bluuebunny/crossref_metadata_2025 huggingface dataset:
Achieving Millennium Development Goals 4 and 5 in Pakistan
Authors: Mahmud G , Zaman F , Jafarey S , Khan RL , Sohail R , Fatima S
Published: September 2011

Please cite this paper as: Mahmud G, Zaman F, Jafarey S, Khan RL, Sohail R, Fatima S. Achieving Millennium Development Goals 4 and 5 in Pakistan. BJOG 2011;118 (Supp. 2):69–77.

Pakistan is a signatory of many international development strategies including the Millennium Development Goals, and the government is committed to achieving a reduction in infant mortality rate from 72 to <55 per 1000 live births, the newborn mortality rate from 55 to <40 per 1000 live births and the maternal mortality rate from 276 per 100 000 to 140 per 100 000 live births by 2015. Maternal, newborn and child health play a key role in reducing poverty and promoting social and economic development. Improvement in maternal and child health is a priority agenda of the Government of Pakistan.
From home to hospital, a continuum of care: making progress towards Millennium Development Goals 4 and 5 in rural Bangladesh
Authors: Edwards C , Saha S
Published: September 2011

Please cite this paper as: Edwards C, Saha S. From home to hospital, a continuum of care: making progress towards Millennium Development Goals 4 and 5 in rural Bangladesh. BJOG 2011;118 (Suppl. 2):88–92.

The Lutheran Aid to Medicine in Bangladesh (LAMB) health and development project in rural Bangladesh has developed an integrated maternal and child healthcare system providing appropriate, accessible and affordable health services for the poor, through a home‐to‐hospital, continuum‐of‐care approach. LAMB is thus an example of how high‐quality maternity health services accessible to women of all socio‐economic classes in a rural context can be provided, making progress towards Millennium Development Goals 4 and 5.
Effect of IL‐1β and TNF‐αvs IL‐13 on bronchial hyperresponsiveness, β2‐adrenergic responses and cellularity of bronchial alveolar lavage fluid
Authors: Horiba M. , Qutna N. , Gendapodi P. , Agrawal S. , Sapkota K. , Abel P. , Townley R. G.
Published: September 2011

1 Levels of IL‐13, IL‐1β and TNF‐α are increased in bronchial lavage fluid of asthmatics and induce certain significant features of bronchial asthma including airway hyper‐responsiveness (AHR). In this study, we have investigated the effect of these cytokines in naïve mice and those sensitized to ovalbumin (OVA) on bronchoconstrictions to methacholine (MCh) and the functional antagonism induced by β2‐adrenoceptor agonism.

2 Naïve or OVA‐sensitized mice were treated for 3 days with IL‐1β (250 U), TNF‐α (150 ng), IL‐13 (5 μg) or combinations of IL‐1β with TNF‐α or IL‐1β with IL‐13. MCh‐induced bronchoconstriction and its sensitivity to albuterol, a β2‐adrenoceptor agonist, was assessed 24 h after the last cytokine administration.

3 In naïve mice, responsiveness to MCh was significantly increased by the combination of IL‐1β and TNF‐α, IL‐13 alone or in combination with IL‐1β, but not by treatment with IL‐1β or TNF‐α alone. Similar results were obtained in OVA‐sensitized mice except that treatment with IL‐13 alone did not increase sensitivity to MCh.

4 In naïve mice, albuterol sensitivity was only significantly attenuated by treatment with IL‐1β and TNF‐α in combination. In mice sensitized to OVA, albuterol sensitivity was significantly attenuated by treatment with TNF‐α, IL‐13 or IL‐13 in combination with IL‐1β.

5 Inflammatory cell influx was increased by all cytokines and combinations except IL‐13 in OVA‐sensitized mice.

6 Our data do not support a link between inflammatory cell influx and AHR. In addition, the mechanism of IL‐13‐induced AHR might involve decreased β2‐adrenoceptor responsiveness.
Angiotensin II modifies the expression of α1‐adrenoceptors in aorta smooth muscle cells of α1D‐adrenoceptor knockout mice
Authors: Lázaro‐Suárez M. L. , Gómez‐Zamudio J. H. , Delgado‐Buenrostro N. L. , Tanoue A. , Tsujimoto G. , Villalobos‐Molina R.
Published: September 2011

1 The effect of angiotensin II (Ang II) on α1A‐, α1B‐, and a1D‐adrenoceptors (α1‐AR) expression was analyzed in aorta smooth muscle cells obtained from wild‐type (WT) and knock out of α1D‐AR (α1D‐AR KO) mice.

2 The relative abundance of mRNA for the three α1‐ARs was determined in WT and α1D‐AR KO aortic smooth muscle cells. There were no significant differences between WT and α1D‐AR KO cells.

3 As early as 1 h Ang II increased α1B‐AR mRNA in WT cells ≈ 2 fold compared with control; in contrast, in α1D‐AR KO cells the α1B‐AR transcript was ≈ 50% of control.

4 Western blot assays showed that Ang II incremented protein content for α1A‐AR, 86% and 107% in WT and α1D‐AR KO cells, respectively.

5 Protein for α1B‐ and α1D‐ARs did not change significantly with Ang II in both WT and a1D‐AR KO cells.

6 The effect of Ang II on α1B‐AR mRNA seems to be influenced by the absence of α1D‐AR in aortic smooth muscle cells, which might be important to understand the interactions among α1‐ARs.
Reliability of ultrasonographic measurement of the architecture of the vastus lateralis and gastrocnemius medialis muscles in older adults
Authors: Raj Isaac S. , Bird Stephen R. , Shield Anthony J.
Published: September 2011

Objective:  To determine the test‐retest reliability of measurements of thickness, fascicle length (Lf) and pennation angle (θ) of the vastus lateralis (VL) and gastrocnemius medialis (GM) muscles in older adults.

Participants:  Twenty‐one healthy older adults (11 men and ten women; average age 68·1 ± 5·2 years) participated in this study.

Methods:  Ultrasound images (probe frequency 10 MHz) of the VL at two sites (VL site 1 and 2) were obtained with participants seated with knee at 90º flexion. For GM measures, participants lay prone with ankle fixed at 15º dorsiflexion. Measures were taken on two separate occasions, 7 days apart (T1 and T2).

Results:  The ICCs (95% CI) were: VL site 1 thickness = 0·96(0·90–0·98); VL site 2 thickness = 0·96(0·90–0·98), VL θ = 0·87(0·68–0·95), VL Lf = 0·80(0·50–0·92), GM thickness = 0·97(0·92–0·99), GM θ = 0·85(0·62–0·94) and GM Lf =0·90(0·75–0·96). The 95% ratio limits of agreement (LOAs) for all measures, calculated by multiplying the standard deviation of the ratio of the results between T1 and T2 by 1·96, ranged from 10·59 to 38·01%.

Conclusion:  The ability of these tests to determine a real change in VL and GM muscle architecture is good on a group level but problematic on an individual level as the relatively large 95% ratio LOAs in the current study may encompass the changes in architecture observed in other training studies. Therefore, the current findings suggest that B‐mode ultrasonography can be used with confidence by researchers when investigating changes in muscle architecture in groups of older adults, but its use is limited in showing changes in individuals over time.
Health Care Reform in the Former Soviet Union: Beyond the Transition
Authors: Balabanova Dina , Roberts Bayard , Richardson Erica , Haerpfer Christian , McKee Martin
Published: September 2011

Objective

To assess accessibility and affordability of health care in eight countries of the former Soviet Union.

Data Sources/Study Setting

Primary data collection conducted in 2010 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Moldova, Russia, and Ukraine.

Study Design

Cross‐sectional household survey using multistage stratified random sampling.

Data Collection/Extraction Methods

Data were collected using standardized questionnaires with subjects aged 18+ on demographic, socioeconomic, and health care access characteristics. Descriptive and multivariate regression analyses were used.

Principal Findings

Almost half of respondents who had a health problem in the previous month which they viewed as needing care had not sought care. Respondents significantly less likely to seek care included those living in Armenia, Georgia, or Ukraine, in rural areas, aged 35–49, with a poor household economic situation, and high alcohol consumption. Cost was most often cited as the reason for not seeking health care. Most respondents who did obtain care made out‐of‐pocket payments, with median amounts varying from $13 in Belarus to $100 in Azerbaijan.

Conclusions

Access to health care and within‐country inequalities appear to have improved over the past decade. However, considerable problems remain, including out‐of‐pocket payments and unaffordability despite efforts to improve financial protection.
Surgery Wait Times and Specialty Services for Insured and Uninsured Breast Cancer Patients: Does Hospital Safety Net Status Matter?
Authors: Bradley Cathy J. , Dahman Bassam , Shickle Lisa M. , Lee Woolton
Published: September 2011

Objective

To determine whether safety net and non‐safety net hospitals influence inpatient breast cancer care in insured and uninsured women and in white and African American women.

Data Sources

Six years of Virginia Cancer Registry and Virginia Health Information discharge data were linked and supplemented with American Hospital Association data.

Study Design

Hierarchical generalized linear models and linear probability regression models were used to estimate the relationship between hospital safety net status, the explanatory variables, and the days from diagnosis to mastectomy and the likelihood of breast reconstruction.

Principal Findings

The time between diagnosis and surgery was longer in safety net hospitals for all patients, regardless of insurance source. Medicaid insured and uninsured women were approximately 20 percent less likely to receive reconstruction than privately insured women. African American women were less likely to receive reconstruction than white women.

Conclusions

Following the implementation of health reform, disparities may potentially worsen if safety net hospitals’ burden of care increases without commensurate increases in reimbursement and staffing levels. This study also suggests that Medicaid expansions may not improve outcomes in inpatient breast cancer care within the safety net system.
Eoandromedaand the origin ofCtenophora
Authors: Tang Feng , Bengtson Stefan , Wang Yue , Wang Xun‐lian , Yin Chong‐yu
Published: September 2011

TheEdiacaran fossilEoandromeda octobrachiatahad a high conical body with eight arms in helicospiral arrangement along the flanks. The arms carried transverse bands proposed to be homologous to ctenophore ctenes (comb plates).Eoandromedais interpreted as an early stem‐group ctenophore, characterized by the synapomorphies ctenes, comb rows, and octoradial symmetry but lacking crown‐group synapomorphies such as tentacles, statoliths, polar fields, and biradial symmetry. It probably had a pelagic mode of life. The early appearance in the fossil record of octoradial ctenophores is most consistent with thePlanulozoa hypothesis (Ctenophora is the sister group ofCnidaria +Bilateria) of metazoan phylogeny.
The Limits of Performativity: A Critique of Hegemony in Gender Theory
Authors: Schep Dennis
Published: September 2011

Recently, Judith Butler refused to accept an award for civil courage at the Berlin Christopher Street Day, because she felt the event had become too commercial, and the event's organization had failed to distance itself from certain discriminatory statements. This, as well as many of her works, suggests that more than any other contemporary feminist author, Butler is aware of the risk of implication in exclusionary politics; a risk she might therefore successfully avoid. However, in this essay I argue that to the extent her theory of performativity has become a hegemonic framework within the field of gender studies, it leads to the foreclosure of certain possible gendered identities. Using Nancy's notion of finite thinking, I argue that a different approach to universality may lead to a less exclusionary way of conceptualizing gender.
Comparison of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES®) and Laparoscopy for Elective Bilateral Ovariectomy in Standing Mares
Authors: Pader Karine , Freeman Lynetta J. , Constable Peter D. , Wu Ching C. , Snyder Paul W. , Lescun Timothy B.
Published: September 2011

Objective

To compare surgical trauma, perioperative pain, surgical time, and complication rate in mares undergoing standing bilateral ovariectomy by natural orifice transluminal endoscopic surgery (NOTES) or laparoscopy.

Study Design

Experimental study.

Animals

Healthy mares (n= 12).

Methods

Ovariectomy was performed with a vessel‐sealing device by transvaginalNOTES(n= 6) using a flexible endoscope and specialized instruments or by bilateral flank laparoscopy (n= 6). Preoperative and postoperative complete blood count (CBC), plasma fibrinogen concentration, serum amyloidAconcentration, peritoneal nucleated cell count, and total protein concentration were compared using repeated measuresANOVA. Surgical times were compared using an unpairedt‐test. Mares were monitored for 2 weeks postoperatively and necropsy was performed at 3 weeks (n= 6) or 3 months (n= 6) to assess short‐ and medium‐term effects of each procedure. Complication rate, necropsy, and bacteriology findings were compared using a Fishers exact test. Significance was set atP< .05.

Results

All surgical procedures were performed successfully and all but one laparoscopy mare were bright, alert, and maintained a good appetite until euthanasia. Mean ±SDsurgical time was similar between groups (NOTES: 100 ± 40 minutes; laparoscopy: 107 ± 47 minutes). There were no significant temporal differences in vital parameters, CBC, plasma fibrinogen concentration, serum amyloidAconcentration, peritoneal nucleated cell count, and total protein concentration between groups.

Conclusions

Bilateral ovariectomy by transvaginalNOTESor laparoscopy resulted in minimal inflammation and surgical trauma.
Mechanical Testing of Orthopedic Suture Material Used for Extra‐Articular Stabilization of Canine Cruciate Ligament‐Deficient Stifles
Authors: Rose Nathan D. , Goerke Derek , Evans Richard B. , Conzemius Michael G.
Published: September 2011

Objective

To determine (1) if braided, polyblend orthopedic suture materials are mechanically superior to monofilament nylon leader and (2) have mechanical properties similar to biomechanical properties of the canine cruciate ligament.

Sample Population

Different suture material types.

Methods

Mechanical testing was performed on 5 different orthopedic suture materials: 80# test Mason monofilament nylon leader (MNL), FiberTape (FT), FiberWire (FW), Xgen OrthoFiber (XOF), and LigaFiba (LF) using a servohydraulic materials‐testing machine. Materials were loaded to failure while collecting data for tensile strength, load at 3 mm and 5 mm of elongation and stiffness. Cyclic elongation of each suture material was tested under physiologic loading between 70 and 150 N for 1000 cycles using 3 mm of elongation to describe excessive elongation. Load at 3 mm of elongation and performance during cyclic testing were compared to previously published physiologic loads in the dog stifle.

Results

Ultimate tensile strength was greatest with LF, followed by XOF that was stronger than FT and FW, and the weakest was MNL. LF was the stiffest of all tested materials at 3 mm of elongation. Cyclic elongation was greatest for the MNL elongating 3.75 mm after 1000 cycles. All polyblend braided materials continued to elongate throughout the 1000 cycles under physiologic loads.

Conclusions

Polyblend suture materials are stronger and elongate less than MNL in pure tension. The mechanical performance of all sutures tested is questionable when compared with the mechanical demands of the normal stifle in a mid‐sized dog.
Resection of Grade III Cranial Horn Tears of the Equine Medial Meniscus Alter the Contact Forces on Medial Tibial Condyle at Full Extension: An In‐vitro Cadaveric Study
Authors: Fowlie Jennifer , Arnoczky Steven , Lavagnino Michael , Maerz Tristan , Stick John
Published: September 2011

Objective

To evaluate the magnitude and distribution of joint contact pressure on the medial tibial condyle after grade III cranial horn tears of the medial meniscus.

Study Design

Experimental study.

Animals

Cadaveric equine stifles (n = 6).

Methods

Cadaveric stifles were mounted in a materials testing system and electronic pressure sensors were placed between the medial tibial condyle and medial meniscus. Specimens were loaded parallel to the longitudinal axis of the tibia to 1800 N at 130°, 140°, 150°, and 160° stifle angle. Peak pressure and contact area were recorded from the contact maps. Testing was repeated after surgical creation of a grade III cranial horn tear of the medial meniscus, and after resection of the simulated tear.

Results

In the intact specimens, a significantly smaller contact area was observed at 160° compared with the other angles (P < .05). Creation of a grade III cranial horn tear in the medial meniscus did not significantly alter the pressure or contact area measurements at any stifle angle compared with intact specimens (P > .05). Resection of the tear resulted in significantly higher peak pressures in the central region of the medial tibial condyle at a stifle angle of 160° relative to the intact (P = .026) and torn (P = .012) specimens.

Conclusions

Resection of grade III cranial horn tears in the medial meniscus resulted in a central focal region of increased pressure on the medial tibial condyle at 160° stifle angle.
Socioeconomic Status– and Gender‐Based Differences in Students’ Perceptions of E‐Learning Systems
Authors: Albert Leslie Jordan , Johnson Camille S.
Published: September 2011

Many universities are pursuing increases in on‐line course offerings as a means of offsetting the rising costs of providing high‐quality educational opportunities and of better serving their student populations. However, enrollments in online courses are not always sufficient to cover their costs. One possible way of improving enrollments is through marketing campaigns targeted to specific demographic groups. In this study, we take a first look into how students’ perceptions of e‐learning systems, prior to their enrollment in an online course, vary across socioeconomic status and gender. Findings suggest that prior to taking an online course, working‐class students perceive e‐learning systems more positively than their middle‐class peers but that little difference exists between genders. Armed with this knowledge, universities may improve online course enrollments by marketing online courses specifically to working‐class students or through campaigns aimed at improving middle‐class students’ perceptions of e‐learning systems.
Teaching Cases in a Virtual Environment: When the Traditional Case Classroom is Problematic
Authors: Halvorson Wade , Crittenden Victoria L. , Pitt Leyland
Published: September 2011

The rise in interactive digital media has catapulted faculty‐student contact abilities from the traditional Web 1.0 model to a post‐Web 2.0 world where students and faculty can have much more interaction in classroom exchanges. Since business cases have long been a pedagogy of choice among professors concerned with training the next generation of decision makers, the intent of this exploratory teaching execution was to gain insight into the case teaching experience in Second Life (SL). SL is a virtual world developed by Linden Lab that enables its users to interact with each other through avatars (virtual representations of the self). While online classrooms in SL are not new (a number of universities throughout the world have set up virtual campuses), business education scholarship is lacking as related to the use of virtual worlds for educational purposes. The aim of the execution was not to suggest that SL case teaching should displace the traditional case classroom interactions. Rather, the exercise found that a case‐based class can be held and attended independent of time, distance, and location should the need arise. Case teaching in SL offers an availability alternative or supplement to the traditional case teaching and learning approach.
Course Management Systems and Blended Learning: An Innovative Learning Approach
Authors: Chou Amy Y. , Chou David C.
Published: September 2011

This article utilizes Rogers’ innovation‐decision process model (2003) and Beckman and Berry's innovation process model (2007) to create an innovative learning map that illustrates three learning methods (i.e., face‐to‐face learning, online learning, and blended learning) in two types of innovation (i.e., incremental innovation and radical innovation) that exhibits the behavior and dynamics on a two‐dimensional area of learning changes (i.e., change in learning model and change in technological infrastructure). The behavior and dynamics of face‐to‐face, online, and blended learning are depicted in the innovative learning map. Blended learning is identified as a radical innovative learning method in the innovative learning map. A course management system (CMS) is an information and communication technology (ICT) tool that can be used to facilitate and balance communication channel within a blended learning environment. Two propositions are proposed in this article: (1) CMS facilitates communication channel, enhances learning practice for learners and instructors, and is an enabler for blended learning; and (2) adopting CMS is suitable for blended learning practice. A case study to a college System Analysis and Design (SA&D) course reflects that the adoption of CMS in a blended learning environment is acceptable.
Entrepreneurial Orientation: Assessing the Construct's Validity and Addressing Some of Its Implications for Research in the Areas of Family Business and Organizational Learning
Authors: Dess Gregory G. , Pinkham Brian C. , Yang Haibin
Published: September 2011

Our commentary addresses three papers that we believe make important contributions to the emerging literature on entrepreneurial orientation (EO). The first paper rigorously assesses and enhances the construct validity of EO—an important antecedent to empirical research. The second paper draws on the concepts of identity and social identity and provides a means of predicting how various ownership types of family firms will affect the EO–performance relationship. The third paper synthesizes multiple theoretical perspectives and empirical research to provide insights on the role that EO plays in enhancing a firm's acquisitive and experimental learning. We close with a discussion of EO as an area for theory development.
Entrepreneurial Orientation Theory and Research: Reflections on a Needed Construct
Authors: Covin Jeffrey G. , Lumpkin G.T.
Published: September 2011

This article introduces the Special Issue of Entrepreneurship Theory and Practice on the topic of Entrepreneurial Orientation (EO). In addition to overviewing the preparation and structure of the Special Issue, this article addresses various substantive matters pertinent to the continuing development of EO theory and research including (1) the issue of whether EO is more defensibly conceived of as a dispositional or behavioral construct; (2) the reasons why EO is regarded by some as an “annoying construct,” and what might be done about it; (3) the reasons why the concept of EO fills an important gap in the literature on firm–level entrepreneurship; (4) a proposal that EO theory and research proceed along two concurrent paths corresponding the unidimensional and multidimensional conceptualizations of the construct; (5) a review of EO measurement issues focused on why, in particular, it is problematic to conceive of and measure EO as a formative construct; and (6) a brief consideration of both marginal–value and high–potential topic areas for future EO theory and research.
Dual Atrioventricular Nodal Nonreentrant Tachycardia: A Systematic Review
Authors: WANG NORMAN C.
Published: September 2011

Background:
 Dual atrioventricular nodal nonreentrant tachycardia (DAVNNT) is a relatively uncommon supraventricular tachycardia. The clinical characteristics and optimal management strategies are not well described.

Methods:
 A systematic review of all reported cases of DAVNNT was performed. Articles were included if they described spontaneous tachycardias resulting from 1:2 atrioventricular (AV) conduction as a result of two AV nodal pathways. Data sources included PubMed from 1950 to January 2011, article bibliographies, and the Google internet search engine.

Results:
 Ultimately, 44 citations that reported 49 cases met inclusion criteria. DAVNNT is being reported with increasing frequency. Clinical characteristics were assessed using the 44 cases reported in the English language. Palpitations were the most common presenting symptom (89%). The majority of patients had a significant delay until the correct diagnosis was made (77%). The most common specific mistaken diagnosis was atrial fibrillation (32%) and five patients were diagnosed after referral for pulmonary vein isolation. Nine reports described association with a tachycardia‐mediated cardiomyopathy. Catheter ablation has successfully treated all reported cases since 1994.

Conclusions:
 DAVNNT is an uncommon arrhythmia being reported with increasing frequency. It is commonly mistaken for atrial fibrillation and is associated with a reversible tachycardia‐mediated cardiomyopathy. Catheter ablation of the slow AV nodal pathway is curative and appears to be the therapy of choice, although more systematic study is required. (PACE 2011; 34:1671–1681)
G‐Estimation and Artificial Censoring: Problems, Challenges, and Applications
Authors: Joffe Marshall M. , Yang Wei Peter , Feldman Harold
Published: September 2011

Summary In principle, G‐estimation is an attractive approach for dealing with confounding by variables affected by treatment. It has rarely been applied for estimation of the effects of treatment on failure‐time outcomes. Part of this is due to artificial censoring, an analytic device which considers some subjects who actually were observed to fail as if they were censored. Artificial censoring leads to a lack of smoothness in the estimating function, which can pose problems in variance estimation and in optimization. It also can lead to failure to have solutions to the usual estimating functions, which then raises questions about the appropriate criteria for optimization. To improve performance of the optimization procedures, we consider approaches for reducing the amount of artificial censoring, propose the substitution of smooth for indicator functions, and propose the use of estimating functions scaled to a measure of the information in the data; we evaluate performance of these approaches using simulation. We also consider appropriate optimization criteria in the presence of information loss due to artificial censoring. We motivate and illustrate our approaches using observational data on the effect of erythropoietin on mortality among subjects on hemodialysis.
Identifying Food Safety Concerns When Communication Barriers Exist
Authors: Neal Jack A. , Dawson Mary , Madera Juan M.
Published: September 2011

Abstract:  Students must be prepared to lead a diverse workforce. The objective of this study was to establish a teaching method that helps students identify barriers to food safety while working in a simulated environment with communication barriers. This study employed a perspective taking exercise based upon the principles of social learning theory. Students were randomly assigned as a “manager” or an “employee.” The managers were provided with a recipe and instructions in English and employees were provided with the recipe and instructions in an abstract, non‐English language. Students were instructed to prepare the recipe in silence using only nonverbal communication methods. Three teaching techniques were employed under this scenario to determine the most effective method of instruction. For the 1st method (Barrier Identification), students were asked to complete an open‐ended survey concerning their communication barriers in regards to food safety. Next (Modeling through Pictures), recipe books with pictures of each recipe with food safety icons were provided to half of the participants. In the 3rd scenario (Observation), students were videotaped to identify communication techniques and to identify common food safety violations. Lastly, a focus group was conducted, whereby students were required to reflect upon the experiment in order to identify specific food safety barriers. Students identified communication challenges to food safety and developed techniques to help overcome language barriers. However, the use of pictures did not increase the frequency of proper food handling procedures. This study found that a combination of gestures and demonstrations were the most valuable nonverbal forms of training.
Maternal left ventricular and endothelial functions in preeclampsia
Authors: TYLDUM EVA V. , BACKE BJØRN , STØYLEN ASBJØRN , SLØRDAHL STIG A.
Published: September 2011

Objective. To compare maternal left ventricular and endothelial functions in preeclampsia and normal pregnancy, during pregnancy and after delivery. Design. Observational study with follow‐up. Setting. University hospital and midwife‐led antenatal care center. Samples. Twenty untreated women with preeclampsia and 20 women with normal pregnancy, matched for gestational age and parity. Methods. The women were examined during pregnancy and three months after delivery. Left ventricular function was assessed by echocardiography, including tissue‐Doppler imaging. Endothelial function was assessed by measuring flow‐mediated dilation of the brachial artery. Main outcome measures. Early diastolic mitral annular tissue velocity, “e”, peak systolic tissue velocity, “S”, and flow‐mediated dilation. Results. The diastolic function was reduced in preeclampsia, with lower “e”, and there was a higher ratio of early diastolic mitral inflow velocity and early diastolic mitral annular velocity, “E/e”. Early diastolic mitral inflow deceleration time and isovolumetric relaxation time were similar between the groups, suggesting pseudonormalization and increased filling pressures in preeclampsia. “S” was lower in the preeclampsia group during pregnancy. Both diastolic and systolic left ventricular functions normalized postpartum. The flow‐mediated dilation was impaired in the preeclampsia group both during pregnancy and three months after delivery. Conclusions. The maternal left ventricular function was impaired during preeclampsia but had normalized three months after delivery. The endothelial function, measured by flow‐mediated dilation, was impaired in the preeclampsia group as compared with the normal pregnancy group both during pregnancy and three months after delivery.
Increased attendance rates and altered characteristics of sexual violence
Authors: GISLADOTTIR AGNES , GUDMUNDSDOTTIR BERGLIND , GUDMUNDSDOTTIR RAGNHILDUR , JONSDOTTIR EYRUN , GUDJONSDOTTIR GUDLAUG R. , KRISTJANSSON MAR , VALDIMARSDOTTIR UNNUR A.
Published: September 2011

Objective. To study the attendance rates and characteristics of sexual violence presented at emergency services for rape victims, over a 10‐year period. Design. Incidence study. Setting. Rape Trauma Service, within an emergency department at a tertiary referral university hospital. Population. The total female population in Iceland. Methods. Medical records on visits were reviewed and systematically coded. Annual attendance rates were calculated over time as number of visits per 10 000 female inhabitants aged 13–49 years. Characteristics of sexual violence, perpetrators and victims were compared between 1998–2002 and 2003–2007. Main outcome measures. Annual attendance rates and characteristics of sexual violence. Results. Of 1153 visits, 828 (71.8%) were due to severe sexual violence (penetration). Annual attendance rates of all sexual violence increased from 12.5 to 16.9 per 10 000 women aged 13–49 (p<0.01). Attendance rates due to severe sexual violence increased specifically among women aged 18–25 (p<0.01). The proportion of assaults involving multiple perpetrators increased from 13.9% in 1998–2002 to 18.9% in 2003–2007 (p=0.05). With time, a higher proportion of victims had seriously impaired consciousness due to alcohol consumption (p<0.01) and had used illegal drugs prior to assault (p<0.05). Conclusions. The findings point towards an increase in women's visits to specialized emergency services for rape victims, particularly in the age group 18–25 years. The increased role of multiple perpetrators, alcohol and illicit drugs in sexual violence calls for further attention.
The prevalence and risk factors of premature thelarche and pubarche in 4‐ to 8‐year‐old girls
Authors: Atay Zeynep , Turan Serap , Guran Tulay , Furman Andrzej , Bereket Abdullah
Published: September 2011

Aim:  To assess the prevalence of premature thelarche (PT) and pubarche in healthy 4‐ to 8‐year‐old girls and to investigate factors associated with early pubertal development.

Method:  Eight hundred and twenty girls were examined by two paediatric endocrinologists to determine Tanner staging. The effects of body mass index, gestational age, intrauterine growth status, age at the first tooth eruption, socio‐economical status, maternal age of menarche and consumption of certain food items on early pubertal development were analysed through parametric and nonparametric tests.

Results:  The prevalence of PT and of premature pubarche was 8.9% and 4.3%, respectively. We found a strong association between the prevalence of PT and the body mass index standard deviation scores (BMI SDS). There were more girls with BMI SDS values above 1 in the PT group (56.1%) than among the remaining subjects (22.9%). Premature thelarche was not significantly associated with intrauterine growth, premature birth, socioeconomic status, age of first tooth eruption or maternal age of menarche. Similarly, the amount of milk, eggs, chicken or fish consumed was not associated with PT. None of the investigated factors were associated with premature pubarche.

Conclusion:  Occurrence of PT is strongly associated with BMI SDS. Studies investigating secular trends in pubertal development must consider a secular change in body mass index.
The Geo‐Social Presidency: Lest We Forget
Authors: HART RODERICK P.
Published: September 2011

This article respects Coe and Neumann's call for a unified data set for textual studies of the U.S. presidency, but it objects to its (1) national, (2) formal, and (3) issue‐based characteristics. Coe and Neumann's data set dismissed the ceremonial dimensions of the modern presidency; its partisan‐political events; its dialogue with the nation's press; and, worst of all, the local and regional encounters between the president and the American people. In cordoning off these activities, Coe and Neumann intellectualize an office that is profoundly social and psychological in nature. They also dismiss its transactional aspects as well as its emotional, symbolic dimensions. In offering the list of speeches they do, Coe and Neumann thereby ignore the sociology of American politics, a considerable oversight indeed.
Polls and Elections: Revisiting Midterm Visits: Why the Type of Visit Matters
Authors: LANG MATTHEW , ROTTINGHAUS BRANDON , PETERS GERHARD
Published: September 2011

In this article, we reassess the findings of where presidents visit during midterm elections from 1954 to 2010, with data that, for the first time, segments presidential visits into “rallies,” fundraisers, and “virtual” campaigning. On one hand, our findings reflect what others have found—when aggregating all visits together, the total Electoral College votes and the previous state‐level winning percentage of the president in the state affect the probability of a visit by the president. However, presidents are more likely to visit states for a “rally” when they are more popular, and the number of competitive races in the state is greater. Presidents are more likely to host a fundraiser in a state when the number of Electoral College votes is higher but are less likely to visit when there are fewer competitive races. The results suggest that there is value in knowing the purpose for which a president visited a state in a midterm election.
The Law: Prerogative Power and Executive Branch Czars: President Obama's Signing Statement
Authors: SOLLENBERGER MITCHEL A. , ROZELL MARK J.
Published: September 2011

In his April 15, 2011, signing statement President Barack Obama implied that, as president, he may suspend laws, or portions of laws, and that he is not controlled by statutory language that interferes with his ability to receive advice from White House aides or other executive branch officials. This article analyzes the claim that presidents have the prerogative to wall themselves and their aides off from statutory direction and controls, and concludes that there is no constitutional or legal basis for such an understanding of the executive power.
The Legacy of Harry Truman on Immigration and Native American Policies
Authors: Dean Virgil W.
Published: September 2011

Review of: Native Americans and the Legacy of Harry S. Truman; Immigration and the Legacy of Harry S. Truman
Biofilm and Penile Prosthesis Infections in the Era of Coated Implants: A Review
Authors: Wilson Steven K. , Costerton J. William
Published: September 2011

Introduction

The numbers of inflatable penile prosthesis (IPP) implanted has increased yearly due to the large numbers of patients treated for prostate cancer, patients becoming refractory to the five phosphodiesterase inhibitors and Peyronie’s disease.

Aim

Prosthesis implantation can be associated with a variety of complications with device infection being the most dreaded one.

Main Outcome Measures

An understanding of the pathogenesis of these infections is necessary to allow the surgeon to plan treatment.

Methods

Infection begins with colonization of planktonic bacteria in the implant space. Biofilm forms around the bacterial mass within 48 hours. Bacteria in biofilm have reduced growth rates, may change phenotypically, and develop resistance to drugs. Antibiotics and the body’s macrophages will kill the planktonic bacteria released from the biofilm but never eliminate the infecting organisms. This review will delineate present thinking on infection prevention and biofilm’s role in device infection. IPP infection before and after the coated implants will be characterized. Future ideas for prevention and treatment of infection will be explored.

Results

The coated implants have reduced the incidence of IPP infections. The bacteria that cause the majority of infections in the era of the coated implant seem to have changed from predominantly nosocomial coagulase-negative Staphylococcus to more virulent organisms. Device infection requires new paradigms of prevention and treatment strategy because the infecting bacteria are different and the patients are sicker.

Conclusions

The problem of infection is considerably decreased with coated IPP, yet those infections that do occur are systemic in nature and seem to be caused by more aggressive organisms. These infections are not usually amenable to salvage because the virulence of the bacteria. Future research to prevent these infections must be directed to magnifying the effective dosage of antibiotics to penetrate the biofilm or eliminating the bacteria’s ability to secrete the slime.
Testicular Function After Radiotherapy for Rectal Cancer—A Review
Authors: Buchli Christian , Martling Anna , Arver Stefan , Holm Torbjörn
Published: September 2011

Introduction

Eighty percent of all male rectal cancer patients are sexually active at the time of diagnosis. Because of modern multimodal therapy many can expect long-term survival. The testes can be exposed to scattered or direct radiation during radiotherapy, depending on their position in relation to the targeted volume.

Aim

This review analyzes the current literature providing data on testicular exposure to radiation during radiotherapy for rectal cancer and the consequences on testicular function.

Methods

A systematic search was conducted in PubMed, Embase, and Cochrane. Ten original articles providing data on testicular exposure to radiation and testicular function in men with primary rectal cancer were included for qualitative synthesis.

Main Outcome Measures

Data on testicular exposure to radiation and testosterone levels in men with rectal cancer are reported.

Results

On average, the testes were exposed to 0.24–8.4 Gy during long-course radiotherapy for rectal cancer. Testosterone levels after radiation were significantly lower compared with pretreatment levels or compared with patients treated with surgery alone. After radiotherapy, the absolute risk increase was 0.17–0.30 for posttreatment testosterone levels below 8 nmol/L. In the largest study, the relative risk was 2.7 for testosterone levels below 8 nmol/L for men treated with radiotherapy compared with men treated with surgery alone.

Conclusion

Current data generate three hypotheses: (i) during long-course radiotherapy for rectal cancer, the testes can be exposed to direct and/or scattered radiation; (ii) men treated with radiotherapy seem at risk to develop testicular dysfunction with decreased serum testosterone levels compared with both pretreatment values and men treated with surgery alone; and (iii) a decrease in testosterone levels (<8 nmol/L) may precipitate specific symptoms caused by testosterone deficiency such as impaired physical, psychological, and sexual function after treatment.
The Impact of Systemic Lupus Erythematosus on Women’s Sexual Functioning
Authors: Tseng Jui-Cheng , Lu Ling-Ying , Hu Jui-Chieh , Wang Li-Fong , Yen Ling-Jung , Wu Hsi-Chin , Jiann Bang-Ping
Published: September 2011

Introduction

The effect of systemic lupus erythematosus (SLE) on women’s sexual functioning has been rarely assessed.

Aim

The aim of this study is to evaluate the impact of SLE on women’s sexual functioning.

Methods

A total of 302 consecutive female outpatients with SLE were provided with a questionnaire composed of the Female Sexual Function Index (FSFI), questions for sociodemographic characteristics and comorbidities. Similarly, 2,159 hospital female employees were assessed as the control group. In patients, data of SLE duration and Sjögren’s syndrome were derived from the chart records and the disease activity was assessed using the SLE Disease Activity Index 2000.

Main Outcome Measures

The FSFI scores were compared between the patients and the controls. Correlates of the FSFI scores were determined in the patients.

Results

Of 302 eligible patients, 92.4% (279/302) responded, in addition to 73.2% (1,580/2,159) of controls. Ninety-five percent (255/268) of the respondent patients were in no-to-mild SLE disease activity. Among the respondents, 171 (61.3%) patients and 930 (58.9%) controls were sexually active in the previous month, P = 0.446. Of the sexually active patients, 52.5% (85/162) had impaired sexual function (the FSFI total score < 26.55) and so did 47.1% (408/867) of the sexually active controls, P = 0.206. With adjustment of age group, marital status and education level, patients had lower FSFI scores than controls only in the domains of lubrication and pain. Significant risk factors for lower FSFI scores in the patients included persistent activity or flare of SLE, menstrual cycle disturbances, and vascular disease. With further adjustment of other risk factors, only vascular disease remained significant as a risk factor for impaired sexual function (odds ratio = 5.7; 95% confidence interval 1.6–20.1).

Conclusion

When not in an exacerbation period, the impact of SLE on women’s sexual functioning is not great and is related to vascular factors.
Erectile Function and Sexual Satisfaction Before and After Penile Prosthesis Implantation in Radical Prostatectomy Patients: A Comparison with Patients with Vasculogenic Erectile Dysfunction
Authors: Menard Johann , Tremeaux Jack-Charles , Faix Antoine , Pierrevelcin Jean , Staerman Frédéric
Published: September 2011

Introduction

Patients with erectile dysfunction (ED) after radical prostatectomy (RP) may benefit from penile prosthesis (PP) implantation after failure of less invasive treatments.

Aim

To assess surgical outcomes and satisfaction after PP implantation in RP patients and compare the results with those in patients with vasculogenic ED (controls).

Methods

A database of 415 consecutive PPs (January 1996–December 2008) was used to collate data on preimplantation ED treatments, surgical complications, satisfaction, and International Index of Erectile Function (IIEF) scores before and 3 months after implantation. The results for 90 post-RP implants (79 primary, 11 secondary) and 131 implants for vasculogenic ED were compared.

Main Outcome Measures

The main outcome measures of this study are intra- and postoperative complications and IIEF domain scores.

Results

Mean follow-up of RP patients was 37.6 ± 26.8 months. Mean interval between RP and PP implantation was 31.5 ± 28.7 months. Nearly all primary implants (96.2%) were inflatable (3-piece, 70.1%; 2-piece, 24.1%). There was no significant difference between groups in terms of rates of infection (1.1%), mechanical failure (3.3%), and other surgical complications requiring revision surgery (migration, auto-inflation) (4.4%). For primary implants, the mean preimplantation IIEF score (all items) was significantly lower in RP patients than in controls (14.7 ± 5.9 vs. 22.6 ± 10.8, P = 0.003), chiefly because of significantly lower scores for erectile function, intercourse satisfaction, and orgasmic function. After PP implantation in RP patients, the scores for all domains improved, but the total score remained significantly lower than in controls (63.1 ± 7.0 vs. 68.5 ± 6.9, P = 0.005). The orgasmic function score was significantly lower (P < 0.001). Overall satisfaction rate was 86.1% in RP patients and 90.7% in controls (P = 0.3).

Conclusions

PP implantation after RP is associated with low morbidity and high satisfaction. It improves the scores for all IIEF domains and, in particular, erectile function. Fibrosis of the retropubic space may require a second incision for reservoir placement or implantation of a 2-piece PP.
The International Index of Erectile Function (IIEF-15): Psychometric Properties of the Portuguese Version
Authors: Quinta Gomes Ana Luísa , Nobre Pedro
Published: September 2011

Introduction

The International Index of Erectile Function (IIEF) is a brief, reliable, and multidimensional scale for assessing sexual function in men in both research and clinical trials.

Aim

The objective of the present study was to determine the psychometric properties of the Portuguese version of the IIEF.

Methods

A total of 1,363 Portuguese men participated in this study (a clinical sample of 37 men and a community sample of 1,326 men).

Main Outcome Measures

All participants completed a questionnaire regarding demographic information and the IIEF.

Results

Principal component analysis using varimax rotation indicated a two-factor structure explaining approximately 55% of the total variance (one factor encompassing erection and orgasmic function domains of the original IIEF, and a second factor corresponding to sexual desire, intercourse, and overall satisfaction). The differentiated factor structure with five separate domains of sexual function was not replicated in the Portuguese version. The two-factor model and the original five-factor model of male sexual function were assessed with confirmatory factor analysis (CFA), and overall acceptable fits were demonstrated for both models. However, despite a non-optimal performance, CFA provided a better support for the five-factor solution as the model that best fitted the data. An important lack of discriminant validity evidenced by high intercorrelations among dimensions was detected in both models, suggesting a substantial overlap among factors. Reliability studies showed good internal consistency for the five subscales, and test–retest reliability analysis supported the stability of the measure over time. Discriminant validity confirmed the ability of both subscales to differentiate men with erectile dysfunction from matched controls.

Conclusions

Results suggested that the Portuguese version of the IIEF has adequate psychometric properties, and its use is recommended for clinical and research purposes. Further studies are needed in order to elucidate the association among dimensions of male sexual function and, ultimately, to offer a clearer conceptualization of male’s sexual response.