bluuebunny/crossref_metadata_2025 huggingface dataset:
ICT Based Health Governance Practices
Authors: Nair Pradeep
Published: March 2014

Electronic health commonly described as the health sector use of information and communication technology (ICT), has rapidly spread around the world. Increased use of ICT is stimulating the technology insertion into the health sector and is enabling the effective functioning of public health systems. A steering committee on health constituted by the Planning Commission suggested in its report for the 12th Plan (2012–17) that all the district hospitals, primary health centres and sub centres should be linked to leading tertiary care centres through telemedicine, Skype and similar audio visual media. The committee also urged to give utmost importance to M-health, that is, use of mobile phones as communication tool for health development.

The study intends to discuss the promotion of increased use of information and communication technologies in health care systems to improve efficiency, access and accountability of health care services in India.

The study deals with some references from India which underscore the developments of ICT based health governance and discuss the policies at both national and regional level to shed light on the potential of e-health in improvising the delivery of health care services at domestic level. The purpose of this study is to relay that the effective implementation of information and communication technologies can make health care services more accessible to the all the sections of the society and will help the government and other stake holders in health services to align their services with the increasing needs of good health.
Is Public Private Partnership an Effective Alternative to Government in the Provision of Primary Health Care? A Case Study in Odisha
Authors: Baig M. B. , Panda Bhuputra , Das Jayanta Kumar , Chauhan Abhimanyu Singh
Published: March 2014

Existing public health services are inadequate to cater to the growing demands of quality health care. Public Private Partnership (PPP) has evolved over the last decade as a newer arrangement. This study aimed to understand the breadth and depth of services in primary health centres (PHC) under government (PHC-GOV), NGO (PHC-NGO) and corporate (PHC-COR) management in Kendrapara district of Odisha. One PHC from each model was selected at random. Compliance with Indian Public Health Standards (IPHS), programme performance of last one year and perception of end-users about quality of services were studied. The Government of India (GOI) prescribed IPHS checklist, a performance indicator matrix and a semi-structured interview schedule, respectively, were used for data collection. There were no significant differences in the breadth and depth of services across all three models of PHC management. Comprehensive primary health care including immunization services, health promotion, treatment of common ailments, malaria management and delivery services were almost non-existent in these facilities. PHC-GOV had better accessibility, infrastructure, behaviour of doctors and availability of medicines, whereas laboratory service was better in PHC-NGO and PHC-COR. Human resources and programme performance of last one year was grossly inadequate across all three models. There is no remarkable improvement in the quality of services provided by PPP models. It may not serve as a substitute to inadequate recruitment and retention of staff, erratic programme review and poor capacity building, for attainment of optimal outcomes.
What Motivates Government Doctors in India to Perform Better in their Job?
Authors: Bhatia Shalini , Purohit Bhaskar
Published: March 2014

Objectives:

Addressing the issue of poor motivation of Medical Officers (MOs) to join and continue service in rural India is a major challenge faced by the health system. The present study aimed at assessing the driving factors of motivation for MOs working with rural government health centres in India. The study also aimed at finding out the differences in the preferred factors of motivation based on various job-related aspects of the respondents.

Methods:

The study participants included MOs from Gujarat, India. The study asked the participants to rank 20 factors of motivation (10 intrinsic and 10 extrinsic motivation factors) important for them to continue in their current job. The factors for the study were selected using Herzberg’s two factor theory of motivation and the data was collected with the help of an instrument that has an established reliability and validity. Distribution of ranks of different motivating factors was studied using average ranks assigned by respondents based on different job-related aspects. Average scores were also calculated to see whether the respondents are motivated more by extrinsic factors or by intrinsic factors.

Results:

The results indicate that ‘job security’ was the most preferred factor of motivation followed by ‘adequate salary’ while, the least preferred factor for motivation was ‘local political interference’. Adequate salary and job security also emerged as the two most important motivation factors for all the three groups of respondents based on number of years of work experience. For Ad hoc MOs, ‘adequate salary’ and ‘interesting work’ were the most important motivation factors while for bonded category of MOs, ‘adequate salary’ and ‘opportunities for promotion’ were the two most important factors for motivation.

Conclusion:

The current study concludes that MOs motivation to continue with the current job is driven both by extrinsic and intrinsic factors. Hence, the health departments and systems need to pay close attention to devising strategies that address both the extrinsic as well as intrinsic factors. However, according to study findings, more attention needs to be paid to providing Job security and better salaries and monetary benefits to MOs. The study results may be useful to health departments and systems to design management strategies that are based on motivational needs of MOs to improve their attraction and retention.
Using Campaigns to De-stigmatize Leprosy in India
Authors: Shrivastava Sangeeta
Published: March 2014

Both health communication scholars and practitioners concede the seriousness of stigma in several disease contexts. But the literature on how to deal with it and possibly reduce or remove it is thin. The case of leprosy in the Indian state of Madhya Pradesh, however, illustrates a simple, innovative and community-grown strategy to combat stigma. Supported by the government and designed by the Danish International Development Agency’s Leprosy Unit (DANLEP), the strategy relied upon a small band of trained and motivated leprosy workers. Their main task, among other things, was mobilizing the community. The community was at first cautious, but it began to perceive the benefits in leprosy worker’s effort and argument, and began approaching the afflicted. The community’s concern transformed the patients’ worldview. They grew to be less ashamed of their health condition and themselves. The growing participation of the community in the state transformed leprosy into an ordinary treatable disease. This transformation did not come about at one go, but in slow, sometimes tentative, but measured steps.

This article describes the process of demystifying leprosy. It shows how the three important stakeholders (3Ps)—persons with leprosy, persons with concern and providers of health services—forged a strategic alliance that not only helped eradicate leprosy but also deal with the more intractable issue of social stigma attached to the disease. If leprosy is a common ailment today, it is to a large extent due to community participation. The article emphasizes that if health problems are identified and approached through the community, not only are fears and misconceptions of community removed, but the community reinvents itself to bring about desirable changes.
Communicating Nutrition in Community Settings
Authors: Gavaravarapu SubbaRao M. , Pavarala Vinod
Published: March 2014

With co-existence of under-nutrition and obesity among its people, malnutrition afflicts India like a double-edged sword. The search for solutions has often pointed at ‘Nutrition Communication’ as a tool in alleviating malnutrition. This study, through three case studies in India, attempts to critically examine how various organizations engaged in nutrition communication perceive, develop and implement communicative processes. These case studies typically combined data collection methods like information gathering and interviews. We realize nutrition communication programmes are top-down, expert-driven and are often denied planning, evaluation or budgets. We argue that factors such as the organization’s knowledge of the nutrition problem(s), perceptions of the key communicators, their motivation levels and personal biases also affect the design and implementation of nutrition communication programmes.
Framing of the H1N1 Flu in an Indian Newspaper
Authors: Gadekar Rahul , Krishnatray Pradeep , Ang Peng Hwa
Published: March 2014

This article analyses the H1N1 flu crisis coverage, in the Ahmedabad edition of The Times of India, the highest circulated English daily in India as well as in the western Indian state of Gujarat. The study aimed to look at the journalism practices followed in the coverage of the crisis and to determine how the newspaper framed the H1N1 issue. Systematic random sampling was used to select 127 from all 381 news stories that appeared in the Times between August and November 2009. The article identified six frames in the coverage: fear and panic, severity, safety, human interest, attribution of responsibility and scientific information It concludes that the article set the agenda for H1N1 crisis as a threat to human life and framed it as a war between humans, where the virus has an edge over humans.
What Makes an Effective HIV/AIDS Prevention Communication Campaign? Insights from Theory and Practice
Authors: Melkote Srinivas R. , Moore Dakysha , Velu Sanjanthi
Published: March 2014

The lack of a medical cure for AIDS puts the spotlight on preventive efforts. Therefore, an enormous responsibility is placed on communication since it plays an important role in disseminating information that may prevent risky behaviour as well as help in reducing stigma of AIDS patients. In this article, we wish to highlight what we consider to be important elements in a successful or effective campaign. The article will begin with an overview of important models/theories that are related to HIV/AIDS prevention noting their theoretical contributions as well as some of their weaknesses in addressing pertinent factors. This will be followed by our description of an effective HIV/AIDS prevention campaign. This article also underlines the importance of local stakeholders. The challenge for communication and programme managers/practitioners is to identify and seek collaboration of important local stakeholders.
Factors That Influence Mammography Use Among Older American Indian and Alaska Native Women
Authors: James Rosalina D. , Gold Dana E. , St John-BlackBird Arlene , Brown Trinidad Susan
Published: March 2014

Introduction: American Indian and Alaska Native (AIAN) women have relatively high breast cancer mortality rates despite the availability of free or low-cost screening. Purpose: This qualitative study explored issues that influence the participation of older AIAN women in mammography screening through tribally directed National Breast and Cervical Cancer Early Detection Programs (NBCCEDPs). Methods: We interviewed staff ( n = 12) representing five tribal NBCCEDPs and conducted four focus groups with AIAN women ages 50 to 80 years ( n = 33). Results: Our analysis identified four main areas of factors that predispose, enable, or reinforce decisions around mammography: financial issues and personal investments, program characteristics including direct services and education, access issues such as transportation, and comfort zone topics that include cultural or community-wide norms regarding cancer prevention. Conclusion: This study has implications for nurse education and training on delivering effective mammography services and preventive cancer outreach and education programs in AIAN communities.
The Relationship Between Select Demographic Characteristics and Body Mass Index Among Native Hawaiian and Other Pacific Islander Caregiving Adults
Authors: Duncan Katrina L. , Lassetter Jane H. , VanServellen Gwen , Brown Lora Beth , Clark Lauren , Morgan Sharla , Curtis Samantha , Alleger Brooke , Coleman Jaclyn , Muffler Arielle , Miyamoto Shemnon , Mounga Va , Goodwill Roger , Cummings Jonathan , Hanohano Barbara
Published: March 2014

Purpose: Native Hawaiian and other Pacific Islanders (NHOPIs) have the highest prevalence of overweight and obesity in the world. We identified the proportion of our NHOPI sample in each body mass index (BMI) category and explored relationships between BMI and demographic characteristics. Design/Method: Our descriptive correlational study included 364 NHOPI caregiver adults in Utah ( n = 155) and Hawaii ( n = 209). We gathered demographic information with a questionnaire. Height and weight were measured for BMI calculations. Results: According to the Centers for Disease Control and Prevention’s BMI categories, 84.3% of our sample was overweight or obese. Participants in Utah had significantly higher BMIs than participants in Hawaii. Educational attainment was inversely related with BMI; however, age, gender, and income were not significantly related with BMI. Discussion: NHOPIs on the U.S. mainland may be at greater risk for obesity than those in Hawaii; food price differences between locations may help explain this. NHOPIs in early adulthood had high BMIs; overtime this situation could worsen without intervention. Implications for practice: NHOPIs with low education levels or in areas of low food prices are at increased risk for obesity. Future research should focus on culturally sensitive interventions to reduce NHOPI obesity and associated risks.
Intimate Partner Violence, Depression, and Barriers to Service Utilization in Arab American Women
Authors: Kulwicki Anahid , Ballout Suha , Kilgore Colleen , Hammad Adnan , Dervartanian Hermine
Published: March 2014

How intimate partner violence (IPV), depression, and barriers to services affect Arab American women in the United States is not very well documented. This cross-sectional exploratory descriptive study examines (a) the relationship between depression and IPV and (b) whether living in the United States 10 or more years decreases barriers to reporting intimate partner violence and depression in a sample ( N = 312) of Arab American women 19 years and older. Findings demonstrate significant relationships between women who were at risk for IPV and depression scores ( r = .44, p < .001), and number of years living in the United States and barriers to service ( r = .25, p < .001). There was a significant negative relationship between barriers to service and depression ( r = −.30, p < .001), and barriers to service and IPV ( r = −.23, p < .001), and number of years living in the United States and depression ( r = .25, p < .001). Findings underscore the importance of screening referral and follow-up for Arab American women experiencing IPV and depression.
Transforming English Language Learners’ Work Readiness
Authors: Madrigal-Hopes Diana L. , Villavicencio Edna , Foote Martha M. , Green Chris
Published: March 2014

This qualitative study examined the impact of a six-step framework for work-specific vocabulary instruction in adult English language learners (ELLs). Guided by research in English as a second language (ESL) methodology and the transactional theory, the researchers sought to unveil how these processes supported the acquisition and application of work-specific vocabulary in three adult ELLs. Data were collected in two levels, before and after training. The first data analysis identified and used two themes to develop training modules’ curriculum: (a) policies and procedures related to state and federal regulations and (b) customer service. After participants completed training, the second data analysis identified two additional themes transcending across the three cases: (a) employees’ views in English language proficiency skills and (b) growth in writing within their own continuum of English language development. Data revealed how an explicit, work-specific vocabulary instruction approach has the potential to increase ELLs’ varying levels of English language proficiency, acquisition, and application of work-specific vocabulary, and, simultaneously, confidence in how they view and use English in the workplace.
Green Careers and the Community College
Authors: Diritsky Irene L.
Published: March 2014

This article identifies emerging green themes and describes the green career paths that exist for students who have completed community college level coursework. It also explores the green employment opportunities, future trends, job titles, and salary ranges expected in these positions. It questions the community college’s higher education role, especially going beyond sustainable declarations with national organizations, incorporating green certificates, and becoming a leader in providing sustainable education.
Liberal Constitutionalism and Political Particularism in Montesquieu’s The Spirit of the Laws
Authors: Callanan Keegan
Published: March 2014

The most well-known elements of Montesquieu’s political thought are his liberal constitutionalism and his emphasis on the need for a fit between a regime and a populace. But scholars have rarely sought to understand the theoretical relationship between these elements, and some have denied that they are meaningfully related at all. I argue that Montesquieu’s liberal constitutionalism and his political particularism are theoretically harmonious and mutually reinforcing elements of a unified project. Montesquieu’s liberal political philosophy possesses in-built sources of resistance to the rationalistic and universalistic political projects often associated with modern liberalism.
Modified function projective lag synchronization of hyperchaotic complex systems with parameter perturbations and external perturbations
Authors: Wang Xingyuan , Wei Na
Published: March 2014

In this paper, a novel synchronization method of modified function projective lag synchronizations (MFPLS) between identical and nonidentical hyperchaotic complex nonlinear systems with parameter perturbations and external perturbations is proposed. In the method, the states of two hyperchaotic complex systems with parameter perturbations and external perturbations are asymptotically lag synchronized up to a desired scaling function matrix, and all the perturbations in the parameters asymptotically converge to zero. Base on the Lyapunov stability theory, the adaptive controller and updating laws of parameter perturbations are designed to achieve MFPLS between the drive and response systems. Theoretically the proof that the drive and response system will asymptotically lag synchronization and numerical simulations verify the feasibility and effectiveness of the proposed scheme.
The Group Dynamics of Women’s Self-Defense Training
Authors: Brecklin Leanne R. , Middendorf Rena K.
Published: March 2014

The current study examines the role of group interaction in a women’s self-defense class. Study methods included individual interviews with women who had completed a college-based women-only self-defense course as well as supplemental observation of group behavior during a mock “attack” simulation class. The unique relationship that develops among women’s self-defense classmates seems to improve overall learning and performance due to the group collaboration and vicarious experiences. Results demonstrated that women’s self-defense courses offer participants a beneficial and supportive group atmosphere.
Development of Hot and Cold Executive Function in Boys and Girls With ADHD
Authors: Skogli Erik Winther , Andersen Per Normann , Hovik Kjell Tore , Øie Merete
Published: March 2014

Objective: To investigate the development of executive function with pronounced emotional salience (hot EF) and less pronounced emotional salience (cold EF) in boys and girls with ADHD relative to typically developing (TD) children. Method: Seventy-five children with ADHD and 47 TD children were assessed with hot and cold EF tests at baseline and after 2 years. Results: Despite considerable maturation, the ADHD group remained impaired on all cold EF tests relative to TD children after 2 years. There was no effect of gender on cold EF test results. Females with ADHD outperformed TD counterparts on hot EF at baseline. Females with ADHD showed deteriorating hot EF performance, while TD counterparts showed improved hot EF performance across time. Conclusion: Enduring cold EF impairments after 2 years may reflect stable phenotypic traits in children with ADHD. Results indicate divergent developmental trajectories of hot EF in girls with ADHD relative to TD counterparts.
100 Unintended consequences of policies to improve the energy efficiency of the UK housing stock
Authors: Shrubsole C. , Macmillan A. , Davies M. , May N.
Published: March 2014

As a major sector contributing to the UK’s greenhouse gas (GHG) emissions, housing is an important focus of government policies to mitigate climate change. Current policy promotes the application of a variety of energy efficiency measures to a diverse building stock, which will likely lead to a wide range of unintended consequences. We have undertaken a scoping review identifying more than 100 unintended consequences impacting building fabric, population health and the environment, thus highlighting the urgent need for government and society to reconsider its approach. Many impacts are connected in complex relationships. Some are negative, others possibly co-benefits for other objectives. While there are likely to be unavoidable trade-offs between different domains affected and the emissions reduction policy, a more integrated approach to decision making could ensure co-benefits are optimised, negative impacts reduced and trade-offs are dealt with explicitly. Integrative methods can capture this complexity and support a dynamic understanding of the effects of policies over time, bringing together different kinds of knowledge in an improved decision-making process. We suggest that participatory systems dynamics with multi/inter-disciplinary stakeholders is likely to offer a useful route forward, supporting cross-sectorial policy optimisation that places reducing housing GHG emissions alongside other housing policy goals.
Institution-Specific Victimization Surveys
Authors: Cantalupo Nancy Chi
Published: March 2014

This review brings together both the legal literature and original empirical research regarding the advisability of amending the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act or creating new Department of Education regulations to mandate that all higher education institutions survey their students approximately every 5 years about students’ experiences with sexual violence. Legal research conducted regarding the three relevant federal legal regimes show inconsistent incentives for schools to encourage victim reporting and proactively address sexual violence on campus. Moreover, the original research carried out for this article shows that the experience of institutions that have voluntarily conducted such surveys suggests many benefits not only for students, prospective students, parents, and the general public but also for schools themselves. These experiences confirm the practical viability of a mandated survey by the Department of Education.
Psychological Treatment of Sexual Offenders Against Children
Authors: Grønnerød Cato , Grønnerød Jarna Soilevuo , Grøndahl Pål
Published: March 2014

Numerous meta-analyses and reviews have been conducted on the effectiveness of psychological treatment of sexual offenders in reducing recidivism, but no meta-analysis has been done on sexual offenders against children (SOAC) specifically. A moderate treatment effect has been shown in several evaluations of general sexual offenders, while many scholars maintain that the question remains unanswered until an adequate number of effectiveness studies with a strong research design have been carried out. In this meta-analysis, we evaluated 14 studies selected and coded according to Collaborative Outcome Data Committee (CODC) criteria. They included 1,421 adult offenders in psychotherapy and 1,509 nontreated controls, with a minimum average follow-up period of 3 years, published in peer-reviewed journals in 1980 or later. Recidivism was defined as rearrest or reconviction. Study quality was classified into strong, good, weak or rejected. The analysis revealed a treatment effect size of r = .03 for nine studies evaluated as Good or Weak, while all studies yielded an effect size of r = .08, including five studies classified as Rejected. The results show that the available research cannot establish any effect of treatment on SOAC. Despite a large amount of research, only a tiny fraction of studies meet a minimum of scientific standards, and even fewer provide sensible and useful data from which it is possible to draw conclusions.
Significance, Nature, and Direction of the Association Between Child Sexual Abuse and Conduct Disorder
Authors: Maniglio Roberto
Published: March 2014

To elucidate the significance, nature, and direction of the potential relationship between child sexual abuse and conduct disorder, all the pertinent studies were reviewed. Ten databases were searched. Blind assessments of study eligibility and quality were performed by two independent researchers. Thirty-six studies including 185,358 participants and meeting minimum quality criteria that were enough to ensure objectivity and to not invalidate results were analyzed. Across the majority of studies, conduct disorder was significantly and directly related to child sexual abuse, especially repeated sexual molestation and abuse involving penetration, even after controlling for various sociodemographic, family, and clinical variables. The association between child sexual abuse and conduct disorder was not confounded by other risk factors, such as gender, socioeconomic status, school achievement, substance problems, physical abuse, parental antisocial behavior or substance problems, parent–child relationships, and family disruption, conflict, or violence. Evidence for a significant interactive effect between child sexual abuse and monoamine oxidase A gene on conduct disorder was scant. Early sexual abuse might predispose to the subsequent onset of conduct disorder which, in turn, may lead to further sexual victimization through association with sexually abusive peers or involvement in dangerous situations or sexual survival strategies.
Television Journalism, Politics, and Entertainment
Authors: Bolin Göran
Published: March 2014

This article discusses two trends in the debates about contemporary television journalism. First, journalism is said to be increasingly subsumed an economic logic, privileging entertainment before serious journalistic practices. Most often, this is framed as if entertainment is eating its way into serious journalism, affecting it negatively and thus being detrimental for the political public sphere and political reasoning. Second, it is often pointed to a changed relation between journalism and politicians, where the latter have lost some of their power, for example, in political debates. This article relates these two trends and argues, against a field model inspired by Bourdieu, that it is not entertainment that is eating its way into journalism, but the other way around: Rather than having been absorbed by entertainment, journalism has differentiated, become more autonomous as a subfield of cultural production, and has gradually come to dominate both factual and entertainment television.
Understanding Lunasin’s biology and potential as a cancer therapeutic by utilizingDrosophilagenetics
Authors: Jones Gillian , Srivastava Ajay
Published: March 2014

Soy contains many bioactive molecules known to elicit anticancer effects. One such peptide, Lunasin, has been shown to selectively act on newly transformed cells while having no cytotoxic effect on non-tumorigenic or established cancer cell lines. While this effect on in vitro systems is promising, Lunasin’s efficacy in an in vivo system is yet to be assessed. In this review, we discuss the state of knowledge with respect to Lunasin and then review some of the powerful genetic tools available in Drosophila. The availability of a sophisticated genetic tool box makes Drosophila an excellent genetic model well suited to studying the biology of Lunasin and its effect on tumor progression in an in vivo model organism.
Two Common Tests of Dexterity Can Stratify Upper Limb Motor Function After Stroke
Authors: Thompson-Butel Angelica G. , Lin Gaven G. , Shiner Christine T. , McNulty Penelope A.
Published: March 2014

Background. Neurological deficits after a stroke are commonly classified according to motor function for clinical decision making regarding discharge and rehabilitation. Participants in clinical stroke studies are also stratified by motor function to avoid a sampling bias. Objective. This post hoc analysis examined a suite of upper limb functional assessment tools to test the hypothesis that motor function of survivors of stroke can be stratified using 2 simple tests of manual dexterity despite the heterogeneity of the population. Methods. The functional ability of the more affected hand and arm was assessed for 67 hemiparetic patients, aged 18 to 83 years (mean ± standard deviation, 59.8 ± 14.0 years), at 1 to 264 months after a stroke (23.6 ± 39.6 months) using the Wolf Motor Function Test (WMFT), upper limb motor Fugl-Meyer Assessment (F-M), Box and Block Test (BBT), grooved pegboard test, and wrist range of motion. We tested the strength of our proposed stratification scheme with a hypothesis-driven hierarchical cluster analysis using standardized raw scores and dichotomous BBT and grooved pegboard test values. Results. The most salient discriminator between low and higher motor function was the ability to move >1 block on the BBT. Within the higher function group, the ability to place all 25 pegs on the grooved pegboard test discriminated between moderate and high motor function. The derived scheme was congruent with clinical observations. The WMFT timed tasks, F-M scores, and range of motion did not discriminate functional groups. Conclusions. Two simple unambiguous and objective tests of gross (BBT) and fine (grooved pegboard test) manual dexterity discriminated 3 groups of motor function ability for a heterogeneous group of patients after stroke.
Measurement Properties of Streamlined Wolf Motor Function Test in Patients at Subacute to Chronic Stages After Stroke
Authors: Chen Hui-fang , Wu Ching-yi , Lin Keh-chung , Jang Yuh , Lin Shih-chieh , Cheng Ju-wen , Chung Chia-ying , Yan Yanning
Published: March 2014

Background. Previous research using the streamlined Wolf Motor Function Test (SWMFT) has focused either on the 3- to 9-month period or on the >12-month period after stroke and lacked the information for those at 9 to 12 months. Whether SWMFT scores reflect motor deficit and recovery from early to late stages after stroke remains unclear. Objective. A retrospective study using the Functional Ability Scale (FAS) was conducted to evaluate whether all SWMFTs items measure the poststroke recovery of upper extremity (UE) motor function and if they could be used for patients within 9 to 12 months after a stroke. Methods. Rasch analysis was conducted, and data were drawn from patients 3 months to years after a stroke. Results. The continuum of UE motor function in SWMFT-FAS was supported. Subacute patients had the best motor function, followed by the 9- to 12-month group, and then chronic patients. Variation in UE motor function was large (2.35-2.72 logits), and motor abilities of these 3 groups overlapped. The 8 SWMFT items could target a broad range of UE motor function, from −8.28 to 7.80 logits. The average difficulty of these 8 items also matched the UE motor ability of the subgroup at 9 to 12 months after stroke, and individual versions of the SWMFT performed well to assess the motor ability of this group. Conclusions. The SWMFTs had sound hierarchical properties. The SWMFT-Chronic or the SWMFT-Subacute could be used to evaluate UE function of this subgroup at 9 to 12 months after stroke.
Metabolic Syndrome and Military Policemen’s Quality of Life
Authors: Braga Filho Romário Teixeira , Júnior Argemiro D’Oliveira
Published: March 2014

Men generally have a lower life expectancy and higher mortality than women in nearly all age groups. Military police, whose main activity in Brazil is the maintenance of public order and the prevention of crimes and transgressions of the laws, is mostly composed of men; it is also a risky and stressful profession generally related to poor quality of life. Considering that risk factors for disease and death from cardiovascular causes—including the multiple risk factor metabolic syndrome—are mostly related to lifestyle and associated with impaired quality of life, this study aims to provide a theoretical basis for other studies about the prevalence of metabolic syndrome among police officers. In a theoretical study, the authors present an interdisciplinary review based on studies on the health and quality of life of men in general and policemen in their specificity; published studies were selected according to the key words: men, health, quality of life, police, metabolic syndrome; they should also have been published in the past 15 years and available in the Scientific Electronic Library Online—SciELO—and in the Public Medline—PubMed. In conclusion, military policemen have a risky profession, whose conditions may contribute to low quality of life, illness, and mortality from cardiovascular causes; these conditions indicate a need for the characterization of metabolic syndrome in this population as an important element for promotion of health. Studying these conditions may contribute to the adoption of comprehensive and continuing care for military policemen’s integral health.
‘Picking up the pieces’: Female significant others in the lives of young (ex)incarcerated males
Authors: Halsey Mark , Deegan Simone
Published: March 2014

This article explores the experiences of female significant others ( N = 27) in the lives of young men ( N = 14) subject to repeat cycles of incarceration in South Australia since 2003. It focuses on how these women conceive of their roles during and following the incarceration of their intimate and addresses in detail some of the personal, situational and structural factors that characterize their lives. A major conclusion of the article is that (ex)prisoners’ female significant others are an important but highly marginalized and often traumatized group within the correctional and post-release landscape. Additional institutional and public support for these women is needed in order to maximize their potential impact on (ex)prisoner well-being.
Evaluation of gabapentin in management of hot flushes in postmenopausal women
Authors: Agarwal Nutan , Singh Smita , Kriplani Alka , Bhatla Neerja , Singh Nilanchali
Published: March 2014

This study was conducted to assess the efficacy of gabapentin in controlling hot flushes in postmenopausal women. Fifty postmenopausal patients with hot flushes were randomized in two groups, one receiving gabapentin 900 mg daily along with calcium and another group receiving calcium alone. Frequency, duration and severity of hot flushes were noted and a composite score was calculated. There was around an 80% reduction in composite score in the gabapentin group at 3 and 6 months; significantly more than the placebo group. Gabapentin has a two-fold better response than placebo in reducing hot flushes with the relief starting from the first month and maximum effect at 3 months.
School Nurse Facilitated Programs for Families Living Fit
Authors: Speroni Karen Gabel
Published: March 2014

School nurses are in a unique position to facilitate provision of knowledge to children and their parents regarding balanced, healthy lifestyles. Nurses can become empowered with the knowledge gained from reviewing obesity programs with demonstrated improvements in obesity-related outcomes such as Kids Living Fit™ (KLF) and Nurses Living Fit™ (NLF). Garnering resources from your school and community, school nurses can create programs using methods from KLF and NLF to facilitate Families Living Fit (FLF). With the provision of programs, ideally children and parents will also feel empowered through knowledge gained as a result of their participation in FLF programs focusing on healthy lifestyles, incorporating the balance between activities chosen/exercise and foods consumed/nutrition.
The Use of Computed Tomography Attenuation to Evaluate Osteoporosis Following Acute Fractures of the Thoracic and Lumbar Vertebra
Authors: Emohare Osa , Cagan Amanda , Morgan Robert , Davis Rick , Asis Martin , Switzer Julie , Polly David W.
Published: March 2014

Background:

Relatively few patients have dual-energy x-ray absorptiometry to quantify the magnitude of bone loss as they age. Recent work correlates mean computed tomography (CT) attenuation in the level I (L1) vertebra with bone mineral density (BMD), making it possible to objectively evaluate the magnitude of bone loss in osteoporosis by this method. The aims of this study were to evaluate the utility of using CT scans in patients with acute thoracic and lumbar spine fractures to diagnose osteoporosis and using CT attenuation to evaluate the association between age and BMD.

Methods:

We performed a retrospective study of patients with acute fractures of the thoracic or lumbar spine who had also undergone an abdominal (or L1) CT scan and compared mean CT attenuation in L1 against threshold values. We also compared differences in CT attenuation between younger (<65 years) and older (≥65 years) and older patients.

Results:

A total of 124 patients were evaluated (74 thoracic and 50 lumbar fractures). Overall, there was a strong correlation between age and bone density as measured by CT attenuation ( r = −.76). Among those with thoracic fractures (<65 years), mean CT attenuation was 196.51 HU. Forty-one patients were ≥65 years and had mean CT attenuation of 105.90 HU ( P < .001). In patients with lumbar fractures, 27 patients were <65 years and had a mean CT attenuation of 192.26 HU and 23 patients were ≥65 years and had mean CT attenuation of 114.31 HU ( P < .001). At the threshold of 110 HU, set for specificity, the magnitude of difference between the age-stratified cohorts was greater in the thoracic spine ( P < .0001 vs P = .003).

Discussion:

Using opportunistic CT, we demonstrate the relative frequency of osteoporosis in patients with acute fractures of the thoracic and lumbar spine and confirm that the association increases with age. The CT attenuation may provide a cheap and convenient method to help confirm a clinical diagnosis of osteoporosis in patients with fractures.
Reversible Adrenal Insufficiency in Three Patients With Post–Roux-en-Y Gastric Bypass Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
Authors: Mathur Shelly , Boparai Jasmine , Mediwala Sanjay N. , Garcia Jose M. , Cunningham Glenn R. , Marcelli Marco , Vasudevan Madhuri M.
Published: March 2014

Objective. Noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS) is a disorder of endogenous hyperinsulinemia that is clinically distinguishable from insulinoma, with a greater preponderance after Roux-en-Y gastric bypass (RYBG). Hyperinsulinemic hypoglycemia can predispose to attenuation of counterregulatory hormone responses to hypoglycemia, and consequent suppression of the hypothalamic–pituitary–adrenal (HPA) axis. This case series describes 3 individuals who were diagnosed with adrenal insufficiency (AI) after undergoing RYGB, complicated by NIPHS. Methods. A retrospective chart review was performed for each individual. Chart review applied particular attention to the onset of hyperinsulinemic hypoglycemia following bariatric surgery and the dynamic testing leading to the diagnoses of NIPHS and AI. Results. In each case, reactive hypoglycemia ensued within months to years after RYGB. Cosyntropin stimulation testing confirmed the diagnosis of AI. Hydrocortisone therapy reduced the frequency and severity of hypoglycemia and was continued until successful medical and/or surgical management of hyperinsulinism occurred. Follow-up testing of the HPA axis demonstrated resolution of AI. In all cases, hydrocortisone therapy was finally discontinued without incident. Conclusion. We speculate that transient AI is a potential complication in patients who experience recurrent hyperinsulinemic hypoglycemia after RYGB. The putative mechanism for this observation may be attenuation of the HPA axis after prolonged exposure to severe, recurrent hypoglycemia. We conclude that biochemical screening for AI should be considered in individuals who develop post-RYGB hyperinsulinemic hypoglycemia. If AI is diagnosed, supportive treatment should be maintained until hyperinsulinemic hypoglycemia has been managed effectively.
A Preliminary In Vivo Assessment of Anterior Cruciate Ligament–Deficient Knee Kinematics With the KneeM Device
Authors: Tardy Nicolas , Marchand Philippe , Kouyoumdjian Pascal , Blin Dominique , Demattei Christophe , Asencio Gérard
Published: March 2014

Background:

Methods of objectively measuring rotational knee laxity are either experimental or difficult to use in daily practice. A new method has been developed to quantitatively assess rotatory laxity using an open MRI system and new tool, the KneeM device.

Purpose/Hypothesis:

To perform a preliminary evaluation of a novel knee rotation measurement device to assess knee kinematics during flexion in an MRI field, in both anterior cruciate ligament (ACL)–deficient and healthy contralateral knees. The hypothesis was that the KneeM device would allow in vivo reproduction and analysis of knee kinematics during flexion in healthy and ACL-deficient knees.

Study Design:

Controlled laboratory study.

Methods:

Ten subjects (7 men and 3 women; mean age ± standard deviation, 32.3 ± 9.4 years) with ACL-deficient knees and contralateral uninjured knees participated in the study. An open MRI was performed with the KneeM device at a mean 4.9 months (range, 3.0-7 months) after ACL injury. The device exerted on the knee an anterior drawer force of 100 N, with an internal rotation of 20°, through the range of flexion (0°, 20°, 40°, and 60°). Both ACL-deficient and healthy contralateral knees were analyzed using the Iwaki method.

Results:

There was no statistical difference of anterior translation in the medial compartment between intact and ACL-deficient knees at all degrees of flexion. However, significant differences in the anterior translation of the lateral compartment were observed between ACL-deficient and intact contralateral knees at 0° and 20° of flexion ( P = .005 and P = .002, respectively). Between 20° and 40°, the lateral plateau of ACL-deficient knees translated 7.7 mm posteriorly, whereas the medial compartment remained stable, reflecting a sudden external rotation of the lateral plateau under the femoral condyle.

Conclusion:

This preliminary study suggests that measurement of tibiofemoral movements in both compartments during flexion using the KneeM device was useful for quantifying rotatory laxity in ACL-deficient knees. Moreover, this device seemed to allow a “mechanized pivot shift” and allowed reproduction of the “pivot” phase in the MRI field between 20° and 40° of flexion.

Clinical Relevance:

This device could be used for diagnostic purposes or to investigate the outcomes of ACL reconstructions.
Microparticles and vascular dysfunction in obstructive sleep apnoea
Authors: Trzepizur Wojciech , Martinez Maria Carmen , Priou Pascaline , Andriantsitohaina Ramaroson , Gagnadoux Frédéric
Published: March 2014

Obstructive sleep apnoea (OSA) is independently associated with various cardiovascular diseases, including myocardial infarction and stroke. OSA may promote atherosclerosis risk factors such as hypertension, diabetes and dyslipidaemia, and may have direct proatherogenic effects on the vascular wall. A growing number of studies have recently focused on the role of microparticles (MPs) in the atherogenic process. MPs are small plasma membrane vesicles that can be released by a variety of vascular or blood cells, and contain both membrane and cytosolic elements. Case–control studies have shown that platelet-, endothelium- and leukocyte-derived MP levels are increased in OSA. Experimental evidence has demonstrated that MPs from OSA patients induce endothelial dysfunction, inflammation and vascular hyperreactivity when injected into mice. In this review, we provide an overview of the main characteristics of MPs, their expression in OSA and their potential role in the atherogenic process associated with OSA.
Glucocorticoids induce the production of the chemoattractant CCL20 in airway epithelium
Authors: Zijlstra G. Jan , Fattahi Fatemeh , Rozeveld Dennie , Jonker Marnix R. , Kliphuis Nathalie M. , van den Berge Maarten , Hylkema Machteld N. , ten Hacken Nick H.T. , van Oosterhout Antoon J.M. , Heijink Irene H.
Published: March 2014

Th17-mediated neutrophilic airway inflammation has been implicated in decreased response to glucocorticoids in asthma. We aimed to investigate the effect of glucocorticoids on the airway epithelial release of the neutrophilic and Th17-cell chemoattractant CCL20.

We studied CCL20 and CXCL8 sputum levels in asthmatic subjects using inhaled glucocorticoids or not, and the effect of budesonide on CCL20 and CXCL8 production in primary bronchial epithelial cells. The mechanism behind the effect of budesonide-induced CCL20 production was studied in 16HBE14o- cells using inhibitors for the glucocorticoid receptor, intracellular pathways and metalloproteases.

We observed higher levels of CCL20, but not CXCL8, in the sputum of asthmatics who used inhaled glucocorticoids. CCL20 levels correlated with inhaled glucocorticoid dose and sputum neutrophils. Budesonide increased tumour necrosis factor (TNF)-α-induced CCL20 by primary bronchial epithelium, while CXCL8 was suppressed. In 16HBE14o- cells, similar effects were observed at the CCL20 protein and mRNA levels, indicating transcriptional regulation. Although TNF-α-induced CCL20 release was dependent on the ERK, p38 and STAT3 pathways, the increase by budesonide was not. Inhibition of glucocorticoid receptor or ADAM17 abrogated the budesonide-induced increase in CCL20 levels.

We show that glucocorticoids enhance CCL20 production by bronchial epithelium, which may constitute a novel mechanism in Th17-mediated glucocorticoid-insensitive inflammation in asthma.