bluuebunny/crossref_metadata_2025 huggingface dataset:
Mexican Immigrant Fathers’ and Mothers’ Engagement With School-Age Children
Authors: Hossain Ziarat , Shipman Virginia
Published: September 2009

This study examined mothers’ and fathers’ reports of their time spent in their school-age children’s care and academic work and the relationships between socioeconomic status and social support variables with fathers’ time spent in children’s care and academic work within two-parent Mexican immigrant families. Mother and father dyads from 79 two-parent Mexican immigrant families with a second- or third-grade child residing in rural towns in southwestern United States participated in the study. Multivariate analyses of variance indicated that mothers spent significantly more time in children’s basic care, care on demand, and both academic interaction at home and at school than did fathers. Hierarchical regression analyses revealed that fathers’ time spent in children’s care was positively related to their educational level and extrafamilial support and that their time spent in children’s academic work, although positively influenced by their education, was negatively influenced by family size. Findings are discussed with regard to gender role differences in parental engagement with children within Mexican immigrant families and their implications for informing policy makers, educators, and parents of the importance of parental time spent in enriching children’s development and culturally sensitive strategies for doing so.
The Effects of Instructional Implementation on Learning With Interactive Multimedia Case-Based Instruction
Authors: Mitchem Katherine , Koury Kevin , Fitzgerald Gail , Hollingsead Candice , Miller Kevin , Tsai Hui-Hsien , Shenghua Zha
Published: September 2009

Interactive, multimedia cases with technology supports present new ways of teaching and learning in teacher education. In this mixed-methods, naturalistic study, the authors investigate how and what participants learn from multimedia cases and, in particular, how instructional implementation affects learning outcomes from multimedia cases. Multimedia cases with technology supports were implemented in 20 different higher education courses with varying University of Missouri—Columbia instructional modes involving 251 pre-service and practicing teacher education students from four different universities. Results indicate that how multimedia cases are integrated into courses makes a difference in case-based learning outcomes and that these differences are evidenced in both quantitative and qualitative data. Overall, significant learning occurred for all instructional implementation groups with one exception—limiting use of cases to context for additional course assignments was not effective. Implications for teacher education are explored.
Thermal Degradation of Natural Fiber-reinforced Polypropylene Composites
Authors: Tajvidi Mehdi , Takemura Akio
Published: September 2009

The objective of the present article was to study the thermal degradation behavior of natural fiber polypropylene composites. Composite materials composed of 50% various natural fibers (wood flour, rice hulls, newsprint, and kenaf fibers) and polypropylene were studied using thermogravimetric analysis (TGA), differential thermal analysis (DTA), and differential scanning calorimetry (DSC). The effect of compatibilzer on the thermal stability of the composites was also evaluated. Contributions of components of one composite formulation to thermal degradation were also evaluated. It was found that among natural fibers, rice hulls were the least thermally stable ones in a polypropylene matrix. The compatibilizer slightly reduced thermal stability while enhancing fiber—matrix interaction and fractional crystallinity. The overall thermal degradation profile of the composite materials was found to be a more or less arithmetic average of those of the components.
Copolymers Obtained by ε-Caprolactam and Methyl Methacrylate Polymerization in the Presence of Polyimides
Authors: Vygodskii Yakov S. , Volkova Tat'yana V. , Batalova Tat'yana L. , Zabegaeva Olesya N. , Belavtseva Elena M. , Sakharova Antonina A. , Gasanov Rashid G. , Sapozhnikov Dmitriy A. , Voytekunas Vanda Yu.
Published: September 2009

New copolymers have been synthesized by anionic or radical photopolymerization of ε-caprolactam or methyl methacrylate (MMA) in the presence of dissolved polyimides bearing hexafluoroisopropylidene, fluorene or other groups. Using diimides as models it was shown that the kinetics of anionic polymerization of ε-caprolactam depends on the nature of spacer between the imide cycles. The mechanical and tribological properties of copolymers, their water absorbance and the microstructure of copolymer films were studied. It was found that upon the selection of polyimide activator it was possible to gain the desirable control over the polymer properties, namely, the gel fraction content, phase composition, compression modulus, notched Izod impact strength, friction coefficient and temperature of frictional contact. The kinetics of radical polymerization of MMA in the presence of polyimide and model diimide has been studied by differential scanning photocalorimetry and infrared spectroscopy. From the results of the reaction kinetics and the study of polymer structures by Fourier transform infrared spectroscopy, nuclear magnetic resonance, size-exclusion chromatography and thermogravimetric analysis it has been established that radical photopolymerization of MMA in the presence of polyimide leads to the formation of copolymers owing to chain transfer reactions and/or chain termination by the relevant condensation polymer. It has been established that the imide cycles play a significant role in the formation of both copolymers with ε-caprolactam and MMA, respectively.
Not Immune: Access to Substance Abuse Treatment Among Medicaid-Covered Youth With Mental Retardation
Authors: Maclean Slayter Elspeth
Published: September 2009

Youth with mental retardation* (MR) have experienced increasing levels of participation in community life over the last 30 years. This freedom has facilitated access to community life beyond school settings; it has also created the potential for alcohol and drug use and for the development of substance abuse (SA). Little is known about access to SA treatment for youth with MR—an especially vulnerable population. Through the application of a set of standardized performance measures, this study examines SA treatment access among youth aged 12 to 21 with and without MR ( N = 150,009). Guided by Andersen’s sociobehavioral model of health care utilization, multivariate logistic regression analyses modeled SA treatment initiation and engagement. Youth with MR and SA were less likely to initiate or engage in treatment. Engagement among youth with MR and SA was associated with being male and/or non-White. Implications relate to a need for improved treatment access for youth with MR and SA through cross-system collaboration.
A Response to Jason et al. (2009), “Evaluating the Centers for Disease Control’s Empirical Chronic Fatigue Syndrome Case Definition”
Authors: Reeves William C. , Gurbaxani Brian M. , Lin Jin-Mann S. , Unger Elizabeth R.
Published: September 2009

The recent article by Jason, Najar, Porter, and Reh, “Evaluating the Centers for Disease Control’s Empirical Chronic Fatigue Syndrome Case Definition” (2009; Journal of Disability Policy Studies, 20:2, 93—100) attempted to critically explore several pertinent issues concerning diagnosing chronic fatigue syndrome (CFS). Most of these issues have been brewing since international adoption of the 1994 CFS case definition by Fukuda et al., and it is high time to address them in a peer-reviewed and public forum.
Quantitative Detection of Low Energy Impact Damage in a Sandwich Composite Wing
Authors: Seaver Mark , Aktas Engin , Trickey Stephen T.
Published: September 2009

This work describes damage detection in a foam core composite wing (1320 mm × 152.4 mm × 13.4 mm) following a series of low energy impacts. Thirteen impacts (6—8 J deposited energy) were applied at adjacent locations approximately 1/4 of the way out from the wing center. Following every one or two impacts, the wing was tested using static tip deflection and dynamic vibrational excitation. Static and dynamic strains were measured using eight fiber Bragg grating sensors. Dynamic acceleration was also monitored using three conventional accelerometers. The estimated bicoherence was used to detect the presence of damage-induced non-linearity in time-series data recorded from each sensor. Receiver operating characteristic (ROC) curves were constructed for each sensor based on 15 or more dynamic measurements made for each damage case. The ROC curves provide a quantitative, statistical approach to evaluating the damage detection capabilities of the various sensors.
Development of a Distributed Force Detectable Artificial Skin Using Microbending Optical Fiber Sensors
Authors: Heo Jin-Seok , Kim Ki-Young , Lee Jung-Ju
Published: September 2009

This article describes a skin-like tactile sensor system that can detect a distributed force using microbending optical fiber sensors. In this design, optical fibers are used both as actual force elements and as signal-transmission media. The tactile array sensor is formed by appropriately arranging fibers into two overlapping layers, forming a 2D grid of fibers. When force is imparted to a given fiber taxel, small distortions (microbends) appear in the stressed fibers, resulting in decreases in the transmitted light intensity in these fibers. A prototype sensor of this type has been fabricated and tested. Comparison with a conventional tactile sensor reveals that the proposed tactile sensor provides outstanding performance and many advantages such as water resistive characteristics, high durability, and simple wiring.
Perspectives of Colorectal Cancer Risk and Screening Among Dominicans and Puerto Ricans: Stigma and Misperceptions
Authors: Goldman Roberta E. , Diaz Joseph A. , Kim Ivone
Published: September 2009

Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were “bad food,” digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening.
A Comparative Study of 2 Sustained-Release Morphine Preparations for Pain in Advanced Cancer
Authors: Homsi Jade , Walsh Declan , Lasheen Wael , Nelson Kristine A. , Rybicki Lisa A. , Bast Jane , LeGrand Susan B.
Published: September 2009

Purpose: Several sustained-release morphine (SRM) formulations are available internationally. This study compared 2 such products available in the United States, SR1 and SR2.

Patients and Methods: In an open-label study, patients with advanced cancer pain were randomized to receive SR1 or SR2 every 12 hours around-the-clock (ATC) for 5 days, with immediate release (IR) liquid morphine for rescue dosing (RD). Efficacy, safety, and patient acceptability were determined.

Results: A total of 32 patients were evaluable for efficacy and toxicity. Pain scores, RD dosage, RD frequency over 5 days, RD within 3 hours before and after the scheduled SRM, and 8 of the 11 evaluated side effects were higher in the SR1 group. At presumed morphine steady state (day 3), pain scores (P = .05), RD dosage (P = .07), RD frequency (P = .07), and number of RD ±3 hours from scheduled SRM dose (P = .05) were consistently greater in the SR1 group (despite a higher median morphine dose in that group). There was a clinically important and directionally consistent trend that favored SR2, although not all were statistically significant. Patient preference favored SR2 (P < .05). Neither group had difficulty swallowing SR1 or SR2.

Conclusions: This is the first study that directly compared two 12-hour SRM formulations. The data suggested, by multiple clinically important measures, that SR2 may provide superior analgesic efficacy and less toxicity compared to SR1. It also supports the concept that it cannot be assumed that different SR formulations of a given opioid are clinically equivalent. A larger study is needed to confirm our findings.
Predictors of Symptom Severity and Response in Patients With Metastatic Cancer
Authors: Zimmermann Camilla , Burman Debika , Follwell Matthew , Wakimoto Kristina , Seccareccia Dori , Bryson John , Le Lisa W. , Rodin Gary
Published: September 2009

We examined determinants of symptom severity and response to treatment among 150 patients with cancer participating in a phase II trial of a palliative care team intervention. Patients completed a modified Edmonton Symptom Assessment Scale (ESAS) at baseline and 1 week. Women had a worse baseline ESAS Distress Score (EDS; P = .003) and Total Distress Score (TDS; P = .005); differences were particularly marked for anxiety and appetite. Performance status was inversely associated with EDS, TDS, well-being, appetite, and fatigue (Kruskal-Wallis, all P < .005). Multivariate analysis of covariance (ANCOVA) showed that symptom improvement was independently predicted by worse baseline EDS score and female gender. Performance status, gender, and baseline symptom severity should be accounted for in trials of palliative care interventions; inclusion criteria based on symptom severity should also be considered.
Plea Bargaining Implementation and Acceptance in Modern Russia
Authors: Semukhina Olga B. , Reynolds K. Michael
Published: September 2009

This study examines the scope, results, citizen attitudes, and practices of consensual justice reform in Russia. The Russian Federation adopted a new Criminal Procedure Code (CPC) in December of 2001, which included a procedure closely resembling plea bargaining and termed ‘‘special court order proceedings.’’ The 2001 CPC reforms were intended to move further away from the accusatorial legacy of the Soviet judicial system and closer to a western adversarial model. Criminal cases (N = 316) over a 4-year period (2004—2007) from one district and one regional courts were examined to determine the application and judicial practices associated with plea bargaining. A national representative citizen survey (N = 1,588) was conducted to measure attitudes related to plea bargaining knowledge and acceptance. The study found that 6 years after the introduction of the special court order proceeding, over one third of cases were settled through the special court order proceedings. The use of the special court order proceeding has grown steadily during the period from 2004 to 2008. The majority of citizens reported the special court order proceeding was unfair and less than 20% perceived the reform as fair. Few citizens were knowledgeable about the plea bargaining reform. The introduction of the special court order proceeding has been moderately successful in the judicial system; however, there are systemic hindrances to increased use and citizen acceptance.
School Nurses' Knowledge of Autism Spectrum Disorders
Authors: Strunk Julie A.
Published: September 2009

The purpose of this study was to determine school nurses' working knowledge of autism spectrum disorders (ASDs). The current knowledge of school nurses was investigated by means of a mixed-method exploratory descriptive pilot study. Instrumentation included a scale that measured the knowledge of school nurses in regard to ASD, including medication usage and side effects, communication skills, safety issues, collaboration skills, and community resources. Survey results indicated that the majority of school nurses are knowledgeable about ASD, including symptomology and related medications. Results also suggested that school nurses are not as knowledgeable concerning communication skills, behavioral therapies, and safety issues. This study confirms a need for school nurses to enhance their knowledge of ASD, to familiarize themselves with the policy and health care networks that they collaborate with, and to communicate effectively with students, parents, educators, and community members in dealing with ASD.
The Relations of Vocational Interests and Mathematical Literacy
Authors: Warwas Jasmin , Nagy Gabriel , Watermann Rainer , Hasselhorn Marcus
Published: September 2009

This study examines the relationships of vocational interests and mathematical literacy both cross-sectionally and longitudinally. Extending previous research, the results of Holland’s RIASEC (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional) scale scores are compared with results from a reductionist approach using individual interest profiles (including the parameters level, differentiation, and orientation). Both analyses find significant relations between interests and mathematical literacy. The scale score analyses reveal positive associations of Realistic interests with mathematical literacy, whereas Artistic interests show a negative association. Interest profiles from a dimensional representation show individuals with interest orientations close to the Realistic domain score highest on mathematical literacy, with those with interests in both Artistic and Social domains scoring lowest. Results from profile analyses suggest that interest differentiation moderates the interest—ability relation. Only interest profiles are predictive for mathematical literacy over and above covariates, indicating that interest profiles are more robust predictors than the scale scores. Analyses show that interest profiles are a valid reduction of the scale score models.
Work Family Relations: Antecedents and Outcomes
Authors: Gali Cinamon Rachel , Rich Yisrael
Published: September 2009

This study investigated interrelations between conflict and facilitation in work and family domains, with spousal, managerial, and collegial social support serving as antecedents, and professional vigor and burnout as outcomes. Participants were 322 female, married teachers. Regression analyses revealed complex relations between conflict and facilitation, and different patterns of association in the work and family domains. Only managerial support predicted conflict and facilitation relations. Work-to-family (W→F) and family-to-work (F→W) conflict predicted burnout. Results suggest that conflict and facilitation are distinct constructs and they underscore the importance of working with managers to enhance their ability to promote employees’ health.
The Factor Structure of the Work—Family Conflict Multidimensional Scale: Exploring the Expectations of College Students
Authors: Gaffey Abigail R. , Rottinghaus Patrick J.
Published: September 2009

Work-family conflict (WFC) has been examined from a unidimensional approach, yet recent research has revealed three types (i.e., time, strain, and behavior) and two directions of work— family conflict. Previous researchers suggested that college students are unable to discern between the multiple-facets of WFC, thus measured anticipated WFC addressing only the bidirectional component. This approach assumes that college students have not fully considered each facet of work—family balance. The current study is the first to examine the use of measuring anticipated work—family conflict with college students from a multidimensional perspective. We investigated anticipated levels of three types and two directions of WFC of 295 college students by examining the factor structure of a modified version of the Multidimensional Work—Family Conflict Scale. Participants discerned between the three types of WFC yet were unable to differentiate between the directions of behavior and strain-based conflict. Implications for research and career counseling are also discussed.
Varieties of Carbon Governance: Utilizing the Clean Development Mechanism for Chinese Priorities
Authors: Schroeder Miriam
Published: September 2009

The Clean Development Mechanism (CDM) is a market mechanism that was created by an international regime, but its successful implementation relies on effective CDM governance within its host countries. What kinds of carbon governance patterns are appropriate for reaching the goals of the Kyoto Protocol? Taking China—the leading CDM host country worldwide—as a case study, this article examines the patterns of Chinese carbon governance. The hypothesis brought forward is that the Chinese government is apt in utilizing the international market mechanism CDM for its own priorities by adding own national requirements. The dominating carbon governance pattern is state regulation, while private actors from the business community and from civil society play only a minor role. The article concludes by discussing the implications of the Chinese variety of carbon governance for the post-2012 climate regime.
Implementing Family Nursing: How Do We Translate Knowledge Into Clinical Practice?
Authors: Leahey Maureen , Svavarsdottir Erla Kolbrun
Published: September 2009

Health care systems worldwide are faced with the challenge of improving the quality of care, closing the knowledge-to-practice gap, and identifying the facilitators in these processes. Knowledge translation that promotes circularity between knowledge and practice is often overlooked. Knowledge transfer and translation are defined and briefly discussed in this article. Examples of knowledge translation in family nursing are provided, including knowledge creation research in pediatrics and adult pulmonary health at a University Hospital in Iceland. A second example focuses on the application of knowledge in mental health urgent care in a community health center in Calgary, Canada. Improving and speeding the circularity between knowledge translation and clinical practice reaps benefits for patients, families, health care providers, and the health care system. Conclusions about facilitating the implementation of family nursing knowledge into clinical practice are offered. The circularity between knowledge translation and practice is emphasized.
The Other Side of the Diaspora: Race, Threat, and the Social Psychology of Evacuee Reception in Predominantly White Communities
Authors: Hunt Jennifer S. , Armenta Brian E. , Seifert April L. , Snowden Jessica L.
Published: September 2009

This article provides a social psychological framework for understanding the reception of Hurricane Katrina evacuees in predominantly White relocation communities. According to this framework, racial prejudice and perceptions of economic and social threat are likely to have an important influence on residents’ reactions to the evacuees. In the “Katrina in my Community Study,” the authors surveyed 532 residents from Colorado Springs, CO, Salt Lake City, UT, and San Antonio, TX—three cities that had African American populations well below the national average and that received large numbers of Katrina evacuees. The respondent’s evaluations of and judgments about the evacuees, including overall attitudes and support for continued assistance, were explained to a greater extent by perceived threat and prejudice than by their actual experiences with the evacuees. Thus, at least in predominantly White communities, race and subjective feelings of threat may frame decisions about helping newcomers to a community, even when need is salient.
Parental Attributions for Success in Managing the Behavior of Children With ADHD
Authors: Coles Erika K. , Pelham William E. , Gnagy Elizabeth M.
Published: September 2009

Objective: The current study evaluated the effects of differing intensities of behavior modification and medication on parents’ self-reported success in managing their child’s misbehavior and the attributions parents gave for success or failure.

Method: Children were randomized to receive in counterbalanced orders different levels of behavior modification, each for 3-week cycles. In addition, medication was manipulated using a medication assessment procedure. Parents reported daily how successful they were in managing their child’s misbehavior and the attributions for either their success or failure.

Results: Parents of children with ADHD generally felt successful in managing their child’s behavior, regardless of treatment condition. In the high behavior modification condition, they were more likely to endorse items that attributed their success to their own effort. Conclusion: In conditions in which parents were given more intensive tools to manage misbehavior they were more likely to attribute their success to their own effort.
Short-Term Effects of Playing Computer Games on Attention
Authors: Tahiroglu Aysegul Yolga , Celik Gonca Gul , Avci Ayse , Seydaoglu Gulsah , Uzel Mehtap , Altunbas Handan
Published: September 2009

Objective: The main aim of the present study is to investigate the short-term cognitive effects of computer games in children with different psychiatric disorders and normal controls. Method: One hundred one children are recruited for the study (aged between 9 and 12 years). All participants played a motor-racing game on the computer for 1 hour. The TBAG form of the Stroop task was administered to all participants twice, before playing and immediately after playing the game. Results: Participants with improved posttest scores, compared to their pretest scores, used the computer on average 0.67 ± 1.1 hr/day, while the average administered was measured at 1.6 ± 1.4 hr/day and 1.3 ± 0.9 hr/day computer use for participants with worse or unaltered scores, respectively. According to the regression model, male gender, younger ages, duration of daily computer use, and ADHD inattention type were found to be independent risk factors for worsened posttest scores. Conclusion: Time spent playing computer games can exert a short-term effect on attention as measured by the Stroop test. (J. of Att. Dis. 2010; 13(6) 668-676)
Reduced Capacity in a Dichotic Memory Test for Adult Patients With ADHD
Authors: Dige Niels , Maahr Eija , Backenroth-Ohsako Gunnel
Published: September 2009

Objective: To evaluate whether a dichotic memory test would reveal deficits in short-term working-memory recall and long-term memory recall in a group of adult patients with ADHD. Methods: A dichotic memory test with ipsilateral backward speech distraction in an adult ADHD group ( n = 69) and a control group ( n = 66) is used to compare performance between the groups and inside the subgroups of ADHD diagnosed with DSM-IV. Results: The ADHD participants showed significant impairment in the dichotic memory test compared with control participants when controlled for age, sex, and education. Study findings reveal that there is no difference in subdivision in the three ADHD subgroups of DSM-IV. A discriminant analysis shows an overall classification rate of 78% and specific in ADHD 80%. Conclusions: The results indicate that the dichotic test is measuring one of the important ADHD deficits. (J. of Att. Dis. 2010; 13(6) 677-683)
Increased intima thickness of the radial artery in patients with coronary heart disease
Authors: Myredal Anna , Osika Walter , Li Ming Gan  , Friberg Peter , Johansson Mats
Published: September 2009

Ultrabiomicroscopy is a novel high-frequency (55 MHz) ultrasound technique that could be used to non-invasively measure the vessel wall and separate the intima—media complex into measurements of intima and media thickness. Since no previous study has measured intima and media thickness separately in vivo in patients with coronary heart disease (CHD), the aim of the current study was to measure intima and intima—media thickness of the radial and the anterior tibial arteries among patients with CHD and healthy subjects (HS). Thirty-two patients with CHD and 46 HS underwent investigations with ultrabiomicroscopy measurements of the radial and anterior tibial arteries. Patients with CHD showed a 19% increase in intima thickness of the radial artery compared with HS (0.088 ± 0.024 mm versus 0.074 ± 0.015 mm; p < 0.015), whereas no difference was seen in media thickness. There were no differences in intima or media thickness within the anterior tibial arteries. In conclusion, CHD is associated with thickening of the intima of the radial artery whereas media thickness was unchanged compared with HS. Assessment of intima thickness by high-frequency ultrasound may provide a tool for non-invasive early detection of atherosclerosis.
The effect of claudication pain on temporal and spatial gait measures during self-paced ambulation
Authors: Gardner Andrew W , Montgomery Polly S , Ritti-Dias Raphael M , Forrester Larry
Published: September 2009

We determined the effect of claudication pain on temporal and spatial gait characteristics, and on ambulatory symmetry at preferred and rapid self-selected walking paces in patients with unilateral peripheral arterial disease (PAD). Twenty-eight patients with PAD limited by intermittent claudication were studied. Patients ambulated at their preferred and rapid paces over a 7.3-meter portable gait mat system while they were pain-free and after experiencing claudication pain. The order of the pain-free and painful walking trials was randomized, and the following gait parameters were obtained: velocity, cadence, stride length, swing time, stance time, single-support time, and double-support time. During the self-selected rapid pace, patients walked 3% slower ( p = 0.020) while in pain due to a 3% shorter stride length ( p < 0.001), and they were in double-stance longer ( p = 0.024). Claudication pain in the symptomatic leg resulted in an increase in single-stance ( p = 0.007). Furthermore, gait became asymmetrical with pain, as the symptomatic leg spent a higher percentage of the gait cycle in the swing phase ( p < 0.01) and lower percentages in stance ( p < 0.01) and single-stance ( p < 0.01) than the asymptomatic leg. Ambulation was symmetrical for all measures during the pain-free trial. In conclusion, claudication pain slows ambulatory velocity at preferred and rapid paces, and increases asymmetry when ambulatory function is challenged with rapid walking. The reduced ambulatory speed with the development of claudication pain may be an adaptation to elicit a safer and less destabilizing gait pattern.
Appalachian Women Leaders: Products of Culture and Life Events
Authors: Smith Devona G. , Reed Kendra
Published: September 2009

This study explores the effects of cultural expectations and critical life events on women’s leadership influence in Appalachia, a unique subculture of the United States. Using a sample of 347 female MBA students, the researchers examined the impact of education, gender bias, family/work issues, and family violence on leadership influence. Not only did results demonstrate significant relationships between education and gender bias with leadership influence, but also these relationships were moderated by culture-leadership style fit. In both researching and developing leaders, special attention needs to be paid to the culturally specific ideologies, events, and other idiosyncrasies within national subcultures.
Review: Integration of targeted agents in the neo-adjuvant treatment of gastro-esophageal cancers
Authors: Power D.G. , Ilson D.H.
Published: September 2009

Pre- and peri-operative strategies are becoming standard for the management of localized gastro-esophageal cancer. For localized gastric/gastro-esophageal junction (GEJ) cancer there are conflicting data that a peri-operative approach with cisplatin-based chemotherapy improves survival, with the benefits seen in esophageal cancer likely less than a 5-10% incremental improvement. Further trends toward improvement in local control and survival, when combined chemotherapy and radiation therapy are given pre-operatively, are suggested by recent phase III trials. In fit patients, a significant survival benefit with pre-operative chemoradiation is seen in those patients who achieve a pathologic complete response. In esophageal/GEJ cancer, definitive chemoradiation is now considered in medically inoperable patients. In squamous cell carcinoma of the esophagus, surgery after primary chemoradiation is not clearly associated with an improved overall survival, however, local control may be better. In localized gastric/GEJ cancer, the integration of bevacizumab with pre-operative chemotherapy is being explored in large randomized studies, and with chemoradiotherapy in pilot trials. The addition of anti-epidermal growth factor receptor and anti-human epidermal growth factor receptor-2 antibody treatment to pre-operative chemoradiation continues to be explored. Early results show the integration of targeted therapy is feasible. Metabolic imaging can predict early response to pre-operative chemotherapy and biomarkers may further predict response to pre-operative chemo-targeted therapy. A multimodality approach to localized gastro-esophageal cancer has resulted in better outcomes. For T3 or node-positive disease, surgery alone is no longer considered appropriate and neo-adjuvant therapy is recommended. The future of neo-adjuvant strategies in this disease will involve the individualization of therapy with the integration of molecular signatures, targeted therapy, metabolic imaging and predictive biomarkers.
Febuxostat treatment for gout: what the clinician needs to know
Authors: Chen Lan X. , Schumacher H. Ralph
Published: September 2009

Febuxostat is a new non-purine based inhibitor of xanthine oxidase that will be a useful addition to the drugs available to treat gout. This short review covers general principles of the management of gout and then focuses on practical aspects and use of febuxostat.
CPAP and/or NIV in cardiogenic pulmonary oedema
Authors: Köhnlein T.
Published: September 2009

Educational aims

Define the benefits of using CPAP and/or NIV in heart failure.

Detail recommendations for the use of ventilators for the clinical treatment of heart failure.

Discuss the evidence for and against using ventilators in heart failure.

Describe the benefit of using NIV in a pre-clinical setting.

Heart failure is a complex topic which poses difficult decisions for ventilator specialists. Currently available therapies are mechanical ventilation and standard therapy with oxygen or medical intervention. Ventilator specialists face a difficult decision when choosing which of these to use as the evidence for each is not conclusive. The primary aim of the chosen treatment is to improve oxygenation and respiratory acidosis and reduce the work of breathing and dyspnoea. In addition, another goal of treatment is an improvement of cardiac performance. To date, it is difficult to recommend which available treatment is the best at achieving these goals and it is recommended that individual treatment for each patient should be based on their specific needs and circumstances.
Visualization of ribosomal RNA operon copy number distribution
Authors: Rastogi Rajat , Wu Martin , DasGupta Indrani , Fox George E
Published: September 2009

Background

Results of microbial ecology studies using 16S rRNA sequence information can be deceiving due to differences in rRNA operon copy number and genome size of the detected organisms. It therefore will be useful for investigators to have a better understanding of how these two parameters differ in various organism types. In this study, the number of ribosomal operons and genome size were separately mapped onto a Bacterial phylogenetic tree.

Results

A representative Bacterial tree was constructed using 31 marker genes found in 578 bacterial genome sequences. Organism names are displayed on the trees using graduations of color such that similar colors indicate similar numbers of operons or genome size. The resulting images provide an intuitive understanding of how copy number and genome size vary in different Bacterial phyla.

Conclusion

Once the phylogenetic position of a novel organism is known the number of rRNA operons, and to a lesser extent the genome size, can be estimated by examination of the colored maps. Further detail can then be obtained for members of relevant taxa from the rrnDB database.
Locations and patterns of meiotic recombination in two-generation pedigrees
Authors: Ting Jason C , Roberson Elisha DO , Currier Duane G , Pevsner Jonathan
Published: September 2009

Background

Meiotic crossovers are the major mechanism by which haplotypes are shuffled to generate genetic diversity. Previously available methods for the genome-wide, high-resolution identification of meiotic crossover sites are limited by the laborious nature of the assay (as in sperm typing).

Methods

Several methods have been introduced to identify crossovers using high density single nucleotide polymorphism (SNP) array technologies, although programs are not widely available to implement such analyses.

Results

Here we present a two-generation "reverse pedigree analysis" method (analyzing the genotypes of two children relative to each parent) and a web-accessible tool to determine and visualize inheritance differences among siblings and crossover locations on each parental gamete. This approach is complementary to existing methods and uses informative markers which provide high resolution for locating meiotic crossover sites. We introduce a segmentation algorithm to identify crossover sites, and used a synthetic data set to determine that the segmentation algorithm specificity was 92% and sensitivity was 89%. The use of reverse pedigrees allows the inference of crossover locations on the X chromosome in a maternal gamete through analysis of two sons and their father. We further analyzed genotypes from eight multiplex autism families, observing a 1.462 maternal to paternal recombination ratio and no significant differences between affected and unaffected children. Meiotic recombination results from pediSNP can also be used to identify haplotypes that are shared by probands within a pedigree, as we demonstrated with a multiplex autism family.

Conclusion

Using "reverse pedigrees" and defining unique sets of genotype markers within pedigree data, we introduce a method that identifies inherited allelic differences and meiotic crossovers. We implemented the method in the pediSNP software program, and we applied it to several data sets. This approach uses data from two generations to identify crossover sites, facilitating studies of recombination in disease. pediSNP is available online at http://pevsnerlab.kennedykrieger.org/pediSNP.
Association of common variants in mismatch repair genes and breast cancer susceptibility: a multigene study
Authors: Conde João , Silva Susana N , Azevedo Ana P , Teixeira Valdemar , Pina Julieta Esperança , Rueff José , Gaspar Jorge F
Published: September 2009

Background

MMR is responsible for the repair of base-base mismatches and insertion/deletion loops. Besides this, MMR is also associated with an anti-recombination function, suppressing homologous recombination. Losses of heterozygosity and/or microsatellite instability have been detected in a large number of skin samples from breast cancer patients, suggesting a potential role of MMR in breast cancer susceptibility.

Methods

We carried out a hospital-based case-control study in a Caucasian Portuguese population (287 cases and 547 controls) to estimate the susceptibility to non-familial breast cancer associated with some polymorphisms in mismatch repair genes (MSH3, MSH4, MSH6, MLH1, MLH3, PMS1 and MUTYH).

Results

Using unconditional logistic regression we found that MLH3 (L844P, G>A) polymorphism GA (Leu/Pro) and AA (Pro/Pro) genotypes were associated with a decreased risk: OR = 0.65 (0.45-0.95) (p = 0.03) and OR = 0.62 (0.41-0.94) (p = 0.03), respectively.

Analysis of two-way SNP interaction effects on breast cancer revealed two potential associations to breast cancer susceptibility: MSH3 Ala1045Thr/MSH6 Gly39Glu - AA/TC [OR = 0.43 (0.21-0.83), p = 0.01] associated with a decreased risk; and MSH4 Ala97Thr/MLH3 Leu844Pro - AG/AA [OR = 2.35 (1.23-4.49), p = 0.01], GG/AA [OR = 2.11 (1.12-3,98), p = 0.02], and GG/AG [adjusted OR = 1.88 (1.12-3.15), p = 0.02] all associated with an increased risk for breast cancer.

Conclusion

It is possible that some of these common variants in MMR genes contribute significantly to breast cancer susceptibility. However, further studies with a large sample size will be needed to support our results.
Colorectal cancer screening, perceived discrimination, and low-income and trust in doctors: a survey of minority patients
Authors: Born Wendi , Engelman Kimberly , Greiner K Allen , Bhattacharya Shelley B , Hall Sandra , Hou Qingjiang , Ahluwalia Jasjit S
Published: September 2009

Background

Completion of colorectal cancer (CRC) screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT) among a low-income, minority primary care population in an urban setting.

Methods

We recruited a convenience sample of adults over age 40 (n = 282) from a federally qualified community health center (70% African American). Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening.

Results

Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p < 0.01). The trend was for older participants to express more trust (p = 0.09) and less perceived discrimination (p < 0.01). Neither trust nor discrimination was associated with race or education. Trust was higher among participants over 50 who were up-to-date on FOBT screening vs. those who were not (31 vs. 29 (median), p < 0.05 by T-test). Among those over 50, up-to-date FOBT screening was nearly associated with high trust (p < 0.06; 95% CI 0.99, 1.28) and low perceived discrimination (p < 0.01; 95% CI 0.76, 0.96). Nevertheless, in multivariate-modeling, age and income explained FOBT completion better than race, trust and discrimination.

Conclusion

Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.
Long-term care cost drivers and expenditure projection to 2036 in Hong Kong
Authors: Chung Roger Y , Tin Keith YK , Cowling Benjamin J , Chan King Pan , Chan Wai Man , Lo Su Vui , Leung Gabriel M
Published: September 2009

Background

Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC) expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036.

Methods

We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions.

Results

Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure.

Conclusion

The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning.
Meteorologically estimated exposure but not distance predicts asthma symptoms in schoolchildren in the environs of a petrochemical refinery: a cross-sectional study
Authors: White Neil , teWaterNaude Jim , van der Walt Anita , Ravenscroft Grant , Roberts Wesley , Ehrlich Rodney
Published: September 2009

Background

Community concern about asthma prompted an epidemiological study of children living near a petrochemical refinery in Cape Town, South Africa. Because of resource constraints and the complexity of refinery emissions, neither direct environmental measurements nor modelling of airborne pollutants was possible. Instead a meteorologically derived exposure metric was calculated with the refinery as the putative point source. The study aimed to determine whether (1) asthma symptom prevalences were elevated compared to comparable areas in Cape Town and (2) whether there was an association between asthma symptom prevalences and the derived exposure metric.

Methods

A cross-sectional study was carried out of all consenting school children aged 11 to 14 years attending schools in a defined area, utilizing the International Study of Asthma and Allergy in Childhood (ISAAC) written and video questionnaires. Information was collected on potential confounders, e.g. parental history of atopic disease, active and passive smoking by the participant, birth order, number of children in the home and distance from a major road. The exposure metric combined residential distance of each child from the refinery with a wind vector in the form of wind speed, wind direction and proportion of the year blown.

Results

A total of 2,361 children from 17 schools met the criteria for inclusion. In multivariate analysis, meteorologically estimated exposure (MEE), but not simple distance from the refinery, was positively associated with having to take an inhaler to school [odds ratio per interquartile range (OR) 1.22, 95% confidence interval (CI) 1.06-1.40], and with a number of video elicited asthma symptoms, including recent waking with wheezing (OR 1.33, 95% CI 1.06-1.66) and frequent wheezing at rest (OR 1.27, 95% CI 1.05 - 1.54). Symptom prevalences were higher than in other areas of the city, with frequent waking with wheezing being in great excess (OR 8.92, 95% CI 4.79-16.63).

Conclusion

The results support the hypothesis of an increased prevalence of asthma symptoms among children in the area as a result of refinery emissions and provide a substantive basis for community concern. The methodology also provides a low cost means of testing hypotheses about point source pollutant effects on surrounding populations of children.