bluuebunny/crossref_metadata_2025 huggingface dataset:
Δ9tetrahydrocannabinol impairs visuo-spatial associative learning and spatial working memory in rhesus macaques
Authors: Taffe Michael A
Published: April 2012

Cannabis remains the most commonly abused illicit drug and is rapidly expanding in quasi-licit use in some jurisdictions under medical marijuana laws. Effects of the psychoactive constituent Δ9tetrahydrocannabinol (Δ9THC) on cognitive function remain of pressing concern. Prior studies in monkeys have not shown consistent evidence of memory-specific effects of Δ9THC on recognition tasks, and it remains unclear to what extent Δ9THC causes sedative versus specific cognitive effects. In this study, adult male rhesus monkeys were trained on tasks which assess spatial working memory, visuo-spatial associative memory and learning as well as motivation for food reward. Subjects were subsequently challenged with 0.1–0.3 mg/kg Δ9THC, i.m., in randomized order and evaluated on the behavioral measures. The performance of both vsPAL and SOSS tasks was impaired by Δ9THC in a dose and task-difficulty dependent manner. It is concluded that Δ9THC disrupts cognition in a way that is consistent with a direct effect on memory. There was evidence for interference with spatial working memory, visuo-spatial associative memory and incremental learning in the latter task. These results and the lack of specific effect of Δ9THC in prior visual recognition studies imply a sensitivity of spatial memory processing and/or working memory to endocannabinoid perturbation.
Species distribution models
Authors: Miller Jennifer A.
Published: April 2012

The main goal of species distribution modeling is to identify important underlying factors related to broad-scale ecological patterns in order to make meaningful explanations or accurate predictions. When standard statistical methods such as regression are used to formulate these models, assumptions about the spatial structure of the data and the model parameters are often violated. Autocorrelation and non-stationarity are characteristics of spatial data and models, respectively, and if present and unaccounted for in model development, they can result in poorly specified models as well as inappropriate spatial inference and prediction. While these spatial issues are addressed here in an ecological context using species distribution models, they are broadly relevant to any statistical modeling applications using spatial data.
Predilection to deafferentation pain syndrome after radiosurgery in cluster headache
Authors: Donnet A , Carron R , Régis J
Published: April 2012

Cluster-tic syndrome is a rare, disabling disorder. We report the first case of cluster-tic syndrome with a successful response to stereotactic radiosurgery.

After failing optimal medical treatment, a 58-year-old woman suffering from cluster-tic syndrome was treated with gamma knife radiosurgery. The trigeminal nerve and sphenopalatine ganglion were targeted with a maximum dose of 85 and 90 Gy respectively. The patient experienced a complete resolution of the initial pain, but developed, as previously described after radiosurgical treatment for cluster headache, a trigeminal nerve dysfunction. This suggests that trigeminal nerve sensitivity to radiosurgery can be extremely different depending on the underlying pathological condition, and that there is an abnormal sensitivity of the trigeminal nerve in cluster headache patients. We do not recommend trigeminal nerve radiosurgery for treatment of cluster headache.
Motion processing deficits in migraine are related to contrast sensitivity
Authors: Shepherd Alex J , Beaumont Heidi M , Hine Trevor J
Published: April 2012

Background: There are conflicting reports concerning the ability of people with migraine to detect and discriminate visual motion. Previous studies used different displays and none adequately assessed other parameters that could affect performance, such as those that could indicate precortical dysfunction.

Methods: Motion-direction detection, discrimination and relative motion thresholds were compared from participants with and without migraine. Potentially relevant visual covariates were included (contrast sensitivity; acuity; stereopsis; visual discomfort, stress, triggers; dyslexia).

Results: For each task, migraine participants were less accurate than a control group and had impaired contrast sensitivity, greater visual discomfort, visual stress and visual triggers. Only contrast sensitivity correlated with performance on each motion task; it also mediated performance.

Conclusions: Impaired performance on certain motion tasks can be attributed to impaired contrast sensitivity early in the visual system rather than a deficit in cortical motion processing per se. There were, however, additional differences for global and relative motion thresholds embedded in noise, suggesting changes in extrastriate cortex in migraine. Tasks to study the effects of noise on performance at different levels of the visual system and across modalities are recommended. A battery of standard visual tests should be included in any future work on the visual system and migraine.
Research on heated-mandrel winding process for resin-matrix composite shells
Authors: Xu JZ , Qiao M , You B , Yu Y
Published: April 2012

This paper presents a new technology named heated-mandrel winding, in which the composite is cured simultaneously while the fiber soaked with resin continuously winds onto a mandrel heated by steam. The thermochemical, cure kinetic, and strain models during the heated-mandrel winding process are established and a numerical simulation program is developed by APDL. The influence of the heating rate, winding speed, and film coefficient on the temperature, curing degree, and strain is researched and analyzed. The effectiveness of the algorithm adopted and the validity of the analytical model and method in this study are experimentally testified. This research provides a theoretical basis and analytical method for the design and parameter optimization of the heated-mandrel winding process.
A system dynamics approach for healthcare waste management: a case study in Istanbul Metropolitan City, Turkey
Authors: Ciplak Nesli , Barton John R
Published: April 2012

Healthcare waste consists of various types of waste materials generated at hospitals, medical research centres, clinics and laboratories. Although 75–90% of this waste is classified as ‘domestic’ in nature, 20–25% is deemed to be hazardous, which if not disposed of appropriately, poses a risk to healthcare workers, patients, the environment and even the whole community. As long as healthcare waste is mixed with municipal waste and not segregated prior to disposal, costs will increase substantially. In this study, healthcare waste increases along with the potential to decrease the amounts by implementing effective segregation at healthcare facilities are projected to 2040. Our long-term aim is to develop a system to support selection and planning of the future treatment capacity. Istanbul in Turkey was used as the case study area. In order to identify the factors affecting healthcare waste generation in Istanbul, observations were made and interviews conducted in Istanbul over a 3 month period. A system dynamics approach was adopted to build a healthcare waste management model using a software package, Vensim Ple Plus. Based on reported analysis, the non-hazardous municipal fraction co-disposed with healthcare waste is around 65%. Using the projected waste generation flows, reducing a municipal fraction to 30% has the potential to avoid some 8000 t year−1 of healthcare waste by 2025 and almost 10 000 t year−1 by 2035. Furthermore, if segregation practices ensured healthcare waste requiring incineration was also selectively managed, 77% of healthcare waste could be diverted to alternative treatment technologies. As the throughput capacity of the only existing healthcare waste treatment facility in Istanbul, Kemerburgaz Incinerator, has already been exceeded, it is evident that improved management could not only reduce overall flows and costs but also permit alternative and cheaper treatment systems (e.g. autoclaving) to be adopted for the healthcare waste.
Direct Versus Indirect Compensation
Authors: Taras Vas
Published: April 2012

The effect of compensation on employee performance, satisfaction and organizational commitment is hard to overstate. Designing an effective compensation structure may be a daunting task, in particular with respect of finding a balance between direct and indirect compensation. The paper discusses the challenges and offers best practices for incorporating non-monetary benefits in a compensation package.
Human Colostrum and Breast Milk Contain High Levels of TNF-Related Apoptosis-Inducing Ligand (TRAIL)
Authors: Davanzo Riccardo , Zauli Giorgio , Monasta Lorenzo , Vecchi Brumatti Liza , Abate Maria Valentina , Ventura Giovanna , Rimondi Erika , Secchiero Paola , Demarini Sergio
Published: April 2012

Background:

TNF-related apoptosis inducing ligand (TRAIL) is a pleiotropic cytokine, which plays a key role in the immune system as well as in controlling the balance of apoptosis and proliferation in various organs and tissues.

Objective:

To investigate the presence and levels of soluble TRAIL in human colostrum and milk.

Methods:

The levels of soluble human TRAIL were measured in human colostrum (day 2 after delivery) and breast milk (day 5 after delivery). The presence of TRAIL was also measured in infant formula.

Results:

Levels of soluble TRAIL in the colostrum and mature human milk were, respectively, at least 400 and 100 fold higher than those detected in human serum. No TRAIL was detected in formula.

Conclusion:

Human soluble TRAIL is present at extremely high levels in human colostrum and human milk and might have a significant role in mediating the anti-cancer activity of human milk.
Utility modelling, equilibrium, and coordination of resource service transaction in service-oriented manufacturing system
Authors: Tao Fei , Cheng Ying , Zhang Lin , Zhao Dongming
Published: April 2012

The resource service transaction in service-oriented manufacturing systems is one of the key issues in deciding its practical implementation and application. In order to enhance the benefit of the three sides or users (i.e. resource service provider, resource service demander, and resource service agent or operator (agent)) using service-oriented manufacturing systems, the comprehensive utility models consider the revenue, time, and reliability for the three sides in the resource service-transaction process faced with uncertain factors under decentralized decision-making conditions are established first. Then the related comprehensive utility model for the resource service transaction chain of ‘multiple resource service providers – one agent – multiple resource service demanders’ under a centralized decision-making condition is proposed and discussed. The existence of utility equilibrium between resource service provider and agent is studied and proved. As is the optimal decision of a resource service transaction chain under the decentralized decision-making condition, as well as the utility equilibrium between agent and resource service demander. A utility coordination method is proposed, with the aim of improving the comprehensive utility of the resource service transaction chain under a decentralized decision-making condition. The case study illustrates that the proposed approach is practicable and effective.
Nonlinear vibration analysis of protein microtubules in cytosol conveying fluid based on nonlocal elasticity theory using differential quadrature method
Authors: Arani A Ghorbanpour , Shirali AA , Farahani M Noudeh , Amir S , Loghman A
Published: April 2012

In this article, nonlinear vibration of protein microtubules in cytosol with internal flow is studied. Based on the Euler–Bernoulli beam theory with von Kármán nonlinearity type and using Hamilton’s principle, the equations of motion for fluid-conveying microtubules are derived. The size effect is taken into account using Eringen’s nonlocal elasticity theory; moreover, the effect of an elastic surrounding filament network and the surface traction of cytosol are studied. The governing differential equations for vibration response of microtubules are solved using the differential quadrature method. The nonlinear frequency response of microtubules, considering the effect of microtubule properties, size effect, the surrounding elastic media, and the fluid motion are reported in this article. It has been found that the effect of nonlocal parameter on the vibration behavior and instability of the embedded microtubule conveying fluid are significant. In this regard, we need to point out that the critical flow velocity for a range of nonlocality parameter from 0 to 2 nm varies between 41 and 47 m/s, which should be avoided due to instability of the microtubule system. Therefore, they should be taken into account in the design of nano/micro-devices for measuring density of a fluid, such as drugs flowing through such microtubules, with great applications in biomechanics.
Human Visual Short-Term Memory Precision Can Be Varied at Will When the Number of Retained Items Is Low
Authors: Machizawa Maro G. , Goh Crystal C W , Driver Jon
Published: April 2012

It has been debated whether human visual working memory is limited by the number of items or the precision with which they are represented. In the research reported here, we show that the precision of working memory can be flexibly and willfully controlled, but only if the number of retained items is low. Electroencephalographic recordings revealed that a neural marker for visual working memory (contralateral delay activity, or CDA) that is known to increase in amplitude with the number of retained items was also affected by the precision with which items were retained. However, willfully enhanced precision increased CDA amplitude only when the number of retained items was low. These results show that both the number and the (willfully controlled) precision of retained items constrain visual working memory: People can enhance the precision of their visual working memory, but only for a few items.
On Standards: A Reply to Christopher Bell
Authors: Lambert Nicholas A.
Published: April 2012

During his first term as first sea lord (1904–10), Admiral Sir John Fisher set in motion the intellectual, organizational, and technological forces that, in very rapid order, combined and recombined to generate new approaches to British naval policy. Like most if not all ‘revolutions’ in technology and warfare, this one did not start and end neatly under one man’s control, but took on a life of its own. Not all elements of his original vision advanced as far as others. Yet, however variable the direction and extent of the revolution at particular times, in retrospect we can say indubitably that it was Fisher who launched it. This essay is a response to Professor Christopher Bell’s July 2011 article: ‘Sir John Fisher’s Naval Revolution Reconsidered: Winston Churchill at the Admiralty, 1911–1914’.
How Expectancy Motivation Influences Information Exchange in Small Groups
Authors: Emich Kyle J.
Published: April 2012

Groups rarely use the unique knowledge of their members when making decisions, focusing instead on knowledge that members have in common. This tendency to neglect the expertise of group members severely limits the effectiveness of group decision making. Previously, this problem has been addressed by showing that groups will pool task-relevant information and make effective decisions if members have knowledge of each other’s expertise. However, these studies are generally limited because they disregard why people use each other’s expertise once they are aware of it. The current study uses expectancy theory to investigate this issue and to link motivation to information exchange in groups. Results of a hidden profile study involving 40 groups indicated that expectancy motivation drives groups to use expertise awareness, exchange more unique information, and thus solve a hidden profile problem correctly.
Response: From Fish and Bicycles to a Science of Social Work
Authors: Marsh Jeanne Cay
Published: April 2012

John Brekke challenges the field and profession of social work to define and develop the “science of social work”. This response to Brekke's paper identifies the premises undergirding a discussion of the science of social work related to (1) a definition of “science”; (2 ) an organizing principle for social work; (3) a recognition that the task is a dynamic and evolving one; and, (4) an understanding that the science of social work is a reflection on what we study and how we study it. The paper identifies a tripartite conceptual framework to guide the discussion of the science of social work, one that focuses on semantics, syntactics, and pragmatics. The paper asserts that critical reflection on the science of social work, disciplined by a framework such as the one proposed, is needed to advance the science of social work.
Response: Hermeneutics and Accountable Practice
Authors: Lorenz Walter
Published: April 2012

Central to this article are two concerns: It seeks to demonstrate that social work theories and methods always need to be evaluated with reference to the social policy context in which they operate and in which they might assume unintended functions. It further proposes that the dominance of a positivist epistemology in the current surge for evidence-based practice needs to be critically cross-referenced with hermeneutic approaches to theorizing that emphasize the importance of intersubjectivity and communication in the human and social sphere. References to critical phases in the history of social work and an examination of the social pedagogy paradigm, developed in the context of German social policies, illustrate the promises—and pitfalls—of the privileging of humanist theory frameworks with reference to the key exponents of hermeneutics in social pedagogy.
“This is your heart speaking. Call 911.”
Authors: Day Mary Carol , Young Christopher
Published: April 2012

Early warning for heart attacks could save many lives. We conducted three studies to design and evaluate multimodal alarms and patient training for an implanted heart attack detector. An implanted device provided vibrotactile alarms subcutaneously, and a pager-like device provided auditory and visual alarms. Temporal alarm patterns connoted an urgent emergency alarm (“Call 911”) and a less urgent alarm (“See your doctor”). In the third, clinical, study, most patients (94%) correctly responded to the alarms at 1, 3, and 6 months after device implantation. Subcutaneous vibrotactile alarms show great potential for use in critical medical applications.
Environmental Fiscal Reform in Namibia
Authors: Sahlén Linda , Stage Jesper
Published: April 2012

In this article, the likely effects of an environmental fiscal reform in Namibia are examined using a Computable General Equilibrium model. We find that a triple dividend—improving the environment, increasing employment, and reducing poverty at the same time—remains elusive. Subsidizing unskilled labor would give the most favorable result in terms of real GDP and employment, but the worst in terms of environmental effects. Transfers targeted toward poorer households have the best distributional and environmental impacts, but do not lead to increases in GDP or employment. Thus there is scope to create additional benefits for society through the various environmental fiscal reform options studied, but there is no option that clearly outperforms the others in all respects.
Where is Family in the Family Nurse Practitioner Program? Results of a U.S. Family Nurse Practitioner Program Survey
Authors: Nyirati Christina M. , Denham Sharon A. , Raffle Holly , Ware Lezlee
Published: April 2012

Though recent progress in family nursing science can serve the family nurse practitioner (FNP) to intervene in the regulation of family health, whether those advances are taught to FNP students has been unclear. All 266 FNP programs in the United States were invited to participate in a survey to assess the content and clinical application of family nursing theories in the curriculum. The majority of FNP programs frame family as the context of care for the individual. Though FNP students receive a foundation in family nursing theory in core courses, they are not usually expected to use family assessment methods in clinical practicum courses or to plan interventions for the family as the unit of care. The authors challenge educators to consider family nursing science as an essential component of the FNP program as the Doctor of Nursing Practice (DNP) evolves and becomes requisite for entry into advanced practice.
The Psychopharmacological Management of RLS in Psychiatric Conditions
Authors: Cuellar Norma G.
Published: April 2012

Background:

Restless legs syndrome (RLS) is a movement disorder treated with dopamine agonists. RLS is often diagnosed as a comorbid condition with psychiatric disorders, which are treated with dopamine antagonists or antidepressants resulting in onset or exacerbation of RLS symptoms.

Objectives:

The objectives of this article are to provide a review of the literature to (a) describe the comorbidity of psychiatric disorders associated with RLS, (b) identify the treatment of psychiatric disorders that cause or exacerbate symptoms of RLS, and (c) provide clinical recommendations for psychiatric health care providers.

Design:

A review of the literature of English articles included the databases of Medline, Pubmed, PsychINFO, and CINAHL for “Restless Legs Syndrome” with major psychiatric disorders including mood disorders (depression and bipolar), schizophrenia, and anxiety disorders (anxiety, panic disorder, obsessive compulsive disorder). The PRISMA guidelines were used to improve the reporting of the review of the literature.

Results:

There were 61 articles that met the inclusion and exclusion criteria identified for the review of the literature, including RLS with mood disorders ( n = 36), schizophrenia ( n = 9), and anxiety disorders ( n = 16).

Conclusions:

Clinical trials are lacking on the best treatment for persons with RLS and psychiatric disorders; the most rigorous research found in the literature related to depression and anxiety. Studies lack evidence to document the best practice for persons with RLS and comorbid psychiatric disorders. Psychiatric health care providers should be aware of RLS, which is influenced by psychiatric medications.
The Influence of Hotel Price on Perceived Service Quality and Value in E-Tourism
Authors: Ye Qiang , Li Huiying , Wang Zhisheng , Law Rob
Published: April 2012

The relationship between price and postpurchase perceptions is an important topic in tourism and hospitality studies. However, little is known about how this relationship operates in an online context. Using 43,726 online reviews covering 774 star-rated hotels, this study empirically investigated the influence of price on customers’ perceptions of service quality and value. The results show that it has a positive impact on perceived quality but has a negative impact on perceived value. Price also has a more significant impact on perceived quality for higher-star, luxury hotels than lower-star, economy establishments. Additionally, it has a significant influence on perceived quality for business travelers but the equivalent value for leisure travelers is not significant.
The Architecture of the Disaster
Authors: Stoppani Teresa
Published: April 2012

This essay considers the irruption of the designed destructive event in the order of the project of architecture. The artificial disaster brings onto architecture destructive sudden forces that operate against it with an intensity and speed that are different from those that are at play in it. It imposes on architecture the man-devised, forceful, and violent interference of a project that is alien to that of architecture. The violent orchestrated event in space is interpreted here as a paroxysmal—explicit, sudden, violent—actualization of the forces that contribute to the shaping of the environment. Design and planning are about space-definition and form-making, while the destruction inflicted by the disaster concerns the undoing of form, of planned orders, of structures (be they societal, urban, economic, national). Through a series of examples, this text explores those practices which—in architecture and around architecture—work on and with the energy released by the disastrous event. It aims to understand the effects of the planned disaster on the wider questions that the discipline of architecture needs to ask and suggests that silence—or, the project of silence of architecture—is an act of design too.
‘Now can I watch my video?’: Exploring musical play through video sharing and social networking in an early childhood music class
Authors: Koops Lisa Huisman
Published: April 2012

The purpose of this research was to explore factors influencing musical play of preschool children in home and class settings through the use of video sharing by parents and teacher in an early childhood music course. Six families, all of whom had participated in at least one semester of prior research, attended a 45-minute music class each week for nine weeks and completed and documented assignments via a private online social network. Research questions explored musical play-enhancing and play-inhibiting factors as identified by parents, teacher, and outside observers, and how the behaviors varied across settings. Data included field notes, parent-written posts on the social network site, video footage of children in home and community settings, class video, and transcripts of exit interviews. Results of qualitative data analysis suggested that the expression of child’s agency was a key element in play-enhancing behaviors; adult involvement fell into both categories, but was more often play-enhancing when paired with child agency.
Listening in to water routes: Soundscapes as cultural systems
Authors: Chandola Tripta
Published: April 2012

In this article I draw upon ethnographic research in Govindpuri slums in Delhi, capital city of India, to explore the everyday through the politics of sound. Here I highlight the negotiations across space, gender and communities through the listenings of the water routes to suggest that soundscapes can be considered as cultural systems. This, I argue, could open ways into the processes of listening(s), its politics and practices – to ‘make sense’ of a place, its culture, and its communities. And through these listenings I emphasize the complexity of experience and everyday life in the Govindpuri slums.
Rethinking neoliberalism
Authors: Dean Mitchell
Published: April 2012

There are many key questions concerning the current status of the notion of neoliberalism. What is it? Is it an appropriate concept to describe a political and intellectual movement or form of state? What are its prospects as a framework of public policy after the global financial crisis? The article proposes a way of answering these questions by regarding neoliberalism as a definite ‘thought collective’ and a regime of government of and by the state. It exemplifies these by shifts within neoliberalism regarding the question of monopoly, its relationship to classical liberalism and its approach to crisis management. In regard to the latter, it further proposes an emergent rationality of the government of and by the state concerning the fostering of resilience in the anticipation of catastrophe.
Effects of mixing and chemical parameters on thermal efficiency in a partly premixed combustion diesel engine with near-zero emissions
Authors: Su Wanhua , Yu Wenbin
Published: April 2012

A hybrid combustion control strategy in a partly premixed combustion diesel engine have been developed and carefully optimized for high thermal efficiency and near-zero emissions in a wide engine operation range, up to a gross indicated mean effective pressure of 1.1 MPa. The mixing and chemical control parameters of combustion include fuel injection timing, injection rate pattern (such as multi-pulse injections), boost pressure, exhaust gas recirculation and in-cylinder temperature, regulated by the timing of intake valve closing. The interaction of the control parameters plays a decisive role in the determination of thermal efficiency and exhaust emissions, which are investigated by means of a comparison analysis with sweeping control parameters and data statistics. It is also found that thermal efficiency is more sensitive to combustion control parameters than emissions in clean partly premixed combustion.
Influence of O2-enriched intake air with CO2 dilution on the combustion process of an optically accessible spark-ignition engine
Authors: Seers Patrice , Foucher Fabrice , Mounaïm-Rousselle Christine
Published: April 2012

Oxygen-enriched air combustion has been extensively studied, but not for internal-combustion engines. This paper presents how oxygen-enriched intake air influences early flame growth and the combustion process, and looks at how oxygen (O2) enrichment translates into resistance to carbon dioxide (CO2) dilution. The experiments were conducted with an optical single-cylinder engine instrumented with an in-cylinder pressure transducer and a high-speed camera to monitor early flame growth. During the experiments, O2 concentrations were varied from 18% to 29%, while CO2 was varied from 0% to 35%. The main findings are that O2 addition speeds up the combustion process and renders the flame more resistant to CO2 dilution. It was observed that the amount of CO2 can be significantly increased to reduce the combustion process to a level similar to that with air. Finally, laminar flame speed correlated well with early flame growth and fully developed turbulent combustion periods.
Long-haired, freaky people need to apply: Rock music, cultural intermediation, and the rise of the ‘company freak’
Authors: Powers Devon
Published: April 2012

This article explores the phenomenon of the ‘company freak’ at American record labels of the late 1960s and early 1970s. It presents historical research on company freaks as well as theorizes how the concept of cultural intermediation might be recast as a means of complicating the standard narrative of rock’s commercial ‘co-optation’ during the period. In highlighting that company freaks were no simple appropriators, I argue that scholarship on consumer culture needs a sharper focus on historical instances of cultural intermediation in order to avoid gross caricatures of cultural commodification.
A participatory action research training initiative to improve police effectiveness
Authors: Rai Rajnish Kumar
Published: April 2012

Police work is becoming extremely complex, challenging, demanding, and ill-structured, which calls for better problem-solving and decision-making skills from police workers. Participatory action research approach is applied to understand how training methodologies can contribute to creative thinking, exploration of alternatives and democratization, consequently enhancing the problem-solving and decision-making skills of field-level police workers. A series of five sessions with two groups of police workers provided substantial insights that informed the research methodology, the learning experience of participants and the relative value of various training delivery modes for improving problem-solving and decision-making skills. The methodology gave opportunities to the researcher and the participants to reflect on processes and learn from the feedback. The study reveals that the training must seek to give voice to the learners and help them to discover an agency through which they can critically reflect on the needs of their job and fulfil them. This study reflects on the question of rigour and relevance in PAR and provides directions for future research.
Reflection in action with care workers in emotion work
Authors: Amble Nina
Published: April 2012

At first glance, ‘reflection in action’ seems like a fairly unambiguous concept. Many will associate the term with Schön (1983) as a central a point in his work was to emphasize the ability to reflect as a prerequisite for organizational learning ( Senge, 1990 ). The purpose of this article is to establish self-reflection in emotion work ( Hochschild, 1983 ) as a building block towards reflection in action and sustainable organizational learning ( Herbst, 1974 ; Kira, 2006 ). It also aims to show how knowledge of self-reflection through a joint-learning process ( Svensson, 2002 ) in the context of service work ( Amble et al., 2003 ) has been transformed into the sector of elderly care. Far removed from knowledge work in which thinking and fixing thoughts is part of a contemplative tradition ( Shotter, 2006 ), women as care workers in interdisciplinary reflection groups appear to profit from a written log that can be seen as an aid to self-reflection, confidence and robustness, as well as contributing to reflection in action in work with people. The empirical basis for this article is several interactive research projects primarily conducted by Norwegian researchers from WRI, both in private and public service work, during the period from 2000 to 2011 ( Amble, 2010 ; Gjerberg & Amble, 2011a ).
Adaptive immunity is related to coronary artery disease severity after acute coronary syndrome in subjects with metabolic syndrome
Authors: Izar Maria C , Fonseca Henrique A , Pinheiro Luiz F , Monteiro Carlos M , Póvoa Rui M , Monteiro Andréa M , Figueiredo-Neto Antonio M , Gidlund Magnus A , Fonseca Francisco A
Published: April 2012

Metabolic syndrome (MetS) is an inflammatory state associated with high coronary disease risk. Inflammation and adaptive immunity modulate atherosclerosis and plaque instability. We examined early changes in anti-oxidized low-density lipoprotein (LDL) (anti-oxLDL) autoantibodies (Abs) in patients with MetS after an acute coronary syndrome (ACS). Patients of both genders ( n=116) with MetS were prospectively included after an acute myocardial infarction (MI) or hospitalization due to unstable angina. Anti-oxLDL Abs (IgG class) were assayed at baseline, three and six weeks after ACS. The severity of coronary disease was evaluated by the Gensini score. We observed a decrease in anti-oxLDL Abs titers ( p<0.002 vs. baseline), mainly in males ( p=0.01), in those under 65 y ( p=0.03), and in subjects with Gensini score above median ( p=0.04). In conclusion, early decrease in circulating anti-oxLDL Abs is associated with coronary disease severity among subjects with MetS.
Why is joint range of motion limited in patients with cerebral palsy?
Authors: de Bruin M. , Smeulders M. J. C. , Kreulen M.
Published: April 2012

Patients with spastic cerebral palsy of the upper limb typically present with various problems including an impaired range of motion that affects the positioning of the upper extremity. This impaired range of motion often develops into contractures that further limit functioning of the spastic hand and arm. Understanding why these contractures develop in cerebral palsy will affect the selection of patients suitable for surgical treatment as well as the choice for specific surgical procedures. The generally accepted hypothesis in patients with spastic cerebral palsy is that the hyper-excitability of the stretch reflex combined with increased muscle tone result in extreme angles of the involved joints at rest. Ultimately, these extreme joint angles are thought to result in fixed joint postures. There is no consensus in the literature concerning the pathophysiology of this process. Several hypotheses associated with inactivity and overactivity have been tested by examining the secondary changes in spastic muscle and its surrounding tissue. All hypotheses implicate different secondary changes that consequently require different clinical approaches. In this review, the different hypotheses concerning the development of limited joint range of motion in cerebral palsy are discussed in relation to their secondary changes on the musculoskeletal system.
Role of diagnostic ultrasound in the assessment of musculoskeletal diseases
Authors: Patil Pravin , Dasgupta Bhaskar
Published: April 2012

The wide availability and recent improvement in technology coupled with portability, low cost and safety makes ultrasound the first choice imaging investigation for the evaluation of musculoskeletal diseases. Diagnostic use of ultrasound findings is greatly enhanced by knowledge of the clinical presentation. Conversely, ultrasound skills with its prerequisite anatomical knowledge make the clinical diagnosis more precise and reduce uncertainty in the choice of therapy. Therefore, it is essential for rheumatologists to acquire ultrasonography skills in order to improve patient care. Ultrasound examination provides an excellent opportunity for patient education and to explain the rationale for therapy. This review summarizes the indications for musculoskeletal ultrasound and describes its role in diagnosis, monitoring and prognosis.
Double Vision
Authors: Comrie Margie
Published: April 2012

At a time when traditional media industries are searching for new models, the rapidly growing Indigenous media are gaining in confidence and influence. New Zealand’s Ma–ori Television Service (MTS) has been dubbed the country’s only real provider of public service television and has appeal far beyond a narrow target audience. An analysis of 2008 national election coverage shows that MTS, while focused on Ma–ori concerns, was closer to public service expectations on a number of measurements than the two mainstream prime-time news programs. The paper examines coverage on state-owned TVNZ, private channel TV, and MTS, aiming to throw light on the contribution that a different—indigenous—perspective can make.
Testing of a Web-Based Program to Facilitate Parental Smoking Cessation Readiness in Primary Care
Authors: Gillaspy Stephen R. , Leffingwell Thad , Mignogna Melissa , Mignogna Joseph , Bright Brianna , Fedele David
Published: April 2012

Objective: To test the efficacy of a self-administered web-based computer intervention designed to facilitate readiness to alter tobacco use or secondhand smoke exposure among parents of children visiting a pediatric primary care clinic. The computer program included an assessment of the participant’s smoking behavior and personalized feedback. Methods: Self-identified smoking parents of children presenting to a general pediatric outpatient clinic completed measures of motivation and readiness to cease smoking. Participants were then randomly assigned to complete the computer program or receive treatment as usual. One month after completing the intervention, participants were contacted either in person or by phone to complete measures of motivational readiness to engage in smoking cessation. Results: Compared to treatment-as-usual parents, intervention parents reported increased readiness to change their smoking at follow-up. This effect appeared to strengthen, favoring the intervention condition, when analyses included only those participants who identified at baseline that they were contemplating quitting smoking in the next 6 months. Conclusions: Results of this small study supported the integration of a brief computerized tobacco intervention in the pediatric primary care setting and provided some evidence for efficacy. Brief, self-administered, and computer-based interventions such as this can be disseminated and deployed at relatively little cost or burden to existing practices, which makes small effects more meaningful and justifiable. Future investigations should investigate this intervention with larger samples and with expanded measures of parent smoking behavior.
Multiple myeloma–related deregulation of bone marrow–derived CD34+ hematopoietic stem and progenitor cells
Authors: Bruns Ingmar , Cadeddu Ron-Patrick , Brueckmann Ines , Fröbel Julia , Geyh Stefanie , Büst Sebastian , Fischer Johannes C. , Roels Frederik , Wilk Christian Matthias , Schildberg Frank A. , Hünerlitürkoglu Ali-Nuri , Zilkens Christoph , Jäger Marcus , Steidl Ulrich , Zohren Fabian , Fenk Roland , Kobbe Guido , Brors Benedict , Czibere Akos , Schroeder Thomas , Trumpp Andreas , Haas Rainer
Published: April 2012

Multiple myeloma (MM) is a clonal plasma cell disorder frequently accompanied by hematopoietic impairment. We show that hematopoietic stem and progenitor cells (HSPCs), in particular megakaryocyte-erythrocyte progenitors, are diminished in the BM of MM patients. Genomic profiling of HSPC subsets revealed deregulations of signaling cascades, most notably TGFβ signaling, and pathways involved in cytoskeletal organization, migration, adhesion, and cell-cycle regulation in the patients. Functionally, proliferation, colony formation, and long-term self-renewal were impaired as a consequence of activated TGFβ signaling. In accordance, TGFβ levels in the BM extracellular fluid were elevated and mesenchymal stromal cells (MSCs) had a reduced capacity to support long-term hematopoiesis of HSPCs that completely recovered on blockade of TGFβ signaling. Furthermore, we found defective actin assembly and down-regulation of the adhesion receptor CD44 in MM HSPCs functionally reflected by impaired migration and adhesion. Still, transplantation into myeloma-free NOG mice revealed even enhanced engraftment and normal differentiation capacities of MM HSPCs, which underlines that functional impairment of HSPCs depends on MM-related microenvironmental cues and is reversible. Taken together, these data implicate that hematopoietic suppression in MM emerges from the HSPCs as a result of MM-related microenvironmental alterations.
Mitochondrial dysfunction in antiphospholipid syndrome: implications in the pathogenesis of the disease and effects of coenzyme Q10 treatment
Authors: Perez-Sanchez Carlos , Ruiz-Limon Patricia , Aguirre Maria Angeles , Bertolaccini Maria Laura , Khamashta Munther A. , Rodriguez-Ariza Antonio , Segui Pedro , Collantes-Estevez Eduardo , Barbarroja Nuria , Khraiwesh Husam , Gonzalez-Reyes Jose Antonio , Villalba Jose Manuel , Velasco Francisco , Cuadrado Maria Jose , Lopez-Pedrera Chary
Published: April 2012

The exact mechanisms underlying the role of oxidative stress in the pathogenesis and the prothrombotic or proinflammatory status of antiphospholipid syndrome (APS) remain unknown. Here, we investigate the role of oxidative stress and mitochondrial dysfunction in the proatherothrombotic status of APS patients induced by IgG-antiphospholipid antibodies and the beneficial effects of supplementing cells with coenzyme Q10 (CoQ10). A significant increase in relevant prothrombotic and inflammatory parameters in 43 APS patients was found compared with 38 healthy donors. Increased peroxide production, nuclear abundance of Nrf2, antioxidant enzymatic activity, decreased intracellular glutathione, and altered mitochondrial membrane potential were found in monocytes and neutrophils from APS patients. Accelerated atherosclerosis in APS patients was found associated with their inflammatory or oxidative status. CoQ10 preincubation of healthy monocytes before IgG-antiphospholipid antibody treatment decreased oxidative stress, the percentage of cells with altered mitochondrial membrane potential, and the induced expression of tissue factor, VEGF, and Flt1. In addition, CoQ10 significantly improved the ultrastructural preservation of mitochondria and prevented IgG-APS–induced fission mediated by Drp-1 and Fis-1 proteins. In conclusion, the oxidative perturbation in APS patient leukocytes, which is directly related to an inflammatory and pro-atherothrombotic status, relies on alterations in mitochondrial dynamics and metabolism that may be prevented, reverted, or both by treatment with CoQ10.
Residual plasmatic activity of ADAMTS13 is correlated with phenotype severity in congenital thrombotic thrombocytopenic purpura
Authors: Lotta Luca A. , Wu Haifeng M. , Mackie Ian J. , Noris Marina , Veyradier Agnes , Scully Marie A. , Remuzzi Giuseppe , Coppo Paul , Liesner Ri , Donadelli Roberta , Loirat Chantal , Gibbs Richard A. , Horne April , Yang Shangbin , Garagiola Isabella , Musallam Khaled M. , Peyvandi Flora
Published: April 2012

The quantification of residual plasmatic ADAMTS13 activity in congenital thrombotic thrombocytopenic purpura (TTP) patients is constrained by limitations in sensitivity and reproducibility of commonly used assays at low levels of ADAMTS13 activity, blunting efforts to establish genotype-phenotype correlations. In the present study, the residual plasmatic activity of ADAMTS13 was measured centrally by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (limit of detection = 0.5%) in 29 congenital TTP patients. The results were used to study correlations among ADAMTS13 genotype, residual plasmatic activity, and clinical phenotype severity. An ADAMTS13 activity above 0.5% was measured in 26 (90%) patients and lower levels of activity were associated with earlier age at first TTP episode requiring plasma infusion, more frequent recurrences, and prescription of fresh-frozen plasma prophylaxis. Receiver operating characteristic curve analysis showed that activity levels of less than 2.74% and 1.61% were discriminative of age at first TTP episode requiring plasma infusion < 18 years, annual rate of TTP episodes > 1, and use of prophylaxis. Mutations affecting the highly conserved N-terminal domains of the protein were associated with lower residual ADAMTS13 activity and a more severe phenotype in an allelic-dose dependent manner. The results of the present study show that residual ADAMTS13 activity is associated with the severity of clinical phenotype in congenital TTP and provide insights into genotype-phenotype correlations.
Immunosuppression for acquired hemophilia A: results from the European Acquired Haemophilia Registry (EACH2)
Authors: Collins Peter , Baudo Francesco , Knoebl Paul , Lévesque Hervé , Nemes László , Pellegrini Fabio , Marco Pascual , Tengborn Lilian , Huth-Kühne Angela
Published: April 2012

Acquired hemophilia A (AHA) is an autoimmune disease caused by an autoantibody to factor VIII. Patients are at risk of severe and fatal hemorrhage until the inhibitor is eradicated, and guidelines recommend immunosuppression as soon as the diagnosis has been made. The optimal immunosuppressive regimen is unclear; therefore, data from 331 patients entered into the prospective EACH2 registry were analyzed. Steroids combined with cyclophosphamide resulted in more stable complete remission (70%), defined as inhibitor undetectable, factor VIII more than 70 IU/dL and immunosuppression stopped, than steroids alone (48%) or rituximab-based regimens (59%). Propensity score-matched analysis controlling for age, sex, factor VIII level, inhibitor titer, and underlying etiology confirmed that stable remission was more likely with steroids and cyclophosphamide than steroids alone (odds ratio = 3.25; 95% CI, 1.51-6.96; P < .003). The median time to complete remission was approximately 5 weeks for steroids with or without cyclophosphamide; rituximab-based regimens required approximately twice as long. Immunoglobulin administration did not improve outcome. Second-line therapy was successful in approximately 60% of cases that failed first-line therapy. Outcome was not affected by the choice of first-line therapy. The likelihood of achieving stable remission was not affected by underlying etiology but was influenced by the presenting inhibitor titer and FVIII level.