bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistence and malignant sequelae of gestational trophoblastic disease: Clinical presentation, diagnosis, treatment and outcome
Authors: KHOO Soo‐Keat , SIDHU Mukhtiar , BAARTZ David , YIP Wai‐Lum , TRIPCONY Lee
Published: February 2010

Background:  The major concern in gestational trophoblastic disease is management of persistent disease and malignant sequelae. However, prediction of response to treatment is difficult and methods used controversial.

Aim and methods:  To evaluate the usefulness of clinical presentation, methods of diagnosis and categorisation of risk in determining clinical outcomes, by analysis of a database of 705 registered patients collected over 30 years.

Results:  From the database, there were 97 patients who developed persistent disease and malignant sequelae on the basis of defined criteria – 80.4% had molar pregnancy and 19.6% non‐molar pregnancy. Vaginal bleeding was not a common presentation; 59.8% had no clinical symptoms. According to protocol, monitoring by serial human chorion gonadotrophin (HCG) levels followed by imaging screen was used in all patients; histology was also available in 41.2% from hysterectomy and curettage specimens. There were 16 of 76 patients with persisting disease who had metastases (21.1%), and 2 of 20 patients with choriocarcinoma who had an antecedent molar pregnancy (10.0%). Based on five risk factors, 25 patients were categorised as ‘high risk’ and assigned to receive multi‐drug chemotherapy. There were two deaths (2.1% for all malignant sequelae); both were from molar pregnancies. One patient failed to respond and the other suffered a complication of intensive chemotherapy.

Conclusion:  Serial HCG levels remain the best monitor to determine therapeutic response. Categorisation of ‘high risk’ by five factors is useful in treatment. Albeit a small series, clinical outcome is favourable with a five‐year survival of 89.7%.
Mifepristone and second trimester pregnancy termination for fetal abnormality in Western Australia: Worth the effort
Authors: DICKINSON Jan E. , BROWNELL Phoebe , McGINNIS Kaitlin , NATHAN Elizabeth A.
Published: February 2010

Objective:  To determine the impact on the process of second trimester medical termination for fetal abnormality following the introduction of adjunctive mifepristone in an Australian tertiary hospital.

Methods:  All second trimester medical terminations for fetal abnormality between July 2006 and June 2009 were prospectively identified. Two temporal therapeutic cohorts were created: the first (1 July 2006 to 31 December 2007) using vaginal misoprostol alone and the second (1 January 2008 to 30 June 2009) using mifepristone priming prior to the administration of misoprostol. The primary outcome was to evaluate the impact of mifepristone priming upon the duration of pregnancy termination.

Results:  During the study period, 388 women with prenatally recognised fetal anomalies between 14 and 24 weeks gestation underwent medical termination: 189 with misoprostol alone and 199 with mifepristone priming followed by misoprostol. There was no difference between the groups for maternal age, parity or prior caesarean delivery. The median abortion duration was 15.5 h (interquartile ranges (IQR) 11.2–22.7) in the misoprostol group and 8.6 h (IQR 5.6–13.8) in the mifepristone primed group (P < 0.001). In both the groups, nulliparity and advancing gestation were associated with a significant prolongation of the abortion interval. Duration of hospitalisation was significantly longer in the misoprostol alone group (31.5 h (27–48.9) vs 27.2 h (22–31.5), misoprostol vs mifepristone priming, respectively, P < 0.001).

Conclusions:  The introduction of mifepristone priming prior to second trimester medical termination with misoprostol has resulted in a significant reduction in the duration of the termination procedure and length of inpatient stay. These observed benefits of mifepristone provide objective support for the decision to permit use of this medication in Australia.
Little Ice Age advance and retreat sediment budgets for an outlet glacier in western Norway
Authors: BURKI VALENTIN , HANSEN LOUISE , FREDIN OLA , ANDERSEN THORBJØRN A. , BEYLICH ACHIM A. , JABOYEDOFF MICHEL , LARSEN EILIV , TØNNESEN JAN‐FREDERIK
Published: February 2010

Burki, V., Hansen, L., Fredin, O., Andersen, T. A., Beylich, A. A., Jaboyedoff, M., Larsen, E. & Tønnesen, J.‐ F. 2009: Little Ice Age advance and retreat sediment budgets for an outlet glacier in western Norway. Boreas, Vol. 39, pp. 551–566. 10.1111/j.1502‐3885.2009.00133.x. ISSN 0300‐9483

Bødalsbreen is an outlet glacier of the Jostedalsbreen Ice Field in western Norway. Nine moraine ridges formed during and after the maximum extent of the Little Ice Age (LIA). The stratigraphy of proglacial sediments in the Bødalen basin inside the LIA moraines is examined, and corresponding sediment volumes are calculated based on georadar surveys and seismic profiling. The total erosion rates (etot) by the glacier are determined for the periods AD 1650–1930 and AD 1930–2005 as 0.8 ± 0.4 mm/yr and 0.7 ± 0.3 mm/yr, respectively. These rates are based on the total amount of sediment delivered to the glacier margin. The values are almost one order of magnitude higher than total erosion rates previously calculated for Norwegian glaciers. This is explained by the large amount of pre‐existing sediment that was recycled by Bødalsbreen. Thus, the total erosion rate must be considered as a composite of eroded bedrock and of removed pre‐existing sediments. The total erosion rate is likely to vary with time owing to a decreasing volume of easily erodible, unconsolidated sediment and till under the glacier. A slight increase in the subglacial bedrock erosion is expected owing to the gradually increasing bedrock surface area exposed to subglacial erosion.
From Adaptive Management to Adjustive Management: A Pragmatic Account of Biodiversity Values
Authors: MARIS VIRGINIE , BÉCHET ARNAUD
Published: February 2010

Abstract:  The conservation of biodiversity poses an exceptionally difficult problem in that it needs to be effective in a context of double uncertainty: scientific (i.e., how to conserve biodiversity) and normative (i.e., which biodiversity to conserve and why). Although adaptive management offers a promising approach to overcome scientific uncertainty, normative uncertainty is seldom tackled by conservation science. We expanded on the approach proposed by adaptive‐management theorists by devising an integrative and iterative approach to conservation that encompasses both types of uncertainty. Inspired by environmental pragmatism, we suggest that moral values at stake in biodiversity conservation are plastic and that a plurality of individual normative positions can coexist and evolve. Moral values should thus be explored through an experimental process as additional parameters to be incorporated in the traditional adaptive‐management approach. As such, moral values should also be monitored by environmental ethicists working side by side with scientists and managers on conservation projects. Acknowledging the diversity of moral values and integrating them in a process of collective deliberation will help overcome the normative uncertainty. We used Dewey's distinction between adaptation and adjustment to offer a new paradigm built around what we call adjustive management, which reflects both the uncertainty and the likely evolution of the moral values humans attribute to biodiversity. We illustrate how this paradigm relates to practical conservation decisions by exploring the case of the Sacred Ibis (Threskiornis aethiopicus), an alien species in France that is the target of an eradication plan undertaken with little regard for moral issues. We propose that a more satisfying result of efforts to control Sacred Ibis could have been reached by rerouting the traditional feedback loop of adaptive management to include a normative inquiry. This adjustive management approach now needs to be tested in real‐case conservation programs.
Poor Functional Status Is an Independent Predictor of Surgical Site Infections Due to Methicillin‐Resistant Staphylococcus aureus in Older Adults
Authors: Chen Ting‐Yi , Anderson Deverick J. , Chopra Teena , Choi Yong , Schmader Kenneth E. , Kaye Keith S.
Published: February 2010

BACKGROUND: Methicillin‐resistant Staphylococcus aureus (MRSA) has become a common surgical site infection (SSI) pathogen, particularly in older adults. Risk factors for MRSA SSI in elderly patients have not been described.

METHODS: A nested case–control study was conducted. Patients were enrolled from seven study hospitals (one medical center and six community hospitals) between January 1, 1998, and April 1, 2003. Risk factors for MRSA SSI were identified by comparing cases with two reference groups: uninfected surgical patients and patients with SSI due to methicillin‐susceptible S. aureus (MSSA). Two separate multivariate models were created using logistic regression and then compared and contrasted.

RESULTS: Eighty‐six patients with MRSA and 64 with MSSA SSI were identified. One hundred sixty‐seven uninfected surgical patients were selected. In multivariate analysis using uninfected surgical patients as controls, requiring assistance in three or more activities of daily living (ADLs) was an independent risk factor for MRSA SSI (odds ratio (OR)=2.73, 95% confidence interval (CI)=1.16–6.46). Using patients with MSSA SSIs as a reference group, requiring assistance in three or more ADLs was also a significant predictor for MRSA SSI (OR=3.78, 95% CI=1.43–9.98) in multivariate analysis. Other independent predictors included Charlson score, wound class, and surgical duration. Lack of independence in ADLs was an independent risk factor for MRSA SSI in elderly patients in both models.

CONCLUSION: Poor functional status (requiring assistance in ≥3 ADLs) was specifically associated with MRSA SSI. Functional status is an objective, readily available variable that can be used to stratify patients at risk for MRSA SSI.
Physicians' Views on the Importance of Patient Preferences in Surrogate Decision‐Making
Authors: Torke Alexia M. , Moloney Rachael , Siegler Mark , Abalos Anna , Alexander G. Caleb
Published: February 2010

OBJECTIVES: To explore the degree to which physicians report reliance on patient preferences when making medical decisions for hospitalized patients lacking decisional capacity.

DESIGN: Cross‐sectional survey.

SETTING: One academic and two community hospitals in a single metropolitan area.

PARTICIPANTS: Two hundred eighty‐one physicians who recently cared for hospitalized adults.

MEASUREMENTS: A self‐administered survey addressing physicians' beliefs about ethical principles guiding surrogate decision‐making and physicians' recent decision‐making experiences.

RESULTS: Overall, 72.6% of physicians identified a standard related to patient preferences as the most important ethical standard for surrogate decision‐making (61.2% identified advanced directives and 11.4% substituted judgment). Of the 73.3% of physicians who reported recently making a surrogate decision, 81.8% reported that patient preferences were highly important in decision‐making, although only 29.4% reported that patient preference was the most important factor in the decision. Physicians were significantly more likely to base decisions on patient preferences when the patient was in the intensive care unit (odds ratio (OR)=2.92, 95% confidence interval (CI)=1.15–7.45) and less likely when the patient was older (OR=0.76 for each decade of age, 95% CI=0.58–0.99). The presence of a living will, prior discussions with the patient, and the physicians' beliefs about ethical guidelines did not significantly predict the physicians' reliance on patient preferences.

CONCLUSION: Although a majority of physicians identified patient preferences as the most important general ethical guideline for surrogate decision‐making, they relied on a variety of factors when making treatment decisions for a patient lacking decisional capacity.
Association Between Vitamin B12 Levels and Mortality in Hospitalized Older Adults
Authors: Tal Sari , Shavit Yoav , Stern Felicia , Malnick Stephen
Published: February 2010

OBJECTIVES: To investigate the effect of various medications on vitamin B12 status and the association between vitamin B12 levels and mortality.

DESIGN: Retrospective cross‐sectional study.

SETTING: Four internal medicine departments and the geriatrics department at Kaplan Medical Center (KMC), Rehovot and Harzfeld Geriatrics Hospital, Gedera, Israel.

PARTICIPANTS: One thousand five hundred seventy patients aged 65 and older hospitalized at the KMC and Hartzfeld Hospital in 2007.

MEASUREMENTS: Blood vitamin B12 levels and demographic, clinical, and laboratory data obtained from electronic medical records.

RESULTS: Vitamin B12 deficiency (≤200 pmol/L) was found in 15% of older hospitalized patients. Fifty percent of the patients had high vitamin B12 levels (≥350 pmol/L), 68.2% of whom were aged 80 and older. Metformin use was clearly associated with lower vitamin B12 levels. In patients aged 65 and older, an inverse correlation was found between vitamin B12 levels and albumin, metformin, and angiotensin‐converting enzyme (ACE) inhibitor use. Age, number of medications, and mortality were linearly correlated with vitamin B12 levels.

CONCLUSION: Higher vitamin B12 levels were associated with greater mortality, but it is unclear whether vitamin B12 is a marker or a surrogate marker or even a substance that directly causes death. Further investigation is needed to clarify.
Perspectives of Older Persons on Bathing and Bathing Disability: A Qualitative Study
Authors: Ahluwalia Sangeeta C. , Gill Thomas M. , Baker Dorothy I. , Fried Terri R.
Published: February 2010

OBJECTIVES: To understand the bathing experiences, attitudes, and preferences of older persons in order to inform the development of effective patient‐centered interventions.

DESIGN: Qualitative study using the Grounded Theory framework.

SETTING: In‐depth, semistructured interviews were conducted in participants' homes.

PARTICIPANTS: Twenty‐three community‐living persons aged 78 and older identified from the Precipitating Events Project (PEP).

MEASUREMENTS: Open‐ended questions about bathing habits, personal meaning and purpose of bathing, difficulties and concerns about bathing, preferences for independent bathing, and attitudes toward different types of bathing assistance.

RESULTS: Three themes emerged: the importance and personal significance of bathing to older persons; variability in attitudes, preferences, and sources of bathing assistance; and older persons' anticipation of and responses to bathing disability.

CONCLUSION: The bathing experiences described by study participants underscore the personal significance of bathing and the need to account for attitudes and preferences when designing bathing interventions. Quantitative disability assessments may not capture the bathing modifications made by older persons in anticipation of disability and may result in missed opportunities for early intervention. Findings from this study can be used to inform the development of targeted, patient‐centered interventions that can subsequently be tested in clinical trials.
Supernates from stored red blood cells inhibit platelet aggregation
Authors: Matheu Frederick A. , McFaul Steve J.
Published: February 2010

BACKGROUND: Previously, we reported that red blood cells (RBCs) stored in AS‐5 accumulated proinflammatory substances during storage. We observed in those studies that supernates from nonleukoreduced (NLR) RBCs reduced mean anti‐CD41a‐fluorescein isothiocyanate (FITC) fluorescence on platelets (PLTs), indicative of decreased expression of glycoprotein (GP)IIb/IIIa on the PLT membrane. The objective of this study was to determine if supernates from stored RBCs impaired PLT aggregation as a consequence of reduction in GPIIb/IIIa expression.

STUDY DESIGN AND METHODS: Leukoreduced (LR) and NLR RBC units were prepared in AS‐5 and stored at 1 to 6°C for 6 weeks. Supernates from RBC samples collected every 2 weeks were mixed with freshly collected type‐matched blood and incubated for 30 minutes at 37°C. PLTs in each incubated blood sample were evaluated for GPIIb/IIIa expression by flow cytometry and for aggregation response to collagen by whole blood aggregometry.

RESULTS: Supernates from stored NLR RBCs reduced CD41a‐FITC fluorescence on PLTs by 15% to 31%. A reduction in fluorescence was induced by supernates of RBCs stored for 14 days and increased as storage time increased. Supernates from Day 42 NLR RBCs reduced the mean amplitude of PLT aggregation by 31% compared to Day 0 supernates and lengthened the time before onset of aggregation by 21%. In addition, amplitude correlated directly and lag time correlated inversely with CD41a‐FITC fluorescence in all samples. Supernates from prestorage LR RBCs did not affect PLT CD41a‐FITC fluorescence or aggregation response.

CONCLUSIONS: Substances that decrease expression of GPIIb/IIIa and inhibit PLT aggregation accumulate in NLR RBCs. Accumulation of this material is prevented by leukoreduction.
Effects of red blood cells on hemostasis
Authors: Roeloffzen Wilfried W.H. , Kluin‐Nelemans Hanneke C. , Bosman Lotte , De Wolf Joost Th.M.
Published: February 2010

BACKGROUND: Currently there is no sensitive laboratory test to establish the influence of red blood cells (RBCs) on hemostasis. As thromboelastography (TEG) measures hemostasis in whole blood, taking into account the interactions of all cellular elements, we used this instrument to investigate the role that RBCs play in hemostasis.

STUDY DESIGN AND METHODS: In 29 patients with chemotherapy‐induced anemia we studied the effect of progressive anemia on the coagulation profile. In 24 patients with chronic anemia we studied the effect of transfusion of RBCs on coagulation. Finally, in 18 patients we evaluated whether storage time of RBCs has additional effects on hemostasis.

RESULTS: We observed a significant negative correlation between hemoglobin and TEG variables related to both clot strength and elasticity (p < 0.05). Moreover, anemia was associated with a delay in the initiation of the coagulation cascade. Correction of anemia by RBC transfusion resulted in significant shortening of this initiation phase with now the opposite effect on clot strength and elasticity. The negative effects on clot quality were significantly worse when fresh RBCs were transfused compared to longer‐stored RBCs. Furthermore, in contrast to the longer‐stored RBCs, fresh RBCs did not enhance initial fibrin formation.

CONCLUSIONS: In this study we found that anemia was associated with a delay in the initiation of the coagulation cascade with a finally formed clot with superior strength and viscoelastic properties. Transfusion of RBCs was associated with impaired clot quality, with even worse effects on the initial fibrin build‐up and clot quality by fresh RBCs.
Screening of Canadian Blood Services donors for severe immunoglobulin A deficiency
Authors: Palmer Douglas S. , O'Toole Joan , Montreuil Therese , Scalia Vito , Yi Qi‐Long , Goldman Mindy , Towns Dale
Published: February 2010

BACKGROUND: Immunoglobulin A (IgA)‐deficient patients with antibodies to IgA require transfusions with IgA‐deficient blood components to either avoid or reduce the frequency of serious adverse reactions. To supply compatible blood components for these individuals, the Canadian Blood Services (CBS) National Testing Laboratory must initially screen and subsequently identify, after confirmatory testing at the American Red Cross (ARC), donors severely deficient in IgA (<0.05 mg/dL).

STUDY DESIGN AND METHODS: The Ouchterlony double immunodiffusion assay was used as an initial screen at CBS to identify IgA‐deficient donors (test sensitivity 2‐4 mg/dL). Sample aliquots from these donors were then sent to the ARC for confirmatory testing using an enzyme‐linked immunosorbent assay method for severe IgA deficiency (<0.05 mg/dL) and a passive hemagglutination assay to detect anti‐IgA.

RESULTS: From November 2007 to December 2008, of 54,594 samples screened initially at CBS there were 137 samples (0.251%) identified as possibly IgA deficient. Of these 137, there were 100 reports returned from ARC confirming severe IgA deficiency in 65 donors (25 female, 40 male) without detectable anti‐IgA and in 35 donors (18 female, 17 male) with anti‐IgA. The remaining 37 donors had IgA levels of more than 0.05 mg/dL.

CONCLUSION: Results from the ARC confirmed a frequency of 1 in 546 in the CBS' blood donor population for severe IgA deficiency (<0.05 mg/dL), 1 in 840 for those without anti‐IgA, and 1 in 1560 for those with antibody. Donors repeatedly confirmed as severely IgA deficient without anti‐IgA were considered eligible for the CBS IgA‐deficient donor registry program.
Identification of specificities of antibodies against human leukocyte antigens in blood donors
Authors: Endres Robert O. , Kleinman Steven H. , Carrick Danielle M. , Steele Whitney R. , Wright David J. , Norris Philip J. , Triulzi Darrell , Kakaiya Ram , Busch Michael P. ,   for the National Heart, Lung, and Blood Institute Retrovirus Epidemiology Donor Study‐II
Published: February 2010

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is the leading cause of transfusion‐related mortality. Blood centers are implementing TRALI risk reduction strategies based on screening apheresis donors for antibodies to human leukocyte antigens (HLA).

STUDY DESIGN AND METHODS: HLA antibody screening was performed on 7920 blood donors from the Leukocyte Antibody Prevalence Study (LAPS) using Luminex‐based normalized background (NBG) cutoff ratios of 10.8 (Class I) and 6.9 (Class II). Single antigen bead (SAB) assay cutoffs of 2500 median fluorescence intensity units (Class I) and 1500 (Class II) were established based on results of two subpopulations of LAPS donors. Antibody frequencies against HLA A, B, C, DR, DQ, and DP antigens were determined for screen‐reactive donors with prior pregnancies.

RESULTS: SAB reactivity for samples above our multiantigen bead NBG cutoffs was 78% for Class I and 79% for Class II. The SAB‐positive rate increased among women with zero to four or more pregnancies (0.3%‐15.6% Class I and 0.4%‐18% Class II; p < 0.00001). The highest frequency antibodies were DR11 and B15 (4.4% of women with prior pregnancies). The majority of Class I positives contained more than five specificities. For Class II, antibody‐positive women segregated into two groups: a single specificity or more than five specificities.

CONCLUSIONS: Identification of HLA antigen specificities supports pregnancy associations previously found with screening assays. The significance of particular HLA specificities for inducing TRALI is currently being evaluated in a large lookback study of recipients of high‐plasma‐volume components from this donor cohort.
Convalescent transfusion for pandemic influenza: preparing blood banks for a new plasma product?
Authors: Leider Jonathon P. , Brunker Patricia A.R. , Ness Paul M.
Published: February 2010

Due to the potential of a severe pandemic to limit efficacy or availability of medical countermeasures, some researchers have begun a search for new interventions that could complement the planned antiviral‐ and vaccine‐based response to an influenza pandemic. One such countermeasure—the transfusion of pandemic influenza‐specific antibodies from surviving patients to the clinically ill—is the focus of this commentary. Passive immunotherapy, which includes the use of monoclonal antibodies (MoAbs), hyperimmune globulin, or convalescent plasma, had been used before the advent of antibiotics and has recently reentered the limelight due to the accelerating development of MoAb therapies against cancer, a number of microbes, allograft rejection, and a host of other conditions. After the plausible biologic mechanism and somewhat limited data supporting the efficacy for this modality against influenza are reviewed, safety and logistical concerns for utilization of this potential new product (fresh convalescent plasma against influenza [FCP‐Flu]) are discussed. FCP‐Flu could indeed prove useful in a response to a pandemic, but two necessary items must first be satisfied. Most importantly, more research should be conducted to establish FCP‐Flu efficacy against the current and other pandemic strains. Second, and also importantly, blood banks and donor centers should examine whether offering this new product would be feasible in a pandemic and begin planning before a more severe pandemic forces us to respond without adequate preparation.
Did Max Weber's Agony and Ecstasy Influence His Scholarship?
Authors: Raadschelders Jos C. N.
Published: February 2010

When exploring the intellectual history of a discipline, one cannot help but wonder about the “real” person behind the scholarship. To what extent do personal life experiences influence a scholar's theories, conceptualizations, and expectations? Max Weber, the German scholar whose intellectual curiosity was, at least partially, inspired by strong personal anxieties, became one of the most influential social scientists of the twentieth century. His own intellectual and personal obsessions, along with the efforts of his wife and colleagues to present his work to a larger audience, had much to do with who he was, as well as the body of scholarship that he created.
Interlocal Service Cooperation in U.S. Cities: A Social Network Explanation
Authors: LeRoux Kelly , Brandenburger Paul W. , Pandey Sanjay K.
Published: February 2010

Local governments increasingly confront policy problems that span the boundaries of individual political jurisdictions. Institutional theories of local governance and intergovernmental relations emphasize the importance of networks for fostering service cooperation among local governments. Yet empirical research fails to examine systematically the effects of social networks on interlocal service cooperation. Do the individual networks of local government actors increase their jurisdiction's level of interlocal service delivery? Drawing data from the National Administrative Studies Project IV (NASP‐IV), multivariate analysis is applied to examine this question among 919 municipal managers and department heads across the United States. The findings indicate that interlocal service cooperation increases when jurisdictional actors network frequently through a regional association or council of government and when they are united by a common set of professional norms and disciplinary values. Manager participation in professional associations, however, does not increase interjurisdictional cooperation. The key conclusion for local government practitioners searching for ways to increase collaboration: networks that afford opportunities for more face‐to‐face interaction yield better results for effective service partnerships.
The Conditions of Care: Reframing the Debate about Public Sector Ethic
Authors: Stensöta Helena Olofsdotter
Published: February 2010

While a growing body of research argues for increased attention to ethics within public administration, scholars diverge on how to conceptualize the character of public ethics. Likewise, empirical evidence regarding the role that ethics plays in the quality of service delivery is rare. The author argues that the concept of a public ethics of care is useful for public administration in welfare states. She examines the idea empirically through a large‐N analysis of frontline bureaucrats within the Swedish Social Insurance Administration. The analysis develops two general measures of a public ethics of care as well as a public ethics of justice. The author proceeds to show a clear presence of an ethics of care in the Swedish public sector. Further, analysis shows that these two ethics measures are supplementary, not contradictory, and that age is the main individual determinant behind ethics of care, strongly correlating with number of years in office. The conclusion underscores how public ethics of care results from acquired experience in fulfilling care‐oriented tasks.
Challenges Confronting Contemporary Public Budgeting: Retrospectives/Prospectives from Allen Schick
Authors: Caiden Naomi
Published: February 2010

For nearly half a century, Allen Schick's works have explored and analyzed central issues in the role of budgets in modern government. In 2009, the Organisation for Economic Co‐operation and Development published Evolutions in Budgetary Practice: Allen Schick and the OECD Senior Budget Officials, a selection of his work, together with new chapters. The book traces developments in budget practices and reforms since the 1980s, relating them to changes in the role of government, and discusses challenges to contemporary budgeting and how they might be met. This collection provides an invaluable insight into Schick's thinking about public budgeting: a perspective on the past, a practical resource for the present, and a guide to the future.
Prevalence and Clinical Characteristics Associated With Left Atrial Appendage Thrombus in Fully Anticoagulated Patients Undergoing Catheter‐Directed Atrial Fibrillation Ablation
Authors: WALLACE THOMAS W. , ATWATER BRETT D. , DAUBERT JAMES P. , VOORA DEEPAK , CROWLEY ANNA LISA , BAHNSON TRISTRAM D. , HRANITZKY PATRICK M.
Published: February 2010

LAA Thrombus Among Anticoagulated AF Patients. Introduction: Catheter‐directed atrial fibrillation (AF) ablation is contraindicated among patients with left atrial appendage (LAA) thrombus. The prevalence of LAA thrombus among fully anticoagulated patients undergoing AF ablation is unknown.

Methods and Results:
We retrospectively evaluated the prevalence of LAA thrombus among 192 consecutive patients undergoing AF ablation between July 2006 and January 2009. Seven of 192 patients (3.6%) had evidence of thrombus on transesophageal echocardiogram (TEE) despite being fully anticoagulated on warfarin (international normalized ratio [INR] 2–3) for 4 consecutive weeks prior to echocardiogram. Univariate analysis demonstrated that structural heart disease, large left atrial dimension, and number of AF ablations were associated with thrombus. Three patients with thrombus had paroxysmal AF with normal LV function.

Conclusion:
Despite full anticoagulation, 3.6% of patients undergoing AF ablation had LAA thrombus. We recommend that all patients, regardless of LV function or left atrial size, should undergo preprocedural TEE to exclude the presence of LAA thrombus. (J Cardiovasc Electrophysiol, Vol. 21, pp. 849‐852, August 2010)
Correlative Anatomy for the Electrophysiologist: Ablation for Atrial Fibrillation. Part II: Regional Anatomy of the Atria and Relevance to Damage of Adjacent Structures During AF Ablation
Authors: MACEDO PAULA G. , KAPA SURAJ , MEARS JENNIFER A. , FRATIANNI AMY , ASIRVATHAM SAMUEL J.
Published: February 2010

Anatomy for Atrial Fibrillation.  Ablation procedures for atrial fibrillation have become an established and increasingly used option for managing patients with symptomatic arrhythmia. The anatomic structures relevant to the pathogenesis of atrial fibrillation and ablation procedures are varied and include the pulmonary veins, other thoracic veins, the left atrial myocardium, and autonomic ganglia. Exact regional anatomic knowledge of these structures is essential to allow correlation with fluoroscopy and electrograms and, importantly, to avoid complications from damage of adjacent structures within the chest.

We present this information as a series of 2 articles. In a prior issue, we have discussed the thoracic vein anatomy relevant to paroxysmal atrial fibrillation. In the present article, we focus on the atria themselves, the autonomic ganglia, and anatomic issues relevant for minimizing complications during atrial fibrillation ablation. (J Cardiovasc Electrophysiol, Vol. pp. 829‐836, July 2010)
Reasonable Hope: Construct, Clinical Applications, and Supports
Authors: WEINGARTEN KAETHE
Published: February 2010

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full‐text page on Wiley InterScience (http://interscience.wiley.com/journal/famp).

Hope may be the most laden shorthand term of all time. Everyone wants it; few know how to articulate what it is. Although family therapists frequently work to restore hope with hopeless families, they have contributed little to the abundant literature on hope. I present a new conceptualization of hope—reasonable hope—that reflects how family therapists think and practice. By subscribing to reasonable hope, clinicians enhance their ability to offer accompaniment and bear witness to clients. I describe clinical practices that, informed by reasonable hope, also facilitate its cocreation. Finally, I suggest supports for clinicians who practice reasonable hope.
Preschoolers with Asthma: Narratives of Family Functioning Predict Behavior Problems
Authors: SPAGNOLA MARY , FIESE BARBARA
Published: February 2010

This study tested a model predicting behavior symptoms in preschoolers with asthma. Specifically, it examined the role that asthma severity and children's representations of family functioning may play in the development of child behavior problems in a sample of 53 low‐income preschoolers. The study included parent report of asthma severity and a narrative story‐stem method to assess children's representations of both general and disease‐specific family processes. A regression model tested the inclusion of both types of family processes in predicting child internalizing and externalizing behavior. Disease severity and children's family narratives independently predicted children's behavior over and above the combined effects of demographic variables including child age, socioeconomic status, and family structure. Although children's narratives about general family functioning predicted children's behavior, narratives about family response to asthma symptoms did not. Findings support that both disease severity and family functioning are important considerations in understanding children's behavior problems in the context of asthma. Clinical applications of findings may include: (1) Informing family based‐assessments to incorporate children's narratives, and (2) A focus on reducing asthma symptoms and strengthening family functioning to prevent or address child behavior problems.
Parental Separation and Children's Behavioral/Emotional Problems: The Impact of Parental Representations and Family Conflict
Authors: STADELMANN STEPHANIE , PERREN SONJA , GROEBEN MAUREEN , Von KLITZING KAI
Published: February 2010

In this longitudinal study, we examine whether the effect of parental separation on kindergarten children's behavioral/emotional problems varies according to the level of family conflict, and children's parental representations. One hundred and eighty seven children were assessed at ages 5 and 6. Family conflict was assessed using parents' ratings. Children's parental representations were assessed using a story‐stem task. A multiinformant approach (parent, teacher, child) was employed to assess children's behavioral/emotional problems. Bivariate results showed that separation, family conflict, and negative parental representations were associated with children's behavioral/emotional problems. However, in multivariate analyses, when controlling for gender and symptoms at age 5, we found that children of separated parents who showed negative parental representations had a significantly greater increase in conduct problems between 5 and 6 than all other children. In terms of emotional symptoms and hyperactivity, symptoms at 5 and (for hyperactivity only) gender were the only predictors for symptoms 1 year later. Our results suggest that kindergarten children's representations of parent‐child relationships moderate the impact of parental separation on the development of conduct problems, and underline play and narration as a possible route to access the thoughts and feelings of young children faced with parental separation.
Conceptions Regarding Children’s Health: An Examination of Ethnotheories in a Sending and Receiving Community
Authors: De Guzman Maria Rosario T. , DeLeon Jennifer , Gonzalez‐Kruger Gloria , Cantarero Rodrigo
Published: February 2010

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty‐four Mexican adults in six focus groups discussed well‐being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components and an interwoven system of causes with microlevel issues embedded in broader social, economic, and cultural contexts.
Connecting with Millennials: Using Tag Clouds to Build a Folksonomy from Key Home Economics Documents
Authors: Pendergast Donna
Published: February 2010

Coinciding with the celebration of the centennial of the International Federation for Home Economics (IFHE) in 2008 and the American Association for Family and Consumer Sciences in 2009, several celebratory events have taken place and a number of artifacts produced. These serve as a permanent legacy and historical account of the attainment of the centennial. In this study, selected artifacts are analyzed and presented using a contemporary tool that connects specifically with the multiliteracy capabilities of the emerging generation in schools, tertiary institutions and new entrants in the workforce—the Millennials—who are the future generation of home economists. Through the use of tag clouds evidence of the emergence of a folksonomy of terms associated with the field is apparent, featuring words such as: profession, social, life, and future.
Perceptions of the Value of Undergraduate Research: A Pilot Qualitative Study of Human Sciences Graduates
Authors: Collins Nina , Hymon‐Parker Shirley , Mitstifer Dorothy I. , Nelson Goff Briana S.
Published: February 2010

The purpose of this study was to assess the value of research from the perspective of alumni who completed an undergraduate research (UGR) project in family and consumer sciences. The sample included 16 participants from three institutions with similar missions but different structures. The interviewees’ responses were coded by the authors to develop an initial set of descriptors. The text was also coded using Ethnograph version 6.0. The findings revealed many more positive than negative responses in regard to attitudes, research skills, professionalism, value of the project to their current job, relationship with their undergraduate mentor, presentation of the research project, and suggestions for improvement. The most positive responses were in the categories of research skills attributed to the UGR (89%), value of the project to their job (87%), and faculty mentorship (81%). Overall, these findings support the benefits of UGR and the investment of university resources for research projects with faculty members for undergraduate students.
Association of Home Equipment Educators—The Changing Face of Home Equipment Education
Authors: Emmel JoAnn M. , Lovingood Rebecca P. , Michael Carol M. , Wysocki Joseph L.
Published: February 2010

The need for information about household tools and equipment in the home dates back to the beginning of civilization and continues today. In response to an increased demand for home equipment information around the beginning of the 20th century, formal education on the topic began to grow, and manufacturers and utility companies contributed to consumers’ education on home equipment. From this growing interest, a professional association developed to bring together professionals in the field. The Association of Home Equipment Educators, in collaboration with government agencies, private organizations, trade associations, and equipment manufacturers, has had a significant impact on research and education in the field of home equipment.
Osteoporosis Health Beliefs in Women Differ by Menopausal Status and Across Age Cohorts
Authors: Piehowski Kathryn E. , Nickols‐Richardson Sharon M. , Clymer Eric K. , Roberto Karen A.
Published: February 2010

This study examines the differences in osteoporosis health beliefs and practices between pre‐ and postmenopausal women and across four age cohorts. Two hundred and three women, aged 26–86 years, completed the self‐administered Osteoporosis Health Belief Scale (OHBS). Responses and scores for each statement of the OHBS ranged from Strongly Disagree = 1 to Strongly Agree = 5. Means for OHBS subscales (susceptibility, seriousness, health motivation, prevention benefits, and prevention barriers) were calculated. Calcium HBS and calcium food frequency questionnaires were also completed. Premenopausal women perceived osteoporosis as more serious compared to postmenopausal women, while postmenopausal women perceived higher health motivation and greater benefits from osteoporosis prevention. Women aged 40–49.9 years perceived osteoporosis as more serious versus women aged 50–59.9 and 60+ years. Osteoporosis health belief constructs may be utilized to determine osteoporosis prevention priorities for specific cohorts of women.
Identification from Chest X‐Rays: Reliability of Bone Density Patterns of the Humerus*
Authors: Ciaffi Romina , De Angelis Danilo , Gherardini Pier Federico , Arcudi Giovanni , Nessi Renato , Cornalba Gian Paolo , Grandi Marco , Cattaneo Cristina
Published: February 2010

Abstract:  A critical review of Kahana and Hiss’ study on identification from bone trabecular pattern and a test of their method conducted on the humerus are presented. Bone trabecular pattern was studied through the generation of a numerical file representing the gray scale. Using the correlation coefficient, several pairwise comparisons between numerical files were performed. The test gave nearly 30% of incorrect exclusions (the method did not recognize couples of radiographs belonging to the same subject) and 50% of misidentifications (the method recognized couples of radiographs belonging to different subjects, as belonging to the same subject); therefore, this research shows that at the present time, it is not possible to safely quantify identification through bone density patterns, of the proximal humerus taken from thoracic X‐rays. Thus, an “easy”—but dangerous—use of trabecular density patterns on this specific type of radiogram as an identification method should be currently avoided.
Predicting Phenotype from Genotype: Normal Pigmentation*
Authors: Valenzuela Robert K. , Henderson Miquia S. , Walsh Monica H. , Garrison Nanibaa’ A. , Kelch Jessica T. , Cohen‐Barak Orit , Erickson Drew T. , John Meaney F. , Bruce Walsh J. , Cheng Keith C. , Ito Shosuke , Wakamatsu Kazumasa , Frudakis Tony , Thomas Matthew , Brilliant Murray H.
Published: February 2010

Abstract:  Genetic information in forensic studies is largely limited to CODIS data and the ability to match samples and assign them to an individual. However, there are circumstances, in which a given DNA sample does not match anyone in the CODIS database, and no other information about the donor is available. In this study, we determined 75 SNPs in 24 genes (previously implicated in human or animal pigmentation studies) for the analysis of single‐ and multi‐locus associations with hair, skin, and eye color in 789 individuals of various ethnic backgrounds. Using multiple linear regression modeling, five SNPs in five genes were found to account for large proportions of pigmentation variation in hair, skin, and eyes in our across‐population analyses. Thus, these models may be of predictive value to determine an individual’s pigmentation type from a forensic sample, independent of ethnic origin.
Mutational analysis of caspase genes in prostate carcinomas
Authors: KIM MIN SUNG , PARK SANG WOOK , KIM YOO RI , LEE JI YOUL , LIM HYEON WOO , SONG SANG YONG , YOO NAM JIN , LEE SUG HYUNG
Published: February 2010

Kim MS, Park SW, Kim YR, Lee JY, Lim HW, Song SY, Yoo NJ, Lee SH. Mutational analysis of caspase genes in prostate carcinomas. APMIS 2010; 118: 308–12.

Evasion of apoptosis is one of the hallmarks of cancer. Of the components of apoptosis machinery, caspases are the main executioners of apoptosis that initiate and propagate the apoptosis, and finally degrade target molecules. Caspase‐encoding genes have been reported to harbor inactivating mutations in many human cancers. However, mutational status of caspase genes in prostate carcinomas has not been identified. The aim of this study was to explore whether caspase genes are somatically mutated in prostate carcinomas. For this, we analyzed entire coding regions of 11 human caspase‐encoding genes (CASP1–10 and 14) in 45 prostate carcinoma tissues by a single‐strand conformation polymorphism (SSCP) assay. In this study, however, we detected no somatic mutation of CASP genes in the prostate carcinomas by the SSCP. This is the first report on systematic evaluation of caspase‐encoding gene mutations in human prostate carcinomas, and our data indicate that CASP genes may not be mutated in prostate carcinomas. The data suggest that apoptosis evasion in prostate carcinoma may be dependent on other mechanisms besides genetic alteration of caspase‐encoding genes.
Urban Mexican‐American mothers’ beliefs about caries etiology in children
Authors: Hoeft Kristin S. , Barker Judith C. , Masterson Erin E.
Published: February 2010

Hoeft KS, Barker JC, Masterson EE. Urban Mexican‐American mothers’ beliefs about caries etiology in children. Community Dent Oral Epidemiol 2010; 38: 244–255. © 2010 John Wiley & Sons A/S

Abstract –  Objectives:  Caries is a severe condition which disproportionately affects Latino children in the US. This study sought contextual understanding of urban, low‐income Mexican‐American mothers’ beliefs, perceptions, knowledge and behavior surrounding causes of caries.

Methods:  In urban San José, CA, a qualitative study was conducted with a convenience sample of Mexican‐American mothers of young children about their beliefs and knowledge about the causes of caries. Audio‐taped in‐depth interviews with open‐ended questions, primarily in Spanish, were translated to English and then transcribed verbatim. Texts were independently read and thematically analyzed by two researchers.

Results:  Even while expressing uncertainty, all 48 mothers mentioned specific causes of caries, most frequently citing candy or juice consumption (85%), poor oral hygiene (65%) and use of the bottle (52%). Mothers rarely recognized cariogenic foods beyond candy, did not know or perform recommended oral hygiene routines, and demonstrated confusion and uncertainty about exactly how baby bottles are detrimental to teeth. Nearly half of these mothers also mentioned secondary cavity causes, such as genetics, lack of calcium, not going to the dentist or lack of fluoride. Mothers did not mention the role of bacteria. While mothers recognized that oral hygiene can counteract the detrimental effects of candy consumption, they did not recognize its beneficial effects in other contexts. Nor did they know about other preventive activities.

Conclusions:  Mothers recognized the three major important factors causing caries: sugar consumption, poor oral hygiene and bottle use. However, their knowledge is limited in depth and specificity which restricts development of caries prevention behaviors. More comprehensive education is needed, including about caries prevention (oral hygiene) behaviors, which could lead to an increased sense of self‐efficacy with respect to their children’s oral health.