bluuebunny/crossref_metadata_2025 huggingface dataset:
Short- and long-term changes in perceived work ability after interdisciplinary rehabilitation of chronic musculoskeletal disorders: prospective cohort study among 854 rehabilitants
Authors: Saltychev Mikhail , Laimi Katri , Pentti Jaana , Kivimäki Mika , Vahtera Jussi
Published: January 2014

Objective:

To investigate the changes in rehabilitants’ perceived work ability after rehabilitation for chronic musculoskeletal disorders with respect to the baseline characteristics.

Design:

Prospective cohort study based on register and repeated survey data.

Setting:

Public sector employees in ten towns and five hospital districts.

Subjects:

A total of 854 employees who participated in the rehabilitation programme owing to common chronic musculoskeletal disorders between 1997 and 2009.

Interventions:

Interdisciplinary, biopsychosocial, inpatient rehabilitation programme targeting people of working age with common chronic musculoskeletal disorders. The programme was executed in different rehabilitation centres across the country and funded by the Social Insurance Institution of Finland.

Main measures:

Differences in perceived work ability level before and after rehabilitation. Data were derived from repeated surveys on average 2.1 years before rehabilitation, and 1.5 years (short-term follow-up) and 6.0 years (long-term follow-up) after rehabilitation.

Results:

Before the rehabilitation, perceived work ability was 7.13 (SD 1.84) among the rehabilitants and 7.27 (SD 1.72) in the matched reference population. Among rehabilitants, this figure decreased by 0.82 (95% confidence interval −0.98 to −0.67) in the short-term and by 1.26 (95% confidence interval −1.45 to −1.07) in the long-term follow-up. Only slight differences in steepness of this deterioration were observed between subgroups, created based on the participants’ baseline characteristics.

Conclusions:

Perceived work ability of participants, in an interdisciplinary biopsychosocial rehabilitation programme for common musculoskeletal disorders, deteriorated regardless of any studied pretreatment characteristics. The improvement of work ability may be an unrealistic goal for participants in this type of rehabilitation.
Effect on arm function and cost of robot-assisted group therapy in subacute patients with stroke and a moderately to severely affected arm: a randomized controlled trial
Authors: Hesse Stefan , Heß Anke , Werner C Cordula , Kabbert Nadine , Buschfort Rüdiger
Published: January 2014

Objective:

To evaluate the effectiveness and efficiency of robot-assisted arm group therapy (RAGT) versus individual arm therapy (IAT) to restore motor function in the moderately to severely affected patient after stroke.

Design:

Single blind randomized controlled trial.

Setting:

Two in-patient neurological rehabilitation centers.

Participants:

Fifty first time subacute patients with stroke and a non-functional hand.

Intervention:

The patients practiced either 30 minutes of RAGT + 30 minutes of IAT (group A) or 2x30 minutes of IAT (group B), per workday for four weeks. The RAGT consisted of six workstations enabling repetitive practice of finger, wrist, forearm and shoulder movements. Patients practiced according to their impairment level on at least two workstations per session. The IAT followed the Motor Relearning Programme, enriched by elements of the impairment-oriented training.

Main outcome measure:

Changes of the Fugl Meyer Score (FM, 0-66) between baseline and after 4 weeks, incremental cost effectiveness.

Results:

Patients were homogeneous at study onset. All patients improved their upper limb motor function over time, but there were no between group differences. The initial (terminal) FM scores were 14.6±9.4 (25.7±16.5) in group A and 16.5±9.8 (31.1±19.1) in group B. The treatment of a single patient with RAGT cost 4.15 €, compared to 10.00 € for a patient to receive IAT.

Conclusion:

RAGT in combination with IAT was equally effective as a double session of IAT regarding the restoration of upper limb motor functions in moderate to severely affected subacute patients with stroke. The treatment costs for RAGT were less.
Application of Tendon-Derived Stem Cell Sheet for the Promotion of Graft Healing in Anterior Cruciate Ligament Reconstruction
Authors: Lui Pauline Po Yee , Wong On Tik , Lee Yuk Wa
Published: January 2014

Background:

Both osteointegration and remodeling of graft midsubstance (collectively called graft healing) are slow processes after anterior cruciate ligament (ACL) reconstruction. Tendon-derived stem cells (TDSCs) form a cell sheet after treatment with connective tissue growth factor (CTGF) and ascorbic acid, which exhibits higher tenogenic and maintains high chondro-osteogenic gene expression of TDSCs. No external scaffold is required for cell delivery.

Hypothesis:

Wrapping the TDSC sheet around the ACL graft would promote early graft healing in a rat model.

Study Design:

Controlled laboratory study.

Methods:

Green fluorescent protein (GFP) rat TDSCs were treated with connective tissue growth factor and ascorbic acid to promote cell sheet formation. Rats undergoing unilateral ACL reconstruction were divided into a control group and a TDSC group. The tendon graft was wrapped with the GFP-TDSC sheet before graft insertion in the TDSC group. At weeks 2, 6, and 12 after reconstruction, the samples were harvested for computed tomography imaging and histologic or biomechanical testing. The fate of the transplanted cell sheet was examined by immunohistochemical staining of GFP.

Results:

There were significantly higher tunnel bone mineral density (BMD) (42.3% increase, P = .047) and bone volume/total volume (BV/TV) (625% increase, P = .009) at the metaphyseal region of the tibial tunnel at week 2 and at the femoral tunnel at week 6 (BMD: 30.8% increase, P = .014; BV/TV: 100% increase, P = .014) in the TDSC group compared with the control group. Only the TDSC group showed a time-dependent increase in tunnel BMD (overall P = .038) and BV/TV (overall P = .015) at the epiphyseal region of the tibial tunnel. Semiquantitative image analysis showed better graft osteointegration and higher intra-articular graft integrity with lower cellularity and vascularity, better cell alignment, and higher collagen birefringence in the TDSC group. The ultimate load at week 2 (52.5% increase, P = .027) and stiffness at week 6 (62% increase, P = .008) were significantly higher in the TDSC group. Cells positive for GFP were observed in all samples in the TDSC group at week 2 but became reduced with time after reconstruction.

Conclusion:

The TDSC sheet improved early graft healing after ACL reconstruction in the rat model.

Clinical Relevance:

The TDSC sheet could potentially be used for the promotion of graft healing in ACL reconstruction.
Younger Patients Are at Increased Risk for Graft Rupture and Contralateral Injury After Anterior Cruciate Ligament Reconstruction
Authors: Webster Kate E. , Feller Julian A. , Leigh Warren B. , Richmond Anneka K.
Published: January 2014

Background:

Graft rupture of the same knee or injury to the anterior cruciate ligament (ACL) in the contralateral knee is a devastating outcome after ACL reconstruction surgery. While a number of factors have been identified as potentially increasing the risk of subsequent ACL injury, the literature is far from definitive.

Purpose:

To determine the rates of graft rupture and contralateral ACL injury in a large cohort and to investigate patient characteristics that may be associated with these.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A consecutive cohort of 750 patients who had undergone primary ACL reconstruction surgery with a minimum 3-year follow-up were questioned about the incidence of ACL graft rupture, contralateral ACL injury, family history of ACL injury, and current activity level. Patient databases provided details for age, sex, original injury mechanism, meniscus or articular surface injury, and graft diameter.

Results:

Responses were received from 561 patients (75%) at a mean ± SD follow-up time of 4.8 ± 1.1 years. Anterior cruciate ligament graft ruptures occurred in 25 patients (4.5%), and contralateral ACL injuries occurred in 42 patients (7.5%). The highest incidence of further ACL injury occurred in patients younger than 20 years at the time of surgery. In this group, 29% sustained a subsequent ACL injury to either knee. The odds for sustaining an ACL graft rupture or contralateral injury increased 6- and 3-fold, respectively, for patients younger than 20 years. Returning to cutting/pivoting sports increased the odds of graft rupture by a factor of 3.9 and contralateral rupture by a factor of 5. A positive family history doubled the odds for both graft rupture and contralateral ACL injury.

Conclusion:

Patients younger than 20 years who undergo ACL reconstruction are at significantly increased risk for both graft rupture and contralateral ACL injury. Whether age per se is a risk factor or age represents a proxy for other factors remains to be determined.
Wasteful disposition: Analysis of municipal household waste using geodemographic classification
Authors: Lawal Olanrewaju
Published: January 2014

The continuous flow of resources through the economy is the origin of most of the environmental problems evident today. These problems are directly related to production and introduction of wastes and pollutants into the natural environment. The study investigated the relationship between household waste and geodemographic grouping (GDG) at the municipal level across England.

A correlation analysis of the GDG and waste data revealed a positive relationship between waste and proportion of different GDG. A robust regression model generated represents 74% of the variation across the dataset, and it shows that there is a significant relationship between municipal waste and GDG. A higher number of GDG (e.g. 3, 4, 6, 7 and 8) displayed a very strong association with increasing total municipal household waste (TMHW). GDG such as 1, 2 and 10, despite their higher disposable incomes, displayed a weak association with TMHW. Furthermore, GDGs such as 8, 3, 7, 4 and 6 generated more household waste in comparison to GDG. This model provides an understanding that can influence the organisation of waste management programmes and forecasting of municipal waste. It also provides essential input for decisions in structuring promotion of sustainable behaviour and implementing local initiatives to support such activities.
The Prognostic Value of Concurrent Horner Syndrome in Extended Erb Obstetric Brachial Plexus Palsy
Authors: El-Sayed Amel A. F.
Published: January 2014

Horner syndrome may be seen in infants with extended Erb obstetric brachial plexus palsy. However, its prognostic value in these infants has not been previously investigated. A total of 220 infants with extended Erb palsy were included and divided into 2 groups: group I (n = 209) were infants with extended Erb palsy without Horner syndrome, and group II (n = 11) were infants with extended Erb palsy and concurrent Horner syndrome. The rate of good spontaneous recovery of elbow flexion was 59% in group I and 27% in group II, and the difference was significant ( P = .038). The rate of good spontaneous recovery of wrist extension was 61% in group I and 0% in group II, and the difference as highly significant ( P < .0001). Concurrent Horner syndrome in infants with extended Erb palsy may be considered as a poor prognostic sign for recovery of the sixth and seventh cervical roots.
Episodic Epileptic Verbal Auditory Agnosia in Landau Kleffner Syndrome Treated With Combination Diazepam and Corticosteroids
Authors: Devinsky Orrin , Goldberg Rina , Miles Daniel , Bojko Aviva , Riviello James
Published: January 2014

We report 2 pediatric patients who presented initially with seizures followed by subacute language regression characterized by a verbal auditory agnosia. These previously normal children had no evidence of expressive aphasia during their symptomatic periods. Further, in both cases, auditory agnosia was associated with sleep-activated electroencephalographic (EEG) epileptiform activity, consistent with Landau-Kleffner syndrome. However, both cases are unique since the episodic auditory agnosia and sleep-activated EEG epileptiform activity rapidly responded to combination therapy with pulse benzodiazepine and corticosteroids. Further, in each case, recurrences were characterized by similar symptoms, EEG findings, and beneficial responses to the pulse benzodiazepine and corticosteroid therapy. These observations suggest that pulse combination high-dose corticosteroid and benzodiazepine therapy may be especially effective in Landau-Kleffner syndrome.
Glutaric Aciduria Type II Presenting as Myopathy and Rhabdomyolysis in a Teenager
Authors: Prasad Manish , Hussain Shanawaz
Published: January 2014

Late-onset glutaric aciduria type II has been described recently as a rare but treatable cause of proximal myopathy in teenagers and adults. It is an autosomal recessive disease affecting fatty acid, amino acid, and choline metabolism. This is usually a result of 2 defective flavoproteins: either electron transfer flavoprotein (ETF) or electron transfer flavoprotein–ubiquinone oxidoreductase (ETF:QO). We present a 14-year-old boy with a background of autistic spectrum disorder who presented with severe muscle weakness and significant rhabdomyolysis. Before the onset of muscle weakness, he was very active but was completely bedridden at presentation. Diagnosis was established quickly by urine organic acid and plasma acylcarnitine analysis. He has shown significant improvement after starting oral riboflavin supplementation and is now fully mobile. This case highlights that late-onset glutaric aciduria type II is an important differential diagnosis to consider in teenagers presenting with proximal myopathy and rhabdomyolysis and it may not be associated with hypoglycemia.
A Novel Mutation of NKX2-1 Affecting 2 Generations With Hypothyroidism and Choreoathetosis
Authors: Williamson Scott , Kirkpatrick Martin , Greene Stephen , Goudie David
Published: January 2014

The NKX2-1 (TTF-1 or TITF-1) gene on chromosome 14q13 codes for the thyroid transcription factor 1 (TTF-1). It is expressed in the developing brain, lung, and thyroid. Defects have been associated with chorea, hypothyroidism, and lung disease, comprising the “brain-thyroid-lung syndrome.” We describe here 3 cases of novel missense mutation (c.626G>C; p.Arg209Pro) in NKX2-1 in 2 generations of a nonconsanguinous family. Firstly 2 sons were affected by childhood-onset hypothyroidism and a movement disorder characterized by ataxia in the early years followed by the emergence of a superimposed chorea. The mutation was also found in the granddaughter, when she presented with the same clinical features. We hypothesize that the mutation arose as a result of gonadal mosaicism, as the mutation was not detected in leucocyte DNA from either grandparent. The features are consistent with a diagnosis of Brain-thyroid-lung syndrome, which previously could have been classified as benign hereditary chorea with hypothyroidism.
In vitro osteogenic cell proliferation, mineralization, and in vivo osseointegration of injection molded high-density polyethylene-based hybrid composites in rabbit animal model
Authors: Tripathi Garima , Basu Bikramjit
Published: January 2014

The present work reports the biocompatibility property of injection molded HDPE-HA-Al2O3 hybrid composites. In vitro cytocompatibility results reveal that osteogenic cell viability and bone mineralization are favorably supported in a statistically significant manner on HDPE-20% HA-20% Al2O3 composite, in comparison to HDPE-40 wt.% HA or HDPE-40 wt.% Al2O3. The difference in cytocompatibility property is explained in terms of difference in substrate wettability/surface energy and importantly, both the cell proliferation at 7 days or bone mineralization at 21 days on HDPE-20% HA-20% Al2O3 composite are either comparable or better than sintered HA. The progressive healing of cylindrical femoral bone defects in rabbit animal model was assessed by implantation experiments over 1, 4 and 12 weeks. Based on the histological analysis as well as histomorphometrical evaluation, a better efficacy of HDPE-20% HA-20% Al2O3 over high-density polyethylene (HDPE) for bone regeneration and neobone formation at host bone-implant interface was established. Taken together, the present study unequivocally establishes that despite the presence of 20% Al2O3, HDPE-based hybrid composites are as biocompatible as HA in vitro or better than HDPE in vivo.
Determinants of Trends in Loneliness Among Dutch Older People Over the Period 2005-2010
Authors: Honigh-de Vlaming Rianne , Haveman-Nies Annemien , Bos-Oude Groeniger Inge , de Groot Lisette , van ’t Veer Pieter
Published: January 2014

Objective: This study aims to investigate the influence of socio-demographic, health, and municipal characteristics on trends in loneliness among community-dwelling elderly people. Method: Data were gathered from 4,868 and 4,773 non-institutionalized elderly people aged 65 years and above in a health survey in 2005 and 2010, respectively. Crude and adjusted multilevel models were analyzed to study the independent associations of study year and socio-demographic, health, and municipal characteristics with loneliness. Results: Overall and across municipalities, loneliness estimates did not significantly differ between 2005 and 2010. However, among the sub-group with activity limitations, loneliness was higher in 2010 compared with 2005. Discussion: This study indicates a constant trend in loneliness in the total population and across sub-groups with the exception of participants with one or more activity limitations, where loneliness increased. Individual socio-demographic and health characteristics were explanatory factors for variation in loneliness over time, whereas municipal characteristics were not.
Estimation of the collision speed in a collision of a motorcycle or scooter with a car from individual vehicle deformation
Authors: Wood Denis P , Glynn Colin , Walsh Darren
Published: January 2014

It has been demonstrated in previous research that the collision closing speed in a collision of a motorcycle or scooter with a car can be estimated on the basis of the residual crushing damage shared between the two vehicles, using an energy-derived relationship between the residual crushing damage and the collision closing speed. This paper reviews the original research and develops two further models that allow independent estimates of the collision closing speed to be calculated on the basis of either the residual deformation to the motorcycle or the residual deformation to the car. The models are validated from further crash test data taken from the literature. The principal results of the analyses are presented in the form of two predictive equations, together with the associated uncertainty that arises from the nature of the various constructions and stiffnesses of the vehicles within the population fleet. Comparison is made with other analyses in the literature. Further consideration is given to deviations from the mean estimate for subsets of the fleet population, taking into account the fact that the sides of cars have portions of various stiffnesses and that the mean stiffness of the sides of cars differed historically from those of modern models. Correction factors are presented which allows for a refined prediction based on the vehicle age and the car impact location.
Simulation of the suspension of a vehicle using Chebyshev series
Authors: López Alberto , Moriano Cristina
Published: January 2014

This article presents approximate analytical solutions of the differential equation system governing the vertical dynamics of a vehicle, using an approximation through expansions in Chebyshev series. These solutions allow faster solution processing than do the traditional numerical methods. The Lanczos τ method is used in order to obtain lower-degree polynomials with much reduced errors for the simulation times proposed. Finally, an analysis of the computational efficiency of the outcomes is carried out, comparing the time spent in processing exact and numerical solutions of the system with the time taken by this expansion method using Chebyshev series. It can be checked that the calculations of these polynomials are far more efficient with low-degree excitations.
Robust handling enhancement on a slippery road using quantitative feedback theory
Authors: Rezai Mohsen , Heidari Shirazi Kourosh
Published: January 2014

In the present paper, a quantitative feedback theory controller is developed to control the lateral motion and yawing motion of a car equipped with a mechatronic front-wheel steering system. The overall objective is to track the yaw rate with the aim of achieving satisfactory performance specifications for the lateral dynamics of the vehicle, regarding different road conditions as well as uncertain parameters such as the mass, the velocity and the moment of inertia of the vehicle. To establish an accurate model of the vehicle, a seven-degree-of-freedom model is considered. An observer for detecting the cornering stiffnesses of the tyres based on the beta-less method is designed. In spite of the estimation of the cornering stiffnesses, a wide range of uncertainties for this parameter in the design procedure of the quantitative feedback theory controller is predicted. The effects of practical data acquisition and processing time delays as well as the dynamic behaviours of the actuators are studied. The simulations show that the designed quantitative feedback theory controller has a significant effect on stable cornering in the presence of the numerous wide-ranging uncertainties. Nevertheless, for satisfactory behaviour of the controller, there are some important practical considerations such as the fast response of actuators and the short processing time of the computational electronic unit especially for a slippery road.
Durability of response to vaccination against viral hepatitis A in HIV-infected patients: a 5-year observation
Authors: Jabłonowska E , Kuydowicz J
Published: January 2014

The aim of this study was to estimate the prevalence of total antibodies to hepatitis A virus (anti-HAV-T) in the group of HIV-positive adults in Lodz region of Poland, and to evaluate the response and long-term immunity after vaccination against hepatitis A virus. In the group of 234 HIV-infected patients, 72 persons (30.8%) were anti-HAV-T positive (>20 IU/L). In multivariate analysis, two independent factors associated with the presence of anti-HAV-T were identified: the age of patients (OR = 1.07) and the presence of antibodies to hepatitis C virus (OR = 2.87). Vaccination was completed in 83 patients. Good response (anti-HAV-T >20 IU/L one month after the booster dose) was obtained in 79.5% of patients. In patients with CD4 >200 cells/µL in multivariate analysis only presence of antibodies to hepatitis C virus was a prognostic factor for the response to vaccination (OR = 0.13). Among responders available for the follow-up, 82% (50 out of 61) had detectable anti-HAV-T at 1 year and 75.5% (37 out of 49) at 5 years. Our results demonstrate that most of the studied HIV-positive patients were susceptible to hepatitis A virus infection. Most HIV-infected adults with high CD4 counts had a durable response even up to 5 years after vaccination. Patients with a HIV/hepatitis C virus coinfection displayed a worse response to vaccination.
The Scent of Disease
Authors: Olsson Mats J. , Lundström Johan N. , Kimball Bruce A. , Gordon Amy R. , Karshikoff Bianka , Hosseini Nishteman , Sorjonen Kimmo , Olgart Höglund Caroline , Solares Carmen , Soop Anne , Axelsson John , Lekander Mats
Published: January 2014

Observational studies have suggested that with time, some diseases result in a characteristic odor emanating from different sources on the body of a sick individual. Evolutionarily, however, it would be more advantageous if the innate immune response were detectable by healthy individuals as a first line of defense against infection by various pathogens, to optimize avoidance of contagion. We activated the innate immune system in healthy individuals by injecting them with endotoxin (lipopolysaccharide). Within just a few hours, endotoxin-exposed individuals had a more aversive body odor relative to when they were exposed to a placebo. Moreover, this effect was statistically mediated by the individuals’ level of immune activation. This chemosensory detection of the early innate immune response in humans represents the first experimental evidence that disease smells and supports the notion of a “behavioral immune response” that protects healthy individuals from sick ones by altering patterns of interpersonal contact.
Positive and Negative Correlations Between Confidence and Accuracy for the Same Events in Recognition of Categorized Lists
Authors: DeSoto K. Andrew , Roediger Henry L.
Published: January 2014

Different researchers have reported positive, null, and negative relationships between confidence and accuracy in reports from memory. One possible reason for this paradox is the variety of materials used across experiments, but the two experiments reported in this article show that positive and negative confidence-accuracy correlations can be observed using a single procedure and the same materials. Subjects studied words from semantic categories and then took a recognition test while making confidence ratings. For previously studied items, positive correlations between confidence and accuracy were obtained using three different measures. Yet when confidence-accuracy correlations were assessed for unstudied items from studied categories, the correlations were zero or negative. The critical factors in determining when negative correlations will be found are the similarity of lures to presented items and the type of analysis used. These results indicate that one should be cautious about relying on confidence of recognition when rememberers must decide among highly similar events.
The rise and fall of government spending in affluent democracies, 1971–2008
Authors: Brady David , Lee Hang Young
Published: January 2014

One of the enduring conclusions of political economy is that the government’s share of the economy tends to grow over time and with a rising gross domestic product (GDP) per capita. Yet, from the late 1980s through to 2008, government spending as a percentage of GDP declined in the typical year in affluent democracies. Synthesizing and building on literatures on the welfare state, state size and neoliberalism, we evaluate three explanations for the expansion and retrenchment of government spending as a percentage of GDP. We estimate fixed effects models of three measures of changes and cuts in government spending. In the full sample 1971–2008, changes and cuts were driven by the structural pressures of unemployment and trade openness, and the institutional factor of the adoption of the Euro. However, this conceals important historical variation. In the earlier period of expansion, the power resource of unionization was the most robust influence. In the later period of retrenchment, changes and cuts were shaped by the adoption of the Euro and a set of structural pressures. In contrast to previous research, changes and cuts in government spending are not associated with a country’s GDP per capita after the mid-1980s. We conclude by discussing implications for the welfare state and neoliberalism, and by encouraging caution for universal theories of state size.
Blame avoidance, electoral punishment and the perceptions of risk
Authors: Wenzelburger Georg
Published: January 2014

Recent findings about the electoral cost of welfare state retrenchment challenge the view of the ‘New Politics’ literature that cutting welfare state entitlements is electorally risky. In fact, there seems to be no systematic punishment for governments retrenching the welfare state. At the same time, however, studies show that governments use numerous blame avoidance strategies when cutting welfare. Reflecting on this apparent contradiction we put forward two points. First, qualitative evidence from interviews with political leaders suggests that it is not the actual risk of being punished that entices politicians to use blame avoidance but the perception of this risk. This explains why blame avoidance strategies are widely used. Second, the existing studies showing that governments are not systematically punished for cutting the welfare state suffer from the lack of control for blame avoidance effects. We show that an experimental design could be a remedy for this problem.
Lupus vasculopathy: Diagnostic, pathogenetic and therapeutic considerations
Authors: Gonzalez-Suarez ML , Waheed AA , Andrews DM , Ascherman DP , Zeng X , Nayer A
Published: January 2014

A rare form of vascular disease in systemic lupus erythematosus (SLE), lupus vasculopathy is characterized by necrosis and accumulation of immunoglobulins (IGs) and complements in the wall of arterioles and small arteries resulting in luminal narrowing. Lupus vasculopathy often accompanies lupus nephritis and portends a poor prognosis. Although there is general agreement on the treatment of lupus nephritis, effective treatment strategies for lupus vasculopathy remain to be defined. We report a 20-year-old woman with SLE who presented with generalized tonic-clonic seizure. Her immunosuppressive regimen consisted of mycophenolate mofetil, prednisone and hydroxychloroquine. On physical examination, she was Cushingoid in appearance and hypertensive. Laboratory tests indicated renal disease. Coagulation studies disclosed de novo lupus anticoagulant. Magnetic resonance imaging of the brain demonstrated acute focal cerebral hemorrhage. Echocardiography revealed reduced ejection fraction and severe mitral regurgitation. Despite high-dose glucocorticoids and mycophenolate mofetil, renal function remained poor. Kidney biopsy demonstrated lupus vasculopathy and glomerulonephritis. Plasma exchange therapy and intravenous cyclophosphamide were administered. Over the ensuing four weeks, renal function improved, complement levels increased, autoantibody titers decreased and lupus anticoagulant disappeared. In conclusion, lupus vasculopathy can occur in SLE despite a heavy immunosuppressive regimen. Antiphospholipid antibodies might be involved in the pathogenesis of lupus vasculopathy. Plasma exchange therapy in conjunction with intravenous cyclophosphamide may represent an effective treatment strategy for lupus vasculopathy.
Using Adult Children to Enhance Participation in Colorectal Cancer Screening
Authors: Martínez Jose A. , Ruiz Manuel , Vivo Maria del Carmen
Published: January 2014

We pre-tested if a new communication strategy addressed to adult children could be effective in helping to improve colorectal cancer screening (CRCS) participation rates. In a first study we used a sample of undergraduate students who participated in an experiment with six different conditions to analyze their risk perceptions regarding CRCS and their family role. A second study with a portion of that sample was also achieved to give robustness to the findings. In addition, we achieved a third study using the first sample to replicate previous findings. In a fourth study we used a sample of participants above 50 years old in order to test if the responses regarding how adult children advise their parents and their perceived influence regarding adopting healthy behaviour were similar to parents’ responses to the same questions. A final fifth study was achieved to inquire about the reasons why adult children would decide to advise their parents if a hypothetical marketing campaign was targeted at them. The results showed that designing a communication campaign addressed to adult children could help to increase rates. This result is mainly derived from the role adult children play in a parent’s decision about health behaviour, and the willingness to influence parents to participate in the screening. Adult children could also prescribe CRCS to their parents, as health services or celebrities do. Therefore, they might help to convince the at-risk population to comply with the screening, and consequently, to enhance participation rates.
Choice of Delivery Facility among Expectant Mothers in Ghana
Authors: Nketiah-Amponsah E. , Arthur E.
Published: January 2014

This article examines the effect of health insurance ownership among expectant mothers on facility-based delivery, having controlled for a host of socio-economic and demographic characteristics. Home deliveries often endanger the health of women, where complications are often referred to appropriate health facilities only when the condition has already deteriorated. Consequently, this study examines the extent to which expectant mothers’ access to health insurance influence their choice of delivery facilities broadly categorized into public health facilities, private health facilities and home delivery. Methodologically, the multinomial logistic regression is employed in the empirical estimation. Using the 2008 Ghana Demographic and Health Survey, we found at both the bivariate and multivariate level that women with access to health insurance are more likely to deliver in modern health facilities namely public and private allopathic health facilities relative to home delivery. In particular, women with access to health insurance are approximately 18 percentage points more likely to deliver in a public health facility as compared to home delivery. Also, the propensity to deliver in private health facilities relative to home delivery increases by one percentage point for women with health insurance. Thus, for expectant mothers with health insurance, the utilization of public health facilities predominates. Some of the control variables that were found to significantly influence the choice of delivery facilities include age, educational attainment, wealth quintile, area of residence, religion and region of residence. The study makes a case for scaling up access to health insurance among expectant mothers due to its positive effect on the choice of appropriate delivery facilities.
Disseminated histoplasmosis (Histoplasma capsulatum) in a pet rabbit: case report and review of the literature
Authors: Brandão João , Woods Samantha , Fowlkes Natalie , Leissinger Mary , Blair Robert , Pucheu-Haston Cherie , Johnson James , Elster Phillips Christina , Tully Thomas
Published: January 2014

A 2.5-year-old intact male miniature lop rabbit ( Oryctolagus cuniculus) was presented with multiple nodules surrounding the eyes, nose, mouth, and prepuce. Cytological evaluation of the periocular nodules revealed the presence of intracellular (within macrophages) and extracellular yeast organisms. The yeast organisms were approximately 3–5 µm in diameter, round to oval, with a thin clear capsule, and contained an eccentrically placed basophilic crescent-shaped nucleus. The clinical pathological interpretation was granulomatous inflammation with intralesional yeast of a morphology consistent with Histoplasma spp. The rabbit was treated with microsized griseofulvin (25 mg/kg, orally, once a day) for 12 days pending final cytological diagnosis of histoplasmosis. No significant improvement was noted during the treatment period, and humane euthanasia was performed. Postmortem examination revealed the presence of intracellular and extracellular yeast organisms in the small intestine, skin (antebrachium, perioral, palpebral, perianal, and pinnal), penis, penile urethra, rectum, axillary lymph node, and conjunctiva. Postmortem fungal culture yielded Histoplasma capsulatum. Based on clinical and postmortem findings, a definitive diagnosis of disseminated histoplasmosis was made. Disseminated histoplasmosis appears to be unreported in rabbits. Although the treatment used did not provide noticeable improvement, available information on histoplasmosis treatment in other species has been reviewed to provide useful information for future management of this condition in rabbits.
Childhood Cancer Camps
Authors: Beckwitt Asher E.
Published: January 2014

This study investigates the role that childhood cancer camps continue to play in the lives of adults surviving childhood cancers (ASCCs). Specifically, the purpose of this study is to understand the roles these camps play in enhancing ASCCs’ psychosocial and emotional well-being and access to information. Twenty-three ASCCs participated in this study. Illness narratives were used to understand ASCCs’ camp experiences. Three themes emerged from the data analysis to reflect ASCCs’ experiences: (1) normalcy, (2) meaningful camp experiences, and (3) access to information. Results show that in the years following camp participation, childhood cancer camps continue to play an important role in ASCCs’ lives, providing them with ongoing social and emotional support and access to resources.
Why Mothers Accompany Adolescent and Young Adult Childhood Cancer Survivors to Follow-up Clinic Visits
Authors: Doshi Kinjal , Kazak Anne E. , Hocking Matthew C. , DeRosa Branlyn Werba , Schwartz Lisa A. , Hobbie Wendy L. , Ginsberg Jill P. , Deatrick Janet
Published: January 2014

Purpose. Parents often accompany adolescent and young adult (AYA) pediatric cancer survivors to follow-up oncology clinic visits and remain involved in their care, although little is known about their reasons for doing so. Method. This mixed methods (qualitative–quantitative) study of 76 mothers of AYA survivors of childhood cancer uses content analysis and logistic regression to identify and explore reasons mothers provided for coming to the visit. Demographic and treatment data are examined as potentially explanatory factors. Results. Ten reasons (in decreasing order of frequency) were derived: Concern for Child’s Health and Well-Being, Practical Support, Transportation, Familial Experience, General Support, Companionship, Personal Interest in Follow-up Care, Characteristics of their Child, Emotional Support, and Parental Duty. The reasons were not related to demographic or treatment factors. Conclusion. Mothers accompany AYAs to survivorship clinic for both maternal/family-focused and survivor-focused reasons that can be incorporated in survivorship and transition care to reflect ongoing communications among survivors, parents, and health care teams.
Fiber strain sensors from carbon nanotubes self-assembled on aramid fibers
Authors: Ehlert Gregory J , Sodano Henry A
Published: January 2014

A self-assembly method is developed for creating a thin shell of multiwall carbon nanotubes on aramid fibers. The fibers show resistive behavior and exhibit a gauge factor of approximately 1.6, which is competitive with existing foil strain gauges. The robust sensing package could be used in the development of embedded strain sensors in multifunctional composites.
Optimizing product form attractiveness using Taguchi method and TOPSIS algorithm: A case study involving a passenger car
Authors: Chang Hua-Cheng , Chen Hung-Yuan
Published: January 2014

Form attractiveness is an important catalyst driving consumer preference for a particular product. However, a designer faces two major difficulties when attempting to enhance the attractiveness of a product form. First, consumer perception regarding form attractiveness involves a number of different intricate psychological and circumstantial evaluation bases. Second, variability exists between different consumer’s perceptions of the same product form. This study treats the task of satisfying consumer needs/desires for product form as a multi-objective design activity and develops a product form optimization method, which combines the Taguchi method with the TOPSIS algorithm. A case study involving the design of a passenger car form targeted at a particular consumer group is presented to demonstrate the operational procedure involved in the proposed method and to verify its performance. The results of the verification experiments confirm that the optimized design has a higher attractiveness in terms of each evaluation basis and results in a more consistent consumer evaluation than the non-optimized designs. The method proposed in this study is straightforward to implement and provide an effective means of reducing the time and costs associated with product form design.
The Association of Hospital Cost-Inefficiency With Certificate-of-Need Regulation
Authors: Rosko Michael D. , Mutter Ryan L.
Published: January 2014

Certificate-of-need (CON) regulations can promote hospital efficiency by reducing duplication of services; however, there are practical and theoretical reasons why they might be ineffective, and the empirical evidence generated has been mixed. This study compares the cost-inefficiency of urban, acute care hospitals in states with CON regulations against those in states without CON requirements. Stochastic frontier analysis was performed on pooled time-series, cross-sectional data from 1,552 hospitals in 37 states for the period 2005 to 2009 with controls for variations in hospital product mix, quality, and patient burden of illness. Average estimated cost-inefficiency was less in CON states (8.10%) than in non-CON states (12.46%). Results suggest that CON regulation may be an effective policy instrument in an era of a new medical arms race. However, broader analysis of the effects of CON regulation on efficiency, quality, access, prices, and innovation is needed before a policy recommendation can be made.
The Possibilities of Phenomenology for Organizational Research
Authors: Gill Michael J.
Published: January 2014

Qualitative researchers have developed and employed a variety of phenomenological methodologies to examine individuals’ experiences. However, there is little guidance to help researchers choose between these variations to meet the specific needs of their studies. The purpose of this article is to illuminate the scope and value of phenomenology by developing a typology that classifies and contrasts five popular phenomenological methodologies. By explicating each methodology’s differing assumptions, aims, and analytical steps, the article generates a series of guidelines to inform researchers’ selections. Subsequent sections distinguish the family of phenomenological methodologies from other qualitative methodologies, such as narrative analysis and autoethnography. The article then identifies institutional work and organizational identity as topical bodies of research with particular research needs that phenomenology could address.
Surviving colonization and the quest for healing: Narrative and resilience among California Indian tribal leaders
Authors: Ramirez Lucio Cloud , Hammack Phillip L.
Published: January 2014

American Indians must negotiate the cultural and psychological legacy of colonialism as they construct coherent, purposive individual and communal narratives. Analysis of the life stories of highly generative members of these groups who have emerged as leaders offers important insights for psychological adaptation in the context of the historical legacy of colonialism. Based on an interpretive analysis of the life stories of two California Indian tribal leaders, we posit a resilient-strength-based approach to narrative identity development to complement and counter the historical trauma discourse. Native American identity emerged as the major source of psychological resilience in the life stories analyzed. This identity manifested and was supported through a commitment to the wellness of tribal community, spiritual practices, and beliefs. For these men, their relationship to their grandmothers was central in molding their identities and serving as a source of resilience throughout their lives. As leaders of a federally unrecognized tribal group, they have adopted a narrative of survivance ( Vizenor, 2008 ), which appears to buffer psychosocial stress and provide a resilient narrative identity. Based on these findings, we theorize an indigenous California Native psychology of resilience.
After Lévinas
Authors: Hirst Benjamin Adam
Published: January 2014

The centrality of Lévinasian ethics to Zygmunt Bauman’s sociological vision has been affirmed by a number of writers. However, the way in which Bauman attempts to think through the implications of this ethical framework for political decision-making on a global scale has been seen as highly problematic. In recent years, Bauman has arguably begun to veer towards what can be seen as a more ‘legislative’ position, prioritizing what Lévinas calls archic issues relating to government, foundation and sovereignty, and arguably jettisoning his earlier commitment to socialism as the ‘active utopia’. It is the aim of this article to track this move in Bauman's thought, first of all locating structural continuities between his earliest English-language books written during the 1970s with those of the 1990s. It is shown that while much of the same terminology is carried over into his 1990s work, Bauman moves away from affirming the dynamics of human history and the almost ontological necessity of utopia, towards a sociologically suspect individual moral impulse which exists outside distinct social and historical formations. The sheer enthusiasm with which Bauman took hold of this idea had the result of completely frustrating the movement back to social formations. As such, it is argued that as Bauman moved towards theorizing the individual in ‘liquid modernity’ or consumer society, he developed a highly problematic concept of the individual which relies on the sociologically deterministic understandings of the human being which he was attempting to move away from before and during his engagement with Lévinas.
Do Angiotensin Type 2 Receptors Modulate Haemodynamic Effects of Type 1 Receptors in Conscious Newborn Lambs?
Authors: Vinturache Angela E , Smith Francine G
Published: January 2014

Introduction and hypothesis:

It was hypothesized that in the immediate newborn period, when the renin–angiotensin system (RAS) is activated, angiotensin type 2 receptors (AT2Rs) buffer the haemodynamic effects of angiotensin type 1 receptors (AT1Rs), as occurs in adult animals when the RAS is activated.

Materials and methods:

Arterial (systolic, diastolic, and mean) pressures (SAP, DAP, MAP), mean venous pressures (MVP) and renal blood flows (RBF) were measured in conscious, chronically instrumented lambs aged ~1 (8±2 days, N=8) and 6 weeks (41±4 days, N=11). In each animal, measurements were made before and after administration of the selective AT1R antagonist ZD 7155 (experiment one) and the selective AT2R antagonist PD123319 (experiment two) as well as both antagonists, ZD 7155 and PD 123319 (experiment three).

Results:

Haemodynamic responses to combined inhibition of both AT1Rs and AT2Rs were similar to inhibition of AT1Rs alone: there was a significant decrease in SAP, DAP, and MAP and a significant increase in RBF within minutes of concomitant administration of ZD 7155 and PD 123319 in both age groups. These responses were similar to responses to ZD 7155 alone, whereas PD 123319 alone did not alter any of the measured variables.

Conclusions:

AT2Rs do not counterbalance the pressor and renal vasoconstrictor effects elicited by activation of AT1Rs in the immediate newborn period. During this time, AT1Rs appear to predominate in eliciting the haemodynamic effects of angiotensin II (ANG II), whereas the role of the upregulated AT2Rs remains elusive.
Cultural change in the creative industries: a case study of BBC graphic design from 1990–2011
Authors: Macdonald Iain
Published: January 2014

Using his own experience as a witness and participant in the convulsion that the BBC, and specifically the BBC Graphic Design Department underwent, the author aims to illuminate the cultural change to the creative industries in many advanced industrialised countries that has occurred over the last 20 years. Many industries in the past have undergone similar ruptures and transformations and they will again in the future. The author hopes to draw lessons from an analysis of television graphic design using examples of work that can point out the attributes and skills that a new designer across the globe will need to have and obtain in order to withstand future industrial and cultural changes.