bluuebunny/crossref_metadata_2025 huggingface dataset:
Does work engagement increase after a short respite? The role of job involvement as a double‐edged sword
Authors: Kühnel Jana , Sonnentag Sabine , Westman Mina
Published: September 2008

This study extends research on work engagement by examining how a short respite and general job involvement contribute to work engagement. We gathered questionnaire data from 156 nurses before and after a short respite. Results indicated an increase of work engagement after the respite. Structural equation modelling showed that nurses who experienced psychological detachment from work during the respite showed a higher increase of work engagement. Moreover, nurses who indicated higher job involvement also showed a higher increase of work engagement. Contradictory to this direct positive effect job involvement had on change in work engagement, job involvement exerted a negative indirect effect on change in work engagement by impaired psychological detachment during the respite. Hence, job involvement acted as a double‐edged sword for the increase of work engagement. Practical implications for the organization of short respites and suggestions for future research on recovery processes are discussed.
A test of methodology intended to assist detection of aggressive offence paralleling behaviour within secure settings
Authors: Daffern Michael , Howells Kevin , Mannion Aisling , Tonkin Matthew
Published: September 2008

Purpose. Treatments and risk assessments determined by the offence paralleling behaviour (OPB) framework appear to have found a place in practice well ahead of empirical support and conceptual clarity. Although the framework is intuitively appealing its inappropriate use may have profound negative implications for patients. Incapacitation and unnecessary treatments may be demanded when observed behaviours are interpreted as evidence of persistent pathology related to previous patterns of criminal offending. Conversely, behaviours occurring within institutions that are not topographically similar but that fall within the same response class and do represent the continuation of problematic patterns of behaviour may be ignored if observers are not sensitive to the possibility that problem behaviours, albeit muted, may persist within institutions.

Methods. This paper presents a study examining the similarity of personality disordered patients' violent index acts with their aggressive behaviour during hospitalization.

Results. Results revealed evidence of cross situational similarity for some but not all aggressive behaviours.

Conclusion. These results provide support for the OPB framework. However, the lack of similarity on a significant number of incidents indicates a need for thorough, structured analysis to determine whether an aggressive behaviour observed in an institution parallels violent acts preceding incarceration.
Forced confabulation more strongly influences event memory if suggestions are other‐generated than self‐generated
Authors: Pezdek Kathy , Lam Shirley T. , Sperry Kathryn
Published: September 2008

Purpose. Virtually all eyewitnesses to a crime, who eventually testify in court, are interviewed by police officers at least once. How do these interviews affect what the eyewitnesses are subsequently likely to report? The purpose of this study is to compare the relative impact of self‐ versus other‐generated misinformation on confabulated memory about an event. Self‐generated misinformation can occur by encouraging eyewitnesses to guess or speculate about possible answers to questions about which they report having no memory. Other‐generated misinformation can occur by having an investigator suggest an answer to an eyewitness.

Methods. After viewing a 5 minutes crime video, participants answered written questions. One week later these same questions were answered again. We specifically focused on individuals' answers to unanswerable questions that probed information not actually presented in the video. If a participant answered an unanswerable question, we know that their answer was confabulated because the information was not presented in the video.

Results. If an answer to an unanswerable question was forced confabulated at time 1, that answer was more likely to be repeated at time 2 if it had been other‐generated (suggested in the question) rather than self‐generated (fabricated by the participant).

Conclusions. Pressuring eyewitnesses to answer questions about an event, when they indicate that they do not know the answer, can result in false confabulations. Answers suggested by the investigator are more likely to be repeated later than are answers that are simply self‐generated or speculated by the eyewitness. These results are consistent with the reality monitoring framework and ‘recollect‐to‐reject’ metacognitive reasoning strategies.
Addressing problems with traditional crime linking methods using receiver operating characteristic analysis
Authors: Bennell Craig , Jones Natalie J. , Melnyk Tamara
Published: September 2008

Purpose. Through an examination of serial rape data, the current article presents arguments supporting the use of receiver operating characteristic (ROC) analysis over traditional methods in addressing challenges that arise when attempting to link serial crimes. Primarily, these arguments centre on the fact that traditional linking methods do not take into account how linking accuracy will vary as a function of the threshold used for determining when two crimes are similar enough to be considered linked.

Methods. Considered for analysis were 27 crime scene behaviours exhibited in 126 rapes, which were committed by 42 perpetrators. Similarity scores were derived for every possible crime pair in the sample. These measures of similarity were then subjected to ROC analysis in order to (1) determine threshold‐independent measures of linking accuracy and (2) set appropriate decision thresholds for linking purposes.

Results. By providing a measure of linking accuracy that is not biased by threshold placement, the analysis confirmed that it is possible to link crimes at a level that significantly exceeds chance (AUC = .75). The use of ROC analysis also allowed for the identification of decision thresholds that resulted in the desired balance between various linking outcomes (e.g. hits and false alarms).

Conclusions. ROC analysis is exclusive in its ability to circumvent the limitations of threshold‐specific results yielded from traditional approaches to linkage analysis. Moreover, results of the current analysis provide a basis for challenging common assumptions underlying the linking task.
Children’s Rights and Children’s Action in International Relief and Domestic Welfare: The Work of Herbert Hoover Between 1914 and 1950
Authors: Marshall Dominique
Published: September 2008

Herbert Hoover authored three charters of rights for children. They protected a distinct place for children in society and allowed them to express their spirit and, more broadly, the renewal of democratic institutions and a world where international relations would be the responsibility of many. This article investigates the international and domestic contexts of the charters and of their uses, in order to retrieve the meanings associated with this rhetoric in its time, as well as the actual limits the promises made in the three lists contained and encountered. It is especially interested in the public role of children associated with the three charters, and with the tensions between ideas of neutrality and autonomy. Finally, it suggests some parallels with current humanitarian institutions and debates on children’s entitlements. Contemporary debates and uses are discussed around four main themes: children as bodies to be fed and cured, as emotional beings to be loved, as politically neutral citizens, and as future citizens.
“Do Your Promises and Tell the Truth. Treat us with Respect”: Realizing the Rights of Children and Young People in Northern Ireland
Authors: Haydon Deena
Published: September 2008

In 1991, the UK Government, incorporating the jurisdiction of Northern Ireland, ratified the United Nations Convention on the Rights of the Child (CRC). Reports about progress in implementation of the Convention are submitted to the UN Committee on the Rights of the Child (UN Committee) at regular intervals. Because the Convention is not incorporated into domestic law there is no redress for breach of its Articles. But when the UK Government reported in 1994 and 1999, the UN Committee responded critically, raising a number of serious concerns and making a range of recommendations. In 2007, the UK Government submitted its third and fourth consolidated report. Based on consultations with 132 children and young people in Northern Ireland, this article reflects their understanding and expectations regarding rights, specifically: participation, religion and culture, protection from harm, health care, standard of living, education, age-appropriate play and leisure. Discussion of the relevance of a rights-based perspective to understanding about childhood and youth explores social constructions of ‘children’ and ‘childhood’, the centrality of participation, current promotion and protection of children’s rights. How children and young people define rights, and their lived experiences, provide an insight into the realization of children’s rights in contemporary Northern Ireland. The final words are key messages for Government from the children and young people who participated.
'The Cream,' The 'Clear,' BALCO and Baseball: An Analysis of MLB Players Image
Authors: Haigh Michel M.
Published: September 2008

In 2003, the FBI raided BALCO laboratory. The client list of the "nutritional supplement lab" included Major League Baseball players Barry Bonds and Jason Giambi. They were accused of using performance-enhancing drugs manufactured by BALCO. A content analysis examined newspaper coverage for three years. Results revealed articles had a negative tone toward the baseball industry, and sources were depicted as knowledgeable but lacking character. The players repaired their image by shifting the blame, evading responsibility, and apologizing.
Through the Hoop: How Sports Participation Displaces Media Use and Is Related to Body Self-Esteem in Competitive Female Athletes
Authors: Bissell Kimberly , Birchall Katharine
Published: September 2008

This exploratory study analyzed competitive adolescent female athletes' use of entertainment media and sports participation and looked for possible predictors of more positive body self-esteem, an affective trait that could be present in women who have eating disorder tendencies. In this survey of 80 8-18 female athletes, overall body self-esteem was found to be quite high, but athletes in specific sports (golf, volleyball, and soccer) were much more likely to have a more positive outlook on their body shape than athletes in other sports such as gymnastics. The samples' recall of their media use was quite detailed and specific because so much media use was displaced by their involvement in sports. It was further found that older athletes, between 12-18, were more likely to believe that television played an important and influential role in learning how to be a girl. These and other findings are discussed.
The Black Press and the Integration of Professional Baseball: A Content Analysis of Shifts in Coverage, 1945–1948
Authors: Carroll Brian
Published: September 2008

The purpose of this study is to analyze black press coverage of both the Negro leagues and major league baseball before and after Jackie Robinson broke the color barrier with the Brooklyn Dodgers in April 1947. This study quantifies coverage over time and employs a content analysis of columns and articles in the black weeklies immediately before integration, in 1945 and 1946, and immediately after Robinson's signing, during the seasons of 1947 and 1948.
The Prophecies of Calchas in the Aulis Narrative of Aeschylus’ Agamemnon
Authors: Egan Rory B.
Published: September 2008

Dans Agamemmnon 104–263, le chœur relate les événements qui se sont déroulés à Aulis. Nous proposons une nouvelle lecture de ce passage et avançons plusieurs nouvelles interprétations syntaxique, sémantique et mythologique. Il en résulte pour la pièce et toute la trilogie des implications poétiques, dramaturgiques, morales et théologiques. Nous étayons ici des arguments que nous avions déjà invoqués en 1979 en posant en prémisse que le discours attribué à Calchas (aux vers 123–125) continue pendant tout l’< hymne à Zeus > et jusqu’à la finale au vers 183. Ce discours ne connaît qu’une brève interruption aux vers 157–158.
Building the Kingdom of God: Religious Discourse, National Identity, and the Good Neighbor Policy, 1930–1938
Authors: Zietsma David
Published: September 2008

This article argues that Protestant modernist discourse framed U.S. foreign relations during the 1930s. The good neighbor policy emerged as part of a rhetorically constructed national identity narrative that reinvigorated Americans' sense of manifest destiny in the face of Great Depression anxiety. U.S. policies ostensibly advocating nonintervention, disarmament, and international cooperation inscribed a religiously oriented national mission centered on international beneficence. These discursive frames altered the form rather than the substance of U.S. hegemony in the Western Hemisphere while rendering the United States militarily inert amid rising tensions in Asia and Europe.
Death by Publicity: U.S. Freemasonry and the Public Drama of Secrecy
Authors: Gunn Joshua
Published: September 2008

In this essay I argue that the decline of Freemasonry in the United States is homologous to a general decline in civic engagement. An examination of the centuries-old ritual and symbolism of the fraternity reveals a dynamic relationship between promise making and secrecy that has sustained Masonry for almost 300 years. In the context of its dwindling membership, I argue that recent attempts by Masonic leaders to promote the fraternity in the language of transparency not only bespeak the paradoxical way in which publics are threatened by publicity, but also suggest that a sense of mystery is necessary to sustain a public over time.
Enacting Transformation: George W. Bush and the Pauline Conversion Narrative in A Charge to Keep
Authors: Bailey David C.
Published: September 2008

This essay considers how George W. Bush rhetorically enacted personal and political transformation before the electorate in his 2000 presidential campaign. Bush accomplished these tasks by bringing his conversion experience into conformity with the Pauline conversion narrative. This rhetorical modification enabled Bush to (1) create a sense of "consubstantiality" with evangelical Christians, (2) declare his previous transgressions off limits for public scrutiny, and (3) claim no less than Rev. Billy Graham as his spiritual mentor.
"Playing Up Being a Woman": Femme Performance and the Potential for Ironic Representation
Authors: Galewski Elizabeth
Published: September 2008

Synecdochic representation reproduces commonplace identity categories in the very attempt to question them. Could there be another way to represent that does not fall into this trap? This study explores the possibility of an ironic mode of political representation and posits femme gender performance as an example. The femme goes forth into the heterosexual mainstream as "straight" and returns as "queer," a surprising reversal that casts heteronormative assumptions into doubt. Yet irony has its own limits. Ironic and synecdochic representation gain ground by working together in a productive tension, alternately opening up new possibilities and appealing to existing commonplaces.
Insisting on Persisting: The Nuclear Rhetoric of "Stockpile Stewardship"
Authors: Taylor Bryan C. , Hendry Judith
Published: September 2008

This essay critiques official rhetoric surrounding post–Cold War–era management of the U.S. nuclear arsenal. During the 1990s, the U.S. Department of Energy developed a "Stockpile Stewardship Program" to certify the safety and reliability of that arsenal in the absence of explosive testing. This program has subsequently been challenged for its vast scale and expense, for its actual utility, and for its potential to facilitate the development of "new" nuclear weapons. This essay critiques "stewardship" as a contested historical and cultural discourse. It argues that, by appropriating this discourse, nuclear officials have rhetorically cast themselves as guardians of nuclear resources for the benefit of current and future generations, and have successfully defended themselves against undesirable change arising from public reconsideration of nuclear deterrence. As a result, this rhetoric has undermined the possibility of a genuine nuclear democracy based on adequate representation and deliberation of nuclear interests in the post–Cold War era.
Phenotypic and Genetic Associations Between the Big Five and Trait Emotional Intelligence
Authors: Vernon Philip A. , Villani Vanessa C. , Schermer Julie Aitken , Petrides K. V.
Published: October 2008

This study reports the first behavioral genetic investigation of the extent to which genetic and/or environmental factors contribute to the relationship between the Big Five personality factors and trait emotional intelligence. 213 pairs of adult monozygotic twins and 103 pairs of same-sex dizygotic twins completed the NEO-PI-R and the Trait Emotional Intelligence Questionnaire (TEIQue). Replicating previous non-twin studies, many significant phenotypic correlations were found between the Big Five factors — especially Neuroticism, Extraversion, and Conscientiousness — and the facets, factors, and global scores derived from the TEIQue. Bivariate behavioral genetic model-fitting analyses revealed that these phenotypic correlations were primarily attributable to correlated genetic factors and secondarily to correlated non-shared environmental factors. The results support the feasibility of incorporating EI as a trait within existing personality taxonomies.
Phenotypic, Genetic, and Environmental Properties of the Portrait Values Questionnaire
Authors: Schermer Julie Aitken , Feather N. T. , Zhu Gu , Martin Nicholas G.
Published: October 2008

The purpose of the present study was to examine the 10 value types from the Portrait Values Questionnaire (PVQ; Schwartz et al., 2001) both at the phenotypic (observed) level as well as the genetic and environmental level. Australian twins (N= 695) completed the PVQ as part of a larger questionnaire battery. Nine of the value types were found to have a genetic component with heritability estimates ranging from 10.8% for power to 38% for conformity. The achievement scale was best explained by environmental factors. The interscale correlations were found to range from –.02 to .70 at the phenotypic level. Of these 45 correlations, 16 were found to be explained by overlapping genetic factors and almost all (41) were found to have significant unique environment correlations.
The Actin-Binding Protein Abp1 Controls Dendritic Spine Morphology and Is Important for Spine Head and Synapse Formation
Authors: Haeckel Akvile , Ahuja Rashmi , Gundelfinger Eckart D. , Qualmann Britta , Kessels Michael M.
Published: October 2008

Polymerization and organization of actin into complex superstructures, including those found in dendritic spines, is indispensable for structure and function of neuronal networks. Here we show that the filamentous actin (F-actin)-binding protein 1 (Abp1), which controls Arp2/3 complex-mediated actin nucleation and binds to postsynaptic scaffold proteins of the ProSAP (proline-rich synapse-associated protein 1)/Shank family, has a profound impact on synaptic organization. Overexpression of the two Abp1 F-actin-binding domains increases the length of thin, filopodia-like and mushroom-type spines but dramatically reduces mushroom spine density, attributable to lack of the Abp1 Src homology 3 (SH3) domain. In contrast, overexpression of full-length Abp1 increases mushroom spine and synapse density. The SH3 domain alone has a dominant-negative effect on mushroom spines, whereas the density of filopodia and thin, immature spines remains unchanged. This suggests that both actin-binding and SH3 domain interactions are crucial for the role of Abp1 in spine maturation. Indeed, Abp1 knockdown significantly reduces mushroom spine and synapse density. Abp1 hereby works in close conjunction with ProSAP1/Shank2 and ProSAP2/Shank3, because Abp1 effects were suppressed by ProSAP2 RNA interference and the ProSAP/Shank-induced increase of spine head width is further promoted by Abp1 cooverexpression and reduced on Abp1 knockdown. Also, interfering with the formation of functional Abp1–ProSAP protein complexes prevents ProSAP-mediated spine head extension. Spine head extension furthermore depends on local Arp2/3 complex-mediated actin polymerization, which is controlled by Abp1 via the Arp2/3 complex activator N-WASP (neural Wiskott-Aldrich syndrome protein). Abp1 thus plays an important role in the formation and morphology control of synapses by making a required functional connection between postsynaptic density components and postsynaptic actin dynamics.
Role of GluR1 in Activity-Dependent Motor System Development
Authors: Zhang Lei , Schessl Joachim , Werner Markus , Bonnemann Carsten , Xiong Guoxiang , Mojsilovic-Petrovic Jelena , Zhou Weiguo , Cohen Akiva , Seeburg Peter , Misawa Hidemi , Jayaram Aditi , Personius Kirkwood , Hollmann Michael , Sprengel Rolf , Kalb Robert
Published: October 2008

Activity-dependent specification of neuronal architecture during early postnatal life is essential for refining the precision of communication between neurons. In the spinal cord under normal circumstances, the AMPA receptor subunit GluR1 is expressed at high levels by motor neurons and surrounding interneurons during this critical developmental period, although the role it plays in circuit formation and locomotor behavior is unknown. Here, we show that GluR1 promotes dendrite growth in a non-cell-autonomous mannerin vitroandin vivo. The mal-development of motor neuron dendrites is associated with changes in the pattern of interneuronal connectivity within the segmental spinal cord and defects in strength and endurance. Transgenic expression of GluR1 in adult motor neurons leads to dendrite remodeling and supernormal locomotor function. GluR1 expression by neurons within the segmental spinal cord plays an essential role in formation of the neural network that underlies normal motor behavior.
Moment-to-Moment Tracking of State Value in the Amygdala
Authors: Belova Marina A. , Paton Joseph J. , Salzman C. Daniel
Published: October 2008

As an organism interacts with the world, how good or bad things are at the moment, the value of the current state of the organism, is an important parameter that is likely to be encoded in the brain. As the environment changes and new stimuli appear, estimates of state value must be updated to support appropriate responses and learning. Indeed, many models of reinforcement learning posit representations of state value. We examined how the brain mediates this process by recording amygdala neural activity while monkeys performed a trace-conditioning task requiring fixation. The presentation of different stimuli induced state transitions; these stimuli included unconditioned stimuli (USs) (liquid rewards and aversive air puffs), newly learned reinforcement-predictive visual stimuli [conditioned stimuli (CSs)], and familiar stimuli long associated with reinforcement [fixation point (FP)]. The FP had a positive value to monkeys, because they chose to foveate it to initiate trials. Different populations of amygdala neurons tracked the positive or negative value of the current state, regardless of whether state transitions were caused by the FP, CSs, or USs. Positive value-coding neurons increased their firing during the fixation interval and fired more strongly after rewarded CSs and rewards than after punished CSs and air puffs. Negative value-coding neurons did the opposite, decreasing their firing during the fixation interval and firing more strongly after punished CSs and air puffs than after rewarded CSs and rewards. This representation of state value could underlie how the amygdala helps coordinate cognitive, emotional, and behavioral responses depending on the value of one's state.
Spontaneous and Evoked Glutamate Release Activates Two Populations of NMDA Receptors with Limited Overlap
Authors: Atasoy Deniz , Ertunc Mert , Moulder Krista L. , Blackwell Justin , Chung ChiHye , Su Jianzhong , Kavalali Ege T.
Published: October 2008

In a synapse, spontaneous and action-potential-driven neurotransmitter release is assumed to activate the same set of postsynaptic receptors. Here, we tested this assumption using (+)-5-methyl-10,11-dihydro-5H-dibenzo [a,d] cyclohepten-5,10-imine maleate (MK-801), a well characterized use-dependent blocker of NMDA receptors. NMDA-receptor-mediated spontaneous miniature EPSCs (NMDA-mEPSCs) were substantially decreased by MK-801 within 2 min in a use-dependent manner. In contrast, MK-801 application at rest for 10 min did not significantly impair the subsequent NMDA-receptor-mediated evoked EPSCs (NMDA-eEPSCs). Brief stimulation in the presence of MK-801 significantly depressed evoked NMDA-eEPSCs but only mildly affected the spontaneous NMDA-mEPSCs detected on the same cell. Optical imaging of synaptic vesicle fusion showed that spontaneous and evoked release could occur at the same synapse albeit without correlation between their kinetics. In addition, modeling glutamate diffusion and NMDA receptor activation revealed that postsynaptic densities larger than ∼0.2 μm2can accommodate two populations of NMDA receptors with nonoverlapping responsiveness. Collectively, these results support the premise that spontaneous and evoked neurotransmissions activate distinct sets of NMDA receptors and signal independently to the postsynaptic side.
Upregulation of Calcium/Calmodulin-Dependent Protein Kinase IV Improves Memory Formation and Rescues Memory Loss with Aging
Authors: Fukushima Hotaka , Maeda Ryouta , Suzuki Ryousuke , Suzuki Akinobu , Nomoto Masanori , Toyoda Hiroki , Wu Long-Jun , Xu Hui , Zhao Ming-Gao , Ueda Kenji , Kitamoto Aya , Mamiya Nori , Yoshida Taro , Homma Seiichi , Masushige Shoichi , Zhuo Min , Kida Satoshi
Published: October 2008

Previous studies have suggested that calcium/calmodulin-dependent protein kinase IV (CaMKIV) functions as a positive regulator for memory formation and that age-related memory deficits are the result of dysfunctional signaling pathways mediated by cAMP response element-binding protein (CREB), the downstream transcription factor of CaMKIV. Little is known, however, about the effects of increased CaMKIV levels on the ability to form memory in adult and aged stages. We generated a transgenic mouse overexpressing CaMKIV in the forebrain and showed that the upregulation of CaMKIV led to an increase in learning-induced CREB activity, increased learning-related hippocampal potentiation, and enhanced consolidation of contextual fear and social memories. Importantly, we also observed reduced hippocampal CaMKIV expression with aging and a correlation between CaMKIV expression level and memory performance in aged mice. Genetic overexpression of CaMKIV was able to rescue associated memory deficits in aged mice. Our findings suggest that the level of CaMKIV expression correlates positively with the ability to form long-term memory and implicate the decline of CaMKIV signaling mechanisms in age-related memory deficits.
Brain SIRT1: Anatomical Distribution and Regulation by Energy Availability
Authors: Ramadori Giorgio , Lee Charlotte E. , Bookout Angie L. , Lee Syann , Williams Kevin W. , Anderson Jason , Elmquist Joel K. , Coppari Roberto
Published: October 2008

SIRT1 is a nicotinamide adenosine dinucleotide-dependent deacetylase that orchestrates key metabolic adaptations to nutrient deprivation in peripheral tissues. SIRT1 is induced also in the brain by reduced energy intake. However, very little is known about SIRT1 distribution and the biochemical phenotypes of SIRT1-expressing cells in the neuraxis. Unknown are also the brain sites in which SIRT1 is regulated by energy availability and whether these regulations are altered in a genetic model of obesity. To address these issues, we performedin situhybridization histochemistry analyses and found thatSirt1mRNA is highly expressed in metabolically relevant sites. These include, but are not limited to, the hypothalamic arcuate, ventromedial, dorsomedial, and paraventricular nuclei and the area postrema and the nucleus of the solitary tract in the hindbrain. Of note, our single-cell reverse transcription-PCR analyses revealed thatSirt1mRNA is expressed in pro-opiomelanocortin neurons that are critical for normal body weight and glucose homeostasis. We also found that SIRT1 protein levels are restrictedly increased in the hypothalamus in the fasted brain. Of note, we found that this hypothalamic-specific, fasting-induced SIRT1 regulation is altered in leptin-deficient, obese mice. Collectively, our findings establish the distribution ofSirt1mRNA throughout the neuraxis and suggest a previously unrecognized role of brain SIRT1 in regulating energy homeostasis.
Spastikquantifizierung während therapeutischer Muskelstimulation Spasticity Quantification during Therapeutic Muscle Stimulation
Authors: Bernhardt Michael , Meissner Daniel , Struppler Albrecht , Buss Martin
Published: October 2008

Die repetitive periphere Magnetstimulation (RPMS) ist eine innovative Methode zur Rehabilitation von spastischer Parese nach Schlaganfall. Die Quantifizierung des Spastizitätslevels ist für die Therapie als auch für die Spastikforschung von Bedeutung. Im vorliegenden Artikel wird eine Methode zur Spastikquantifizierung basierend auf Modellbildung und Parameteridentifikation vorgestellt. Sie kann während der Stimulationstherapie eingesetzt werden und wird in einer Pilotstudie evaluiert.
Messeinrichtung für Wechselspannungen und Phasenverschiebungswinkel im Frequenzbereich 0,3Hz bis 50kHz Instrumentation for the Measurement of Alternating Voltage and Angle of Phase Difference in the Frequency Range 0.3Hz to 50kHz
Authors: Bühn Uwe
Published: October 2008

Kalibriersysteme zur Ermittlung des komplexen Übertragungskoeffizienten von Schwingungs-Aufnehmern bedingen die Ermittlung der Phasen-Frequenzgänge der systemeigenen Elektronik-Baugruppen sowie die Kalibrierung des Gesamtsystems. Da bisher kein Staatsinstitut über entsprechende Messmöglichkeiten verfügte, wurde im Rahmen eines Forschungsvorhabens zwischen SPEKTRA und der PTB eine derartige Messeinrichtung entwickelt, aufgebaut und an das nationale Normal angeschlossen.
Controversies in the Management of Patent Ductus Arteriosus
Authors: Gien Jason
Published: October 2008

Exposure to a chronic persistent patent ductus arteriosus (PDA) is associated with several neonatal morbidities, but whether such outcomes are as a result of a persistent left-to-right shunt across the PDA or as a consequence of prematurity remains in question. Animal studies have shown significant benefit to early PDA closure, but such findings have not been replicated in any human trial. Both pharmacologic and surgical treatment options exist for closing a PDA, both of which have their own morbidities. Although the incidence of PDA is high in preterm infants, there also is a high rate of spontaneous PDA closure. Treatment of a PDA is not benign and has not been shown to prevent any morbidities associated with prematurity. For this reason, there has been much debate in recent years as to when a PDA is pathologic and when closure is indicated. This discussion focuses on the debate, treatment options for PDA, and outcomes associated with PDA and its treatment.
Randomized, Controlled Trial on Tracheal Colonization of Ventilated Infants: Can Gravity Prevent Ventilator-Associated Pneumonia?
Authors: Aly Hany , Badawy Magda , El-Kholy Amany , Nabil Reem , Mohamed Afaf
Published: October 2008

OBJECTIVE. The goal was to test the hypothesis that intubated infants positioned on their sides would be less likely to contract bacterial colonization in their tracheae, compared with those positioned supine.

METHODS. We conducted a prospective, randomized, controlled trial with 60 intubated infants; 30 infants were positioned supine (supine group), and 30 infants were maintained in the lateral position (lateral group). Tracheal aspirates were cultured and bacterial colony counts were recorded after 48 hours and after 5 days of mechanical ventilation.

RESULTS. After 2 days, the numbers of positive tracheal cultures in the supine group (67%) and in the lateral group (47%) showed no statistical difference. After 5 days of mechanical ventilation, tracheal cultures differed significantly between groups. Cultures were positive for 26 infants (87%) in the supine group and 9 infants (30%) in the lateral group. Compared with the lateral group, more infants in the supine group experienced increased colony counts or had new organisms in their tracheal aspirates over time (21 vs 8 infants). The most common organisms isolated from tracheal aspirates in both groups were Gram-negative rods.

CONCLUSIONS. Respiratory contamination is very common among ventilated infants. Therefore, judicious use of mechanical ventilation cannot be overemphasized. Gravitational force can ameliorate the onset of respiratory colonization. The mechanism and clinical applicability of such observations need to be explored further.
Do Cortisol Concentrations Predict Short-Term Outcomes in Extremely Low Birth Weight Infants?
Authors: Aucott Susan W. , Watterberg Kristi L. , Shaffer Michele L. , Donohue Pamela K. ,   for the PROPHET Study Group
Published: October 2008

OBJECTIVE. Relative adrenal insufficiency in extremely low birth weight infants may contribute to significant morbidity and death. Our objective was to evaluate the relationship between cortisol concentrations and short-term outcomes.

METHODS. Cortisol concentrations were obtained for 350 intubated, extremely low birth weight infants at postnatal age of 12 to 48 hours and at day 5 to 7, as part of a multicenter, randomized trial of hydrocortisone treatment for prophylaxis of relative adrenal insufficiency. Death and short-term morbidity were monitored prospectively. Cortisol levels at each time point were divided into quartiles. The incidence rates of outcomes were determined for each quartile and for infants with cortisol values of <10th percentile or >90th percentile.

RESULTS. Median cortisol values were 16.0 μg/dL at baseline and 13.1 μg/dL on day 5 to 7 in the placebo group. Outcomes did not differ in each quartile between treatment and placebo groups. Low cortisol values at baseline or day 5 to 7 were not associated with increased morbidity or mortality rates and were not predictive of open-label hydrocortisone use. In fact, vasopressor use was lower for infants with lower cortisol values at baseline. Severe intraventricular hemorrhage was more frequent in infants with cortisol levels in the upper quartile at baseline, and values of >90th percentile were significantly associated with higher rates of death, severe intraventricular hemorrhage, periventricular leukomalacia, gastrointestinal perforation, and severe retinopathy of prematurity.

CONCLUSIONS. Low cortisol concentrations were not predictive of adverse short-term outcomes, but high cortisol concentrations were associated with severe intraventricular hemorrhage, and extremely elevated values were associated with morbidity and death. Low cortisol concentrations alone at these 2 time points did not identify the infants at highest risk for adverse outcomes. In contrast, high cortisol values were associated with increased morbidity and mortality rates.
Randomized Trial of Very Low Birth Weight Infants Receiving Higher Rates of Infusion of Intravenous Fat Emulsions During the First Week of Life
Authors: Drenckpohl Douglas , McConnell Connie , Gaffney Shirley , Niehaus Matt , Macwan Kamlesh S.
Published: October 2008

OBJECTIVE. The goal was to determine whether very low birth weight infants could tolerate higher rates of infusion of intravenous fat emulsion during the first week of life and maintain their serum triglyceride levels at ≤200 mg/dL.

METHODS. This was a randomized, controlled trial of 110 infants who were classified as appropriate for gestational age and had birth weights between 750 g and 1500 g. The primary clinical outcome was serum triglyceride levels; secondary outcomes also were monitored.

RESULTS. One hundred infants completed the study (experimental group: N = 48; control group: N = 52). Infants in the experimental group had significantly higher energy intake for the entire 7-day study period and achieved 90 kcal/kg per day (1 kcal = 4.184 kJ) significantly sooner (7.38 ± 3.381 days vs 9.44 ± 3.578 days). Triglyceride levels for infants in the experimental group remained significantly higher for the first 5 days of life. Fifteen percent of infants in the experimental group but only 4% of infants in the control group developed hypertriglyceridemia. Ten percent of infants in the control group but no infants in the experimental group required insulin therapy. Forty-two percent of infants in the experimental group and 17% of infants in the control group remained at ≥10th percentile for weight for age. Fourteen percent of infants in the control group but no infants in the experimental group developed necrotizing enterocolitis. Twenty-three percent of infants in the control group but only 6% of infants in the experimental group developed retinopathy of prematurity. There were no significant differences in other outcomes.

CONCLUSIONS. Very low birth weight infants can tolerate higher rates of infusion of intravenous fat emulsion solutions during the first week of life without significant adverse events.
Pediatric Private Practice After Hurricane Katrina: Proposal for Recovery
Authors: Needle Scott
Published: October 2008

The health care system of the US Gulf Coast was severely damaged by Hurricane Katrina in August 2005. Physicians in the region have faced enormous financial and psychological challenges. Pediatricians have been particularly affected, because of the large number of children covered by Medicaid, with its associated low payments, and the failure of children and families to return to affected areas. Federal relief efforts to date have largely benefited nonprofit organizations, community health centers, and hospitals. Private physicians have received little to no governmental assistance, despite their vital role in the health care system. This article explores the many factors threatening the survival of pediatric private practice in the aftermath of Hurricane Katrina and offers some practical governmental solutions. The proposals outlined here aim to provide stability and recovery to health care in the region by enabling residents to obtain care from local preexisting providers on the Gulf Coast and ensuring that physicians are paid adequately for their services. These ideas have applicability beyond Hurricane Katrina and should encourage thought regarding health care delivery after future regional disasters.
Adolescent Immunizations: Missed Opportunities for Prevention
Authors: Lee Grace M. , Lorick Suchita A. , Pfoh Elizabeth , Kleinman Ken , Fishbein Daniel
Published: October 2008

OBJECTIVES. The goals were (1) to describe immunization rates for tetanus-diphtheria, hepatitis B, and measles-mumps-rubella vaccines among 13-year-old adolescents; (2) to identify missed opportunities for tetanus-diphtheria immunization among adolescents 11 to 17 years of age; and (3) to evaluate the association between preventive care use and tetanus-diphtheria immunization.

METHODS. Adolescents born between January 1, 1986, and December 31, 1991, and enrolled in Harvard Pilgrim Health Care and Harvard Vanguard Medical Associates for ≥1 year in 1997–2004 were included. Immunization rates for tetanus-diphtheria, hepatitis B, and measles-mumps-rubella were assessed at 13 years of age. Missed opportunities for tetanus-diphtheria immunization within 14 days after a health care visit were measured. Multivariate models were used to determine predictors of timeliness of tetanus-diphtheria vaccination, particularly the use of preventive care services.

RESULTS. A total of 23987 eligible adolescents were enrolled in Harvard Pilgrim Health Care and Harvard Vanguard Medical Associates between 1997 and 2004. Among 13-year-old adolescents in the most recent birth cohort, 84%, 74%, and 67% were up to date for tetanus-diphtheria, hepatitis B, and measles-mumps-rubella, respectively. When the analysis was limited to those with ≥1 vaccine received before 2 years of age (a proxy measure for complete records), 92%, 82%, and 85% were up to date for tetanus-diphtheria, hepatitis B, and measles-mumps-rubella, respectively. Missed opportunities for tetanus-diphtheria immunization occurred at 84% of all health care visits. Adolescents who did not seek preventive care were less likely to receive tetanus-diphtheria in a timely manner.

CONCLUSIONS. Adolescent immunization rates lag far behind childhood rates, and missed opportunities are common. Additional strategies are needed to increase the use of preventive services among adolescents and to enable providers to vaccinate adolescents at every opportunity.
Free Drug Samples in the United States: Characteristics of Pediatric Recipients and Safety Concerns
Authors: Cutrona Sarah L. , Woolhandler Steffie , Lasser Karen E. , Bor David H. , Himmelstein David U. , Shrank William H. , LeLeiko Neal S.
Published: October 2008

OBJECTIVES. Free drug samples frequently are given to children. We sought to describe characteristics of free sample recipients, to determine whether samples are given primarily to poor and uninsured children, and to examine potential safety issues.

METHODS. We analyzed data on 10295 US residents <18 years of age from the 2004 Medical Expenditure Panel Survey, a nationally representative survey that includes questions on receipt of free drug samples. We performed bivariate and multivariate analyses to evaluate characteristics associated with receipt of ≥1 free drug sample in 2004. We identified the most frequently reported sample medications and reviewed potential safety issues.

RESULTS. Ten percent of children who received prescription medications and 4.9% of all children received ≥1 free drug sample in 2004. In bivariate analyses, poor children (family incomes of <200% of the federal poverty level) were no more likely to receive free samples than were those with incomes of ≥400% of the poverty level (3.8% vs 5.9%). Children who were uninsured for part or all of the year were no more likely to receive free samples than were those who were insured all year (4.5% vs 5.1%); 84.3% of all sample recipients were insured. In multivariate analyses, routine access to health care (≥3 provider visits in 2004) was associated with free sample receipt. The 15 most frequently distributed pediatric free samples in 2004 included 1 schedule II controlled medication, Adderall (amphetamine/dextroamphetamine), and 4 medications that received new or revised black box warnings between 2004 and 2007, Elidel (pimecrolimus), Advair (fluticasone/salmeterol), Strattera (atomoxetine), and Adderall (amphetamine/dextroamphetamine).

CONCLUSIONS. Poor and uninsured children are not the main recipients of free drug samples. Free samples do not target the neediest children selectively, and they have significant safety considerations.
Retrospective Evaluation of a Computerized Physician Order Entry Adaptation to Prevent Prescribing Errors in a Pediatric Emergency Department
Authors: Sard Brian E. , Walsh Kathleen E. , Doros Gheorghe , Hannon Megan , Moschetti Wayne , Bauchner Howard
Published: October 2008

OBJECTIVE. The goal was to determine the impact on medication prescribing errors of adding a pediatric medication list (quicklist) to a computerized physician order entry system in a pediatric emergency department.

METHODS. The quicklist is a drug dosing support tool that targets the most common medications in our clinical setting. We performed a retrospective comparison of orders from 420 randomly selected visits before and after quicklist introduction. Error rates were analyzed with respect to urgency level, physician training level, and patient age. The quicklist was examined for frequency of use and error rates.

RESULTS. The 840 patient visits (420 before intervention and 420 after intervention) generated 724 medication orders, which contained 156 medication prescribing errors (21%). The groups did not differ with respect to urgency level, physician training level, or patient age. There were significant decreases in the rate of errors per 100 visits, from 24 to 13 errors per 100 visits, and in the rate of errors per 100 orders, from 31 to 14 errors per 100 orders. The decrease in the error rates did not vary according to urgency score, age group, or physician training level. The quicklist was used in 30% of the orders in the postintervention group. In this group, the error rate was 1.9 errors per 100 orders when the quicklist was used, compared with 18.3 errors per 100 orders when the list was not used. Errors of wrong formulation, allergy, drug-drug interaction, and rule violations were eliminated.

CONCLUSION. The introduction of the quicklist was followed by a significant reduction in medication prescribing errors. A list with dosing support for commonly used pediatric medications may help adapt computerized physician order entry systems designed for adults to serve pediatric populations more effectively.
Experience of Families During Cardiopulmonary Resuscitation in a Pediatric Intensive Care Unit
Authors: Tinsley Cynthia , Hill J. Brandon , Shah Jason , Zimmerman Grenith , Wilson Michele , Freier Kiti , Abd-Allah Shamel
Published: October 2008

OBJECTIVES. Having parents present during cardiopulmonary resuscitation is becoming a common practice in pediatrics. This study aimed to determine parents' perception of the effects of their presence during the resuscitation efforts of their child and whether they would recommend the experience to other families.

METHODS. This study included parents or guardians of children who underwent cardiopulmonary resuscitation, and died at least 6 months before the interview. After telephone consent was obtained, a survey questionnaire was completed. The interviewees answered whether they were asked to be present, whether they had physical contact with their child, and whether the experience frightened them or gave them and their child comfort. The interviewees were asked to express their feelings about what was helpful to them and what could be done to improve the experience.

RESULTS. A total of 41 interviews were conducted, and responders were divided into 2 groups: 21 in the present group and 20 in the not-present group for cardiopulmonary resuscitation. Twelve (60%) of those in the not-present group believed that their presence would have comforted the child, and 50% (10 of 20) believed that it would have helped them accept the child's death. Of those in the present group, 67% (8 of 12) believed that touching their child brought comfort, 29% (6 of 21) felt scared during cardiopulmonary resuscitation, 71% (15 of 21) believed that their presence comforted their child, and 67% (14 of 21) believed that their presence helped them adjust to the loss of the child. The majority in both groups (63% [26 of 41]) would recommend being present during cardiopulmonary resuscitation.

CONCLUSIONS. This study supports encouraging family presence during cardiopulmonary resuscitation. The majority of parents who had been present and those who had not been present believed that all families should be given the option to be present.