bluuebunny/crossref_metadata_2025 huggingface dataset:
Microvascular Obstruction Remains a Portent of Adverse Remodeling in Optimally Treated Patients With Left Ventricular Systolic Dysfunction After Acute Myocardial Infarction
Authors: Weir Robin A.P. , Murphy Charles Aengus , Petrie Colin J. , Martin Thomas N. , Balmain Sean , Clements Suzanne , Steedman Tracey , Wagner Galen S. , Dargie Henry J. , McMurray John J.V.
Published: March 2010

Background—

Microvascular obstruction (MO) is associated with large acute myocardial infarction and lower left ventricular (LV) ejection fraction and predicts greater remodeling, but whether this effect is abolished by contemporary antiremodeling therapies is subject to debate. We examined the influence of several infarct characteristics, including MO, on LV remodeling in an optimally treated post–acute myocardial infarction cohort, using contrast-enhanced cardiac magnetic resonance.

Methods and Results—

One hundred patients (mean age, 58.9±12 years, 77%men) underwent contrast-enhanced cardiac magnetic resonance at baseline (≈4 days) and at 12 and 24 weeks. The effects on LV remodeling (ie, change in LV end-systolic volume index [ΔLVESVi]) of infarct site, transmurality, endocardial extent, and the presence of early and late MO were analyzed. Mean baseline infarct volume index decreased from 34.0 (21.2) mL/m
2
to 20.9 (12.9) mL/m
2
at 24 weeks (
P
<0.001). Infarct site had no influence on remodeling, but greater baseline infarct transmurality (
r
=0.47,
P
<0.001) and endocardial extent (
r
=0.26,
P
<0.01) were associated with higher ΔLVESVi. Early MO was seen in 69 patients (69%) and persisted as late MO in 56 patients (56%). Patients with late MO underwent significantly greater remodeling than those without MO (ΔLVESVi, +4.1 [13.4] versus −7.0 [12.7] mL/m
2
, respectively,
P
=0.001); those with early MO only displayed an intermediate ΔLVESVi (−4.9 [13.0] mL/m
2
). Importantly, late MO was seen frequently despite optimal coronary blood flow having been restored at angiography.

Conclusions—

Late MO on predischarge contrast-enhanced cardiac magnetic resonance remains an ominous predictor of adverse LV remodeling despite powerful antiremodeling therapy and may be useful in the risk stratification of survivors of acute myocardial infarction.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00132093.
Discontinuation of Antihyperglycemic Therapy and Clinical Outcomes After Acute Myocardial Infarction in Older Patients With Diabetes
Authors: Lipska Kasia J. , Wang Yongfei , Kosiborod Mikhail , Masoudi Frederick A. , Havranek Edward P. , Krumholz Harlan M. , Inzucchi Silvio E.
Published: March 2010

Background—

Patients with diabetes are frequently admitted for acute myocardial infarction (AMI) on antihyperglycemic agents but may be discharged without glucose-lowering therapy. We examined the frequency of this practice and evaluated the associated outcomes of readmission and mortality.

Methods and Results—

We conducted a retrospective study of 24 953 Medicare beneficiaries with diabetes discharged after hospitalization for AMI. We examined the frequency of discontinuation of antihyperglycemic agents on discharge among those patients admitted on a diabetic regimen. The independent association between discharge on versus off antihyperglycemic therapy and outcomes at 1 year was assessed in multivariable Cox proportional hazards models, adjusting for patient, physician, and hospital variables. The primary outcome was time to death within 1 year of discharge; secondary outcomes were time to first rehospitalization within 1 year for AMI, heart failure, and all causes. There were 8751 patients admitted on at least 1 antihyperglycemic agent who met our inclusion/exclusion criteria. Of these, 7581 (86.6%) were discharged on antihyperglycemic therapy and 1170 (13.4%) were discharged off antihyperglycemic therapy. After multivariable analysis, as compared with those whose diabetes therapy was continued at discharge, patients who were not prescribed a glucose-lowering agent had higher 1-year mortality rate (hazard ratio, 1.29; 95% confidence interval, 1.15 to 1.45). Readmission rates did not differ significantly between the 2 groups (hazard ratio, 0.95; 95% confidence interval, 0.87 to 1.03).

Conclusions—

In older patients with diabetes after AMI, discontinuation of antihyperglycemic therapy is common and associated with higher mortality rates. The reasons behind this practice as well as the specific effects of hyperglycemia after AMI merit further study.
Adverse Events After Stopping Clopidogrel in Post–Acute Coronary Syndrome Patients
Authors: Ho P. Michael , Tsai Thomas T. , Wang Tracy Y. , Shetterly Susan M. , Clarke Christina L. , Go Alan S. , Sedrakyan Art , Rumsfeld John S. , Peterson Eric D. , Magid David J.
Published: March 2010

Background—

A prior study from the Veterans Health Administration found a clustering of cardiovascular events after clopidogrel cessation. We sought to confirm and expand these findings.

Methods and Results—

This was a retrospective cohort study of 2017 patients with acute coronary syndrome discharged on clopidogrel from an integrated health care delivery system. Rates of all-cause mortality or acute myocardial infarction (MI) within 1 year after stopping clopidogrel were assessed among patients who did not have an event before stopping clopidogrel. Death/MI occurred in 4.3% (n=71) of patients. The rates of death/MI were 3.07, 1.62, 0.70, and 0.95 per 10 000 patient-days for the time intervals of 0 to 90, 91 to 180, 181 to 270, and 271 to 360 days after stopping clopidogrel. In multivariable analysis, the 0- to 90-day interval after stopping clopidogrel was associated with higher risk of death/MI (incidence rate ratio, 2.74; 95% confidence interval, 1.69 to 4.44) compared with 91- to 360-day interval. There was a similar trend of increased events after stopping clopidogrel for various subgroups (women versus men, medical therapy versus percutaneous coronary intervention, stent type, and ≥6 months or <6 months of clopidogrel treatment). Among patients taking clopidogrel but stopping ACE inhibitor medications, the event rates were similar in the 0- to 90-day versus the 91- to 360-day interval (2.67 versus 2.91 per 10 000 patient-days;
P
=0.91).

Conclusions—

We observed a clustering of adverse events in the 0 to 90 days after stopping clopidogrel. This clustering of events was not present among patients stopping ACE inhibitors. These findings are consistent with a possible rebound platelet hyper-reactivity after stopping clopidogrel and additional platelet studies are needed to confirm this effect.
Risk Factors for Nonfatal Pulmonary Embolism in a Japanese Population: A Hospital-Based Case-control Study
Authors: Yamada Norikazu , Ota Satoshi , Ying Liu  , Crane Martin M. , Chang Cindy M. , Thaker Samruddhi , Nakamura Mashio , Ito Masaaki
Published: March 2010

Risk factors for pulmonary embolism (PE) have been identified among populations in Western countries but have not been well characterized in Japan. A hospital-based case-control design employed cases with PE, which diagnosed by standard imaging techniques; controls were individuals drawn by systematic random sampling from the hospital admission register. A total of 100 (38 males and 62 females) and 199 controls were identified. Patients with PE were younger (56.5 vs 60.9 years) and more likely to be female. The odds ratio ([OR] adjusted for other factors) and 95% confidence interval (CI) for risk of PE was elevated for the following: female gender, prolonged immobilization, history of prior venous thromboembolism (VTE), lower extremity varicose veins, body mass index (BMI) ≥ 25 kg/m 2, extremity paralysis, and gout/hyperuricemia. Inherited thrombophilia was found in 14 patients with PE (14%). Risk factors for PE in Japan are comparable in magnitude to those in Western countries; only one third of PE cases had received VTE prophylaxis.
Depressive Symptoms and Their Social Contexts: a Qualitative Systematic Literature Review of Contextual Interventions
Authors: Gottlieb Laura , Waitzkin Howard , Miranda Jeanne
Published: March 2010

Background: Numerous observational studies demonstrate associations between social context and depressive symptoms, yet few intervention trials exist in this arena.

Aims: This review examines intervention trials that explore the impact of contextual change on depressive symptoms.

Methods: Electronic literature databases of PubMed and PsycINFO, bibliographies of retrieved articles and the publicly available internet were searched for English-language articles published between 1997 and 2008. Peer-reviewed studies were eligible for inclusion if they reported contextual interventions and depressive symptoms measures in adult populations without other significant underlying medical or psychological illness. In total, 2,128 studies met search term criteria. Of these, 13 studies meeting inclusion criteria were classified by type of intervention. Qualitative synthesis was used to interpret the mental health impact of contextual interventions.

Results: The interventions focused on employment, housing, poverty, parenting and violence. Eight of these studies reported a decrease in depressive symptoms and/or psychological distress in intervention groups. Interventions varied in focus, length of follow-up and measures of depressive symptoms.

Conclusions: Contextual interventions for the prevention and treatment of depressive symptoms and psychological distress can be effective, though very limited data exist in this field. Policy implications include a greater emphasis on improving context to decrease depression and other mental disorders.
Organizational Change Within Morally Ambiguous Contexts: A Case Study of Conflicting Postmerger Discourses
Authors: Teram Eli
Published: March 2010

Based on a case study of a merger between organizations working with youth in trouble, this article analyzes the parallel success and failure discourses representing management and staff’s conflicting views about the organizational change. The symbolic core of these conflicting discourses was the transformation of a group home’s kitchen to food services for the merged organizations. For management, this transformation signified one of the best and most visible outcomes of the merger in terms of efficiency; for staff, it provided the clearest evidence of the harm caused by the merger in terms of providing a caring environment for youth. These discourses are analyzed in relation to two conflicting organizational identities championed by management and staff. It is argued that such contested organizational changes provide opportunities for open discussions of the dilemmas faced by human service organizations within their morally ambiguous contexts. Ethical organizational leadership entails the facilitation of such dialogue rather than ignoring the connectivity between internal and external ambiguities and enforcing the managerial rationale for organizational change.
Expanding a Conversation: Is How We Live as a Culturally Diverse Society Congruent With Our Underlying Assumptions, Methodologies, and Theories Regarding Change?
Authors: Easley Christopher Anne
Published: March 2010

Our world is very culturally and ethnically diverse. Although there is so much beauty in the diversity of our world, the multiplicity of cultures can be very challenging when working to evoke change. Therefore, in an effort to better serve the realities of our environment, this article examines the question, “Is there a need for a different awareness on the part of researchers and/or intervention strategists when working to evoke change within diverse cultures, organizations, and/or communities?” And, equally important, how do we gain this awareness as we engage in change processes? Within the contextual framework of this question, this article also discusses the consequences that can and do emerge when one uses intervention strategies that may be grounded in generalized theory and practice when working within culturally and ethnically diverse populations. It concludes with a posit that suggests the need to evoke a more culturally sensitive approach to change, which is built on the use of discourse strategies that address the individualities of the environments, giving privilege to the diversity and culture.
Codesigning as a Discursive Practice in Emergency Health Services: The Architecture of Deliberation
Authors: Iedema Rick , Merrick Eamon , Piper Donella , Britton Kate , Gray Jane , Verma Raj , Manning Nicole
Published: March 2010

This article addresses the issue of how government agencies are increasingly attempting to involve users in the design of public services. The article examines codesign as a method for fostering new and purposeful interaction among service-delivery staff and their customers. Codesign brings together stakeholders who, in the past, have had limited input into the way public services are experienced. By participating in this emerging discourse practice, codesign stakeholders can construct new ways of relating and deliberating. The data presented in this article are drawn from a codesign study initiated by the New South Wales Department of Health in an effort to improve the experience of staff, patients, and caregivers. The article concludes that codesign presents service consumers, professionals, and government officials with new opportunities as well as new challenges. Its opportunities reside in codesign bringing stakeholders together across previously impervious boundaries, producing new understandings, relationships, and engagements. Its challenges reside in these new understandings, relationships, and engagements only becoming possible and only continuing to be relevant if and when stakeholders are prepared to adopt and adapt to the new discourse needed to realize them, implicating them in what has been referred to as the “design competency spiral.”
Damage and Reliability of Y-TZP after Cementation Surface Treatment
Authors: Guess P.C. , Zhang Y. , Kim J.-W. , Rekow E.D. , Thompson V.P.
Published: March 2010

Zirconia-based restorations are widely used in prosthetic dentistry, but their susceptibility to post-sintering cementation surface treatments remains controversial. We hypothesized that grinding (600-grit) and alumina abrasion (50 µm, 5 sec, 0.5 MPa) affect the damage modes and reliability of zirconia core material. Monolithic CAD/CAM-machined and sintered Y-TZP plates (0.5 mm thickness) were adhesively cemented to dentin-like composite substrates. Uni-axial mouth-motion cyclic contact was applied through a tungsten carbide spherical indenter (r = 3.18 mm). Results showed that zirconia core ceramic is vulnerable to lower surface radial fracture after grinding or alumina abrasion, while the as-received control chiefly fractured from load-application surface cone fracture. Significantly lower reliability of ground and alumina-abraded compared with the as-received zirconia core ceramic can be attributed to damage induced on the cementation surface. Clinical relevance concerning surface treatment protocols for zirconia framework materials prior to cementation is addressed.
Can Fiber Posts Increase Root Stresses and Reduce Fracture?
Authors: Santos A.F.V. , Meira J.B.C. , Tanaka C.B. , Xavier T.A. , Ballester R.Y. , Lima R.G. , Pfeifer C.S. , Versluis A.
Published: March 2010

The clinical success of fiber posts has been attributed to their lower elastic modulus. The tested hypothesis was that fiber posts could lead to lower risk of post debonding and lower risk of root fracture, despite an increase in root stresses. Stress analyses were carried out with a 3D finite element model of a premolar restored with a metallic or a fiber post. Bonded and non-bonded post/cement interface conditions were simulated. We calculated risk-of-fracture indices by determining the highest principal stress values divided by the tensile strength. Shear stresses along the post/cement interface were analyzed for the bonded models. Compared with the premolar restored with a metallic post, the fiber post generated lower stresses along the interface and higher stresses in the root. However, with the fiber post, fracture was less likely to occur in the root, since its core and post fracture indices were higher.
Transcriptomes and Proteomes of Dental Follicle Cells
Authors: Morsczeck C. , Schmalz G.
Published: March 2010

Ectomesenchymal dental stem cells could be feasible tools for dental tissue engineering. Dental follicle cells are a promising example, since they are capable of differentiation into various dental tissue cells, such as osteoblasts or cementoblasts. However, cellular mechanisms of cell proliferation and differentiation are not understood in detail. Basic knowledge of these molecular processes may shorten the time before ectomesenchymal dental stem cells can be exploited for bone augmentation in regenerative medicine. Recent developments in proteomics and transcriptomics have made information about genome-wide expression profiles accessible, which can aid in clarifying molecular mechanisms of cells. This review describes the transcriptomes and proteomes of dental follicle cells before and after differentiation, and compares them with differentially expressed populations from dental tissue or bone marrow.
Integral Love: The Role of Love in Clinical Practice as a Rite of Passage
Authors: Sleeth D. B.
Published: March 2010

The profession of psychology seems embarrassed, even apprehensive, about love being part of the therapeutic process. Yet the essence of treatment comes down to a single precept: Love is the healing principle. When people speak of recovery in clinical practice, that which is recovered is best thought of as love. Unfortunately, love is poorly understood. People tend to align with either of its two main forms, autistic love or empathetic love, where each vies for dominion as the respective pole of a seemingly inexorable paradox. Consequently, the developmental task of treatment is to integrate these two poles into their most mature and auspicious form: integral love. Only when all forms of love are taken together can clinical practice operate within a shared framework of understanding, ever working toward a deeper and more profound embrace of the whole person.
An Existential Gaze at Multiracial Self-Concept: Implications for Psychotherapy
Authors: Taylor Matthew J. , Nanney John T.
Published: March 2010

Multiracial self-concept is conceptualized using an existential framework. First, the authors offer an analysis of how existential concerns are revealed within the multiracial experience, employing the theoretical constructs of terror management and social identity theories. Expanding on this foundation, they apply Heideggerian notions of human existence and self to multiracialness. And finally, using the aforementioned analysis as a backdrop, the authors discuss the emergence of existential themes in psychotherapy with multiracial individuals.
Effect of Electron Beam Irradiation and Reactive Compatibilizers on Some Properties of Polypropylene and Epoxidized Natural Rubber Polymer Blends
Authors: Senna Magdy M.H. , Abdel-Monem Yasser K.
Published: March 2010

Effect of reactive compatibilizers on the mechanical, thermal and morphological properties of polymer blends based essentially on polypropylene (PP) and different ratios of epoxidized natural rubber (ENR) was investigated. The same properties were also, studied before and after electron beam irradiation to various doses. The results showed that the mechanical and thermal properties of unirradiated PP/ENR blends were improved after using the reactive compatibilizers: PP graft copolymer with maleic anhydride (PP-g-MAH) or 1,6-hexandiol-diacrylate (HDDA). This improvement was attributed to the formation of interfacial bonding between PP and ENR phases during the melt processing. Further improvement in these properties was observed under effect of electron beam irradiation and the reactive compatibilizer. However, this effect was clear in the case of the monomer HDDA than PP-g-MAH. Scanning electron microscopy (SEM) micrographs indicated that the morphology was improved by the addition of the reactive compatibilizers and electron beam irradiation. The wide angle X-ray diffraction (WAXD) results indicated that the crystallinity of the blend was increased by the addition of the compatiblizing agents due to the plasticizing effect and/or the nucleatating properties of the compatibilizer. However, the crystallinity of the PP/ENR blend was decreased after electron beam irradiation.
Motivations for Sexual Risk Behavior Across Commercial and Casual Partners Among Male Urban Drug Users: Contextual Features and Clinical Correlates
Authors: Bornovalova Marina A. , Daughters Stacey B. , Lejuez Carl W.
Published: March 2010

The current study aimed to develop a measure for assessing the various motivations for sexual risk behavior (SRB) across commercial (involving the exchange of sex for money or drugs) and casual (nonregular) partners in a sample of inner-city, primarily African American drug users, and to examine the relationship of these motivations with a history of childhood trauma, as well as current symptoms of depression, posttraumatic stress disorder (PTSD), and borderline personality disorder (BPD). Exploratory factor analysis indicated a 5-factor solution for commercial partner type, and a 4-factor solution for casual partner type, including the motivations of sexual sensation-seeking, intimacy seeking, reassurance-seeking, emotional avoidance, and emotional expressivity. Emotional avoidance and emotional expressivity were strongly related to childhood trauma and PTSD and BPD symptoms. These results provide initial results for mechanisms underlying the relationship between SRB and a history of trauma and psychopathology.
Pathways Into Marriage: Cohabitation and the Domestic Division of Labor
Authors: Baxter Janeen , Haynes Michele , Hewitt Belinda
Published: March 2010

Does time spent in a cohabiting relationship prior to marriage lead to more egalitarian housework arrangements after marriage? Previous research has shown that housework patterns within cohabiting relationships are more egalitarian than in marital relationships. But do these patterns remain when couples marry? The findings from previous studies are mixed. This article uses three waves of data from the Household, Income and Labour Dynamics in Australia (HILDA) survey to examine changes in men’s and women’s time spent on housework as they transition into marriage. The results show that men’s housework hours remain stable regardless of life course pathway, and for women there is only minimal evidence that different pathways into marriage lead to different housework outcomes. The article concludes that the gender division of labor is developed well before the formation of a union and that the pathway to marriage has a relatively small effect on housework patterns after marriage.
Stress, Marital Satisfaction, and Psychological Distress Among African Americans
Authors: Lincoln Karen D. , Chae David H.
Published: March 2010

This study examines relationships among financial strain, unfair treatment, and martial satisfaction among African Americans. Using data from the National Survey of American Life, findings indicated that social stressors that occur inside of the home (i.e., financial strain) as well as those experienced outside of the home (i.e., unfair treatment) have negative consequences for marital quality and psychological distress. Furthermore, the combination of experiencing unfair treatment and financial strain has particularly deleterious mental health consequences for married African Americans. Results also highlight the protective effect of marital satisfaction on psychological distress as well as its potential to buffer the negative effects of unfair treatment and financial strain on psychological distress. Implications for policy to improve marital quality and promote the mental health of African Americans are discussed.
Marital Status and Sexually Transmitted Infections Among African Americans
Authors: Taylor Eboni M. , Adimora Adaora A. , Schoenbach Victor J.
Published: March 2010

This article assesses the relationship between low marriage rates and racial disparities in sexually transmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage patterns help account for racial disparities in STI rates. Results indicate that the 12-month prevalence of multiple partners and high-risk partnerships was lowest among currently married, intermediate among cohabiting, and highest among formerly and never-married respondents. Of all racial/ethnic groups, African Americans were least likely to be married. In multiple logistic analyses adjustment for marriage attenuated the association between race and STI risk behaviors for African Americans. Low marriage rates may be an important contributing factor to racial/ethnic disparities in STI rates, particularly for African Americans.
Measuring language-specific phonetic settings
Authors: Mennen Ineke , Scobbie James M. , de Leeuw Esther , Schaeffler Sonja , Schaeffler Felix
Published: March 2010

While it is well known that languages have different phonemes and phonologies, there is growing interest in the idea that languages may also differ in their ‘phonetic setting’. The term ‘phonetic setting’ refers to a tendency to make the vocal apparatus employ a language-specific habitual configuration. For example, languages may differ in their degree of lip-rounding, tension of the lips and tongue, jaw position, phonation types, pitch range and register. Such phonetic specifications may be particularly difficult for second language (L2) learners to acquire, yet be easily perceivable by first language (L1) listeners as inappropriate. Techniques that are able to capture whether and how an L2 learner’s pronunciation proficiency in their two languages relates to the respective phonetic settings in each language should prove useful for second language research. This article gives an overview of a selection of techniques that can be used to investigate phonetic settings at the articulatory level, such as flesh-point tracking, ultrasound tongue imaging and electropalatography (EPG), as well as a selection of acoustic measures such as measures of pitch range, long-term average spectra and formants.
Quantitative analyses in a multivariate study of language attrition: the impact of extralinguistic factors
Authors: Schmid Monika S. , Dusseldorp Elise
Published: March 2010

Most linguistic processes — acquisition, change, deterioration — take place in and are determined by a complex and multifactorial web of language internal and language external influences. This implies that the impact of each individual factor can only be determined on the basis of a careful consideration of its interplay with all other factors. The present study investigates to what degree a number of sociolinguistic and extralinguistic factors, which have been previously demonstrated or claimed to be relevant in the context of language attrition, can account for individual differences in first language (L1) proficiency. Data were collected from attriting populations with German as their L1: one in a Dutch language context ( n = 53) and one in a Canadian English setting ( n = 53). These groups were compared to a reference group of Germans in Germany ( n = 53). Overall, the proposed outcome measures (derived from both formal tasks and a free speech task) are argued to be stable and valid indicators of attrition effects. The predictor variables under investigation are shown to fall into several reliable factor groups, for example, identification and affiliation with L1, exposure to German language and attitude towards L1. These are the factor groups that have, so far, been considered the most important for the process of L1 attrition or maintenance. However, the predictive power exercised by these factor groups in the present study is shown to be relatively weak.
A simple circuit for cerebral perfusion during cardiopulmonary bypass surgery of the ascending aorta and the aortic arch
Authors: Macrina F. , Capelli A. , Trigilia F. , Ippoliti F. , Mioli R. , Totaro M. , Toscano M.
Published: March 2010

Introduction A circuit was developed to allow for rapid reaction to the needs of perfusion during extracorporeal circulation (ECC) in surgery of the aortic arch and ascending aorta. Method From January 2008 through January 2010, a home-designed circuit was used on 30 patients with aortic dissection who underwent surgery to replace the ascending aorta and the aortic arch and, in some cases, the aortic valve and re-implant of the coronary arteries using Bentall’s technique.
Multidisciplinary rehabilitation after primary total knee arthroplasty: a randomized controlled study of its effects on functional capacity and quality of life
Authors: Kauppila Anna-Maija , Kyllönen Eero , Ohtonen Pasi , Hämäläinen Martti , Mikkonen Paula , Laine Vesa , Siira Pertti , Mäki-Heikkilä Paula , Sintonen Harri , Leppilahti Juhana , Arokoski Jari PA
Published: March 2010

Objective: To examine whether a multidisciplinary rehabilitation programme can improve functional recovery and quality of life and reduce the use of rehabilitation services compared with conventional care one year after total knee arthroplasty.

Design: Prospective, randomized, non-blinded, controlled trial.

Setting: An outpatient centre-based setting.

Subjects: Eighty-six patients who were scheduled for primary total knee arthroplasty due to osteoarthritis of the knee.

Interventions: A ten-day multidisciplinary rehabilitation programme, which was focused on enhancing functional capacity, was organized 2—4 months after surgery. In both groups, a standard amount of physiotherapy was included in conventional care.

Main measures: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 15D, 15-m walk test, stair test, isometric strength measurement of the knee. Use of rehabilitation services was asked about with a questionnaire. Outcomes were assessed preoperatively and at 2-, 6- and 12-month follow-ups.

Results: In both groups, functional capacity and quality of life improved significantly. The mean absolute change in the WOMAC function score was —32.4 mm (SD 26.4) in the rehabilitation group and —32.8 mm (SD 20.1) in the control group (P-time*group = 0.40). No difference was found between groups in any outcome measure or in the use of rehabilitation services during the study period.

Conclusions: This study indicates that for knee osteoarthritis patients treated with primary total knee arthroplasty, a 10-day multidisciplinary outpatient rehabilitation programme 2—4 months after surgery does not yield faster attainment of functional recovery or improvement in quality of life than can be achieved with conventional care.
Writing and Being Written: Issues of Identity Across Timescales
Authors: Burgess Amy , Ivanič Roz
Published: March 2010

This article argues for the differentiation according to timescales of aspects of writer identity. It presents a framework for investigating the discoursal construction of writer identity that develops the categories proposed by Ivanič in two ways. First, it distinguishes aspects of writer identity according to the timescales over which they develop; second, it proposes interrelationships among the different aspects. The authors demonstrate the relevance of this framework for understanding how identity is constructed and changed through acts of writing by using it to interpret data drawn from a study of writing in adult literacy education in England.
“Whose Inquiry Is This Anyway?” Money, Power, Reports, and Collaborative Inquiry
Authors: Kasl Elizabeth , Yorks Lyle
Published: March 2010

Collaborative/cooperative inquiry (CI) is both a method for engaging in new paradigm human inquiry and a strategy for facilitating adult learning. Adult educators who use CI in institutional settings must be aware of potential corrupting influences. The authors alert educators to three factors interjected by institutional affiliation that challenge the integrity of the CI process: financial support, power inequities, and reporting requirements. These factors are examined in three different contexts: inquiries used for dissertation research, inquiries in the workplace conducted for professional development, and multiple inquiry projects sponsored by an institution to serve its mission.
The Transformative Power of Democracy and Human Rights in Nonformal Education: The Case of Tostan
Authors: Gillespie Diane , Melching Molly
Published: March 2010

This case study analyzes the introduction of democracy and human rights into the educational program of Tostan, a nongovernmental organization working in Africa. The authors show how Tostan’s original educational approach created a meaningful context for integrating democracy and human rights into its curriculum, a process that took place from 1995 to 2003. The integration produced unexpected results: a participant-led social movement to end harmful practices such as female genital cutting and child and/or forced marriage. After describing the phases of curricular revision in the case, the authors draw out themes to show how the phases interacted to produce social transformation. A visioning exercise at the beginning of the program created a discursive context for the introduction of democracy and human rights, the democracy and human rights sessions created critical reflection about past practices, and awareness of an international human rights framework emboldened participants to undertake actions that created new social norms.
Sleep Well, Think Well: Sleep-Wake Disturbance in Mild Cognitive Impairment
Authors: Naismith Sharon L. , Rogers Naomi L. , Hickie Ian B. , Mackenzie Jennifer , Norrie Louisa M. , Lewis Simon J. G.
Published: March 2010

While literature suggests that sleep is important for cognition and mood, and that sleep disturbance is a prominent feature of neurodegenerative and neuropsychiatric disorders, these relationships have not yet been examined in older people ‘‘at risk"" of dementia. In this study, 15 older people with the nonamnestic subtype of mild cognitive impairment ([MCI] mean age = 66.7 years, SD = 8.7) underwent psychiatric and neuropsychological assessment. Participants completed sleep diaries, questionnaires, and 2 weeks of actigraphy. Key outcome data during the rest interval were time spent ‘‘awake"" or wake after sleep onset (WASO) and the number of arousals/wake bouts. Results showed that even after controlling for age, greater WASO was associated with reduced attention and executive functioning and increased arousals were related to poorer nonverbal learning and problem solving. This preliminary data suggests that sleep-wake disturbance in nonamnestic forms of MCI is related to cognitive functioning and may be indicative of shared neurobiological underpinnings.
Hematological and biochemical profiles and histopathological evaluation of experimental intoxication by sodium fluoroacetate in cats
Authors: Collicchio-Zuanaze RC , Sakate M. , Langrafe L. , Takahira RK , Burini C.
Published: March 2010

Sodium fluoroacetate (SFAC) is a potent rodenticide, largely used for rodent and domestic pest control. The toxic effects of SFAC are caused by fluoroacetate, a toxic metabolite, whose toxic action blocks the Krebs cycle and also induces the accumulation of citrate in the body, which is a serum calcium chelator. The most common clinical signs of this intoxication are the cardiac and neurological effects. However, the hematological, biochemical and histopathological findings occurring in intoxication are still unknown in different species. In the present study, 16 domestic cats were experimentally intoxicated with oral doses of fluoroacetate (0.45 mg/kg). The hematological and biochemical profiles and histopathological findings were made to look for auxiliary diagnosis methods in SFAC intoxications. The hematological profile showed transitory leucopenia and thrombocytopenia; in the biochemical profiles were detected hyperglycemia, increase of creatinequinase enzyme (CK) and creatinequinase cardiac isoenzyme (CK-MB), hypokalemia and hypophosfatemia. In the macroscopic and histopathological findings were observed lesions characteristic of degenerative and ischemic processes in heart, kidneys, liver, brain and lungs. These changes may be auxiliary to the diagnosis of intoxication by SFAC in cats, when associated with clinical signs described for the species. Thus, the complete blood count with platelet count, serum glucose, enzymes CK and CK-MB isoenzyme, as well as the electrolytes potassium and phosphorus, can facilitate the laboratory diagnosis during intoxication by SFAC, associated with the pathological findings in the case of death of the intoxicated animal.
In vivo antioxidant potentials of Piliostigma thonningii (Schum) leaves: Studies on hepatic marker enzyme, antioxidant system, drug detoxifying enzyme and lipid peroxidation
Authors: Olakunle Ajiboye Taofeek
Published: March 2010

In this study, the in vivo antioxidant potentials of Piliostigma thonningii were investigated in carbon tetrachloride-induced hepatic and oxidative damage in rat. Albino rats were grouped into six, group A rats received sterile distilled water for 14 days while B rats received 0.5 mL/kg body weight of carbon tetrachloride intraperitoneally on day 14. Group C rats received 200 mg/kg body weight of Piliostigma thonningii leaves extract for 14 days. Groups D, E and F rats were pretreated with 50, 100 and 200 mg/kg body weight of Piliostigma thonningii leaves for 14 days and challenged with 0.5 mL/kg body weight of carbon tetrachloride on day 14. The extract treatment significantly attenuated both the decrease and the increase in liver and serum marker enzyme. Antioxidant enzyme activity as well as level of uridyl diphosphoglucuronosyl transferase, quinone oxidoreductase and glutathione S-transferase was significantly induced. There was attenuation of malonidialdehyde and lipid hydroperoxide increase. On the basis of the available data in this report, it can be postulated that Piliostigma thonningii leaves protect liver against hepatic and oxidative damage by carbon tetrachloride possibly by acting as an in vivo free radical scavenger, induction of antioxidant enzymes, drug detoxifying enzymes and prevention of excessive stimulation of antioxidant enzyme and lipid peroxidation.
Ethical Principles as a Guide in Implementing Policies for the Management of Food Allergies in Schools
Authors: Behrmann Jason
Published: March 2010

Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to handle the advent of anaphylaxis and policies for the prevention of allergen exposure are missing essential components. Furthermore, certain policies are inappropriate because they are blatantly discriminatory. This article aims to provide further guidance for school health officials involved in creating food allergy policies. By structuring policies around ethical principles of confidentiality and anonymity, fairness, avoiding stigmatization, and empowerment, policy makers gain another method to support better policy making. The main ethical principles discussed are adapted from key values in the bioethics and public health ethics literatures and will be framed within the specific context of food allergy policies for schools.
Behaviors That Discriminate ADHD in Children and Adolescents: Primary Symptoms, Symptoms of Comorbid Conditions, or Indicators of Functional Impairment?
Authors: Harrison Judith R. , Vannest Kimberly J. , Reynolds Cecil R.
Published: March 2010

Objective: The objectives of this study were to evaluate whether behaviors that differentiate children and adolescents with ADHD from those without are related to the primary diagnostic criteria (i.e., inattention and impulsivity—hyperactivity), symptoms of comorbid conditions, functional impairment, or a combination, and to determine whether behaviors that discriminate are consistent between the key developmental stages of childhood and adolescence. Method: Parents and teachers rated children and adolescents with a formal diagnosis of ADHD and those without any mental, physical, or emotional disorders on the multidimensional Behavior Assessment System for Children (2nd ed., BASC-2). Results: Results indicated that behaviors that discriminate children and adolescents with ADHD from those without were associated with primary symptoms, symptoms of comorbid conditions, and indicators of functional impairment. Teachers rated atypicality as the strongest discriminator of children with ADHD from those without and learning problems as the strongest discriminator of adolescents. Parents rated hyperactivity as the strongest discriminator for children and attention problems for adolescents. Activities of daily living was the third strongest discriminator of adolescents as rated by parents. Conclusions: Findings supported the need for a multidimensional view of ADHD that adds emphasis to issues of functional impairment in routine, daily activities important to success in school and interpersonally. Findings showed that conceptualizing and assessing behaviors demonstrated by children and adolescents with ADHD as a whole instead of only equating a diagnosis of ADHD to hyperactivity, inattention, and impulsivity will establish a foundation for understanding, interpreting, and addressing students’ academic and behavioral needs across the home and school. ( J. of Att. Dis. 2011; 15(2) 147-160)
European American children’s and adolescents’ evaluations of interracial exclusion
Authors: Killen Melanie , Clark Kelly Megan , Richardson Cameron , Crystal David , Ruck Martin
Published: March 2010

No research, to date, has investigated the role of ethnic school composition (and intergroup contact) on European American youth’s use of stereotypes to explain interracial discomfort in the context of peer exclusion. In this study, European American fourth-, seventh- and 10th-grade students ( N = 414), attending low and high ethnically-diverse public schools (with low and high self-reports of cross-race/ethnic friendships respectively) evaluated three contexts of interracial exclusion (at lunch time, at a school dance, and at a sleepover). In addition to age and context effects, participants enrolled in high-diversity schools were less likely to use stereotypes to explain racial discomfort, more likely to view racial exclusion as wrong, and more likely to estimate that racial exclusion occurs, than were participants enrolled in low-diversity schools. These findings have implications for the role of social experience on racial attitudes and judgments about exclusion.
Expertise in your midst: How congruence between status and speech style affects reactions to unique knowledge
Authors: Lewin Loyd Denise , Phillips Katherine W. , Whitson Jennifer , Thomas-Hunt Melissa C.
Published: March 2010

We examine how the status and speech style of experts impacts how they are perceived and their level of influence. In our experiment we manipulate whether high-status and low-status experts share their expert knowledge using a more or less powerful style of speech, and find that experts are more liked, more influential, and engender more confidence when they express themselves in a manner congruent with their status (i.e., high status with powerful speech and low status with powerless speech). We further show that liking acts as a mediator between congruence and influence. This study suggests that experts with low-status characteristics who want to be influential should ensure that their expertise, a marker of high status, is known to the listener before engaging in powerful styles of speech.
Changes in the couple relationship in dementia care
Authors: O'Shaughnessy Margaret , Lee Kristina , Lintern Tracey
Published: March 2010

Spouse carers of people with dementia face unique challenges as they adapt to the demands of caring whilst experiencing significant losses in their couple relationship. The ‘professionalization’ of carers by services has been criticized, and recent UK government guidance proposes that carers receive an assessment of psychological need. This study explored spouse carers’ experiences. Semi-structured interviews were conducted with seven spouses, recruited though local Alzheimer’s Societies, who were caring for their partners with mid-stage dementia at home. The data were analysed using interpretative phenomenological analysis. Four overarching themes emerged: ‘connectedness and separateness’; ‘tension between meeting own needs and meeting needs of spouse’; ‘knowing and not knowing the future’; and ‘seeking control — emotional and practical strategies’. With the progressive decline in their partners’ functioning, spouse carers experienced an ongoing process of re-evaluation and re-positioning of themselves in relation to their partner and their couple relationship. Implications for services highlight the importance of support groups and psychological support.
The lives of the RAF revisited: The biographical turn
Authors: Preece Julian
Published: March 2010

The 2000s saw a flurry of biographies in German of figures in the Baader-Meinhof Group (the Red Army Faction or RAF) or associated with it in one way or another. This is remarkable for a number of reasons. Germans, especially on the Left, are traditionally suspicious of this genre of life-writing because of its association with nationalism and related tendency to personalize rather than politicize complex questions and historical processes. Recent RAF biographies have contributed, however, to our understanding of the causes of domestic German terrorism in the 1970s and beyond in various ways, showing in particular personal continuities with the Nazi past that inflected the RAF’s thoughts and actions. The prevalence of ‘novelistic’ approaches, including the dual or triple biography contrasting two or more lives (such as political outlaw and detective, perpetrator and victim, terrorist and legitimate campaigner) shows how the need for new narratives of the recent past often outweighs the value of new research, which, given the paucity of biographical material covering the time ‘underground’, can be hard to conduct. The competing interpretations of the life of Ulrike Meinhof, the subject of by far the highest number of biographies in the survey, shows also how far Germans are from a consensus on the significance of the RAF.
Redeeming the demon? The legacy of the Stasi in Das Leben der Anderen
Authors: Evans Owen
Published: March 2010

The Lives of Others (2006) has been a phenomenally successful film, winning the Oscar for Best Foreign Feature in 2007. Yet despite the critical acclaim it has received abroad, in Germany reactions have been more mixed. Many commentators, especially historians, have been at pains to point out that the transformation of the Stasi officer into the guardian angel of his target is wholly unrealistic in the context of the GDR. However, many of the same critics also concede that the film is very effective. It is this paradox that the present article will examine. Hitherto, very few, if any, examinations of the film have ever looked at its construction and impact as film. We will explore the way that the generic conventions of melodrama have been adapted to create what we might call an authenticity of affect, which actually enhances the film’s treatment of injustice and redemption.
Emotions on a Continuum
Authors: Franks David D.
Published: March 2010

An alternative approach to emotion is presented here, which differs from that of Kagan and others. It orders emotion along a continuum of the embodiment of emotion, starting with a clear but rare case of pure emotion and at the other extreme discusses Damasio’s intelligent prefrontal patients who could not feel emotions critical to social life.