bluuebunny/crossref_metadata_2025 huggingface dataset:
The Legacy of Pediatric Oncology Nursing in Advancing Survivorship Research and Clinical Care
Authors: Ruccione Kathleen
Published: October 2009

Today, the growing population of cancer survivors, both pediatric and adult, along with the accumulated weight of data characterizing late and lingering effects of cancer and its treatment are attracting attention in the form of reports, conferences, publications and media coverage.The emphasis on survivorship research and outcomes-based clinical care began with pediatric oncology, and pediatric oncology nurses have been at the forefront of survivorship clinical care, research, and education for more than 30 years.This article highlights these contributions to the body of survivorship knowledge and quality of care, as well as areas of ongoing challenge and future directions suggested by thought leaders in our specialty. Key contributions are examined decade by decade and against the six recommendations for health care policy and practice delineated in the two recent IOM survivorship reports: evidence-based guidelines for follow-up care, standards and models of care, increasing awareness of late effects and needed follow-up care, improving professional education and training, improving access to care for survivors, and increasing research to prevent or manage late effects.
Endocrine Late Effects in Survivors of Pediatric Brain Tumors
Authors: Shaw Susan
Published: October 2009

Central nervous system tumors are the most common solid tumor diagnosed in children under the age of 14 years. Chronic health conditions related to endocrine and metabolic late effects are one of the most common medical late effects seen in childhood cancer survivors. Over the past 2 decades, outcomes have improved significantly for children diagnosed with a brain tumor. Curative therapy for childhood brain tumors survivors places them at significant risk for complex multi-organ medical late effects.These late effects can create a negative effect on cognition, growth, organ function, body image, sexual function and quality of life. Treatment related complications can occur many years after completion of therapy. Close monitoring is necessary so that early detection and intervention can hopefully decrease the full negative impact of many of these effects. Lifelong medical surveillance with a multidisciplinary team approach is essential to maximize health and improve the quality of life of survivors of pediatric brain tumors.
Brain Tumor Survivors Speak Out
Authors: Carlson-Green Bonnie
Published: October 2009

Although progress has been made in the treatment of childhood brain tumors,work remains to understand the complexities of disease, treatment, and contextual factors that underlie individual differences in outcome. A combination of both an idiographic approach (incorporating observations made by adult survivors of childhood brain tumors) and a nomothetic approach (reviewing the literature for brain tumor survivors as well as childhood cancer survivors) is presented. Six areas of concern are reviewed from both an idiographic and nomothetic perspective, including social/emotional adjustment, insurance, neurocognitive late effects, sexuality and relationships, employment, and where survivors accessed information about their disease and treatment and possible late effects. Guidelines to assist health care professionals working with childhood brain tumor survivors are offered with the goal of improving psychosocial and neurocognitive outcomes in this population.
Transitioning Survivors of Central Nervous System Tumors: Challenges for Patients, Families, and Health Care Providers
Authors: Eshelman-Kent Debra , Gilger Elizabeth , Gallagher Maureen
Published: October 2009

Survivors of central nervous system tumors (SCNST) are a growing group of cancer survivors who require risk-based, long-term health care due to the chemotherapy, surgery, and radiation they have received.Although treatment strategies are being developed to reduce morbidity and mortality, ultimately this subgroup of pediatric cancer survivors often faces moderate to severe late effects of their treatment.As a result, they will need lifelong health care that includes risk-based health care due to cancer treatment exposures as well as primary adult health care, including primary and secondary preventative care. The best way to accomplish lifelong health care for SCNST as they enter adulthood is not clearly defined. In this article, the authors plan to (1) present an overview of the complexities of health care problems that make transition challenging for SCNST; (2) review the evolving transition literature; (3) explore the barriers to successful transition; (4) discuss methods to facilitate transition; (5) describe approaches, strategies, and models for survivorship care in SCNST; (6) present issues for consideration when transitioning SCNST; and (7) provide information on transition-related resources.
Adequacy of Nutritional Support in Pediatric Blood and Marrow Transplantation
Authors: Cohen Jennifer , Maurice Lucy
Published: October 2009

The use of nutrition support has become standard practice in blood and marrow transplantation, but what remains unclear is whether patients receive adequate nutrition supplementation during this time. This study is a retrospective audit of the nutritional supplementation of 34 pediatric patients admitted to a pediatric oncology unit for a blood and marrow transplantation. All patients received parenteral nutrition (PN) as their standard nutritional therapy with an average of 79 ± 10.6% of their estimated requirements given over the transplant period. The glucose/amino acid infusion was inadequate on 40% of PN days mainly because of fluid overload causing a reduction in infusion rates. The lipid infusion was inadequate on 60% of PN days mainly because of stoppages when drugs and/or blood were infused. The mean percentage weight change on discharge was +0.3 ± 4.7%. This had a large range of between −9.9% and +7.9% of body weight and did not seem to be related to adequacy of nutrition during transplant. This study showed that although frequent rate reductions in nutrition infusions did occur, most patients still received the majority of their nutritional requirements.
Club Goods and Post-Disaster Community Return
Authors: Chamlee-Wright Emily , Storr Virgil Henry
Published: October 2009

Hurricane Katrina caused over one hundred billion dollars in property damage in the Greater New Orleans region. Although much attention has been paid to why particular communities have begun to recover and others have failed to rebound, very little attention has been paid to how the communities that have recovered actually went about doing so. This paper attempts to close that gap by examining how the church provision of club goods can foster social cooperation and community redevelopment in the wake of a disaster. In particular, we investigate the swift return of the community surrounding the Mary Queen of Vietnam (MQVN) Catholic Church in New Orleans East after Hurricane Katrina. Utilizing a unique bundle of club goods provided by the MQVN Catholic Church, residents in the New Orleans East Vietnamese-American community (a) rebuilt their distinct ethnic— religious—language community, (b) overcame the social coordination difficulties created by Katrina, and (c) engaged in successful political action to protect their community.
Stratification Theory, Socioeconomic Background, and Educational Attainment
Authors: Lucas Samuel R.
Published: October 2009

Three proposals explicate the social origins/education transitions association. Maximally maintained inequality (MMI) (Raftery and Hout 1993) claims the association declines only at transitions high origin persons universally or nearly universally make. Relative risk aversion (RRA) (Breen and Goldthorpe 1997) suggests broader inequality reduction is possible and depends on changing costs and norms. Effectively maintained inequality (EMI) (Lucas 2001) contends meaningful inequality reduction is elusive because qualitatively different types of education maintain consequential inequality, even at universal transitions. Each proposal has evidentiary support, yet because proposals highlight different association indices, most are described informally, and their distinctiveness is disputed, comparative evaluation requires a prior, clarifying, formal analysis. Formal analysis reveals that MMI is non-falsifiable. RRA and EMI are falsifiable and are potentially but not necessarily complementary. Future research should investigate whether and why RRA, EMI, both, or neither, apply.
Relationship Between Platelet Indices and Aortic Valve Sclerosis
Authors: Sucu Murat , Davutoglu Vedat , Sari Ibrahim , Ozer Orhan , Aksoy Mehmet
Published: October 2009

Objective: Aortic valve sclerosis (AVS) is a progressive disease that is characterized by aortic valve thickening without causing significant narrowing and in which pathology resembles atherosclerotic coronary heart disease. We aimed to evaluate the relationship between AVS and platelet indices including mean platelet volume (MPV), platelet distribution weight (PDW), and platelet count. Method: Two hundred ten patients who were evaluated in the echocardiography unit due to various reasons between January and October 2008 were consecutively included in the study. The patients were divided into 2 groups according to presence or absence of AVS. The patient group consisted of 150 patients (76 females and 74 males; mean age, 64.5 ± 11.5 years). Patients without AVS (24 females and 36 males; mean age, 49.8 ± 15.7 years) were assigned as control group. The MPV, PDW, and platelet count were measured. Results: The MPV (9.56 ± 1.3 fL vs 9.15 ± 1.0 fL, P = .022) and PDW (16.9 ± 2.3% vs 14.9 ± 2.3, P = .001) were significantly higher in patients with AVS (+) compared to the AVS (—) group. No significant difference was demonstrated between the groups in terms of white blood cell and platelet counts (P > .05). When the AVS (+) group was compared to the AVS (—) group, a significant difference was found in respect of hypertension, diabetes mellitus, and smoking status. Conclusion: Platelet production indices including MPV and PDW were increased in patients with AVS. The complex interrelationship between increased platelet production indices and AVS and value of antithrombotic therapies in patients with AVS need to be evaluated in further studies.
Recurrent Pulmonary Embolism Associated With a Hemostatic Drug: Tranexamic Acid
Authors: Krivokuca I. , Lammers J.-W.J.
Published: October 2009

Tranexamic acid (TA) used in a variety of conditions associated with bleeding has been associated with potential thrombotic side effects such as formation of thrombi and pulmonary embolism (PE). We describe a case of a woman with chronic hemoptysis and a history of PE, who recently used TA as a prophylactic measure, which could have resulted in a new episode of PE. Tranexamic acid probably played a contributory role in the development of her second PE.
Photo-Optical Methods Can Lead to Clinically Relevant Overestimation of Fibrinogen Concentration in Plasma Diluted With Hydroxyethyl Starch
Authors: Adam Susanne , Karger Ralf , Kretschmer Volker
Published: October 2009

Background: Adequate fibrinogen concentration is a crucial component of sufficient perioperative/posttraumatic hemostasis. In major blood loss, large volumes of fluids are being administered, which have been shown to interfere with valid determination of fibrinogen concentration. This may lead to wrong treatment decisions. We studied the variables that cause the discrepancies between measured and true fibrinogen concentrations in samples diluted with volume replacement fluids. Methods: Citrated plasma samples of healthy volunteers were diluted by 30% and 50% with phosphate buffered saline (PBS), hydroxyethyl starch (HES) 10% (200/0.5), or gelatine (GEL). Fibrinogen concentrations of diluted samples were derived from the prothrombin time (PT) and the Clauss method (CLS) was applied. With the latter, several modifications and combinations of detection principles and thrombin reagents were investigated. Values were compared with ‘‘true,’’ that is, calculated values based on the results of undiluted samples for each method. Results: Photo-optical methods resulted in significant overestimation of the fibrinogen concentration in blood diluted with HES, depending on the thrombin reagent used. This was particularly true for modifications of the CLS aimed at measuring low fibrinogen concentrations. Use of another thrombin reagent gave satisfactory results for this modification. The validity of mechanical end point determination methods was considered sufficient and was not influenced by the use of different thrombin reagents. Conclusions: Fibrinogen determination methods used in situations of major blood loss need to be validated with samples containing significant amounts of volume replacement fluids, particularly colloids. Only some combinations of test principle, detection method, and reagents will give valid results.
Early Discharge of Patients With Venous Thromboembolism: Implications Regarding Therapy
Authors: Stein Paul D. , Hull Russell D. , Matta Fadi , Yaekoub Abdo Y.
Published: October 2009

The purpose of this investigation is to show trends in the duration of hospitalization of patients with pulmonary embolism (PE) and deep venous thrombosis (DVT). The number of patients discharged from short-stay non-Federal hospitals throughout the United States with a primary diagnostic code for PE or DVT from 1979 through 2005 was obtained from the National Hospital Discharge Survey. By 2005, 13% of patients with PE were discharged in 1 to 2 days, 30% in 3 to 4 days, 26% in 5 to 6 days, and 31% in ≥7 days. Regarding DVT, by 2005, 26% of patients with DVT were discharged in 1 to 2 days, 34% were discharged in 3 to 4 days, 20% were discharged in 5 to 6 days, and 19% were discharged in ≥7 days. The data indicate that large proportions of patients with a primary diagnosis of PE and of DVT are being discharged before adequate heparin can be administered and before warfarin can become antithrombotic. Others have reported an increased mortality among patients with PE discharged in ≤4 days. If patients are to be discharged before adequate heparin can be administered, outpatient treatment with low-molecular-weight heparin (LMWH) for at least 5 days and until the international normalized ratio (INR) is ≥2.0 for 24 hours is recommended or extended outpatient treatment with LMWH may be considered.
Effect of Recombinant Single-Chain Urokinase-Type Plasminogen Activator on Experimental Pulmonary Embolism
Authors: Yang Wang  , Chen Wang  , Yuanhua Yang  , Baosen Pang
Published: October 2009

To compare experimental canine pulmonary thromboembolism (PTE) treatment effects among domestic recombinant single-chain urokinase-type plasminogen activator (scu-PA), recombinant tissue plasminogen activator (rt-PA), and heparin, we injected autologous blood clots into 19 dogs. Those dogs were divided into 3 groups randomly: (1) scu-PA group (n = 6), (2) rt-PA group (n = 6), and (3) heparin group (n = 7). The measurement of hemodynamics and pulmonary angiography was, respectively, carried out at the time spots of preemboli and postemboli, 2 hours and 3 hours after treatment. Results: (1) An obvious increase in mean pulmonary arterial pressure (mPAP) from preemboli (P < .01) and a decrease in cardiac output (CO; P < .01) after blood clot injection. (2) Intergroup comparisons 2 and 3 hours after treatment: mPAP in scu-PA and rt-PA groups were remarkably lower than those of heparin group (P < .05). (3) Intragroup comparisons after thrombolysis, mPAP declined obviously (P < .01), heparin group saw a further decrease in CO. (4) Pulmonary angiography scoring: decrease in the 2 thrombolytic groups was higher than that of the heparin group. Conclusions: The effects of domestic recombinant scu-PA in experimental PTE resemble that of rt-PA in terms of the improvements of hemodynamics and angiography, better than heparin.
Ultrastructural and Morphological Analyses of the In Vitro and In Vivo Hemostatic Effects of Ankaferd Blood Stopper
Authors: Haznedaroglu Berat Z. , Haznedaroglu Ibrahim C. , Walker Sharon L. , Bilgili Hasan , Goker Hakan , Kosar Ali , Aktas Alper , Captug Ozge , Kurt Mevlut , Özdemir Oktay , Kirazli Serafettin , Firat Huseyin C.
Published: October 2009

Ultrastructural and morphological analyses of a novel hemostatic agent, Ankaferd Blood Stopper (ABS), in comparison to its in vitro and in vivo hemostatic effects were investigated. High-resolution scanning electron microscopy (SEM) images accompanied with morphological analysis after topical application of ABS revealed a very rapid (<1 second) protein network formation within concurrent vital erythroid aggregation covering the classical coagulation cascade. Histopathological examination revealed similar in vivo ABSinduced hemostatic network at the porcine hepatic tissue injury model. Instantaneous control of bleeding was achieved in human surgery-induced dental tissue injury associated with primary and secondary hemostatic abnormalities. Ankaferd Blood Stopper could hold a great premise for clinical management of surgery bleedings as well as immediate cessation of bleeding on external injuries based on upcoming clinical trials.
Eosinophilia and Thrombosis in Parasitic Diseases: An Overview
Authors: Ames Paul R. J. , Aloj Giuseppina , Gentile Fabrizio
Published: October 2009

It is known that peripheral blood eosinophilia (PBE) is a normal hematopoietic response to several parasitic diseases, but it is less known that PBE promotes a hypercoagulable state that may favor thrombosis. Scope of this article is to explore which parasitic infestations are most likely to be complicated by thrombosis and to highlight the pathogenetic contribution of PBE to vascular occlusions in this setting. A review of the world literature revealed 18 cases in which PBE was associated with vascular occlusion though no specific surveys were dedicated to this topic. The eosinophil exerts its thrombogenic potential by inhibition of the natural anticoagulant pathways and release of tissue factor with enhanced coagulation activation leading to vascular occlusion. It is hoped that this review contributes to the awareness of the link between PBE and thrombosis in parasitic disorders to foster research in this area.
Eosinophilia and Thrombophilia in Churg Strauss Syndrome: A Clinical and Pathogenetic Overview
Authors: Ames Paul R. J. , Margaglione Maurizio , Mackie Sara , Delgado Alves José
Published: October 2009

During the past decade, there has been an increased description of Churg Strauss syndrome (CSS) characterized by vascular occlusions possibly linked to the thrombogenic potential of the eosinophil that is poorly appreciated. The purpose of this overview is 3-fold: the first to evaluate the available prevalence of thrombosis in Churg Strauss series, the second to demonstrate that any vascular district may be affected, and the third to describe the pathogenesis of thrombosis in CSS. A Pubmed, EMBASE, and Google search of CSS series from 1951 to date revealed a prevalence of arterial occlusion ranging between 3.1% and 18.7% and a prevalence of venous occlusion between 5.8% and 30%, whereas a specific survey for venous thromboembolism in CSS yielded a prevalence of 8.1%. Eosinophils store and release tissue factor as well as other cationic proteins: the former initiates coagulation while the latter inhibits natural anticoagulant activity and activate platelets eventually culminating in excessive thrombin generation and clot formation. In addition, antineutrophil cytoplasmic antibodies may shift the endothelial lining to proadhesive and prothrombotic surface. It is hoped that the review will represent a basis to foster novel research on this topic.
Pathways to Poly-Victimization
Authors: Finkelhor David , Ormrod Richard , Turner Heather , Holt Melissa
Published: October 2009

Some children, whom we have labeled poly-victims, experience very high levels of victimizations of different types. This article finds support for a conceptual model suggesting that there may be four distinct pathways to becoming such a poly-victim: (a) residing in a dangerous community, (b) living in a dangerous family, (c) having a chaotic, multiproblem family environment, or (d) having emotional problems that increase risk behavior, engender antagonism, and compromise the capacity to protect oneself. It uses three waves of the Developmental Victimization Survey, a nationally representative sample of children aged 2—17 years. All four hypothesized pathways showed significant independent association with poly-victim onset. For the younger children, the symptom score representing emotional problems was the only significant predictor. For the older children, the other three pathway variables were significant predictors—dangerous communities, dangerous families, and problem families—but not symptom score. Poly-victimization onset was also disproportionately likely to occur in the year prior to children’s 7th and 15th birthday, corresponding roughly to the entry into elementary school and high school. The identification of such pathways and the ages of high onset should help practitioners design programs for preventing vulnerable children from becoming poly-victims.
Docetaxel combined with oral etoposide as second-line treatment for advanced gastric carcinoma after failure of platinum- and fluoropyrimidine-based regimens
Authors: Yildiz Ramazan , Kalender Mehmet Emin , Dane Faysal , Sevinc Alper , Gumus Mahmut , Camci Celalettin , Alici Suleyman , Kaya Ali Osman , Yaman Emel , Ozturk Banu , Coskun Ugur , Benekli Mustafa , Uncu Dogan , Buyukberber Suleyman
Published: October 2009

Background. Platinum, antracyline, and fluoropyrimidine combination chemotherapy has been widely used as a first-line treatment for advanced gastric cancer (AGC). In the present study, we determined the efficacy and the safety of docetaxel and oral etoposide as second-line combination chemotherapy after failure of commonly used combination regimens in AGC.

Methods. Patients with histologically proven gastric cancer and measurable metastatic disease received docetaxel 75 mg/m2 as a 1-h intravenous infusion on day 1, and oral etoposide 50 mg/m2 once daily on days 1—5, every 3 weeks until disease progression or unacceptable toxicities.

Results. Between June 2006 and September 2008, 32 patients, of median age 60 years (range 32—77 years) were included in the study. Overall response rate was 9.4% and 31.3% of patients achieved a stable disease. Median progression-free survival was 3 months (95% CI, 2.5—3.5). Median overall survival was 6 months (95% CI, 3.8—8.2) with 16.9% 1-year survival rate. Grade 3—4 toxicities included neutropenia (28.8%), febrile neutropenia (18.8%), thrombocytopenia (3.1%), nausea and vomiting (15.6%), diarrhea (9.4%), and mucositis (6.2%).

Conclusion. Docetaxel and oral etoposide combination was moderately effective and safe in appropriately selected AGC patients after failure of platinum- and fluoropyrimidine-based combination regimens. J Oncol Pharm Practice (2010) 16: 173—178.
Drug administration error related to computerized prescribing
Authors: Le Garlantezec P. , Aupée O. , Alméras D. , Lefeuvre L. , Souleau B. , Sgarioto A. , Bohand X.
Published: October 2009

Introduction. One of the main reasons for the implementation of computer-based prescribing was to reduce medication errors. However, the risk has not fallen to zero and new kinds of errors have been detected.

Setting. The following case relates one of these medication errors involving a preparation of vincristine. This antineoplastic drug was injected to a patient via a subcutaneous route of administration instead of an intravenous bolus injection.

Results. Consequently, a cutaneous erythema appeared. This incident resulted from an error in the programming of the administration route of the protocol operated by a pharmacist and a physician. The pharmacist, who was responsible for the validation of the computerized medical order and then for the compounding and the dispensing of the drug, did not detect the error.

Conclusion. This case highlights the need of improved and irreproachable therapeutic protocols. Recorded in a database, they must be validated pharmaceutically and medicinally to secure computer-based prescribing, drug handling, dispensing, and administering of the antineoplastic drugs. Even if the pharmaceutical analysis of prescriptions is made easier with computerization, we encourage the training of nurses and the evaluation of their knowledge as well as the necessity for pharmacists to learn to detect new kinds of errors and to verify periodically protocols.
Inulin Addition in Starch-based Dairy Desserts: Instrumental Texture and Sensory Aspects
Authors: Lobato L.P. , Grossmann M.V.E. , Benassi M.T.
Published: October 2009

Interactions between ingredients have a wide application in the food industry. The objective of this work was to investigate the combined effect of milk, starch, and inulin on textural properties (firmness, gumminess, cohesiveness, and adhesiveness), syneresis, and sensory characteristics of pudding (by free-choice profile (FCP) and acceptability test), applying the experimental design for mixtures. Milk and starch were significant for all the studied texture parameters. Milk, inulin, and the interaction of the inulin with starch were significant for syneresis. It was possible to formulate pudding with the maximum inulin concentration (3.9%) with good textural characteristics. The judges were capable of distinguishing attribute differences and similarities, mainly in relation to texture, by applying the FCP. In the acceptance test, the judges concluded that there are no differences (p < 0.05) among the tested formulations. The different proportions among ingredients in the system can affect the characteristics of the final product. Inulin inclusion in pudding, as a functional ingredient, was successful.
Review. Freeze Concentration in the Fruit Juices Industry
Authors: Sánchez J. , Ruiz Y. , Auleda J.M. , Hernández E. , Raventós M.
Published: October 2009

In conventional processes, such as evaporation, higher levels of concentration can be reached compared with freeze concentration or membrane techniques. However, the advantage of the freeze concentration technique is based on the quality of the product obtained due to the low temperatures used in the process, which makes it a very suitable technology for the processing of fruit juices. There are two basic methods for concentrating solutions by freezing: suspension and film freeze concentration. Suspension freeze concentration systems (FCS) already have operating equipment in the food industry, while film FCSs, also called layer crystallization, is still at an experimental stage. This review summarizes the most important studies relating to the suspension and film freeze concentration in fruit juices and sugar solutions, illustrating the different possibilities that freeze concentration has in the fruit juices industry; it also presents trends and suggests improvements for the future development of this technology. It is noted that most recent publications refer to the film FCS. The technology used to design, build and maintain layer crystallization equipment is simple and it can be available to any operator in the food industry, layer systems will be used in the future if their results can be improved in terms of ice purity and degree of fluid concentration.
Sensory Profile and Acceptability of Juices from Mandarin Varieties and Hybrids
Authors: Carbonell L. , Bayarri S. , Navarro J.L. , Carbonell I. , Izquierdo L.
Published: October 2009

Fresh juices from mandarin varieties, from hybrids, and from blends of these raw materials were evaluated by 100 consumers to determine acceptability, and by 10 trained panelists to quantify sensory attributes. Trained panelists found the juice from Clemenules richer in both mandarin and fresh flavor (odor and taste) whereas Nova juice presented minimum scores for these attributes. These aspects obviously affected the evaluation of acceptability by consumers, who preferred the juice from Clemenules (a Clementine variety) either alone or blended in major proportions with less preferred varieties such as Marisol, Hernandina (Clementines), Ortanique or Nova (hybrids). Nova juice was rejected by most consumers, but accepted by a small group of them. These results are of great importance for the European citrus industry since Clemenules is the most abundant variety and will constitute the main source of raw material for processing plants.
The Effect of Cooking in a Steam-convection Oven and Storage in Vacuum on the Quality of Turkey Meat
Authors: Danowska-Oziewicz M. , Karpińska-Tymoszczyk M. , Borowski J. , Białobrzewski I. , Zapotoczny P.
Published: October 2009

The effect of cooking on the quality of turkey meat heated by steam at different temperatures and saturation levels, and then vacuum stored at 3 °C for 28 days, was studied. The smallest cooking loss was observed in meat cooked at 220 °C and when the highest air steam saturation was applied. The rate of lipid oxidation as a result of cooking and storage was the lowest in sample cooked at 180 °C and in meat heated by 20% steam, and additionally during storage in sample treated with 0% steam. The higher cooking temperature was applied, the more intensive hydrolytic process took place in fat. Heating at 180 °C and in hot air with 0%, 70%, and 90% steam resulted in a more intensive hydrolytic process in meat during storage than other cooking parameters. The oxidation rate of -SH groups was higher in sample heated by 90% steam than the ones by 20%, 50%, and 70% steam. The use of steam saturation over 20% caused a decrease in mono-unsaturated fatty acids and an increase in saturated fatty acids content. Meat cooked at 220 °C and treated with 0% or 90% steam was characterized by better sensory attributes than other samples.
Effect of Raisin Juice Addition on Bread Produced from Different Wheat Cultivars
Authors: Sabanis D. , Soukoulis C. , Tzia C.
Published: October 2009

Concentrated and two types of dried raisin juice were added to bread and durum wheat flour dough at 50% level of sucrose substitution to prepare different bread samples. Baking (specific volume, color, crumb moisture, sensory evaluation), textural properties, and dough rheological properties were determined in breads. Results suggested that Greek durum wheat flour was appropriate for breadmaking and contributed to the baking, sensory, and textural properties of the final product. Addition of concentrated raisin juice in dough products both as a sucrose substitute and natural colorant gave breads with a higher loaf volume, fruity flavor, and an appealing brown color. Breads containing dried raisin juice were sensory rated lower than those with sucrose, however, they improved loaf volume and increased preservation time. This study also examined statistically the relationship between sensory responses and instrumental measurements, which is of major importance in the food industry for various applications.
Intermittent Microwave-convective Air Drying of Oregano
Authors: Soysal Y. , Arslan M. , Keskin M.
Published: October 2009

Effectiveness of intermittent microwave-convective air drying (IMWC) was investigated and compared to continuous microwave-convective air drying (CMWC) and convective air drying for oregano. Both CMWC and IMWC increased the drying rate of oregano compared to convective drying. The CMWC and IMWC were 12.7-14.0 and 4.7-11.2 times more energy efficient in drying than convective drying, respectively. The highest essential oil contents were obtained from convective drying at 40 °C and 45 °C. However, these treatments had the longest drying time and the highest energy consumption. The CMWC yielded the lowest essential oil content and resulted in an extreme change in the essential oil composition. The IMWC, except with the pulse ratio of 3.0, resulted in similar essential oil content compared to convective drying at 50 °C and shade drying. No identical result was found among the prevailing compounds of essential oil of oregano obtained from shade drying, convective drying and IMWC. Both CMWC and IMWC did not yield acceptable results of product color. However, in terms of essential oil content and quality, the IMWC at 25 °C room temperature with the pulse ratio of 5.0 was judged as the most suitable drying method for oregano due to its rational drying time and energy consumption compared to CMWC drying, convective air dying, and shade drying.
Order of Conners’ CPT-II Administration Within a Cognitive Test Battery Influences ADHD Indices
Authors: Erdodi Laszlo A. , Lajiness-O'Neill Renee , Saules Karen K.
Published: October 2009

Objective: To study the effect of administration sequence on Conner’s continuous performance test (CPT-II) scores in clients requesting psychological assessment. It was hypothesized that when administered at the end rather than beginning of a test battery, the test scores will show higher symptom severity. If present, order effects may cause the over- or underdiagnosing of ADHD. Method: Participants were recruited at a Midwestern university’s training clinic (16 men, 9 women; mean age = 22.4, SD = 10.2). The CPT-II was administered twice to each client: once at the beginning of the testing session and once at the end of their appointment. The clients completed at least a full Wechsler intelligence battery in between the CPT-II administrations. Results: Clients’ ADHD index score (interpreted as percent confidence in an ADHD diagnosis) is more impaired at Time 2 ( M = 53.3, SD = 29.0) compared to Time 1 ( M = 39.4, SD = 22.5): t (24) = 3.93, p < .05, Cohen’s d = .79. The number of T-scores above 60 on the subscales also changed from Time 1 ( M = 1.92, SD = 1.73) to Time 2 ( M = 3.12, SD = 2.05): t(24) = 3.47, p < .01, Cohen’s d = .71. Conclusions: If the CPT-II is administered later in a sequence of tests, it is more likely to yield scores in the impaired range. Order effects are more pronounced in individuals diagnosed with ADHD. Recommendations include the adoption of a standardized administration sequence, further research to investigate the nature of order effects, and a strategic use of order effects in ADHD assessment. (J. of Att. Dis. 2010; 14(1) 43-51)
Understanding the Role of Numeracy in Health: Proposed Theoretical Framework and Practical Insights
Authors: Lipkus Isaac M. , Peters Ellen
Published: October 2009

Numeracy—that is, how facile people are with mathematical concepts and their applications—is gaining importance in medical decision making and risk communication. This article proposes six critical functions of health numeracy. These functions are integrated into a theoretical framework on health numeracy that has implications for risk communication and medical decision-making processes. The authors examine practical underpinnings for targeted interventions aimed at improving such processes as a function of health numeracy. They hope that the proposed functions and theoretical framework will spur more research to determine how an understanding of health numeracy can lead to more effective communication and decision outcomes.
Network-Domains in Combat and Fashion Organizations
Authors: Corona Victor P. , Godart Frédéric C.
Published: October 2009

This article adapts and extends the ‘network-domain’ concept from Harrison White’s Identity and Control in order to consider how social ties are interwoven with domains of meaning in organizations. Our interpretation claims that modalities of behaviour in organizations are consequences of identities’ persistent movements among positions in network-domains as well as organizational efforts to manage these movements. This idea is outlined through discussion of two organizational antipodes: combat operations and fashion design. While combat operations require internal group cohesion and constrained individuality, the fashion industry is based on the distinctiveness of designs and the display of personal tastes. Despite clear differences, however, we trace how attempts at managing movements among network-domains are central to identities in both contexts. This effort builds on the generally accepted understanding of identities in organizations as labile and socially constituted and thereby contributes to bridging micro/macro and structural/cultural gaps in organizational theorizing.
Thalamic stimulation in multiple sclerosis: evidence for a ‘demyelinative thalamotomy’
Authors: Moore GR Wayne , Vitali Aleksander M , Leung Esther , Laule Cornelia , Kozlowski Piotr , MacKay Alex L , Honey Christopher R
Published: October 2009

The mechanism of action of deep brain stimulation (DBS) in the alleviation of tremor in multiple sclerosis (MS) and other neurological disorders is unknown. Moreover, whether the trauma accompanying this surgery is responsible for the induction of new MS plaques is controversial. Here we report the first description of the post-mortem imaging and pathologic findings in the brain of a MS patient who underwent thalamic DBS for the treatment of MS-induced tremor. MR imaging of formalin-fixed brain slices was carried out at 1.5, 3 and 7 Tesla and correlated with the histopathology. There were numerous demyelinative plaques in the white mater, cortex and deep gray matter. There were no plaques along the DBS tract within the sections that sampled the deep hemispheric white matter. However, deep within the thalamus focal demyelination approximated the tract, particularly in the region corresponding to the electrical field. The findings in this single case raise the possibility that focal demyelination may be induced by the electrical field and this may be responsible for long-lasting alleviation of tremor in the absence of continued electrostimulation.
Cultural Formulation Guidelines
Authors: Mezzich Juan E. , Caracci Giovanni , Fabrega Horacio , Kirmayer Laurence J.
Published: October 2009

The outline for the Cultural Formulation (CF) introduced in DSM-IV does not present any method for collecting the required cultural information. The absence of specific guidelines and illustrative cases has hampered its wider use. This article offers a practical approach to preparing a Cultural Formulation as a component of culturally competent clinical care. We summarize the rationale for the four sections of the CF, describe the process of conducting culturally focused clinical interviews, and present examples of questions or lines of inquiry that can be used to collect the information needed to construct the CF. An online supplement provides case examples of cultural formulations applied to patients seen in the US.
The Cultural Formulation: A Model to Combine Nosology and Patients’ Life Context in Psychiatric Diagnostic Practice
Authors: Bäärnhielm Sofie , Scarpinati Rosso Marco
Published: October 2009

This article discusses the experience of adapting and applying the Outline for a Cultural Formulation in DSM-IV to the Swedish context. Findings from a research project on the Cultural Formulation highlight the value of combining psychiatric nosological categorization with an understanding of patients’ cultural life context in order to increase the validity of categorization and to formulate individualized treatment plans. In clinical care practitioners need models and tools that help them take into account patients’ cultural backgrounds, needs, and resources in psychiatric diagnostic practice. We present a summary of a Swedish manual for conducting a Cultural Formulation interview. The need for further development of the Cultural Formulation is also discussed.
A Qualitative Study of Clinicians’ Use of the Cultural Formulation Model in Assessing Posttraumatic Stress Disorder
Authors: Fortuna Lisa R. , Porche Michelle V. , Alegría Margarita
Published: October 2009

The Cultural Formulation (CF) of the Diagnostic and Statistical Manual (DSM) provides a potential framework for improving the diagnostic assessment of Posttraumatic Stress Disorder (PTSD) in culturally diverse patients. We analyzed data from the Patient-Provider Encounter Study, a multi-site study that examines the process of diagnosis and clinical decision-making during an initial clinical intake session, in order to examine use of CF for PTSD diagnosis. We find that while the CF is generally used inconsistently or underutilized in routine community settings, when employed appropriately it may assist the formulation and interpretation of traumatic experiences. We discuss the implications for improving the assessment of PTSD in the time-limited setting of the clinical intake encounter and across race/ethnicity.
Recognizing Cultural Identity in Mental Health Care: Rethinking the Cultural Formulation of a Somali Patient
Authors: Groen Simon
Published: October 2009

Although there are many ways to produce a cultural formulation that facilitates a culturally sensitive diagnosis and treatment for asylum seekers and refugees in mental health care, it is essential to gain trust and ‘recognize’ the patient. One way to achieve this recognition is through a cultural interview, in which cultural references of the health care provider and the patient are exchanged. This paper presents an example of such a process with a Somali migrant to the Netherlands, whose passivity and inactivity puzzled the psychiatrist. Gaining his trust and recognizing his cultural roots as a member of a Somali ethnic group revealed more about his motives, concepts and attitude. This example suggests the importance of cultural identity as a way to explore the meanings of the illness and the interrelationship between the patient and health care provider. The cultural identity of the patient is a basis on which meanings can be exchanged in an ongoing way and starting points for effective treatment can be found.
Clinical Pitfalls in the Diagnosis of Ataque de Nervios: A Case Study
Authors: Lizardi Dana , Oquendo Maria A. , Graver Ruth
Published: October 2009

Ataque de nervios (attack of nerves) is an idiom of distress generally thought of in relation to Caribbean Hispanics. The following case study discusses the presentation of ataque de nervios in a Colombian female. This case study provides insight into a different presentation of ataque de nervios in a new population that clinicians should be aware of in order to ensure accurate diagnosis. Ataque de nervios is a distinct syndrome that does not fully correspond with any single DSM-IV diagnosis. However, there is overlap between symptoms in this condition and those in conventional clinical diagnoses. Common problems in deriving an accurate differential diagnosis are discussed. Implications for treatment are also reviewed, with an emphasis on a comprehensive approach to treatment that supports the client’s norms and values.
After-school program to reduce obesity in minority children: a pilot study
Authors: Madsen Kristine A. , Thompson Hannah R. , Wlasiuk Lidya , Queliza Emily , Schmidt Colin , Newman Thomas B.
Published: October 2009

This study explored a community-based after-school program’s effect on obesity in minority children. Study participants included 178 third through fifth graders (47% Latino, 25% Asian, and 18% African-American) enrolled in America SCORES Bay Area. Outcomes were attendance, change in fitness (20-meter shuttle test), and body mass index (BMI) z-score over eight months. At baseline, 52 percent of children were overweight or obese. Children attended SCORES > 4 days/week and fitness significantly improved (p < 0.01). BMI z-score decreased by 0.04 (p = 0.10) overall, and by 0.05 (p = 0.08) among obese children, but increased among African-American children. These results suggest that SCORES increases fitness and may improve BMI in some minority children. Effect modification by race may relate to differential growth patterns or engagement in SCORES. These findings suggest community-based programs could effectively address obesity. A randomized trial of the SCORES program is warranted to rigorously examine this type of after-school program’s impact on child health.
Review: Functional behavioral assessment as a model for multidisciplinary assessment and treatment
Authors: Olson Page Lynn , Golden Jeannie A.
Published: October 2009

Behavior, whether internalizing or externalizing, constitutes a primary challenge in any inpatient setting. In many cases, behavior may interfere with progress during inpatient treatment, resulting in the need for a behavioral strategy for those concerns. A multidisciplinary team approach is often necessary to fully identify and remediate interfering difficulties. Functional behavioral assessment (FBA) is a team-based technique that offers a positive option to these types of difficulties. This article provides a rationale for and delineates the use of FBA as a strategy for assessment and treatment for a complex care patient. Two uncontrolled case studies (pediatric rehabilitation and cancer) are used to illustrate the use of FBA in the tertiary hospital setting. Both cases demonstrated improvements in behavior with limited resources (time and training) needed to implement behavioral plans. Additional case-controlled research is needed to demonstrate the feasibility and utility of FBA as a strategy for multidisciplinary treatment planning and intervention.
Decreasing pediatric patient anxiety about radiology imaging tests: prospective evaluation of an educational intervention
Authors: Johnson Annette J. , Steele Jennifer , Russell Gregory B. , Moran Rhonda , Fredericks Kirsten P. , Jennings S. Gregory
Published: October 2009

This trial investigated anxiety levels and effect of an educational coloring book (CB) among pediatric patients about to undergo radiology imaging tests. Control group ( N = 101) and intervention group ( N = 175) children ages 3—10 years and their parents were surveyed to determine anxiety levels before the imaging test, with the intervention group being surveyed after patient and parental review of the CB. Anxiety was low for all subjects overall compared with findings from previously published literature, perhaps related to systemic measures to make children’s hospitals more child friendly in recent years. Review of the CB was not associated with decreased anxiety among patients or parents. However, among a subgroup with higher baseline parental anxiety, there was a trend toward lower patient anxiety in the intervention group. Most parents indicated that the CB was informative and helped them and their child be less worried, and that they were pleased to have received the CB.
Talking to Teenagers: Using Anthropological Methods to Explore Identity and the Lifeworlds of Young People Who Use AAC
Authors: Wickenden Mary
Published: October 2009

The article outlines the methodology used in an ethnographic study of identity with teenagers who use augmentative and alternative communication (AAC). It is unusual to investigate this population in naturalistic contexts using qualitative methods. Nine individuals are studied, in a range of contexts using ethnography as the main method. The research draws on theory from childhood and disability studies to gain a broad picture of the participants’ lives. The aim was to explore the teenagers’ views of their lives while also contextualizing these with perspectives of people around them and three adult AAC users. The method enabled the researcher to see the many ways in which disabled teenagers experience their worlds. The study shows that they are more interested in the ways that they are like others than anything else and that they identify themselves most importantly as teenagers rather than as disabled.