bluuebunny/crossref_metadata_2025 huggingface dataset:
The Fair Transaction Model of Informed Consent: An Alternative to Autonomous Authorization
Authors: Miller Franklin G. , Wertheimer Alan
Published: February 2012

The doctrine of informed consent in bioethics has relied on the view that consent is valid when it represents a patient or research subject’s autonomous authorization. In this article we challenge this reigning conception of the validity of informed consent in clinical research, focusing in particular on the problem of the therapeutic misconception. We argue that the autonomous authorization model of informed consent suffers from four defects: (1) it fails to do justice to the relevance of risk-benefit considerations in shaping the criteria for the validity of consent, (2) it compromises the interests of subjects by preventing them from consenting to research participation with less than substantial understanding when doing so would likely be consistent with their preferences and beneficial to them or at least be unlikely to cause them harm, (3) it jeopardizes the interests of investigators by denying them fair notice regarding when the consent of research subjects can be considered valid and thus make it permissible for them to be enrolled in research, and (4) it threatens the reasonable limits on the responsibility of investigators to assure the adequacy of subjects’ understanding of what research participation involves. In place of the autonomous authorization model, we present and defend a fair transaction model of informed consent, which better reflects the values served by consent.
Not Gone with the Wind: Libraries in Oklahoma in the 1930s
Authors: Finchum Tanya Ducker , Finchum Allen
Published: February 2012

Oklahoma in the 1930s dealt with severe depression and drought, both of which affected the development of the state's public libraries. While the libraries experienced growth at the beginning of the century, helped along by the contributions of women's clubs, the establishment of a state library association and agency, and funding legislation, leaner times appeared in the middle years of the 1930s. Oklahoma's libraries began to rejuvenate by the end of the decade, with an increase in services and facilities, and avoided being "gone with the wind" of the Great Depression.
The Concept of Information Literacy in Policy-Making Texts: An Imperialistic Project?
Authors: Pilerot Ola , Lindberg Jenny
Published: February 2012

Organizations such as the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the International Federation of Library Associations (IFLA) put a lot of effort in advocacy and policy making for information literacy (IL). Their ambition to foster IL can be seen as a part of a multinational educational project. By exporting a Western IL model focused on textual information sources and the use of information and communication technologies (ICTs) into non-Western contexts that to a great extent lack ICTs, the educational project for IL runs the risk of turning into an imperialistic project. A discursively oriented analysis of two prominent policy documents—discussed in the light of the so-called new imperialism and the idea of invisible technologies—indicates a standardized one-size-fits-all-model of IL. Through establishing a close contact between the policy-making strand and the research strand in the IL literature and by adhering to the broad concept of information literacies, the risk of imperialism and oppression might lessen.
From Black & White to Color and Back: What Does It Mean (not) to Use Color?
Authors: Baetens Jan
Published: February 2012

This essay deals with the form and function of color in comics, a strongly undertheorized aspect of graphic storytelling. It makes a plea for a holistic approach of color, whose use cannot be separated from the system of narrative in general. From a methodological point of view, it focuses less on the opposition between black and white and color, which is difficult to maintain for in-depth analyses, than on the shift from one system to another. It discusses two main examples that in the 1930s have similarly undergone such a paradigm shift from the monochromatic to the multichromatic, one European (Hergé) and the other American (Herriman).
Truth Made Visible: Crises of Cultural Expression in Truth: Red, White, and Black
Authors: Ryan Jennifer
Published: February 2012

Robert Morales and Kyle Baker’s 2004 graphic novel Truth: Red, White, and Black incorporates the visual vocabularies of social realism and a grotesque cartoon style in order to represent the devastating experiences of African Americans during World War II. The book’s revisionist version of the Captain America mythology depicts a black Captain, Isaiah Bradley, as not only the successful product of an experiment with super-soldier serum but also a would-be savior of Jewish concentration-camp inmates. The story both reveals the subversive potential of the Captain America story and challenges the traditions in which characters of color have been excluded from superheroic accounts of American culture by invoking some of the many real-world histories that shape accurate wartime accounts. Morales and Baker depict such histories through moments of cultural crisis, when racial identities visually oversignify the graphic boundaries that attempt to contain them, highlighting the interracial foundation of contemporary American literature.
Going Wendigo: The Emergence of the Iconic Monster in Margaret Atwood's Oryx and Crake and Antonia Bird's Ravenous
Authors: DiMarco Danette
Published: February 2012

Margaret Atwood's interpretation of the concept of becoming or going Wendigo, discussed in her work Strange Things (1995), is useful to a reading of Antonia Bird's film Ravenous (1999). This essay will first investigate Atwood's novel Oryx and Crake (2003) as an application of her own conclusions regarding the Wendigo as a cultural metaphor. Then the essay will analyze Bird's deployment of the Wendigo in her film—which, unlike Oryx and Crake , directly establishes a specific temporal and geographical setting, during the Mexican-American war in the wilds of northern California—in order to consider how the iconic Wendigo serves as a symbol for a critique of Manifest Destiny and military resistance.
Gondär Land Documents: Multiple Copies, Multiple Recensions
Authors: Crummey Donald
Published: February 2012

A comparison of two eighteenth-century land grants to churches in Gondär town are the point of departure for reflections on the creation of the documents themselves. Both grants are recorded in multiple copies—5 in one case; 9 in the other. A close reading of the documents reveals that the copies represent different stages in the development of the grant. This is particularly the case with the grant to the Church of Q w esq w am Däbrä Ṣäḥay, which, made in the 1730s and 1740s, unfolded over a period of more than ten years. The evidence concerning the Church of Bä‘ata Däbrä Ṭebäb is less striking, but still suggestive. After an indication of the wealth of social and geographic information, which the grants contain, the paper explores similarities and differences between contemporary practices of granting of land in Ethiopia and in the riverine Sudan.
The Southern Interests of the Royal Court of Ethiopia in the Light of Bərbər Maryam’s Ge’ez and Amharic Manuscripts
Authors: Ayenachew Deresse
Published: February 2012

Oral traditions recount a long period of interaction between the Ethiopian royal court and the country’s southwestern peoples. The traditions served as the basis for a late-nineteenth-century account written in Amharic, which we can compare with medieval documents in Ge’ez dating back to the fifteenth/sixteenth centuries. These documents from the Bərbər Maryam church attest the economic and political interests that the Christian kingdom of Ethiopia had in the southwest. They can be used to identify medieval chiefs in this area. Most of the small territories named in the Ge’ez documents can still be identified: Waǧ, Qogga, and Wälamo; but a few cannot: Gäda, K w äm Dahar, Q w aṣä, and Bäräza. The present article shows how written sources are related to oral traditions and can be used to reconstruct local history.
Cultural Ecology and Chinese Hamlets
Authors: Berensmeyer Ingo
Published: February 2012

This essay examines the critical potential of cultural ecology and cultural mobility studies for modeling the relations between literature and culture. It investigates the mobility and portability of literary effects across different media, periods, and cultural and geographical spaces. It intends to offer a glimpse of what a continentally informed view of cultural ecology can contribute to the understanding of literary history as a cultural history of media effects. With a view to the twofold promise of cultural ecology, it hopes to accommodate both the historical singularity of literary objects (mostly, but not exclusively, texts) and their multifarious continuations in other media configurations. As a paradigmatic example, it explores the global cultural mobility of Shakespeare. Using the example of the adaptation of Hamlet in recent Chinese films, the essay demonstrates how literary effects circulate in different media contexts across temporal and spatial distances, beyond the range of traditional literary history. In the larger framework of cultural mobility studies, these suggestions also attempt to overstep the self-imposed generic limits of current world literature studies and to find an alternative to their methodological problems.
The Correspondence of Alberto Ginastera at the Library of Congress
Authors: Schwartz-Kates Deborah
Published: February 2012

The city of Washington, D.C., held a special place in the creative life of Alberto Ginastera (1916-1983). It was there that the Argentine composer achieved many important successes, beginning with the premiere of his Second String Quartet (1958), which was commissioned by the Elizabeth Sprague Coolidge Foundation, and performed in the Library of Congress. Given these achievements, it is no surprise that Ginastera considered Washington his lucky city. The U.S. capital also proves providential for Ginastera researchers, since much of the documentation about the composer's U.S. activities is housed at the Library of Congress. This article explores the highlights of the Ginastera letters at LC—a resource that yields fresh perspectives into the composer's connections with music and musicians from the United States. Ginastera's letters to Aaron Copland open a window into the composer's relationship with his teacher, mentor, and friend. His correspondence with Harold Spivacke illustrates the role that the former chief of the LC Music Division played in shaping his career. Together these collections offer a glimpse into the interior world of a musician whose thoughts and words are little known. They illuminate important moments of his life, reveal insights into his creative process, and question traditional assumptions about his musical development.
Mohist Care
Authors: Robins Dan
Published: February 2012

This essay refutes the widely held view that the Mohist doctrine of inclusive care ( jian ai 兼愛) rules out any special preference for those close to us, especially family. Family values such as filial piety were in fact extremely important for the Mohists, as is clear even in their writings on inclusive care. Caring inclusively involved taking up a social perspective by committing oneself to collective norms that, if widely followed, would secure everybody’s well-being. This would not be a pure form of altruism, since many people would be able to care inclusively for others only if they could in turn benefit from other people’s care. This distinguishes the inclusive from the truly benevolent, who would remain benevolent regardless of how other people treat them. Understood, as it is argued here that we should, the Mohist doctrine of inclusive care provides a compelling account of how we should concern ourselves with one another’s well-being in a society in which caring attitudes are sufficiently widespread.
Learning Behaviors and Learning Spaces
Authors: Bennett Scott
Published: February 2012

What specific learning behaviors are important to students and faculty members? Does the campus provide spaces that foster these behaviors? Where are those spaces? Asking these three questions at six colleges and universities reveals notable differences in the ways students and faculty members answer them. Student and faculty member answers also reveal how narrowly and unevenly their institutions provide supportive learning spaces beyond the classroom. Their answers suggest a fundamental misalignment between learning behaviors identified as important and the campus spaces that can be a chief asset or a serious liability in achieving institutional mission.
Comparative Recall and Precision of Simple and Expert Searches in Google Scholar and Eight Other Databases
Authors: Walters William H.
Published: February 2012

This study evaluates the effectiveness of simple and expert searches in Google Scholar (GS), EconLit, GEOBASE, PAIS, POPLINE, PubMed, Social Sciences Citation Index, Social Sciences Full Text, and Sociological Abstracts. It assesses the recall and precision of 32 searches in the field of later-life migration: nine simple keyword searches and 23 expert searches constructed by demography librarians at three top universities. For simple searches, Google Scholar’s recall and precision are well above average. For expert searches, the relative effectiveness of GS depends on the number of results users are willing to examine. Although Google Scholar’s expert-search performance is just average within the first fifty search results, GS is one of the few databases that retrieves relevant results with reasonably high precision after the fiftieth hit. The results also show that simple searches in GS, GEOBASE, PubMed, and Sociological Abstracts have consistently higher recall and precision than expert searches. This can be attributed not to differences in expert-search effectiveness, but to the unusually strong performance of simple searches in those four databases.
Responsibility Without Blame: Empathy and the Effective Treatment of Personality Disorder
Authors: Pickard Hanna
Published: February 2012

Abstract:
Effective treatment of personality disorder (PD) presents a clinical conundrum. Many of the behaviors constitutive of PD cause harm to self and others. Encouraging service users to take responsibility for this behavior is central to treatment. Blame, in contrast, is detrimental. How is it possible to hold service users responsible for harm to self and others without blaming them? A solution to this problem is part conceptual, part practical. I offer a conceptual framework that clearly distinguishes between ideas of responsibility, blameworthiness, and blame. Within this framework, I distinguish two sorts of blame, which I call ‘detached’ and ‘affective.’ Affective, not detached, blame is detrimental to effective treatment. I suggest that the practical demand to avoid affective blame is largely achieved through attention to PD service users’ past history. Past history does not eliminate responsibility and blameworthiness. Instead, it directly evokes compassion and empathy, which compete with affective blame.
Predictors of Fathers' Use of Parental Leave in Germany
Authors: Reich Nora
Published: February 2012

The aim of this study is the identification of socio-economic and workplace-related predictors of the fathers' use of parental leave after the introduction of the Parental Allowance and Parental Leave Act in Germany in 2007. This reform implied a paradigm shift in German family policy and led to a sharp increase in the share of leave taken by fathers. Using the 2008 German Microcensus database, three logistic models are developed, including all fathers, working fathers, and fathers in dual-earner couples, respectively. The dependent variable distinguishes between fathers who were on parental leave at the time of the interview and those who were not. Many of each father's personal characteristics and workplace-related variables as well as some of his partner's attributes increase the odds of using parental leave significantly. Especially the female partner's full-time employment and income have a strong positive impact. Overall, the findings are in part consistent with existing empirical studies from Scandinavian countries and Germany under the former legislation.
Ladies and Lynching: Southern Women, Civil Rights, and the Rhetoric of Interracial Cooperation
Authors: Jack Jordynn , Massagee Lucy
Published: February 2012

As a women's antilynching association in the 1930s, the Association of Southern Women for the Prevention of Lynching ( ASWPL ) developed a repertoire of rhetorical strategies to encourage communication between their white supporters and their African American counterparts. These strategies included choices that may not seem overtly rhetorical, but can nonetheless be understood as laying the groundwork for communication between groups. Strategies such as choosing meeting facilities, composing official statements, and listening to guest speakers helped members to forge common ground, but ultimately, larger disagreements prevented the ASWPL supporters from reaching consensus with African American campaigners who were pushing for federal antilynching legislation. Nonetheless, this example contributes to scholarship on the rhetoric of the civil rights movement by highlighting the importance of interracial communication as a rhetorical practice.
Obama at West Point: A Study in Ambiguity of Purpose
Authors: Ivie Robert L.
Published: February 2012

The progressive form and corresponding theme of transition in Barack Obama's West Point address—especially in the context of his speeches in Cairo, at the United Nations, and in Oslo—insinuated an attitude of peace, which conflicted with his announcement of a new war-fighting strategy in Afghanistan. The resulting ambiguity of purpose about a way forward in and out of Afghanistan tilted the president's rhetoric toward the mindset of war but left open and unresolved the embedded question of peace building. This rhetorical exercise in strategic ambiguity, understood as an episode of symbolic action, managed immediate political tensions while keeping open presidential options for adapting to changing circumstances in a dynamic situation.
Organizational Factors and Instructional Decision-Making: A Cognitive Perspective
Authors: Hora Matthew Tadashi
Published: February 2012

Given the limited adoption of research-based teaching methods at the postsecondary level, research is necessary that examines why faculty choose to teach the way they do. In this article, I draw on insights from research on teacher cognition and naturalistic decision-making research to identify how perceptions of organizational factors influence instructional decision-making. Results indicate that respondents perceive structural and socio-cultural factors as constraining and affording practice by exerting normative pressures on teaching decisions, imposing logistical constraints, and encouraging autonomy. The relationship between these factors and teaching practice was moderated by factors such as status and other individual characteristics.
The Whiteness of the Soldier-Speaker in Brian Turner's Here, Bullet
Authors: Najmi Samina
Published: February 2012

In Brian Turner's collection of Iraq War poems Here, Bullet (2005), the soldier-speaker minimizes his white military subjectivity in order to preserve his own individuality. Turner meets the representational challenges of first-hand war poetry through his emphasis on narrative descriptions, his focus on natural objects and mundane particularities, juxtaposed with references to ancient Iraqi culture, and through the surrealism of his imagery. Together, these poetic strategies enable him to process and articulate his experiences in Iraq without succumbing to the paradoxically empowering and obliterating effects of his own uniformed whiteness in occupied Iraq. In the process, Turner gives space to a multiplicity of "observation posts" that decenter the lyric consciousness and enable the reader's empathy.
Geographies of Race in the American South: The Continuing Legacies of Jim Crow Segregation
Authors: Inwood Joshua F. J.
Published: February 2012

El estudio moderno del Sur de los Estados Unidos ha experimentado un resurgimiento en la geografía a lo largo de una década, y ha llegado a ser definido por interrogantes sobre desigualdad y justicia social. Este resurgimiento representa un enfoque innovador para la disciplina geográfica, de cual las bases, contribuyen a los ampliamente teorizados justicia social / acercamiento geográfico crítico. A partir de esta base, el presente documento incorpora acercamientos metodológicos e intelectuales recientes con el Sur de los Estados Unidos a través de un enfoque en la Constitución del Estado de Alabama de 1901, en un esfuerzo por esbozar la actividad académica basada en la justicia social. La Constitución de 1901creó la justificación legal para la segregación de las razas, y fue el producto de la ideología de la supremacía blanca. Esto en sí mismo es irrelevante. Casi todas las constituciones de los estados del sur fueron escritas en circunstancias similares. En cambio, lo que hace la Constitución del Estado de Alabama un estudio de caso interesante es el hecho de que nunca se volvió a escribir. Por lo tanto, la Constitución de Alabama es un ejemplo de cómo el legado de la segregación de Jim Crow, y la supremacía blanca que dieron paso a una mayor desigualdad política, social, y económica, sigue presente en los paisajes del Sur de los Estados Unidos. Finalmente, este trabajo es una oportunidad para pensar acerca de los legados generales de la desigualdad en el Sur de los Estados Unidos, y cómo el legado del desplazamiento y la segregación racial siguen funcionando mucho tiempo después de que los últimos vestigios de la segregación fueron supuestamente eliminados.
Discriminating Appraisals: Cartography, Computation, and Access to Federal Mortgage Insurance in the 1930s
Authors: Light Jennifer
Published: February 2012

Histories of the emergence of national standards for underwriting at the US Federal Housing Administration (FHA) during the 1930s focus on the discriminatory aspects of agency practices. Yet the officials who designed the FHA’s risk-rating system believed they were building a neutral tool to ensure quality control in lending. This article situates risk-rating within the history of real estate science and technology, and links the agency’s risk-mapping techniques to the era’s similarly aspirational social “science,” to reveal how discriminatory practices could be regarded as apolitical. Its account of the FHA’s risk-rating system in general and neighborhood risk-rating in particular provides a compelling addition to studies of statistics and social control. This article’s broader insights into maps’ uses for social data-processing argue for including cartography alongside other twentieth-century computational tools.
Staging the "Cartography of Paradox": The DMZ Special Exhibition at the Korean War Memorial, Seoul
Authors: Kim Suk-Young
Published: February 2012

The Korean Demilitarized Zone (DMZ) may be a small strip of land, but it is one of the most dramatic spaces on earth, simultaneously standing for the devastating traumas of war and an activist movement for peace and environmentalism. Using the 2010 DMZ Special Exhibition at the Korean War Memorial in Seoul as a case study, this essay examines South Korea's strategic staging of discursive memories of the Korean War in a museum space, where certain performative conditions illuminate the immanent absurdities of the Korean partition. The central questions concern the curatorial design of the exhibition, especially the ways by which spectators are conditioned, both ideologically and kinesthetically, to recall events in history that few of the exhibition visitors experienced firsthand. What happens when the exhibition's mise en scène controls spectators' experiences of recent Korean history—namely, the partition of Korea and the subsequent creation of the DMZmdash;so completely that it potentially alters their perceptions of the historic past and hopes for the future? More broadly, the essay asks how the performative embodiment of memory, often aided by new technologies of seeing, might shift the chronological orientation of museum and memorial spaces. Finally, the essay asks whether museums and memorials that commemorate past events should also speculate on the future.
Improved Sequence Learning with Subthalamic Nucleus Deep Brain Stimulation: Evidence for Treatment-Specific Network Modulation
Authors: Mure Hideo , Tang Chris C. , Argyelan Miklos , Ghilardi Maria-Felice , Kaplitt Michael G. , Dhawan Vijay , Eidelberg David
Published: February 2012

We used a network approach to study the effects of anti-parkinsonian treatment on motor sequence learning in humans. Eight Parkinson's disease (PD) patients with bilateral subthalamic nucleus (STN) deep brain stimulation underwent H215O positron emission tomography (PET) imaging to measure regional cerebral blood flow (rCBF) while they performed kinematically matched sequence learning and movement tasks at baseline and during stimulation. Network analysis revealed a significant learning-related spatial covariance pattern characterized by consistent increases in subject expression during stimulation (p= 0.008, permutation test). The network was associated with increased activity in the lateral cerebellum, dorsal premotor cortex, and parahippocampal gyrus, with covarying reductions in the supplementary motor area (SMA) and orbitofrontal cortex. Stimulation-mediated increases in network activity correlated with concurrent improvement in learning performance (p< 0.02). To determine whether similar changes occurred during dopaminergic pharmacotherapy, we studied the subjects during an intravenous levodopa infusion titrated to achieve a motor response equivalent to stimulation. Despite consistent improvement in motor ratings during infusion, levodopa did not alter learning performance or network activity. Analysis of learning-related rCBF in network regions revealed improvement in baseline abnormalities with STN stimulation but not levodopa. These effects were most pronounced in the SMA. In this region, a consistent rCBF response to stimulation was observed across subjects and trials (p= 0.01), although the levodopa response was not significant. These findings link the cognitive treatment response in PD to changes in the activity of a specific cerebello-premotor cortical network. Selective modulation of overactive SMA–STN projection pathways may underlie the improvement in learning found with stimulation.
Dephosphorylation-Induced Ubiquitination and Degradation of FMRP in Dendrites: A Role in Immediate Early mGluR-Stimulated Translation
Authors: Nalavadi Vijayalaxmi C. , Muddashetty Ravi S. , Gross Christina , Bassell Gary J.
Published: February 2012

Fragile X syndrome is caused by the loss of fragile X mental retardation protein (FMRP), which represses and reversibly regulates the translation of a subset of mRNAs in dendrites. Protein synthesis can be rapidly stimulated by mGluR-induced and protein phosphatase 2a (PP2A)-mediated dephosphorylation of FMRP, which is coupled to the dissociation of FMRP and target mRNAs from miRNA-induced silencing complexes. Here, we report the rapid ubiquitination and ubiquitin proteasome system (UPS)-mediated degradation of FMRP in dendrites upon DHPG (3,5-dihydroxyphenylglycine) stimulation in cultured rat neurons. Using inhibitors to PP2A and FMRP phosphomutants, degradation of FMRP was observed to depend on its prior dephosphorylation. Translational induction of an FMRP target, postsynaptic density-95 mRNA, required both PP2A and UPS. Thus, control of FMRP levels at the synapse by dephosphorylation-induced and UPS-mediated degradation provides a mode to regulate protein synthesis.
Phospholipase C-Mediated Suppression of Dark Noise Enables Single-Photon Detection inDrosophilaPhotoreceptors
Authors: Katz Ben , Minke Baruch
Published: February 2012

Drosophilaphotoreceptor cells use the ubiquitous G-protein-mediated phospholipase C (PLC) cascade to achieve ultimate single-photon sensitivity. This is manifested in the single-photon responses (quantum bumps). In photoreceptor cells, dark activation of Gqα molecules occurs spontaneously and produces unitary dark events (dark bumps). A high rate of spontaneous Gqα activation and dark bump production potentially hampers single-photon detection. We found that in wild-type flies thein vivorate of spontaneous Gqα activation is very high. Nevertheless, this high rate is not manifested in a substantially high rate of dark bumps. Therefore, it is unclear how phototransduction suppresses dark bump production arising from spontaneous Gqα activation, while still maintaining high-fidelity representation of single photons. In this study we show that reduced PLC catalytic activity selectively suppressed production of dark bumps but not light-induced bumps. Manipulations of PLC activity using PLC mutant flies and Ca2+modulations revealed that a critical level of PLC activity is required to induce bump production. The required minimal level of PLC activity selectively suppressed random production of single Gqα-activated dark bumps despite a high rate of spontaneous Gqα activation. This minimal PLC activity level is reliably obtained by photon-induced synchronized activation of several neighboring Gqα molecules activating several PLC molecules, but not by random activation of single Gqα molecules. We thus demonstrate how a G-protein-mediated transduction system, with PLC as its target, selectively suppresses its intrinsic noise while preserving reliable signaling.
CMOS Compatible Growth of Carbon Nanotubes and Their Application in Field-Effect Transistors
Authors: Uchino T. , Ayre G. N. , Smith D. C. , Hutchison J. L. , de Groot C. H. , Ashburn P.
Published: February 2012

The metal-catalyst-free growth of carbon nanotubes (CNTs) using chemical vapor deposition and the application in field-effect transistors (FETs) is presented. The CNT growth process used a 3-nm-thick Ge layer on SiO2 that was subsequently annealed to produce Ge nanoparticles. Raman measurements show the presence of radial breathing mode (RBM) peaks and the absence of the disorder induced D-band, indicating single walled CNTs (SWNTs) with a low defect density. The synthesized CNTs are used to fabricate CNTFETs and the best device has a state-of-the-art on/off current ratio of 3×108 and a steep sub-threshold slope of 110 mV/decade.
Palliative Care Consultation Service and Palliative Care Unit: Why Do We Need Both?
Authors: Gaertner Jan , Frechen Sebastian , Sladek Markus , Ostgathe Christoph , Voltz Raymond
Published: February 2012

Background.

Palliative care (PC) infrastructure has developed differently around the globe. Whereas some institutions consider the palliative care unit (PCU) a valuable component, others report that the sole provision of a state-of-the art palliative care consultation service (PCCS) suffices to adequately care for the severely ill and dying.

Objective.

To aid institutional planning, this study aimed at gathering patient data to distinguish assignments of a concomitantly run PCU and PCCS at a large hospital and academic medical center.

Methods.

Demographics, Eastern Cooperative Oncology Group performance status, symptom/problem burden, discharge modality, and team satisfaction with care for all 601 PCU and 851 PCCS patients treated in 2009 and 2010 were retrospectively analyzed.

Results.

Patients admitted to the PCU versus those consulted by the PCCS: (a) had a significantly worse performance status (odds ratio [OR], 1.48); (b) were significantly more likely to suffer from severe symptoms and psychosocial problems (OR, 2.05), in particular concerning physical suffering and complexity of care; and (c) were significantly much more likely to die during hospital stay (OR, 11.03). For patients who were dying or in other challenging clinical situations (suffering from various severe symptoms), self-rated team satisfaction was significantly higher for the PCU than the PCCS.

Conclusion.

This study presents a direct comparison between patients in a PCU and a PCCS. Results strongly support the hypothesis that the coexistence of both institutions in one hospital contributes to the goal of ensuring optimal high-quality PC for patients in complex and challenging clinical situations.
Rockfill shear strength evaluation: a rational method based on size effects
Authors: FROSSARD E. , HU W. , DANO C. , HICHER P.-Y.
Published: February 2012

The shear strength of coarse granular materials, widely used in civil works such as rockfill in dam construction, is seldom measured because of severe practical experimental limitations. This paper presents an original method for evaluating the shear strength of such materials, based on size effects in granular materials affected by grain breakage according to fracture mechanics. Through a general size effect relation operating on shear strength envelopes, this method makes it possible to determine the shear strength of a coarse-grained granular material from the measured properties of a finer-grained granular material made of the same mineral. In the paper, the method is explicitly proved, taking into account the statistical distribution of breakage resistances of particles with different sizes, within materials that can be considered as physically similar, particularly having parallel grain size distributions and the same compactness. A wide set of independent experimental results is shown to validate the method consistently.
Strain gradient effects on concrete stress–strain curve
Authors: Peng Jun , Ho Johnny Ching Ming
Published: February 2012

The stress–strain characteristic of concrete developed in flexure is one of the essential parameters for the ultimate flexural strength design of reinforced concrete (RC) members. Currently, the stress–strain curve of concrete developed in flexure is obtained by scaling down the uniaxial stress–strain curve. In current RC design codes, it is represented by an equivalent rectangular concrete stress block depending solely on the concrete strength. By comparing the theoretical strength evaluated for the stress block with the measured strength, the authors found that current codes underestimate the actual flexural strength of RC beams and columns by 9% and 19%, respectively. Since the underestimation is different for beams and columns, which are subjected to different strain gradients at ultimate, it is suggested that the maximum concrete stresses developed in flexure should depend also on strain gradient. The effects of strain gradient on the concrete stress developed in flexure were investigated in this work by testing RC columns under concentric and eccentric axial loads or horizontal loads. The concrete stress–strain curves of the eccentrically/horizontally loaded specimens were derived by modifying those of concentrically loaded counterparts based on axial force and moment equilibriums. The results indicate that the maximum concrete stress developed in flexure depends significantly on strain gradient. Formulas were developed to correlate the maximum and equivalent concrete stresses developed in flexure to the strain gradient. Their applicability was verified by comparing the results with measured flexural strengths of RC beams and columns.
Odontoid Fracture Following a Fall in an Elderly Man
Authors: Pagnez Maria Alice Mainenti , Elliott James M.
Published: February 2012

The patient was a 79-year-old man with a chief complaint of neck pain after a fall. Three days following the fall, the patient was seen in the emergency department, where computed tomography imaging of the head and radiographs of the cervical spine were completed. The patient was subsequently referred to a physical therapist. Due to concern for a possible undetected cervical spine fracture, the patient was immediately referred to his physician. Magnetic resonance imaging demonstrated a type II fracture of the odontoid.

J Orthop Sports Phys Ther 2011;41(12):981. doi:10.2519/jospt.2011.0424
Change in Psychosocial Distress Associated With Pain and Functional Status Outcomes in Patients With Lumbar Impairments Referred to Physical Therapy Services
Authors: Werneke Mark W. , Hart Dennis L. , George Steven Z. , Deutscher Daniel , Stratford Paul W.
Published: February 2012

Study Design

Prospective, longitudinal, observational cohort design.

Objective

The primary aim was to examine the association between changes in psychosocial distress (PD), and functional status (FS) and pain intensity at discharge from physical therapy.

Background

Patients with lumbar impairments seeking physical therapy commonly demonstrate elevated PD. However, it is not clear if PD changes that occur during physical therapy management are associated with improved clinical outcomes.

Methods

Data from adults (n = 692) with lumbar impairment were analyzed. Patients were screened using the Symptom Checklist Back Pain Prediction Model questionnaire (SCL BPPM) to identify patients at intake and discharge into 3 levels of risk for persistent disability (high, intermediate, or low). SCL BPPM classifications allowed for 5 patterns of change in PD during therapy (decreased, stable low, stable intermediate, stable high, or increased). Associations between PD change patterns and discharge FS and pain intensity were assessed using multivariable linear regression models, controlling for selected risk-adjustment variables.

Results

Proportions of patients classified by patterns of PD change for decreased, stable low, stable intermediate, stable high, and increased were 0.34, 0.52, 0.05, 0.06, and 0.03, respectively. Compared to the decreased PD group, (1) increased, stable high, and stable intermediate PD patterns were associated with worse discharge FS scores (−7.9 [95% CI: −13.5, −2.21], −10.9 [95% CI: −15.25, −6.49], and −8.9 [95% CI: −13.65, −4.21] units, respectively), and (2) stable high and stable intermediate PD patterns were associated with higher pain intensity (2.59 [95% CI: 1.81, 3.56] and 2.14 [95% CI: 1.25, 3.04] units, respectively).

Conclusions

Lower FS and higher pain intensity outcomes were associated in similar but not identical patterns with patients whose SCL BPPM classification of PD increased, or remained at high or intermediate levels during physical therapy. Serial assessments of change in PD during rehabilitation are recommended as a possible treatment-monitoring tool. J Orthop Sports Phys Ther 2011;41(12):969–980. doi:10.2519/jospt.2011.3814
Physical Therapy in a Value-Based Healthcare World
Authors: Fritz Julie M.
Published: February 2012

Musculoskeletal conditions are important contributors to United States healthcare spending and are certain to play an important role in the future as the population continues to age. Almost half of the population of the United States experiences a musculoskeletal condition annually. Meeting the needs of these individuals within a changing healthcare delivery and reimbursement environment prompted a recent Summit sponsored by the United States Bone and Joint Initiative (USBJI). The Summit dealt with a topic critical to the future of healthcare for clinicians, consumers, and payers alike: value. We do not operate within a value-based healthcare system. Our current delivery system continues to reward volumes, not value. Failure to focus on value has had devastating consequences. The challenge of shifting from a volume-based to a value-based system is central to the future of healthcare. Discussion and action will be critical for the physical therapy profession moving into the future.

J Orthop Sports Phys Ther 2012;42(1):1–2. doi:10.2519/jospt.2012.0101
The FIT-HaNSA Demonstrates Reliability and Convergent Validity of Functional Performance in Patients With Shoulder Disorders
Authors: Kumta Prajyot , MacDermid Joy C. , Mehta Saurabh P. , Stratford Paul W.
Published: February 2012

Study Design

Psychometric study design.

Objectives

To assess the test-retest reliability and convergent validity of the Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA) in patients with shoulder disorders.

Background

Performance tests that assess functional ability of patients with shoulder disorders can provide useful information for making clinical or return-to-activity decisions. No performance-based shoulder test has yet demonstrated sufficient relevance or clinical measurement properties. The FIT-HaNSA examines upper extremity performance during repetitive tasks that emphasize shoulder reaching and static postures and, therefore, has greater relevance for assessing performance.

Methods

Thirty-six patients with shoulder disorders and 65 healthy controls were recruited for the study. The FIT-HaNSA, the Disabilities of the Arm, Shoulder and Hand questionnaire, the Shoulder Pain and Disability Index, isometric shoulder strength, and shoulder range of motion were assessed at baseline and repeated 2 to 7 days later. Test-retest reliability was described using intraclass correlation coefficient (ICC2,1) and standard error of measurement. Pearson correlation coefficients were used to examine the level of association between the FIT-HaNSA scores and the other measures.

Results

The ICCs for test-retest reliability for the FIT-HaNSA ranged from 0.89 to 0.97 in the patient group and 0.79 to 0.91 in the control group. The FIT-HaNSA showed high correlation with the Disabilities of the Arm, Shoulder and Hand and the Shoulder Pain and Disability Index, and moderate correlations with shoulder range of motion and muscle strength.

Conclusion

The FIT-HaNSA demonstrated high test-retest reliability and convergent validity with other related outcomes in patients with shoulder disorders. Further longitudinal studies are required to evaluate the responsiveness of the FIT-HaNSA in patients with different upper extremity conditions. J Orthop Sports Phys Ther 2012;42(5):455–464, Epub 25 January 2012. doi:10.2519/jospt.2012.3796
Management of Dancers With Symptomatic Accessory Navicular: 2 Case Reports
Authors: Smith Teresa Riemer
Published: February 2012

Study Design

Case report.

Background

Symptomatic accessory navicular can be a source of pain and disability. The treatment considerations for accessory navicular in dancers may differ due to increased demands on the foot, the repetitive nature of the movements, and the specific footwear required. The purpose of this report is to describe the management (1 conservative and 1 postoperative) of 2 adolescent dancers with symptomatic accessory navicular.

Case Descriptions

Case 1 was an 11-year-old female who underwent surgical excision of a symptomatic accessory navicular. Case 2 was a 15-year-old female who, following a traumatic injury that caused pain judged to be related to her accessory navicular, was managed nonsurgically. Treatment included pain management, range-of-motion exercises, trunk and lower extremity strengthening, balance and proprioception training, orthoses, crosstraining, and a guided return-to-dance progression.

Outcomes

Both patients had improved pain, dance technique, strength, and patient-reported outcome scores that allowed a full return to dance.

Discussion

The 2 dancers presented here had foot pain believed to be related to a symptomatic accessory navicular. In both cases, treatment targeted specific impairments to improve function and disability. The guided progression of activities was intended to facilitate a return to dance that protected healing tissues and prevented a recurrence of symptoms. Clinicians should be aware of the effect of a symptomatic accessory navicular in the young dancer and potentially effective nonsurgical treatment options for this condition.

Level of Evidence

Therapy, level 4. J Orthop Sports Phys Ther 2012;42(5):465–473, Epub 25 January 2012. doi:10.2519/jospt.2012.3809
Elite Swimmers With Unilateral Shoulder Pain Demonstrate Altered Pattern of Cervical Muscle Activation During a Functional Upper-Limb Task
Authors: Hidalgo-Lozano Amparo , Calderón-Soto Carmen , Domingo-Camara Antonio , Fernández-de-las-Peñas César , Madeleine Pascal , Arroyo-Morales Manuel
Published: February 2012

Study Design

Cross-sectional cohort study.

Objective

To investigate the differences in the level of activation of neck-shoulder muscles between elite swimmers with and without shoulder pain during a functional upper-limb task.

Background

Previous studies have reported altered motor control of the neck-shoulder muscles in patients with chronic neck-shoulder pain. Whether the activation of neck-shoulder muscles is altered among elite swimmers who have shoulder pain is unknown.

Methods

Surface electromyography from the sternocleidomastoid, upper trapezius, and anterior scalene (SCL) muscles was recorded bilaterally in 17 elite swimmers (9 men, 8 women; mean ± SD age, 21 ± 3 years) with unilateral shoulder pain, and 17 age- and sex-matched elite swimmers without pain. Root-mean-square values were calculated and normalized to assess the level of muscular activation 5 seconds before, 120 seconds into, 150 seconds into, and 10 seconds after a functional upper-limb task.

Results

The data revealed significant differences between groups for the root-mean-square of both SCL muscles (F = 3.733, P = .016) but not for the sternocleidomastoid and upper trapezius muscles. Swimmers with shoulder pain had higher normalized root-mean-square values in both SCL muscles at 120 seconds (78% on average) and 150 seconds (86% on average) into the task and at 10 seconds after the task (40% on average), as compared with swimmers without shoulder pain (P<.05).

Conclusion

The elite swimmers with shoulder pain demonstrated greater activation of the SCL muscles during a functional task and a lower ability to relax the SCL muscles after completion of the task than elite swimmers without shoulder pain. The present findings suggest an altered pattern of cervical muscle activation in elite swimmers with shoulder pain during performance of a functional task. J Orthop Sports Phys Ther 2012;42(6):552–558, Epub 25 January 2012. doi:10.2519/jospt.2012.3875
Experimental Study on Methane Hydrate Dissociation by Depressurization in Porous Sediments
Authors: Xiong Lijun , Li Xiaosen , Wang Yi , Xu Chungang
Published: February 2012

Based on currently available data from site measurements in the Shenhu Area of the South China Sea, methane hydrate dissociation behavior by depressurization is studied in a one-dimensional experimental apparatus. According to time variation of temperature, resistance and gas production, the hydrate dissociation process is divided into three stages: free gas release, rapid dissociation and gradual dissociation. The experimental results show that as the hydrate saturation increases the proportion of hydrate decomposed decreases in the rapid dissociation stage. The hydrate dissociation rate and the dissociation heat increase as the dissociation pressure decreases. Furthermore, the decrease of the dissociation pressure works against the secondary formation of the hydrate.
Pyrrolo[3,2-d]pyrimidine Derivatives as Type II Kinase Insert Domain Receptor (KDR) Inhibitors: CoMFA and CoMSIA Studies
Authors: Wu Xiao-Yun , Chen Wen-Hua , Wu Shu-Guang , Tian Yuan-Xin , Zhang Jia-Jie
Published: February 2012

Kinase insert domain receptor (KDR) inhibitors have been proved to be very effective anticancer agents. Molecular docking, 3D-QSAR methods, CoMFA and CoMSIA were performed on pyrrolo[3,2-d]pyrimidine derivatives as non-ATP competitive KDR inhibitors (type II). The bioactive conformation was explored by docking one potent compound 20 into the active site of KDR in its DFG-out inactive conformation. The constructed CoMFA and CoMSIA models produced statistically significant results with the cross-validated correlation coefficients q2 of 0.542 and 0.552, non-cross-validated correlation coefficients r2 of 0.912 and 0.955, and predicted correction coefficients r2pred of 0.913 and 0.897, respectively. These results ensure the CoMFA and CoMSIA models as a tool to guide the design of a series of new potent KDR inhibitors.