bluuebunny/crossref_metadata_2025 huggingface dataset:
Musical exploration using ICT in the middle and secondary school classroom
Authors: Ward Christopher J.
Published: April 2009

In this article, I explore musical creativity through Information and Communication Technology (ICT). This article aims to show that secondary school pupils can compose freely using ICT in the classroom, easing and `democratizing' the creative process, enabling a high standard for all, regardless of formal musical training. The fieldwork project was conducted across one secondary school (Years 9—13, ages 14—18) and one middle school (Years 5—8, ages 9—13) in Windsor, UK from November 2002 to December 2003. There were opportunities in the music classrooms of both schools to develop creative ideas based around tonalities of the last 40 years in spite of the fact that creativity in a non-tonal medium was well established in the professional field. I intended to show that pupils were more inventive and motivated in the music classroom when given opportunities to: (1) use ICT as an integral part of the creative process; (2) explore new sounds in a non-fixed-tonal environment; and (3) promote motivation through learning by relevant and interesting lesson content, enthusiastic delivery and an informal class atmosphere.

Pupil response, and multi-levelled and open-ended lesson content were the key to impetus, with creative catalysts and subject matter reflecting the interests of mixed-ability pupils. The students became self-motivating, and were captivated by their `play-art'. Semi-supervision became possible as pupils worked on the assignment in their groups, with the teacher helping to facilitate ideas in turn. Action research was used to continuously improve the learning environment. ICT enabled pupils to follow Bruner's constructivist philosophy and go beyond the information given. Pupils became less inclined to adopt media-generated tonal attitudes merely because they were the `norm' after the research, and showed more independence of mind in discussion and evaluation.
Effects of plantar hardness discrimination training on standing postural balance in the elderly: a randomized controlled trial
Authors: Morioka Shu , Hiyamizu Makoto , Fukumoto Tahahiko , Kataoka Yasunori , Yagi Fumio
Published: April 2009

Objective: To investigate the effects of sensory perception exercises for discrimination of surface hardness by the soles of the feet on standing postural balance in the elderly.

Design: A randomized two-group parallel controlled trial.

Subjects: Twenty-four healthy people aged from 61 to 71 years were enrolled and randomly assigned to a perception exercise group (n = 12) or a control group (n = 12).

Intervention: The perception exercise group were given a task designed to train ability to discriminate different degrees of hardness of foam rubber. The training period was 10 days. Control group subjects were instructed to maintain a standing posture on foam rubber for 10 seconds for a total of 10 days.

Measurements: Before and after training we measured centre-of-gravity sway with the subject standing, obtaining sway path length and area of ellipse. The Functional Reach Test was used to measure the forward displacement distance of the centre of gravity.

Results: Our data revealed a significant reduction in centre-of-gravity sway post training in the perception exercise group as well as a significant increase in forward displacement of the centre of gravity. These parameters were unchanged in the control group. As to change values (difference between pre- and post-training values), the perception exercise group had significantly better values than the control group, indicating the efficacy of sensory perception exercises.

Conclusions: We demonstrated that standing postural balance was improved by sensory perception exercises involving the soles of the feet. Used in addition to balance training, such training for hardness discrimination could be effective in the clinical setting to improve balance in the elderly.
Randomized controlled trial for clinical effects of varying types of insoles combined with specialized shoes in patients with rheumatoid arthritis of the foot
Authors: Nam Soon Cho  , Ji Hye Hwang  , Hyun Jung Chang  , Eun Mi Koh  , Hae Soo Park
Published: April 2009

Objective: To determine the effects of specialized shoes with insoles in patients with rheumatoid arthritis and the differences in terms of type of insole and anatomical location of foot pathology.

Design: Single-blinded randomized controlled trial.

Setting: Outpatients of physical medicine and rehabilitation clinic at university hospital.

Subjects: Forty-two patients with rheumatoid foot lesions were randomly assigned to two different orthotic intervention groups. The anatomical locations of the foot lesions were recorded (hindfoot or forefoot).

Intervention: Participants were provided with an extra deep forefoot-rockered shoe and either a custom-made semi-rigid insole or a ready-made simple soft insole. They wore the provided footwear for at least 3 hours a day over six months.

Main outcome measures: Primary outcome measures were foot pain visual analogue scale (VAS) scores and Foot Function Index (FFI). Secondary outcome measures were erythrocyte sedimentation rate and C-reactive protein levels in blood, amounts of medications and active joint counts. These were checked at baseline and post intervention.

Results: Eight patients dropped out at follow-up after six months of treatment. At six-month follow-ups, VAS scores and total Foot Function Index scores had decreased significantly in both groups versus baseline but intergroup comparison showed no significant differences in view of type of insoles and anatomical locations of foot pathology.

Conclusions: We were unable to identify differences between the types of insoles in terms of their clinical effects or between anatomical locations of foot lesions in the two groups, but both groups improved. Therapeutic shoes plus soft insoles might be effective enough in terms of foot pain and foot function for specific patients with rheumatoid foot problems regardless of the location of foot pathology.
Person—environment fit predicts falls in older adults better than the consideration of environmental hazards only
Authors: Iwarsson Susanne , Horstmann Vibeke , Carlsson Gunilla , Oswald Frank , Wahl Hans-Werner
Published: April 2009

Objective: To test the hypotheses that the empirical consideration of objective person—environment fit in the home environment is a stronger predictor of indoor falls among older adults than the assessment of environmental barriers only, and that perceived aspects of home play a role as predictors for falls.

Design: Survey study with data collection at home visits, followed up by self-reports about falls at home visits one year later.

Setting: Urban districts in Sweden, Germany, Latvia.

Participants: Eight hundred and thirty-four single-living, older adults (75—89 years), in ordinary housing.

Measurements: An assessment of objective person—environment fit in the home environment (housing enabler), a self-rating of the perceived home environment (usability in my home) and retrospective self-reports on indoor falls.

Results: The participants reporting falls tended to be frailer than the non-fallers. The number of environmental barriers in the home was similar for the fallers and non-fallers; the magnitude of person—environment fit problems was higher among the fallers. The person—environment fit problem variable was a stronger fall predictor (odds ratio (OR) = 1.025; P=0.037) than number of environmental barriers (n.s.), even after controlling for confounders. Fallers also experienced lower usability of their home.

Conclusion: The results suggest that much of the inconclusiveness of the data in the relationship between environmental hazards and falls in the previous falls literature could be due to the neglect of person—environment fit assessment. The effectiveness of environmental interventions based on the notion of person—environment fit compared with traditional home hazard checklists remains to be tested.
Changing self-efficacy in individuals following a first time stroke: preliminary study of a novel self-management intervention
Authors: Jones Fiona , Mandy Anne , Partridge Cecily
Published: April 2009

Objective: To examine the effects of a self-management workbook intervention designed for use with individuals disabled after first time stroke.

Design: Multiple-participant two-phase (baseline followed by treatment) single subject design. The intervention was introduced at a randomly generated time-point.

Setting: Community.

Subjects: Seven men and three women, with a mean age of 61.5 years (SD 8.15), on average 24.2 weeks (SD 18.29) following first stroke, all with residual restriction of activity and participation.

Intervention: An individualized self-management workbook based on self-efficacy principles, incorporating sections to increase mastery, vicarious experience and feedback.

Main measures: Stroke Self-Efficacy Questionnaire, General Self-Efficacy Scale, Recovery Locus of Control Scale, Rivermead Mobility Index, Rivermead Activities of Daily Living Scale, Subjective Index of Physical and Social Outcome and the Hospital Anxiety and Depression Scale. Individual data were analysed with weighted mean trend test and two standard deviation band test. Group data were analysed with a randomization test.

Results: Visual inspection of the data over the 14-week period showed steady improvement for all of the 10 participants on the majority of variables. A randomization test indicated a statistically significant change in Stroke Self-Efficacy Questionnaire scores and Recovery Locus of Control Scale scores which followed introduction of the intervention. Measures of activity, participation and mood scores did not show a statistically significant change.

Conclusion: There is preliminary evidence that the use of an individualized stroke self-management intervention is acceptable and can lead to a change in self-efficacy in this small sample.
A preliminary investigation of a novel design of visual cue glasses that aid gait in Parkinson's disease
Authors: McAuley JH , Daly PM , Curtis CR
Published: April 2009

Objective: Parkinson's disease is a relatively common progressive neurodegenerative disorder, one of whose main features is difficulty with walking. This can be partially corrected by providing cues for the placement of each step. We piloted the potential benefit of simple custom-designed `walking glasses' worn by the patient that provide visual and auditory cues to aid in step placement.

Design: We used a repeated measures design to compare gait performance when unaided and when using the walking glasses with different patterns of visual and auditory stimulation by timing patients' walking over a `real-life' predefined 30-m course.

Setting: Hospital outpatient clinic.

Subjects: Fifteen patients with idiopathic Parkinson's disease who had significant gait problems and no other condition affecting gait performance.

Main measures: Timed walk.

Results: Using the glasses, 8 of 15 patients achieved a significant and meaningful average improvement in walking time of at least 10% (mean (95% confidence interval) improvement in these patients was 21.5% (3.9%)), while a further 2 had subjective and modest objective benefit. Different patterns of visual and auditory cues suited different patients. Visual cueing alone with a fixed horizontal cue line present all the time statistically resulted in the greatest improvement in walking time.

Conclusions: This pilot study shows promising improvement in the gait of a significant proportion of Parkinson's disease patients through the use of a simple, inexpensive and robust design of walking glasses, suggesting practical applicability in a therapy setting to large numbers of such patients.
Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature
Authors: Babyar Suzanne R , Peterson Margaret GE , Bohannon Richard , Pérennou Dominic , Reding Michael
Published: April 2009

Objective: To examine the clinimetric properties and clinical applicability of published tools for `quantifying' the degree of lateropulsion or pusher syndrome following stroke.

Data sources: Search through electronic databases (MEDLINE, EMBASE, CINAHL, Science Citation Index) with the terms lateropulsion, pushing, pusher syndrome, validity, reliability, internal consistency, responsiveness, sensitivity, specificity, posture and stroke. Databases were searched from their inception to October 2008.

Review methods: Abstracts were selected by one author. A panel of experts then determined which should be included in this review. Five abstracts were reviewed and the panel agreed to omit one abstract because those authors did not write a full manuscript. The panel critiqued manuscripts according to predetermined criteria about clinical and clinimetric properties.

Results: Four manuscripts referencing three tools for examining lateropulsion were found. Validity and reliability data support the clinical use of the Scale for Contraversive Pushing, the Modified Scale for Contraversive Pushing and the Burke Lateropulsion Scale. The Scale for Contraversive Pushing has the most extensive testing of clinimetric properties. The other tools show promising preliminary evidence of clinical and research utility. More testing is needed with larger, more diverse samples.

Reviewers' conclusions: The Scale for Contraversive Pushing, the Modified Scale for Contraversive Pushing and the Burke Lateropulsion Scale are reliable and valid measures with good clinical applicability. Larger, more varied samples should be used to better delineate responsiveness and other clinimetric properties of these examination tools.
Comparative Evaluation of the Measurement Properties of Various Shoulder Outcome Instruments
Authors: Oh Joo Han , Jo Ki Hyun , Kim Woo Sung , Gong Hyun Sik , Han Seo Gyeong , Kim Yeon Ho
Published: April 2009

Background

Various shoulder outcome instruments have been used despite lack of information on their measurement properties; reliability, responsiveness, and validity; and correlation with health-related quality of life.

Hypothesis

Most shoulder outcome instruments have poor correlation with Short Form−36, a general measure of health-related quality of life, and with each other.

Study Design

Cohort study (diagnosis); Level of evidence, 2.

Methods

A consecutive group of 285 patients who had undergone shoulder surgery completed several shoulder outcome instruments—Short Form−36; University of California, Los Angeles shoulder score; American Shoulder and Elbow Surgeons shoulder evaluation form; Constant score; Simple Shoulder Test; Western Ontario Shoulder Instability Index; and the rating sheet for Bankart repair (Rowe score)—preoperatively and at 3, 6, 9, and 12 months postoperatively. Internal consistency, standardized response mean, effect size, and Pearson correlation were used to evaluate reliability, responsiveness, and validity.

Results

The American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and Western Ontario Shoulder Instability Index displayed good internal consistency. The University of California, Los Angeles shoulder score and American Shoulder and Elbow Surgeons form exhibited good responsiveness, whereas Short Form−36 showed the least responsiveness. Pearson correlation coefficients between the shoulder outcome instruments and Short Form−36 were less than excellent ( r < .60). Pearson correlation coefficients between the outcome instruments were generally low except for the Constant score and University of California, Los Angeles shoulder score ( r = .673, P < .01).

Conclusion

There was no single shoulder outcome instrument that was superior to the others in terms of the measurement properties. Most of the tested shoulder outcome instruments did not reflect health-related quality of life well and poorly correlated with each other. This meant that the comparison of a given surgical result with different outcome instruments might be of little practical utility. Further prospective and serial studies should be conducted to develop better shoulder outcome instruments that have significant reliability, responsiveness, validity, and correlation with health-related quality of life. A careful combination of outcome instruments might be necessary to compensate the current evaluation systems.
Ocular Myasthenia Gravis and Graves Disease in a 10-year-old Child
Authors: Koves Ildiko H. , Cameron Fergus J. , Kornberg Andrew J.
Published: April 2009

We report the association between myasthenia gravis and Graves disease in a 10-year-old boy and discuss the important aspects of both diseases, the importance of recognizing the association, and the investigations of choice to distinguish the 2 disorders. Early diagnosis of the 2 disorders may help in effective treatment institution with more rapid treatment responses with a possible improvement in prognosis and clinical course. Resolution of myasthenia gravis is not expected until the euthyroid state is restored. We recommend complete thyroid status review on all patients presenting with ocular myasthenia gravis.
Juvenile Myasthenia Gravis: Three Case Reports and a Literature Review
Authors: Gadient Paul , Bolton Jeffrey , Puri Vinay
Published: April 2009

Juvenile myasthenia gravis is a rare disorder acquired in childhood, representing 10% to 15% of all cases of myasthenia gravis. Like the adult form, it is generally characterized by an autoimmune attack on acetylcholine receptors at the neuromuscular junction. Most patients present with ptosis, diplopia, and fatigability. More advanced cases may also have bulbar problems and limb weakness. Left untreated, the disease may progress to paralysis of the respiratory muscles. Early recognition of this disease helps avoid unnecessary testing, prevent undue parental anxiety, and stop the progression of symptoms. Here, we relate the clinical course and current status of 3 patients with juvenile myasthenia gravis, discuss the disease in general, and review current treatment modalities.
Headache in a National Sample of American Children: Prevalence and Comorbidity
Authors: Lateef Tarannum M. , Merikangas Kathleen R. , Jianping He  , Kalaydjian Amanda , Khoromi Suzan , Knight Erin , Nelson Karin B.
Published: April 2009

The purpose of this study was to determine the prevalence, sociodemographic correlates, and comorbidity of recurrent headache in children in the United States. Participants were individuals aged 4 to 18 years (n = 10 198) who participated in the National Health and Nutrition Examination Surveys. Data on recurrent and other health conditions were analyzed. Frequent or severe headaches including migraine in the past 12 months were reported in 17.1% of children. Asthma, hay fever, and frequent ear infections were more common in children with headache, with at least 1 of these occurring in 41.6% of children with headache versus 25.0% of children free of headache. Other medical problems associated with childhood headaches include anemia, overweight, abdominal illnesses, and early menarche. Recurrent headache in childhood is common and has significant medical comorbidity. Further research is needed to understand biologic mechanisms and identify more homogeneous subgroups in clinical and genetic studies.
Adolescent and Caregiver Experiences With Epilepsy
Authors: Asato Miya R. , Manjunath Ranjani , Sheth Raj D. , Phelps Stephanie J. , Wheless James W. , Hovinga Collin A. , Pina-Garza Jesus E. , Haskins Lisa S. , Zingaro Wendy M.
Published: April 2009

Epilepsy during adolescence can impede the development of psychosocial independence and typical biological maturational processes. We examined in parallel the experiences and perceptions of adolescent patients with epilepsy and their caregivers. Specifically, we focused on frequency and type of seizures, comorbid conditions, adherence to therapies, productivity, clinical and quality of life consequences of seizures, estimated use and content of seizure emergency plans, and the patient—physician relationship. Two cross-sectional online surveys were conducted among 153 adolescent patients with epilepsy and their respective caregivers. A total of 35% of adolescents indicated that they had been nonadherent to antiepileptic medications in the prior month. Adolescents scored significantly lower compared with their peers on quality-of-life measures. Adolescents and caregivers reported similarly on nearly all domains. An adolescent-centered epilepsy management program may help alleviate concerns and also help the adolescent independently manage their epilepsy as they transition into adulthood.
The Relationship Between Medical Impairments and Arithmetic Development in Children With Cerebral Palsy
Authors: Jenks Kathleen M. , van Lieshout Ernest C. D. M. , de Moor Jan
Published: April 2009

Arithmetic ability was tested in children with cerebral palsy without severe intellectual impairment (verbal IQ ≥ 70) attending special (n = 41) or mainstream education (n = 16) as well as control children in mainstream education (n = 16) throughout first and second grade. Children with cerebral palsy in special education did not appear to have fully automatized arithmetic facts by the end of second grade. Their lower accuracy and consistently slower (verbal) response times raise important concerns for their future arithmetic development. Differences in arithmetic performance between children with cerebral palsy in special or mainstream education were not related to localization of cerebral palsy or to gross motor impairment. Rather, lower accuracy and slower verbal responses were related to differences in nonverbal intelligence and the presence of epilepsy. Left-hand impairment was related to slower verbal responses but not to lower accuracy.
Estimation of Intrinsic Damage State in Materials using Non-local Perturbation: Application to Active Health Monitoring
Authors: Banerjee Sourav
Published: April 2009

Quantifying damage parameters from macroscale wave signals has gained enormous popularity in recent years in the field of structural health monitoring (SHM). However, suitable parametric variation which manifests such lower scale effect to predict incubation of damage is an intricate subject. Hence, a relatively simpler way of quantifying the damage state is discussed in this article. An effort has been made to preset the dispersive solution of Cristoffel equation using non-local formulation. The solution of non-local Cristoffel equation is presented for isotropic (iron crystal—metal) and anisotropic material (cubic crystal—gallium arsenide—semiconductor). Conventional solution of Cristoffel equation is non-dispersive, but this study shows that the wave modes such as quasi-longitudinal, quasi-shear wave speeds are dispersive when non-local theory is employed. However, velocity directions are not perturbed from the non-local Cristoffel equation. Non-local parameters can be used as a migratory parameter for elastodynamic analysis at the macroscale considering the intrinsic length scale effect. The variations of wave velocities (phase velocities) in frequency domain are also presented under the influence of non-local parameter. This study has two implications in the SHM field. The dispersive nature of waves in a periodic crystal structure can be obtained from a MD study of the undamaged condition. Hence, a suitable value of the non-local parameter can be found and can be used as an input parameter in the derived equation in this article. On the other hand, the experimental study on wave velocity can be used to estimate the suitable non-local parameter as a damage parameter which carries the property of damaged crystals. In this article, the later approach has been adopted to study using COMSOL multiphysics software. Three different types of damages are considered inside the materials mentioned above. The effect on wave velocity is found and from the reverse analysis, non-local parameter is determined.
Effects of the Pendant Naphthalene Group on the Mechanical Properties and Low Temperature Shape Memory Effect of Polyurethane Copolymer
Authors: Chung Yong-Chan , Noh Kyung Lim  , Jae Won Choi  , Byoung Chul Chun
Published: April 2009

A series of shape memory polyurethane (SMPU) attached by pendant naphthalenes along the polyurethane (PU) chains was prepared. The SMPU chain was composed of 4,4'-methylenebis(phenylisocyanate) (MDI), poly(tetramethyleneglycol)-2000, 1,4-butanediol (BD) as a chain extender, and glycerol. The naphthalene was connected to the glycerol moiety of the PU chain using the second MDI as a connecting agent. The key point was whether the pendant naphthalene would improve the mechanical properties and shape recovery at subzero temperature. Similar mechanical properties (maximum stress and strain at break) and shape recovery, compared to the previous SMPUs, were attained at temperature above Tm, but a contrasting difference was observed in the shape recovery at subzero temperature. The conventional SMPU was not able to return to the original shape below -10°C, but the developed SMPU recovered its original shape even at -30°C. The reason for the exceptional shape recovery at both low temperature and ambient temperature is sought from a structural viewpoint.
The Value of Sustainability Education
Authors: Bradfield Steven L.
Published: April 2009

This article offers the perspectives of a veteran in the field of sustainability. The author shares the steps in the development, evolution, and management of sustainability and sustainable practices at a leading flooring manufacturer. The author leverages over 20 years of experience in industry to discuss the necessary skills and mindsets to enable managers to address sustainability effectively in their organizations. In addition, he addresses the necessary tools and perspectives for universities, business schools, and students with respect to advancing sustainability among all stakeholders in the future.
Distinctive Morphology of Renal Cell Carcinomas in Tuberous Sclerosis
Authors: Schreiner Andrew , Daneshmand Siamak , Bayne Aaron , Countryman Gayle , Corless Christopher L. , Troxell Megan L.
Published: April 2009

Tuberous sclerosis complex results from mutations in 1 of 2 interacting gene products, hamartin or tuberin. The syndrome is characterized by hamartomas and neoplastic lesions, including angiomyolipomas of the kidney and other organs. Renal cell carcinoma (RCC) in tuberous sclerosis remains relatively poorly characterized because historical studies were confounded by the inclusion of epithelioid angiomyolipomas. The authors present a patient with tuberous sclerosis and bilateral renal lesions, including multiple minute angiomyolipomas, cortical cysts, and 4 separate RCCs of unclassified type. The carcinomas shared distinctive morphological features, including sheet-like, glandular, trabecular, or cystic architecture and abundant granular eosinophilic cytoplasm. By definition, the carcinomas were keratin positive and negative for HMB-45 and Melan-A. Detailed immunohistochemical analysis revealed heterogeneity among the cortical cysts and carcinomas. The histopathological features of these carcinomas illustrate characteristics of renal carcinoma that are probably related to genetic alterations of tuberous sclerosis.
Absence of Peritumoral Fibrosis or Inflammatory Infiltrate May Be Related to Clinical Progression of Papillary Thyroid Microcarcinoma
Authors: Ramos Ana Maria de Oliveira , Sales Alexandre de Oliveira , Barbalho de Mello Luis Eduardo , Cirino de Andrade Márcia , Pinto Paiva Fernando , Ramos Carlos Cesar Oliveira , de Carvalho Formiga Maria Célia , de Formiga Ramos Carlos Cesar , de Matos Patricia Sabino , Ward Laura Sterian
Published: April 2009

Rio Grande do Norte (RN) shows the highest relative incidence of papillary carcinomas in Brazil. To analyze histological features that might be associated with this incidence, the authors compared thyroid glands from 463 autopsies performed in RN with 427 surgical and autopsy glands previously studied in Sao Paulo (SP). The authors found 41 papillary thyroid microcarcinomas (PTMs) in 35 glands (8.1%), an incidence similar to the one reported in SP (7.8%). However, PTMs were predominantly nonencapsulated nonsclerosing at microscopy (44.0%), in contrast with SP where these types of lesion represented only 4 out of 32 PTMs (12.5%; P = .0046). The authors suggest that these nonencapsulated lesions with no sign of inflammation may represent an early stage that may evolve to clinical cancers, contributing to the high incidence of clinically differentiated thyroid carcinomas observed in RN.
Dedifferentiated Epithelial-Myoepithelial Carcinoma of the Parotid Gland With Aberrant Expression of Prostate Specific Antigen: A Case Report
Authors: Sarode Venetia R. , Truelson John , Zaidie Mandolin
Published: April 2009

This report describes a rare case of dedifferentiated epithelial—myoepithelial carcinoma (EMCa) of the parotid gland. The tumor had 2 distinct components; a well-differentiated EMCa comprising of ductal and myoepithelial cells with low nuclear grade and low proliferation index. The second component showed a completely different morphology comprising of sheets and clusters of poorly differentiated cells with high nuclear grade and proliferative activity. The dedifferentiation was associated with an accelerated clinical course. Dedifferentiated EMCa is extremely rare with only 8 cases reported in the English literature. An unusual feature, hitherto not described in this tumor is the aberrant expression of prostate-specific antigen in the dedifferentiated component. In male patients, this may cause diagnostic confusion with metastatic prostate carcinoma.
E-mail Use Among a Sample of Intimate Partner Violence Shelter Residents
Authors: Rothman Emily F. , Meade Jennifer , Decker Michele R.
Published: April 2009

Although it is estimated that approximately 75% of U.S. adults have e-mail access, the proportion of battered women's shelter residents who use e-mail is currently unknown. Remaining in contact with residents following shelter stays is challenging. E-mail might hold promise for follow-up contact if a sufficient number of survivors use e-mail and safety concerns can be addressed. Among a convenience sample of residents of 11 Massachusetts shelters ( N = 57), the authors find that 47% had a current e-mail account. Among those with e-mail accounts, 89% used e-mail in locations other than their own homes; 81% reported that, to their knowledge, their e-mail accounts had never been accessed by unauthorized dating partners; and 88% reported that they thought it would be safe for the shelter to e-mail them following their departure. Additional research assessing the feasibility (i.e., safety, acceptability, and cost benefit) of remaining in contact with shelter residents via the Internet would be beneficial.
Liberating Bicentennial America
Authors: Clark Jennifer S.
Published: April 2009

With popular 1970s television programs Wonder Woman (ABC 1975—1976, CBS 1977—1979) and Isis (CBS 1975—1977) as its primary focus, this article explores the ways that network television utilized images of liberated women to revise its aesthetics, ensure audience capture, and produce fictions about American cultural coherence and political superiority. These television programs expressed fantasies of a viable American society during the mid- to late 1970s, a time of uncertainty and flux in American cultural coherence and global political might. Both fantasy superheroine series illustrate the ways representations of America's “progressive” gender politics worked to the economic advantage of TV networks, formulated reassuring messages about the state of the nation, helped manage America's less progressive attitudes about race and other nations, and justified America's imperialist impulses.
Visuospatial Function is a Significant Contributor to Functional Status in Patients With Alzheimer’s Disease
Authors: Fukui Toshiya , Lee Eiyai
Published: April 2009

Background: Contribution of visuospatial abilities to the functional status in patients with Alzheimer’s disease (AD) has been controversial. Aim: To address whether visuospatial abilities have independent association with functional measures in patients with AD. Methods: We regressed performances on a global cognitive (the revised Hasegawa Dementia Scale: HDSR), executive/ visuoconstruction (Clock drawing), visuoperception (Clock reading: CRT), simple visuoconstruction (figure copying), and frontal behavioral tasks on measures of basic and instrumental activities of daily living (BADL and IADL) in 57 patients (78.0 + 6.1 years) with AD of various severity (mean HDSR score: 16.0 + 5.9). We sought independent contributions of these visuospatial measures to functional status. Results: Performance on the CRT contributed significantly to BADL and IADL and the results of HDSR contributed to IADL. Results of figure copying related significantly to BADL especially in mild AD. Conclusion: Visuospatial ability is one of the important contributors to functional status.
Review: Comparing drug treatments in epilepsy
Authors: Chadwick David , Shukralla Arif , Marson Tony
Published: April 2009

The great majority of randomised controlled trials (RCTs) that compare antiepileptic drugs are industry sponsored and have the objective of obtaining a monotherapy license for a drug. Such trials do not inform everyday clinical practice as they tend to be too short and to depart from clinical practice by restricting clinicians in their choice of actions. The data that exists provides evidence that drugs with actions on voltage-gated sodium channels provide best seizure control for localised onset seizures and epilepsy syndromes, while valproate provides best seizure control for generalised epilepsy and unclassified syndromes. Drugs do, however, vary in their tolerability over the short term and in their risk for rare serious idiosyncratic adverse events, chronic toxicity and teratogenicity; issues that cannot be examined within the scope of RCTs.
Review: Drug and nondrug treatment in tension-type headache
Authors: Bendtsen Lars
Published: April 2009

Tension-type headache (TTH) is a common primary headache with tremendous socioeconomic impact. Establishment of an accurate diagnosis is important before initiation of any treatment. Nondrug management is crucial. Information, reassurance and identification of trigger factors may be rewarding. Psychological treatments with scientific evidence for efficacy include relaxation training, EMG biofeedback and cognitive-behavioural therapy. Physical therapy and acupuncture are widely used, but the scientific evidence for efficacy is sparse. Simple analgesics are the mainstays for treatment of episodic TTH. Combination analgesics, triptans, muscle relaxants and opioids should not be used, and it is crucial to avoid frequent and excessive use of simple analgesics to prevent the development of medication-overuse headache. The tricyclic antidepressant amitriptyline is drug of first choice for the prophylactic treatment of chronic TTH. The efficacy is modest and treatment is often hampered by side effects. Thus, treatment of frequent TTH is often difficult and multidisciplinary treatment strategies can be useful. The development of specific nonpharmacological and pharmacological managements for TTH with higher efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient.
Fixed-dose sumatriptan/naproxen sodium compared with each monotherapy utilizing the novel composite endpoint of sustained pain-free/no adverse events
Authors: Landy Stephen , White Jonathan , Lener Shelly E. , McDonald Susan A.
Published: April 2009

A novel composite endpoint, sustained pain-free/no adverse events, was recently proposed as a more rigorous means of capturing in a single measure the attributes of migraine pharmacotherapy that patients consider most important: rapid and sustained pain-free response with no side-effects. Using pooled data from two replicate randomized, double-blind, parallel-group, placebo-controlled studies, this post hoc analysis compared the fixed-dose combination tablet sumatriptan/naproxen sodium (n = 726) with sumatriptan monotherapy (n = 723), naproxen sodium monotherapy (n = 720), and placebo (n = 742) with respect to sustained pain-free/no adverse events and closely related composite measures. Sustained pain-free/no adverse events was defined as having both a sustained pain-free response from 2 through 24 hours post-dose with no use of rescue medication and having no adverse events within up to 5 days after dosing with study medication. The percentage of patients with sustained pain-free/no adverse events was 16% with sumatriptan/naproxen sodium compared with 11%, 9% and 7% for sumatriptan, naproxen sodium and placebo, respectively (p50.01 sumatriptan/naproxen sodium versus each other treatment). Sumatriptan/naproxen sodium was also significantly more effective than sumatriptan, naproxen sodium, and placebo for other composite endpoints including the percentages of patients with (1) sustained pain-free/no adverse events within 1 day; (2) sustained pain-free/no drug-related adverse events within up to 5 days; (3) sustained pain-free/no drug-related adverse events within 1 day; (4) sustained pain relief/no adverse events within up to 5 days; and (5) sustained pain relief/no adverse events within 1 day. The results demonstrate the superiority of sumatriptan/naproxen sodium to sumatriptan monotherapy, naproxen sodium monotherapy and placebo with respect to the rigorous and clinically relevant endpoint of sustained pain-free/no adverse events and reinforce the usefulness of utilizing this new composite endpoint.
Progress in enzyme replacement therapy in glycogen storage disease type II
Authors: Angelini Corrado , Semplicini Claudio , Tonin Paola , Filosto Massimiliano , Pegoraro Elena , Sorarù Gianni , Fanin Marina
Published: April 2009

Glycogen storage disease type II (GSDII) is an autosomal recessive lysosomal disorder caused by mutations in the gene encoding alpha-glucosidase (GAA). The disease can be clinically classified into three types: a severe infantile form, a juvenile and an adult-onset form. Cases with juvenile or adult onset GSDII mimic limb-girdle muscular dystrophy or polymyositis and are often characterized by respiratory involvement. GSDII patients are diagnosed by biochemical assay and by molecular characterization of the GAA gene. Ascertaining a natural history of patients with heterogeneous late-onset GSDII is useful for evaluating their progressive functional disability. A significant decline is observed over the years in skeletal and respiratory muscle function. Enzyme replacement therapy (ERT) has provided encouraging results in the infantile form. It is not yet known if ERT is effective in late-onset GSDII. We examined a series of 11 patients before and after ERT evaluating muscle strength by MRC, timed and graded functional tests, 6-minute walk test (6MWT), respiratory function by spirometric parameters and quality of life. We observed a partial improvement during a prolonged follow-up from 3 to 18 months. The use of different clinical parameters in the proposed protocol seems crucial to determine the efficacy of ERT, since not all late-onset patients respond similarly to ERT.
Prevalence of residual excessive sleepiness in CPAP-treated sleep apnoea patients: the French multicentre study
Authors: Pépin J-L. , Viot-Blanc V. , Escourrou P. , Racineux J-L. , Sapene M. , Lévy P. , Dervaux B. , Lenne X. , Mallart A.
Published: April 2009

The percentage of compliant continuous positive airway pressure (CPAP)-treated apnoeic patients that continue to experience residual excessive sleepiness (RES) is unknown.

RES was defined by an Epworth Sleepiness Scale (ESS) score of ≥11. In total, 502 patients from 37 French sleep centres using CPAP >3 h·night−1attending their 1-yr follow-up visit were eligible.

ESS and polysomnographic data as well as symptoms, quality of life, depression scores and objective CPAP compliance at 1 yr were collected. Overall, 60 patients remained sleepy on CPAP (ESS 14.3±2.5) leading to a prevalence rate of RES of 12.0% (95% confidence interval (CI) 9.1–14.8). After having excluded associated restless leg syndrome, major depressive disorder and narcolepsy as confounding causes, the final prevalence rate of RES was 6.0% (95% CI 3.9–8.01). Patients with RES were younger and more sleepy at diagnosis. The relative risk of having RES was 5.3 (95% CI 1.6–22.1), when ESS before treatment was ≥11. Scores of emotional and energy Nottingham Health Profile domains were two times worse in patients with RES.

As 230,000 obstructive sleep apnoea patients are currently treated in France by continuous positive airway pressure, more than 13,800 of them might suffer from residual excessive sleepiness.
Plasmapheresis for treatment of pulmonary alveolar proteinosis: Fig. 1—
Authors: Luisetti M. , Rodi G. , Perotti C. , Campo I. , Mariani F. , Pozzi E. , Trapnell B. C.
Published: April 2009

Whole lung lavage (WLL) is currently the standard therapy for pulmonary alveolar proteinosis (PAP). Nevertheless, some PAP patients respond poorly to WLL or require it frequently. The present paper reports a patient with autoimmune PAP with persistent disease despite three WLL treatments over 10 months.

Plasmapheresis with ten 1.5-L plasma exchanges was performed, which lowered the serum granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibody level from 250 μg·mL−1to 156 μg·mL−1but did not improve respiratory impairment. Further WLL therapy was required and transiently effective. Serum GM-CSF autoantibody levels declined progressively, reaching a value of 56 μg·mL−180 weeks after completion of plasmapheresis. However, this decrease was not accompanied by clinical improvement and the patient required additional WLL therapy.

The results confirm that minor reductions in serum granulocyte-macrophage colony-stimulating factor autoantibody levels from plasmapheresis are not reflected in clinical improvement in the severity of lung disease in pulmonary alveolar proteinosis.
Effectiveness and safety of endobronchial ultrasound–transbronchial needle aspiration: a systematic review
Authors: Varela-Lema L. , Fernández-Villar A. , Ruano-Ravina A.
Published: April 2009

The aim of the present systematic review was to assess the effectiveness and safety of real time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS–TBNA) in patients with suspected or known bronchopulmonary carcinoma, as well as in other clinical indications presented by lymphatic adenopathies.

A systematic review was carried out in November 2007 and updated in April 2008 using the main databases. Inclusion and exclusion criteria were applied to the papers retrieved.

A total of 20 publications were included. Of these, 14 were original studies that investigated the clinical usefulness of the technique in visualising and staging lymph nodes in patients with suspected or established lung cancer. Sensitivity ranged 85–100% and negative predictive value ranged 11–97.4%. Three studies assessed the clinical usefulness of the technique in the diagnosis of sarcoidosis. EBUS–TBNA was diagnostic in 88–93% of patients. One retrospective study evaluated the use of EBUS–TBNA in the diagnosis of lymphoma. None of the studies included in the present review reported important complications.

Endobronchial ultrasound-guided transbronchial needle aspiration is a safe and highly accurate procedure for the examination and staging of mediastinal and hilar lymph nodes in patients with known or suspected lung malignancy. The evidence is promising for sarcoidosis but is not sufficient for lymphoma.
LTBI: latent tuberculosis infection or lasting immune responses toM. tuberculosis? A TBNET consensus statement
Authors: Mack U. , Migliori G. B. , Sester M. , Rieder H. L. , Ehlers S. , Goletti D. , Bossink A. , Magdorf K. , Hölscher C. , Kampmann B. , Arend S. M. , Detjen A. , Bothamley G. , Zellweger J. P. , Milburn H. , Diel R. , Ravn P. , Cobelens F. , Cardona P. J. , Kan B. , Solovic I. , Duarte R. , Cirillo D. M. ,   C. Lange for the TBNET
Published: April 2009

Tuberculosis control relies on the identification and preventive treatment of individuals who are latently infected withMycobacterium tuberculosis. However, direct identification of latent tuberculosis infection is not possible. The diagnostic tests used to identify individuals latently infected withM. tuberculosis, thein vivotuberculin skin test and theex vivointerferon-γ release assays (IGRAs), are designed to identify an adaptive immune response against, but not necessarily a latent infection with,M. tuberculosis. The proportion of individuals who truly remain infected withM. tuberculosisafter tuberculin skin test or IGRA conversion is unknown. It is also uncertain how long adaptive immune responses towards mycobacterial antigens persist in the absence of live mycobacteria. Clinical management and public healthcare policies for preventive chemotherapy against tuberculosis could be improved, if we were to gain a better understanding onM. tuberculosislatency and reactivation. This statement by the TBNET summarises knowledge and limitations of the currently available tests used in adults and children for the diagnosis of latent tuberculosis infection.

In summary, the main issue regarding testing is to restrict it to those who are known to be at higher risk of developing tuberculosis and who are willing to accept preventive chemotherapy.
Efficient context-dependent model building based on clustering posterior distributions for non-coding sequences
Authors: Baele Guy , Van de Peer Yves , Vansteelandt Stijn
Published: April 2009

Background

Many recent studies that relax the assumption of independent evolution of sites have done so at the expense of a drastic increase in the number of substitution parameters. While additional parameters cannot be avoided to model context-dependent evolution, a large increase in model dimensionality is only justified when accompanied with careful model-building strategies that guard against overfitting. An increased dimensionality leads to increases in numerical computations of the models, increased convergence times in Bayesian Markov chain Monte Carlo algorithms and even more tedious Bayes Factor calculations.

Results

We have developed two model-search algorithms which reduce the number of Bayes Factor calculations by clustering posterior densities to decide on the equality of substitution behavior in different contexts. The selected model's fit is evaluated using a Bayes Factor, which we calculate via model-switch thermodynamic integration. To reduce computation time and to increase the precision of this integration, we propose to split the calculations over different computers and to appropriately calibrate the individual runs. Using the proposed strategies, we find, in a dataset of primate Ancestral Repeats, that careful modeling of context-dependent evolution may increase model fit considerably and that the combination of a context-dependent model with the assumption of varying rates across sites offers even larger improvements in terms of model fit. Using a smaller nuclear SSU rRNA dataset, we show that context-dependence may only become detectable upon applying model-building strategies.

Conclusion

While context-dependent evolutionary models can increase the model fit over traditional independent evolutionary models, such complex models will often contain too many parameters. Justification for the added parameters is thus required so that only those parameters that model evolutionary processes previously unaccounted for are added to the evolutionary model. To obtain an optimal balance between the number of parameters in a context-dependent model and the performance in terms of model fit, we have designed two parameter-reduction strategies and we have shown that model fit can be greatly improved by reducing the number of parameters in a context-dependent evolutionary model.