bluuebunny/crossref_metadata_2025 huggingface dataset:
Commissioning NHS dental services
Authors: Bishop Karl
Published: June 2013

In February 2013 the Department of health published Securing excellence in commissioning NHS dental services, which set out NHS England's intentions for dentistry in England.
A Critical Appraisal of the Evidence of Current Methods of Assessment for Surgical Trainees
Authors: Batchelder AJ , McCarthy MJ
Published: June 2013

Over the past decade training pathways in the UK have been subject to extensive changes. Concerns regarding the supervision and training of junior doctors led to a number of reforms that were implemented through the Modernising Medical Careers programme and these mandated formalisation of curricula for all specialties. Consequently, the surgical royal colleges of the UK and Ireland designed the Intercollegiate Surgical Curriculum Programme (ISCP), which delineates the framework for surgical training from core trainee level through to the award of a Certificate of Completion of training.
ImprovIng Trauma OperatIon Notes at an EmergIng Trauma UnIt in the RegIonal Trauma Network
Authors: Malik SS , Nogaro MC , Shenoy R , Mitchell PD
Published: June 2013

The operation note is a legal document that is the surgeon's only written record of the operation. It is the professional responsibility of the operating surgeon to ensure that the operation note is complete and accurate. A clear and complete operation note is paramount to good communication as well as safe management of the patient.
Do Operative Notes from the National Hospital for Neurology and Neurosurgery Follow RCS Guidelines? A Complete Audit Cycle
Authors: Amiri N Damali , Nowak VA , Sethi H
Published: June 2013

The General Medical Council's Good Medical Practice requires doctors to keep clear, accurate and legible records and the Royal College of Surgeons (RCS) has produced guidelines setting out which details should be included (Table 1). Surgical operation notes are not only crucial in facilitating the best possible postoperative care, they are also important for academic and medicolegal reasons.
The Ward Round Assessment Tool: A New Workplace-based Assessment Tool
Authors: Kumar S , Danino J , Skinner DW
Published: June 2013

Workplace-based assessments (WBAs) are now embedded firmly in the StR assessment process throughout higher specialty training, as well as in foundation and core surgical training. From ST3 to ST8, all StRs undertake WBAs regularly to aid the assessment of their competence in the workplace. These are assessed by surgical trainers using the Intercollegiate surgical curriculum programme (ISCP) web-based process (see https://www.iscp.ac.uk/).
The impact of the introduction of the londonTrauma Network on a trauma and orthopaedic department within its catchment area
Authors: Sinnett Tim , Bacon Sheila , Somashaker Naresh
Published: June 2013

Following the decision by the Joint Committee of Primary CareTrusts (JPCTs) in July 2009 to designate four major trauma centres (MTC) in London, each with its own trauma network, the final MTC went fully live in January 2011. The primary aim of the LondonTrauma System is to ensure that those patients who suffer major trauma are treated at specialist MTCs. The National Audit Office Report published in 2010 revealed the literature suggested that where trauma systems had been introduced, in-hospital mortality was reduced by 15 to 20 per cent.
Policy–research linkage: what we have learned from providing a rapid response facility for international healthcare comparisons to the Department of Health in England
Authors: Ettelt Stefanie , Mays Nicholas , Nolte Ellen
Published: June 2013

In this paper we reflect on our experience of providing a rapid response facility for international healthcare policy comparisons to the English Department of Health. We examine the challenges of developing sustained relationships with policy officials while providing an ‘on-demand’ service in an environment with high turnover of policies and staff. It may be easier for policy makers to draw on researchers in such a setting than for researchers to foster ‘linkage and exchange’ relationships with policy makers. Under the facility, knowledge transfer has mostly been from researchers to policy officials, affording us little insight into the policy process or the impact of our work.
Making the most of obesity research: developing research and policy objectives through evidence triangulation
Authors: Oliver Kathryn , Aicken Catherine , Arai Lisa
Published: June 2013

Drawing lessons from research can help policy makers make better decisions. If a large and methodologically varied body of research exists, as with childhood obesity, this is challenging. We present new research and policy objectives for child obesity developed by triangulating user involvement data with a mapping study of interventions aimed at reducing child obesity. The results suggest that enhancing mental wellbeing should be a policy objective, and greater involvement of peers and parents in the delivery of obesity interventions would be beneficial. We conclude that exploiting the evidence base through triangulation is a useful and valid method.
Polarisation, radicalisation and social policy: evaluating the theories of change
Authors: Lub Vasco
Published: June 2013

This article evaluates the validity of ‘theories of change’ of anti-polarisation and anti-radicalisation interventions. Assumptions of four dominant social policies are confronted with the literature. In addition, epistemological issues are discussed. Notions of ‘what works and why’, do not equate to straightforward application. Also, the potential of the four policy approaches depends in great measure on their conceptualisation of ‘polarisation’ or ‘radicalisation’. A focus on interventions could be dismissed as naive, when no account is offered of wider sociopolitical factors fuelling radicalisation or ethnic tensions. The interaction between these two notions is a relevant topic for future research.
Qualities of knowledge brokers: reflections from practice
Authors: Phipps David , Morton Sarah
Published: June 2013

Employing knowledge brokers is one way that universities and research centres have responded to the increasing emphasis on the wider usefulness and uptake of research beyond the academy. While there is an increase in the numbers of such professionals, there has been little focus on their roles, skills and development. In this paper, two knowledge exchange directors from Canada and the United Kingdom reflect on their combined experiences of being, developing and employing knowledge brokers in a range of roles.
The cooperative competitive citizen: What does it take?
Authors: Fülöp Márta , Takács Szabolcs
Published: June 2013

Each human group and each society is a complex system of cooperative and competitive relationships. These two relations are intertwined, however, it is not indifferent in what way and to what extent. The present research has aimed at revealing the requirements of cooperative competition
which is a competitive process with a high degree of cooperation among the competing parties. The Critical Incident Technique was applied. This procedure is based on the direct observation of human behaviour and was elaborated in order to examine complex interpersonal phenomena and to provide
ecological validity. Altogether 483 critical incidents were described by teachers and university students of education. They were instructed to recall competitive relationships that have certain characteristics (e.g. high degree of cooperation among the parties vs no cooperation among the
parties; high degree of trust among the parties vs high degree of distrust among the parties, etc.) After the free description of the incident, the participants had to characterize the competitive event along different dimensions on a Likert-scale, for instance intense/not intense competition;
rules kept or violated. Applying principal component analysis, four different scales were constructed: the Cooperation Scale (i.e. the relationship among the competitors, cooperation, trust and communication), the Motivation Scale (i.e. motivation, the importance of the goal, development and
learning), the Fairness Scale (i.e. rule keeping, no aggression and no manipulation) and the Enjoyment Scale (i.e. enjoyment and positive stress). The correlation analysis of the interrelations among the scales and individual variables has indicated that the high degree of cooperation among
the competitors was positively related to fairness, the clarity of rules of competition, enjoyment and motivation. Less cooperation among the competitors was related to higher level stress and more intensive competition among them. If competitive processes are characterized by high degree
of cooperation, i.e. they are cooperative competitions that have no detrimental but only beneficial effects, then they combine the constructive aspects of both cooperation and competition.
Justice perceptions and cooperation of citizens with the tax-authorities: The group engagement model of cooperation
Authors: Hartner-Tiefenthaler Martina , Rechberger Silvia , Kirchler Erich
Published: June 2013

One of the mandatory responsibilities of each citizen is paying taxes. Even though it is a legal requirement to do it, citizens have the possibility to adjust their payments and cheat on it. Thus, the paying of taxes can be seen as cooperative act between the state and its citizens.
Based on the group engagement model of cooperation, this study (N=474) demonstrates the interplay of perceived justice, national identification, motivational postures and tax compliance. Extending the justice dimensions of the original group engagement model by retributive justice, a positive
relationship of all three forms of perceived justice (i.e. procedural justice, resource judgements, and justice of punishment) with national identification was achieved. Furthermore, while national identification was positively associated with deference, its negative association with defiance
could not be shown. Tax compliance was high in case of strong attitudes of deference and weak attitudes of defiance. Results indicate partial mediation of justice judgments and deference through national identification. Judging justice is not an easy task and thus, citizens should be taught
about the rationale behind tax law. Understanding the reasons for the law facilitates making up one’s mind regarding the fairness of tax distribution, tax procedures and retribution for cheating on taxes that influences tax compliance in the long run.
Objectivity versus ‘toxic propaganda’: The case of transborder broadcasts to Portugal during World War II
Authors: Ribeiro Nelson
Published: June 2013

This article describes the role of foreign radio propaganda in Portugal in the years that preceded and the years during World War II. It demonstrates how the BBC became the most effective weapon to counterattack the German propaganda in the country and comments on the strategies used
by the British in order to reach the Portuguese public. Among those strategies the most important was the promotion of the objectivity of the broadcasts from London, as opposed to the German transmissions that were known for airing mainly ‘toxic propaganda’. Evidence is also presented
according to which news bulletins and talks broadcast by the BBC were perceived by the receivers as independent from political interference while the Axis transmissions were mostly considered as airing ‘toxic information’, demonstrating how during the war British white propaganda
became very effective in regards to its impact on the Portuguese public.
The Eeuropean Union as a managerial state: On the anti-publicity bias of an identity-less political regime
Authors: Pérez Francisco Seoane
Published: June 2013

The set-up of a European Semester, under which EU Member States’ public budgets and accounts are supervised by the European Council, along with the prospect of a fiscal harmonization across Eurozone Member States that would limit the agency of national governments’ economic
policy, has thrown the EU political system into the spotlight of public (and published) opinion. This article argues that, in the context of an absent European identity that would be commensurable with the scope of European institutions, Europe seems to be heading for a technocratic regime
backed up by a revival of the nineteenth century’s ‘Concert Européen’ (what press commentators nowadays call the ‘European directorate’). Drawing from in-depth interviews with policy makers, journalists and civil society actors from Brussels and two contrasting
countries (the United Kingdom and Spain), on their acceptance of EU institutions, I discard the ‘communications gap’ theory to explain the distant and bureaucratic character of European institutions, resorting instead to an explanation related to the kind of political system the
European Union is, based upon principles that are inherently biased against the publicity of procedures: corporatism, diplomacy and technocracy.
Activism, health and the Net: Are new media shaping our perception of uncertainty?
Authors: Camerini Luca , Diviani Nicola
Published: June 2013

The Internet represents a fertile ground for the communication and dissemination of information about health in general, and about health risks in particular. Moreover, new media can play a key role in shaping the public perception of risk and uncertainty, potentially allowing everybody
to have a say in public discussions. More and more activist groups profit from this opportunity and increasingly exploit new media to draw attention to and make sense of the diverse information delivered in the public debate on health issues. Moving from the results of a content analysis of
702 messages posted between 2001 and 2007 in a Swiss activist group’s online discussion forum discussing the risks linked to non-ionizing radiation, this article explores the ways communication flows within new technologies. Non-ionizing radiation is an interesting topic because there
is no scientific evidence that supports either its positive or negative effect on health, shifting the burden of proof and discussion to the population. Lacking clear and definitive institutional communication about the topic, we assume that the information presented on the Internet in general,
and by online activist groups in particular, could have a great impact on people’s risk perception.
Helping self-help books: Working towards a new research agenda
Authors: Neville Patricia
Published: June 2013

Self-help books are one of the most prolific and commercially successful book genres of the past 30 years (Smith 2002). Described as a genre of books that outline a particular problem in the leading title, which is then followed by its remedy in the subtitle, the self-help genre has
also undergone substantial product diversification to include inspirational pamphlets, affirmational daily journals, audio books and miniature self-help books (e.g. The Little Book of Hope) to emerge as a very lucrative global cultural industry. While it is estimated that the self-help industry
is worth $10 billion in America, this strong consumptive relationship with self-help books is not an exclusive American phenomenon, but can also be found to be on the increase in Britain, as well as Japan, China and India, among other countries. However, despite the sizeable presence
of self-help books in contemporary popular culture, the practice of consuming and reading self-help books has yet to receive the scholarly attention that this phenomenon now deserves. In this article I will attempt to rectify this impasse by conducting a critical review of the research already
conducted into self-help books and their readers, highlighting the inconsistencies and impediments that hamper a sustained and systematic analysis of self-help books, with a view to signposting new areas for development and a fusion of different perspectives in the years ahead.
Bladder Preservation Therapy for Muscle-Invading Bladder Cancers on Radiation Therapy Oncology Group Trials 8802, 8903, 9506, and 9706: Vascular Endothelial Growth Factor B Overexpression Predicts for Increased Distant Metastasis and Shorter Survival
Authors: Lautenschlaeger Tim , George Asha , Klimowicz Alexander C. , Efstathiou Jason A. , Wu Chin-Lee , Sandler Howard , Shipley William U. , Tester William J. , Hagan Michael P. , Magliocco Anthony M. , Chakravarti Arnab
Published: June 2013

Background.

From 1988 to 1999, the Radiation Therapy Oncology Group (RTOG) conducted four prospective studies (8802, 8903, 9506, 9706) of patients with clinical stage T2–4a muscle-invasive bladder cancer. Treatment was selective bladder preservation using transurethral surgery (TURBT) plus cisplatin-based induction and consolidation chemoradiation regimens, reserving radical cystectomy for invasive tumor recurrence. We investigated vascular endothelial growth factor (VEGF) pathway biomarkers in this unique clinical dataset (median follow-up of 3.1 years).

Methods.

A total of 43 patients with tissue available from the entry TURBT were included in this analysis. Expression of VEGF ligands and receptors were quantified and scored by the AQUA platform (HistoRX, now Genoptix, Carlsbad, CA) and analyzed after median split.

Results.

VEGF expression levels were not associated with increased rates of complete response to induction chemoradiation. Higher levels of cytoplasmic VEGF-B, VEGF-C, and VEGF-R2 were associated with decreased overall survival rates. The 3-year overall survival estimates for high and low expressers were 43.7% and 75% for VEGF-B cytoplasm (p = .01), 40.2% and 86.7% for VEGF-C cytoplasm (p = .01), and 49.7% and 66.7% for VEGF-R2 cytoplasm (p = .02). Higher expression levels of cytoplasm VEGF-B were associated with higher rates of distant failure (p = .01).

Conclusions.

Although VEGF ligands and receptors do not appear to be associated with complete response to induction chemoradiation for muscle-invasive bladder cancer, we report significant associations with overall survival and distant failure for certain VEGF family members.
Lipophilic nano-bismuth inhibits bacterial growth, attachment, and biofilm formation
Authors: Badireddy Appala Raju , Marinakos Stella M. , Chellam Shankararaman , Wiesner Mark R.
Published: June 2013

There is an urgent need for low-cost and low-toxicity antimicrobial agents for water treatment and medical applications. Current approaches utilize relatively expensive and corrosive chemicals and disinfectants to reduce, prevent or remove biofilms in technological systems. Nanoparticle-based approaches are sought increasingly to develop disinfection systems and self-cleaning surfaces that could ‘seek and destroy’ microorganisms. In this context, the authors have developed novel lipophilic bismuth dimercaptopropanol (BisBAL) nanoparticles using a simple aqueous reduction reaction with sodium borohydride at room temperature. The objective of this study was to assess the effect of BisBAL nanoparticles on growth, attachment and biofilm formation by Pseudomonas aeruginosa. Characterization of nanoparticles showed them to be very lipophilic, with a rhombohedral crystalline structure and crystallite size of approximately 18 nm. When introduced at or above the minimum inhibitory concentration (MIC = 12·5 µM), the growth of bacteria was completely inhibited for at least 30 d. The authors show that lipophilic BisBAL nanoparticles at the MIC inhibited bacterial attachment to track-etched polycarbonate membrane surfaces and lysed bacteria embedded in biofilms, within 1 h of exposure. The authors conclude that lipophilic bismuth nanoparticles are promising antimicrobial agents, that have the capability to inhibit growth, prevent bacterial attachment to surfaces or damage existing biofilms.
Risk Factors for Posttraumatic Stress Disorder in Female Help-Seeking Victims of Sexual Assault
Authors: Elklit Ask , Christiansen Dorte M.
Published: June 2013

Posttraumatic stress disorder (PTSD) is common in the aftermath of rape and other sexual assault, but the risk factors leading to PTSD following rape have been shown to differ from those related to PTSD following nonsexual assault. This prospective study examined risk factors for PTSD severity in 148 female help-seeking victims of sexual assault. Approximately 70% of the victims experienced significant levels of traumatization, with 45% reporting symptoms consistent with a probable PTSD diagnosis. Regression analyses showed that relationship with the assailant, number of assailants, the nature of the assault, perceived positive social support, support satisfaction, feeling let down by others, and prior exposure to sexual trauma did not significantly predict PTSD severity at the final level of analysis. In accordance with suggestions by Dancu, Riggs, Hearst-Ikeda, and Shoyer (1996), it is suggested that this is partly caused by a very high degree of traumatization in the sample. Instead, previous nonsexual traumatic experiences and negative affectivity accounted for 30% of the variance in PTSD severity. Although more research is needed on risk factors of assault-related PTSD, these findings suggest that although sexual assault is associated with a high degree of PTSD severity, prior nonsexual victimization and high levels of negative affectivity appear to further increase the vulnerability toward developing symptoms of assault-related PTSD.
A Revision of the Sexual Coercion in Intimate Relationships Scale for Young Adults in China
Authors: He Shanshan , Tsang Sandra , Li Caina
Published: June 2013

The Sexual Coercion in Intimate Relationships Scale (SCIRS; 34 items) assesses the severity of sexual coercion (SC) in committed intimate relationships, but it does not validly screen out valid target cases or accurately assess prevalence. This study aims to revise the SCIRS to facilitate research in China. There were 927 college students in active dating relationships, from 5 large Chinese cities, who participated in the study. The results showed that the revised SCIRS (33 items) measured 3 constructs—Emotional Manipulation (17 items), Defection Threat (7 items), and Violence Threat (7 items)—and that the reliability and validity properties were satisfactory. The advantages of the revision and the limitations of this study are discussed.
Violent Victimization Among State Prison Inmates
Authors: Wooldredge John , Steiner Benjamin
Published: June 2013

Violent victimization in prison may enhance inmates’ cynicism toward legal authority and the risk of subsequent criminality. Both micro- and macro-level effects on the prevalence and incidence of inmate-on-inmate physical assault during a 6-month period were examined for random samples of inmates (n1= 5,640) from all state prisons in Ohio and Kentucky (n2= 46). Findings revealed that nonprovoked assaults were more common among inmates with lifestyles that might have increased their vulnerability to victimization (less time spent in structured activities, committed violent acts themselves, etc.), and in prisons with larger populations and officers who practice lax rule enforcement. A supplementary analysis of violent offending also revealed that inmate offenders and victims may look less like each other compared to offenders and victims in the general population. Policies focused on increasing inmates’ involvement in structured prison activities, enhancing professionalism among officers, and lowering prison populations may be most effective for minimizing the risk of violent victimization.
Adverse Childhood Experiences, Posttraumatic Stress Disorder Symptoms, and Emotional Intelligence in Partner Aggression
Authors: Swopes Rachael M. , Simonet Daniel V. , Jaffe Anna E. , Tett Robert P. , Davis Joanne L.
Published: June 2013

Intimate partner violence (IPV) has been linked to childhood abuse, posttraumatic stress disorder (PTSD), and low emotional intelligence (EI). Relationships among adverse childhood experiences (ACE), PTSD symptoms, and partner aggression (i.e., generalized tendency to aggress toward one’s partner) were assessed in 108 male IPV offenders. It was hypothesized that ACE is positively correlated with partner aggression, PTSD mediates the ACE-aggression relationship, and the ACE-PTSD-aggression mediation varies by selected EI facets. Results indicate that ACE has an indirect effect on partner aggression via PTSD and PTSD mediates the ACE–aggression link when emotional self-regulation is low and when intuition (vs. reason) is high. Trauma-exposed IPV offenders may benefit from comprehensive treatments focusing on PTSD symptoms, emotional control, and reasoning skills to reduce aggression.
Fear of Rape Among College Women: A Social Psychological Analysis
Authors: Pryor Douglas W. , Hughes Marion R.
Published: June 2013

This article examines social psychological underpinnings of fear of rape among college women. We analyze data from a survey of 1,905 female undergraduates to test the influence of 5 subjective perceptions about vulnerability and harm: unique invulnerability, gender risk, defensibility, anticipatory shame, and attribution of injury. We include 3 sources of crime exposure in our models: past sexual victimization, past noncontact violent victimization, and structural risk measured by age, parent’s income, and race. Separate measures of fear of stranger and acquaintance rape are modeled, including variables tapping current versus anticipatory fear, fear on campus versus everywhere, and fear anytime versus at night. The data show that fear of rape among college women appears more grounded in constructed perceptions of harm and danger than in past violent experiences.
Rupture of the Anterior Cruciate Ligament and Bucket Handle Tear of the Medial Meniscus
Authors: Mabry Lance M. , Mcgill Troy E. , Abbott Jessica L.
Published: June 2013

The patient was a 33-year-old man currently serving in the military as a radio operator, who had a chief complaint of right knee pain. After the patient returned from his deployment, he sought further medical care and was referred to a physical therapist. Visual observation revealed right quadriceps muscle atrophy, mild right knee effusion, and decreased duration of terminal stance phase for the right lower extremity during gait. During range-of-motion assessment, the patient was unable to fully extend his right knee due to a mechanical limitation. Due to concern for an anterior cruciate ligament tear and a medial meniscal tear, the physical therapist referred the patient to an orthopaedic surgeon for additional evaluation. Magnetic resonance imaging revealed a complete rupture of the anterior cruciate ligament and a double posterior cruciate ligament sign, suggestive of a bucket handle tear of the medial meniscus. The patient subsequently underwent surgical reconstruction of the anterior cruciate ligament and repair of the medial meniscus.

J Orthop Sports Phys Ther 2013;43(6):427. doi:10.2519/jospt.2013.0410
Symptomatic Discoid Medial Meniscus
Authors: Zhang Chunli , Xu Hu , Wang Yingchun
Published: June 2013

The patient was a 27-year-old man with a chief complaint of right medial knee pain for the past 4 months. Despite physical therapist intervention for a month, the patient's right knee pain continued to progressively worsen, and the patient was subsequently referred to an orthopaedic surgeon. Arthroscopic examination found that the medial tibial plateau was not completely covered by the discoid meniscus, and complex horizontal and peripheral longitudinal tears of the medial meniscus were identified. A partial meniscectomy was performed and the parameniscal cyst was removed. At 3 months following surgery, the patient had no complaints of right knee pain and had successfully returned to all required activities of daily living.

J Orthop Sports Phys Ther 2013;43(6):428. doi:10.2519/jospt.2013.0411
The Impact of a Classroom-Based Guidance Program on Student Performance in Community College Math Classes
Authors: Butcher Kristin F. , Visher Mary G.
Published: June 2013

Passing through remedial and required math classes poses a significant barrier to success for many community college students. This study uses random assignment to investigate the impact of a “light-touch” intervention, where an individual visited math classes a few times during the semester, for a few minutes each time, to inform students about available services. Entire class sections, rather than individuals, were randomly assigned to program and control groups, reducing the administrative burden for the college of a randomized-controlled experiment. This study finds that the intervention increased students’ use of tutoring services and reduced math class withdrawal rates, but had no effect on overall pass rates. The program did, however, increase the math class pass rates for part-time students, who represented almost 50% of the participants.
“Nothing” Works: Sentencing “Reform” in Canada and the United States
Authors: Tonry Michael
Published: June 2013

Anthony Doob has documented the evolution of knowledge about sentencing and sentencing policy in Canada since the 1970s, and the social, attitudinal, and psychological forces that influenced them. Except for the enactment, in 1996, of a statute specifying general purposes of sentencing and the enactment of mandatory minimum sentencing laws of limited scope, not much has happened in Canada. By contrast, enormous numbers of changes in law, policy, and practice have occurred in the United States, with mostly negative effects in terms of diminution of justice, crowded prisons, unprecedented imprisonment rates, and worsened racial disparities. Americans would have benefitted from something like Canadian inertia. Canadians have little that is positive and much that is negative to learn from the American sentencing reform experience.
Usage Patterns and Beliefs about Therapeutic Ultrasound by Canadian Physical Therapists: An Exploratory Population-Based Cross-Sectional Survey
Authors: Armijo-Olivo Susan , Fuentes Jorge , Muir Iain , Gross Douglas P.
Published: June 2013

Purpose: To explore the frequency and patterns of ultrasound (US) usage among physical therapists, to describe the most common purposes for using therapeutic US, and to investigate beliefs about therapeutic US. Methods: A survey was sent to 95% of physical therapists licensed to practise in the province of Alberta, Canada. Results: Of 2,269 physical therapists to whom email invitations were sent, 438 (19.3%) provided full responses. Results indicate that US is still frequently incorporated into treatment regimens and is widely believed to be effective; however, the study also found a decrease in US usage over the past 15 years. While physical therapists recognize the lack of evidence for the effectiveness of US, many consider it clinically useful. Physical therapists using US rely largely on their clinical experience when making decisions about its use, but this depends on level of education: clinicians with an MScPT degree tended to base more of their US decisions on research evidence, likely because of the increasing emphasis on research evidence in graduate education. Conclusions: Despite the questionable effectiveness of therapeutic US, physical therapists still commonly use this treatment modality, largely because of a belief that US is clinically useful. However, US usage has decreased over the past 15 years.
A Comparison of Implicit and Explicit Attitude Measures: An Application of the Implicit Association Test (IAT) to Fast Food Restaurant Brands
Authors: Lee Kwang-Ho , Kim Dae-Young
Published: June 2013

The study attempted to assess people's attitudes toward fast food restaurant brands by comparing the results of explicit and implicit attitude measures. A total of 60 college students (33 Americans and 27 Koreans) were recruited to complete both a self-report survey and the Implicit
Association Test (IAT). Two known fast food restaurant brands were selected and the results of this study show that Korean respondents have inconsistent response patterns in explicit/implicit measures toward the two brands, while consistent patterns are found among Americans in the same context.
In terms of the correlation results, it was observed that both explicit and implicit attitude measures are significantly correlated with the frequency of fast food restaurant visits (FFRV) among Koreans, whereas explicit liking was not correlated with FFRV in the significant correlations between
other variables (GEA and IA) among Americans. The researchers' elaborations on the literature and the experimental study reveal several conclusions, recommendations, and implications.
The Changing Distribution of Global Tourism: Evidence from Gini Coefficients and Markov Matrixes
Authors: Lacher R. Geoffrey , Nepal Sanjay K.
Published: June 2013

This article examines the global distribution of tourism arrivals over 1995–2008 to determine whether there is a pattern of concentration or dispersal of tourist arrivals at a global scale, and then predicts the possible future distribution of global tourists arrival based on
changes in those years. The study employs Gini coefficients and a Markov matrix to international arrival data in 153 countries for the period between 1995 and 2008. The Gini coefficient is used to measure the dispersion of total inter- national tourist arrivals (ITA) in each country. Results
show that the Gini coefficient has decreased over time (i.e., the distribution is gradually dispersed but the overall pattern remains unchanged). Using the same data, Markov matrix is used to predict the future distribution based on changes over the 14-year period. These results suggest future
dispersion of international tourist arrivals would be somewhat different than it is today but the overall dominance of the leading countries (i.e., those with high arrival numbers) will continue. The implication is that the leading countries must develop strate- gies to continue to remain
competitive, as other less visited countries make stronger efforts to pro- mote tourism to counterbalance the current imbalance in international arrivals.
Developing and Testing a Suite of Institutional Indices to Underpin the Measurement and Management of Tourism Destination Transformation
Authors: McLennan Char-Lee J. , Moyle Brent D. , Ruhanen Lisa M. , Ritchie Brent W.
Published: June 2013

Economic, social, and environmental transformation of destinations as a consequence of tourism has been observed and studied extensively within the tourism literature. transformation theory has evolved as a tool for understanding structural economic, social, or environmental change,
which is driven by institutions. there is an emerging body of research that has sought to identify the institutional aspects of the tourism transformation process. Despite this, there has been limited development of tools that can measure institutions, inhibiting the development of long-run
decision-making models that governments can use when developing policies for tourism destination development. As a result this research contributes a suite of institutional indices that can be used by tourism managers and planners to monitor, evaluate, and benchmark the tourism industry's
institutions. Drawing from the organizational change literature, the proposed indices focus on competition, management processes, data and research capabilities, collaboration efforts, benchmarking processes, learning ability, and agility and adaptability. this research is an important step
in developing combined structural and institutional models that will contribute to the development and implementation of decision-making tools to assist destinations seeking to achieve long-term sustainable tourism transformation.
Evaluating the Impact of Crime on Tourism in Barbados: A Transfer Function Approach
Authors: Lorde Troy , Jackman Mahalia
Published: June 2013

The impact of crime on tourism to Barbados was examined using a transfer function approach. results indicate that an increase in the overall crime rate has a negative and significant impact on arrivals to the island, and the fall-off is delayed, starting 6 months after a one-unit increase
in the crime rate. The impulse response function shows that a 1% shock to crime reduces arrivals to Barbados, but takes about 20 months for arrivals to return to normalcy. This results in direct income losses of US$47,000 and indirect losses of US$108,000. Impacts for murder,
assault with intent to rob, rape, and residential burglary rates were also investigated. Qualitatively, the results resemble those for the overall crime rate; however, the magnitudes of the impacts are greater and income losses are generally in the millions. Given the country's dependence
on tourism receipts to sustain its current account, shocks to the crime rate can lead to balance of payment problems. Since there is a lag before the impact of increases in crime takes its full toll on arrivals, it is advised that at the first sign of heightened criminal activity policy makers
should act to minimize losses.
Effect of Genetic Polymorphisms on Development of Gout
Authors: Urano Wako , Taniguchi Atsuo , Inoue Eisuke , Sekita Chieko , Ichikawa Naomi , Koseki Yumi , Kamatani Naoyuki , Yamanaka Hisashi
Published: June 2013

Objective.

To validate the association between genetic polymorphisms and gout in Japanese patients, and to investigate the cumulative effects of multiple genetic factors on the development of gout.

Methods.

Subjects were 153 Japanese male patients with gout and 532 male controls. The genotypes of 11 polymorphisms in the 10 genes that have been indicated to be associated with serum uric acid levels or gout were determined. The cumulative effects of the genetic polymorphisms were investigated using a weighted genotype risk score (wGRS) based on the number of risk alleles and the OR for gout. A model to discriminate between patients with gout and controls was constructed by incorporating the wGRS and clinical factors. C statistics method was applied to evaluate the capability of the model to discriminate gout patients from controls.

Results.

Seven polymorphisms were shown to be associated with gout. The mean wGRS was significantly higher in patients with gout (15.2 ± 2.01) compared to controls (13.4 ± 2.10; p < 0.0001). The C statistic for the model using genetic information alone was 0.72, while the C statistic was 0.81 for the full model that incorporated all genetic and clinical factors.

Conclusion.

Accumulation of multiple genetic factors is associated with the development of gout. A prediction model for gout that incorporates genetic and clinical factors may be useful for identifying individuals who are at risk of gout.
Sustained Clinical Remission and Rate of Relapse After Tocilizumab Withdrawal in Patients with Rheumatoid Arthritis
Authors: Aguilar-Lozano Luis , Castillo-Ortiz Jose Dionisio , Vargas-Serafin Cesar , Morales-Torres Jorge , Sanchez-Ortiz Adriana , Sandoval-Castro Carlos , Padilla-Ibarra Jorge , Hernandez-Cuevas Claudia , Ramos-Remus Cesar
Published: June 2013

Objective.

Data on when to stop use of biological agents in rheumatoid arthritis (RA) are scant. We assessed the length of remission and the rate of clinical relapse in patients with RA who had to discontinue treatment with tocilizumab (TCZ) because of the ending of longterm (5 yrs) open-label clinical trials.

Methods.

All patients at 2 participating centers in Mexico were in remission, defined as Disease Activity Score 28 ≤ 2.6, with no swollen joints at the time of the last TCZ infusion. Patients were followed thereafter every 8 weeks for 12 months or until relapse. Relapse was defined as the presence of ≥ 1 swollen joint. Doses of methotrexate and antiinflammatory drugs were not changed during the followup period.

Results.

Forty-five patients were analyzed, 87% were women (mean age 52 yrs, mean disease duration 14 yrs). During the 12 months of followup, 44% of patients maintained remission. Relapses occurred in 56% of patients: 14 during the first 3 months after the last TCZ administration. Retreatment using other agents achieved low disease activity or remission.

Conclusion.

Longterm clinical remission is possible in a number of patients with RA after suspension of TCZ. This effect has also been reported with other biologic agents. Additional data are required to support recommendations for discontinuing a biological agent after achieving remission.
Head-of-Bed Elevation in Critically Ill Patients: A Review
Authors: Metheny Norma A. , Frantz Rita A.
Published: June 2013

Clinicians are confused by conflicting guidelines about the use of head-of-bed elevation to prevent aspiration and pressure ulcers in critically ill patients. Research-based information in support of guidelines for head-of-bed elevation to prevent either condition is limited. However, positioning of the head of the bed has been studied more extensively for the prevention of aspiration than for the prevention of pressure ulcers, especially in critically ill patients. More research on pressure ulcers has been conducted in healthy persons or residents of nursing homes than in critically ill patients. Thus, the optimal elevation for the head of the bed to balance the risks for aspiration and pressure ulcers in critically ill patients who are receiving mechanical ventilation and tube feedings is unknown. Currently available information provides some indications of how to position patients; however, randomized controlled trials where both outcomes are evaluated simultaneously at various head-of-bed positions are needed.
CD166/ALCAM Mediates Proinflammatory Effects of S100B in Delayed Type Hypersensitivity
Authors: von Bauer Rüdiger , Oikonomou Dimitrios , Sulaj Alba , Mohammed Sawsan , Hotz-Wagenblatt Agnes , Gröne Hermann-Josef , Arnold Bernd , Falk Christine , Luethje Dorit , Erhardt Axel , Stern David M. , Bierhaus Angelika , Nawroth Peter P.
Published: June 2013

Promiscuity of pattern recognition receptors, such as receptor for advanced glycation end products (RAGE), allows for a complex regulatory network controlling inflammation. Scavenging of RAGE ligands by soluble RAGE treatment is effective in reducing delayed-type hypersensitivity (DTH), even in RAGE−/− mice by 50% (p < 0.001). This has led to the hypothesis that molecules scavenged by soluble RAGE bind to receptors other than RAGE. This study identifies CD166/ALCAM (ALCAM) as a close structural and functional homolog of RAGE, and it shows that binding of S100B to CD166/ALCAM induces dose- and time-dependent expression of members of the NF-κB family in wild type (WT) and RAGE−/− mouse endothelial cells. Blocking CD166/ALCAM expression using small interfering RNA completely inhibited S100B-induced NF-κB activation in RAGE−/−, but not in WT cells. The in vivo significance of these observations was demonstrated by attenuation of DTH in WT and RAGE−/− animals pretreated with CD166/ALCAM small interfering RNA by 50% and 40%, respectively (p < 0.001). Experiments in ALCAM−/− animals displayed an only slight reduction of 16% in DTH, explained by compensatory reciprocal upregulation of RAGE in animals devoid of CD166/ALCAM, and vice versa. Consistently, ALCAM−/− mice, but not WT mice treated with RAGE small interfering RNA show a 35% reduction in DTH, and ALCAM−/− RAGE−/− double-knockout mice show a 27% reduction in DTH reaction. Thus, S100B is a proinflammatory cytokine bridging RAGE and CD166/ALCAM downstream effector mechanisms, both being compensatory upregulated after genetic deletion of its counterpart.
GILZ Overexpression Inhibits Endothelial Cell Adhesive Function through Regulation of NF-κB and MAPK Activity
Authors: Cheng Qiang , Fan Huapeng , Ngo Devi , Beaulieu Elaine , Leung Patrick , Lo Camden Y. , Burgess Rosemary , van der Zwan Yvonne G. , White Stefan J. , Khachigian Levon M. , Hickey Michael J. , Morand Eric F.
Published: June 2013

Glucocorticoid-induced leucine zipper (GILZ) is an anti-inflammatory protein first identified in T lymphocytes. We recently observed that GILZ is highly expressed in synovial endothelial cells in rheumatoid arthritis. However, the function of GILZ in endothelial cells is unknown. To investigate the actions of GILZ in this cell type, we induced GILZ expression in HUVECs via transient transfection. GILZ overexpression significantly reduced the capacity of TNF-stimulated HUVECs to support leukocyte rolling, adhesion, and transmigration. These effects were associated with decreased expression of E-selectin, ICAM-1, CCL2, CXCL8, and IL-6. Experiments in a human microvascular endothelial cell line demonstrated that TNF-inducible NF-κB activity was significantly inhibited by overexpression of GILZ. Exogenous GILZ inhibited TNF-induced NF-κB p65 DNA binding, although this occurred in the absence of an effect on p65 nuclear translocation, indicating that the mechanism of action of exogenous GILZ in endothelial cells differs from that reported in other cell types. GILZ overexpression also inhibited TNF-induced activation of p38, ERK, and JNK MAPKs, as well as increased expression of the MAPK inhibitory phosphatase, MKP-1. In contrast, silencing endogenous GILZ in glucocorticoid-treated HUVECs did not alter their capacity to support leukocyte interactions. These data demonstrate that exogenous GILZ exerts inhibitory effects on endothelial cell adhesive function via a novel pathway involving modulation of NF-κB p65 DNA binding and MAPK activity. Induction of GILZ expression in endothelial cells may represent a novel therapeutic modality with the potential to inhibit inflammatory leukocyte recruitment.
Phosphatidylinositol 3-Kinase–Independent Signaling Pathways Contribute to ICOS-Mediated T Cell Costimulation in Acute Graft-Versus-Host Disease in Mice
Authors: Li Jun , Heinrichs Jessica , Leconte Julien , Haarberg Kelley , Semple Kenrick , Liu Chen , Gigoux Mathieu , Kornete Mara , Piccirillo Ciriaco A. , Suh Woong-Kyung , Yu Xue-Zhong
Published: June 2013

We and others have previously shown that ICOS plays an important role in inducing acute graft-versus-host disease (GVHD) in murine models of allogeneic bone marrow transplantation. ICOS potentiates TCR-mediated PI3K activation and intracellular calcium mobilization. However, ICOS signal transduction pathways involved in GVHD remain unknown. In this study, we examined the contribution of ICOS-PI3K signaling in the pathogenic potential of T cells using a knock-in mouse strain, ICOS-YF, which selectively lost the ability to activate PI3K. We found that when total T cells were used as alloreactive T cells, ICOS-YF T cells caused less severe GVHD compared with ICOS wild-type T cells, but they induced much more aggressive disease than ICOS knockout T cells. This intermediate level of pathogenic capacity of ICOS-YF T cells was correlated with similar levels of IFN-γ–producing CD8 T cells that developed in the recipients of ICOS-WT or ICOS-YF T cells. We further evaluated the role of ICOS-PI3K signaling in CD4 versus CD8 T cell compartment using GVHD models that are exclusively driven by CD4 or CD8 T cells. Remarkably, ICOS-YF CD8 T cells caused disease similar to ICOS wild-type CD8 T cells, whereas ICOS-YF CD4 T cells behaved very similarly to their ICOS knockout counterparts. Consistent with their in vivo pathogenic potential, CD8 T cells responded to ICOS ligation in vitro by PI3K-independent calcium flux, T cell activation, and proliferation. Thus, in acute GVHD in mice, CD4 T cells heavily rely on ICOS-PI3K signaling pathways; in contrast, CD8 T cells can use PI3K-independent ICOS signaling pathways, possibly through calcium.