bluuebunny/crossref_metadata_2025 huggingface dataset:
Internal Fixation Versus Shoulder Hemiarthroplasty for Displaced 4-part Proximal Humeral Fractures in Elderly Patients
Authors: Cai Ming , Tao Kun , Yang Chunxi , Li Shaohua
Published: September 2012

The purpose of this single-center, randomized, controlled trial was to report on the 2-year outcomes of proximal humerus fractures in elderly patients treated with open reduction and internal fixation (ORIF) with either a locking plate or shoulder hemiarthroplasty.

Thirty-two patients (87% women) with a mean age of 71.9 years (range, 67–86 years) were treated with ORIF with either a locking plate or shoulder hemiarthroplasty after shoulder injury. The main outcome measures were the Constant score, Disabilities of the Arm, Shoulder and Hand (DASH) score, and health-related quality of life (HRQoL) according to the EQ-5D (EuroQol Group, Rotterdam, The Netherlands). At final 2-year follow-up, DASH and pain scores favored the shoulder hemiarthroplasty group. Mean flexion was 129° in the shoulder hemiarthroplasty group and 117° in the ORIF group (
P
=.27), and mean abduction was 123° in the shoulder hemiarthroplasty group and 111° in the ORIF group (
P
=.41). In the shoulder hemiarthroplasty group, the EQ-5D index score decreased from 0.85±0.21 before injury to 0.65±0.14 at 4 months postoperatively. The score was 0.79±0.24 at 12 months postoperatively and 0.81±0.17 at 24 months postoperatively.

The results of this study indicate an advantage in functional outcomes and HRQoL favoring shoulder hemiarthroplasty compared with ORIF with a locking plate, although most outcomes were not significantly different.
Surgical Management of Sportsman’s Hernia in Professional Soccer Players
Authors: Messaoudi Nouredin , Jans Christophe , Pauli Steven , Van Riet Roger , Declercq Geert , Van Cleemput Marc
Published: September 2012

Soccer players frequently experience acute and chronic groin pain. Sportsman’s hernia is a common injury in professional soccer players, that causes inguinal pain. The authors discuss their experience with the management of sportsman’s hernia in professional soccer players competing in national and international competition in a retrospective review of prospectively collected data. Between March 2004 and December 2009, seventy-one professional soccer players were surgically treated for sportsman’s hernia. Average age at surgery was 24 years, and average duration of symptoms from onset to surgical repair was 11 months. Conservative treatment improved symptoms temporarily or to some extent in 18 athletes. All athletes underwent a bilateral open hernia repair with concurrent adductor tendon release. Average follow-up was 4 years, and average time to return to competitive sport was 4 months. At final follow-up, 95% of soccer players were still active, 48 at the same level and 19 at a lower level. Four athletes had stopped their careers because of another injury (n=2) or recurrence (n=2).

Sportsman’s hernia is a potentially career-ending injury in professional soccer players. Conservative management is often unsuccessful. An open surgical hernia repair combined with an adductor longus tenotomy relieves the symptoms caused by a sportsman’s hernia and restores activity in 95% of athletes. This study offers insight into the management of sportsman’s hernia and offers a successful treatment to salvage the careers of professional soccer players.
Characteristics and Impact of Animal Models Used for Sports Medicine Research
Authors: Krueger Chad A. , Wenke Joseph C. , Masini Brendan D. , Stinner Daniel J.
Published: September 2012

Animal models are commonly used for translational research despite evidence that the methodology of these studies is often inconsistent and substandard. This study describes the characteristics and impact of published research using animal models in the
American Journal of Sports Medicine
(AJSM).

Peer-reviewed articles published in the AJSM between January 1990 and January 2010 using animal models were identified using MEDLINE. The articles were reviewed for funding source, anesthesia used, animal used, study type, study location, outcome measures, number of animals, duration of animal survival, main topic being studied, and positive or negative treatment effect. The impact factor of the studies published between 2005 and 2010 was calculated. Two hundred fifty-seven articles, or 6% (257/4278) of the total publications during the 20-year period, were analyzed. The impact factor increased from 1.83 in 2005 to 3.9 in 2010. The most common animals used were rabbits (24%) and pigs (16%). The anterior cruciate ligament was studied in 34% of the articles, and a pig model was used for 31% of these studies. Eighty-six percent of the studies had a positive treatment effect.

This study shows that animal models used in sports medicine research lack uniformity in their methods and suggests that a publication bias may exist for animal research in the sports medicine literature.
Selective Computed Tomography–guided Perisciatic Injection as a Diagnostic Tool in Multiple Hereditary Exostoses
Authors: Tenenbaum Shay , Arzi Harel , Shabshin Nogah , Liberman Boaz , Caspi Israel
Published: September 2012

Multiple osteochondromas, also known as multiple hereditary exostoses, is an autosomal-dominant disease. Multiple osteochondromas are characterized by the development of cartilage-capped bony tumors, known as osteochondromas. Osteochondromas can cause limb deformities, limb-length discrepancies, angular deformations, bursitis, and impingement of adjacent tendons or neurovascular structures. They have also been reported as a cause of sciatic pain. Sometimes, more than 1 location of neural compression exists, thereby presenting a difficult diagnostic challenge for treating physicians.

This article describes a patient with multiple hereditary exostoses and accompanying severe sciatic pain who was referred for a revision decompressive spine surgery. The patient’s functional impairment was such that he was unable to sit for a few minutes. A selective computed tomography–guided perisciatic nerve injection was performed to differentiate between lateral spinal stenosis and peripheral nerve compression or impingement by an existing large pelvic osteochondroma. The patient reported substantial relief and regained the ability to sit pain free immediately postoperatively. Excision of a proximal femur osteochondroma was performed based on the results of a selective perisciatic nerve injection, resulting in successful resolution of his sciatic pain and functional impairment.

The current case is an example of the diagnostic challenge in treating patients with multiple anatomic lesions that can cause symptoms and demonstrate how selective computed tomography–guided perisciatic nerve injection can aid clinicians in obtaining an accurate diagnosis and choosing the most appropriate surgical management.
Task-Resource Capability Alignment
Authors: Ishfaq Rafay , Raja Uzma
Published: September 2012

The effective management of software maintenance processes involves decisions about workforce levels, skill and expertise mix of developers, assignment of defect resolution tasks, and monitoring key system performance measures. This research uses a queuing based simulation approach to study these managerial issues. Using the data archives of a large global software organization, an empirical study of the historical defect reports and management decisions is conducted. A task-resource capability alignment scheme is developed that captures the defect complexity and skill/experience capabilities of software maintainers. The results of the empirical-computational study show that the defect arrival/reporting process affects the resource utilization and the time a defect spends in the system. The results also highlight the role of dedicated and shared resources on the system performance and indicate that replacing an experienced and skilled developer requires a significant order of magnitude increase in the maintenance workforce.
An Evolving Residential Landscape in Post-Katrina New Orleans
Authors: Strait John Byron , Gong Gang
Published: September 2012

Residential landscapes across the United States have been significantly altered in recent years by the increased racial and ethnic diversity evident within urban areas. In New Orleans, Louisiana, residential landscapes were particularly impacted by the disruptive influences associated with Hurricane Katrina, a storm that ultimately transformed the demographic make-up of this urban area. This research investigates the impacts that increased diversity has had on the levels of residential segregation among racial and/or ethnic groups in New Orleans from 2000 to 2010. Empirical analysis entailed the measurement of two dimensions of segregation evident among Non-Hispanic whites, African-Americans, Hispanics and Asians. Measures of residential exposure were decomposed in order to investigate the relative impacts of metropolitan-wide compositional change and intra-urban redistributive change on segregation among the four groups. During the 2000s, New Orleans exhibited very modest forms of residential integration. Results suggest that Non-Hispanic whites, Asians, and Hispanics exhibited some degree of “ethnic (or racial) self-selectivity” that functioned to concentrate these groups residentially, although these forces were partially overwhelmed by other forces operating at both the neighborhood and metropolitan scales. The evidence further suggests that the residential experiences among minorities were strongly impacted by the redistributive behavior of whites.
Decision Making Modeled as a Theorem Proving Process
Authors: Calmet Jacques , Schneider Marvin Oliver
Published: September 2012

The authors introduce a theoretical framework enabling to process decisions making along some of the lines and methodologies used to mechanize mathematics and more specifically to mechanize the proofs of theorems. An underlying goal of Decision Support Systems is to trust the decision that is designed. This is also the main goal of their framework. Indeed, the proof of a theorem is always trustworthy. By analogy, this implies that a decision validated through theorem proving methodologies brings trust. To reach such a goal the authors have to rely on a series of abstractions enabling to process all of the knowledge involved in decision making. They deal with an Agent Oriented Abstraction for Multiagent Systems, Object Mechanized Computational Systems, Abstraction Based Information Technology, Virtual Knowledge Communities, topological specification of knowledge bases using Logical Fibering. This approach considers some underlying hypothesis such that knowledge is at the heart of any decision making and that trust transcends the concept of belief. This introduces methodologies from Artificial Intelligence. Another overall goal is to build tools using advanced mathematics for users without specific mathematical knowledge.
Usability of Selected Databases for Low-Resource Clinical Decision Support
Authors: Callaghan F. , Gavino A. , Liu F. , Fontelo P. , Sheets L.
Published: September 2012

Background: Smartphones are increasingly important for clinical decision support, but smartphone and Internet use are limited by cost or coverage in many settings. txt2MEDLINE provides access to published medical evidence by text messaging. Previous studies have evaluated this approach, but we found no comparisons with other tools in this format.

Objectives: To compare txt2MEDLINE with other databases for answering clinical queries by text messaging in low-resource settings.

Methods: Using varied formats, we searched txt2MEDLINE and five other search portals (askMED-LINE, Cochrane, DynaMed, PubMed PICO, and UpToDate) to develop optimal strategies for each. We then searched each database again with five benchmark queries, using the customized search-optimization formats. We truncated the results to less than 480 characters each to simulate delivering them to a maximum of three text messages. Clinicians with practice experience in low-resource areas scored the results on a 5-point Likert scale.

Results: Median scores and standard deviations from 17 reviewers were: txt2MEDLINE, 3.2±0.82 (control); askMEDLINE, 3.2±0.90 (p = 0.918); Cochrane, 3.8±0.58 (p = 0.073); DynaMed, 3.6±0.65 (p = 0.105); PubMed PICO, 3.6±0.82 (p = 0.005); and UpToDate, 4.0±0.52 (p = 0.002). Our sample size was sufficiently powered to find differences of 1.0 point.

Conclusions: Comparing several possible sources for texting-based clinical-decision-support information, our results did not demonstrate one-point differences in usefulness on a scale of 1 to 5. PubMed PICO and UpToDate were significantly better than txt2MEDLINE, but with relatively small improvements in Likert score (0.4 and 0.8, respectively). In a texting-only setting, txt2MEDLINE is comparable to simulated alternatives based on established reference sources.
Validation of Malayalam Version of the Voice Handicap Index
Authors: Menon Unnikrishnan , Sheejamol VS , Cherian Meera P
Published: September 2012

Background

It is important to have a subjective measure of hoarseness. This can be best achieved if the questionnaire is in the patient's own language.

Objective

To translate the voice handicap index (VHI) into the Malayalam language, and to evaluate its clinical validity and internal consistency.

Materials and methods

One hundred and six patients with dysphonia and 20 asymptomatic subjects were included in the study. Internal consistency was analyzed through Cronbach's alpha coefficient. For the clinical validity assessment, the scores obtained in the patient group were compared with those found in asymptomatic individuals through the Mann-Whitney U-test. Also, comparison between the VHI scores before and after phonomicrosurgery on 14 out of the studied 106 patients was done using the nonparametric Wilcoxon signed ranks test. Spearman rank correlation was used to find the effect of patient's age on VHI scores. Finally, the gender-wise average VHI score and its three subsets was analyzed using Wilcoxon signed ranks test.

Results

The internal consistency was found to be excellent (α = 0.946). The control group scored significantly lower than the patients group (p < 0.001). Similarly, significant improvement was seen in the postoperative average VHI scores (p < 0.004). All of the preceding proves the validity of the translated questionnaire. Age showed a significant negative correlation for the overall VHI and their three domains (p < 0.001) in the dysphonic patients. There was no such correlation between male and female patient groups.

Conclusion

This Malayalam language version of the VHI questionnaire is a valid instrument for use in the voice clinic. Clinical implication: Encouragement to all voice clinicians in India to develop and use the VHI in their native tongues.

How to cite this article

Menon U, Sheejamol VS, Cherian MP. Validation of Malayalam Version of the Voice Handicap Index. Int J Phonosurg Laryngol 2012;2(1):1-4.
Laryngeal Ulceration in Behcet's Disease
Authors: Orhan Israfil , Yilmaz Fahrettin , Eken Mehmet
Published: September 2012

Behcet's disease is a multisystem inflammatory disorder of unknown origin, characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis, central nervous system and vascular disease. There is no pathognomanic laboratory test, but there are clinical criteria to assist in establishing the diagnosis.

There are only a few study about the laryngeal manifestation of Behcet's disease in the literature. We describe the case of a patient in whom epiglottic ulcers developed 7 years after the diagnosis of Behcet disease.

How to cite this article

Orhan I, Yilmaz F, Eken M. Laryngeal Ulceration in Behcet's Disease. Int J Phonosurg Laryngol 2012;2(1):49-51.
The efficiency of accounting normalization in the matter Of intangibles: Asset versus Expense
Authors: Houneida Ben Brahim , Ben Arab Mounira
Published: September 2012

Abstract In this paper, we seek to show if the intangible investments may accomplish the recognition’s criteria of an intangible asset and we show, thus, if these criteria are capable to preserve the quality of accounting information. We find that the capability of the intangible investments (R&D), immediately expensed, in the generation of future benefits is more important than the other investments (tangibles and intangibles investments recognized in the balance sheet). This capability is largely influenced by the engagement’s degree of the managers. Further, these investments are susceptible to diminish the future earnings volatility and, consequently, their future profits may be measured with reliability and capitalized in the balance sheet as an asset essentially for the firms that have a strong alignment between the manager’s and shareholder’s interest.
Design and Use of Management Accounting and Control Systems in the Jordanian Universities' Faculties
Authors: Al-Tarawneh Hussien Ahmad , Mubaslat Mania Moayyad
Published: September 2012

Drawing on upper echelon theory and focusing on the context of higher education reforms in Jordan within new public management in university faculties/colleges, this study investigates the diagnostic versus interactive uses of management control systems by Deans/Pro-Vice Chancellors of Faculties/Colleges (hereafter called Faculty PVCs). It seeks to identify how the professional and experiential characteristics of these senior academic executives and the structure of their Faculty, impact on their managerial and collegial orientation as reflected in their approach to using management controls. A mail survey of Faculty PVCs is conducted amongst a census of all Faculties/Colleges of all universities in Jordan. Supplementing this survey are semi-structured interviews with the PVC of the business and science Faculty at a large Jordanian university. Results reveal that PVCs who have had a longer career in higher education tend to use MCSs more interactively (or collegially). There is also evidence that as PVCs hold their current position for longer periods; they tend to move from an early diagnostic use of MCSs to a subsequent interactive use. Further, the higher the complexity of a Faculty the more PVC will adopt an interactive approach to MCS use. Other PVC and Faculty characteristics did not reveal patterns of significant influence on the interactive or diagnostic use of MCSs. A key revelation from interviews is that PVCs will give over-riding importance to meeting centrally-set diagnostically-focused KPI, but still take a collegial approach within their Faculty to the broader use of MCSs. The findings lend limited support to upper echelons theory, but provide grounding for further research into the impact that a managerial versus a collegial approach by PVCs/Deans may have on their Faculty’s growth in innovative capacities, teaching qualities or financial strength.
Attitudes on Financial Reporting Issues: An Australian Study
Authors: Laing Gregory Kenneth , Perrin Ronald William
Published: September 2012

The aim of this research was to test the attitudes of professional accountants with regards to financial reporting issues. Given the changes arising from the adoption of the International Accounting Standards the expectation was that problems identified by prior research would have been mitigated. Surveys were conducted of accounting professionals using the questionnaire instrument designed by Francia and Strawser (1971).  The data were collated and processed to determine the perceived information deficiency and importance of the various aspects of financial reporting. The major items in which information was considered to be deficient were – timing of revenue recognition, income tax effect accounting, executory contracts and treatment of prior period adjustments. By contrast the most important items were found to be uniformity in financial reporting, income tax effect accounting, use of fair market values, definition of equity versus liability and treatment of prior period adjustments. The findings have implications for the future development of accounting standards. Greater guidance should be given to explaining the practice, applications and consequences of the accounting standards on financial reporting. This paper provides a valuable insight into the perceived deficiencies of information on items that affect financial reporting by accountants in the Australian environment and adds a new perspective to the evaluation of adoption of international accounting standards.
Robust Optimal Design of Fiber-Reinforced Composite Cylinder with Metallic Liner
Authors: Chiou Chwei-Yuh
Published: September 2012

An enhanced robust optimal design method dealing with both property and material uncertainties is established in this paper. The method is applied to the robust optimal design of fiber-reinforced composite cylinder with reinforced composite patches and metallic liner subjected to uniform pressure and local loadings. Instead of the traditional numerical approach, modified constraints are used to analytically solve the antioptimization subproblem by a maximizing procedure in the developed method, consequently the computation time for robust optimal design problem can be significantly reduced. The effectiveness and accuracy of the developed method are verified by a degenerated example. Analysis result shows the optimal weight increases significantly with property and material uncertainties as expected. It is also found that the optimal thickness of metallic liner is affected by the utilized design rules of metallic liner. For plastic design, the thickness of metallic liner should be kept as small as possible for a minimal weight optimal design provided that manufacturing and nonleakage constraints can be met. On the contrary the optimal thickness of metallic liner depends on the relative ratio of allowable strain of metallic liner and composite material if elastic design is used.
Enjeux et pratique sociale en SAE : les intervenantes seront-elles les exclues de leur propre pratique?
Authors: Drolet Marie , Ouellette Denise
Published: September 2012

Initiée en1997, la réforme ontarienne de la protection de l’enfance a modifié la pratique sociale dans les Sociétés d’aide à l’enfance (SAE). Entre autres, deux outils standardisés de prise de décision ont été introduits: le modèle d’évaluation des risques (ORAM) et le modèle de mesure du bien-être des enfants placés (Looking after children). Le concept de diffusion de l’innovation sera ici utilisé pour jeter un éclairage sur les enjeux inhérents à l’introduction de nouveautés. Ceux liés à la pratique actuelle en SAE seront aussi cernés afin de dresser un bilan critique des conditions de pratique que les intervenantes sociales y affrontent.
Stratégies de survie et d’identité : les dynamiques culturelles dans un projet d’intervention en prévention communautaire
Authors: Diallo Lamine , Reitsma-Street Marge
Published: September 2012

Le projet « Partir d'un bon pas vers un avenir meilleur », conçu et mis sur pied à Sudbury, offre l'exemple d'un travail de collaboration entre la communauté minoritaire franco-ontarienne et d'autres communautés culturelles, axé sur le respect des différences, l'autonomie et la valorisation de la culture. Ce texte présente trois étapes clés du processus de développement de ce projet, et analyse les tensions qui ont été soulevées et qui ont contribué à la définition de la structure actuelle du projet.
« Les chemins qu’on parcourt pour livrer un combat contre la maladie sont très difficiles par bouts »
Authors: Gagné Elsy
Published: September 2012

Suite à une recherche qualitative effectuée auprès de 20 femmes vivant en français au Manitoba,cet article fait état de leur expérience avec le cancer du sein et du rôle actif des groupes desoutien. Il s’agit de comprendre plus profondément comment les femmes francophones vivantau Manitoba ont réagi à et vivent avec la maladie et de présenter les initiatives développéespar et pour les femmes pour leur venir en aide afin de contrer l’isolement et le rejet social.Avec le temps, on verra que la maladie devient une manière d’être et de vivre, une occasionde dire et de faire le sens de sa vie et de sa mort. C’est grâce à cette expérience que ces femmespartagent un sentiment d’appartenance à une communauté basée sur la langue d’usage, lamaladie et la survie et qu’elles expriment le besoin de se reconnaître en tant que groupe et departager un héritage culturel et une expérience sociale bien définis.
Étiologie sociale et santé mentale : ouvertures et fermetures des modèles explicatifs dominants
Authors: Blais Louise
Published: September 2012

La pauvreté est un thème récurrent de l’épidémiologie psychosociale et psychiatrique depuis deux siècles. Cet article examine les divers modèles explicatifs concernant le lien entre la pauvreté et la problématique générale de ce qui est communément appelé la «santé mentale». Il s’agit, en particulier, de dégager les ouvertures et fermetures de ces modèles. Si les approches épidémiologiques peuvent jouer un rôle important en identifiant des indicateurs socio-économiques qui menacent la santé mentale, elles peuvent, par effet pervers, stigmatiser des personnes vulnérables en les enfermant dans une logique de groupes à risque sur lesquels seradéployé le dispositif d’intervention formel. En conclusion, l’article fait appel à la nécessitéd’un recadrage dans l’étude du lien entre santé mentale et facteurs sociaux de manière à faireplace à l’expérience de la pauvreté et à la façon dont les problèmes qui en découlent sontreprésentés, vécus et exprimés dans des contextes spécifiques et différents.
L’étranger : ogre ou bon Samaritain?
Authors: Trocmé Nico
Published: September 2012

Les programmes de prévention s'adressant aux enfants, concernant le risque d'enlèvement oud'agression sexuellle ou phsique, reposent sur des efforts de prévention face à l'étranger. Laréalité des enfants est toute autre. L'auteur montre que la maltraitance physique et sexuelle enOntario est le fait de personnes connues de l'enfant, tout particulièrement des parents.
Le secret et l’enfant victime de maltraitance sexuelle
Authors: de Lajudie Martine
Published: September 2012

Cet article met en évidence la mutiplicité des raisons qui poussent un enfant à garder le silence sur sa victimisation sexuelle. Trois catégories de facteurs ont été identifiées. La première se rapporte au stade de développement de l'enfant. La seconde concerne l'agresseur sexuel et les épisodes de maltraitance sexuelle. La troisième relève des caractéristiques du milieu de soutien de l'enfant et de la façon dont elles sont perçues par ce dernier.
Conviction de la différence
Authors: Bernier Christiane
Published: September 2012

Synthèse d’une recherche à trois volets sur la famille franco-ontarienne, ce texte présente les principaux résultats qu’ont révélé une comparaison entre familles francophones et familles anglophones en Ontario. Le premier volet établit un profil statistique des familles des deux groupes linguistiques. Le deuxième volet tente d’en mesurer la cohésion familiale et le troisième présente, à travers une analyse du discours, les éléments sur lesquels repose la constructionsymbolique de l’ethos de la famille franco-ontarienne.
Le défi des pratiques d’intervention interculturelle dans le champ de la santé sexuelle
Authors: Parrot Claire
Published: September 2012

Un quart des 10 millions de personnes qui habitent en Ontario sont des membres d’uneminorité raciale, des immigrantes et immigrants récents ou des personnes réfugiées. Cela veutdire que parmi ces personnes, il y a plus d’un million de jeunes filles et de femmes qui ont unproblème commun : elles ne reçoivent pas les services de santé qu’elles méritent. (ministère dela Santé de l’Ontario 1993).
La formation à distance : un moyen novateur pour promouvoir la santé
Authors: Deroche Francine , Simard Anne
Published: September 2012

Cet article trace les grandes lignes d'un projet de formation à distance qui a été mis en oeuvre en Ontario français. Plusieurs leçons ont été tirées de cette expérience qui peuvent servir dans la planification de futures activités de formation.
La loi 68 : loi en l’honneur de Brian Smith
Authors: Gagnon Julie
Published: September 2012

Au cours de l’hiver 2000, le gouvernement ontarien annonçait la venue prochaine desordonnances de traitement communautaire obligatoire pour les psychiatrisés. Méthode d’intervention controversée, le traitement coercitif soulève plusieurs enjeux, pratiques et éthiques, dont plusieurs sont liés aux droits et libertés des psychiatrisés. Dans ce travail, nous étudions la question du traitement communautaire obligatoire. Nous décrivons son concept et son contexte. Nous identifions les partisans et les opposants au traitement coercitif, tout comme leurs arguments à l’appui. Nous soulevons les thèmes et les enjeux qui ressortent de ce débat. Nous suggérons d’ailleurs des interventions alternatives au traitement communautaire obligatoire.
L’enseignement des enjeux de la paternité dans les universités canadiennes
Authors: deMontigny Francine , Devault Annie , Lacharité Carl , Quéniart Annie , Dubeau Diane , Miron Jean-Marie , Fleurant Annie , Gervais Christine , Dragon Jean-François , Este David , St-Amand Nérée , Bélanger Jean-Marc , Lozier Fernand
Published: September 2012

Un nombre significatif de chercheurs et de cliniciens portent attention au développement du rôle du père dans la famille, particulièrement sous l’angle de l’engagement paternel. Pourtant, l’examen pancanadien des curriculums d’enseignement universitaire en soins infirmiers effectué en 2002 a révélé que dans 68 institutions offrant la formation de premier cycle en soins infirmiers, peu de cours portaient spécifiquement ou indirectement sur les pères ou la paternité. Une autre étude auprès de 30 étudiants de premier cycle en sciences infirmières, en pratiques sages-femmes et en travail social a révélé que ces étudiants se sentaient inconfortables à interagir avec les pères, surtout lors de situations plus critiques émotionnellement. Ces études ont conduit un groupe de chercheurs québécois à développer un cours interdisciplinaire de cycles supérieurs portant sur les enjeux de la paternité. Cet article vise à présenter brièvement les résultats des deux études citées, ainsi qu’à donner un aperçu de la structure du cours proposé. Les retombées pour le développement ultérieur de curriculums d’enseignement seront discutées.
Les croyances des pères originaires du Maghreb immigrés au Québec envers l’allaitement maternel
Authors: Gervais Christine , de Montigny Francine
Published: September 2012

La transition à la paternité dans un contexte d’immigration récente comporte de nombreux défis pour les hommes. Parmi ceux-là, l’expérience de l’allaitement est déterminante pour leur adaptation à leur nouveau rôle de père, particulièrement dans un contexte d’immigration où les pratiques culturelles traditionnelles de maternages sont remises en question au contact de la société d’accueil. Cette étude vise à examiner les croyances des pères d’origine maghrébine reliées à l’allaitement maternel. Les données ont été recueillies lors d’entrevues semi-dirigées intégrant le génogramme menées auprès de 12 pères immigrés du Maghreb depuis moins de 10 ans. L’analyse des données révèle les croyances des pères envers l’allaitement maternel ainsi que leurs croyances quant aux facteurs facilitant l’expérience de l’allaitement. Les résultats permettent de formuler des recommandations pour la pratique clinique auprès des familles immigrantes, pour la recherche et pour l’enseignement en santé familiale.
Que signifie être jeune adulte aujourd’hui? Les points de vue de jeunes adultes ayant reçu un diagnostic de maladie mentale
Authors: Veilleux1 Caroline , Molgat Marc
Published: September 2012

Cet article est issu d’une étude qui s’inscrit dans une démarche d’exploration de la réalité plurielle actuelle des jeunes adultes ayant reçu un diagnostic de maladie mentale à travers la considération de leur discours. Il vise dans un premier temps à déterminer si ces jeunes adultes se perçoivent comme des adultes et à identifier les critères associés à cette perception d’être adulte. En second lieu, la recherche vise à circonscrire l’impact de la maladie mentale sur la perception de soi en tant que jeune adulte et à connaître la représentation et le positionnement de ces jeunes adultes par rapport aux services de santé mentale. Pour ce faire, des entrevues semi-dirigées ont été réalisées auprès de huit jeunes adultes âgés de 18 à 35 ans, qui ont reçu un diagnostic de maladie mentale. L’analyse approfondie du discours a permis de relever que ces jeunes adultes se réfèrent moins aux marqueurs de transition formels tels que l’entrée dans le marché du travail et la parentalité, pour expliquer leur parcours de vie et s’en remettent davantage à leurs expériences personnelles de vie. Ils se réfèrent à de nouveaux repères pour ainsi donner un sens à leur réalité, ce qui a comme conséquence de préserver en partie l’image de soi. Quelques pistes de réflexion pour l’intervention sont finalement proposées.
Modeling and simulation of iron/sand filters
Authors: Kamga Fulbert Togue , Noubactep Chicgoua , Woafo Paul
Published: September 2012

Water pollution is increasingly becoming an issue of global concern, especially in developing countries. Therefore, the development of affordable, reliable, low-maintenance, electricity-free technologies for reducing biological and chemical pollutants in drinking water to an acceptable level for human consumption is an interesting topic of research. The suitability of metallic iron (Fe0) as a universal filter material has been recently discussed. Iron/sand filters have a great potential for rural regions where source water may be subjected to various microbial and chemical contaminations. This is based on the fact that corroding iron has the ability to remove all soluble species by an unspecific mechanism. This article develops a mathematical model of iron(Fe0)/sand filter taking into account the loss of porosity during the filtration process. The porosity loss with time is calculated using the rate of formation of corrosion products. The time after which the porosity is reduced to zero indicating a zero flow rate is estimated. The mass transport advection-dispersion equation is derived to predict, through numerical simulation, the spatiotemporal distribution of pollutants and the flow rate in the filter as well as the water quality at the exit of the filter. The control parameters are the iron proportion, the volume of sand particles, the height of the filter and the sorption coefficient. It is found that the pollutant removal percentage and the service life of the filter depend on the relative proportions of sand and iron in the filter.

For instance, taking the guideline equal to be 25% of the influent concentration, simulation results demonstrated that by mixing sand and iron particles in proportion of 40 vol% Fe0, the filter can be used continuously for 83 months.
Processes underlying tidal variability of carbon dioxide in the Tagus Estuary (Portugal)
Authors: Oliveira AP , Cabeçadas G
Published: September 2012

Tidal variation of CO2 system parameters was evaluated in the Tagus Estuary (SW Portugal) based on field observations performed in 2007 in the lower estuary under low river discharge conditions, during spring and autumn. Differences were found in the distribution patterns of environmental variables along a tidal cycle and at neap and spring tides essentially due to tide amplitude effects and tidal asymmetric behavior. A dominant east-westbound current was detected transporting CO2 enriched estuarine water offshore mainly during the ebb, and the reverse tidal current transporting more oxygenated marine water and with high chlorophyll a concentration during the flood. Distinct seasonal features were observed in terms of CO2 water properties and productivity. Regarding the tidal variability of the CO2 system parameters, besides the key processes controlling the variability, such as tidal advection and horizontal mixing of the two water masses present (estuarine and oceanic), specific biogeochemical processes emerged as playing an important role. Data obtained indicate that photosynthesis (in spring), aerobic respiration, and CaCO3 precipitation/dissolution (mainly in autumn) processes co-occur and control short-scale variations of CO2, reflecting the complexity of CO2 chemistry in the Tagus Estuary.
Incidence and clinical implications of ATM aberrations in chronic lymphocytic leukemia
Authors: Ouillette Peter , Li Jinghui , Shaknovich Rita , Li Yifeng , Melnick Ari , Shedden Kerby , Malek Sami N.
Published: September 2012

A subset of chronic lymphocytic leukemia (CLL) carries mutations in ataxia telangiectasia mutated (ATM). Such ATM mutations may be particularly relevant in the setting of del11q, which invariably results in the deletion of one ATM allele. To improve our understanding of the frequency and type of ATM mutations that exist in CLL, we resequenced all ATM coding exons in 24 CLL with del11q using direct sequencing. We detected two missense mutations, resulting in an ATM mutation frequency of 8%; nonsense and frameshift mutations were not identified. Given the low ATM mutation frequency detected in this cohort, we proceeded with measurements of nonmutational ATM aberrations in CLL through analysis of the activation state of ATM in response to external irradiation. The phosphorylation state of ATM at Ser‐1981 was measured using quantitative immunoblotting in purified CLL cells isolated from 251 CLL patients; data were normalized to simultaneous measurements of total ATM protein and actin. Resulting p‐ATM/ATM and p‐ATM/actin ratios were subsequently analyzed for prognostic significance inclusive and exclusive of TP53 exons 2–10 mutations. From these analyses, conducted in a large prospectively enrolled CLL patient cohort, neither the p‐ATM/ATM nor the p‐ATM/actin ratios were found to be prognostic for short survival. These data in aggregate demonstrate a low frequency of ATM aberrations in an unselected CLL cohort and do not support a major prognostic role for ATM aberrations in CLL, thus motivating renewed research efforts aimed at understanding the pathobiology of 11q deletions in CLL. © 2012 Wiley Periodicals, Inc.
Mineral and Water Content of the Fat‐Free Body: Effects of Gender, Maturation, Level of Fatness, and Age
Authors: Slaughter Mary H. , Christ Constance B. , Stillman Rachel J. , Boileau Richard A.
Published: September 2012

Variability associated with the effects of gender, level of fatness (LOF), maturation (ML), and age on the mineral (MFFB) and water (WFFB) content of the fat‐free body (FFB) was investigated in 188 males and 144 females, aged 8 to 17 years. Measures of body density, bone mineral content, total body water, and skin‐fold thicknesses were obtained. FFB was calculated using a multicomponent model based on body density and adjusting for variability in body water and mineral content. Subjects were classified by ML as prepubescent, pubescent, and postpubescent42. Subjects were also grouped by LOF as lean, average, and obese based on percentile rankings from the age‐related norms of the National Children and Youth Fitness Study34,35. Least squares multiple regression analysis using weighted orthogonal contrasts to account for sample size differences revealed significant (p<.01) gender, ML, gender x LOF, and gender x ML effects for MFFB; however, no significant (p>.05) effects between, or within, gender were noted for WFFB. Significant ML, and nearly significant (p>.056) LOF x ML, effects were found for MFFB in the males. In contrast, only ML was significant within the female sample for MFFB. These results were upheld when age2, rather than ML, was used in the analysis. The overall relative increase in MFFB across ML was greatest in the obese (17.4%, 93%) and least in the lean (11.3%, 63%) males and females, respectively. A significant increase in MFFB across ML was observed in both genders; however, the pattern and magnitude of increase is dependent upon LOF considered. Hence, consideration of gender, ML, LOF and age is essential in estimating body composition in children.
Gallstone Formation and Weight Loss
Authors: Weinsier Roland L. , Ullmann Daniel O.
Published: September 2012

Obesity is associated with increased bile stasis and cholesterol saturation, and an increased risk of gallstone development. Conversely, bile composition is normalized following reduction in body weight. It would appear advantageous to promote weight loss in obesity, which would reduce the predisposition to gallstone formation. Despite the potential health benefits of weight reduction, very‐low‐calorie diets appear to increase the risk for cholesterol crystal and gallstone formation. The incidence of gallstone formation seems to be dependent on the degree of caloric restriction, the rate of weight loss, and the duration of the dietary intervention. Thus, faster rates of weight loss for longer periods of time are associated with increased risk.

Available data obtained from prospective studies of subjects during active weight loss suggest that newly formed gallstones occur within 4 weeks and with incidence rates 15 to 25‐fold higher than in the general obese population. The stones produce symptoms in approximately one‐third of the subjects, of whom approximately one‐half will undergo surgery. Proposed mechanisms underlying gallstone formation during weight reduction include bile stasis due to reduced caloric intake, increased biliary cholesterol saturation secondary to increased cholesterol mobilization, and increased nucleation due to changes in bile arachidonate and givcoprotein concentrations. Data are lacking on the effects of gradual rates of weight loss and risk of gallstone formation.
Effect of Enterostatin on the Feeding Responses to Galanin and NPY
Authors: Lin Ling , Gehlert Donald R. , York David A. , Bray George A.
Published: September 2012

We have investigated the possibility that enterostatin may inhibit the intake of dietary fat by inhibiting either galanin or NPY‐induced feeding pathways. Rats, adapted to either high fat (HF) or low fat‐high carbohydrate (HC) diets and fitted with third ventricular cannulas were used to study the effects of intracerebroventricular (icv) enterostatin on icv NPY and galanin induced feeding responses in satiated rats. An equimolar dose of enterostatin (0.1nmoles) inhibited, while a tenfold excess of entersotatin abolished the feeding response to galanin in rats adapted to a HF diet. The galanin stimulation of food intake was reduced in rats adapted to the HC diet and this response was less sensitive to inhibition by enterostatin. Enterostatin had no inhibitory effects on NPY‐induced feeding in rats adapted to the HC diet and only a small inhibitory effect, at tenfold molar excess, in rats adapted to the HF diet. The ability of enterostatin to bind to galanin or NPY Y‐1 receptors was investigated in lig and binding studies. Enterstatin fialed to dispace 125I‐galanin or 125I‐PYY from specific binding sites in rat forebrain homogenates or SK‐N‐MC cells respectively. The data provide support for the hypothesis that enterostatin specifically inhibits a galanin‐responsive fat intake system, but indicate that this effect is not modulated by direct interaction with either galanin or NPY‐Y1 receptors.
Visceral Obesity: A “Civilization Syndrome”
Authors: Björntorp Per
Published: September 2012

The controversial question of the relationship between obesity and disease has been considerably clearer after the demonstration in several prospective, epidemiological studies that the subgroup of central, visceral obesity is particularly prone to develop cardiovascular disease, stroke, and noninsulin dependent diabetes mellitus.

Visceral obesity is associated with multiple central endocrine aberrations. The hypothalamo‐adrenal axis is apparently sensitive to stimuli, sex steroid hormone secretion blunted, and hyperandrogenicity is found in women. In addition, there seem to be signs of central dysfunctions in the regulation of hemodynamic factors after stress, and growth hormone secretion appears to be particularly blunted.

Several of these endocrine abnormalities are associated with insulin resistance, particularly glycogen synthesis in muscle. Fiber composition with low type I/type II ratio might be secondary to the prevailing hyperinsulinemia, but low capillary density in muscle may well be of importance. In combination with elevated turn‐over of free fatty acids (FFA) this will probably provide powerful mechanisms whereby insulin resistance is created. Portal FFA, from the highly lipolytic visceral depots may, in addition, affect hepatic metabolism to induce increased gluco‐neogenesis, production of very low density lipoproteins as well as to perhaps inhibit clearance of insulin. By these mechanisms a Metabolic Syndrome may arise in which visceral obesity is a central part.

Visceral adipocytes seem to have a high density of several steroid hormone receptors, directing steroid hormone effects particularly to these depots. The net effect of cortisol is apparently a stimulation of lipid storage, with opposing effects of sex steroid hormones which also facilitate lipid mobilization, regulations most often found at the gene transcription level. Growth hormone inhibits cortisol effects on lipid accumulation, and amplifies the lipid mobilizing effects of steroid hormones. The combined perturbations of hormonal secretions will therefore probably direct triglycerides toward visceral depots. Circulatory and nervous regulatory mechanisms require, however, more attention.

The multiple central endocrine and nervous aberrations of visceral obesity suggest neuroendocrine dys‐regulations, and have features characteristic of the hypothalamic arousal seen after certain types of stress, alcohol intake, and smoking. Such factors can be traced to subjects with visceral fat accumulation. Standardized stress, eliciting a “defeat reaction” in primates is followed by an apparently identical syndrome.

This integrated picture of the multiple symptoms of visceral obesity is based on epidemiological, clinical, experimental, cellular, and molecular evidence. The ingredients of positive energy balance, including physical inactivity, stress, smoking, and alcohol consumption are frequent features of modern, urbanized society. Visceral obesity may therefore be an expression of a “Civilization Syndrome.”
Androgen Treatment of Abdominally Obese Men
Authors: Mårin Per , Holmtäng Sten , Gustafsson Carola , Jönsson ‡Lars , Kvist ‡Henry , Elander Anna , Eldh Jan , Sjöström Lars , Holm Göran , Björntorp Per
Published: September 2012

Middle‐aged men with abdominal obesity were treated in a double‐blind study with moderate doses of transdermal preparations of testosterone (T), dihydrotestosterone (DHT), or placebo. This resulted in moderately elevated T concentrations and marked decreases in follicle stimulating and luteinizing hormones in the group treated with T, while the DHT group showed elevated DHT, markedly lower T values, and less diminution of gonadotropin concentrations. In the group treated with T visceral fat mass decreased (measured by computerized tomography) without significant changes in other depot fat regions. Lean body mass did not change. In the group treated with T, glucose disposal rate, measured with the euglycemic hyperinsulinemic clamp method, was markedly augmented. Plasma triglycerides, cholesterol, and fasting blood glucose concentrations as well as diastolic blood pressure decreased. There were no such changes in the DHT or placebo treatment groups. The men treated with T reported increased well‐being and energy. In none of the groups did prostate volume, specific prostate antigen concentration, genitourinary history, or urinary flow measurement change. It is suggested that supplementation of abdominal obese men with moderate doses of T might have several beneficial effects. (OBESITY RESEARCH 1993;1:245–251)