bluuebunny/crossref_metadata_2025 huggingface dataset:
Life satisfaction effects of unemployment in Europe: The moderating influence of labour market policy
Authors: Wulfgramm Melike
Published: June 2014

Public policy shapes the lives of individuals, and even more so if they depend on state support. In the case of unemployment, the financial situation is largely determined by cash transfers and daily routines depend on the involvement in active labour market policy measures. To what extent, however, can subjective well-being differences of European unemployed be traced back to the national design and generosity of labour market policy? This article applies multilevel and panel estimation techniques to identify the moderating effect of unemployment benefit generosity and active labour market policy on life satisfaction of the unemployed. While unemployment has strong negative life satisfaction effects in all 21 European countries under study, the generosity of passive labour market policy moderates this effect to a surprisingly large extent: the adverse effect of unemployment is almost doubled if unemployment benefits are meagre. This moderating effect can be explained both by a resource as well as a non-pecuniary mechanism. The positive moderating effect of active labour market policy is less robust across model specifications.
Migrant deprivation, conditionality of legal status and the welfare state
Authors: Corrigan Owen
Published: June 2014

This article adds to our theoretical understanding of the determination of third-country national (TCN) migrant deprivation and poverty in western Europe. The stratifying effects of different types of legal status on migrant outcomes have been established in previous research. The conditionality that states attach to securing different types of legal status has heretofore been overlooked as an important explanatory factor, however. A measure of the conditionality attached to attaining the key social rights–granting status of long-term residency (LTR) is operationalized using cross-national policy data. Building on existing theory, we hypothesize that the negative impact of welfare generosity on TCN material deprivation is moderated by a state’s level of LTR conditionality, such that deprivation will be greatest where conditionality is high and generosity is low. This hypothesis is tested using large-scale European microdata in the context of multilevel modelling. The empirical results are consistent with the central hypothesis. These findings have implications for policymakers and for extant accounts of migrant welfare, the welfare state and the factors implicated in the determination of poverty and deprivation in Europe.
Pandemic influenza immunization in primary antiphospholipid syndrome (PAPS): a trigger to thrombosis and autoantibody production?
Authors: de Medeiros D Martins , Silva C A , Bueno C , Ribeiro A C Medeiros , Viana V dos Santos T , Carvalho J Freire , Bonfa E
Published: June 2014

Objective

The objective of this report is to conduct short- and long-term evaluation of a large panel of antiphospholipid (aPL) autoantibodies following pandemic influenza A/H1N1 non-adjuvant vaccine in primary antiphospholipid syndrome (PAPS) patients and healthy controls.

Methods

Forty-five PAPS and 33 healthy controls were immunized with H1N1 vaccine. They were prospectively assessed at pre-vaccination, and three weeks and six months after vaccination. aPL autoantibodies were determined by an enzyme-linked immunosorbent assay (ELISA) and included IgG/IgM: anticardiolipin (aCL), anti-beta2glycoprotein I (anti-β2GPI); anti-annexin V, anti-phosphatidyl serine and anti-prothrombin antibodies. Anti-Sm was determined by ELISA and anti-double-stranded DNA (anti-dsDNA) by indirect immunofluorescence. Arterial and venous thrombosis were also clinically assessed.

Results

Pre-vaccination frequency of at least one aPL antibody was significantly higher in PAPS patients versus controls (58% vs. 24%, p = 0.0052). The overall frequencies of aPL antibody at pre-vaccination, and three weeks and six months after immunization remained unchanged in patients ( p = 0.89) and controls ( p = 0.83). The frequency of each antibody specificity for patients and controls remained stable in the three evaluated periods ( p > 0.05). At three weeks, two PAPS patients developed a new but transient aPL antibody (aCL IgG and IgM), whereas at six months new aPL antibodies were observed in six PAPS patients and none had high titer. Anti-Sm and anti-dsDNA autoantibodies were uniformly negative and no new arterial or venous thrombosis were observed throughout the study.

Conclusions

This is the first study to demonstrate that pandemic influenza vaccine in PAPS patients does not trigger short- and long-term thrombosis or a significant production of aPL-related antibodies (ClinicalTrials.gov, #NCT01151644).
Correlation between serum 25(OH)D values and lupus disease activity: an original article and a systematic review with meta-analysis focusing on serum VitD confounders
Authors: Sahebari M , Nabavi N , Salehi M
Published: June 2014

Notwithstanding that several original studies and some systematic reviews have been undertaken on the subject “correlation between serum values of vitamin D (VitD) and lupus disease activity,” there is still no consensus on the importance of sectional measurement of serum VitD in the prediction of disease activity and important confounders in estimation of serum VitD. Medline, Web of Knowledge, and Scopus databases were searched from 1995 to 2013. The following medical subject heading (MeSH) terms and/or text words were used: “Vitamin D” OR “25OHD” OR “25(OH)D” combined with “systemic lupus erythematosus” OR “lupus” OR “SLE.” References cited in the identified articles were also manually searched. Human studies in any language were included. Original research on this topic was also carried out on 82 lupus patients, considering important VitD confounders according to our systematic review and we included them in the meta-analysis. A total of 35 studies were registered for this study. Only 11 of these pointed to this correlation by Pearson test. The pooled Pearson correlation ( r) of associations between disease activity and VitD was −0.365 (95% CI: −0.536, −0.165) with significant heterogeneity ( p = 0.001 I2 = 93%). Sensitivity analysis resulted in no significant differences. The most important adjustable confounders considered by researchers were drugs, especially hydroxychloroquine, prednisolone and supplementary VitD, body mass index (BMI) and proteinuria or renal function. Only proteinuria was reported to influence VitD concentration strongly. BMI was another probable influencing factor. Our original research presented no correlation between VitD and SLEDAI ( p = 0.68, rs = 0.003). This meta-analysis demonstrated that most of the studies on the relationship between VitD and lupus disease activity that found no correlation did not present the details of the statistics. However, analyzing 11 studies, most of which found a reverse correlation and reported it in detail, and our study found a weak reverse correlation between those two items. Systematic review of confounders showed that BMI, medications and kidney involvement were the most remarkable ones reported by researchers.
New Zealand Mental Health Review Tribunal characteristics and outcomes 1993–2011
Authors: Thom Katey
Published: June 2014

Objective:

This paper provides a descriptive statistical overview of Mental Health Review Tribunal outcomes from 1992 to 2011.

Method:

A database used by administrators of the Mental Health Review Tribunal to store information on applicants and their hearing outcomes was subjected to basic descriptive analysis.

Results:

A total of 3117 applications were received, with most applications received from males ( n=2039, 65%) of New Zealand European ethnicity and a mean age of 49 years. A similar number of applications were received from inpatient and community patients (35%, 28% respectively). There was only a small percentage (7%) of applicants who were released and the number of applications withdrawn before a hearing took place was high, at 45%.

Conclusion:

The success rates of New Zealand Mental Health Review Tribunal applicants is low compared with some international jurisdictions, while at the same time withdrawals are high, warranting further investigation. Applicants in the community are underrepresented, which is of concern in the context of rising use of community treatment orders. Future research focused on service users’ experiences of using the Mental Health Review Tribunal and improvements to the existing data stored on applicants are also suggested.
Expectation in Life Review
Authors: Deng Di , Deng Qing , Liu Xiaofang , Xie Cong Hua , Wu Xin
Published: June 2014

Terms such as spirituality and spiritual needs are abstract and difficult to understand. Realization of spirituality of hospice patients was premise in addressing expression of their spiritual needs. This study investigated expectations expressed during life review and tried to prove that the expectation was intelligible term for spiritual needs in Chinese hospice from May 2011 to June 2013. Among the 107 recruited patients, families were the most frequent emotion-expressing recipients, and 133 expectations related to patients’ spiritual needs were identified. The emotion-expressing recipients and the patient’s expectations were not affected by demographic characteristics. The expectations in life review with hospice patients and their families had the features of spiritual essence. The identified expectation contents could be used to address spiritual needs in hospice care in Chinese.
Motion Analysis to Track Navicular Displacements in the Pediatric Foot
Authors: Kothari Alpesh , Dixon Philippe Courtney , Stebbins Julie , Zavatsky Amy Beth , Theologis Tim
Published: June 2014

Background:

Increased navicular drop (NDro) and navicular drift (NDri) are associated with musculoskeletal pathology in adults. The aim of this study was to investigate navicular motion in children, with respect to foot posture, and identify altered patterns of motion that demonstrate midfoot dysfunction. Navicular motion in different activities was evaluated as well as the role of flexibility and body mass index (BMI).

Methods:

Twenty-five children with flatfeet and 26 with neutral feet (age range, 8-15) underwent gait analysis using a 12-camera Vicon MX system (Vicon, UK). Navicular motion indices were calculated from marker coordinates. Student t tests and Pearson’s correlation coefficient (R) were used to investigate navicular motion differences between groups. The relationship between NDRo, NDRi, and their dynamic counterparts was also assessed.

Results:

Normalized NDri (NNDri) and normalized NDro (NNDro) correlated strongly in neutral feet (R = 0.56, P = .003) but not in flatfeet (R = 0.18, P > .05). Flatfeet demonstrated reduced NNDri compared to neutral footed children (0.7 vs 1.6, P = .007). No difference was observed in NNDro between groups. Standard and dynamic measures of NDri and NDRo were highly correlated. Navicular motion correlated poorly with BMI and flexibility.

Conclusion:

Motion of the navicular in the transverse and the sagittal plane is important when investigating foot function. Uncoupling of this motion in flatfeet may indicate impaired midfoot function. Reduced navicular medial translation in flatfeet may indicate altered alignment of the talonavicular joint.

Clinical Relevance:

The measurement of dynamic navicular motion indices did not add information about dynamic foot function compared to measurement of static indices.
Posterior Facet Cartilage Injury in Operatively Treated Intra-articular Calcaneus Fractures
Authors: Rothberg David L. , Yoo Brad J.
Published: June 2014

Background:

Direct visualization of the posterior facet in displaced intra-articular calcaneus fractures (DIACF) frequently shows partial or full thickness cartilage delamination. This is felt to be secondary to the depression of an osteoarticular segment of the posterior facet within the calcaneal body and the subsequent contact with fracture edges as it impacts caudally. The purpose of this study was to determine the frequency of cartilage injury and if it correlates with fracture classification.

Methods:

A single surgeon prospective, observational series of 28 patients with 28 DIACFs was reviewed for patient demographic and injury data, radiographic fracture characterization, and intraoperative observation of articular injury size, depth, and location over the time period of February 2010 to December 2012. Observations were correlated with the OTA and Sanders classification systems.

Results:

Age, sex, mechanism of injury, and depth and location of cartilage injury were not significantly different between the 13 OTA/Sanders type 2 and 15 type 3 DIACFs evaluated in this study. Posterior facet articular cartilage delamination was found in 77% of type 2 and 100% of type 3 fractures ( P = .09). Location of cartilage injury was common (56%) along the distal, lateral aspect of the posterior facet ( P < .05). The percentage area of cartilage injury was significantly larger in type 3 fractures (3.1%) then type 2 (1.3%) ( P < .02).

Conclusions:

DIACFs had a consistent location of posterior facet articular cartilage delamination along the distal lateral aspect of the osteoarticular fragment. This lesion was larger in OTA/Sanders classification type 3 fractures compared to type 2 fractures.

Level of Evidence:

Level IV, prospective, observational series.
Accessory Talar Facet Impingement in Pathologic Conditions of the Peritalar Region in Adults
Authors: Niki Hisateru , Hirano Takaaki , Akiyama Yui , Beppu Moroe
Published: June 2014

Introduction:

Associations between accessory anterolateral talar facet (AALTF) and sinus tarsi pain in adults have not been reported. This study aimed to investigate the clinical and imaging characteristics of pathologic conditions of the peritalar region in adults with painful accessory talar facet impingement (ATFI).

Methods:

We included 31 patients (aged 19-75 years) with persistent sinus tarsi pain who underwent surgery and had pathologic conditions of the peritalar region, including adult acquired flatfoot deformity (AAFD; 18 patients), ankle osteoarthritis (8 patients), and ankle instability (5 patients). Continuity between the articular surface of the posterior facet of the talus and AALTF was identified on preoperative computed tomography and magnetic resonance imaging (MRI) of the cartilage. In addition, focal abutting bone marrow edema (FABME) of the talus and calcaneal neck around the AALTF on short TI inversion recovery sequence MRI was confirmed. Subtalar arthroscopy was used to evaluate the AALTF surface characteristics. Pre- and postoperative objective scores were compared. Eight pre- and postoperative radiographic parameters were compared to confirm the effect of foot alignment changes after reconstructions on sinus tarsi pain with ATFI. Pre- and postoperative changes in FABME were compared with 17.1 (7-60) months of follow-up.

Results:

Subjects underwent accessory facet resection with balancing reconstruction. Arthroscopically, 66% of patients showed a focal defect on the AALTF cartilage surface, and 83% showed attenuation of the posterior capsular ligament. All x-ray parameters in AAFD patients showed significant improvement postoperatively ( P < .001). Mean objective scores improved from 54.0 preoperatively to 91.0 postoperatively ( P < .001). Sinus tarsi pain and FABME were absent in all cases at the final follow-up.

Conclusion:

AALTF represents a new etiology of subsequent painful intra-articular talocalcaneal impingement. When addressing sinus tarsi pain, it is important to detect the signs of AALTF on MRI of the cartilage and accompanying FABME.

Level of Evidence:

Level IV, retrospective case series.
Understanding Structural-Functional Relationships in the Human Brain
Authors: Wang Zhijiang , Dai Zhengjia , Gong Gaolang , Zhou Changsong , He Yong
Published: June 2014

Relating the brain’s structural connectivity (SC) to its functional connectivity (FC) is a fundamental goal in neuroscience because it is capable of aiding our understanding of how the relatively fixed SC architecture underlies human cognition and diverse behaviors. With the aid of current noninvasive imaging technologies (e.g., structural MRI, diffusion MRI, and functional MRI) and graph theory methods, researchers have modeled the human brain as a complex network of interacting neuronal elements and characterized the underlying structural and functional connectivity patterns that support diverse cognitive functions. Specifically, research has demonstrated a tight SC-FC coupling, not only in interregional connectivity strength but also in network topologic organizations, such as community, rich-club, and motifs. Moreover, this SC-FC coupling exhibits significant changes in normal development and neuropsychiatric disorders, such as schizophrenia and epilepsy. This review summarizes recent progress regarding the SC-FC relationship of the human brain and emphasizes the important role of large-scale brain networks in the understanding of structural-functional associations. Future research directions related to this topic are also proposed.
Personality Traits and Personal Values
Authors: Parks-Leduc Laura , Feldman Gilad , Bardi Anat
Published: June 2014

Personality traits and personal values are important psychological characteristics, serving as important predictors of many outcomes. Yet, they are frequently studied separately, leaving the field with a limited understanding of their relationships. We review existing perspectives regarding the nature of the relationships between traits and values and provide a conceptual underpinning for understanding the strength of these relationships. Using 60 studies, we present a meta-analysis of the relationships between the Five-Factor Model (FFM) of personality traits and the Schwartz values, and demonstrate consistent and theoretically meaningful relationships. However, these relationships were not generally large, demonstrating that traits and values are distinct constructs. We find support for our premise that more cognitively based traits are more strongly related to values and more emotionally based traits are less strongly related to values. Findings also suggest that controlling for personal scale-use tendencies in values is advisable.
Predicting the Outcomes of Single- and Multistage Selections When Applicant Pools Are Small and Heterogeneous
Authors: De Corte Wilfried
Published: June 2014

This article presents analytic methods and accompanying computational tools for estimating the expected quality and diversity outcome of general multistage selections when the applicant pool is a finite, typically small sample from a mixture of majority and minority applicant populations. The new methods generalize the analytic estimation of the expected quality of small heterogeneous applicant pool selections from simple, single-stage selection situations to the more general, multistage selection context. In addition, the new methods also compute the sampling variability of the selection quality outcome for these selection decisions.
Reputation and the Sexual Abuse of Boys
Authors: Pavlakis Dean
Published: June 2014

In 1895, a Manchester (UK) newspaper accused Gilbert Kirlew of sexually abusing boys at a refuge for homeless and neglected children. Kirlew, the epitome of middle-class respectable masculinity, was a leader in local philanthropic action and mobilization of all kinds. Notably, he was in the forefront of the new social movement to rescue poor children in order to provide them with a secure home and an education suitable for working-class adulthood. The Kirlew sexual abuse scandal illustrates how changes in late-Victorian attitudes about homosexuality, society’s responsibilities to children, and sexual abuse came into conflict with the class-based cultural power of male reputation and character.
Inflammatory joint disease in cats
Authors: Lemetayer Julie , Taylor Susan
Published: June 2014

Practical relevance:

Osteoarthritis, a degenerative non-inflammatory joint disease, is common in cats, usually causing gradual changes in behavior and lifestyle rather than severe lameness. Inflammatory arthritis occurs much less frequently and is nearly always associated with debilitating lameness. It may have an infectious or immune-mediated cause – but, unlike the canine disease, is much more likely to be infectious in origin.

Clinical challenges:

Cats with inflammatory joint disease are presented for evaluation of lethargy, anorexia, reluctance to walk or fever. Synovial fluid collection and analysis is required to confirm joint inflammation, but this is a procedure many veterinarians are not comfortable performing in cats. Once inflammatory arthritis is confirmed, extensive testing is required to diagnose infectious causes and determine appropriate treatment. Immune-mediated polyarthritis can be treated with immunosuppressive drugs only after all infectious possibilities are eliminated. Radiographs are used to characterize the arthritis as erosive or nonerosive, but radiographic changes in cats are often subtle compared with those described in canine rheumatoid-like arthritis.

Audience:

This review, aimed at all veterinarians who treat cats, describes the general clinical approach to feline joint disease, the collection and analysis of synovial fluid, and the diagnosis and management of inflammatory joint diseases affecting cats. The diagnostic approach to an unusual case of erosive polyarthritis is discussed in the Case Notes.

Evidence base:

To date, the veterinary literature on inflammatory joint disease in cats has been limited to older reviews of immune-mediated disorders and multiple single case reports or small case series describing infectious disorders. This article offers a current comprehensive review of these disorders.
Feline respiratory disease
Authors: Lee-Fowler Tekla
Published: June 2014

Practical relevance:

Non-hemotropic Mycoplasma species are frequently implicated in cases of respiratory disease, and also conjunctivitis, in cats.

Clinical challenges:

Mycoplasma species are considered commensal bacteria of the conjunctiva and the upper respiratory tract of cats, and hence their role as a primary pathogen is difficult to determine. These organisms certainly appear to play a significant role as a secondary pathogen in the upper airways, and there is increasing evidence that in some animals they may represent a primary infection. However, mycoplasmas have not been found in the lower airways of clinically healthy cats – suggesting that, when present, they likely represent a pathologic process. Diagnostic challenges exist as well; Mycoplasma species are not typically identified via cytology due to their small size, and culture of these organisms requires special media and handling. Although PCR has improved identification and allowed for speciation, conflicting culture and PCR results can create a dilemma regarding the clinical relevance of infection.

Evidence base:

This article draws on original research and case reports to provide information about the role of Mycoplasma species in thefeline upper and lower respiratory tract, diagnostic methods and associated challenges, and treatment options.

Audience:

The goal is to provide small animal practitioners with a current and organized review of the often-conflicting literature regarding the role of Mycoplasma species in feline respiratory infections.
Risk attitudes and birth order
Authors: Krause Philipp , Heindl Johannes , Jung Andreas , Langguth Berthold , Hajak Göran , Sand Philipp G
Published: June 2014

Risk attitudes play important roles in health behavior and everyday decision making. It is unclear, however, whether these attitudes can be predicted from birth order. We investigated 200 mostly male volunteers from two distinct settings. After correcting for multiple comparisons, for the number of siblings and for confounding by gender, ordinal position predicted perception of health-related risks among participants in extreme sports ( p < .01). However, the direction of the effect contradicted Adlerian theory. Except for alcohol consumption, these findings extended to self-reported risk behavior. Together, the data call for a cautious stand on the impact of birth order on risk attitudes.
Clinical Document Architecture integration system to support patient referral and reply letters
Authors: Lee Sung-Hyun , Song Joon Hyun , Kim Il Kon , Kim Jeong-Whun
Published: June 2014

Many Clinical Document Architecture (CDA) referrals and reply documents have been accumulated for patients since the deployment of the Health Information Exchange System (HIES) in Korea. Clinical data were scattered in many CDA documents and this took too much time for physicians to read. Physicians in Korea spend only limited time per patient as insurances in Korea follow a fee-for-service model. Therefore, physicians were not allowed sufficient time for making medical decisions, and follow-up care service was hindered. To address this, we developed CDA Integration Template (CIT) and CDA Integration System (CIS) for the HIES. The clinical items included in CIT were defined reflecting the Korean Standard for CDA Referral and Reply Letters and requests by physicians. CIS integrates CDA documents of a specified patient into a single CDA document following the format of CIT. Finally, physicians were surveyed after CIT/CIS adoption, and they indicated overall satisfaction.
Nuclear expression of renin-angiotensin system components in NRK-52E renal epithelial cells
Authors: Alzayadneh Ebaa M , Chappell Mark C
Published: June 2014

Introduction:

Isolated nuclei of sheep proximal tubules express angiotensin (Ang) receptors as well as angiotensinogen (AGT) and renin. The present study characterized the NRK-52E tubular epithelial cell line for the intracellular expression of renin-angiotensin system (RAS) components.

Methods:

RAS components were visualized by immunofluorescent staining in intact cells and protein expression in isolated nuclei.

Results:

An antibody to the angiotensin I (Ang I) sequence of AGT (AI-AGT) revealed only cytosolic staining, while an antibody to an internal sequence of AGT (Int-AGT) revealed primarily nuclear staining. Immunoblots of nuclear and cytosolic fractions confirmed the differential cell staining of AGT. Immunostaining for renin was present on nuclei of intact cells. Nuclear renin activity averaged 0.77±0.05 nmol/mg protein/h that was reduced by aliskiren (0.13±0.01 nmol/mg/h, n=3, p<0.01); trypsin activation increased activity three-fold. Peptide staining localized angiotensin II (Ang II) and Ang-(1-7) to the nucleus and peptide content averaged 59±2 and 57±22 fmol/mg ( n=4), respectively. Peptide metabolism in isolated nuclei revealed the processing of Ang I to Ang-(1-7) by thimet oligopeptidase.

Conclusion:

We conclude that the NRK-52E cells express an intracellular RAS localized to the nucleus and may be an appropriate cell model to elucidate the functional relevance of this system.
Use of photovoice with people with younger onset dementia
Authors: Evans David , Robertson Jacinta , Candy Allen
Published: June 2014

Photography is a tool that has been used in research for many years. It allows people to create a record of an event, capture a complex phenomenon or to tell a story with pictures. Because it does not rely on language, it can be used with vulnerable populations who might not normally be included in research. This paper discusses the use of photography as one component of the evaluation strategy for a project that provided an opportunity for people with younger onset dementia to return to the workplace one day per week. Participants in the workplace project used photography to create a record of their experience of returning to the workplace. Based on the nature of the participant’s comments, photographs were grouped into four broad areas: impact of dementia, impact on family, the work experience and new friends. Issues related to the use of photography with people who have dementia are explored based on the experiences gained during this project.
The abuse, neglect and mistreatment of older people with dementia in care homes and hospitals in England: The potential for secondary data analysis: Innovative practice
Authors: Manthorpe Jill
Published: June 2014

There is concern that people with dementia may be at particular risk of elder abuse however there is little data to confirm such fears. This paper presents findings from an up-dated investigation of secondary sources of data about the abuse of older people with dementia in England conducted in 2013. There are many sources of data about poor care, abuse and neglect of people with dementia in care home and hospital settings but these are collected for different purposes and hard to link. The article discusses the ways in which dementia care practitioners may be able to make the most of existing data.
Design of Polycaprolactone Vascular Grafts
Authors: Yalcin I , Horakova J , Mikes P , Sadikoglu T Gok , Domin R , Lukas D
Published: June 2014

A large number of patients suffer from vascular diseases, resulting in the need for bypass surgery. Since there are still limitations in the replacement of small diameter vascular grafts, the need and demand for developing more desirable grafts is increasing day by day. In this study, polycaprolactone small-diameter (6 mm) vascular grafts were produced successfully using custom-designed electrospinning apparatus. Radial fiber orientation was achieved by increasing the rotational speed of the collector. The morphological, structural, mechanical, and biological properties were examined. The results show that oriented scaffolds with 2 µm average fiber diameter provide 1 MPa ultimate tensile strength in the radial direction. The pore size area was found to be adequate in the oriented samples required for cell proliferation and diffusion through the tunica media. In vitro biocompatibility of the grafts was proven with 3T3 mouse fibroblasts. After cell seeding, the oriented fibers serve as a cue for radial cell alignment. An understanding of electrospun material parameters together with knowledge of native blood vessel structures and properties is a considerable part in designing small-diameter vascular grafts.
Computer-Based Cognitive Training for Individuals With Intellectual and Developmental Disabilities
Authors: Siberski James , Shatil Evelyn , Siberski Carol , Eckroth-Bucher Margie , French Aubrey , Horton Sara , Loefflad Rachel F. , Rouse Phillip
Published: June 2014

Background:

There is a growing focus in the United States on preserving cognitive functioning. However, individuals with intellectual and developmental disabilities (ID/DD) are not provided with opportunities to prevent cognitive decline. To investigate whether participants with ID/DD would improve in cognitive function after cognitive training, a cognitive training group (N = 11) was compared to 2 control groups, a computer games group (N = 11) and a waitlist group (N = 10) on performance on 15 cognitive functions.

Findings:

(1) Very high adherence rates (94%) of the sample and 100% of the cognitive training group indicate that when given adequate individual support, adults with ID/DD can successfully use a cognitive stimulation program. (2) No significant between- or within-group effects were observed for cognitive training when a stringent α, corrected for multiple comparisons, was used. (3) Trends of improvement in cognitive function were observed for the cognitive training group.
Total wrist arthroplasty: a systematic review of the evidence from the last 5 years
Authors: Yeoh D. , Tourret L.
Published: June 2014

We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3–7.3 years with an average age of 52–63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3–5 years), while Elos had the lowest (57% at 5 years). Biaxial had the highest complication rates (68.7%), while Remotion had the lowest (11%). Wrist arthroplasty preserves some range of motion. Functional scores improved and were maintained over the mid- to long-term. Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. The evidence does not support the widespread use of arthroplasty over arthrodesis, and careful patient selection is essential.

Level of Evidence: III
Extended interval dosing of natalizumab: a two-center, 7-year experience
Authors: Bomprezzi Roberto , Pawate Siddharama
Published: June 2014

Background:

The enthusiasm for natalizumab, a highly efficacious agent in the treatment of multiple sclerosis (MS), has been tempered by the risks of progressive multifocal leukoencephalopathy associated with its use, and strategies to minimize those risks are of great interest. Extended interval dosing (EID) has been proposed as a way to maintain the efficacy of natalizumab while reducing exposure to it. We reviewed a cohort of patients who received natalizumab at 6–8-week intervals instead of the typical infusions every 4 weeks with the goal to assess if patients on EID had an increase in clinical relapses.

Methods:

This is a retrospective review of all patients with MS treated with natalizumab at two MS centers where patients were offered the opportunity to switch to an EID every 6 or 8 weeks.

Results:

A total of 361 patients received natalizumab for 22 ± 13 months (minimum duration 6 months). Of these, 96 patients received EID natalizumab at some point for 20 ± 11 months (minimum duration 6 months). Over the study period, there was no significant difference between the relapse rate in the monthly dosing (13%) and the EID (13%) groups of patients.

Conclusion:

Natalizumab is effective in controlling MS as very few clinical relapses were observed in our dataset. We found that EID did not compromise the treatment effect as measured by relapse rate and no significant breakthrough disease activity was observed. EID is an optional regimen for maintenance natalizumab therapy, but prospective studies are warranted to determine its efficacy.
To what extent can evaluation frameworks help NGOs to address health inequalities caused by social exclusion?
Authors: Kara Helen , Arvidson Malin
Published: June 2014

Aim:

Tackling health inequalities is a top priority for public health services in England. Third sector organisations, or non-governmental organisations (NGOs), are seen as having a key role in providing these services, particularly to the socially excluded, often dubbed ‘hard to reach’, for whom services must be provided if health inequalities are to be reduced. The plethora of evaluation frameworks available to NGOs have a variety of value bases, ranging from those which unambiguously support commissioners and providers to address health inequalities and work with the ‘hard to reach’, through to those which could offer such support if suitably adapted, to those that would struggle to address these issues in practice. In this context, the aim of this article is to answer the question, ‘to what extent can evaluation frameworks help NGOs to address health inequalities caused by social exclusion?’

Method:

The literature on health inequalities, evaluation frameworks, and the policy context within which NGOs deliver public health services, is briefly reviewed. We then draw on the concepts of ‘comparative advantage’ and the ‘space of access’ to explore the extent to which evaluation frameworks can help NGOs to address health inequalities caused by social exclusion.

Results:

We identify contradictions between recent government policies around public service delivery in England which can make it difficult for service providers and commissioners to know which value(s) to focus on. This confusion is likely to at least perpetuate, perhaps even exacerbate, the marginalisation of socially excluded people, particularly in the current climate of austerity. The evaluation frameworks NGOs choose to use, and how they decide to use them, can have a real impact on health inequalities. We argue that, wherever possible, NGOs should place social value at the centre of the evaluation process, or at least make sure they capture as much as they can of the social value they create, in line with their own value base.

Conclusion:

Commissioners and providers do not always have a free choice about which evaluation framework to use, for example, due to resource constraints. Nevertheless, commissioners or providers can still influence evaluators to address health inequalities and involve the ‘hard to reach’.
Community-based Research Methods
Authors: Merenstein Beth Frankel
Published: June 2014

This article explores how we can more fully engage our students in research and social problems by creating community-based research methods courses. I describe a course I created in which students learned qualitative research methods and then conducted the majority of the interviews for a homelessness prevention program evaluation project. Showing how we worked closely with the community organization and the students were fully engaged in using their sociological imagination, I explain the details of the course and the project. I provide specific feedback from both the students and the organization, as well as explain areas of limitation and complication in conducting these types of courses.
Lateral Ankle Sprain and Chronic Ankle Instability
Authors: Kobayashi Takumi , Gamada Kazuyoshi
Published: June 2014

Many studies investigated the contributing factors of chronic ankle instability, but a consensus has not yet been obtained. The objective of this critical review is to provide recent scientific evidence on chronic ankle instability, including the epidemiology and pathology of lateral ankle sprain as well as the causative factors of chronic ankle instability. We searched MEDLINE from 1964 to December 2013 using the terms ankle, sprain, ligament, injury, chronic, functional, mechanical, and instability. Lateral ankle sprain shows a very high recurrence rate and causes considerable economic loss due to medical care, prevention, and secondary disability. During the acute phase, patients with ankle sprain demonstrate symptoms such as pain, range of motion deficit, postural control deficit, and muscle weakness, and these symptoms may persist, leading to chronic ankle instability. Although some agreement regarding the effects of chronic ankle instability with deficits in postural control and/or concentric eversion strength exists, the cause of chronic ankle instability remains controversial.

Levels of Evidence: Therapeutic Level IV: Review of Level IV studies
Nature in the ‘neoliberal laboratory’
Authors: Benediktsson Karl
Published: June 2014

Prompted by observations by Weller and O’Neill (2014) of the particularities of neoliberalism in resource-based economies such as Australia’s, this commentary looks into the partial and uneven introduction of neoliberal ideas and practices to natural resource management in Iceland. Some resource-based sectors have been profoundly impacted by neoliberalism, whereas others have been marked by an uneasy blend of developmental and neoliberal governance. The example strengthens the case for a careful contextual analysis of neoliberal ideologies, processes and outcomes.
Australia’s developmental trajectory
Authors: Higgins Vaughan
Published: June 2014

General support is given for Weller and O’Neill’s (2014) aim to question the influence of neoliberalism on political and economic change in Australia. However, their key proposition that Australia’s developmental trajectory has never been neoliberal in intent or outcome is challenged. Critiqued also is Weller and O’Neill’s use of a working definition of neoliberalism that fails to engage explicitly or sufficiently with theoretical perspectives on neoliberal governance. A governmentality approach is argued to offer a way forward in exploring how neoliberal and non-neoliberal rationalities and techniques articulate with one another as part of attempts to address specific problematizations of rule.
Discourses of food sovereignty from somewhere
Authors: Bartos Ann E
Published: June 2014

This commentary raises concern for the situated nature of knowledge production in relation to food politics. Investigating geographies of food sovereignty and food security requires attention to where and how different contexts set the stage for specific discourses to come into existence. This commentary specifically examines how the concept of food sovereignty is troubled in New Zealand due to the role of the dairy industry in the global economy, the pervasive branding of New Zealand as 'pure', and the politics of sovereignty within a multicultural, former British colony. Bringing these concerns to the fore enables an exploration of the web of assemblages that comprise the political projects of outward focused government policies and the inward focused mundane politics of eating.
Urban Food Advocates' tactics to rebuild food systems
Authors: Lyons Kristen
Published: June 2014

Food movement advocates articulate a diversity of approaches to address the current food crisis. These approaches resonate with both food security and food sovereignty discourses and range between reform and radical rights-based theories of change. This paper draws from research with urban food advocates in Australia to provide insights into the relations between tactics to change food systems and their resonance with food security and food sovereignty discourses. On the basis of this analysis, the paper concludes that tactics for social change – or the food politics enacted by urban food advocates – both converge and diverse with food security and food sovereignty discourses. These outcomes point to the diversity of approaches for identifying and evaluating pathways for rebuilding food systems.
Expanding the possibilities for a future free of hunger
Authors: Murphy Sophia
Published: June 2014

In attempting a rapprochement between food security and food sovereignty, it is important to understand their full historical contexts. It is also important to note that they are not ‘like’ categories. Food security is a normative objective, where food sovereignty is a normative process. The rejection of food security by some food sovereignty writers reflects too narrow an understanding of the rich history of food security and its continuing importance in policy research and analysis as well as in providing direction for food security laws and programmes. Many equate food security with a simplistic insistence on supply to the exclusion of food security’s other dimensions. This is mistaken but should not lead to a rejection of all food security work. Food security and food sovereignty are complementary rather than substitutable terms. Respect for the histories and achievements of both will expand our possibilities for realizing a future free of hunger.
Hepatic Dysfunction as a Paraneoplastic Manifestation of Metastatic Prostate Adenocarcinoma
Authors: Kato David , Okwara Chinemerem , Moreland Christopher , Parker Allan
Published: June 2014

Cholestasis is a general feature of intrahepatic or extrahepatic biliary obstruction by various mechanisms including cirrhosis, stricture, choledocholithiasis, hepatitis, and neoplasms. Neoplasms can directly impinge on the hepatobiliary tree resulting in bile stasis. Stauffer’s syndrome is another variant of this neoplastic process that can cause cholestasis and liver enzyme elevation without any direct hepatobiliary obstruction, and is thus categorized as a paraneoplastic syndrome of unclear pathophysiology. We report a first case of metastatic prostate adenocarcinoma with features of Stauffer’s syndrome that reversed completely on androgen deprivation therapy. This is in contrast to a previously reported case of Stauffer’s syndrome due to metastatic prostate adenocarcinoma, which reversed partially to androgen deprivation therapy. Our case demonstrates the importance of early recognition of Stauffer’s syndrome and underlying neoplasms in patients who present with cholestasis without clear evidence of intrahepatic or extrahepatic biliary obstruction, which may lead to early initiation of treatment.
A phase 2 single-center study of carfilzomib 56 mg/m2 with or without low-dose dexamethasone in relapsed multiple myeloma
Authors: Lendvai Nikoletta , Hilden Patrick , Devlin Sean , Landau Heather , Hassoun Hani , Lesokhin Alexander M. , Tsakos Ioanna , Redling Kaitlyn , Koehne Guenther , Chung David J. , Schaffer Wendy L. , Giralt Sergio A.
Published: June 2014

Key Points

Carfilzomib 56 mg/m2 provided a high overall response rate with a remarkable duration of response in patients with R/RMM. Nonhematologic grade 3/4 AEs likely related to carfilzomib treatment included hypertension and heart failure.
Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials
Authors: van Es Nick , Coppens Michiel , Schulman Sam , Middeldorp Saskia , Büller Harry R.
Published: June 2014

Key Points

DOACs have similar efficacy as VKAs in the treatment of acute symptomatic VTE, but significantly reduce the risk of major bleeding. The efficacy and safety of DOACs in the treatment of acute VTE are consistent in clinically important subgroups.
A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?
Authors: Tanzil Sana , Zahidie Aysha , Ahsan Adeel , Kazi Ambreen , Shaikh Babar Tasneem
Published: June 2014

Background

Since a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples’ Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh.

Methods

A cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered.

Results

There was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects.

Conclusion

Out-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services.