bluuebunny/crossref_metadata_2025 huggingface dataset:
Religiosity and psychological well‐being
Authors: Leondari Angeliki , Gialamas Vasilios
Published: May 2008

The aim of the present study was to investigate the relationship between religiosity and psychological well‐being in a sample of Greek Orthodox Christians. Previous research has documented that personal devotion, participation in religious activities, and religious salience are positively associated with different criteria of psychological well‐being. The sample (83 men and 280 women) with an age range from 18 to 48 years, was strongly skewed with respect to sex (77% female) and education level (95% were university students or university graduates). Religiosity was operationalized as church attendance, frequency of prayer and belief salience. In addition, a single item referring to beliefs about God was used. Depression, anxiety, loneliness, and general life satisfaction were selected as dependent variables because they reflect important dimensions of psychological well‐being. Preliminary analyses showed that sex was significantly related to the three religiosity variables (church attendance, frequency of prayer, belief salience), with women being more religious than men. Consistent with previous research, correlations suggested that church attendance and belief salience were associated with better life satisfaction. The results of hierarchical regression analysis showed a significant positive association between anxiety and frequency of personal prayer. Finally, personal beliefs about God did not seem to relate to any of the psychological well‐being measures. The results of the present study partially support the hypothesized association between religiosity and psychological well‐being.
A cross‐cultural comparison of the coexistence and domain superiority of individuating and relating autonomy
Authors: Yeh Kuang‐Hui , Bedford Olwen , Yang Yung‐Jui
Published: May 2008

The consensus definition of autonomy in the psychological literature emphasizes self‐governance through free volition, not separation or independence from others. Since the concept of self may differ cross‐culturally, several researchers have tried to incorporate types of self into the notion of autonomy; however, only the dual model of autonomy has been able to do this while retaining an emphasis on volition. The dual model describes two distinct forms of autonomy—individuating and relating—each with superior function in a specific domain of individual functioning. Individuating autonomy represents a volitional capacity to act against social constraints and offers a route to achieve an independent self‐identity by expressing individualistic attributes and distinctions. Relating autonomy represents a volitional capacity to act by emphasizing the harmony of self‐in‐relation‐to‐others, the quality of interpersonal relationships, and self‐transcendence. These two forms of autonomy have been shown to coexist at the individual level in a Taiwanese sample. This study takes the next step, with a cross‐cultural test of the coexistence and domain superiority hypotheses of individuating and relating autonomy. Participants included 306 college students from Taiwan and 183 college students from the United States. Structural equation modelling by multigroup analyses confirmed the cross‐cultural equivalence of the two‐factor individuating autonomy and relating autonomy measurement model. Across both samples the two forms of autonomy were shown to be mutually inclusive and not exclusive or independent. The domain‐superior function of each form of autonomy was also confirmed cross‐culturally; each form of autonomy has a dominant, but not necessarily exclusive, domain of functioning. Specifically, individuating autonomy was more associated with intrapersonal than interpersonal domain dependent variables, while relating autonomy was more associated with interpersonal than intrapersonal domain dependent variables. Limitations of the study and considerations for future research are discussed.
The willingness to relocate to another country: The impact of cultural similarity, destination safety, and financial incentive
Authors: Wagner Michael R. , Westaby James D.
Published: May 2008

Because of increased concerns about terrorism around the globe, international organizations are very interested in understanding how safety and cultural issues impact their employees' willingness to relocate abroad. This has been especially true for international companies based in the United States, given the recent salience of US activities around the world. Additionally, questions remain regarding the efficacy of financial incentives to motivate individuals' willingness to relocate when the destination may be dangerous. Therefore, the factors impacting willingness to relocate from the US to another country were examined experimentally in this study. Based upon theory and research in social and organizational psychology, it was hypothesized that cultural similarity, destination safety, and financial incentives would have direct effects on individuals' willingness to accept relocation offers. It was also predicted that cultural similarity and destination safety would moderate the effects of incentives upon willingness to relocate. The study used a 2×2×3 between‐subjects design manipulating destination similarity (similar, different), destination safety (safe, dangerous), and bonus for relocating (0% bonus, 20% bonus, 40% bonus). Results from 196 participants at a university in the northeastern part of the US revealed that financial incentives and safety perceptions directly impacted willingness to relocate. In line with moderator predictions, financial incentives had a stronger effect on willingness to relocate when the destination was culturally different from the United States than when it was similar. Against expectations, there was no interaction between financial incentives and safety. Destination safety perceptions were relatively strong determinants of willingness to relocate.
Academic achievement in the Chinese context: The role of goals, strategies, and effort
Authors: Ho Irene T. , Hau Kit‐Tai
Published: May 2008

Previous studies have suggested that Western constructs of academic motivation may operate in different ways in Asian contexts due to differences in the cultural environment. In the present study, the integrative effects of achievement goals, strategy orientations, and effort expenditure on achievement outcomes were examined among 1950 seventh‐grade Chinese students in Hong Kong. Participants completed separate questionnaires for mathematics and English. Results for the two subjects were largely similar. There were significant positive relationships between mastery and performance goals, between cooperative and competitive orientations, as well as between understanding and memorizing strategies. Regression analyses further revealed that goals and strategies were highly predictive of effort expenditure, but only goals and effort significantly predicted achievement outcome, with strategies being barely significant. The need to further investigate how Chinese students reconcile the apparently antithetical orientations in learning as well as the effective strategies contributing to their learning is indicated.
Personal investment, culture and learning: Insights into school achievement across Anglo, Aboriginal, Asian and Lebanese students in Australia
Authors: McInerney Dennis M.
Published: May 2008

Personal investment theory is a multifaceted theory of motivation, in which three key components: achievement goals (mastery, performance, social, and extrinsic), sense of self (sense of purpose, self‐reliance, negative self‐concept, positive self‐concept), and facilitating conditions (parent support, teacher support, peer support), engage students in the process of learning. Four cultural groups (Anglo Australian, n = 852, Aboriginal Australian, n = 343, Lebanese Australian, n = 372, and Asian Australian, n = 283) of students were compared on these personal investment components and on several outcome measures (engagement, affect, achievement, participation). A series of MANOVAs, followed up by univariate tests, indicated ethnic differences and similarities in the endorsement of the personal investment theory components as well as in the outcome measures. Multiple regression analyses showed that each of the three sets of predictors (achievement goals, sense of self, facilitating conditions) explained a significant amount of the variance in almost all of the outcome measures. Across cultural groups, students' mastery goal and sense of purpose were consistently found to be significant predictors of their intention for further education, positive affect for schooling, and valuing of schooling.
Socially oriented achievement goals of Chinese university students in Singapore: Structure and relationships with achievement motives, goals and affective outcomes
Authors: Chang Weining C. , Wong Kaishi
Published: May 2008

Contemporary literature on culture, self, and motivations (Markus & Kitayama, 1991) suggests that in collectivistic cultures, individual achievement is interdependent of one's social others. We proposed that this cultural characteristic could be exemplified in the achievement goal orientation and tested the notion with university students in a collectivistic community—Singapore. A socially oriented achievement goal construct was developed by taking into consideration the significant social others in the students' lives. A measuring instrument was established with a sample of Singaporean Chinese university students (N = 196; 144 females and 52 males); its relationships to achievement motives, goals, and consequences were examined. Although the socially oriented achievement goal items were originally constructed from four categories of social others, confirmatory factor analysis suggested a unifactor structure. Results showed that the socially oriented goal was related positively with students' performance goal, mastery goal, and competitive motive; it bore no relationship to mastery motive, work ethic, and interest in learning; and it predicted negatively future engagement. After the effects of mastery and performance goals were controlled for, the socially oriented goal did not predict test anxiety.
Predictors of sociocultural adjustment among sojourning Malaysian students in Britain
Authors: Swami Viren
Published: May 2008

The process of cross‐cultural migration may be particularly difficult for students travelling overseas for further or higher education, especially where qualitative differences exist between the home and host nations. The present study examined the sociocultural adjustment of sojourning Malaysian students in Britain. Eighty‐one Malay and 110 Chinese students enrolled in various courses answered a self‐report questionnaire that examined various aspects of sociocultural adjustment. A series of one‐way analyses of variance showed that Malay participants experienced poorer sociocultural adjustment in comparison with their Chinese counterparts. They were also less likely than Chinese students to have contact with co‐nationals and host nationals, more likely to perceive their actual experience in Britain as worse than they had expected, and more likely to perceive greater cultural distance and greater discrimination. The results of regression analyses showed that, for Malay participants, perceived discrimination accounted for the greatest proportion of variance in sociocultural adjustment (73%), followed by English language proficiency (10%) and contact with host nationals (4%). For Chinese participants, English language proficiency was the strongest predictor of sociocultural adjustment (54%), followed by expectations of life in Britain (18%) and contact with host nationals (3%). By contrast, participants' sex, age, and length of residence failed to emerge as significant predictors for either ethnic group. Possible explanations for this pattern of findings are discussed, including the effects of Islamophobia on Malay‐Muslims in Britain, possible socioeconomic differences between Malay and Chinese students, and personality differences between the two ethnic groups. The results are further discussed in relation to practical steps that can be taken to improve the sociocultural adjustment of sojourning students in Britain.
Alcohol and substance use in the Arabian Gulf region: A review
Authors: AlMarri Tayyiba S. K. , Oei Tian P. S.
Published: May 2008

Despite cultural, social, religious, and legal constraints on Muslim Arab nationals living in the Arabian Peninsula against the consumption of alcohol or drugs, usage and dependence do exist. The aim of this paper is to provide a systematic review, compiling and critiquing the literature in this interesting yet neglected area. Information about the current status of alcohol and substance abuse research and knowledge in the Arabian Gulf region will be presented, providing an accessible synopsis of available papers. A systematic review of English and Arabic language literature was conducted by searching electronic databases (1975–2007) and conducting hand searches of Arab published journals. Only studies investigating alcohol and/or substance use or abuse issues with participants (1) of Arab nationality, (2) living in an Arabian Gulf country, and (3) of Muslim faith were included. Within this literature, the majority of research has been conducted with clinical male participants. The most commonly abused drugs are alcohol, heroin, and hashish. Literature investigating the substance use domain with people who are not seeking treatment for addiction is extremely limited. Although the research is largely in its infancy, it does however confirm alcohol and substance abuse in Muslim, Gulf Arab nationals. We strongly urge that further research into substance use and abuse in this region is conducted. Community investigations assessing the prevalence, magnitude, and associated problems with alcohol and substance abuse and also research into valid and reliable measurements in these countries are warranted.
Role models, school improvement and the ‘gender gap’—do men bring out the best in boys and women the best in girls?1
Authors: Carrington Bruce , Tymms Peter , Merrell Christine
Published: May 2008

A number of countries are running role model recruitment drives under the assumption that like is good for like: ethnic minority teachers should teach ethnic minority children, women should teach girls, and so on. The empirical basis for this would appear to be case study and personal reflection. This article will examine quantitative data to test the hypothesis that male teachers produce more positive attitudes amongst boys and female teachers amongst girls. Using data from the Performance Indicators in Primary Schools (PIPS) Project, information from 413 separate classes for 11 year‐olds (in England) was examined. One hundred and thirteen were taught by males and 300 by females. All the pupils completed questionnaires that were designed to measure attitude to school, reading, mathematics and science. In addition, background data on those pupils were collected, including cognitive measures, attainment scores, ability measures and home background measures. The data were examined to look at attitudes using multilevel models controlling for background factors. The analysis concentrated on interaction effects between the gender of the teacher and the gender of the pupil and the results gave little support for those who advocate recruitment drives with role models in mind.
Motor skills, attention and academic achievements. An intervention study in school years 1–3
Authors: Ericsson Ingegerd
Published: May 2008

The aim was to study effects of an extension of physical education and motor training on motor skills, attention and cognition during a period of three years. The study has two intervention groups (n = 152) that have physical activity and motor training one lesson every school day and one control group (n = 99) that has the school's ordinary physical education two lessons per week. The method is hypothetic‐deductive. The results confirm the hypothesis that children's motor skills improve with extended physical activity and motor training. The hypothesis that children's attention will improve cannot be confirmed. Although pupils in intervention groups have better attention in school year 2 than pupils in the control group, the differences do not remain in school year 3. The third hypothesis concerning academic achievements is confirmed by several results in Swedish and mathematics. The MUGI observation programme was found to be useful both as a screening and as a pedagogic instrument.
Improvement in National Test arithmetic scores at Key Stage 1: Grade inflation or better achievement?
Authors: Meadows Sara , Herrick David , Witt Marcus ,   The ALSPAC Study Team
Published: May 2008

The aim of the National Numeracy Strategy is to raise standards in numeracy. Strong evidence for its success has, however, been lacking: most of the available data come from performance on National Test assessments administered in schools or from Ofsted reports, and is vulnerable to suggestions of bias. An opportunistic analysis of data from a population cohort study extending over three school years compares school‐based scores at school entry and at age 7–8 with clinic‐based scores on similar tests. The results show a small but statistically significant rise between 1998 and 1999 and between 1998 and 2000 in scores on both KS1 arithmetic SATs taken in schools and the arithmetic component of the WISC test taken in an independent research clinic. This is evidence for a real rise in generalised arithmetic ability over this period which may be attributable to the children's experience of the National Numeracy Strategy.
White matter abnormalities in children with idiopathic developmental delay
Authors: Widjaja E. , Nilsson D. , Blaser S. , Raybaud C.
Published: May 2008

Background: The underlying cause of developmental delay (DD) often remains unclear despite extensive clinical examination and investigations. Interference in normal development of the brain may result in DD.

Purpose: To identify the prevalence of abnormalities on magnetic resonance (MR) imaging in idiopathic developmental delay.

Material and Methods: Of the 124 children referred for MR imaging with DD, 34 were excluded due to known history of progressive neurodevelopmental disorders, birth asphyxia, congenital CNS infections, metabolic disorder, chromosomal anomalies, and severe epileptic syndromes. The following structures were systematically reviewed: ventricles, corpus callosum, gray and white matter, limbic system, basal ganglia, brainstem, and cerebellum.

Results: Ten out of 90 (11%) were referred with DD only, whilst 80/90 (89%) were referred with DD and additional clinical findings, such as seizures, neurological deficit, and abnormal head size. Of the 90 patients, 14 (16%) had normal MR and 76 (84%) had abnormal MR findings. Abnormal ventricles were seen in 43/90 (48%); abnormal corpus callosum was identified in 40/90 (44%). Other MR findings included abnormalities in the white matter (23/90, 26%), hippocampi (5/90, 6%), cerebellum (5/90, 6%), and brainstem (4/90, 4%).

Conclusion: Abnormalities of the ventricles and corpus callosum were identified in a large proportion of patients with idiopathic DD, indicative of changes in the white matter. Further studies using quantitative methods and diffusion tensor imaging are required to evaluate the white matter in these children.
Magnetic resonance imaging results can affect therapy decisions in hyperacute stroke care
Authors: Heidenreich J. O. , Hsu D. , Wang G. , Jesberger J. A. , Tarr R. W. , Zaidat O. O. , Sunshine J. L.
Published: May 2008

Background: Despite some limitations, a perfusion/diffusion mismatch can provide a working estimate of the ischemic penumbra in hyperacute stroke and has successfully been used to triage patients.

Purpose: To evaluate whether the addition of magnetic resonance imaging (MRI) to clinical and non-contrast computed tomography (CT) data alters diagnosis and choice of therapy.

Material and Methods: We retrospectively analyzed clinical records, and CT and MRI data fully available in 97 of 117 patients. Upon clinical examination and CT, a diagnosis and treatment path was scored and compared to treatment path after addition of MRI data. The MRI protocol included T2-weighted images, diffusion-weighted images (DWI), and perfusion-weighted images (PWI), and MR angiography (MRA).

Results: MRI data were acquired in less than 15 min. In 20 of 97 patients (21%), the diagnosis changed after MRI. In 25 of 97 patients (26%), the presumptive treatment plan was changed after MRI evaluation. Thirteen patients had their treatment changed from thrombolytic to nonthrombolytic therapy. Three patients were changed from nonthrombolytic to intraarterial (IA) thrombolysis. In one patient, treatment was changed from intravenous (IV) to IA thrombolysis, and in five patients it was changed from IA to IV thrombolysis. In two patients, systemic heparin was added to antiplatelet therapy.

Conclusion: The expansion of the acute stroke protocol to include MRI altered the therapy plan in 26% of our patients. The utility of MRI, shown here to improve patient stratification into best-treatment options, demonstrates the value of using MRI to optimize care in hyperacute stroke patients.
Evaluation of accordance of magnetic resonance volumetric and flow measurements in determining ventricular stroke volume in cardiac patients
Authors: Jeltsch M. , Ranft S. , Klass O. , Aschoff A. J. , Hoffmann M. H. K.
Published: May 2008

Background: Cardiovascular magnetic resonance imaging (CMR) has become an established noninvasive method for evaluating ventricular function utilizing three-dimensional volumetry. Postprocessing of volumetric measurements is still tedious and time consuming. Stroke volumes obtained by flow quantification across the aortic root or pulmonary trunk could be utilized to increase both speed of workflow and accuracy.

Purpose: To assess accuracy of stroke volume quantification using MR volumetric imaging compared to flow quantification in patients with various cardiac diseases. Strategies for the augmentation of accuracy in clinical routine were deduced.

Material and Methods: 78 patients with various cardiac diseases—excluding intra- or extracardiac shunts, regurgitant valvular defects, or heart rhythm disturbance—underwent cardiac function analysis with flow measurements across the aortic root and cine imaging of the left ventricle. Forty-six patients additionally underwent flow measurements in the pulmonary trunk and cine imaging of the right ventricle.

Results: Left ventricular stroke volume (LVSV) and stroke volume of the aortic root (SVAo) correlated with r=0.97, and Bland-Altman analysis showed a mean difference of 0.11 ml and a standard error of estimation (SEE) of 4.31 ml. Ninety-two percent of the data were within the 95% limits of agreement. Right ventricular stroke volume (RVSV) and stroke volume of the pulmonary trunk (SVP) correlated with a factor of r=0.86, and mean difference in the Bland-Altman analysis was fixed at –2.62 ml (SEE 8.47 ml). For RVSV and SVP, we calculated r=0.82, and Bland-Altman analysis revealed a mean difference of 1.27 ml (SEE 9.89 ml). LVSV and RVSV correlated closely, with r=0.91 and a mean difference of 2.79 ml (SEE 7.17 ml). SVAo and SVP correlated with r=0.95 and a mean difference of 0.50 ml (SEE 5.56 ml).

Conclusion: Flow quantification can be used as a guidance tool, providing accurate and reproducible stroke volumes of both ventricles. Combining both offers a highly accurate tool to gauge ventricular function in a routine clinical setting, increasing workflow speed.
Prostate cancer detection: comparison of t2-weighted imaging, diffusion-weighted imaging, proton magnetic resonance spectroscopic imaging, and the three techniques combined
Authors: Chen M. , Dang H.-D. , Wang J.-Y. , Zhou C. , Li S.-Y. , Wang W.-C. , Zhao W.-F. , Yang Z.-H. , Zhong C.-Y. , Li G.-Z.
Published: May 2008

Background: Magnetic resonance (MR) imaging has been established as the best imaging modality for the detection, localization, and staging of prostate cancer on account of its high resolution of soft tissue and the possibilities of multiplanar and multiparameter scanning.

Purpose: To evaluate T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), MR spectroscopy (MRS), and the combination of these three MR techniques in the diagnosis of prostate cancer, as correlated to histopathologic findings.

Material and Methods: MR imaging, including T2WI, DWI, and MRS, was performed at 1.5T with a body coil combined with a spine coil in 42 cases. Diagnosis was confirmed by histopathology through systematic transrectal prostate biopsy. Apparent diffusion coefficient (ADC) maps were obtained with two b values (0 and 1000 s/mm2). The metabolic maps of 3D-MRS imaging were analyzed for the ratio of (Cho+Cre)/Cit in each sextant. All cases were evaluated by T2WI, DWI, and MRS, and then by the three methods combined. The statistical indicators and the receiver operating characteristic (ROC) curve analysis of each method were compared to the results of histopathology obtained by transrectal prostate biopsy.

Results: 15 of 42 cases were confirmed to be cancerous, and 27 of 42 cases were noncancerous. All the 252 sextants were confirmed by biopsies, including 201 benign sextants and 51 malignant sextants. The sensitivity and the specificity for the detection of prostate cancer were 88.2% and 67.2% for T2WI, as the cutoff was 3; 82.4% and 81.6% for DWI, as the cutoff was 4; 84.3% and 98.0% for MRS, as the cutoff was 5; and 96.1% and 96.5% for the combined T2WI+DWI+MRS, as the cutoff was 4. In the ROC analysis, the correlative areas under the ROC curves (Az) were 0.848±0.030, 0.860±0.033, and 0.961±0.016 for T2WI, DWI, and MRS, respectively, and 0.978±0.009 for the combination of T2WI+DWI+MRS.

Conclusion: The accuracy of the detection of prostate cancer is increased through a combination of the three techniques. Moreover, MRS demonstrated higher accuracy compared with T2WI or DWI.
Redistribution of multiple hepatic arteries into a single hepatic artery to perform repeated hepatic arterial infusion chemotherapy
Authors: Yamagami T. , Yoshimatsu R. , Matsumoto T. , Nishimura T.
Published: May 2008

Background: In patients with two or more intrahepatic arteries, multiple intrahepatic arteries should be converted into a single intrahepatic artery before repeated hepatic arterial infusion chemotherapy. However, the number of reports investigating this has been scanty.

Purpose: To evaluate the usefulness of the redistribution of multiple hepatic arteries into a single hepatic artery for repeated hepatic arterial infusion chemotherapy (HAIC) through an indwelling port-catheter system for unresectable liver malignancies.

Material and Methods: In 76 patients with unresectable advanced liver cancer, redistribution of multiple hepatic arteries into one hepatic artery was performed prior to port-catheter system implantation. Investigated were distribution in the liver, as evaluated with computed tomography (CT) during arteriography via the port after implantation, and management of cases in which distribution in the entire liver was not achieved.

Results: In 64 patients, good distribution in the entire liver was confirmed on CT arteriography via the port. In the remaining 12 patients, contrast material was heterogeneously distributed. The segments with poor distribution were segments VI, VII, VIII, and I. In the five patients with tumors in segments having poor distribution, the right inferior phrenic artery was successfully embolized and good distribution throughout the entire liver was thereafter achieved in all five.

Conclusion: In cases with multiple hepatic arteries, redistribution procedures allow application of repeated HAIC through a single indwelling catheter while maintaining distribution over the entire liver. However, care regarding hepatopetal flow of the right inferior phrenic artery is necessary.
Magnetic resonance features of cerebral malaria
Authors: Yadav P. , Sharma R. , Kumar S. , Kumar U.
Published: May 2008

Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome.

Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium.

Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm2, and apparent diffusion coefficient (ADC) maps were obtained.

Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map.

Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients.
Imaging of the inflammatory response in reperfusion injury after transient cerebral ischemia in rats: correlation of superparamagnetic iron oxide-enhanced magnetic resonance imaging with histopathology
Authors: Kim J. , Kim D. I. , Lee S.-K. , Kim D. J. , Lee J. E. , Ahn S. K.
Published: May 2008

Background: Acute inflammatory responses have been thought to play a central role in ischemia-reperfusion injury after acute ischemic stroke. Superparamagnetic iron oxide (SPIO) particles have been known to enable in-vivo monitoring of macrophage infiltration by magnetic resonance imaging (MRI) in the experimental ischemic rat brain.

Purpose: To determine whether the accumulation of macrophages could be seen in vivo in a reperfusion animal model after focal cerebral ischemia using SPIO-enhanced MRI.

Material and Methods: Thirty-four adult male rats were enrolled in this study. SPIO particles were injected into the rats at different time points after 1-hour transient occlusion of the middle cerebral artery, and three-dimensional (3D) T2*-weighted magnetic resonance (MR) images with a gradient-echo sequence were performed 24 hours later. Histochemical iron staining was compared with T2* signal abnormalities.

Results: At days 3 and 4 post-reperfusion, focal areas of signal loss indicating local accumulation of SPIO particles appeared in a part of the damaged brain. Areas of signal loss corresponded to local accumulation of iron-laden macrophages in histologic sections, and SPIO-induced signal loss indicated active macrophage transmigration into the reperfused brain.

Conclusion: SPIO-enhanced MRI demonstrated through in-vivo monitoring that macrophages participate in reperfusion injury at early stages of injury development. SPIO-enhanced MRI could be a useful tool to examine the inflammatory mechanisms involved in reperfusion brain injury.
Color doppler appearance of penile cavernosal-spongiosal communications in patients with high-flow priapism
Authors: Bertolotto M. , Zappetti R. , Pizzolato R. , Liguori G.
Published: May 2008

Background: Superselective embolization of the torn artery is currently considered the treatment of choice for patients with high-flow priapism. After embolization, however, the arterial-sinusoidal fistula is still patent in a significant percentage of patients, despite arteriographic evidence of occlusion.

Purpose: To investigate the prevalence and flow characteristics of penile cavernosal-spongiosal communications (CSCs) in patients with high-flow priapism, and to establish whether the recognition of these vessels before and after angiographic embolization has a role in predicting the outcome of therapy.

Material and Methods: Twelve consecutive patients with high-flow priapism underwent penile color Doppler ultrasound before and after angiographic embolization of the arterial-sinusoidal fistula. The prevalence of CSCs feeding the fistula was evaluated before and after embolization.

Results: Before angiographic embolization, color Doppler ultrasound identified five CSCs in 3/12 patients. One CSC was proximal to the fistula, and 4/5 were distal. After angiographic embolization, the fistula was not completely closed in these patients, fed by the distal CSCs. However, spontaneous closure occurred within 1 month. The fistula was also fed by CSCs in another two patients in whom these vessels were not evident before embolization. In one case, the fistula closed spontaneously within 1 week, while in the other case the fistula remained patent, fed by other collateral vessels.

Conclusion: The type of vessels that are involved in refilling the fistula after embolization is of concern for the outcome of the patients. In our series, the fistulas supplied only by CSCs closed spontaneously within 1 month. Watchful waiting should be preferred to repeated embolization to avoid the risk of unnecessary procedures.
Contrast medium dose-to-gfr ratio: a measure of systemic exposure to predict contrast-induced nephropathy after percutaneous coronary intervention
Authors: Nyman U. , Björk J. , Aspelin P. , Marenzi G.
Published: May 2008

Background: The contrast medium (CM) dose-to-eGFR (estimated glomerular filtration rate) ratio has recently been advocated to express systemic exposure to CM in assessing the risk of contrast medium-induced nephropathy (CIN).

Purpose: To evaluate how CIN risk might vary with decreasing eGFR at fixed CM-dose/eGFR ratios and other CIN risk factors, and to find a relatively safe CM-dose/eGFR ratio.

Material and Methods: 391 patients underwent primary coronary angioplasty for ST-segment elevation acute myocardial infarction. CM dose (grams iodine; g I), eGFR (ml/min), and preprocedural CIN risk factors were entered into a multiple logistic regression model. From the established statistical model, the probability of CIN (≥44.2 µmol/l serum creatinine rise or oliguria/anuria) was calculated at various eGFR levels based on g-I/eGFR ratios of 1:2, 1:1, 2:1, and 3:1.

Results: At a g-I/eGFR ratio <1 the risk of CIN was 3%, while it was 25% at a g-I/eGFR ratio ≥1. Independent predictors of CIN were CM dose, eGFR, left ventricular ejection fraction (LVEF) and cardiogenic shock (ROC area =0.87). An estimated CIN risk of 10% would for example occur at a g-I/eGFR ratio of 1.5:1 in patients with 50% LVEF without shock. At a 1:2, 1:1, 2:1, and 3:1 g-I/eGFR ratio with 50% LVEF without shock, the CIN risk was about 2, 6, 18, and 30%, respectively, over a wide range of eGFR values (30–90 ml/min). At a 1:1 g-I/eGFR ratio with 50% LVEF+shock, 25% LVEF without shock, or 25% LVEF+shock, the CIN risk was 20, 55, and 80%, respectively.

Conclusion: Relating CM dose to eGFR appears to be an attractive pharmacotoxic model to assess CIN risk. At fixed CM-dose/eGFR ratios, CIN risk increased marginally with decreasing eGFR. Limiting the CM dose in g I numerically to the eGFR value in ml/min or less may be relatively safe with regard to CIN, unless multiple risk factors are present.
Magnetic resonance evaluation of adnexal masses
Authors: Guerra A. , Cunha T. M. , Félix A.
Published: May 2008

Background: Accurate evaluation of adnexal masses allows correct surgical procedure, avoiding unnecessary surgery.

Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of malignancy of adnexal lesions.

Material and Methods: We retrospectively reviewed the pelvic MRI scans of 161 patients with 199 surgically confirmed adnexal masses, between November 1998 and June 2005. The criteria for adnexal malignancy were contrast-enhanced solid lesions, contrast-enhanced solid components in mixed lesions (except those with low-signal-intensity solid components on T2-weighted imaging [T2WI]), contrast-enhanced papillary projections in cystic lesions (except those with low-signal-intensity papillary projections on T2WI), or septal thickness ≥3 mm. Ascites, peritoneal metastasis, and pelvic adenopathy were also regarded as criteria for malignancy.

Results: On MRI evaluation, 97 adnexal lesions were malignant and 102 were non-malignant. Thirty-two percent of patients with ascites had benign lesions. Histopathologic evaluation of the adnexal lesions showed that 83 were malignant (true positives), 100 were non-malignant (true negatives), and seven were uncertain malignant potential tumors; two were false negative and seven were false positive. The MRI sensitivity and specificity for malignancy were 98% and 93%, respectively. MRI reached an accuracy of 95%, with a positive predictive value of 0.92 and a negative predictive value of 0.98 for malignant adnexal lesions. The kappa coefficient was 0.906, indicating almost perfect agreement between MRI and histological results.

Conclusion: MRI is an accurate method for evaluating the malignancy of adnexal lesions.
Muscle compromise in diabetes
Authors: Yildirim Donmez F. , Feldman F.
Published: May 2008

Muscle compromise associated with diabetes includes muscle infarction, myositis, pyomyositis, and abscess formation. These conditions may also be seen in various other conditions, such as trauma, alcoholism, neoplasia, vasculopathy, HIV infection, and other immunocompromised states and hemoglobinopathies. Due to recent advances in imaging technology, these entities are readily detected and treated at an earlier stage. Different diagnostic modalities may be used, particularly magnetic resonance imaging (MRI), which is best for soft-tissue pathologies. Muscle infarction appears with acute edema and inflammatory changes on T1- and T2-weighted images, enhancing peripherally postcontrast, and nonenhancing central areas suggestive of necrosis, lacking focal fluid collections. The latter feature may help to exclude abscesses, as these mostly present with fluid collections. Pyomyositis in its early period demonstrates ill-defined muscle enlargement with increased signal on T2-weighted images. Myositis shows no signal changes or mild hypointensity on T1-weighted images, but diffuse hyperintensity on T2-weighted images, with no or minimal enhancement following intravenous contrast media. Recognition of these pathologies is important, since management approaches vary depending on the etiology of the muscle involvement and overall status of the patient.
Có vay có tra’ (What goes around comes around): culture, risk and vulnerability to blood‐borne viruses among ethnic Vietnamese injecting drug users
Authors: HO HIEN THI , MAHER LISA
Published: May 2008

Introduction and Aims. Ethnic and cultural differences in vulnerability to drug‐related harms have received little attention in Australia. The current study aimed to explore the influence of cultural beliefs and practices on vulnerability to blood‐borne viral infections (BBVIs) among ethnic Vietnamese IDUs and to identify barriers to this group accessing health and preventive programmes. Design and Methods. Observational fieldwork and in‐depth interviews (n = 58) were conducted in South Western Sydney. Participants were recruited using a mix of snowball and theoretical sampling strategies. Open coding was used to inductively classify data into themes and data examined for regularities and variations in relationships between and within themes. Results. Participants embraced pluralistic approaches to prevention, diagnosis and treatment, relying on co‐existing layers of beliefs and utilising both traditional and western remedies. Four main cultural characteristics influenced vulnerability to BBVIs: trust and obligation, stoicism, the importance of ‘face’ and beliefs in fate. Other factors influencing injecting risk included low levels of knowledge, being in a state of withdrawal, availability of sterile injecting equipment and environmental constraints. Barriers to accessing services included stigma and discrimination, concerns in relation to confidentiality, long waiting times, resistance to pharmacotherapy treatment and language and financial barriers. Discussion and Conclusions. Results indicate a need for interventions based on culturally specific meanings and contexts of health, illness and risk. By understanding how culture impacts risk and protective behaviours among ethnic Vietnamese IDUs, clinicians and other service providers will be better equipped to meet the needs of this vulnerable group.
Why are alcohol‐related emergency department presentations under‐detected? An exploratory study using nursing triage text
Authors: INDIG DEVON , COPELAND JAN , CONIGRAVE K. M. , ROTENKO IRENE
Published: May 2008

Introduction and Aims. This study examined two methods of detecting alcohol‐related emergency department (ED) presentations, provisional medical diagnosis and nursing triage text, and compared patient and service delivery characteristics to determine which patients are being missed from formal diagnosis in order to explore why alcohol‐related ED presentations are under‐detected. Design and Methods. Data were reviewed for all ED presentations from 2004 to 2006 (n = 118 881) for a major teaching hospital in Sydney, Australia. Each record included two nursing triage free‐text fields, which were searched for over 60 alcohol‐related terms and coded for a range of issues. Adjusted odds ratios were used to compare diagnostically coded alcohol‐related presentations to those detected using triage text. Results. Approximately 4.5% of ED presentations were identified as alcohol‐related, with 24% of these identified through diagnostic codes and the remainder identified by triage text. Diagnostic coding was more likely if the patient arrived by ambulance [odds ratio (OR) = 2.35] or showed signs of aggression (OR = 1.86). Failure to code alcohol‐related issues was more than three times (OR = 3.23) more likely for patients with injuries. Discussion and Conclusions. Alcohol‐related presentations place a high demand on ED staff and less than one‐quarter have an alcohol‐related diagnosis recorded by their treating doctor. In order for routine ED data to be more effective for detecting alcohol‐related ED presentations, it is recommended that additional resources such as an alcohol health worker be employed in Australian hospitals. These workers can educate and support ED staff to identify more clearly and record the clinical signs of alcohol and directly provide brief interventions.
Satisfaction guaranteed? What clients on methadone and buprenorphine think about their treatment
Authors: MADDEN ANNIE , LEA TOBY , BATH NICKY , WINSTOCK ADAM R.
Published: May 2008

Introduction and Aims. A consumer satisfaction survey was conducted among clients receiving methadone or buprenorphine treatment for opioid dependence. The survey aimed to assess client perceptions across a number of treatment domains, including the clinic environment, service provision, clinical relationships, medication and treatment outcomes. Design and Methods. Participants were 432 clients receiving treatment at nine public clinics in New South Wales, Australia. An interviewer‐administered questionnaire was utilised, designed by the researchers. Participation was voluntary and anonymous. All participants received $10 remuneration. Results. Seventy‐eight per cent of participants were on methadone treatment. Overall satisfaction with treatment was high (mean: 3.8; very satisfied = 5). Participants were mainly satisfied with service provided by the clinic, although had concerns over the inflexibility associated with the clinic atmosphere, frequency of clinic attendance, dosing hours and lack of takeaway doses. While relationships with prescribers and case managers were rated positively, 16% and 21% of participants wanted to see their prescriber and case manager more often, respectively; 53% reported that they did not have input into their care plan. Regarding the helpfulness of case managers in assisting clients with problems experienced in identified domains of case management (e.g. drug use, physical and mental health, psychosocial supports), the mean rating was 5.2 (excellent = 10). Discussion and Conclusions. While participants reported being mainly satisfied with their treatment, results must be viewed within the context of what a consumer reasonably expects to receive from a service. The concept of ‘expectation’ and ‘relative experience’ is crucial in measuring consumer satisfaction among pharmacotherapy consumers.
How large must a treatment effect be before it matters to practitioners? An estimation method and demonstration
Authors: MILLER WILLIAM R. , MANUEL JENNIFER KNAPP
Published: May 2008

Introduction and Aims. Treatment research is sometimes criticised as lacking in clinical relevance, and one potential source of this friction is a disconnection between statistical significance and what clinicians regard to be a meaningful difference in outcomes. This report demonstrates a novel methodology for estimating what substance abuse practitioners regard to be clinically important differences. Design and Methods. To illustrate the estimation method, we surveyed 50 substance abuse treatment providers participating in the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Practitioners identified thresholds for clinically meaningful differences on nine common outcome variables, indicated the size of effect that would justify their learning a new treatment method and estimated current outcomes from their services. Results. Clinicians judged a difference between two treatments to be meaningful if outcomes were improved by about 10 – 12 points on the percentage of patients totally abstaining, arrested for driving while intoxicated, employed or having abnormal liver enzymes. A 5 percentage‐point reduction in patient mortality was regarded as clinically significant. On continuous outcome measures (such as percentage of days abstinent or drinks per drinking day), practitioners judged an outcome to be significant when it doubled or halved the base rate. When a new treatment meets such criteria, practitioners were interested in learning it. Discussion and Conclusions. Effects that are statistically significant in clinical trials may be unimpressive to practitioners. Clinicians' judgements of meaningful differences can inform the powering of clinical trials.