bluuebunny/crossref_metadata_2025 huggingface dataset:
Low prevalence of Pneumocystis pneumonia in hospitalized patients with systemic lupus erythematosus: review of a clinical data warehouse
Authors: Kapoor T M , Mahadeshwar P , Nguyen S , Li J , Kapoor S , Bathon J , Giles J , Askanase A
Published: April 2017

Objective

In the era of powerful immunosuppression, opportunistic infections are an increasing concern in systemic lupus erythematosus. One of the best-studied opportunistic infections is Pneumocystis pneumonia; however, the prevalence of Pneumocystis pneumonia in systemic lupus erythematosus is not clearly defined. This study evaluates the prevalence of Pneumocystis pneumonia in hospitalized systemic lupus erythematosus patients, with a focus on validating the Pneumocystis pneumonia and systemic lupus erythematosus diagnoses with clinical information.

Methods

This retrospective cohort study evaluates the prevalence of Pneumocystis pneumonia in all systemic lupus erythematosus patients treated at Columbia University Medical Center-New York Presbyterian Hospital between January 2000 and September 2014, using electronic medical record data. Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and patients with renal transplants (including both early and late post-transplant patients) represented immunocompromised control groups. Patients with systemic lupus erythematosus, Pneumocystis pneumonia, HIV/AIDS, or renal transplant were identified using diagnostic codes from the International Classification of Diseases, Ninth Revision (ICD-9).

Results

Out of 2013 hospitalized systemic lupus erythematosus patients, nine had presumed Pneumocystis pneumonia, yielding a low prevalence of Pneumocystis pneumonia in systemic lupus erythematosus of 0.45%. Three of the nine Pneumocystis pneumonia cases were patients with concomitant systemic lupus erythematosus and HIV/AIDS. Only one of these nine cases was histologically confirmed as Pneumocystis pneumonia, in a patient with concomitant systemic lupus erythematosus and HIV/AIDS and a CD4 count of 13 cells/mm3. The prevalence of Pneumocystis pneumonia in renal transplant patients and HIV/AIDS patients was 0.61% and 5.98%, respectively.

Conclusion

Given the reported high rate of adverse effects to trimethoprim-sulfamethoxazole in systemic lupus erythematosus and the low prevalence of Pneumocystis pneumonia in hospitalized systemic lupus erythematosus patients, our data do not substantiate the need for Pneumocystis pneumonia prophylaxis in systemic lupus erythematosus patients, except in those with concurrent HIV/AIDS.
‘I Didn’t Raise My Boy to Be a Soldier’: Popular Song and American Neutrality, 1914–1917
Authors: Monod David
Published: April 2017

What can popular song tell us about American attitudes to the First World War? One of the hit songs of 1915, Al Piantadosi and Alfred Bryan’s ‘I Didn’t Raise My Boy to Be a Soldier’, appears to support the idea that the American public was in a pacifist mood prior to 1917. But the success of the song provides misleading evidence of public sentiments. Far from opposing war, the entertainment business between 1914 and 1917 can be said to have prepared the way for US intervention by promoting a militarized form of patriotism, by linking soldiering to manliness, and by offering aural and visual imagery favourable to the Allies.
Effect of Honesty as an Ethical Value on Software Project Performance: A Grounded Theory Approach
Authors: Padhi Shradha , Mishra Sumita
Published: April 2017

For successful project outcomes to organizations and clients alike, project managers (PMs) need to make ethical decisions and yet balance the interests of all stakeholders involved. Hence, honest communication among project stakeholders is essential as a countermeasure to this paradox. Honesty is one of the core ethical values propagated by the Project Management Institute (PMI), USA. Our study aimed to gain an endogenous perspective on honesty vis-à-vis its reification by PMI in its effect on software project performance. Empirical data were collected through in-depth interviews from 83 Indian PMs in one of the prominent Indian software consulting organizations. Grounded theory was utilized to analyze the data obtained. Our results validate the importance of honesty on software project performance, the need for trust among stakeholders in maintaining honesty, importance of Indian culture in understanding honesty and ensuing ethical challenges faced by PMs. Our results bear implications to extant research on honesty in projects with specific reference to the Indian software context. They are important for PMI professionals as they provide a culture-specific perspective to honesty and the scope for ideation on how to inculcate and sustain honesty in project management in India.
Information accuracy in legislative oversight: Theoretical implications and experimental evidence
Authors: Shikano Susumu , Stoffel Michael F , Tepe Markus
Published: April 2017

The relationship between legislatures and bureaucracies is typically modeled as a principal–agent game. Legislators can acquire information about the (non-)compliance of bureaucrats at some specific cost. Previous studies consider the information from oversight to be perfect, which contradicts most real-world applications. We therefore provide a model that includes random noise as part of the information. The quality of provided goods usually increases with information accuracy while simultaneously requiring less oversight. However, bureaucrats never provide high quality if information accuracy is below a specific threshold. We assess the empirical validity of our predictions in a lab experiment. Our data show that information accuracy is indeed an important determinant of both legislator and bureaucrat decision-making.
Terrorism as Self-Help: Accounts of Palestinian Youth Incarcerated in Israeli Prisons for Security Violations
Authors: Berko Anat , Erez Edna , Gur Oren M.
Published: April 2017

Adopting and expanding Black’s conception of terrorism as self-help, this study examines how Palestinian youth become involved in security violations. Based on an analysis of in-depth interviews conducted with 10 Palestinian youth incarcerated in Israeli prisons, their experiences are described, including the aftermath of arrest and imprisonment. Their accounts are complemented by interviews with six wardens and correctional officers overseeing the prison’s youth wings, a review of military court transcripts from proceedings leading up to the youth’s incarceration, and observations of participants’ daily prison routines. The data detail pathways and recruitment processes, motivations, rewarding aspects of participation, and the costs incurred as a result by participants and their families. Security violations are analyzed as self-help responses to collective grievances and personal problems. The theoretical and policy implications of the findings are discussed.
Acute Tears of the Tibialis Posterior Tendon Following Ankle Sprain
Authors: Jackson Lyle T. , Dunaway Linda J. , Lundeen Gregory A.
Published: April 2017

Background:

Traumatic tears of the tibialis posterior (TP) tendon following an ankle sprain are rare. The purpose of this study was to report our case series of TP tendon tears following an ankle sprain.

Methods:

Patients with persistent TP tendon pain after an ankle sprain were retrospectively identified over a 4-year period and reviewed. A comparison of magnetic resonance imaging (MRI) interpretations by a radiologist and surgeon was made. Patients failing conservative management underwent operative repair of the TP tendon tear and concomitant pathology. Failure of the index surgery was defined as TP tendinosis, which was treated with excision and flexor digitorum longus tendon transfer. Outcomes were measured with the Foot Function Index (FFI) and American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scores.

Results:

Thirteen patients were found to have a TP tendon tear following an ankle sprain. The incidence for TP tears with sprains presented to our clinic was 1.04%. MRI identified TP tendon pathology in 4 patients by a radiologist review and in 11 patients by a surgeon review. The most common concomitant pathology was a talar osteochondral defect in 13 of 13 patients and ligament instability in 12 of 13 patients (5/13 lateral, 3/13 medial, 4/13 multidirectional instability). Four of 13 patients failed the index surgery. Of the 9 remaining patients, 4 had clinical follow-up at an average of 4.6 years postoperatively. The average FFI subscale scores were the following: pain, 40.4; disability, 28.9; and activity, 23.6. The average AOFAS hindfoot score was 68.8.

Conclusion:

Despite being rare, a TP tendon tear should be included in the differential diagnosis for persistent medial-sided pain following an ankle sprain. MRI findings can be subtle. Associated pathology was very common and likely confounded the diagnosis and outcomes. Patients should be counseled on the possibility of poor outcomes and long-term pain.

Level of Evidence:

Level IV, case series.
Value of Tourniquet Use in Anterior Ankle Arthroscopy: A Randomized Controlled Trial
Authors: Dimnjaković Damjan , Hrabač Pero , Bojanić Ivan
Published: April 2017

Background:

A tourniquet is usually used during anterior ankle arthroscopy to allow for improved visibility and reduced operation time. However, this has not been demonstrated to be true in clinical studies on knee arthroscopy, while limited tourniquet time has been described as a possible factor to lower the complication rate of ankle arthroscopy. The purpose of this randomized controlled trial was to examine the effect of tourniquet use on arthroscopic visualization, operative time, postoperative intra-articular bleeding, postoperative pain scores, and outcome of anterior ankle arthroscopy.

Methods:

A consecutive series of 50 patients who were scheduled for anterior ankle arthroscopy were randomized to have the surgery done either without the tourniquet inflated (25 patients) or with the tourniquet inflated (25 patients). The patients were evaluated by the course of the surgery, postoperative intra-articular bleeding, and pain during the early postoperative period, and subjective and objective functional scores were used to evaluate the condition of the ankle before and 3 and 6 months after the surgery. Forty-nine patients were present at the final follow-up, 6 months after the surgery.

Results:

The results between the groups were comparable regarding the duration of the operative procedure, consumption of sterile saline, visualization, and functional scores. A notable difference between the groups in favor of the nontourniquet group was present regarding postoperative bleeding but was not statistically significant. A statistically significant difference in favor of the nontourniquet group was found regarding postoperative pain during several days in the early postoperative period.

Conclusion:

Our study showed that anterior ankle arthroscopy was performed adequately without the use of a tourniquet and that it had the same operative course as cases in which the tourniquet was used and functional outcomes that were not worse than cases in which the tourniquet was used.

Level of Evidence:

Level I, prospective randomized controlled trial
Parametric resonances for torsional vibration of excited rotating machineries with nonconstant velocity joints
Authors: SoltanRezaee Masoud , Ghazavi Mohammad-Reza , Najafi Asghar
Published: April 2017

The shaft system is a rotating machinery with many applications due to its high speed. The angle between shafts may not be zero. So the shafts can be connected to each other through a nonconstant velocity U-joint, which transforms a constant input angular velocity into a periodically fluctuating velocity. Consequently, the mechanism is parametrically excited and may face resonance conditions. Herein, a power transmission system including three elastic shafts is considered. The polar inertia moment of each shaft is modeled as a dynamic system with two discrete disks at the shaft ends. The equations of motion consist of a set of Mathieu–Hill differential equations with periodic coefficients. The dynamic stability and torsional vibration of the shaft system are analyzed. The system geometry and inertia moment effect are the main issues in this contribution. Parametric instability charts are achieved via the monodromy matrix technique. The graphical numerical results are validated with the frequency analytical results. Finally, the stability regions are shown in the parameter spaces of velocity, misalignment angles and the inertia of disks. The results demonstrated that by changing the system inertia and geometry, stabilizing the whole system is possible. Moreover, to check the precision of the model, the results are compared with a basic single-disk model, which is prevalent in two-shaft systems.
An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness
Authors: Baker Jeannemarie , Travers Jasmine L. , Buschman Penelope , Merrill Jacqueline A.
Published: April 2017

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.
Effects of cellulose fiber with different fiber length on rheological properties of wheat dough and quality of baked rolls
Authors: Lauková Michaela , Kohajdová Zlatica , Karovičová Jolana , Kuchtová Veronika , Minarovičová Lucia , Tomášiková Lenka
Published: April 2017

Powdered cellulose is often used in cereal processing industry. The effects of partial replacement (0.5%, 1%, 2% and 5%) of wheat flour by cellulose fiber with different fiber length (80, 120 and 220 µm) on rheological properties of wheat dough and qualitative parameters of baked rolls were studied. Sensory evaluation of baked products was also performed. Mixing and pasting properties of dough were determined by Mixolab. Generally, cellulose-enriched dough was characterized with higher water absorption, dough stability and parameters C2 and C3. Moreover, it was found that parameters C4 and C5 increased with increasing cellulose fiber length. From the results, it was also concluded that the physical parameters of baked rolls containing cellulose were reduced. It was also observed that the incorporation of cellulose fiber with shorter fiber length concluded in lower rolls volume compared to cellulose fiber with long fiber length. Texture analyses showed that the firmness of rolls containing cellulose at the substitution level 5% was significantly higher than those of the control, whereas the springiness of wheat rolls was not significantly affected. It was also recorded that the firmness and cohesiveness of baked rolls were higher after the addition of cellulose fiber with shorter fiber length. Sensory evaluation indicated that baked rolls with cellulose addition up to 1% were comparable with control rolls. Results also showed that higher levels of cellulose significantly decreased crust, taste, color and porosity of rolls.
The Impact of Work/Family Conflict and Workplace Social Support on Mental Distress in Home Health Workers
Authors: Lee Ahyoung , Jang Yuri
Published: April 2017

The study explored the role of work/family conflict and workplace social support in predicting home health workers’ mental distress using a sample of home health workers in Central Texas ( n = 150). The result of multivariate analysis showed that work/family conflict increased mental distress, while client support and organizational support decreased mental distress. In addition to the direct effects, client support was found to buffer the negative impact of work/family conflict. Findings call attention to the ways to reduce work/family conflict and increase workplace social support in efforts to promote home health workers’ mental well-being.
Associations of Maternal Testosterone and Cortisol Levels With Health Outcomes of Mothers and Their Very-Low-Birthweight Infants
Authors: Cho June , Su Xiaogang , Holditch-Davis Diane
Published: April 2017

Objective:

Although the roles of testosterone and cortisol in various health problems have been extensively investigated, little is known about their associations with health outcomes in mothers and their very-low-birthweight (VLBW) infants when maternal testosterone and cortisol are examined together during the postpartum period.

Method:

The 101 mother–VLBW infant pairs were recruited from the neonatal intensive care unit of a tertiary medical center in the southeastern United States. Demographic information, pregnancy and labor complications of mothers, and health and growth outcomes of infants were obtained from medical records and interviews with mothers. Maternal salivary testosterone and cortisol levels were determined using enzyme immunoassay.

Results:

Linear regression showed that mothers who were older and had a larger body mass index experienced more pregnancy complications, whereas mothers who were single and had a cesarean section experienced more labor complications. Generalized linear models showed that mothers with high cortisol levels had more antepartum hemorrhage, whereas infants of mothers with high cortisol levels had fewer neurological insults and shorter hospitalizations than other infants. More mothers experienced premature prolonged rupture of membranes (PPROM) than chorioamnionitis, and maternal medical complications were negatively associated with infant health outcomes except PPROM, which was positively associated with infant outcomes.

Conclusions:

High maternal cortisol levels were associated with maternal health problems during pregnancy. Beneficial effects of PPROM and high maternal cortisol levels on infant health outcomes were important findings, and understanding the mechanisms of these relationships may be of practical value for clinicians and researchers.
Integrative Analysis of MicroRNA-Mediated Gene Signatures and Pathways Modulating White Blood Cell Count in Childhood Acute Lymphoblastic Leukemia
Authors: Ramani Ritika , Megason Gail , Schallheim Jason , Karlson Cynthia , Vijayakumar Vani , Vijayakumar Srinivasan , Hicks Chindo
Published: April 2017

MicroRNAs (miRNAs) regulate the expression of protein-coding genes and represent potential biomarkers for childhood acute lymphoblastic leukemia (ALL). However, information linking miRNAs with their messenger RNA (mRNA) target genes modulating white blood cell (WBC) count is lacking. Here, we analyzed miRNAs and gene expression data from pediatric patients with ALL to identify a signature of miRNAs involved in ALL and their mRNA target genes, molecular networks, and biological pathways modulating WBC. We discovered a signature of miRNAs differentially expressed in ALL and a signature of mRNA target genes distinguishing patients with high WBC from patients with low WBC. In addition, we identified molecular networks and biological pathways, among them PI3/AKT, JAK/STAT, IL-17, TGF-β, apoptosis, IL-15, STAT3, IGF-1, FGF, mTOR, VEGF, NF-kB, and P53 signaling pathways, enriched for or targeted by miRNAs. The discovered miRNAs and their target genes and pathways represent potential clinically actionable biomarkers and therapeutic targets.
Effects of Acute Exercise on Circulating Soluble Form of the Urokinase Receptor in Patients With Major Depressive Disorder
Authors: Gustafsson Anna , Ventorp Filip , Wisén Anita GM , Ohlsson Lars , Ljunggren Lennart , Westrin Åsa
Published: April 2017

Inflammation has been proposed to play a role in the generation of depressive symptoms. Previously, we demonstrated that patients with major depressive disorder (MDD) have increased plasma levels of the soluble form of the urokinase receptor (suPAR), a marker for low-grade inflammation. The aim of this study was to test the hypothesis that acute exercise would induce inflammatory response characterized by increased suPAR and elucidate whether patients with MDD display altered levels of suPAR in response to acute exercise. A total of 17 patients with MDD and 17 controls were subjected to an exercise challenge. Plasma suPAR (P-suPAR) was analyzed before, during, and after exercise. There was a significantly higher baseline P-suPAR in the patients with MDD, and the dynamic changes of P-suPAR during the exercise were significantly lower in the patients with MDD, compared with the controls. This study supports the hypothesis that an activation of systemic inflammatory processes, measured as elevated P-suPAR, is involved in the pathophysiology of depression. The study concludes that P-suPAR is influenced by acute exercise, most likely due to release from activated neutrophils.
Visualization of Breast Microcalcifications on Digital Breast Tomosynthesis and 2-Dimensional Digital Mammography Using Specimens
Authors: Byun Jieun , Lee Jee Eun , Cha Eun Suk , Chung Jin , Kim Jeoung Hyun
Published: April 2017

Purpose:

The purpose of this study is to compare the visibility of microcalcifications of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) using breast specimens.

Materials And Methods:

Thirty-one specimens’ DBT and FFDM were retrospectively reviewed by four readers.

Results:

The image quality of microcalcifications of DBT was rated as superior or equivalent in 71.0% by reader 1, 67.8% by reader 2, 64.5% by reader 3, and 80.6% by reader 4. The Fleiss kappa statistic for agreement among readers was 0.31.

Conclusions:

We suggest that image quality of DBT appears to be comparable with or better than FFDM in terms of revealing microcalcifications.
Studying dyadic structure–function relationships: a review of current modeling approaches and new insights into Ca2+ (mis)handling
Authors: Maleckar Mary M , Edwards Andrew G , Louch William E , Lines Glenn T
Published: April 2017

Excitation–contraction coupling in cardiac myocytes requires calcium influx through L-type calcium channels in the sarcolemma, which gates calcium release through sarcoplasmic reticulum ryanodine receptors in a process known as calcium-induced calcium release, producing a myoplasmic calcium transient and enabling cardiomyocyte contraction. The spatio-temporal dynamics of calcium release, buffering, and reuptake into the sarcoplasmic reticulum play a central role in excitation–contraction coupling in both normal and diseased cardiac myocytes. However, further quantitative understanding of these cells’ calcium machinery and the study of mechanisms that underlie both normal cardiac function and calcium-dependent etiologies in heart disease requires accurate knowledge of cardiac ultrastructure, protein distribution and subcellular function. As current imaging techniques are limited in spatial resolution, limiting insight into changes in calcium handling, computational models of excitation–contraction coupling have been increasingly employed to probe these structure–function relationships. This review will focus on the development of structural models of cardiac calcium dynamics at the subcellular level, orienting the reader broadly towards the development of models of subcellular calcium handling in cardiomyocytes. Specific focus will be given to progress in recent years in terms of multi-scale modeling employing resolved spatial models of subcellular calcium machinery. A review of the state-of-the-art will be followed by a review of emergent insights into calcium-dependent etiologies in heart disease and, finally, we will offer a perspective on future directions for related computational modeling and simulation efforts.
Nodular Sarcoidosis Masquerading as Cancer
Authors: Sweidan Alexander J , Singh Navneet K , Stein Alexander , Tanios Maged
Published: April 2017

Nodular lung disease is a rare pulmonary manifestation of sarcoidosis and resembles metastatic neoplasm disease. Nodular sarcoidosis is rare, varying from 1.6% to 4% of patients with sarcoidosis. Radiographic nodules measure from 1 to 5 cm in diameter that typically consist of coalescent granulomas. There is limited data on this form of sarcoidosis and its presentation can mimic primary or metastatic pulmonary neoplasms. Nodular sarcoidosis has a favorable prognosis, and resolution can be seen with oral corticosteroids. Herein, we present such a case of nodular pulmonary sarcoidosis with a lung nodule measured up to 6 cm.
Elastohydrodynamic lubrication of coated finite line contacts
Authors: Alakhramsing Shivam S , de Rooij Matthijn B , Schipper Dirk J , van Drogen Mark
Published: April 2017

In this work, a finite element-based model is presented that simulates elastohydrodynamic lubrication in coated finite line contacts. Using this model, the film thickness and pressure distributions, between a straight roller with rounded edges on a plate, were analyzed. The model was successfully validated against representative results reported in literature. Parameter studies were conducted to study the influence of varying operating conditions, axial surface profile parameters and coating mechanical properties on the overall elastohydrodynamic lubrication behavior of the contact. It was found that in contrast with typical elastohydrodynamic lubrication behavior, the maximum pressure and minimum film thickness, which are located at the rear of the contact, are largely influenced by variations in load. Results also reveal that axial surface profile parameters and coating mechanical properties may act as amplifiers to the effect of load on pressure and film thickness distribution and can thus, if smartly chosen, significantly enhance lubrication performance.
Primary progressive multiple sclerosis presenting with severe predominant cognitive impairment and psychiatric symptoms: A challenging case
Authors: Zambon Alberto Andrea , Cecchetti Giordano , Caso Francesca , Santangelo Roberto , Baldoli Cristina , Natali Sora Maria Grazia , Comi Giancarlo , Magnani Giuseppe , Martinelli Vittorio
Published: April 2017

Severe cognitive dysfunction is a frequent feature of multiple sclerosis (MS), normally associated with later stages of the disease in adult population. Nevertheless, progressive cognitive and neuropsychiatric disturbances might rarely be the presenting and predominant symptom. In order to better characterize this peculiar phenotype of MS, we report on the case of a 38-year-old man who referred to our hospital with the suspect of hereditary leukodystrophy after 5 years of behavioral and mood abnormalities, global cognitive dysfunction, clumsiness, and very mild pyramidal and cerebellar signs. Brain and spinal magnetic resonance imaging (MRI) combined with cerebrospinal fluid (CSF) analysis prompted the diagnosis of MS.
The diagnostic dilemma of multiple sclerosis presenting with isolated cognitive and behavioral disorders
Authors: Amato Maria Pia
Published: April 2017

Cognitive and behavioral symptoms are common in multiple sclerosis (MS), even from the early stages of the disease, but they are considered to be rarely the inaugural and predominant manifestation of the disease, thus jeopardizing early and accurate diagnosis. This clinical commentary highlights a number of peculiar characteristics that should be taken into consideration in case of primary cognitive/neuropsychiatric dysfunction and white matter lesions of unclear origin, in order to prompt appropriate diagnostic workup.
‘Drawing’ conclusions
Authors: Parker Melissa , MacPhail Ann , O’Sullivan Mary , Ní Chróinín Déirdre , McEvoy Eileen
Published: April 2017

This study explores the relationship between primary school physical education and physical activity as sites for the practice of physical activity of Irish primary school children. Understanding how children make connections between physical activity sites is important in shaping physical education experiences that promote lifelong participation. Children’s (aged 8–11) awareness, knowledge, and understanding of physical activity and physical education were examined using participatory methods of ‘draw and write’ ( n = 135) and focus group interviews ( n = 34). In Phase 1, data collection focused on physical activity, while Phase 2 focused on physical education and connections between physical activity and physical education. Data were analysed using a general inductive approach. Data analysis resulted in four themes: gendered patterns of participation; connections between physical education and physical activity; the nature and choice of participation in activities; and perceptions of ability. Children had varying understandings of the connections between their participation in physical education and physical activity. These findings highlight the importance of supporting all children to make explicit connections between their learning in physical education and their wider physical activity participation. An implication of the findings is that children need to be explicitly prompted to engage in physical activity. Without such encouragement, children are unlikely to draw linkages between physical activity and physical education.
‘Physical education’ in early childhood education
Authors: Petrie Kirsten , Clarkin-Phillips Jeanette
Published: April 2017

Children’s physical education in early childhood settings has always been underpinned by an emphasis on play. This is viewed as foundational for child development (movement education, cognitive growth, socialising functions, emotional development). However, where priorities about childhood obesity prevail, increased ‘prevention’ efforts have become targeted at primary and pre-school-aged children. It could be argued that early childhood education has become another site for the ‘civilising’ of children’s bodies. Drawing on data from a questionnaire completed by 65 early childhood education centres in Aotearoa New Zealand, we examine the play and physical education ‘curriculum’ and what this may mean for pre-school children’s views of physical activity and health. In light of the evidence that suggests pre-school physical education programmes reinforce achievement of a certain restrictive and narrow model of physical health and activity, we explore the implications for primary school physical education. In doing so we consider how teachers of physical education in primary schools may need to reconsider the curriculum to support young children to regain enthusiasm for pleasurable movement forms that are not centred on narrowly perceived notions of the healthy or sporting body.
Hooked on a feeling? Exploring desires and ‘solutions’ in infertility accounts given by women with ‘atypical’ sex development
Authors: Guntram Lisa
Published: April 2017

Sociocultural meanings accorded to infertility, and rapid developments in assisted reproductive technologies, have long been central concerns in feminist and social scientific research. However, knowledge is scarce concerning how individuals make sense of infertility when it is disclosed in adolescence, for example as the result of an ‘atypical’ sex development, rather than as a result of failed conception. This article examines how understandings of desires, kinship and ‘solutions’ take shape and are negotiated in the accounts women give of infertility resulting from ‘atypical’ sex development. Through a thematic analysis it demonstrates how the interviewees described their desire for relationships and connectedness, which they considered to be made possible through pregnant embodiment, and details how these desires connected to a preference for medical ‘solutions’. Specifically, the article discusses how the interviewees’ accounts exemplifies how biological kinship can be ‘done’ without giving precedence to genetics. By addressing the specificities of finding out about infertility as a result of ‘atypical’ sex development, it furthermore highlights gaps in the common medical definition of infertility. These findings underscore the urgency of examining how definitions of infertility obscure certain experiences and consequently limit affected individuals’ access to support and treatment. In conclusion, it is suggested that the article contributes to a more positive discourse on infertility in feminist scholarship by teasing out the temporal dimensions of how affected individuals ‘make active use’ of assisted reproductive technologies to mitigate uncertainty and maintain hope, while at the same time renegotiating dominant norms of kinship.
Public discourse on mental health and psychiatry: Representations in Swedish newspapers
Authors: Ohlsson Robert
Published: April 2017

Mass media plays a central role in shaping public discourse on health and illness. In order to examine media representations of mental health and expert knowledge in this field, two major Swedish daily newspapers from the year 2009 were qualitatively analysed. Drawing on the theory of social representations, the analysis focused on how issues concerning mental health and different perspectives are represented. The results show how the concept of mental illness is used in different and often taken-for-granted ways and how the distinction between normal and pathological is a central underlying question. Laypersons’ perspectives are supplemented by views of professionals in the newspapers, where signs of confidence and dependence on expert knowledge are juxtaposed with critique and expressions of distrust. The newspaper discourse thus has salient argumentative features and the way that conflicts are made explicit and issues concerning authoritative knowledge are addressed indicates ambivalence towards the authoritative role of expert knowledge concerning mental health. In this way, the newspapers provide a complex epistemic context for everyday sense-making that can be assumed to have implications for relations between laypersons and professionals in the field of mental health.
To be or not to be sick and tired: Managing the visibility of HIV and HIV-related fatigue
Authors: Schuft Laura , Duval Estelle , Thomas Julie , Ferez Sylvain
Published: April 2017

This article takes a new direction in exploring HIV-related fatigue by adopting a qualitative interactionist approach. We analyse the social meanings attributed to fatigue among people living with HIV in France, the social gains and losses of its visibility and the social frames that condition its discursive and physical expression. The two-part methodology combines grounded theory analysis of 50 transcribed unstructured interviews conducted across France and participant observations within four HIV-related associations. Results reveal that the visibility of fatigue is in part dependent on the visibility of this stigmatized illness. The expression of fatigue is therefore closely linked with disclosure and concerns about HIV stigma. The degree to which HIV and HIV-related fatigue are rendered (in)visible also depends on structural factors including gender prescriptions, as well as context effects such as the type of social or ‘care’ relations involved in the social frame of interaction.
Narratives of nationhood: Young Australians’ concepts of nation and their attitudes towards ‘boat people’
Authors: Laughland-Booÿ Jacqueline , Skrbiš Zlatko , Tranter Bruce
Published: April 2017

In Australia, questions surrounding national identity often feature in public discussions on asylum seekers. Using qualitative interview data collected from 40 participants in an ongoing study of young people in Queensland, we explore the connections between young people’s understandings of Australian national identity and their attitudes towards ‘boat people’. We identify distinct points of interconnection and disjuncture between participants’ notions of being ‘Australian’ and their thoughts on how Australia should respond to asylum seekers. With respect to the asylum seeker debate, we find narratives of Australian nationhood are flexible in interpretation and can serve contrasting and competing functions.
Opportunities for Alcohol Policy in the Countries of Central and Eastern Europe
Authors: Lehto Juhani
Published: April 2017

Both alcohol consumption and alcohol-related problems are, it is claimed, rapidly increasing problems in Central and Eastern Europe, due to the transition period. The article presents some available data and discusses the problems in making conclusions from rather inaccurate statistics. The second objective is to discuss the opportunities for effective alcohol policies, and the relevance of the studies made in established market economies, such as the Anglo-American and Scandinavian countries. An important condition for a control policy, the author concludes, is the re-establishment of a basic regulation of the alcohol market, now missing in these countries. Otherwise any policy measures will be ineffective or even counterproductive. The process will probably be different in different countries, due to differences in the economic restructuring and recovery, and to differences between the “beer”, “wine”, and “vodka” cultures.
An Alcohol Policy in the European Union?
Authors: Van Iwaarden M.J.
Published: April 2017

Although the production and consumption of alcoholic beverages in Europe ranks among the highest in the world, resulting in many social and public health problems, measures to create an EU level alcohol control policy are yet to be made. Alcoholic beverages are currently regarded mainly as one product among many other products and the related restrictions are, for the most part, market oriented. The Nordic Countries, the author argues, cannot therefore expect much from EU as regards alcohol policy. Rather, he concludes, it is the other way around. However, Article 129 of the Treaty of Maastricht could perhaps form the basis for a general EU health policy.
Notes on Alcohol Policy in Germany — with Special Emphasis on the Workplace
Authors: Appel Christa
Published: April 2017

In Germany drinking has traditionally been integrated into daily life and the concept of alcohol policy (as known in Scandinavia) appears strange. Alcohol is also generally accepted in the workplace where one frequently can buy even alcoholic beverages. This reflects the commonly held attitude that normal consumers should not be “punished” because other consumers have problems. This general attitude is also reflected in both workers' and employers' organizations, as well as in enterprises, which all tend to place priority on individual case-by-case management of alcohol and drug problems, instead of on formal, written policies. The empirical material for the article is taken from a current study on alcohol, drugs and the workplace, which was made for ILO.
New Radiance in the Tricolour — Changes in French Drinking Patterns
Authors: Warsell Leena
Published: April 2017

During the past fifteen years the alcohol culture in France has undergone remarkable changes. The French, for whom a meal without wine is no meal, have decreased their alcohol consumption from about 20 to 11.9 liters (absolute alcohol per capita). This has been a trend in all age groups, although most markedly among those under thirty-five. The common denominator has been “less, but better”, which means quality wines and imported spirits. The effect of this “drying” can be seen in the health statistics, which show, for example, that the frequency of cirrhosis has decreased by one-half, due to less heavy consumption. The drinking trend is reflected also in attitudes toward alcohol advertising: the new French law on alcohol advertising is said to be the strictest in Europe. France played an active role in formulating the health policy in the Treaty of Maastricht — perhaps a sign of French aspirations to be a model, also in this respect, for all Europe.
The Fluctuating Boundaries between Alcoholics Anonymous, Alcoholism Treatment and the Icelandic Society
Authors: Ólafsdóttir Hildigunnur
Published: April 2017

Since AA's beginning in 1954 the number of AA meetings has increased from 0.6 to 82.4 per 100 000 inhabitants in 1990. The structure above the local level is rather weak and attempts to create committees to link the local and national level have not been successful. In general, the membership includes a broad range of members with about 30 percent of the members under 30 years old and 29 percent women. Because of the small size of the population, the organizational principles of AA have proven problematic, in particular the principle on anonymity. AA's first involvement with treatment came about already in its first year when a group of founding members established and ran a clinic for alcoholics that was closely tied to AA. Later the Laymen's Council on Alcoholism (founded in the mid 1970s largely by AA members) established 12–step alcoholism treatment units, while aftercare became the AA's main function. Thereafter, the boundaries between AA and the Laymen's Council on Alcoholism became unclear to the general public. The vigour of the Icelandic AA lies in its relatively large size and nation-wide growth, while the weakness lies in lost functions. Political consensus on the importance of alcoholism treatment, the strength of the family institution, and the closeness of the people may explain why inpatient treatment has become such an important factor in AA and society as a whole.
Stories as Therapy – Life Stories and Myth in Alcoholics Anonymous
Authors: Steffen Vibeke
Published: April 2017

Personal stories play a central role for communication in AA AA groups. To tell your story is considered both a therapeutic necessity and a moral obligation. By placing important events in meaningful contexts the stories contribute to an understanding of individual experience as well as the creation of a common identity. The article analyses different constructions of personal stories as they are told in AA in Denmark. Focusing on forms of communication and social interaction in the groups, the article illustrates how individual life stories are presented as respectively pedagogical anecdotes, illness stories and mythical tales. Thus, individual and collective experience are merged into the same therapeutic process.
Political Culture and Treatment Strategies in the Nordic Countries
Authors: Grindheim Jan E.
Published: April 2017

Taking as a point of departure Mary Douglas' grid-group analysis, elaborated on by Aaron Wildavsky in his cultural theory, the article explores the variations in the development of methadone treatment programmes in the Nordic countries from the mid-1960's to the mid-1990's. In Sweden, the first Nordic country to start an organized treatment of heroin addicts with methadone in 1966, the strategy has been characterized by many rules and strong control. In Denmark, methadone treatment was introduced in the late 1960's, and it has been characterized by few rules and weak control. In Norway, methadone treatment was banned in 1979, after some years of occasional experiments. But the spread of HIV among intravenous heroin addicts altered the attitudes and a small and highly regulated program was set up in the beginnings of the 1990's. In Finland, the attitude has been reserved, primarily due to the small population of heroin addicts. The organized treatment in the 1970's was limited, and still is, as it was set up again in 1995. In spite of the differences, however, there are two main patterns of harmonization that should be noticed. Firstly, as a result of HIV, regulated programmes have been developed in all four countries in the 1990's. Secondly, the prevailing abstinence-oriented philosophy has been questioned and supplemented by harm-reducing measures. Today, there is a stronger tendency to treat drug addicts as clients in the Nordic welfare state, entitled to individual treatment in the countries' general health and welfare systems.
Preoperative Magnetic Resonance Imaging in Patients With Stage I Invasive Ductal Breast Cancer: A Prospective Randomized Study
Authors: Brück N. , Koskivuo I. , Boström P. , Saunavaara J. , Aaltonen R. , Parkkola R.
Published: April 2017

Background and Aims:

Preoperative magnetic resonance imaging has become an important complementary imaging technique in patients with breast cancer, providing additional information for preoperative local staging. Magnetic resonance imaging is recommended selectively in lobular breast cancer and in patients with dense breast tissue in the case when mammography and ultrasound fail to fully evaluate the lesion, but the routine use of magnetic resonance imaging in all patients with invasive ductal carcinoma is controversial. The purpose of this randomized study was to investigate the diagnostic value of preoperative magnetic resonance imaging and its impact on short-term surgical outcome in newly diagnosed unifocal stage I invasive ductal carcinoma.

Material and Methods:

A total of 100 patients were randomized to either receive preoperative breast magnetic resonance imaging or to be scheduled directly to operation without magnetic resonance imaging on a 1:1 basis. There were 50 patients in both study arms.

Results:

In 14 patients (28%), breast magnetic resonance imaging detected an additional finding and seven of them were found to be malignant. Six additional cancer foci were found in the ipsilateral breast and one in the contralateral breast. Magnetic resonance imaging findings caused a change in planned surgical management in 10 patients (20%). Mastectomy was performed in six patients (12%) in the magnetic resonance imaging group and in two patients (4%) in the control group ( p = 0.140). The breast reoperation rate was 14% in the magnetic resonance imaging group and 24% in the control group ( p = 0.202). The mean interval between referral and first surgical procedure was 34 days in the magnetic resonance imaging group and 21 days in the control group ( p < 0.001).

Conclusion:

Preoperative magnetic resonance imaging may be beneficial for some patients with early-stage invasive ductal carcinoma, but its routine use is not recommended without specific indications.
Still plodding along? The police response to the changing profile of crime in England and Wales
Authors: Loveday Barry
Published: April 2017

This article considers the new demands placed on police forces arising from the dramatic increase in the numbers of cases of fraud and cybercrime. It assesses the ability – or current difficulty – of the police to respond to this development. The article is directed towards a growing requirement for substantial internal police reform that goes well beyond anything contemplated heretofore. The article draws on the recent and important Her Majesty’s Inspectorate of Constabulary (HMIC) PEEL Review of police efficiency, which for the first time, has raised the question of identifying not just police capacity, but also police force capability. It is evident that although police forces can quickly identify capacity (ranks and police numbers), they experience great difficulty in relation to capability. This relates to the police response to the ‘new’ forms of crime that are now replacing traditional acquisitive crime. Recent cases include the 2016 cyber-attack on Tesco Bank in which £2.5 million was stolen from 9,000 bank accounts, and a major cyber-attack in the same year that disrupted internet services across Europe and the USA. The article seeks to identify current police responses to this development and also highlight the real challenge this problem represents. It recognizes the competing demands made on the police, but suggests that fraud and cybercrime now constitute the greatest threat confronting the police service in England and Wales.