bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Mastoiditis in Infants and Children
Authors: Ginsburg Charles M. , Rudoy Raul , Nelson John D.
Published: July 2008

During a 25-year period, 57 cases of acute mastoiditis occurred in infants and young children who ranged in age from 2 months to 12 years of age. All patients had abnormalities of the tympanic membrane and most had fever and localized edema and redness of the overlying skin. Fifty per cent of the infants who were less than one year of age had swelling primarily above the involved ear pushing the pinna out and down. By contrast, older children had swelling of the skin overlying the mastoid process which produced the classical finding of an elevated earlobe. Mastoid roentgenograms were a useful adjunct to diagnosis, revealing concurrent osteomyelitis in 9 patients. A diagnosis of specific bac terial etiology was made in 80 per cent of the patients in whom cultures were performed. Streptococcus pneumoniae, Staphylococcus aureus and Streptococcus pyogenes were the bacteria most frequently isolated. Unusual manifestations or serious complications occurred in 53 per cent of the patients, including one death (due to meningitis). These data indicate that the frequency of serious complications from acute mastoiditis has not declined over the past 3 decades.
Pitfalls in the Diagnosis of Acute Osteomyelitis by Bone Scan
Authors: Wald Ellen R. , Mirro Robert , Gartner J. Carlton
Published: July 2008

Two patients with acute osteomyelitis had technetium 99m methylene di phosphonate bone images that were misinterpreted. A review of six prospective evaluations of technetium scanning in the diagnosis of acute osteomyelitis shows that bone image interpretation may be misleading in five to seven per cent of pediatric patients. Definitive diagnostic procedures and management should not be delayed until a positive bone scan is obtained, if the clinical findings are persuasive.
Pulmonary Hemorrhage Secondary to Chest Tube Placement for Pneumothorax in Neonates
Authors: Jung August L. , Minton Stephen D. , Roan Yeai
Published: July 2008

We report two neonates in whom placement of a chest tube for pneumo thorax was followed by hemorrhage, shock, and subsequent death. An autopsy of one of the patients led us to the conclusion that bleeding had occurred from lung perforation. The intercostal artery had been clearly severed and may have contributed to the hemorrhage. We discuss pathogenesis, diagnosis, and offer suggestions for proper placement of the tube.
Simultaneous Hemodialysis and Exchange Transfusion in Hemolytic Uremic Syndrome
Authors: Harden Lewis B. , Gluck Rita S. , Saicedo Jose R.
Published: July 2008

We report our experience in the acute management of a seven-year-old child with severe hemolytic uremic syndrome. On three separate occasions, acute neurologic signs dramatically resolved during simultaneous exchange transfu sion and hemodialysis. The ease with which exchange transfusion may be combined with acute hemodialysis is discussed. In selected cases of hemolytic uremic syndrome with marked neurologic manifestations, exchange trans fusion may offer a benefit similar to that reported in adults with thrombotic thrombocytopenic purpura.
Congenital Asymmetrical Crying Facies
Authors: Singhi Sunit , Sihghi Pratibha , Lall K.B.
Published: July 2008

Congenital asymmetrical crying facies, a minor congenital anomaly due to hypoplasia or the absence of the depressor muscle of the angle of the mouth (musculus depressor anguli oris), manifests as lower lip asymmetry during crying. In a prospective study of 1,600 neonates born at the J.L.N. Medical College in Ajmer, India, during the period from January 1979 to August 1979, 10 infants (6.3 per 1,000 infants) had asymmetrical crying facies. Two of the 10 affected neonates had congenital heart disease (1 ventricular septal defect; 1 tetralogy of Fallot), compared with three out of 1,590 members of a control group (p < 0.00 1). Five babies had other minor congenital malformations. Four of the 10 mothers of probands and three of twelve siblings had the same anomaly, suggesting a familial etiologic factor. No noxious obstetric or pre natal factor could be identified. At a follow-up examination (3 to 6 months later), all of the infants showed normal growth and development, although the effects of the anomaly persisted. We suggest that asymmetrical crying facies is a commonly occurring minor congenital malformation, and in its presence, a thorough search for other congenital malformations, especially of the cardio. vascular system, should be made.
Sexual Offenses Committed against Children
Authors: Scherzer Larry N. , Lala Padma
Published: July 2008

A descriptive analysis was done on 73 consecutive cases of childhood sexual abuse seen in 1978. There were conspicuous similarities among the cases. Sexually abused children tended to come from households with evidence of family stress. The events occurred in safe havens such as the childrens' own homes, by individuals known and trusted by the children. An intrafamilial stress-dysfunction model, rather than a victim-assailant model, is more applicable to childhood sexual abuse.
Acute Septicemic Melioidosis Occurring in a Child with Acute Lymphoblastic Leukemia
Authors: Lin H.P. , Puthucheary S.D. , Sinniah D.
Published: July 2008

A 13-year-old boy with acute lymphoblastic leukemia on chemotherapy developed neutropenia and acute cellulitis progressing to fulminating septicemia due to Pseudomonas pseudomallei. Septicemic melioidosis should be considered in the differential diagnosis of a febrile illness in children who are susceptible to infections.
Febrile Seizures
Authors: Gururaj Vymutt J.
Published: July 2008

Approximately 2 to 5 per cent of all children experience seizures in associa tion with their febrile illness. In a vast majority of instances, these seizures are of benign nature without any long-term adverse implications. A small per centage of these children develop recurrent febrile seizures and a still smaller percentage develop epilepsy. Several studies have attempted to identify those children who are at risk to develop either recurrences or subsequent epilepsy, while others have examined different modalities of management of children with febrile seizures. This review presents an overview of the problem based on the findings of these studies.
Predicting Fever Response of Children with Pneumonia Treated with Antibiotics
Authors: McCarthy Paul L. , Tomasso Lucille , Dolan Thomas F.
Published: July 2008

In order to study predictors of fever response in children with radiologic pulmonary infiltrates treated with antibiotics, 156 children with pneumonia were evaluated with slide test C-reactive protein (CRP), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), blood cultures, acute and con valescent viral and mycoplasma titers, and then followed clinically. Both CRP (+) at a serum dilution of 1:50 and WBC ≥ 15,000 were better predictors of rapid resolution of fever while the patient was receiving antibiotics than were ESR ≥ 30 or temperature ≥ 40 C. WBC ≥ 15,000 was nearly as specific but more sensitive than CRP (+) 1:50 for resolution of fever in either 8, 12 or 24 hours. Positive blood or lung bacterial cultures, but not four-fold or greater viral or mycoplasma titer increases, were also associated with rapid resolution of fever. WBC ≥ 15,000 is useful in predicting rapid fever response in children with pneumonia treated with antibiotics.
Clinical Recognition of Juvenile Hypothyroidism in the Early Stage
Authors: Abbassi V. , Rigterink E. , Cancellieri R.P.
Published: July 2008

The clinical manifestations of biochemically-confirmed acquired hypo thyroidism in nineteen children and adolescents were reviewed to evaluate the symptoms and signs in the early stage of the disease. The group consisted of 14 girls and 5 boys ranging in age from 4 to 15 years. In 13 of the 19 patients with profound biochemical hypothyroidism, classical symptoms were often absent and clinical signs limited. In these patients, hypothyroidism was pre sumed to have been short in duration and consequence of chronic lympho cytic thyroiditis. In the remaining 6 patients, hypothyroidism was long-stand ing and clinical presentation classical, including disproportionate weight gain, fatigue, cold intolerance, myxedematous feature, growth retardation and constipation. Goiter was the most consistent finding in both groups and was present in all instances of spontaneously acquired primary hypothyroidism. These observations emphasize the importance of routine examination of the thyroid gland, particularly in preadolescent and adolescent girls. The finding of goiter may be the only detectable sign of hypothyroidism in the early stage of the disease. Biochemical evaluation should not be deferred because of a clinically euthyroid presentation. Replacement therapy must be instituted when findings indicate a hypothyroid state. Failure to recognize and treat hypo thyroidism in these pubertal patients may compromise the adult height, since skeletal maturation will proceed under the influence of sex hormones despite the presence of hypothyroidism.
Varicocele in Adolescence
Authors: Berger Omer G.
Published: July 2008

Easily detectable varicocele occurs in approximately 10 per cent of boys during puberty, usually on the left side. Discomfort is unusual, and this condi tion is often unrecognized by boys and their physicians. Even when aware of the scrotal mass, adolescent males may not seek consultation; therefore detection on routine examination provides the opportunity for reassurance and planning follow-up. Varicoceles may be associated with reduced testieutar volume and decreased semen quality. The favorable effects of spermatic vein ligation have been demonstrated in men with infertility. In the absence of prospective, con trolled studies concerning the optimal management of asymptomatic varicocele in adolescent, patients and parents may be made aware of possible subsequent infertility. At this time, adolescents with symptomatic or secondary varicocele should be considered for urologic management.
The Underweight Adolescent
Authors: Meyer Harold
Published: July 2008

A brief review of the causes of underweight in adolescence is presented to help the practitioner determine the cause of underweight in his patient. Poor nutrition is determined by several key observations: (1) history; (2) physical examination; (3) amthropometric measurements—height, weight, triceps skin fold thickness (TSF), mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC). Causes of the underweight state may be divided into three categories: disease states; environmental conditions; and factors peculiar to the adolescent.
Attitudes and Knowledge of Secondary School Girls Concerning Breast Feeding
Authors: Berger Anna , Winter S.T.
Published: July 2008

A 20-item questionnaire on breast feeding was completed by 242 high school girls ranging in age from 15 to 18 years old. Many girls had significant appre hensions concerning breast feeding, including deleterious influences on the mother and ignorance of the benefits for the infant. Most stated that they would be interested in learning about breast feeding during school health lessons. Offering information to teenagers and correcting their apprehensions might help create sounder knowledge upon which mature motivation can later be formulated.
Immigrants Into Society
Authors: Hanus Steven H. , Bernstein Norman R. , Kapp Kathleen A.
Published: July 2008

Some of the adaptive coping styles of children with craniofacial anomalies are discussed. Three cases of children with microtia are described to illustrate developmental pathways used in adapting to their deformities. The complexity of the chronic medical and psychological challenges these children face is illustrated and discussed. In contrast to previous frameworks dealing with the problems of deviance and stigmatization, we use a psychological historical framework, drawing an analogy to Handlin's work on immigration. These children are born into a world that considers them strange and abhorent. They can be considered aliens entering a society of normal, non-disfigured people. The craniofacial center is conceptualized as a "naturalization" office where highly valued health care professionals are counted upon to reconstruct facial appearance and function. An enduring attachment and bonding process to the staff takes place, and the center becomes of considerable importance to the craniofacial patient's identity. The craniofacial patient often has to carry the pain of social isolation and stigma. Physicians caring for these children should be cognizant of their coping styles; so that development can be directed to move away from deviance to successful "immigration into the country of normals" and adaptation to life.
Assessment of Evaluation of Hospitalized Pediatric Patients with Genetic Disorders
Authors: Lessick Mira L. , VanPutte Alison W. , Rowley Peter T.
Published: July 2008

A survey of the status of pediatric and neonatal care in a university general hospital was conducted for a 12-month period in order to define existing needs and plan for improved inpatient genetic management. The records of 218 patients with one of 22 specified disorders were reviewed to evaluate the na ture of documented genetic considerations and formulated dispositions during hospitalization. The 22 clinical entities were classified as chromosomal, single- gene, polygenic, or possibly genetic. In 15.1 per cent of cases the need for genetic counseling was recognized and recorded on the patient's chart. Sixteen of the 218 records (7.3%) met the minimum criteria for a "genetic disposition." Suggestions for improving the hospital clinical management of patients with genetic disorders are presented.
Respiratory Syncytial Virus Infection
Authors: Twiggs John T. , Larson Lawrence A. , O'Connell Edward J. , Ilstrup Duane M.
Published: July 2008

Studies within the last 20 years have shown that the incidence of asthma is increased in children who have been hospitalized with bronchiolitis due to respiratory syncytial virus. To evaluate such respiratory consequences in an ambulatory population, a follow-up study was done of 37 children who had respiratory syncytial virus infection documented at a community pediatric clinic in 1968 when they were younger than 4 years. This study, done ten years later by chart review and parental interview, showed that asthma had sub sequently been diagnosed in three (8%). Thus, an increased risk for the development of asthma after respiratory syncytial virus infection was not found. Comparison of these data with those from previous reviews questions a causative role for respiratory syncytial virus in childhood asthma.
Fever in Haemophilus ihfluenzae Type B Meningitis
Authors: Rutman Deanna L. , Wald Ellen R.
Published: July 2008

Ninety-nine cases of HaemoPhilus influenzae type B (HIB) meningitis were analyzed to assess the causes of secondary and persistent fever and outcome of treatment. Secondary fever developed in 47 patients, 11 had persistent fever and 4 patients died. Secondary fevers were associated with intercurrent illness in 30 per cent, drug fever in 15 per cent, and neurologic complications in 13 per cent. Serious neurologic or other complications were no more common in patients with than in those without secondary fever. However, patients with persistent fever demonstrated a higher rate of neurologic complications. Neither persistent nor secondary fever are markers of bacteriologic relapse or inadequate therapy.
Sudden Death Due to Colloid Cyst of the Third Ventricle
Authors: Saulsbury Frank T. , Sullivan John S. , Schmitt Edward J.
Published: July 2008

The sudden death of a 6-year-old child due to a colloid cyst of the third ventricle is described. Although rare, colloid cysts do present in childhood. The initial manifestation may be signs of acute increased intracranial pressure, and sudden death may result unless recognition and treatment are prompt.
The Association of Patient-Held Records and Completion of Immunizations
Authors: McCormick Marie C. , Shapiro Sam , Starfield Barbara H.
Published: July 2008

Patient-held records have been advocated as a means of increasing knowledge of and compliance with the processes of health care. The association between one type of patient-held record, the immunization record, and completion of the recommended immunizations for the first year is examined. Immunization completion rates varied by socioeconomic and medical care use variables; but, for all variables studied, completion rates were higher for those infants for whom immunization records were available than those without such records. An experimental assessment of the usefulness of patient-held immunization records as a means of improving compliance and meeting national goals for levels of immunization is suggested.
Observations on the Natural History of Dactylitis in Homozygous Sickle Cell Disease
Authors: Stevens M.C.G. , Padwick M. , Serjeant G.R.
Published: July 2008

The incidence of the hand-foot syndrome (dactylitis) has been studied in a group of. 233 children with homozygous sickle cell (SS) disease followed prospectively from birth. Dactylitis affected 45% of the children by the age of 2 years, with most cases occurring before this age. Episodes were significantly more common during colder months of the year, similar to the seasonal rela tionship previously noted in painful crises. Comparison of hematologic indices at age 6 months in patients with and without development of dactylitis indicated a lower fetal hemoglobin and higher reticulocyte counts in affected patients. The occurrence of dactylitis in combination with low fetal hemoglobin may serve to identify high-risk patients with SS disease.
Septicemia in Childhood Malignancy
Authors: Miser James S. , Miser Angela W. , Bleyer W. Archie , Chard Ronald L.
Published: July 2008

One hundred one consecutive episodes of blood-culture-positive infec tion were evaluated in 83 children with malignancy between 1972 and 1977. Eighty-two per cent occurred in relapse, and 75% developed when the ab solute neutrophil count was less than 500 per μl. Forty per cent were fatal. Forty-five per cent of the episodes occurring in relapse and 17% occurring in remission were fatal. Of 88 cases of single-organism infection, 46% were due to gram-positive organisms with a 13% mortality (of these, 28% were due to Staphylococcus aureus with a 4% mortality); 52% were due to gram-negative organisms with a 52% mortality; and two episodes were due to fungal organ isms with no fatalities. Multiple-organism infection occurred 13 times, of which 11 episodes were fatal. The authors' data confirm observations by others that the organisms most commonly causing blood-culture-positive infection in children with malignancy are S. aureus and Escherichia coli and that infection due to gram-positive organisms, particularly S. aureus, is less frequently fatal.
Teenage Pregnancy in Perspective
Authors: Blum Robert Wm. , Goldhagen Jeffrey
Published: July 2008

In an effort to provide the clinician with suggestions for preventive and remedial approaches to adolescent pregnancy, the nature, medical, social, eco nomic, and psychological aspects of the problem are reviewed and discussed. While the rate of adolescent pregnancy is declining, there are more than 560,000 deliveries to teenagers annually. Medical risks are significantly diminished by early and comprehensive prenatal care. The major complica tions continue to be social and economic. Lower I.Q.s in offspring of adoles cent mothers have been reported. Failure to complete high school significantly increases the risk of unemployment, trapping the premature parent and her offspring in a web of poverty. A lack of a sense of future and viable alterna tives may legitimize the option of motherhood in the minds of many adolescent girls. Furthermore, an ignorance and a denial of sexuality combined with the developmental imperatives of experimentation and rebellion place the adolescent at high risk for pregnancy.
The Robert Wood Johnson Foundation National School Health Program
Authors: DeAngelis Catherine
Published: July 2008

The Robert Wood Johnson Foundation National School Health Program is described from the perspectives of history, purpose and objectives, adminis tration, and basic design of the sites located in Colorado, New York, North Dakota, and Utah. The evaluation component and certain current process out comes are discussed briefly.
Management of Febrile Outpatient Neonates
Authors: Greene John W. , Hara Cheryl , O'Connor Susan , Aftemeier William A.
Published: July 2008

To determine whether all febrile outpatients below the age of two months should be routinely hospitalized and given parenteral antibiotics because of the possibility of occult sepsis or meningitis, 147 such admissions were re viewed over four years. None of the neonates had occult bacterial meningitis, while one may have had occult sepsis. Because serious infections may have been missed in outpatients not hospitalized, the outcome of all such illnesses seen in the clinic during a subsequent six months was monitored; none of 17 hospitalized or 20 followed as outpatients experienced sepsis or meningitis. If our findings are confirmed in other studies, febrile outpatient neonates with a well appearance, normal cerebrospinal fluid and physical examination, and dependable follow-up may not require universal hospitalization and antibiotics.
Study of the Usefulness of Clinical and Hematologic Findings in the Diagnosis of Neonatal Bacterial Infections
Authors: Spector Stephen A. , Ticknor Warren , Grossman Moses
Published: July 2008

The purpose of this study was to evaluate the usefulness of clinical and hematologic findings in distinguishing infected from uninfected newborn infants. Of 356 evaluations for infections, 22 (6%) infants were found to have bacterial isolates. Eight of the 52 clinical and historical findings evaluated were found to be statistically associated with infection. Clinical findings of tachypnea/arrhythmia, decreased peripheral perfusion, pallor, hypo- or hyper tension, abdominal distention, irritability, lethargy, and apnea were signifi cantly associated with positive bacterial cultures. Laboratory data found to be significantly associated with infected infants included white blood cell count < 10,000 or ≥20,000/mm 3, absolute neutrophil count < 1,000/mm3, absolute band count > 200/mm3, and neutrophil band forms/mature neutrophils ≥ 0.10. A 5-point scoring system was derived from the data obtained from this study consisting of: ≥ 2 systems involved on clinical assessment; white blood cells < 10,000 or ≥20,000/mm 3; absolute neutrophils < 1,000/mm3; bands/mature neutrophils ≥ 0.10; and age > 1 week. The restrospective use of this scoring system revealed that all infants with life-threatening bacterial infections had three or more of these findings present. All infants suspected of bacterial disease, therefore, who score ≥ 3 points using this system should have antibiotic therapy started and continued until all cultures are negative. In the face of other strong clinical or laboratory evidence of infection, antibiotics should be begun following appropriate cultures, in spite of a low score. So used, the scoring sys tem described can be helpful to clinicians in making decisions concerning newborn infants suspected of bacterial infections.
Ocular Manifestations of the Fetal Hydantoin Syndrome
Authors: Hampton G. Robert , Krepostman Jaime I.
Published: July 2008

Eleven per cent of infants exposed to hydantoins in utero have a recogniz able pattern of abnormalities with serious clinical consequences. This report of a child born to a mother taking diphenylhydantoin emphasizes the ocular find ings.

At birth and subsequent 8-month exam, a girl was noted to have microph thalmus, prominent iris vessels, and an inferior iris and choroidal colobma. Relation of these anomalies to teratogenic properties of diphenylhydantoin is discussed.
Arizona hinshawii Meningitis in a Neonate
Authors: Jarvis William R. , Luce W. David , Baltimore Robert
Published: July 2008

A 3-day-old infant presented with Arizona hinshawii sepsis and meningitis. Despite parenteral chloramphenicol, A. hinshawii persisted in the cerebro spinal fluid and blood until trimethoprim-sulfamethoxazole was added. Three weeks following discharge the infant returned and A. hinshawii was re- cultured from the blood and cerebrospinal fluid. Chloramphenicol and tri methoprim-sulfamethoxazole was re-instituted and the infant recovered. This report demonstrates the potentially serious consequences of A. hinshawii infections in the neonate and emphasizes the need for proper identifica tion of this organism with appropriate biochemical tests and individualization of antimicrobial therapy.
Neonatal Hypernatremic Dehydration Due to Excessively Concentrated Prepared Milk Formula
Authors: Birenbaum Emanuel , Shahar Eli , Aladjem Mordechay , Brish Michael
Published: July 2008

Excessively concentrated milk formula was administered accidentally to five newborn infants. Diarrhea, dehydration, hypernatremia, and hyperosmolality were present in all of them. Abnormal neurologic manifestations during the acute disease were observed in one infant. On follow-up, psychomotor devel opment and electroencephalographic recordings were normal in four infants. One infant, in whom accelerated growth of head circumference had been noted before the episode of diarrhea, was found to have obstruction of the foramen of Monro at the age of 6 weeks. Possible errors in preparing milk formulas by medical staff resulting in hypertonic dehydration are stressed in this report.
Pyogenic Osteomyelitis Versus Pseudo-Osteomyelitis in Gaucher's Disease
Authors: Schubiner H. , Letourneau M. , Murray D.L.
Published: July 2008

Presented is a young girl with Gaucher's disease who developed acute bone pain accompanied by signs of inflammation and who was felt to have possible pyogenic osteomyelitis. The lack of significant pathogenic bacterial growth on culture and the findings at orthopedic surgery led the authors to conclude that this child probably represented a case of pseudo-osteomyelitis, but the isolation of an anaerobe from the operative culture of the involved bone leaves the exact diagnosis unclear. Since this child underwent an open surgical procedure, she was treated with antibiotics to prevent the possible develop ment of chronic osteomyelitis. The anaerobic growth on culture, although strongly felt to be a contaminant, also played a role in this decision. She had an uneventful hospital course and subsequently has done well. It is suggested that great caution be taken before subjecting a patient with Gaucher's disease to orthopedic surgical procedures. If pyogenic osteomyelitis is strongly suspected, obtaining multiple blood cultures and culture by needle aspirate may be preferred over an open surgical procedure. The use of empiric anti biotic therapy without an attempt at further diagnosis is not recommended. If an orthopedic surgical procedure is necessary in a patient with Gaucher's disease, antibiotic coverage is indicated and long-term observation of the opera tive sight for drainage and/or other signs of chronic inflammatory changes is mandatory.
Subcutaneous Fat Necrosis of the Newborn
Authors: Mogilner B.M. , Alkalay A. , Nissim F. , Frumkin A.
Published: July 2008

A case of subcutaneous fat necrosis of the newborn is described. Severe perinatal asphyxia preceded the appearance of the skin lesions. Premature rupture of membranes and the presence of foul-smelling meconium raised the possibility of infection by' anaerobes as an additional etiologic factor. The main hypotheses concerning the cause and pathogenesis of this condition are reviewed. The alarming clinical picture that stands in sharp contrast to the benign prognosis is stressed.
Families without Borders: Mobile Phones, Connectedness and Work-Home Divisions
Authors: Wajcman Judy , Bittman Michael , Brown Judith E.
Published: July 2008

This article examines the widespread proposition that the mobile phone dissolves the boundaries that separate work and home, extending the reach of work. It analyses data derived from a purpose-designed survey to study social practices surrounding mobile phone use.The key components of the survey investigated here are a questionnaire and a log of phone calls retrieved from respondents' handsets. Rather than being primarily a tool of work extension, or even a tool that facilitates greater work-family balance, we show that the main purpose of mobile phone calls is to maintain continuing connections with family and friends. Our findings suggest that individuals exert control over the extent to which calls invade their personal time, actively encouraging deeper contacts with intimates.
Naming Names: Kinship, Individuality and Personal Names
Authors: Finch Janet
Published: July 2008

The article presents an exploratory analysis of the significance of personal names in contemporary Western societies, the UK in particular. Names are seen as having the dual character of denoting the individuality of the person, and also marking social connections.The focus is particularly on kinship, and the ways in which names can be, and are, used to map family connections as well as to identify unique individuals.The author argues that both surnames and forenames can serve to ground the individual within family relationships, though the extent to which this is used actively can vary. In turn the way in which names and naming are used within the family context sheds light upon contemporary kinship, with its enduring and variable dimensions. Additional empirical exploration of names and naming could further illuminate its characteristics.
New Labour and the theory of globalization
Authors: Rustin Michael
Published: July 2008

This article argues that the theoretical basis of the New Labour project was sociological in its framing, drawing in particular on the ideas of Anthony Giddens. The theory of globalization, individualization and risk advanced by him and others became the rationale for New Labour's rejection of `traditional' socialist and welfare ideologies, holding the collectivist, materialist and class-based politics that these had upheld to be now obsolete. However, it is argued that Marxist analytic perspectives retain their relevance in understanding the dynamics of what is more clearly understood as global capitalism than in the more diffuse language of globalization. The concept of systemic contradiction developed by sociologists such as David Lockwood in the 1980s retains its relevance as an analytical resource in contemporary capitalist society.
Family, community and politics: The fertile legacy of Michael Young
Authors: Dench Geoff
Published: July 2008

The Institute of Community Studies was set up by Michael Young in order to carry out research on politically relevant social issues, in a context free from direct political control. A research method was devised for it whereby researchers made their own values and objectives very explicit, while staying as close as possible in their reports to the concerns and language of respondents themselves. This method has often been criticized by professional sociologists: but it reflects quite well the nature of social knowledge. It has produced reports which help to increase public understanding of social processes, and provide useful guidance to policy makers. Professional sociology on the other hand has tried to develop a rigorously value-free method. As a result, though, it often seems to be tied implicitly to values shared among researchers but not more universally. Arguably this makes it harder for the general public to understand, and accept, its findings.
Informing hospital patients and their relatives about stroke
Authors: Lomer M. , McLellan DL
Published: July 2008

Seventy-three episodes of stroke leading to hospital admission were followed up over the first two weeks. Patients and their relatives were assessed shortly after admission to hospital for their knowledge about the predisposing causes of stroke, the nature of the patients' illness and the treatment that was being given, their prognoses and the nature of financial and other help that would be available to them when they returned home. After one week, half the patients and relatives received an informative leaflet about stroke. When their knowledge of these factors was later assessed, only 7% of the patients who had not received the leaflet and 30% of their relatives could recall having received any information about stroke since admission. The corresponding figures for those who had received the leaflet were 65% and 62% respectively. Those who had received a leaflet knew significantly more about the aetiology of stroke and the treatment they were receiving than those who had not, but the leaflet made no difference to the level of knowledge about the patient's specific prognosis, nor about the range of benefits that would be available at the time the patient returned home. It is suggested that ward staff underestimate the amount of information that can usefully be absorbed by patients and their relatives and in this way are failing to establish the optimal conditions for their rehabilitation.
Recognition of the diverse and complex nature of neuromuscular swallowing disorders: a basis for treatment
Authors: McIntosh Jacqueline , Martin Geraldine , Sacchett Carol
Published: July 2008

Ten dysphagic patients referred to speech therapy were assessed using clinical bedside examination and radiographic investigation. The results of these comprehensive assessments confirm the diverse and complex nature of dysphagia, providing a basis for more effective management.
The contribution of the Stanford Health Assessment Questionnaire in rheumatology clinics
Authors: Young JB , Chamberlain MA
Published: July 2008

The contribution of the Stanford Health Assessment Questionnaire (HAQ) to patient management was investigated in patients attending two rheumatology clinics. Additional interventions occurred in 55 (36%) of 147 patients completing the HAQ after the questionnaires had been inspected. It was particularly useful for the review patients compared to the new attenders. The HAQ is a more rational approach to outpatient functional appraisal and improves patient management.
Characteristics of patients with angina pectoris who are unsuitable for rehabilitation
Authors: Okumura Etsushi , Yoneyama Kenichiro , Kakimoto Shotaro , Kitaoka Syunji , Naito Kazuma
Published: July 2008

Exercise testing is important in assessing patients suitable for a rehabilitation programme. The factors associated with inability to complete the exercise test were: being elderly; high level of triglyceride and hyperlipidemia; hypertension; diabetes mellitus; and severe or multiple areas of stenosis demonstrated by coronary artery angiograms. These findings have important implications for rehabilitation programmes.
Resistance to ankle dorsiflexion in hemiparetic stroke patients
Authors: Bohannon Richard W , Larkin Patricia A
Published: July 2008

The purpose of this study was to measure, compare, and correlate on both the paretic and nonparetic sides of 20 hemiparetic stroke patients, the resistance of the ankle to dorsiflexion with the knee extended and the knee flexed. While resistance to ankle dorsiflexion was measured, the electromyographic (EMG) activity of the ankle plantar flexor muscles was monitored. EMG activitywas virtually nonexistent, except in two of the patients tested. An analysis of variance demonstrated that the resistance to dorsiflexion was significantly greater on the paretic side and with the knee extended. Resistance with the knee extended on the paretic side was significantly correlated with time since onset. The resistances of the ankle of each side with the knee in each position were significantly correlated. The results suggest that the triceps surae muscle group of the paretic side is hypoextensible compared to that of the nonparetic side. The hypoextensibility may contribute to the difficulty that stroke patients have in dorsiflexing their ankles.
The value of reality orientation in 1987
Authors: Holden Una
Published: July 2008

When considering the value of Reality Orientation (RO) it is extremely difficult to avoid reference to the many and various meanings, misinterpre tations and misunderstandings which have formed the basis of some criticisms. However, these should be covered in the other part of this critique. Here, RO will be taken to imply an approach (or philosophy) which is continuous and focuses on regaining and maintaining, as far as possible, normal living patterns relevant to each particular individual with impairments of social or intel lectual functions. This includes group sessions, or intensive individual sessions, where the focus could be on relearning verbal or spatial in formation, daily living activities, social behaviour or solving problem behaviours.

Research and evaluation have required a break down of RO into specific aspects in order to assess their relative values. In practice, RO is multi faceted, and carers will use whatever facet or facets that are relevant to the needs of the in dividual.
Adaptive seating and pulmonary function in adults with muscular disease
Authors: Nwaobi Olunwa M
Published: July 2008

Pulmonary infections, possibly due to poor pulmonary functions, are common in individuals with muscular dystrophy. In order to evaluate the relative effects of seating devices on pulmonary function the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory time (FET) in eight adults aged between 12 and 21 years with Duchenne Muscular Dystrophy was measured while seated in an adaptive and a nonadaptive seating device. The results showed a 28.0% increase in FVC, a 14.5% increase in FEV1, and a 17.3% increase in FET in the adaptive seating system compared to the nonadaptive system. This result emphasizes the need for proper seating as an important way of maximising pulmonary function and minimizing pulmonary complications in this population.
The effects of reduced expression in Parkinson's disease on impression formation by health professionals
Authors: Pentland Brian , Pitcairn Thomas K , Gray John M , Riddle William
Published: July 2008

The first impressions formed by 91 therapists shown silent videorecordings of four patients with idiopathic Parkinson's disease and four with ischaemic heart disease were assessed using visual analogue scales directed at aspects of mood, personality and intellect. Although both patient groups showed no abnormalities in terms of affect, personality and intelligence by standardised psychological tests, the Parkinsonian patients appeared more anxious, hostile, suspicious, unhappy, bored and tense than the cardiac cases; they came across as less intelligent, more introverted and passive, less stable and tough minded; they seemed to enjoy and maintain their part in the conversation less well and relate less to the interviewer and overall they were rated as less likeable. These findings are related to the known effects of speech impairment on impression formation in Parkinson's disease and are discussed in terms of the possible effects on therapeutic relationships and their bearing on diagnosis of psychiatric disturbance in the condition.
Clinical trial of incontinence garments: recognition of the possible influence of the Hawthorne effect
Authors: Hanley Janet , Beveridge Mairi , Aitken Cairns , Hunter John , Dick Tom , Prescott Robin
Published: July 2008

The results of clinical trials must be interpreted with care, recognizing that they may be affected by factors other than the items being tested. Different garments were routinely supplied from two distribution centres in Edinburgh, Urocare to the majority of patients in North Lothian and Hygi to those in South Lothian. One hundred patients were recruited and a crossover comparative trial carried out. The response in the two areas was different. Whereas patients in South Lothian found no significant difference between the two garments, those in North Lothian rated the Hygi garment better in terms of comfort (p=0.01), leakage (p<0.001), odour (p=0.01) and avoidance of skin problems (p=0.01). It is suggested that the difference in response may be explained by the Hawthorne effect and this should be taken into account when planning future equipment trials.
Use of computer-presented games with memory-impaired stroke patients
Authors: Towle D. , Edmans JA , Lincoln NB
Published: July 2008

The present study reports on the use of computer-presented games, designed to retrain memory abilities, with memory-impaired stroke patients. Eleven patients underwent a six-week treatment course consisting of practice on computerized games for 40 minutes a day, up to a maximum of four times a week. The patients were assessed on objective memory tasks before and after treatment. Seven patients showed improvements of one standard deviation or more on at least one of the outcome measures, but as a group significant improvement was found only on the immediate recall form of the Prose Recall task. It appears that specific memory skills are learned as a result of treatment, but these skills generalize poorly to untrained memory tasks. The patients' patterns of cognitive deficits affect performance and this type of retraining may not be suitable for all stroke survivors. The study emphasizes the need for evaluation of computer-based cognitive rehabilitation.
Facilities for rehabilitation of adults after head injury
Authors: Cockburn JM , Gatherer A.
Published: July 2008

Little information has been published about facilities that exist for rehabilitation after head injury. In 1985 a questionnaire was sent to 27 centres throughout the UK known to make some provision for rehabilitation of adults after head injury. Information was sought on five broad areas of provision: location and size of centre; patient population; facilities and services provided; communications; teaching and research interests.

Replies were received from 23 centres, all but three of which were funded by the National Health Service. In total 112 beds (14%) were occupied by head-injured patients. One centre took only head injuries and a furtherthree concentrated on neurological rehabilitation. Six excluded referrals with behavioural problems. All the NHS funded centres gave preference to referrals from their own district or region. Length of stay for head-injured patients ranged from one day to three years. Active therapy was provided by all centres and occupied between three and six hours per day.

Although this survey was not exhaustive, it indicates wide regional differences in the availability of rehabilitation and provides a framework for further investigations, especially in regions where no facilities were identified.
Evaluation of the effects of functional electrical stimulation on muscle power and spasticity in spinal cord injury patients
Authors: Barr Fmd , Moffat B. , Bayley Jil , Middleton Fri
Published: July 2008

Nineteen paraplegic patients were entered into a trial to evaluate the use of functional electrical stimulation (FES) as a practical and reliable method of aiding standing. The clinical study used commercially available muscle stimulators, in contrast to the many previously reported case studies where prototype equipment has been used. This paper examines the effect of FES on muscle strength and spasticity in the paretic quadriceps muscle of paraplegic patients and demonstrates that only five of the subjects in the study exhibited an increase in muscle power of the stimulated quadriceps muscle, and that change in the level of spasticity, with varying patterns, occurred in all but two patients.
Forward upward leading step test for the clinical evaluation of locomotor ability
Authors: Olaogun Mob , Abereoje OK , Obajuluwa VA
Published: July 2008

The stepping movement is a form of locomotion used in standard fitness testing and in the prediction of physical work capacity. The present study examined the forward upward leading step test (FULST) as a clinical instrument in categorizing locomotor disability. Three individuals with unilateral affectation of the lower limb were tested using the FULST. Their cases were presented to demonstrate the value of the test in locomotor assessment. Though conclusive inferences cannot be made from the cases, they do demonstrate that: (1) stepping can be used in assessing the locomotor capability of the lower limb; (2) the procedure can be used in detecting abnormality in stepping arising as a direct result of problems in joints and/or muscles of the lower limbs; (3) the FULST can be used to assess functionality of orthotic devices such as ankle foot orthosis; (4) status following treatment can be monitored in a simple way by subjecting patients to periodic step tests.
Evaluation of social work on depression after stroke
Authors: Towle Deborah , Lincoln Nadina B , Mayfield Louise M
Published: July 2008

This study investigates the contribution of social work in the alleviation of depression after stroke. Forty-four depressed stroke patients, all more than one year since stroke, were identified and randomly allocated to either a social work intervention group or a nontreatment group. After 16 weeks of intervention, no significant differences were found between the groups on the Wakefield Depression Inventory, General Health Questionnaire, Nottingham Health Profile, Life Satisfaction Index or Frenchay Activities Index. Therefore, social work involvement had no detectable effect on level of depression at this stage after stroke.
On rehabilitation of stoma patients
Authors: Riedler L.
Published: July 2008

Between 1981 and 1985, 130 patients received a permanent colostomy and an ileostomy at the First Surgery Department of Innsbruck University. Of these, 108 patients were entered into a rehabilitation programme. A special stoma outpatient department was established for these patients. At least one of the members of the department was constantly available to the patients by telephone. The results of rehabilitation are encouraging with 90% of the patients being fully reintegrated into professional and social life whilst only 10% could not be helped. The latter were patients who had either arteriosclerosis or personality problems.
A shortened version of the Rivermead Perceptual Assessment Battery?
Authors: Lincoln NB , Edmans JA
Published: July 2008

The aim was to investigate whether the Rivermead Perceptual Assessment Battery could be shortened. The relationships between subtest scores were examined and three short versions were developed by different methods. Comparison of these indicated no clear overall advantage of any one method. It is suggested that any of the three shortened versions are acceptable for clinical use.
Engagement levels on a unit for people with a physical disability
Authors: Newton Tim , Butler Nina Mary , Dawson John
Published: July 2008

The activities of twenty people with a physical handicap were observed over a period of 13 days. On average 35% of the patients were observed to be engaged in no obvious activity. After 'inactivity' the two most frequently endorsed categories of activity were 'conversation' and 'watching TV or listening to the radio'. The implications of these findings for the social rehabilitation of disabled people are discussed.
Medical complications in acute rehabilitation units: deep vein thrombosis
Authors: Miller Catherine N , Semble Elliott L , Dalgleish Debra C
Published: July 2008

The acute rehabilitation unit is the transitional setting of patients progressing from acute medical management to the initiation of rehabilitative therapies. There is a large population represented within the acute rehabilitation unit at increased risk of deep vein thrombosis including patients with head injury, stroke and spinal cord injury. The diagnostic accuracy of the clinical assessment of deep vein thrombosis is limited. Noninvasive techniques such as impedance plethysmography increase the sensitivity of the diagnosis substantially while venography remains the gold standard for diagnosis. Due to the potential morbidity and mortality associated with deep venous thrombosis, prophylaxis should be considered for populations at risk in the acute rehabilitation unit and treatment instituted when the diagnosis is strongly suspected or confirmed.