bluuebunny/crossref_metadata_2025 huggingface dataset:
Dependence in Prestroke Mobility Predicts Adverse Outcomes Among Patients With Acute Ischemic Stroke
Authors: Dallas Mary I. , Rone-Adams Shari , Echternach John L. , Brass Lawrence M. , Bravata Dawn M.
Published: June 2008

Background and Purpose—

Stroke survivors are commonly dependent in activities of daily living; however, the relation between prestroke mobility impairment and poststroke outcomes is poorly understood. The primary objective of this study was to evaluate the association between prestroke mobility impairment and 4 poststroke outcomes. The secondary objective was to evaluate the association between prestroke mobility impairment and a plan for physical therapy.

Methods—

This was a secondary analysis of the National Stroke Project data, a retrospective cohort of Medicare beneficiaries who were hospitalized with an acute ischemic stroke (1998 to 2001). Logistic-regression modeling was used to examine the adjusted association between prestroke mobility impairment with patient outcomes and a plan for physical therapy.

Results—

Among the 67 445 patients hospitalized with an ischemic stroke, 6% were dependent in prestroke mobility. Prestroke mobility dependence was independently associated with an increased odds of poststroke mobility impairment (odds ratio [OR]=9.9; 95% CI, 9.0 to 10.8); in-hospital mortality (OR=2.4; 95% CI, 2.2 to 2.7); discharge to a skilled nursing facility (OR=3.5; 95% CI, 3.2 to 3.8); and the combination of in-hospital death or discharge to a skilled nursing facility (OR=3.5; 95% CI, 3.3 to 3.8). Prestroke mobility dependence was independently associated with a decreased odds of having a plan for physical therapy (OR=0.79; 95% CI, 0.73 to 0.85).

Conclusions—

These data, obtained from a large, geographically diverse cohort from the United States, demonstrate a strong association between dependence in prestroke mobility and adverse outcomes among elderly stroke patients. Clinicians should screen patients for prestroke mobility impairment to identify patients at greatest risk for adverse events.
Intradural Saccular Aneurysms Treated by Guglielmi Detachable Bare Coils at a Single Institution Between 1993 and 2005
Authors: Holmin Staffan , Krings Timo , Ozanne Augustin , Alt Jan-Patrick , Claes Ann , Zhao Wenyuan , Alvarez Hortensia , Rodesch Georges , Lasjaunias Pierre
Published: June 2008

Background and Purpose—

The aim of this study was to analyze the clinical results of Guglielmi detachable bare coil (GDC) embolization of intradural saccular aneurysms (AAs) at a single center and to relate the morphological results at various time points to the clinical situation.

Methods—

All intradural saccular AAs treated with GDCs between 1993 and April 2005 were prospectively entered into a database completed by retrospective analysis of charts and images and a long-term clinical outcome questionnaire. In 413 consecutive patients, there were 466 treated AAs, of which 68.7% were ruptured and 31.1% were unruptured.

Results—

The periprocedural thromboembolic event rate, retreatment procedures included, was 5.4%, causing permanent neurologic deficits in 2.2% of patients. One patient (0.2%) bled during a mean±SD clinical follow-up of 64.3±39.9 months (93 AAs were followed up for >8 years and 45 AAs were followed up for >10 years) for a total of 1810 patient-years. The modified Rankin Scale score was 0 in 54.7%, 1 in 21.0%, 2 in 12.1%, 3 in 7.1%, 4 in 2.1%, 5 in 0.3%, and 6 (death from unrelated causes) in 2.7% of patients. If an aneurysm, with or without a remnant, was unchanged for 12 months, then the risk for future morphological loss was 4.8%, whereas if an aneurysm showed a morphological loss during the earlier 12-month interval, the risk for additional late loss was 38.3% (
P
<0.001, odds ratio=12.4).

Conclusions—

Embolization of saccular AAs entails a prolonged management period. A stable angiographic result during a 12-month interval predicts a low risk for morphological deterioration. This regimen, aiming for a stable angiographic result rather than complete aneurysm occlusion, gives a low rebleed rate and excellent clinical long-term results.
Predictors of Death and Stroke After Carotid Angioplasty and Stenting
Authors: Theiss Wolfram , Hermanek Peter , Mathias Klaus , Brückmann Hartmut , Dembski Jürgen , Hoffmann Franz-Josef , Kerner Rüdiger , Leisch Franz , Mudra Harald , Schulte Karl-Ludwig , Sievert Horst
Published: June 2008

Background and Purpose—

Little is known about the significance of patient characteristics, clinical indications, and technical details on the risk of carotid angioplasty and stenting (CAS). The purpose of this study was to test these parameters as to their predictive value for the peri-interventional risk of CAS.

Methods—

Pro-CAS is a prospective, multicenter registry of CAS. Logistic regression analysis of possible predictive factors was performed on 5341 interventions that had been entered by 25 clinical centers between July 1999 and June 2005.

Results—

The combined in-hospital mortality and stroke rate was 3.6%. The following were found to be significant predictors of peri-interventional stroke and death: center experience (≤50 versus 51 to 150 versus ≥151 interventions), age, prior symptoms, primary intervention as compared with intervention for restenosis, angioplasty without stent, predilatation, and heparin dosage >5000 IU. No statistically significant result was found for year of intervention, patient volume, gender, interval between symptoms and CAS, ocular versus neurological symptoms, side of CAS, degree of stenosis of the target lesion, presence of contralateral high-degree stenosis or occlusion, method of gaining access to the carotids, stent type, and use of a protection system.

Conclusions—

Our findings underline the need for dedicated training and strict credentialing rules for CAS. In addition, they might help to identify subgroups of patients at differential risk for CAS and carotid endarterectomy and yield a basis for correcting risks due to differences in case mix in reports about CAS.
Sudden Sensorineural Hearing Loss Increases the Risk of Stroke
Authors: Lin Herng-Ching , Chao Pin-Zhir , Lee Hsin-Chien
Published: June 2008

Background and Purpose—

No previous study has investigated the incidence or risk of cerebrovascular diseases developing after the sudden sensorineural hearing loss (SSNHL). This study sets out to estimate the risk of stroke development among SSNHL patients during a 5e-year follow-up period after hospitalization for acute episodes of SSNHL.

Methods—

Our study design features a study cohort and a comparison cohort. The study cohort consists of all patients hospitalized with a principal diagnosis of sudden hearing loss (n=1,423), whereas the control cohort comprised all patients hospitalized for an appendectomy in 1998 (n=5692) as a surrogate for the general population. Each patient was tracked from hospitalization in 1998 until the end of 2003. Cox proportional hazard regressions were performed as a means of computing the 5-year stroke-free survival rates after adjustment for possible confounding factors.

Results—

Of the total sample, 621 patients (8.7%) had strokes during the 5-year follow-up period: 180 (12.7% of the SSNHL patients) from the study cohort and 441 (7.8% of patients undergoing an appendectomy) from the control cohort. After adjusting for other factors, the hazard of stroke during the 5-year follow-up period was 1.64-times (95% CI, 1.31 to 2.07;
P
<0.001) greater for SSNHL patients than for appendectomy patients.

Conclusions—

Our findings suggest that SSNHL can be an early warning sign of impending stroke. We suggest that SSNHL patients should undergo a comprehensive hematologic and neurological examination to help clinicians identify those potentially at risk for stroke developing in the near future.
Umbanda - Eine Brasilianische Religion
Authors: Figge Horst H.
Published: June 2008

Im zweiten Drittel dieses Jahrhunderts entstand in Brasilien die Umbanda, eine neue Religion, die inzwischen insbesondere in den Groß-städten über eine Millionen zählende Anhängerschaft verfügt. Sie kann als animistisch-mediunistisch charakterisiert und als Konsolidierung des brasilianischen Volkskatholizismus in den vakant gewordenen Formen ehemals afro-brasilianischer Sekten verstanden werden.
Exilsgemeinde Und Jerusalem in Ez Viii-Xi Eine Literarische Untersuchung
Authors: Horst Friedrich
Published: June 2008

Ez viii-xi ist ein literarisches Gefüge, das von einem eröffnenden und schliessenden Rahmen (viii 1-3b α und xi 24-25) umspannt wird und mehrere Einzelstücke in sich enthält. Die meisten dieser Einzelstücke heben sich gut erkennbar von einander ab. Man tut gut, sie zunächst von einander gelöst und ohne Rücksicht auf ihre jetzige Unterbringung zu betrachten und nach ihrem Aufbau und ihrer Abzielung zu bestimmen. Dabei bewegt man sich, wie mir scheint, am sichersten vorwärts, wenn man den Anfang mit xi und hier mit dem Stück xi 14-21 macht.
The Susa Tablets, the Bible and the Aramaic Papyri
Authors: Rabinowitz Jacob J.
Published: June 2008

The Susa Tablets 1) reveal a number of remarkable parallels to the Bible and to the Aramaic papyri. I do not profess to know what precisely the significance of these parallels is. The primary task, however, is to recognize them. In the process some new interpretations will emerge and, perhaps, some widely held notions will have to be modified.
The Gibeonites, the Nethinim and the Sons of Solomon's Servants
Authors: Haran Menahem
Published: June 2008

The aim of this article is to assemble the main features of the history of a Canaanite community whose fate was bound up with that of Israel. This community first emerges during the wars of Canaan, and disappears in the obscure period after Nehemiah. Its life-span thus virtually coincides with the history of Biblical Israel. During this long period the nature of the community in question underwent profound changes; nevertheless, it can be shown that its history forms a continuous whole which throws light on some social processes at work in Israel during the Biblical period 1). In this history, the following three main turning-points can be distinguished: Joshua's wars, the reign of Solomon, and the Return from Exile. Each of these turning-points marks a social and juridical change in the status of the community, as will be shown in the following pages.
The Literary Form and Liturgical Background of Psalm Lxxxix
Authors: Ward James M.
Published: June 2008

Ps. lxxxix is in many ways the most interesting and important of the royal psalms. Taken as a whole it is a lamentation (vss. 39-52) over the frustration of God's promises to the Davidic dynasty (vss. 20-38), which were made possible by his cosmic sovereignty (6-15). The first part of the psalm recalls the hymns of Yahweh's enthronement (xlvii, xciii, xcv-c), the second, the oracle of Nathan (2 Sam. vii; Ps. cxxxii), and the third, the individual lamentations of the Psalter. This complexity of form and content has led most commentators to divide the psalm into two or three originally separate poems, and to interpret their significance more or less independently of each other. It is the aim of the present study to demonstrate the formal integrity of the psalm as it appears in the Psalter, and to discover, if possible, its original liturgical setting.
PRIESTS AND LEVITES IN DEUTERONOMY an examination of Dr. G. E. WRIGHT'S theory
Authors: Emerton J.A.
Published: June 2008

In a paper which was published in this journal several years ago I), Professor G. E. WRIGHT challenged the usual interpretation of passages in Deuteronomy referring to priests and Levites. He tells the reader that he began by accepting the usual view but that a careful study of the evidence led him to explain these passages in a different way. A theory advanced by so eminent a scholar is certainly worthy of serious consideration, especially since he believes that its implications are many and important. He does not himself state or discuss these implications, because he thinks that the correctness of his thesis must first be tested by others. The present paper offers such a testing of Dr. WRIGHT's interesting and stimulating theory.
Le Tresor De La Maison De Yahweh Des Origines a L'Exil
Authors: Delcor M.
Published: June 2008

Tous les temples de l'Antiquité avaient leur trésor contenant souvent des richesses fabuleuses qui ont attiré plus d'un conquérant avideI). La maison de Yahweh à Jérusalem avait aussi le sien et récemment le fameux rouleau de cuivre découvert dans une grotte de Qumrân (3QI5) a attiré l'attention sur les richesses qui y étaient entreposées et qui auraient été cachées un peu partout en Palestine 2). L'imagination populaire a beaucoup brodé sur ce sujet et un écrit tardif intitulé "les vases sacrés", dont on a retrouvé récemment un doublet sur une plaque de marbre de Beyrouth destinée à une synagogue du Liban ou de Syrie, détaille les trésors du Temple qui auraient été cachés ici et là lors de la destruction de Jérusalem par les Babyloniens3). Nous nous proposons uniquement ici d'étudier tout ce qu'on peut connaître du trésor sacré de Jérusalem des origines jusqu'à l'exil, époque sur laquelle nous avons le plus de renseignements par la Bible. Nous ferons cette étude avec le souci de confronter les données bibliques avec l'apport de l'archéologie orientale dans son sens le plus large. Elle voudrait être uniquement une contribution à la connaissance d'une institution importante de l'ancien Israël qui a été jusqu'ici peu étudiée.
The Centralisation of the Cult in Deuteronomy
Authors: Nicholson Ernest
Published: June 2008

It is generally agreed among students of the Old Testament that one of the fundamental demands of the book of Deuteronomy is that Israel's worship of Yahweh is to be carried out at one central sanctuary, viz. at the place which Yahweh shall cboose 1). There has not however been the same unanimity of opinion on the problem of the origin of this dogma. In this short paper we shall outline briefly some recent theories with a view to determining whether a satisfactory solution of the problem has been arrived at or whether some new solution should be attempted.
Israel's Encounters With Edom, Moab, Ammon, Sihon, and Og According To the Deuteronomist
Authors: Sumner W.A.
Published: June 2008

Our examination of the narrative of Israel's encounters with Edom, Moab, Ammon, Sihon, and Og in Deuteronomy has shown some of the ways in which the Deuteronomist has utilised his source material and what interests he had in mind. Our treatment of the parallel accounts in Numbers did much to confirm and qualify our impressions, and helped us to suggest the form and contents of the earlier tradition.
Les Sources Du Chapitre VII De Daniel
Authors: Delcor M.
Published: June 2008

Quand nous employons ici le mot "sources", nous l'entendons dans son sens le plus large. Ce sont d'abord les influences littéraires conscientes qui ont pu s'exercer sur l'auteur de Daniel vii, que celles-ci soient bibliques ou extrabibliques. Mais il y a aussi des influences ou des parentés plus vagues et qui ne sont pas toujours perçues nettement par l'auteur. En effet, il nous semble important d'essayer de déterminer ces influences ou parentés car elles nous permettront sans doute de mieux saisir le sens du chap. vii de Daniel. Mais, auparavant, il nous faut examiner le problème de structure et d'unité littéraire du chapitre. L'un des derniers commentateurs, PORTEOUS, écrit justement: "Wenn man dieses Kapitel deuten will, so muss man zuerst die schwierige Entscheidung treffen, ob es eine Einheit darstellt oder nicht' 1).
The Use of the Word as a Title in the Old Testament
Authors: Bartlett J.R.
Published: June 2008

Many societies have used the word "head" metaphorically to describe the position of the leading figure in a society or in some smaller group, and this title usually has a vague and imprecise meaning. To be intelligible it needs to be given some known context or some further definition. For example, if we are schoolmasters, we may among ourselves refer to "the Head", but outside school, unless we are speaking to people who know the context of our work, we have to refer to "the Headmaster" to be fully understood. And even when the context of the headship is known, the title "head" by itself tells us nothing definite about the position of the person so described. We know nothing, for example, about the means of his appointment, the tenure of his office, or the scope of his powers. Thus the word "head" can often be used in a general sense of some position or office for which there is in fact an official or more descriptive title. In the Old Testament, however, the title is not always so vaguely used. Although the word "head" in Hebrew as in English has a natural ambiguity on many occasions, we can at least show that in the Old Testament the word is used of a person's position only in certain well defined spheres. And because the title "head" in the Old Testament has a fairly limited reference, the details of appointment, tenure of office or position, and scope of powers, though sometimes unknown to us, may not have been so generally unknown in ancient Israel.
La Vision Daniélique Du Fils D'Homme
Authors: Coppens J.
Published: June 2008

Un article récent de M. A. CAQUOT nous invite à revenir une fois de plus à l'explication de la vision daniélique du Fils d'homme, et cela d'autant plus que le professeur de Paris ne se contente pas d'étudier cette figure énigmatique mais s'applique aussi à interpréter le cadre où elle apparaît, c'est-à-dire la vision des quatre empires dont la destruction précède la venue du personnage mystérieux 1). Nous voudrions donc, en dialogue avec l'auteur cité, examiner successivement le cadre de la vision, les origines du symbole et sa signification.
Herabfahrung Jahwes Auf Die Lade Und Entziehung Der Feuerwolke
Authors: Dus J.
Published: June 2008

Es gibt viele Probleme in der Geschichte Altisraels, die noch nicht einmal formuliert wurden, obwohl von ihrer Lösung die Aufklärung des komplizierten Bestandes der alttestamentlichen Überlieferung abhängt. Durch die Besprechung zweier solcher Probleme wollen wir hier zur Erkenntnis der mittleren Richterzeit beitragen. Für diese war, zum Unterschied von der frühen und späten Richterzeit 1), der L a d e k u 1 t 2) bezeichnend.
Text-Sequence and Translation-Revision in 3 Reigns Ix 10-X 33
Authors: Gooding D.W.
Published: June 2008

I have in a former issue of this journa1) suggested that the material which now stands at 3 Reigns x 23-25 stands there as a result of a re-arrangement of the original text, and that the motive for the re-arrangement was a desire to excuse Solomon's accumulation of gold and horses. The purpose of this present article is to call attention to two further pieces of evidence : one confirming that the motive of the re-arrangement was as has been already suggested ; the other revealing at what level this revisory activity took place 2).
A Consideration of Hebrew 1)
Authors: Macintosh A.A.
Published: June 2008

By way of summary, we may state that denotes in origin an aspect of the physical expression of anger; it is used to denote angry protest: when God is the subject its connotation is both his anger and the effective working out of his anger. An extension of such meaning, which is consistent with later Jewish understanding of God, is that of authoritative moral reprimand 4), and in this way the word was mostly interpreted and understood in ancient times.
Diversity in a Multicultural and Poly-Ethnic World: Challenges and Responses
Authors: Du Tott Cornél W.
Published: June 2008

Multiculturalism characterises today's world. The diversity of cultures and conflicting ethnic groups sharing the same territory pose a threat to local and world peace. We have come to the end of the nation' as well as the end of the 'state'homogeneous entities that are increasingly emasculated by instrumental reason qua techno-science and economic globalisation. Ethnic diversity is simultaneously a wealth and threat to African societies. African unity in the form of an ubuntu ethic offers a model to deal, with polyethnicity. Ethnocentrism is biologically rooted and operates through prejudice. Prejudice as a coping mechanism to deal with diversity has its value and limitations. It must be contained where it issues in xenophobia, ethnophobia and war. Polyethnic co-existence is a prerequisite for Africa to attain its developmental ideals as expressed in the NEPAD programme. The way in which ethno-philosophy and ethno-theology can aid this process is looked at.
Lemba Religion. Ancient Judaism or Evolving Lemba Tradition?1
Authors: Le Roux Magdel
Published: June 2008

harious traditions exist as to when the Lemba came to Africa. A possible early departure from Israel (according to the Lemba) can imply that their religion could contain remnants of a very ancient type of religion, zuhich makes this group special and particularly valuable to the historian of religion or comparative religion. Uarious faiths had diverse influences on the religious convictions and life of the Lemba. In this investigation the Juxtaposition of the social and religious practices and rituals of early Israel with those of the Lemba delivered noteworthy findings. Qualitative research in numerous Lemba communities in southern Africa underlies this article. The tlaeoretical framezuork is that of Smart, a scholar in the field of comparative religion.
Courtroom Workgroups and Sentencing
Authors: Haynes Stacy Hoskins , Ruback Barry , Cusick Gretchen Ruth
Published: June 2008

Sentencing decisions are the product of a group of courtroom actors, primarily judges and district attorneys. Although the structure of the courtroom workgroup and the interdependencies among members are assumed to be important determinants of sentencing decisions, the degree of this importance and the specific mechanisms through which workgroups affect these decisions have not been investigated. This study used data from the Pennsylvania Commission on Sentencing (PCS) for the years 1990 to 2000 to examine how three social psychological aspects of courtroom workgroups (similarity, proximity, and stability) affect sentencing decisions. Results indicated (a) that workgroups generally had very high levels of similarity in terms of race, gender, and political party but lower levels of similarity in terms of age, college education, and law school education and (b) that proximity and stability were generally high. Controlling for individual, case, and distal contextual factors, workgroup factors affected the decision to incarcerate, the decision to impose fines, and the decision to impose restitution. In particular, proximity increased the use of economic sanctions relative to incarceration and stability was associated with a decrease in the imposition of economic sanctions. Similarity had inconsistent effects.
Numerical Modeling of Gas Leakage Through Damaged Composite Laminates
Authors: Kumazawa Hisashi , Whitcomb John
Published: June 2008

A computational fluid dynamics (CFD) model was developed to predict leakage through a damaged laminate. Crack opening displacements (COD) from a 3D finite element model were fit using a polynomial function. This curve fit was then used in defining the openings in the CFD model. Delamination length at crack intersections was estimated based on experimental data for specimens subjected to thermal loads only. Leakage under combined thermal and biaxial mechanical loadings was predicted with the estimated delamination length. Considering the sensitivity of the predictions to many variables, the calculated leakage under combined thermal and biaxial mechanical loadings was estimated with reasonable accuracy.
Phenomenological Modeling and Numerical Simulation of Relaxation in Bolted Composite Joints
Authors: Thoppul Srinivasa D. , Gibson Ronald F. , Ibrahim Raouf A.
Published: June 2008

The effects of various bolt preloads, viscoelasticity, and external applied static and dynamic loads on bolt load relaxation in a carbon/epoxy composite bolted joint have been studied. Both phenomenological modeling and finite element analysis (FEA) of bolt-connected three-point bending specimens were employed in the studies. Relaxation of 1.25—4.25% over a period of 30 h was observed depending on the initial preload and applied external loads. Both static and dynamic applied loads were considered. It was observed that for any magnitude of external load the bolt load relaxation decreases with increasing initial preload. These findings emphasize the importance of the magnitude of the preload. Comparing the bolt load relaxation in steel and composite joints for the duration of 30 h, it was concluded that only about 1/3 of the relaxation in composite specimens is due to viscoelastic behavior of the polymer matrix in the composite, and the remaining 2/3 of the relaxation is due to other mechanisms such as bolt thread slip, plasticity and/ or external excitation.
Work Demands, Work–Family Conflict, and Child Adjustment in African American Families
Authors: McLoyd Vonnie C. , Toyokawa Teru , Kaplan Rachel
Published: June 2008

Using data from a sample of 455 African American children (ages 10 to 12 years) and their parents, this study tests a hypothesized model linking (a) maternal work demands to family routines through work–family conflict and depressive symptoms and (b) maternal work demands to children's externalizing and internalizing problems through family routines. Partial support for our hypotheses was found in single-mother families, but not in two-parent families. Work demands decreased family routines in single-mother families by increasing work–family conflict. In addition, higher levels of work–family conflict and maternal depressive symptomatology predicted an increase in children's externalizing problems and these relations were mediated through a decrease in family routines. Contrary to prediction, work demands bore no relation to children's behavior problems either directly or indirectly through family routines. Family structure differences in mediating processes are discussed in relation to mothers' subjective experiences of work and the roles of adults in the household.
Facade Diversity
Authors: Boli John , Elliott Michael A.
Published: June 2008

Diversity and multiculturalism are widely embraced principles, championed by many social movements and promoted through the programs and policies of states, businesses, schools and other organizations throughout the world. Purportedly celebrating and protecting group differences, these principles translate concretely into differences that operate as facades masking the underlying individualization of world society. Fundamental to this process is a dualistic globalization of the individual — both cultural and organizational — that impels the conscious construction of personal identities as both authentic and unique. Individuals therefore activate collective identity elements as sources of personal difference and distinctiveness. The nature of these collective identities is undergoing rapid change, however. The very forces impelling the championing of difference — rising individualism, egalitarianism, identity construction and uniqueness — diminish the degree of difference carried by collective identities, transforming corporate collectivities (once rooted firmly in geographic, ethnic, linguistic or ancestral ties) into categorical groups that provide identity not as a transcendent group property but as a volitional characteristic of categories of individuals. Corporate identities may not disappear, but as they are transformed into categorical identities they become facades behind which the depth of differences among the world's cultures and subcultures is diminishing rapidly.
Converging Divergences?
Authors: Mills Melinda , Blossfeld Hans-Peter , Buchholz Sandra , Hofäcker Dirk , Bernardi Fabrizio , Hofmeister Heather
Published: June 2008

Profound social and economic transformations have taken place over the last two decades in modern societies. These changes are often referred to as globalization. The aim of this article is to examine whether processes of globalization have produced increasing convergence of employment-related aspects of national-level welfare regimes, industrial relation systems and mid-career employment paths among a set of industrialized nations. A theory of convergence is developed to explain the coercive-isomorphic and mimetic-imitation effects of globalization, followed by potential reasons for growing divergence. The study concludes that globalization has produced `converging divergences' and not resulted in a simple convergence based on neoliberal and market employment-related policies that leads to a rise of patchwork careers for all employees. Rather, it has served to intensify existent differences between industrial relations in the welfare regime clusters of countries and accentuated within-country occupational class, educational and gender inequalities.
GlobalIndex
Authors: Raab Marcel , Ruland Michael , Schönberger Benno , Blossfeld Hans-Peter , Hofäcker Dirk , Buchholz Sandra , Schmelzer Paul
Published: June 2008

This article suggests a multidimensional globalization measure, encompassing economic, (socio)technological, cultural and political dimensions of global change. This measure builds on previous work by Dreher, Lockwood and Redoano, the OECD and Kearney, but extends it by additional dimensions and indicators that represent central facets of a genuine sociological concept of globalization. The article first describes in detail the multidimensional nature of the globalization process and then develops an overall sociological index of globalization, which the authors call GlobalIndex. This index covers the development of globalization in 97 different countries from 1970 to 2002. Using the GlobalIndex, the authors describe the development of globalization on a worldwide scale as well as for different country contexts. Finally, they include the GlobalIndex as an explanatory variable in two micro-level longitudinal analyses of labour market transitions during the early career period in Germany and the UK.
Fear of falling after brain injury
Authors: Collicutt McGrath Joanna
Published: June 2008

Objectives: To investigate the prevalence and nature of fear of falling in a sample of people with severe acquired brain injury.

Design: A descriptive study.

Setting: A regional inpatient neurological rehabilitation unit.

Participants: One hundred and five adults with acquired brain injury of mixed aetiology.

Procedure: All 105 participants were rated by observers who were asked to judge the degree to which fear behaviour interfered with rehabilitation therapy (activity limitation). Eighty-two participants also rated themselves. They were asked to report the degree of distress caused by fear. Both participants and observers were asked to describe the focus of any reported fear. Two stepwise logistic regression analyses were carried out to identify variables that predicted fear giving rise to significant activity limitation and fear giving rise to significant subjective distress.

Main measures: Self and observer rating scales designed and constructed specifically for the study.

Results: Raters reported significant fear-related activity limitation in 12—15% of participants. Significant fear-related subjective distress was reported by 40% of participants. Fear of falling, fear of physical harm and fear of not making sufficient rehabilitation progress dominated the reports of both observers and participants. The variables predicting significant activity limitation were premorbid alcohol misuse, low functional ability and the occurrence of a fall since onset. The variables predicting significant subjective distress were poor motor coordination and organization, and good verbal comprehension.

Conclusion: Fear of falling is a clinically significant phenomenon in younger adults recovering from severe acquired brain injury. Fear sufficient to cause high degrees of subjective distress was often not evident to observers. Proactive questioning about fear of falling is therefore advisable when working clinically with this group.
Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study
Authors: Häkkinen Arja , Kautiainen Hannu , Hannonen Pekka , Ylinen Jari
Published: June 2008

Objective: To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain.

Design: A randomized follow-up study.

Participants: One hundred and one patients with chronic non-specific neck pain were randomized in two groups.

Intervention: The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session.

Main outcome measurements: Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention.

Results: No significant differences in improvement in neck pain and disability were found between the two training groups. Mean (SD) pain decreased from 64 (17) mm by 37 (95% confidence interval (CI) 44 to 30) mm in the strength training and stretching group, and from 60 (17) mm by 32 (39 to 25) mm in the stretching group. The improvements in disability were significant in both groups ( P<0.001), while the changes in neck strength and mobility were minor. Training adherence decreased over time from the targeted three sessions a week, ending up at 1.1 (0.7) times a week for strength training and stretching group and 1.4 (0.8) times a week for stretching group.

Conclusions: No statistically significant differences in neck pain and disability were observed between the two home-based training regimens. Combined strength training and stretching or stretching only were probably as effective in achieving a long-term improvement although the training adherence was rather low most of the time.
Global outcome, productivity and epilepsy 3—8 years after severe head injury. The impact of injury severity
Authors: Skandsen Toril , Ivar Lund Tom , Fredriksli Oddrun , Vik Anne
Published: June 2008

Objective: To assess long-term outcome in survivors after severe head injury and relate outcome to injury severity.

Design: Follow-up 3—8 years post injury in a retrospectively collected sample.

Setting: A neurosurgical department in a regional trauma centre.

Subjects: Of 146 individuals admitted, 135 were actively treated. Twenty-four per cent of these died within six months. Ninety-three of the 94 (aged 1—88 years) who survived more than three years were included in the follow-up. They were separated into groups based on their level of consciousness at four weeks post injury: oriented ( n = 39), confused ( n = 22) or in a minimally conscious/vegetative state (MCS/VS) ( n = 26) and not possible to assess ( n = 6).

Outcome measures: Glasgow Outcome Scale Extended (GOSE), participation in work/education (productivity) and posttraumatic epilepsy.

Results: GOSE scores were: vegetative state: 3%, severe disability: 28% (22% lower level, 6% upper level), moderate disability: 39% (22% lower level, 17% upper level) and good recovery: 27% (10% lower level, 17% upper level). Productivity was 34% (aged 7—64 years). The three severity groups had different GOSE scores ( P<0.001) and different proportion of productive individuals ( P<0.001). Twenty-three per cent experienced posttraumatic epilepsy and this was significantly associated with the highest injury severity ( P<0.001) and intracranial surgery ( P = 0.01).

Conclusions: Being independent in daily life but unable to work was the typical long-term outcome. Stratifying the patients based on consciousness at four weeks we found different outcomes. Among oriented patients, almost all regained independency, whereas in the most severe group, poor outcomes and posttraumatic epilepsy was common.
Using mental practice in stroke rehabilitation: a framework
Authors: Braun Susy , Kleynen Melanie , Schols Jos , Schack Thomas , Beurskens Anna , Wade Derick
Published: June 2008

Introduction: Motor imagery and mental practice are getting increased attention in neurological rehabilitation. Several different mental practice intervention protocols have been used in studies on its effect on recovery in stroke rehabilitation. The content of the intervention protocols itself is rarely discussed or questioned.

Objective: To give a practical framework of how mental practice could be integrated into therapy, drawing on available evidence and theory. The aim of the treatment programme described is to enhance both the patient's physical performance and their empowerment and self-determination.

The framework: Based on evidence from sports rehabilitation and our own experiences the framework will eventually be evaluated in a randomized controlled trial. Five steps are described to teach and upgrade the patient's imagery technique: (1) assess mental capacity to learn imagery technique; (2) establish the nature of mental practice; (3) teach imagery technique; (4) embed and monitor imagery technique; (5) develop self-generated treatments. The description is not, however, a recipe that should be followed precisely. It leaves enough room to tailor the mental practice intervention to the specific individual possibilities, skills and needs of the patient in accordance with evidence-based practice.

Discussion: Different aspects of the described protocol are discussed and compared with experiences from sports and evidence available in rehabilitation.
Modelling of the concentration—effect relationship of THC on central nervous system parameters and heart rate — insight into its mechanisms of action and a tool for clinical research and development of cannabinoids
Authors: Strougo A. , Zuurman L. , Roy C. , Pinquier JL , van Gerven JMA , Cohen AF , Schoemaker RC
Published: June 2008

Pharmacokinetics after pulmonary administration of δ-9-tetrahydrocannabinol (THC) and its major metabolites 11-OH-THC and 11-nor-9-COOH-THC was quantified. Additionally, the relationship between THC and its effects on heart rate, body sway and several visual analogue scales was investigated using pharmacokinetic—pharmacodynamic (PK-PD) modelling. This provided insights useful for the research and development of novel cannabinoids and the physiology and pharmacology of cannabinoid systems. First, the PK-PD model gave information reflecting various aspects of cannabinoid systems. The delay between THC concentration and effect was quantified in equilibration half-lives of 7.68 min for heart rate and from 39.2 to 84.8 min for the CNS responses. This suggests that the effect of THC on the different responses could be due to different sites of action or different physiological mechanisms. Differences in the shape of the concentration—effect relationship could indicate various underlying mechanisms. Second, the PK-PD model can be used for prediction of THC concentration and effect profiles. It is illustrated how this can be used to optimise studies with entirely different trial designs. Third, many new cannabinoid agonists and antagonists are in development. PK-PD models for THC can be used as a reference for new agonists or as tools to quantitate the pharmacological properties of cannabinoid antagonists.
Effect of valproic acid on body weight, food intake, physical activity and hormones: results of a randomized controlled trial
Authors: Martin CK , Han H , Anton SD , Greenway FL , Smith SR
Published: June 2008

Abstract

The objective of this study was to identify mechanisms through which valproic acid (VPA) causes weight gain. Healthy participants ( N = 52) were randomized to VPA or placebo in a double-blind study. Energy intake (EI) was measured in the laboratory at lunch and dinner, and physical activity (PA) was measured with accelerometry. Glucose levels and hormones [Peptide YY3–36, glucagon-like peptide-1 (GLP-1), leptin, ghrelin, insulin] that regulate EI were measured. Assessments occurred at baseline and week 3. Change from baseline was evaluated with mixed models (α = 0.05). Weight significantly increased in the VPA group (+0.49 kg), but not the placebo group. The VPA group increased fast food fats cravings and decreased glucose levels compared with placebo. Change in weight, EI and PA did not differ by group. Within group analyses indicated that the VPA group increased PA, hunger, binge eating, depression and GLP-1. VPA-associated weight gain is not likely due to changes in PA or the gut hormones studied. Although EI did not increase when measured after 3 weeks of treatment, VPA decreased glucose levels and increased motivation to eat; hence, EI might have increased in the short-term. Research testing VPA on short-term (1 week) EI, metabolism, and substrate partitioning is warranted.
Review: Should ethanol be scheduled as a drug of high risk to public health?
Authors: Sellman JD , Robinson GM , Beasley R.
Published: June 2008

Six criteria described in the New Zealand Misuse of Drugs Act and used by the Expert Advisory Committee on Drugs (EACD) for determining the risk of a drug to public health were examined in relation to ethanol, using γ-hydroxybutyric acid (GHB) as a comparator drug. GHB is an ideal candidate for use as a comparator because it is a sedative substance very similar to ethanol and has been previously investigated by the EACD using these six criteria. GHB was subsequently classified as a Class B1 drug under the Misuse of Drugs Act, that is, as a prohibited drug of high risk to public health. The dangerousness level of ethanol was found to be at least similar to that of GHB in this analysis. This highlights a major discrepancy in public policy.
Omega-3 fatty acids (fish-oil) and depression-related cognition in healthy volunteers
Authors: Antypa N , Van der Does AJW , Smelt AHM , Rogers RD
Published: June 2008

Abstract

Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation may be beneficial in the treatment of several psychiatric disorders, including depression. A small number of studies have suggested that there may also be cognitive and mood effects in healthy samples. The purpose of the present study was to investigate the effects of n-3 PUFA on depression-relevant cognitive functioning in healthy individuals. Fifty-four healthy university students were randomized to receive either n-3 PUFA supplements or placebo for 4 weeks in a double-blind design. The test battery included measures of cognitive reactivity, attention, response inhibition, facial emotion recognition, memory and risky decision-making. Results showed few effects of n-3 PUFAs on cognition and mood states. The n-3 PUFA group made fewer risk-averse decisions than the placebo group. This difference appeared only in non-normative trials of the decision-making test, and was not accompanied by increased impulsiveness. N-3 PUFAs improved scores on the control/perfectionism scale of the cognitive reactivity measure. No effects were found on the other cognitive tasks and no consistent effects on mood were observed. The present findings indicate that n-3 PUFA supplementation may have a selective effect on risky decision making in healthy volunteers, which is unrelated to impulsiveness.
Improved stress response in bipolar affective disorder with adjunctive spironolactone (mineralocorticoid receptor antagonist): case series
Authors: Juruena MF , Gama CS , Berk M. , Belmonte-de-Abreu PS
Published: June 2008

The psychopathologies underlying affective disorders are thought to involve persistent changes in the expression and function of both mineralocorticoid receptors and glucocorticoid receptors in the hippocampus. In addition, exposure to stressful stimuli can precipitate episodes in vulnerable individuals. The aim of this study is to determine if spironolactone as an adjunctive therapy is effective in improving residual symptoms in bipolar disorder. Four cases of euthymic bipolar disorder (BD) patients were treated with spironolactone as an adjunctive therapy in a private treatment sector. All patients met the DSM-IV diagnosis criteria for bipolar disorder. Clinical response was assessed retrospectively using the Clinical Global Impression Scale for Improvement. Spironolactone was effective in all patients. The four cases illustrate a clinical response to residual symptoms and improvement in stress response after use of spironolactone as an adjunctive therapy in BD. This pilot case series suggests reducing in residual symptoms, with spironolactone as an adjunctive therapy in these DSM-IV BD patients. Mineralocorticoid receptors antagonists’ role in reducing stress-induced symptoms deserves further investigation through placebo-controlled trials.
Remission in schizophrenia: the relationship to baseline symptoms and changes in symptom domains during a one-year study
Authors: Kelly DL , Weiner E , Ball MP , McMahon RP , Carpenter WT , Buchanan RW
Published: June 2008

Abstract

The concepts of partial recovery and remission have become increasingly important for the evaluation of the effectiveness of schizophrenia therapeutics. The relationship of baseline symptoms and changes in symptoms to remission of psychosis was evaluated. Fifty-six outpatients with residual schizophrenia completed a double-blind trial of olanzapine versus haloperidol and were then enrolled into a one-year open-label trial of olanzapine. Out of these 56 subjects, 13 (23%) met remission criteria at the beginning of the open-label treatment and were excluded. During the one-year study, 7/43 (16%) subjects met remission criteria. These subjects had significantly lower baseline ratings for tardive dyskinesia (TD) than subjects who did not achieve remission (1.8 ± 1.5 vs. 4.2 ± 4.6, P = 0.03). As expected, remitted subjects had significantly greater improvements in Brief Psychiatric Rating Scale total scores, positive subscale scores and scale for the Assessment of Negative Symptoms total scores. Remitted subjects also experienced a significantly greater improvement in depressive symptoms ( P = 0.001), activation ( P = 0.005), and Clinical Global Impressions scores ( P < 0.001), as well as greater improvements in extrapyramidal symptoms ( P = 0.007) and TD ( P < 0.001). These results suggest that the relationship of depressive symptoms and improved side effects to the construct of remission in schizophrenia may deserve special attention. Future studies should aim to relate remission criteria to functional outcomes, cognition, and other important symptom domains.