bluuebunny/crossref_metadata_2025 huggingface dataset:
Health-Related Quality of Life in Adults with Metabolic Syndrome: The Korea National Health and Nutrition Examination Survey, 2007–2008
Authors: Lee Yu-Ji , Woo Sook Young , Ahn Joong Hyun , Cho Seong , Kim Sung Rok
Published: December 2012

Background/Aims: An association between metabolic syndrome and impaired health-related quality of life (HRQoL) is still controversial. We investigated the association between metabolic syndrome in itself and HRQoL in the Korean adult population. Methods: The study is a cross-sectional analysis of 8,941 adults ≥19 years of age who participated in the 2007 and 2008 Korean National Health and Nutrition Examination Survey. EuroQoL five-dimension (EQ-5D), the EQ-5D index and the EQ visual analogue scale (EQ VAS) were used to assess HRQoL. Results: The prevalence of metabolic syndrome was 26.2%. Compared to the participants without metabolic syndrome, those with metabolic syndrome were older and comprised a higher proportion of men. Moreover, participants with metabolic syndrome were more likely to have a lower education level, to be current smokers, to have activity limitation and to have more frequent metabolic abnormalities and comorbidities. Metabolic syndrome was associated with HRQoL based on EQ-5D and EQ VAS in simple regression analysis. However, metabolic syndrome was not significantly associated with HRQoL after adjusting for age, sex, smoking status, income, education level, marital status, obesity, diabetes mellitus, stroke, history of heart disease and chronic kidney disease for EQ-5D, and in addition history of depression for EQ VAS. Conclusion: Metabolic syndrome in itself was not associated with impaired HRQoL after adjusting for confounding variables such as socio-demographic factors, medical comorbidities and obesity.
Adherence Issues in Inherited Metabolic Disorders Treated by Low Natural Protein Diets
Authors: MacDonald A. , van Rijn M. , Feillet F. , Lund A.M. , Bernstein L. , Bosch A.M. , Gizewska M. , van Spronsen F.J.
Published: December 2012

Common inborn errors of metabolism treated by low natural protein diets [amino acid (AA) disorders, organic acidemias and urea cycle disorders] are responsible for a collection of diverse clinical symptoms, each condition presenting at different ages with variable severity. Precursor-free or essential l-AAs are important in all these conditions. Optimal long-term outcome depends on early diagnosis and good metabolic control, but because of the rarity and severity of conditions, randomized controlled trials are scarce. In all of these disorders, it is commonly described that dietary adherence deteriorates from the age of 10 years onwards, at least in part representing the transition of responsibility from the principal caregivers to the patients. However, patients may have particular difficulties in managing the complexity of their treatment because of the impact of the condition on their neuropsychological profile. There are little data about their ability to self-manage their own diet or the success of any formal educational programs that may have been implemented. Trials conducted in non-phenylketonuria (PKU) patients are rare, and the development of specialist l-AAs for non-PKU AA disorders has usually shadowed that of PKU. There remains much work to be done in refining dietary treatments for all conditions and gaining acceptable dietary adherence and concordance, which is crucial for an optimal outcome.
Utilization of Intravenous Thrombolysis in 3–4.5 Hours: Analysis of the Minnesota Stroke Registry
Authors: Tekle Wondwossen G. , Chaudhry Saqib A. , Hassan Ameer E. , Peacock James M. , Lakshminarayan Kamakshi , Tsai Albert , Luepker Russell , Anderson David C. , Qureshi Adnan I.
Published: December 2012

Background: The American Heart Association and the American Stroke Association recommend intravenous (IV) thrombolysis up to 4.5 h from acute ischemic stroke symptom onset based on its proven benefit in improving patient outcomes. We analyzed data from the Minnesota Stroke Registry to assess the rates of IV thrombolytic utilization and the process of care in this expanded window. Methods: We identified patients who had received IV recombinant tissue plasminogen activator (rt-PA) at any of the 19 participating hospitals from January 1, 2008 till December 31, 2010. Treatment groups were those actually treated by IV rt-PA in 0–3 h and those treated by IV rt-PA in 3–4.5 h. Duration from symptom onset to arrival in the emergency department (ED) was dichotomized to cohorts of 0–2 and 2–3.5 h. We determined the overall utilization of IV rt-PA in the expanded window and calculated door-to-needle times for the two treatment windows. We also ascertained the rates of symptomatic intracerebral hemorrhage between the two treatment groups. Results: Out of the total 519 patients who received IV rt-PA for acute ischemic stroke, 433 (83%) were treated within 0–3 h and 86 (17%) within 3–4.5 h. Of all the patients who received IV rt-PA within 3–4.5 h, 45% arrived at the ED within 2 h of symptom onset. Median door-to-needle time for the 0- to 3-hour window was 74.5 min [interquartile range (IQR) 57–90] and 54 min (IQR 43.5–70.5) for the 3- to 4.5-hour window. Based on arrival time to the ED, door-to-needle time of ≤60 min was achieved by only 31% (142/458) of patients who arrived within 0–2 h of their symptom onset compared to 61% (37/61) of those who arrived at the ED within 2–3.5 h of their symptom onset. Fifty-nine (14%) patients in the 0- to 3-hour group and 17 (20%) patients in the 3- to 4.5-hour group received a combination of IV rt-PA and endovascular treatments. Among patients with documented admission National Institutes of Health Stroke Scale scores, the values (median with IQR) were different between the 0- to 3- and the 3- to 4.5-hour group, i.e. 10 (IQR 5–18) and 7 (IQR 4–14), respectively. Conclusion: Patients who received IV rt-PA within the 3- to 4.5-hour window comprised 17% of all IV rt-PA cases treated in the Minnesota Stroke Registry hospitals after the new guidelines recommended a time window expansion. Almost half of these patients would have qualified for treatment within the 0- to 3-hour window as they presented within 0–2 h of symptom onset. Patients arriving 2–3.5 h after symptom onset received thrombolysis on average 20 min faster than patients arriving within 2 h of symptom onset.
Race Adjustment for Estimating Glomerular Filtration Rate Is Not Always Necessary
Authors: Zanocco Juliana A. , Nishida Sonia K. , Tiveron Passos Michelle , Rodrigues Pereira Amélia , Silva Marcelo S. , Pereira Aparecido B. , Mastroianni Kirsztajn Gianna
Published: December 2012

Background: Estimated glomerular filtration rate (eGFR) is very important in clinical practice, although it is not adequately tested in different populations. We aimed at establishing the best eGFR formulas for a Brazilian population with emphasis on the need for race correction. Methods: We evaluated 202 individuals with chronic kidney disease (CKD) and 42 without previously known renal lesions that were additionally screened by urinalysis. Serum creatinine and plasma clearance of iohexol were measured in all cases. GFR was estimated by the Mayo Clinic, abbreviated Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, and creatinine clearance was estimated by the Cockcroft-Gault (CG) formula. Plasma clearance of iohexol was used as the gold standard for GFR determination and for the development of a Brazilian formula (BreGFR). Results: Measured and estimated GFR were compared in 244 individuals, 57% female, with a mean age of 41 years (range 18–82). Estimates of intraclass correlation coefficients among the plasma clearance of iohexol and eGFR formulas were all significant (p < 0.001) and corresponded to the following scores: CG 0.730; obesity-adjusted CG 0.789; Mayo Clinic 0.804; MDRD 0.848; MDRD1 (without race adjustment) 0.846; CKD-EPI 0.869; CKD-EPI1 (without race adjustment) 0.876, and BreGFR 0.844. Conclusions: All cited eGFR formulas showed a good correlation with the plasma clearance of iohexol in the healthy and diseased conditions. The formulas that best detected reduced eGFR were the BreGFR, CKD-EPI, and CKD-EPI1 formulas. Notably, the race correction included in the MDRD and CKD-EPI formulas was not necessary for this population, as it did not contribute to more accurate results.
VACTERL Association Etiology: The Impact of de novo and Rare Copy Number Variations
Authors: Brosens E. , Eussen H. , van Bever Y. , van der Helm R.M. , Ijsselstijn H. , Zaveri H.P. , Wijnen R. , Scott D.A. , Tibboel D. , de Klein A.
Published: December 2012

Copy number variations (CNVs), either DNA gains or losses, have been found at common regions throughout the human genome. Most CNVs neither have a pathogenic significance nor result in disease-related phenotypes but, instead, reflect the normal population variance. However, larger CNVs, which often arise de novo, are frequently associated with human disease. A genetic contribution has long been suspected in VACTERL (Vertebral, Anal, Cardiac, TracheoEsophageal fistula, Renal and Limb anomalies) association. The anomalies observed in this association overlap with several monogenetic conditions associated with mutations in specific genes, e.g. Townes Brocks (SALL1), Feingold syndrome (MYCN) or Fanconi anemia. So far VACTERL association has typically been considered a diagnosis of exclusion. Identifying recurrent or de novo genomic variations in individuals with VACTERL association could make it easier to distinguish VACTERL association from other syndromes and could provide insight into disease mechanisms. Sporadically, de novo CNVs associated with VACTERL are described in literature. In addition to this literature review of genomic variation in published VACTERL association patients, we describe CNVs present in 68 VACTERL association patients collected in our institution. De novo variations (>30 kb) are absent in our VACTERL association cohort. However, we identified recurrent rare CNVs which, although inherited, could point to mechanisms or biological processes contributing to this constellation of developmental defects.
Direct Evidence for Intrarenal Chymase-Dependent Angiotensin II Formation on the Diabetic Renal Microvasculature
Authors: Park Sungmi , Bivona Benjamin J. , Ford Stephen M. , Xu Sen , Kobori Hiroyuki , de Garavilla Lawrence , Harrison-Bernard Lisa M.
Published: December 2012

Our previous work supports a major role for angiotensin-converting enzyme (ACE)-independent intrarenal angiotensin (ANG) II formation on microvascular function in type 2 diabetes mellitus. We tested the hypothesis that there is a switch from renal vascular ACE-dependent to chymase-dependent ANGII formation in diabetes mellitus. The in vitro juxtamedullary afferent arteriole (AA) contractile responses to the intrarenal conversion of the ACE-specific, chymase-resistant ANGI peptide ([Pro
10
]ANGI) to ANGII were significantly reduced in kidneys of diabetic (
db/db
) compared with control (
db/m
) mice. AA responses to the intrarenal conversion of the chymase-specific, ACE-resistant ANGI peptide ([Pro
11
, D-Ala
12
]ANGI) to ANGII were significantly enhanced in kidneys of diabetic compared with control mice. AA diameters were significantly reduced by 9±2, 15±3, and 24±3% of baseline in diabetic kidneys in response to 10, 100, and 1000 nmol/L [Pro
11
, D-Ala
12
]ANGI, respectively, and the responses were significantly attenuated by angiotensin type 1 receptor or chymase-specific (JNJ-18054478) inhibition. [Pro
11
, D-Ala
12
]ANGI did not produce a significant AA vasoconstriction in control kidneys. Chymase inhibition significantly attenuated ANGI-induced AA vasoconstriction in diabetic, but not control kidneys. Renal vascular mouse mast cell protease-4 or chymase/β-actin mRNA expression was significantly augmented by 5.1±1.4 fold; while ACE/β-actin mRNA expression was significantly attenuated by 0.42±0.08 fold in diabetic compared with control tissues. In summary, intrarenal formation of ANGII occurs primarily via ACE in the control, but via chymase in the diabetic vasculature. In conclusion, chymase-dependent mechanisms may contribute to the progression of diabetic kidney disease.
Blood Pressure Parameters and Carotid Intraplaque Hemorrhage as Measured by Magnetic Resonance Imaging
Authors: Selwaness Mariana , van den Bouwhuijsen Quirijn J.A. , Verwoert Germaine C. , Dehghan Abbas , Mattace-Raso Francesco U.S. , Vernooij Meike , Franco Oscar H. , Hofman Albert , van der Lugt Aad , Wentzel Jolanda J. , Witteman Jacqueline C.M.
Published: December 2012

Intraplaque hemorrhage (IPH) is a characteristic of the vulnerable atherosclerotic plaque that has been associated with ischemic stroke. Not much is known about determinants of IPH. We studied whether blood pressure parameters are associated with presence of IPH. Within the framework of a prospective population-based cohort study, The Rotterdam Study, the carotid arteries of 1006 healthy participants ≥45 years and with intima-media thickening (≥2.5 mm) on ultrasound were imaged with a 1.5-T magnetic resonance imaging scanner. IPH was defined as a hyperintense signal on a 3D-T1w-GRE magnetic resonance sequence. Generalized estimation equation analysis, adjusted for age, sex, carotid wall thickness, and cardiovascular risk factors, was used to assess the association between blood pressure parameters and IPH. Magnetic resonance imaging of the carotid arteries revealed presence of IPH in 444 of 1860 plaques (24%). Systolic blood pressure and pulse pressure (PP) were significantly associated with IPH after adjustment for age and sex. In multivariate analysis, PP yielded the strongest association, with an odds ratio per SD increase in PP of 1.22 (95% CI, 1.07–1.40). The odds ratio per SD for systolic blood pressure was 1.13 (0.99–1.28). Only PP remained significant after additional adjustment for other blood pressure components. The combination of smoking and isolated systolic hypertension was associated with 2.5 times increased risk of IPH (1.2–5.2). In conclusion, PP was the strongest determinant of IPH independent of cardiovascular risk factors and other blood pressure components. The association between pulsatile flow and IPH may provide novel insights in the development of the vulnerable plaque.
Prediction and Diagnosis of the Motion and Rapid Intensification of Typhoon Sinlaku during Tropical Cyclone Structure Experiment 2008 (TCS08)
Authors: Leroux Marie-Dominique , Davidson Noel E. , Ma Yimin , Kepert Jeffrey D.
Published: December 2012

The impact of initial structure on storm evolution is examined for the case of a tropical storm entering rapid intensification. At the onset of rapid intensification, satellite cloud signatures suggest that the structural organization of Typhoon Sinlaku (2008) was dominated by a primary band of convection present at outer radii. The development of the eyewall subsequently occurred within this band of deep convection.

Numerical forecasts of Sinlaku are initialized at 15- and 5-km resolution using a broad range of vortex scales, at a time when the storm was still weak and its structure not clearly defined. Evidence is presented that beta propagation played a key role in changing the storm’s motion under weak environmental steering. It is found that the track forecast improves over the period when beta propagation is prominent if the vortex is initialized with a large radius of maximum wind (RMW), corresponding with the primary outer cloud band. The initial vortex structure is also suggested to play a critical role in the pathway to rapid intensification, and in the formation of the eyewall for the defined environmental forcing. With an initially large RMW, the forecast captures the evolution of structure and intensity more skillfully. Eyewall formation inside the primary outer convective band for the weak storm is illustrated and some possible dynamical interpretations are discussed.
Social Margins and Precarious Work In Vietnam
Authors: Arnold Dennis
Published: December 2012

Command economy carryovers and recently implemented labor relation models mark Vietnam’s engagement with global capitalism. Numerous social and economic entitlements are tied to household registration policies, whereas tripartitism is increasingly the mode through which labor and social protections are accessed. Trade unions have a newfound dual function—they must meet the needs of both party and workers. This structural framing shapes workers’ precariousness, marked by insecure work and changing “traditional” social support institutions, particularly the family and community. Insecure work and changing social protections orbit around one another, yet this precariousness is managed through new, worker-initiated support networks.
Killing for Girls
Authors: Bertozzi Elena
Published: December 2012

Predation games—games in which the player is actively encouraged and often required to hunt and kill in order to survive—have historically been the purview of male players. Females, though now much more involved in digital games than before, generally play games that stress traditionally feminine values such as socializing with others, shopping, and nurturing. This article argues that playing games that virtually simulate predation has many benefits for female players. Predation play teaches participants how to survive and succeed in stressful, competitive, aggressive environments. To remain in the game, players have to understand and enjoy the acquisition and negotiation of power, learn to face fear, willingly accept challenges, and accept the inevitability of failure without allowing it to deter future attempts. Through predation play, females can learn to excel in and enjoy high-risk high-reward environments. The author proposes that such play might help address gender disparities outside of play.
Domestic Violence Perpetrator Programs in Europe, Part II
Authors: Akoensi Thomas D. , Koehler Johann A. , Lösel Friedrich , Humphreys David K.
Published: December 2012

In Part II of this article, we present the results of a systematic review of European evidence on the effectiveness of domestic violence perpetrator programs. After searching through 10,446 titles, we discovered only 12 studies that evaluated the effectiveness of a perpetrator program in some systematic manner. The studies applied treatment to a total of 1,586 domestic violence perpetrators, and the sample sizes ranged from 9 to 322. Although the evaluations showed various positive effects after treatment, methodological problems relating to the evaluation designs do not allow attribution of these findings to the programs. Overall, the methodological quality of the evaluations is insufficient to derive firm conclusions and estimate an effect size. Accordingly, one cannot claim that one programmatic approach is superior to another. Evaluation of domestic violence perpetrator treatment in Europe must be improved and programs should become more tailored to the characteristics of the participants.
Social regulation of the gender pay gap in the EU
Authors: Smith Mark
Published: December 2012

There has been more than 30 years of equal pay legislation in the European Union yet the gap between male and female earnings has remained remarkably resilient and is present across all Member States, regardless of national institutional arrangements. The European regulatory landscape has changed to one relying heavily on soft law approaches and with more limited ambitions in the field of gender equality than at the creation of the European Employment Strategy in 1997. In this environment the European Commission has placed greater emphasis on the role of social partners in addressing the gender pay gap. This article critically reviews the role of social partners in addressing these pay inequalities.
The missing link in human security research: Dialogue and insecurity in Kosovo
Authors: Kostovicova Denisa , Martin Mary , Bojicic-Dzelilovic Vesna
Published: December 2012

The concept of human security continues to defy definitional clarity at the same time as it is being embraced by policymakers. This article proposes a practice-grounded approach that focuses on investigative method as a way of linking conceptual understanding of human security to the research process. Probing the ‘actorness’ of individuals in volatile contexts, a study of insecurity in Kosovo shows how dialogue can be applied as a research tool to access and assess human security in the field. Dialogue permits recognition of the power of the researched in the construction of knowledge of security, and accordingly reflects the conceptual shift represented by human security from states to communities and individuals. In the Kosovo study, dialogic research captured individual agency in the face of pervasive insecurity and revealed contradictory effects of such agency. This led to the formulation of the idea of the multidirectional security marker as a means of understanding experiences of insecurity in relation to strategies to combat it. Three such markers – self-reliance, informality and community solidarity – emerged and are analysed in the case of Kosovo. Simultaneously denoting restrictions on people’s security and possibilities for overcoming those very same limitations, the markers express the agential dimension of human security and show how agency and security interact.
Urban Orientation of Rural Consumers: Implication for Consumer Goods Distribution
Authors: Venugopal Pingali
Published: December 2012

Demand for consumer goods in rural markets in the emerging economies is increasing, and these markets are being targeted by multinational companies marketing consumer goods. While all companies are designing distribution strategies to reach the existing rural retail outlets and the periodic markets, a few companies are also developing innovative modes of distribution. Despite the availability of a product in the rural retail formats, some rural consumers were found to make their purchases from a nearby town. This article studied the outshopping behaviour of rural consumers and identified that the decision of what and where to purchase consumer goods could be inferred by identifying their urban orientation. A ‘person–situation’ framework is used to segment the rural market based on the rural consumers’ urban orientation. This framework would help marketers plan their distribution for the rural consumers. The article also suggests a good promotional strategy should support the distribution strategies.
Holistic Rural Marketing
Authors: Jha Mithileshwar
Published: December 2012

Rural Marketing has evolved in India over the years from agricultural marketing with commodity and institutional focus to a more comprehensive three-dimensional perspective of rural to urban, urban to rural and rural to rural focus, in terms of flow of goods, services and ideas. It subsequently adopted a developmental perspective with focus on the poor and vulnerable and development objectives. Marketing as a discipline also evolved over these years from production orientation, product orientation, sales orientation, market orientation, societal marketing orientation to holistic marketing orientation.

This article critically examines the current state of marketing and rural marketing, traces the evolution of rural marketing from agricultural marketing orientation, to rural marketing, and further to developmental orientation and advocates moving to holistic rural marketing orientation. Though normative in approach, it can provide a useful framework for enhancing and enriching rural marketing knowledge and practice.
Effectiveness of Brain-Based Learning and Animated Cartoons for Enhancing Healthy Habits Among School Children in Khon Kaen, Thailand
Authors: Banchonhattakit Pannee , Duangsong Rujira , Muangsom Niramon , Kamsong Theppamon , Phangwan Krittiya
Published: December 2012

The objective of this study was to investigate the effectiveness of brain-based learning (BBL) and animated cartoons on video compact discs (VCDs) in enhancing the healthy habits of school children. A representative sample of 1085 school children in the first through the third grades at 16 schools was selected by multistage random sampling. Knowledge of healthy habits and self-reported adoption of practices were assessed by a questionnaire. BBL and VCD, either combined or as single-intervention techniques, led to improved knowledge and practice of healthy behavior, whereas conventional teaching did not. As a single-intervention technique, BBL on its own led to a greater improvement in healthy practices than VCD, but the addition of BBL to VCD made no difference, and there was no difference between BBL and VCD in terms of improvements in knowledge. In conclusion, both BBL and VCD are effective, but VCD requires fewer resources. Recommendations are made for further research
Children and Youth With Disabilities
Authors: Teachman Gail , Gibson Barbara E.
Published: December 2012

There is a paucity of explicit literature outlining methods for single-interview studies with children, and almost none have focused on engaging children with disabilities. Drawing from a pilot study, we address these gaps by describing innovative techniques, strategies, and methods for engaging children and youth with disabilities in a single qualitative interview. In the study, we explored the beliefs, assumptions, and experiences of children and youth with cerebral palsy and their parents regarding the importance of walking. We describe three key aspects of our child-interview methodological approach: collaboration with parents, a toolkit of customizable interview techniques, and strategies to consider the power differential inherent in child–researcher interactions. Examples from our research illustrate what worked well and what was less successful. Researchers can optimize single interviews with children with disabilities by collaborating with family members and by preparing a toolkit of customizable interview techniques.
Adolescents with a diagnosis of anorexia nervosa: Parents’ experience of recognition and deciding to seek help
Authors: Thomson Samuel , Marriott Michael , Telford Katherine , Law Hou , McLaughlin Jo , Sayal Kapil
Published: December 2012

Background:

Adolescents with anorexia nervosa rarely present themselves as having a problem and are usually reliant on parents to recognise the problem and facilitate help-seeking. This study aimed to investigate parents’ experiences of recognising that their child had an eating problem and deciding to seek help.

Methods:

A qualitative study with interpretative phenomenological analysis applied to semi-structured interviews with eight parents of adolescents with a diagnosis of anorexia nervosa.

Results:

Parents commonly attributed early signs of anorexia nervosa to normal adolescent development and they expected weight loss to be short-lived. As parents’ suspicions grew, close monitoring exposing their child’s secretive attempts to lose weight and the use of internet searches aided parental recognition of the problem. They avoided using the term anorexia as it made the problem seem ‘real’. Following serial unsuccessful attempts to effect change, parental fear for their child’s life triggered a desire for professional help.

Conclusions:

Parents require early advice and support to confirm their suspicions that their child might have anorexia nervosa. Since parents commonly approach the internet for guidance, improving awareness of useful and accurate websites could reduce delays in help-seeking.
Perceptions of intragroup conflict: The effect of coping strategies on conflict transformation and escalation
Authors: Pluut Helen , Curşeu Petru Lucian
Published: December 2012

In this longitudinal study, we contribute to the contingency models of intragroup conflict by examining the moderating role of coping strategies in the evolution of conflict over time. We conceptualize coping strategy as a configural group property and focus on whether task conflict evolves into relationship conflict (conflict transformation) and on whether relationship conflict perpetuates over time (conflict escalation). We use a multilevel model to test the way in which individual conflict perceptions interact with other members’ coping strategies to influence the level of intragroup conflict at later stages. The results indicate that (a) the interaction between task conflict and problem-focused coping decreases the chances that task conflict transforms into relationships conflict and (b) the interaction between relationship conflict and emotion-focused coping decreases and the interaction between relationship conflict and problem-focused coping increases the chances that relationship conflict escalates over time.
Gender inequity needs to be regarded as a social determinant of depressive symptoms: Results from the Northern Swedish cohort
Authors: Hammarström Anne , Phillips Susan P.
Published: December 2012

Background: The importance of social and avoidable determinants of depressive symptoms has been increasingly recognized in public health research. However, when it comes to determinant of gender differences in depressive symptoms the focus is predominantly on biological unavoidable determinants. Thus, there is a need for more focus on gendered social determinants of health. The aim of this study was to analyse the importance of gender relations for depressive symptoms after taking socioeconomic factors and earlier depressive symptoms into account in the Northern Swedish cohort. Methods: A 26-year follow-up study of a cohort of all school leavers in a middle-sized industrial town in Northern Sweden was performed from age 16 until age 42. Of those still alive of the original cohort, 94% participated during the whole period and answered extensive questionnaires. Exposure was measured as socioeconomic status, financial strain, perceived gender inequity in the couple relationship and division of responsibility for domestic work. The outcome was depressive symptoms at age 42, while depressive symptoms were controlled at age 30. Results: In multivariate logistic regression analyses significant relations between financial strain and, among women only, also perceived gender equity in the couple relationship and depressive symptoms after adjustment for earlier health status, as well as for all other exposure measures. Conclusions: Financial strain, and among women, also gender inequity in the couple relationship was related to depressive mood. There is a need to pay more attention to gender relations in future research on social determinants of depressive mood.
Absence from work due to occupational and non-occupational accidents
Authors: Jørgensen Kirsten , Laursen Bjarne
Published: December 2012

Aims: The aim of the present study was to investigate absence from work in Denmark due to occupational and non-occupational accidents. Background: Since the beginning of the last decade, political focus has been placed on the population’s working capacity and the scope of absence due to illness. Absence from work is estimated at between 3% and 6% of working hours in the EU and costs are estimated at approximately 2.5% of GNP. Methods: Victims of accidents treated at two emergency departments were interviewed regarding absence for the injured, the family and others. All answers were linked to the hospital information on the injury, so that it was possible to examine the relation between absence and injury type, and cause of the accident. Results: In total, 1,479 injured persons were interviewed. 36% of these reported absence from work by themselves or others. In mean, an injury caused 3.21 days of absence. Based on this the total absence due to injuries in Denmark was estimated to 1,822,000 workdays, corresponding to approximately 6% of the total absence from work due to all types of illness. Non-occupational injuries resulted in more absence than did occupational injuries. Conclusions: Absence due to accidents contributed to a considerable part of the total absence from work, and non-occupational accidents caused more absence than did occupational accidents.
Adaptive Mixed Reality Rehabilitation Improves Quality of Reaching Movements More Than Traditional Reaching Therapy Following Stroke
Authors: Duff Margaret , Chen Yinpeng , Cheng Long , Liu Sheng-Min , Blake Paul , Wolf Steven L. , Rikakis Thanassis
Published: December 2012

Background. Adaptive mixed reality rehabilitation (AMRR) is a novel integration of motion capture technology and high-level media computing that provides precise kinematic measurements and engaging multimodal feedback for self-assessment during a therapeutic task. Objective. We describe the first proof-of-concept study to compare outcomes of AMRR and traditional upper-extremity physical therapy. Methods. Two groups of participants with chronic stroke received either a month of AMRR therapy (n = 11) or matched dosing of traditional repetitive task therapy (n = 10). Participants were right handed, between 35 and 85 years old, and could independently reach to and at least partially grasp an object in front of them. Upper-extremity clinical scale scores and kinematic performances were measured before and after treatment. Results. Both groups showed increased function after therapy, demonstrated by statistically significant improvements in Wolf Motor Function Test and upper-extremity Fugl-Meyer Assessment (FMA) scores, with the traditional therapy group improving significantly more on the FMA. However, only participants who received AMRR therapy showed a consistent improvement in kinematic measurements, both for the trained task of reaching to grasp a cone and the untrained task of reaching to push a lighted button. Conclusions. AMRR may be useful in improving both functionality and the kinematics of reaching. Further study is needed to determine if AMRR therapy induces long-term changes in movement quality that foster better functional recovery.
Researching sensitive and emotive topics: The participants’ voice
Authors: Crowther Jacqueline L. , Lloyd-Williams Mari
Published: December 2012

There are different groups in society who may be considered vulnerable, for example those experiencing mental or physical health issues, learning disabilities, prisoners or children. There are, however, other groups in society who may also be regarded as vulnerable, such as those who are bereaved. Vulnerability in relation to the bereaved occurs as a result of experiencing a normal life event, death or a loss. In this situation vulnerability may be transient and, depending upon the management of the bereavement, generally temporary. Unlike the aforementioned groups, participants required for this type of research (bereavement, death and dying) are able to consent themselves into projects, and the capacity to do so is not an issue. Undertaking research with those who may be considered vulnerable into sensitive, emotive topics such as death and dying can create difficulties for the National Research Ethics Service (NRES), making it difficult to get approval for such studies. It appears that the ethical issues are concerned with not wishing to cause distress to participants when asked for research purposes to recollect what for some may have been emotionally challenging and traumatic events. The article offers a narrative, reflective account of the above from several perspectives: being employed as a contract researcher in a university; having experience of being an active member of a National Health Service Research Ethics Committee; and later assuming the role of full-time postgraduate (PhD) student requiring ethical approval to undertake research with what may be considered a vulnerable group involving a sensitive and emotive topic. Valuable insights from participants – their views on participation in an emotive research project and good practice in research having been explored via questionnaire – are highlighted and discussed.
A Clash of Cultures
Authors: Clark Andrew M. , Christie Thomas B.
Published: December 2012

This study examines U.S. international broadcasting efforts through the Office of War Information and Voice of America to provide a philosophy and foundation for the use of Alhurra Television. This station was launched during the Iraq war to reach audiences and influence public policy in the Middle East. This study found high percentages of Alhurra viewing classification using the discriminant function, suggesting that the combination of key cultural indicator variables is a sound predictor of viewing this news source. Thus, this study validates the premise of U.S. policy as it confirms the challenges faced by international broadcasting 70 years ago and today—the role key cultural indicators play when these viewers decide to turn to or away from Alhurra for news and other information. Demographic, media usage, and attitudinal variables were used to test a model developed to understand cultural differences for prediction of Alhurra viewing or nonviewing.
Recent trends in regional integration and the Indian experience
Authors: Haokip Thongkholal
Published: December 2012

The post-Cold War period witnessed a spurt in regional integration and regional trading arrangements. India’s attempt at regional integration with Afro-Asian countries during the early years of independence had been without much success. The economic reforms in 1991 and the resultant liberalization and opening of the economy, and the reshaping of its foreign policy have thrown open the floodgate of its Asianism. This article discusses the trend towards regional integration with the end of Cold War and argues that the Look East policy is the byproduct of India’s attempt at regional economic integration with East and Southeast Asian countries. The policy is also used by India as one of the means for solving multiple predicaments in its Northeastern region.
Phosphatase Wip1 negatively regulates neutrophil development through p38 MAPK-STAT1
Authors: Liu Guangwei , Hu Xuelian , Sun Bo , Yang Tao , Shi Jianfeng , Zhang Lianfeng , Zhao Yong
Published: December 2012

Neutrophils are critically involved in host defense and tissue damage. Intrinsic molecular mechanisms controlling neutrophil differentiation and activities are poorly defined. Herein we found that p53-induced phosphatase 1(Wip1) is preferentially expressed in neutrophils among immune cells. The Wip1 expression is gradually up-regulated during the differentiation of myeloid precursors into mature neutrophils. Wip1-deficient mice and chimera mice with Wip1−/− hematopoietic cells had an expanded pool of neutrophils with hypermature phenotypes in the periphery. The in vivo and in vitro studies showed that Wip1 deficiency mainly impaired the developing process of myeloid progenitors to neutrophils in an intrinsic manner. Mechanism studies showed that the enhanced development and maturation of neutrophils caused by Wip1 deficiency were mediated by p38 MAPK-STAT1 but not p53-dependent pathways. Thus, our findings identify a previously unrecognized p53-independent function of Wip1 as a cell type-specific negative regulator of neutrophil generation and homeostasis through limiting the p38 MAPK-STAT1 pathway.
Teacher led school-based surveillance can allow accurate tracking of emerging infectious diseases - evidence from serial cross-sectional surveys of febrile respiratory illness during the H1N1 2009 influenza pandemic in Singapore
Authors: Soh Shu E , Cook Alex R , Chen Mark IC , Lee Vernon J , Cutter Jeffery L , Chow Vincent TK , Tee Nancy WS , Lin Raymond TP , Lim Wei-Yen , Barr Ian G , Lin Cui , Phoon Meng Chee , Ang Li Wei , Sethi Sunil K , Chong Chia Yin , Goh Lee Gan , Goh Denise LM , Tambyah Paul A , Thoon Koh Cheng , Leo Yee Sin , Saw Seang Mei
Published: December 2012

Background

Schools are important foci of influenza transmission and potential targets for surveillance and interventions. We compared several school-based influenza monitoring systems with clinic-based influenza-like illness (ILI) surveillance, and assessed the variation in illness rates between and within schools.

Methods

During the initial wave of pandemic H1N1 (pdmH1N1) infections from June to Sept 2009 in Singapore, we collected data on nation-wide laboratory confirmed cases (Sch-LCC) and daily temperature monitoring (Sch-DTM), and teacher-led febrile respiratory illness reporting in 6 sentinel schools (Sch-FRI). Comparisons were made against age-stratified clinic-based influenza-like illness (ILI) data from 23 primary care clinics (GP-ILI) and proportions of ILI testing positive for pdmH1N1 (Lab-ILI) by computing the fraction of cumulative incidence occurring by epidemiological week 30 (when GP-ILI incidence peaked); and cumulative incidence rates between school-based indicators and sero-epidemiological pdmH1N1 incidence (estimated from changes in prevalence of A/California/7/2009 H1N1 hemagglutination inhibition titers ≥ 40 between pre-epidemic and post-epidemic sera). Variation in Sch-FRI rates in the 6 schools was also investigated through a Bayesian hierarchical model.

Results

By week 30, for primary and secondary school children respectively, 63% and 79% of incidence for Sch-LCC had occurred, compared with 50% and 52% for GP-ILI data, and 48% and 53% for Sch-FRI. There were 1,187 notified cases and 7,588 episodes in the Sch-LCC and Sch-DTM systems; given school enrollment of 485,723 children, this represented 0.24 cases and 1.6 episodes per 100 children respectively. Mean Sch-FRI rate was 28.8 per 100 children (95% CI: 27.7 to 29.9) in the 6 schools. We estimate from serology that 41.8% (95% CI: 30.2% to 55.9%) of primary and 43.2% (95% CI: 28.2% to 60.8%) of secondary school-aged children were infected. Sch-FRI rates were similar across the 6 schools (23 to 34 episodes per 100 children), but there was widespread variation by classrooms; in the hierarchical model, omitting age and school effects was inconsequential but neglecting classroom level effects led to highly significant reductions in goodness of fit.

Conclusions

Epidemic curves from Sch-FRI were comparable to GP-ILI data, and Sch-FRI detected substantially more infections than Sch-LCC and Sch-DTM. Variability in classroom attack rates suggests localized class-room transmission.
A whole blood gene expression-based signature for smoking status
Authors: Beineke Philip , Fitch Karen , Tao Heng , Elashoff Michael R , Rosenberg Steven , Kraus William E , Wingrove James A ,   PREDICT Investigators
Published: December 2012

Background

Smoking is the leading cause of preventable death worldwide and has been shown to increase the risk of multiple diseases including coronary artery disease (CAD). We sought to identify genes whose levels of expression in whole blood correlate with self-reported smoking status.

Methods

Microarrays were used to identify gene expression changes in whole blood which correlated with self-reported smoking status; a set of significant genes from the microarray analysis were validated by qRT-PCR in an independent set of subjects. Stepwise forward logistic regression was performed using the qRT-PCR data to create a predictive model whose performance was validated in an independent set of subjects and compared to cotinine, a nicotine metabolite.

Results

Microarray analysis of whole blood RNA from 209 PREDICT subjects (41 current smokers, 4 quit ≤ 2 months, 64 quit > 2 months, 100 never smoked; NCT00500617) identified 4214 genes significantly correlated with self-reported smoking status. qRT-PCR was performed on 1,071 PREDICT subjects across 256 microarray genes significantly correlated with smoking or CAD. A five gene (CLDND1, LRRN3, MUC1, GOPC, LEF1) predictive model, derived from the qRT-PCR data using stepwise forward logistic regression, had a cross-validated mean AUC of 0.93 (sensitivity=0.78; specificity=0.95), and was validated using 180 independent PREDICT subjects (AUC=0.82, CI 0.69-0.94; sensitivity=0.63; specificity=0.94). Plasma from the 180 validation subjects was used to assess levels of cotinine; a model using a threshold of 10 ng/ml cotinine resulted in an AUC of 0.89 (CI 0.81-0.97; sensitivity=0.81; specificity=0.97; kappa with expression model = 0.53).

Conclusion

We have constructed and validated a whole blood gene expression score for the evaluation of smoking status, demonstrating that clinical and environmental factors contributing to cardiovascular disease risk can be assessed by gene expression.
Evaluation of the positive predictive value of a rapid Immunochromatographic test to detect Campylobacter in stools
Authors: Floch Pauline , Goret Julien , Bessède Emilie , Lehours Philippe , Mégraud Francis
Published: December 2012

The recently developed rapid immunochromatographic tests (ICT) have the potential to provide a quick and easy diagnosis of Campylobacter enteritis in comparison to culture. In a previous study we found them sensitive but lacking in specificity. The aim of the present study was to focus on the problem of specificity and determine the positive predictive value (PPV) of a positive result of the ImmunoCard Stat! Campy (Meridian Bioscience, Cincinnati, OH, USA). For this purpose, the stools positive by ICT were cultured according to 3 different protocols: Karmali agar, Preston enrichment broth subcultured on Karmali agar, and a filtration method on a blood agar without antibiotics, all incubated for 7 days at 37°C. Out of 609 stools from adults and children with community acquired enteritis, the reference methods detected 25 positive cases (4.1%) (culture: 19, specific PCR and ELISA both positive: 6) and the ICT: 31 including the 25 true positives. The PPV was 80.6%. We conclude that ICT is a good method to screen Campylobacter positive stools but because of its lack of specificity the positive stools must be tested by another method.
A European Organisation for Research and Treatment of Cancer Phase III Trial of Adjuvant Whole-Brain Radiotherapy Versus Observation in Patients With One to Three Brain Metastases From Solid Tumors After Surgical Resection or Radiosurgery: Quality-of-Life Results
Authors: Soffietti Riccardo , Kocher Martin , Abacioglu Ufuk M. , Villa Salvador , Fauchon François , Baumert Brigitta G. , Fariselli Laura , Tzuk-Shina Tzahala , Kortmann Rolf-Dieter , Carrie Christian , Ben Hassel Mohamed , Kouri Mauri , Valeinis Egils , van den Berge Dirk , Mueller Rolf-Peter , Tridello Gloria , Collette Laurence , Bottomley Andrew
Published: December 2012

Purpose

This phase III trial compared adjuvant whole-brain radiotherapy (WBRT) with observation after either surgery or radiosurgery of a limited number of brain metastases in patients with stable solid tumors. Here, we report the health-related quality-of-life (HRQOL) results.

Patients and Methods

HRQOL was a secondary end point in the trial. HRQOL was assessed at baseline, at 8 weeks, and then every 3 months for 3 years with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 and Brain Cancer Module. The following six primary HRQOL scales were considered: global health status; physical, cognitive, role, and emotional functioning; and fatigue. Statistical significance required P ≤ .05, and clinical relevance required a ≥ 10-point difference.

Results

Compliance was 88.3% at baseline and dropped to 45.0% at 1 year; thus, only the first year was analyzed. Overall, patients in the observation only arm reported better HRQOL scores than did patients who received WBRT. The differences were statistically significant and clinically relevant mostly during the early follow-up period (for global health status at 9 months, physical functioning at 8 weeks, cognitive functioning at 12 months, and fatigue at 8 weeks). Exploratory analysis of all other HRQOL scales suggested worse scores for the WBRT group, but none was clinically relevant.

Conclusion

This study shows that adjuvant WBRT after surgery or radiosurgery of a limited number of brain metastases from solid tumors may negatively impact some aspects of HRQOL, even if these effects are transitory. Consequently, observation with close monitoring with magnetic resonance imaging (as done in the EORTC trial) is not detrimental for HRQOL.