bluuebunny/crossref_metadata_2025 huggingface dataset:
Aristotle in Phenomenology
Authors: Kontos Pavlos
Published: July 2018

It is not an overstatement to say that no other figure in the history of philosophy has exercised a stronger influence on phenomenology than Aristotle. It suffices to recall Franz Brentano’s decisive role in the genesis of phenomenology or to enumerate the Aristotelian concepts and patterns of thought that phenomenological research—from Husserl to its contemporary practitioners—has appropriated or assimilated. But the most critical element of that influence is the fact that Aristotle has served as the privileged pivot for phenomenology’s own development. The present chapter presents a brief overview of phenomenological approaches to Aristotle and focuses on two episodes in that long story, namely, on Heidegger’s and Gadamer’s interpretations of Aristotle’s practical philosophy and how they contributed to the elaboration of their conceptions of phenomenology.
Simone de Beauvoir
Authors: Bergoffen Debra
Published: July 2018

Identifying herself as a philosopher, author, and feminist, Simone de Beauvoir took the phenomenological ideas of the lived body, situated freedom, intentionality, intersubjective vulnerability, and the existential ethical-political concepts of critique, responsibility, and justice, in new directions. She distinguished two moments in an ongoing dialogue of intentionality: the joys of disclosure and the desires of mastery. She disrupted the phenomenological account of perception, revealing its hidden ideological dimensions. Attending to the embodied experience of sex, gender, and age, she challenged the privilege accorded to the working body and introduced us to the unique humanity of the erotic body. Her categories of the Other and the Second Sex exposed the patriarchal norms that are naturalized in the taken-for-granted givens of the life-world. In translating the phenomenological-existential concepts of transcendence and freedom into an activist ethics of critique, hope, and liberation, her work continues to influence phenomenology, existentialism, and feminist theory and practice.
Science in Merleau-Ponty’s Phenomenology
Authors: Romdenh-Romluc Komarine
Published: July 2018

This chapter considers Merleau-Ponty’s conception of the relation between science and his phenomenology. It sketches one line of thought from his work that uses ideas he takes from Gestalt psychology to argue that science and phenomenology are fundamentally the same sort of investigation. They may employ different concepts to characterize their data and results. They may also investigate different things—a scientist may investigate the effects of climate change on our weather systems; a phenomenologist may inquire into the structure of time consciousness. Yet, even though these investigations are directed at different things, viewed at a certain level of generality, what it is they are discovering and how they are doing so, is the same. Moreover, Merleau-Ponty holds that the different concepts they employ and the different objects they investigate are not essential differences between science and phenomenology. For Merleau-Ponty, therefore, science and phenomenology are “continuous.”
Descartes’ Notion of the Mind–Body Union and its Phenomenological Expositions
Authors: Heinämaa Sara , Kaitaro Timo
Published: July 2018

The chapter clarifies the connections between Descartes’ discussion of the mind–body union and classical phenomenology of embodiment, as developed by Husserl and Merleau-Ponty. It argues that the perplexing twofoldness of Descartes’ account of the mind–body union—interactionistic on the one hand, and holistic on the other—can be explicated and made coherent by phenomenological analyses of the two different attitudes that we can take toward human beings: the naturalistic and the personalistic. In the naturalistic attitude, the human being is understood as a two-layered psycho-physical complex, in which mental states and faculties are founded on the material basis of the body. In the personalistic attitude, the human being forms an expressive whole in which the spiritual and the sensible-material are intertwined. The chapter ends with a discussion of the most important similarities and differences between Descartes’ and Husserl’s conceptions of philosophy as a radical science.
Phenomenological Methodology
Authors: Mertens Karl
Published: July 2018

This chapter discusses how the methodological self-understanding outlined in Husserl’s early writings changes in later stages of the Phenomenological Movement. The discussion is guided by Merleau-Ponty’s short remarks in the preface of his Phenomenology of Perception about the ambiguity of the phenomenological method. Against this background, it is shown that the critical examination of the possibility of phenomenological reflection and the explanation of the idea of intentionality lead to relevant modifications and revisions of the initial assumptions concerning the phenomenological method. Particularly, the phenomenological concepts of the a priori, transcendental subjectivity, constitution, and descriptive analysis should be modified by considering the relevance of opposing aspects binding the phenomenological reflection also to facticity, the natural attitude, our life-world, and constructive moments. In addition, it is argued that the phenomenological task of offering an investigation of originary experience as a pre-linguistic and subjective experience should also be revised.
Social Science and Ideological Critiques of Ecclesiology
Authors: Ormerod Neil
Published: July 2018

Theology has long engaged philosophy as a dialogue partner, but the social sciences raise a new set of issues as both theology and the social sciences reflect concretely on the human condition. The problematic relationship between theology and the social sciences is perhaps nowhere more evident than in the area of ecclesiology. Whenever ecclesiology turns from more idealistic ahistorical forms of discourse to deal with the actual context and constitution of historical communities, the role of the social sciences in providing insights into those contexts and constitutions becomes difficult to deny. This chapter seeks to map out some of the history of the engagement with the social sciences by ecclesiologists such as Clodovis Boff, Dietrich Bonhoeffer, Edward Schillebeeckx, John Milbank, and Roger Haight, and the challenges that this engagement poses. Underlying this debate are profound theological issues concerning grace and nature.
Wolfhart Pannenberg
Authors: Nuessel Friedericke
Published: July 2018

This chapter describes the development of Wolfhart Pannenberg’s ecclesiology in his early work and explores his fully developed ecclesiology in the Systematic Theology of 1993. It analyses the fundamental role of the church to be a sign and foretaste of the kingdom of God. This involves a constitutive self-distinction of the church from any political order or civil state on the one hand and from the future kingdom of God on the other. Moreover, the chapter emphasizes the simultaneity of individual salvation and incorporation into the church as the body of Christ in Pannenberg, and demonstrates the ecclesiological task to overcome the divisions between churches in order to witness to the unity, holiness, catholicity, and apostolicity of the church.
The Ecclesiology of Israel’s Scriptures
Authors: Moberly R. W. L.
Published: July 2018

This chapter begins by exploring the dilemma: How can there be an ecclesiology of the Hebrew Scriptures in the absence of a church? We might say that the theological account of ‘the people of God’ in the Old Testament informed and shaped the Christian sense of ‘the people of God’ in the New. Or we could go further and affirm that there was indeed a church in or of Israel. The chapter then reviews Christian attempts to provide (a) a synthesis of historical and theological interpretations of the Old Testament (Hanson and Goldingay) and (b) canonical approaches (Childs, Lindbeck, and Radner). The remainder of the chapter offers a reading of selected Old Testament passages, seeking to bring together Israel and the church according to the three themes: vocation and assurance; warning and challenge; failure and hope. These readings of the biblical text are followed by reflections on their theological and ecclesiological implications.
Reasons Fundamentalism and Value
Authors: Stratton-Lake Philip
Published: July 2018

Here I address the issue of whether the concept of a reason is a basic normative notion. I do this by considering whether the attempts to analyze this notion in terms of “ought” succeed, as I think these are the most promising accounts. I consider the attempts of Broome, and of Kearns and Star, to attempt to analyze reasons in terms of oughts, and argue that these attempts fail. I defend the view that goodness can be defined in terms of reasons—the buck-passing account of goodness—and defend this view from the most serious objections, the “wrong kind of reasons” objection and the “isolated good” objection. I finish by expressing some doubts about whether “ought” can be defined in terms of reasons. I conclude, therefore, that the notion of a reason is a basic notion, but not the basic normative notion.
Reasons and Rationality
Authors: Way Jonathan
Published: July 2018

This chapter explores the recent debate about the relationship between reasons and rational requirements of coherence—for example, requirements to be consistent in one’s beliefs and intentions. Such requirements seem plausible because they explain what is wrong with incoherence. But it is unclear whether there are always reasons to comply with such requirements. And it is plausible that, if there are not, then there are no such requirements. The first half of this chapter defends these claims. The second half of the chapter discusses an alternative view of what is wrong with incoherence, defended by Kolodny and others. On this view, the problem with incoherence is that it guarantees that you have some attitude that you should not have or that you lack some attitude that you should have. The chapter raises and discusses three problems for this view.
The Place of Reasons in Epistemology
Authors: Sylvan Kurt , Sosa Ernest
Published: July 2018

This chapter defends a middle ground between two extremes in the literature on the place of reasons in epistemology. Against members of the “reasons first” movement, we argue that reasons are not the sole grounds of epistemic normativity. We suggest that the virtue-theoretic property of competence is rather the key building block. To support this approach, we note that reasons must be possessed to ground central epistemic properties, and argue that possession is grounded in competence. But while we here diverge with reasons-firsters, we also distance ourselves from those who deem reasons unimportant. Indeed, we hold that having sufficient epistemic reasons is necessary and sufficient for propositional justification, and that proper basing on them yields doxastic justification. But since possession and proper basing are grounded in competence, reasons are not the end of the road: competence enables them to do their work, putting them—and us—in the middle.
Reasons for Belief and Normativity
Authors: Glüer Kathrin , Wikforss Åsa
Published: July 2018

In this chapter, we critically examine the most important extant ways of understanding and motivating the idea that reasons for belief are normative. First, we examine the proposal that the distinction between explanatory and so-called normative reasons that is commonly drawn in moral philosophy can be rather straightforwardly applied to reasons for belief, and that reasons for belief are essentially normative precisely when they are normative reasons. In the course of this investigation, we explore the very nature of the reasons-for-belief relation, as well as the ontology of such reasons. Second, we examine the idea that the normativity derives from the internal connection between reasons for belief and epistemic justification, distinguishing between two distinct normativist accounts of justification, a weaker and a stronger one. We argue that neither line of argument is compelling. Pending further arguments, we conclude that normativism about reasons for belief is not supported.
Reasons and Perception
Authors: Smithies Declan
Published: July 2018

This chapter is organized around four central questions about the role of reasons in the epistemology of perception. (1) The “whether?” question: does perception provide us with reasons for belief about the external world? (2) The “how?” question: how does perception provide us with reasons for belief about the external world? (3) The “when?” question: when does perception provide us with reasons for belief about the external world? (4) The “what?” question: what are the reasons that perception provides us with for belief about the external world?
The Logic of Reasons
Authors: Nair Shyam , Horty John
Published: July 2018

We discuss the need for and prospects of a logic describing the relation among reasons and the outcomes they support. After noting some shortcomings of the dominant weighing conception of this support relation, we very briefly outline the basic idea behind two attempts at providing such a logic. We then describe a few topics that are ripe for further research: the logical relations among reasons themselves, the source and formal structure of priority relations among reasons, whether the strengths of multiple reasons can combine, and a problem concerning the strength of undercutting defeaters.
Reliving Tragedies as Historical Reawakenings
Authors: Talebi Shahla
Published: July 2018

Since the early twentieth century, Iranians have lived through several critical moments with significant socioeconomic and religiopolitical consequences for the nation and beyond. These include, though not limited to, the Constitutional Revolution (1905–11); Oil Nationalization Movement (1952–53) led by Prime Minister Mohammad Mossadegh; 1979 Revolution (1978–79); and 2009 post-presidential election uprisings—the so-called Green Movement, not to mention the recent protests in severaltowns and cities against economic disparity and corruption (late Dec. 2017 and early Jan. 2017–2018). Never merely about the internal conditions, these movements have always been linked with and responded to the interference of, or anxieties about the role of, foreign powers. This chapter elucidates how Iranians’ sense of indignity at living under tyranny, their concern about national sovereignty, socioeconomic disparity, and the lack of political voice have motivated their resistance. The mytho-historical referent of Karbala, intertwined with modern liberal discourses, nationalist sentiments, and the leftist notion of social justice have simultaneously fueled these movements and led to internal conflicts. Nevertheless, the dreams of a better tomorrow or the desire for freedom from tyranny linger on, anticipating new awakenings.
Scribonius Largus and Friends
Authors: Scarborough John
Published: July 2018

The chapter treats the Latin pharmaceutical work of Scribonius Largus. His recipe book incorporates not merely the “simples” of pharmacology in the first century ce, but also contains numerous complex, multi-ingredient recipes—organized “by diseases” from head to heel. Two smaller portions of the work prescribe antidotes against poisons and bites from venomous animals, and surgical remedies to help heal fractures, wounds, and the like. The work has affinities with the near-contemporary works of Cornelius Celsus and Pliny the Elder. Scribonius writes to defend and demonstrate the healthful and helpful use of drugs and to promote adherence to high standards of medical practice. Scribonius’ generosity in citing names allows us to place him in his sociocultural and medical context; he traveled with Claudius to Britain in 43 ce. To illustrate the intricately complicated multistage, multisubstance prescriptions in the work, one is translated and annotated, a recipe for a diuretic.
Greek Mathematics and Astronomy in Late Antiquity
Authors: Bernard Alain
Published: July 2018

The chapter discusses the mathematics and astronomy of “Late Antiquity” (the early Byzantine period). The period was one of intensive innovation, transformation, and change, involving appropriation and assimilation, and also involved fierce cultural and doctrinal competition between various allegiances. The mathematical or astronomical works of this period are consistently original in their attempt to consolidate mathematical and astronomical practice for literate and/or philosophical education. Cultural competition and emulation existed between various justifications of mathematics and astronomy. These cultural choices were furthermore justified in the terms of wider domains of knowledge and intellectual activities. The period also displays a deep love of traditional knowledge, taken as an almost unavoidable reference point. Fourthly, mathematics and astronomy in Late Antiquity followed a wide range of stylistic patterns. Last, the diversity of works must be seen to include anonymous corpora, such as the pseudo-Heronian metrology, or the scholia on mathematical and astronomical texts, etc.
Science and Medicine in the Roman Encyclopedists
Authors: Beagon Mary
Published: July 2018

The chapter examines encyclopedic literature since its general characteristics directly influence the nature of the areas of knowledge they treat and the manner they are presented. All the works included in this chapter are sole authored and manifest a desire for comprehensiveness, organization, and utility. Encyclopedic literature was essentially a Roman invention. It was the product of a people for whom utility was an integral part of the rhetoric of self-identity, and whose extensive conquests were being arranged into a world empire: a mass of discrete political and geographical entities marshaled into a coherent unity. The treatment of science and medicine in encyclopedic literature highlights the difficulty of dividing ancient ideas into the scientific fields recognizable today. The five authors gathered for study are Varro, Vitruvius, Celsus, Columella, and Pliny.
Mesopotamian Mathematics
Authors: Høyrup Jens
Published: July 2018

The chapter explores “Mesopotamian mathematics,” which arose in the late fourth millennium bce, alongside a logographic script, both of which served in accounting. Writing, accounting, and calculation were in the hands of the manager-priests of the temples, who used the techniques to calculate and control land distribution to high officials, rations in kind to workers, and ingredients necessary for products such as beer. Mathematical texts include problems that seem practical but which would never occur in actual scribal work: their function was to display professional identity by exploiting a professional tool. The place-value system was created to simplify accurate calculations. Central to Old Babylonian mathematics were problems concerned with the properties of the sexagesimal system, as well as “algebraic” problems based on a set of four problems about rectangles with a given area, and some linear constraint. Such geometrical riddles have left traces in the pseudo-Heronian Geometrica collections and in medieval Islamic and Indian practical geometry and are likely to have inspired Euclid’s Elements II.
Astronomy in Ancient Egypt
Authors: Quack Joachim Friedrich
Published: July 2018

This chapter studies Egyptian astronomy based on the very few surviving texts. The Egyptian calendar was purely solar, unlike most ancient calendars. The oldest astronomical monuments from Egypt are the star clocks, mainly on the interior of coffin lids from the Eleventh and Twelfth Dynasties. They divide the year into 36 ten-day intervals (decades), each with 12 stars, to mark the hours of the night for religious purposes. The major text of Egyptian astronomy is the Book of Nut, the sky goddess, which describes the behavior of the sun, moon, and especially fixed stars, as well as shadow clocks and water clocks. The Egyptian constellations were fundamentally different from ours (based on Mesopotamian and Greek myths), with Osiris (our Orion), Seth (our Big Dipper), and Sirius playing a prominent role, plus the Ship, the Sheep, and the Two Tortoises. Late Egyptian astronomy borrows some techniques from Mesopotamian astronomy. In the Greco-Roman period, Egyptian astronomy borrows elements from Greco-Roman astronomy.
Plotinus and Neoplatonism
Authors: Siorvanes Lucas
Published: July 2018

The chapter describes and analyzes the formation of Neoplatonism (flourished 3rd to 6th centuries ce). Philosophers include Plotinus, Porphyry and Iamblichus, and later heads of philosophy schools Proclus and Ammonius. The Neoplatonists believed that true knowledge is ultimately founded in unity. They considered their new ideas as a return to Plato and his sources, particularly Pythagoreanism. They used earlier philosophical sources in a nuanced, selective manner that they called “harmony” of Aristotle and Plato. The Neoplatonists accommodated the Aristotelian and Platonic philosophies. Aristotle is accurate when things are known by sense perception and discursive reasoning, and addressed by ordinary language, whereas Plato prevails when things are conceived in their causes and principles. Plotinus discussed specific topics rather than giving an account of nature. He drew selectively from Aristotle and Plato, with a complex reaction to the Stoics. The Neoplatonic studies included mathematics, physics, and astronomy both theoretical and practical.
Using Personalized Music Playlists for Patients With Dementia as a Teaching Innovation
Authors: Long Elizabeth M. , White Kelli
Published: July 2018

Nursing students need innovative educational approaches to bridge generational and cultural differences and improve communication skills with patients who are cognitively impaired. An individualized music and memory intervention for older adults with dementia and communication issues was implemented. A review of weekly student journals provided information regarding the use of the approach as an alternative therapy and benefit for students. The usefulness of the music and memory program as an innovative learning tool has widespread applicability to various health care settings.
Concordance Within an RN to BSN Program: Standardized Writing Assessment Rubrics
Authors: Abbott Miriam R.B. , Shaw Peggy
Published: July 2018

A standardized rubric for writing assessment can improve concordance in expectations across a nurse educator community; however, standardization may also pose a perceived threat to faculty academic freedom. To improve assessment consistency while retaining academic freedom, an innovative rubric system that offers a compromise is proposed; it includes both standardized objective areas of assessment as well as areas of assessment for individualized instructor determination. In creating a hybrid standardized rubric, a community of nurse educators can retain academic freedom while better serving students with consistent expectations for writing skills.
Long-Term Cognitive Impairment After Preeclampsia
Authors: Elharram Malik , Dayan Natalie , Kaur Amanpreet , Landry Tara , Pilote Louise
Published: July 2018

OBJECTIVE:

To systematically review and summarize studies investigating an association between a history of preeclampsia and cognitive function later in life.

DATA SOURCES:

Studies published before August 2017 were identified without any language restriction or study design limits through electronic searches of 10 main databases including MEDLINE and ClinicalTrials.gov.

METHODS OF STUDY SELECTION:

We considered all observational studies that included preeclampsia as a clearly defined prespecified risk factor and that examined a cognition-related outcome measure including validated cognitive tests, magnetic resonance brain imaging, or a clinical diagnosis of dementia. Study quality was assessed using the New-Castle Ottawa scale. All review stages were conducted independently by two reviewers, and disagreement was resolved by a third reviewer. Where possible, data were pooled using a random-effects model.

TABULATION, INTEGRATION, AND RESULTS:

Of 3,126 potentially relevant studies, 13 were included in our review (1,314 women with prior preeclampsia and 289,080 women with prior normotensive pregnancy); median time since pregnancy was 6 years. A higher number of self-reported deficits in perception, memory, and motor functioning on the Cognitive Failure Questionnaire was reported in women with vs without prior preeclamptic pregnancies (Cognitive Failure Questionnaire mean total score 41.5 vs 36.8 out of 100, weighted mean difference of −5.1 points [−9.4 to −0.8]). Our meta-analysis did not reveal significant differences in studies assessing attention (Digit Symbol Substitution or Coding); however, women with preeclampsia performed worse on one of two meta-analyzed tests assessing memory (Letter Number Sequencing mean total score: 10.6 vs 10.1 out of 21, weighted mean difference of 0.63 points 0.06–1.2). Pooling of cognitive outcome measures for studies assessing brain imaging or a clinical diagnosis of dementia were limited by differences in reporting and marked heterogeneity between studies.

CONCLUSION:

Although preeclampsia is associated with subjective cognitive symptoms, our systematic review did not demonstrate clear evidence of impairment on standard neurocognitive tests. There is a paucity of high-quality studies assessing cognitive outcomes after preeclampsia.
Bazedoxifene–Conjugated Estrogens for Treating Endometriosis
Authors: Flores Valerie A. , Stachenfeld Nina S. , Taylor Hugh S.
Published: July 2018

BACKGROUND:

Endometriosis is a gynecologic disorder affecting 6–10% of reproductive-aged women. First-line therapies are progestin-based regimens; however, failure rates are high, often requiring alternative hormonal agents, each with unfavorable side effects. Bazedoxifene with conjugated estrogens is approved for treatment of menopausal symptoms, and use in animal studies has demonstrated regression of endometriotic lesions. As such, it represents a potential treatment option for endometriosis.

CASE:

A patient with stage III endometriosis referred for management of dysmenorrhea and cyclic pelvic pain was treated with 20 mg bazedoxifene and 0.45 mg conjugated estrogens daily for more than 6 months. She noted resolution of pelvic pain. There were no abnormal effects on hormonal, uterine, or ovarian parameters.

CONCLUSION:

Bazedoxifene with conjugated estrogens may be an effective alternative to traditional endometriosis treatment options.
Salpingectomy During Vaginal Hysterectomy
Authors: Giraudet Géraldine , Rubod Chrystèle , Collinet Pierre , Cosson Michel
Published: July 2018

BACKGROUND:

Opportunistic salpingectomy at the time of hysterectomy is currently recommended to reduce the lifetime risk of ovarian cancer. The vaginal route is least invasive, but surgeons sometimes may choose to perform this procedure laparoscopically or robotically when anticipating adnexal surgery as a result of limited visibility.

TECHNIQUE:

We describe a surgical technique to make salpingectomy by the vaginal route easier and more feasible. Posterior rotation of the uterus provides excellent access to the tube, which can easily be removed before separation of the adnexa.

EXPERIENCE:

We have performed more than 60 vaginal hysterectomies using this technique. Salpingectomy was always feasible.

CONCLUSION:

We demonstrate a simple technique to safely perform opportunistic salpingectomy during a vaginal hysterectomy.
Models for Predicting Recurrence, Complications, and Health Status in Women After Pelvic Organ Prolapse Surgery
Authors: Jelovsek J. Eric , Chagin Kevin , Lukacz Emily S. , Nolen Tracy L. , Shepherd Jonathan P. , Barber Matthew D. , Sung Vivian , Brubaker Linda , Norton Peggy A. , Rahn David D. , Smith Ariana L. , Ballard Alicia , Jeppson Peter , Meikle Susan F. , Kattan Michael W. ,   for the NICHD Pelvic Floor Disorders Network
Published: July 2018

OBJECTIVE:

To develop statistical models predicting recurrent pelvic organ prolapse, surgical complications, and change in health status 12 months after apical prolapse surgery.

METHODS:

Logistic regression models were developed using a combined cohort from three randomized trials and two prospective cohort studies from 1,301 participants enrolled in surgical studies conducted by the Pelvic Floor Disorders Network. Composite recurrent prolapse was defined as prolapse beyond the hymen; the presence of bothersome bulge symptoms; or prolapse reoperation or retreatment within 12 months after surgery. Complications were defined as any serious adverse event or Dindo grade III complication within 12 months of surgery. Significant change in health status was defined as a minimum important change of SF-6D utility score (±0.035 points) from baseline. Thirty-two candidate risk factors were considered for each model and model accuracy was measured using concordance indices. All indices were internally validated using 1,000 bootstrap resamples to correct for bias.

RESULTS:

The models accurately predicted composite recurrent prolapse (concordance index=0.72, 95% CI 0.69–0.76), bothersome vaginal bulge (concordance index=0.73, 95% CI 0.68–0.77), prolapse beyond the hymen (concordance index=0.74, 95% CI 0.70–0.77), serious adverse event (concordance index=0.60, 95% CI 0.56–0.64), Dindo grade III or greater complication (concordance index=0.62, 95% CI 0.58–0.66), and health status improvement (concordance index=0.64, 95% CI 0.62–0.67) or worsening (concordance index=0.63, 95% CI 0.60–0.67). Calibration curves demonstrated all models were accurate through clinically useful predicted probabilities.

CONCLUSION:

These prediction models are able to provide accurate and discriminating estimates of prolapse recurrence, complications, and health status 12 months after prolapse surgery.
Postmenopausal hormone treatment alters neural pathways but does not improve verbal cognitive function
Authors: Berent-Spillson Alison , Kelley Angela S. , Persad Carol C. , Love Tiffany , Frey Kirk A. , Reame Nancy E. , Koeppe Robert , Zubieta Jon-Kar , Smith Yolanda R.
Published: July 2018

Objective:

Cognitive outcomes in trials of postmenopausal hormone treatment have been inconsistent. Differing outcomes may be attributed to hormone formulation, treatment duration and timing, and differential cognitive domain effects. We previously demonstrated treatment benefits on visual cognitive function. In the present study, we describe the effects of hormone treatment on verbal outcomes in the same women, seeking to understand the effects of prior versus current hormone treatment on verbal function.

Methods:

This is a cross-sectional evaluation of 57 women (38 hormone users [25 prior long-term users and 13 current users] and 19 never-users). Hormone users took identical formulations of estrogen or estrogen + progestin (0.625 mg/d conjugated equine estrogens with or without medroxyprogesterone acetate) for at least 10 years, beginning within 2 years of menopause. Women were evaluated with tests of verbal function and functional magnetic resonance imaging (fMRI) of a verbal discrimination task.

Results:

All women scored similarly on assessments of verbal function (Hopkins Verbal Learning Test and a verbal discrimination task performed during the fMRI scanning session); however, women ever treated with hormones had more left inferior frontal (T = 3.72; P < 0.001) and right prefrontal cortex (T = 3.53; P < 0.001) activation during the verbal task. Hormone-treated women performed slightly worse on the verbal discrimination task (mean accuracy 81.72 ± 11.57 ever-treated, 85.30 ± 5.87 never-treated, P = 0.14), took longer to respond (mean reaction time 1.10 ± 0.17 s ever-treated, 1.02 ± 0.11 never-treated, P = 0.03), and remembered fewer previously viewed words (mean accuracy 62.21 ± 8.73 ever-treated, 65.45 ± 7.49 never-treated, P = 0.18). Increased posterior cingulate activity was associated with longer response times (R = 0.323, P = 0.015) and worse delayed verbal recall (R = −0.328, P = 0.048), suggesting that increased activation was associated with less efficient cognitive processing. We did not detect between group differences in activation in the left prefrontal cortex, superior frontal cortex, thalamus, or occipital/parietal junction.

Conclusions:

Although current and past hormone treatment was associated with differences in neural pathways used during verbal discrimination, verbal function was not higher than never-users.
The Effects of Presurgical Nasoalveolar Molding on the Midface Symmetry of Children with Unilateral Cleft Lip and Palate: A Long-term Follow-up Study
Authors: AlHayyan Wasmiya A. , Pani Sharat Chandra , AlJohar Aziza J. , AlQatami Fawzi M.
Published: July 2018

Background:

Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of presurgical nasoalveolar molding (PNAM) on midface symmetry in children treated for CUCLP. This study aimed to compare children with CUCLP who underwent PNAM before surgical interventions, children who did not receive PNAM, and age- and sex-matched controls in terms of midface symmetry.

Methods:

We evaluated 39 frontal facial photographs of 13 patients with CUCLP who underwent PNAM as part of the treatment (group 1: PNAM), 13 patient with CUCLP who did not undergo PNAM (group 2: no nasoalveolar molding), and 13 age- and sex-matched controls. The children were evaluated in their fifth year of life. Three midline and 3 bilateral orthopometric midface landmarks were programmed using a custom software (OnyxCeph3, Image Instruments GmbH, Germany), and corresponding linear measurements from the midline were obtained and compared between the groups using 1-way analysis of variance and Scheffe’s post hoc test.

Results:

Significant differences were observed between the control and CUCLP groups for the measurements of the proanasale, subnasale, and zygion. However, there were no significant differences between the PNAM and no nasoalveolar molding groups for the 6 midface landmarks.

Conclusions:

PNAM does not seem to significantly impact the long-term midface symmetry in children with CUCLP.
Rare Hypothenar Myxoma Causing Ulnar Neuropathy: Histopathology and Treatment Pearls
Authors: Firouzbakht Peter K. , Israel Jacqueline S. , Christie Brian M. , Rao Venkat K.
Published: July 2018

A myxoma is a neoplasm comprised of mesenchymal connective tissue. Myxomas of the upper extremity, and particularly of the hand, are rare. We present a case of a hypothenar myxoma causing ulnar neuropathy in a patient with a history of acute inflammatory demyelinating process. Treatment and management of myxoma may vary depending on whether the process is malignant or benign; thus, histologic diagnosis is critical to determining treatment. The purpose of this article is to review the pathophysiology and clinical features of myxomas, and to provide recommendations for evaluating and treating individuals with extremity masses of unclear clinical diagnosis.
Do post-traumatic pain and post-traumatic stress symptomatology mutually maintain each other? A systematic review of cross-lagged studies
Authors: Ravn Sophie Lykkegaard , Hartvigsen Jan , Hansen Maj , Sterling Michele , Andersen Tonny Elmose
Published: July 2018

After traumatic exposure, individuals are at risk of developing symptoms of both pain and post-traumatic stress disorder (PTSD). Theory and research suggest a complex and potentially mutually maintaining relationship between these symptomatologies. However, findings are inconsistent and the applied methods are not always well suited for testing mutual maintenance. Cross-lagged designs can provide valuable insights into such temporal associations, but there is a need for a systematic review to assist clinicians and researchers in understanding the nature of the relationship. Thus, the aim of this systematic review was to identify, critically appraise, and synthesize results from cross-lagged studies on pain and PTSD symptomatology to assess the evidence for longitudinal reciprocity and potential mediators. Systematic searches resulted in 7 eligible studies that were deemed of acceptable quality with moderate risk of bias using the cohort study checklist from Scottish Intercollegiate Guidelines Network. Furthermore, synthesis of significant pathways in the cross-lagged models showed inconsistent evidence of both bidirectional and unidirectional interaction patterns between pain and PTSD symptomatology across time, hence not uniformly supporting the theoretical framework of mutual maintenance. In addition, the synthesis suggested that hyperarousal and intrusion symptoms may be of particular importance in these cross-lagged relationships, while there was inconclusive evidence of catastrophizing as a mediator. In conclusion, the findings suggest an entangled, but not necessarily mutually maintaining relationship between pain and PTSD symptomatology. However, major variations in findings and methodologies complicated synthesis, prompting careful interpretation and heightening the likelihood that future high-quality studies will change these conclusions.
Contemporary Role and Responsibilities of the Director of Clinical Education: A National Qualitative Study
Authors: McCallum Christine , Engelhard Chalee , Applebaum Donna , Teglia Valerie
Published: July 2018

Introduction.

Clinical education is of broad and current interest topic in physical therapist (PT) education today. The director of clinical education (DCE) is the core faculty member responsible for the components of the clinical education (CE) curriculum. Previous work has questioned whether the position would be a “dinosaur or a rising phoenix”. The objectives of this study was to comprehensively examine the full scope of the role and responsibilities of the DCE.

Methods.

A non-experimental, qualitative descriptive study design was used. A constructivist theoretical framework guided the work. Eleven teams of DCEs and program directors (PD) participated in semi-structured interviews. Onsite interviews were conducted by trained interviewers and transcribed verbatim for analysis. A process of thematic analysis was used to develop results.

Results.

Five themes and 19 subthemes were developed. The DCE was shown to be a value-added position in professional physical therapist programs, whose role and responsibilities are responsive to both internal and external factors to the academy. There is an evolutionary process to the development of a DCE within the academy. A common vision was shared by DCEs and PDs about the future direction of the DCE in today's clinical education marketplace.

Discussion.

The DCE is a central player in moving academic physical therapist education forward. The patterns of current DCE practice may shed light on plausible reasons for challenges association with the CE atmosphere. Study limitations could include interview bias and bias in analysis.

Conclusion.

The contemporary role and responsibilities of the DCE were identified, with recommendations for additional studies to enhance the understanding of the DCE in today's academic and clinical environment.
International Society for the Study of Vulvovaginal Disease Recommendations Regarding Female Cosmetic Genital Surgery
Authors: Vieira-Baptista Pedro , Almeida Gutemberg , Bogliatto Fabrizio , Bohl Tanja Gizela , Burger Matthé , Cohen-Sacher Bina , Gibbon Karen , Goldstein Andrew , Heller Debra , Likes Wendy , Longo da Silva Celene , Marchitelli Claudia , Moyal-Barracco Micheline , Posey Kathleen , Sluga Maria Celeste , Stockdale Colleen Kennedy , Marquini Gisele Vissoci , Zalewski Kamil
Published: July 2018

Female genital cosmetic surgeries (FGCSs) and procedures are increasingly being advertised as common, simple, and complication-free, capable of not only improving aesthetic appearance but also increasing self-esteem and sexual pleasure.

Guidelines for physicians and clear, scientifically correct information for patients must be made available, to minimize the number of ineffective or deleterious procedures.

The International Society for the Study of Vulvovaginal Disease positions/recommendations regarding FGCS are as follows:

1. There is a wide variation regarding genital normalcy; providers must be able to explain this to women.

2. There are no data supporting FGCS including, G-spot augmentation, hymenoplasty, vulvar and perianal bleaching/whitening, vaginal tightening procedures, and other procedures aimed at increasing sexual function.

3. Women should not be offered FGCS before the age of 18 years.

4. Women undergoing FGCS should be evaluated by a provider with expertise in vulvovaginal diseases, including attention to their psychological, social, and sexual context. Evaluation by an experienced mental health provider should be considered when the motivation for seeking surgery and/or expectations are not clear or realistic.

5. Female genital cosmetic surgery is not exempt from complications.

6. Informed consent must always be obtained.

7. Surgeons performing FGCS should refrain from solicitous advertising or promoting procedures without scientific basis, including on Web sites.

8. Surgeons should not perform surgery that they do not agree with and explain their rationale/position when pressured by patients.

9. The genital surgeon must be adequately trained in performing FGCS including knowledge of the anatomy, physiology and pathophysiology of the vulva, vagina and adjacent organs.
Relevance of human fat distribution on lipid and lipoprotein metabolism and cardiovascular disease risk
Authors: Piché Marie-Eve , Vasan Senthil K. , Hodson Leanne , Karpe Fredrik
Published: July 2018

Purpose of review

Upper body abdominal and lower body gluteofemoral fat depot masses display opposing associations with plasma lipid and lipoprotein and cardiovascular disease (CVD) risk profiles. We review developments on adipose tissue fatty acid metabolism in the context of body fat distribution and how that might be related to adverse lipid and lipoprotein profiles and CVD risk.

Recent findings

Recent data have confirmed the paradoxical relationship of upper abdominal and lower body gluteofemoral adiposity and CVD risk. Mechanistically, this is likely to reflect the different ways fat depots handle lipid storage and release, which impacts directly and indirectly on lipid and lipoprotein metabolism. The upper body enhances immediate fat storage pathway with rapid uptake of dietary-derived fatty acids, whereas the lower body fat depot has a reduced lipid turnover accommodating a slower fat redistribution. Body fat distribution and the fat depots’ ability to undergo appropriate expansion when fat storage is required, rather than overall body fatness, appear as the important determinant of metabolic health.

A focus on fat distribution in overweight people, preferably using precise imaging methods, rather than quantifying total body fatness, is likely to provide the medical community with better tools to stratify and treat patients with obesity-related complications.
Efficacy of Compression Gloves in the Rehabilitation of Distal Radius Fractures
Authors: Miller-Shahabar Inbar , Schreuer Naomi , Katsevman Haim , Bernfeld Benjamin , Cons Anat , Raisman Yael , Milman Uzi
Published: July 2018

Objective

The aim of this study was to examine the outcomes of wearing made-to-measure compression gloves after distal radius fracture.

Design

In a randomized controlled trial, adults who were about 6 wks post distal radius fracture were recruited and divided into a comparison control group (n = 15), who received standard rehabilitation twice a week for half an hour, and an intervention group (n = 17), who additionally used compression gloves. All treatments were conducted at a single rehabilitation clinic. Outcomes assessed were wrist and finger range of motion, grip strength, swelling, pain, and activities of daily living (using the Patient Rating Wrist Evaluation). The intervention group underwent additional objective dynamic assessments of range of motion with and without the gloves.

Results

The intervention group demonstrated reduced swelling, pain, and analgesic use; increased wrist range of motion; better scores for specific hand functions; and greater participation in activities of daily living compared with the comparison group.

Conclusion

This randomized controlled trial shows that using compression gloves during the rehabilitation phase after distal radius fracture improves daily functioning and reduces adverse symptoms. These improvements, which are important in their own right, are also expected to aid in preventing the development of chronic conditions and disability.

Evidence Level II

Un-blinded prospective comparative study.
Mechanical In-exsufflation-Expiratory Flows as Indication for Tracheostomy Tube Decannulation
Authors: Bach John R. , Giménez Gloria C. , Chiou Michael
Published: July 2018

Mechanical insufflation exsufflation-expiratory flows (MIE-EFs) correlate with upper airway patency. Patients dependent on continuous noninvasive ventilatory support with severe spinal muscular atrophy type 1, now over 20 yrs old, have used MIE sufficiently effectively along with continuous noninvasive ventilatory support to avoid tracheotomy indefinitely. Although MIE-EFs can apparently decrease in amyotrophic lateral sclerosis to necessitate tracheotomy, they can increase over time and remain effective in all spinal muscular atrophy types. Two cases demonstrate an association between increasing MIE-EF and, ultimately, successful decannulation of a patient with spinal muscular atrophy type 2 who was continuous tracheostomy mechanical ventilation dependent and a patient with obesity hypoventilation syndrome. Only when MIE-EF increased to exceed 200 l/min did the decannulations succeed. Definitive noninvasive management (continuous noninvasive ventilatory support) of these patients may be possible only when MIE is effective, and the greater the MIE-EF, the greater its effectiveness. Thus, increasing MIE-EF can signal resolution of upper airway obstruction sufficiently to permit decannulation whether a patient is ventilator dependent or not.
Family Testing: An Index Case Finding Strategy to Close the Gaps in Pediatric HIV Diagnosis
Authors: Simon Katherine R. , Flick Robert J. , Kim Maria H. , Sabelli Rachael A. , Tembo Tapiwa , Phelps Benjamin Ryan , Rosenberg Nora E. , Ahmed Saeed
Published: July 2018

Despite significant advances in pediatric HIV treatment, too many children remain undiagnosed and thus without access to lifesaving antiretroviral therapy. It is critical to identify these children and initiate antiretroviral therapy as early as possible. Although the children of HIV-infected adults are at higher risk of infection, few access HIV testing services because of missed opportunities in existing case finding programs. Family testing is an index case finding strategy through which HIV-infected patients are systematically screened to identify family members with unknown HIV status. By specifically targeting a high-risk population, family testing is a pragmatic, high-yield, and efficient approach to identify previously undiagnosed HIV-infected children and link them to care before they become symptomatic. Despite this, incorporation of family testing into national guidelines and implementation of this case finding approach is variable. In this article, we review the evidence base for family testing, describe its challenges, and provide guidance and sample tools for program managers aiming to integrate family testing into existing health systems.