biometry of the Amazon Parrot (Amazona aestiva) eye
Authors: Lehmkuhl Ricardo C. , Almeida Mariana F. , Mamprim Maria J. , Vulcano Luiz C.
Published: September 2010

Purpose Ultrasonographic evaluation of the eye is a relatively recent addition to routine ophthalmic diagnostics in small animal ophthalmology. Some parameters for ophthalmic biometry have been established. There are few studies in clinical avian ophthalmology that describe ultrasound images of eye in some nocturnal avian species and in other birds that do not belong to the Brazilian fauna, but the psittacine family is not represented. The purpose of this study was to describe the following measurements: the distances between cornea and anterior lens capsule (D1) between the anterior and posterior lens capsule (D2), between posterior lens capsule and optic papilla (D3) and the axial length.

Method Sixty four transpalpebral ocular ultrasound examinations were performed on 32 Blue fronted Amazon parrots (Amazona aestiva) with no history of previous ophthalmic disease.

Result and Discussion The measurements were taken in sagital planes using a 10 MHz linear probe without a standoff pad. The mean values for the left eye were; D1 0.17 ± 0.03 cm, D2 0.35 ± 0.02 cm, D3 0.73 ± 0.04 cm and the axial length 1.26 ± 0.06 cm. In the right eye D1 0.17 ± 0.02 cm, D2 0.34 ± 0.02 cm, D3 0.74 ± 0.03 cm and the axial length 1.25 ± 0.05 cm. No significant statistical difference was observed among the birds or between the left and right eye. The description of these parameters will allow the veterinary practitioner to evaluate the structural changes that specific diseases may cause in these animals.
Bilateral mydriasis in common buzzards (Buteo buteo) and little owls (Athene noctua) induced by concurrent topical administration of rocuronium bromide
Authors: Barsotti Giovanni , Briganti Angela , Spratte Johanna Roselinde , Ceccherelli Renato , Breghi Gloria
Published: September 2010

Objective To evaluate the achievement of a bilateral mydriasis in raptors induced by a concurrent topical application of rocuronium bromide and to assess any side effects that might result from its use.

Animals studied Ten healthy adult common buzzards (Buteo buteo) and 10 healthy adult little owls (Athene noctua).

Procedures Common buzzards (Group 1) received a single dose of 0.40 mg of rocuronium bromide in each eye (total dose 0.80 mg/bird), whereas the little owls (Group 2) received a single dose of 0.20 mg in each eye (total dose 0.40 mg/bird). The drug was topically instilled in all the birds of both groups. The pupil diameter was measured with a pupillary gauge and the assessment of the pupillary light reflexes was performed using a standard light source.

Results Maximal pupillary diameter was 8.10 ± 0.56 mm in the right eye and 8.05 ± 0.59 mm in the left eye for Group 1 and 10.0 ± 0.75 mm in both eyes for Group 2. No statistical differences were evidenced between the achieved pupillary diameters of both eyes in each group. The maximal pupillary diameter was achieved at T110 min and T40 min for Groups 1 and 2, respectively. The drug did not cause noticeable adverse effects in the examined birds.

Conclusions A single concurrent topical administration of rocuronium bromide to the eyes of the examined birds induced a complete bilateral mydriasis in both eyes without causing any adverse effect.
Characterization of progressive keratitis in Otariids
Authors: Colitz Carmen M. H. , Renner Michael S. , Manire Charles A. , Doescher Bethany , Schmitt Todd L. , Osborn Steven D. , Croft Lara , Olds June , Gehring Erica , Mergl June , Tuttle Allison D. , Sutherland‐Smith Meg , Rudnick Jens Christian
Published: September 2010

Objective  To characterize a form of progressive keratitis that occurs commonly in otariids.

Materials and methods  One hundred and thirteen captive otariids were evaluated by ophthalmologic examination and digital photography.

Results  Forty‐six females and 67 males were in the reference population, average age of 14 years. California sea lions predominated (n = 100); there were also six Steller sea lions, five brown fur seals, one Guadalupe fur seal and one northern fur seal. Three stages of progressive keratitis are described. Overall, 64.6% animals and 142 eyes from 113 animals (62.8%) were affected with one of three stages. The mildest form, Stage 1 keratitis, occurred in 78 of 226 eyes (34.5%); the intermediate Stage 2 keratitis occurred in 30 of 226 eyes (13.3%); and the most severe, Stage 3 keratitis, occurred in 34 of 226 eyes (15%). All but six animals had bilateral disease. Animals with Stage 1 keratitis were significantly younger than those in more advanced stages.

Discussion  ‘Otariid Keratitis’ occurs in all populations of eared seals evaluated. A large‐scale epidemiological study is ongoing to identify the risk factors that contribute to this disease. Exposure to chronic sunlight appears to be an important risk factor as shade diminishes clinical signs; animals kept out of sunlight the majority of the time have less severe clinical signs. Age may be important since exposure accumulates with aging. Progression of the disease is also associated with secondary opportunistic bacterial and fungal infections. The surface immune system may be imbalanced contributing to these infections and progression.
Ultrasonographic aspects and biometry of Striped owl’s eyes (Rhinoptynx clamator)
Authors: Squarzoni Renata , Perlmann Eduardo , Antunes Andrea , Milanelo Liliane , De Moraes Barros Paulo Sérgio
Published: September 2010

Objective To report the biometric values and ultrasonographic aspects of the normal eye of the Striped owl (Rhinoptynx clamator).

Sample population Twenty‐seven healthy, free‐living, adult Striped owls from the Ecological Park of Tiete Veterinary Ambulatory (Sao Paulo, Brazil).

Procedures Both eyes of all owls underwent B‐mode ultrasonographic examination and biometry was performed for lens axial length (WL), depth of the anterior (AC) and vitreous (VC) chambers, axial length of the globe (LB) and the pecten oculi (LP) of both eyes, using a 12 MHz probe. The owls were manually restrained without sedation and the eyes were topically anesthetized.

Results Biometric and statistical findings were as follows: in the left eye, the means and standard deviations were: LB = 23.76 ± 0.92 mm, WL = 7.79 ± 0.27 mm, AC = 4.27 ± 0.47 mm, VC = 11.36 ± 0.29 mm and LP = 5.69 ± 0.50 mm; in the right eye, the values were: LB = 24.25 ± 0.79 mm, WL = 8.03 ± 0.40 mm, AC = 4.56 ± 0.52 mm, VC = 11.40 ± 0.25 mm, and LP = 5.68 ± 0.41 mm. No significant differences were found between left and right eyes measurements of LB, WL, AC, VC, and LP dimensions.

Conclusions Ocular ultrasound aspects and biometric values of the Striped owl are reported. The study’s results provide means for various ocular measurements. The ultrasound is an easy and safe exam to be performed in the Striped owl’s eyes.
Delayed haemorrhage after laparoscopic partial nephrectomy: frequency and angiographic findings
Authors: Montag Sylvia , Rais‐Bahrami Soroush , Seideman Casey A. , Rastinehad Ardeshir R. , Vira Manish A. , Kavoussi Louis R. , Richstone Lee
Published: September 2010

Study Type – Therapy (case series)  Level of Evidence 4

What’s known on the subject? and What does the study add?

Delayed haemorrhage has not been well defined in the literature, clinical presentation has not been well described and treatment algorithms are lacking. From our experience we have shown that patients presenting with delayed bleeding after laparoscopic partial nephrectomy will need definitive rather than conservative treatment and angiographic findings demonstrate definitive lesions in all cases. Potential benefits include faster diagnosis and initiation of definitive treatment (angiography with embolization), avoiding repeat computed tomography imaging as it adds little in such patients and reducing need for prolonged hospitalization.

OBJECTIVES

• To determine the frequency of delayed postoperative haemorrhage requiring selective angioembolization (SAE) after laparoscopic partial nephrectomy (LPN).

• To describe the clinical presentation and characterize the angiographic findings encountered in this setting.

PATIENTS AND METHODS

• Prospective data from 640 LPNs performed between August 1993 and May 2009 were retrospectively analyzed, from which patients with delayed postoperative haemorrhage (defined as ‘gross haematuria ≥7 days postoperatively that persists for more than 24 h’) and requiring SAE were identified.

• Clinicopathological, preoperative and perioperative factors were reviewed.

• Selective catheterization and angiography of the renal artery was performed for persistent gross haematuria and for haemodynamic instability associated with a significant drop in haematocrit level.

• Arteries feeding the bleeding site were identified and embolized with endovascular coils.

RESULTS

• Patients presented with delayed haemorrhage between 7 and 30 days after surgery. SAE was required in 13 patients (2%) for delayed postoperative bleeding.

• Of the 640 LPNs, 68 (10.6%) were performed without hilar occlusion (‘off‐clamp’) of whom one (1.5%) had a delayed haemorrhage, which was successfully embolized.

• For patients with and without delayed haemorrhage after LPN, the mean tumour size was 2.7 cm and 3.3 cm (P= 0.31), the mean warm ischaemia time was 28.2 min and 14.3 min (P < 0.001), and the mean estimated blood loss 403.8 mL and 308.2 mL (P= 0.26), respectively.

• Percutaneous angiography showed renal artery pseudoaneurysm in 10 patients and arterial contrast extravasation in three patients, two of whom also had an arteriovenous fistula.

• Following embolization, creatinine levels remained stable in all patients.

CONCLUSIONS

• Clinically significant delayed postoperative bleeding after LPN occurs in a small percentage of patients.

• Angiography will accurately make the diagnosis of RAP or AVF and SAE is safe and effective procedure that allows for preservation of renal function.
Glycaemic variability is associated with coronary artery calcium in men with Type 1 diabetes: the Coronary Artery Calcification in Type 1 Diabetes study
Authors: Snell‐Bergeon J. K. , Roman R. , Rodbard D. , Garg S. , Maahs D. M. , Schauer I. E. , Bergman B. C. , Kinney G. L. , Rewers M.
Published: September 2010

Diabet. Med. 27, 1436–1442 (2010)

Aims  We investigated coronary artery calcium in association with glucose levels and variability measured using continuous glucose monitoring in adults with Type 1 diabetes in the Coronary Artery Calcification in Type 1 Diabetes study.

Methods  Coronary artery calcium was measured by electron beam tomography. The presence of any coronary artery calcium was analysed with respect to glucose levels [meanT (mean glucose), % of values < 3.9 mmol/l, > 10 mmol/l and either < 3.9 or > 10 mmol/l] and glycaemic variability [sdT (sd of all glucose values); sddm (sd of the daily mean glucose levels) and sdhh:mm (glucose sd for a specified time of day, over all days)] using 3–5 days of continuous glucose monitoring from 75 subjects (45 women, 30 men), age 42 ± 9 years (mean ± sd) and diabetes duration of 29 ± 8 years using logistic regression.

Results  We observed significant associations between coronary artery calcium and meanT (OR = 4.4, 95% CI 1.1–18.6), % of values > 10 mmol/l (OR = 5.5, 95% CI 1.3–22.6), % of measures < 3.9 or > 10 mmol/l (OR = 5.7, 95% CI 1.3–24.9), sdT (OR = 4.7, 95% CI 1.1–19.7), sddm (OR = 6.0, 95% CI 1.2–30.4) and sdhh:mm (OR = 4.0, 95% CI 1.1–15.4), among men, but none of these variables were associated with the presence of coronary artery calcium in women.

Conclusions  We report the novel finding that subclinical atherosclerosis is associated with glucose levels and variability in men with Type 1 diabetes. The relationship of coronary artery calcium and glucose variability in Type 1 diabetes, and potential gender differences in this association, deserve further study.
Determinants of blood glucose and insulin in healthy 9‐month‐old term Danish infants; the SKOT cohort
Authors: Madsen A. L. , Schack‐Nielsen L. , Larnkjær A. , Mølgaard C. , Michaelsen K. F.
Published: September 2010

Diabet. Med. 27, 1350–1357 (2010)

Aims  Insulin secretion is important for early regulation of growth, but high insulin concentration is also a risk factor for insulin resistance later in life. It is therefore important to better understand how insulin and glucose are associated with early diet and growth. The aim of this study was to examine blood glucose and insulin concentration in relation to anthropometric measurements, growth, breastfeeding practice and complementary feeding in 9‐month‐old infants.

Methods  This was a cross‐sectional study (SKOT cohort), examining 312 healthy term infants from the age of 9 months. Of these, 265 infants had data on insulin and glucose and were included in this study. Measurements include weight, length, skinfold thickness, waist circumference, 7‐day food records, 2‐h fasting venous glucose and insulin analysis, and questionnaire.

Results  At 9 months of age there was a strong negative association between number of breastfeedings per day and insulin concentration (P = 0.0015). Insulin concentration was positively associated to waist circumference (P = 0.042) and change in Z‐score for weight‐for‐age between 5 and 9 months (P = 0.004). Glucose concentration was positively associated to subscapular skinfold (P = 0.002) and sum of skinfolds thicknesses (P = 0.006).

Conclusion  At 9 months, breastfeeding still had a strong negative effect on insulin concentrations, which were positively associated with weight gain and current waist circumference, while glucose concentrations were associated with subcutaneous fat. These results are of interest in disentangling the association between early growth and later risk of disease.
IQ IN THE PRODUCTION FUNCTION: EVIDENCE FROM IMMIGRANT EARNINGS
Authors: JONES GARETT , SCHNEIDER W. JOEL
Published: September 2010

We show that a country’s average IQ score is a useful predictor of the wages that immigrants from that country earn in the United States, whether or not one adjusts for immigrant education. Just as in numerous microeconomic studies, 1 IQ point predicts 1% higher wages, suggesting that IQ tests capture an important difference in cross‐country worker productivity. In a cross‐country development accounting exercise, about one‐sixth of the global inequality in log income can be explained by the effect of large, persistent differences in national average IQ on the private marginal product of labor. This suggests that cognitive skills matter more for groups than for individuals.(JELJ24, J61, O47)
HOME COMPUTERS AND EDUCATIONAL OUTCOMES: EVIDENCE FROM THE NLSY97 and CPS*
Authors: FAIRLIE ROBERT W. , BELTRAN DANIEL O. , DAS KUNTAL K.
Published: September 2010

Although computers are universal in the classroom, nearly 20 million children in the United States do not have computers in their homes. Surprisingly, only a few previous studies explore the role of home computers in the educational process. Home computers might be very useful for completing school assignments, but they might also represent a distraction for teenagers. We use several identification strategies and panel data from the two main U.S. data sets that include recent information on computer ownership among children—the 2000–2003 Current Population Survey (CPS) Computer and Internet Use Supplements matched to the CPS basic monthly files and the National Longitudinal Survey of Youth 1997 (NLSY97)—to explore the causal relationship between computer ownership and high school graduation and other educational outcomes. Teenagers who have access to home computers are 6–8 percentage points more likely to graduate from high school than teenagers who do not have home computers after controlling for individual, parental, and family characteristics. We generally find evidence of positive relationships between home computers and educational outcomes using several identification strategies, including controlling for typically unobservable home environment and extracurricular activities in the NLSY97, fixed effects models, instrumental variables, and including future computer ownership and falsification tests. Home computers may increase high school graduation by reducing nonproductive activities, such as truancy and crime, among children in addition to making it easier to complete school assignments (JEL I2).
TYING IN TWO‐SIDED MARKETS WITH MULTI‐HOMING*
Authors: CHOI JAY PIL
Published: September 2010

This paper analyzes the effects of tying on market competition and social welfare in two‐sided markets when economic agents can engage in multi‐homing by participating in multiple platforms to reap maximal network benefits. The model shows that tying induces more consumers to multi‐home and makes platform‐specific exclusive content available to more consumers, which is beneficial to content providers. As a result, tying can be welfare‐enhancing if multi‐homing is allowed, even in cases where its welfare impacts are negative in the absence of multi‐homing. The analysis thus can have important implications for recent antitrust cases in industries where multi‐homing is prevalent.
Celtic Nationalism and Supranationalism: Comparing Scottish and Northern Ireland Party Responses to Europe
Authors: Hepburn Eve , McLoughlin P. J.
Published: September 2010

This article explores how stateless nationalist parties in the ‘Celtic periphery’ of Scotland and Northern Ireland have used Europe to advance their territorial projects. Despite vastly different historical, political and social contexts, the Scottish National Party and Northern Ireland's Social Democratic and Labour Party have both advanced a pro-European, social democratic discourse that emphasises the importance of Europe as a framework for constitutional reform and shared sovereignty. However, in recent years the parties have diverged on Europe. While the SDLP has continued its principled commitment to further integration, the SNP has articulated an increased criticism of the supranational project. This divergence in party attitudes reveals the extent to which the pro-European dimension of Celtic nationalism is ideological or opportunistic.
A Psychologically Based Model of Voter Turnout
Authors: LI MING , MAJUMDAR DIPJYOTI
Published: September 2010

We analyze a psychologically based model of voter turnout. Potential voters experience regret if they fail to vote, which is the motivation for participation in voting. Regret from abstention is inversely related to the margin of victory. Voters on the winner's side experience less regret than those on the loser's side. We show that the unique equilibrium involves positive voter turnout. We show that the losing side has higher turnout. In addition, voter turnout is positively related to importance of the election and the competitiveness of the election. We also consider scenarios in which voters are uncertain about the composition of the electorate's political preferences and show similar phenomena emerge.
Measuring Inequality Using Censored Data: A Multiple-Imputation Approach to Estimation and Inference
Authors: Jenkins Stephen P. , Burkhauser Richard V. , Feng Shuaizhang , Larrimore Jeff
Published: September 2010

To measure income inequality with right-censored (top-coded) data, we propose multiple-imputation methods for estimation and inference. Censored observations are multiply imputed using draws from a flexible parametric model fitted to the censored distribution, yielding a partially synthetic data set from which point and variance estimates can be derived using complete-data methods and appropriate combination formulae. The methods are illustrated using US Current Population Survey data and the generalized beta of the second kind distribution as the imputation model. With Current Population Survey internal data, we find few statistically significant differences in income inequality for pairs of years between 1995 and 2004. We also show that using Current Population Survey public use data with cell mean imputations may lead to incorrect inferences. Multiply-imputed public use data provide an intermediate solution.
A Multiresolution Approach to Time Warping Achieved by a Bayesian Prior–Posterior Transfer Fitting Strategy
Authors: Claeskens Gerda , Silverman Bernard W. , Slaets Leen
Published: September 2010

Warping is an approach to the reduction and analysis of phase variability in functional observations, by applying a smooth bijection to the function argument. We propose a natural representation of warping functions in terms of a new type of elementary functions named ‘warping component functions’, or ‘warplets’, which are combined into the warping function by composition. The inverse warping function is trivial and explicit to obtain. A sequential Bayesian estimation strategy is introduced which fits a series of models and transfers the posterior of the previous fit into the prior of the next fit. Model selection is based on a warping analogue to wavelet thresholding, combined with Bayesian inference.
Problems of a Concept of European Citizenship
Authors: Preuß Ulrich K.
Published: September 2010

Abstract: The article explores the possible content of the newly established institution of ‘Citizenship of the Union” as stipulated in Articles 8–8d of the EU Treaty. Within the broad scope of varying historical meanings which the concept of citizenship has undergone in the last two thousand years its main relevance must be found in its affiliation with the modern constitutional nation‐state and its basic political feature, namely its anti‐primordialism and its representative character. Although the European Community does not satisfy the conditions of democratic representation which are essential for the constitutional nation‐state, the idea of citizenship can acquire a new meaning within the framework of the EU in that it is disconnected both from nationality and from national identity and opens the space for actions of which the significance is no longer defined by the territorial boundaries of the nation‐state.
Does Europe Need a Constitution?
Authors: Grimm Dieter
Published: September 2010

Abstract: In what has become known as the ‘Maastricht II’ debate the call for a European constitution plays a great part. Often it is even expected to provide the solution to Europe's democracy problem. This paper looks at the calls for a constitution and asks how far they are already met by the Treaties and what consequences fully meeting them would have for the Union and the Member States.
Skill: the solution to low wage work?
Authors: Lloyd Caroline , Mayhew Ken
Published: September 2010

During the UK Labour government's 13 years in power, raising skill levels was seen as the principal mechanism to improve the position of workers stuck in low wage jobs. This article draws together research undertaken in low wage sectors to question the assumptions that underlay Labour's approach to low pay.
Combination of skin, joint and quality of life outcomes with etanercept in psoriasis and psoriatic arthritis in the PRESTA trial
Authors: Prinz JC , FitzGerald O , Boggs RL , Foehl J , Robertson D , Pedersen R , Molta CT , Freundlich B
Published: September 2010

Background  Psoriasis and psoriatic arthritis (PsA) affect skin, and/or joints and quality of life (QoL).

Objective  To better assess the success in multiple attributes in subjects with both active psoriasis and PsA, the objective was to quantify the proportion of those who achieved substantial improvement in a composite measure of skin symptoms, joint manifestations, and QoL, on one of two treatment regimens.

Methods  Subjects (n = 752) with psoriasis and PsA (mean age: 46.5 years, 62.9% male) received etanercept (ETN) 50 mg twice weekly (BIW; n = 379) or 50 mg weekly (QW; n = 373) for 12 weeks, followed by open‐label ETN 50 mg QW for 12 weeks. Skin and joint symptoms and QoL were assessed using psoriasis area and severity index (PASI), American College of Rheumatology criteria (ACR) and Euro‐QoL (EQ‐5D), respectively.

Results  By week 24, 30.6% and 25.8% of subjects receiving ETN 50 mg BIW/QW and ETN 50 mg QW/QW, respectively (P = 0.198) achieved the composite measure of efficacy for skin plus joints plus QoL (PASI 75 + ACR 50 + EQ‐5D VAS >82).

Conclusion  At 24 weeks, 25.8–30.6% met the triad of rigorous efficacy outcomes. Evaluation of treatment efficacy should address the multiple components of this disease complex; therefore it may be important to consider this composite measure in future trials.