bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Emulsifiers and Their Liquid Crystalline Structures in Emulsions on Dermal and Transdermal Delivery of Hydroquinone, Salicylic Acid and Octadecenedioic Acid
Authors: Otto A. , Wiechers J.W. , Kelly C.L. , Dederen J.C. , Hadgraft J. , du Plessis J.
Published: May 2010

This study investigated the effect of emulsifiers and their liquid crystalline structures on the dermal and transdermal delivery of hydroquinone (HQ), salicylic acid (SA) and octadecenedioic acid (DIOIC). Emulsions containing liquid crystalline phases were compared with an emulsion without liquid crystals. Skin permeation experiments were performed using Franz-type diffusion cells and human abdominal skin dermatomed to a thickness of 400 µm. The results indicate that emulsifiers arranging in liquid crystalline structures in the water phase of the emulsion enhanced the skin penetration of the active ingredients with the exception of SA. SA showed a different pattern of percutaneous absorption, and no difference in dermal and transdermal delivery was observed between the emulsions with and without liquid crystalline phases. The increase in skin penetration of HQ and DIOIC could be attributed to an increased partitioning of the actives into the skin. It was hypothesized that the interaction between the different emulsifiers and active ingredients in the formulations varied and, therefore, the solubilization capacities of the various emulsifiers and their association structures.
Cytomegalovirus Induces Stage-Dependent Enamel Defects and Misexpression of Amelogenin, Enamelin and Dentin Sialophosphoprotein in Developing Mouse Molars
Authors: Jaskoll Tina , Abichaker George , Htet Khine , Bringas, Jr. Pablo , Morita Scott , Sedghizadeh Parish P. , Melnick Michael
Published: May 2010

Of the approximately 8,400 children born each year in the US with cytomegalovirus (CMV)-induced birth defects, more than one third exhibit hypoplasia and hypocalcification of tooth enamel. Our prior studies indicated that CMV severely delayed, but did not completely interrupt, early mouse mandibular first molar morphogenesis in vitro. The aim of the present study was to examine the effects of CMV infection on progressive tooth differentiation and amelogenesis. Since initial CMV infection in human fetuses can occur at different developmental times, we varied the stage of initial viral infection (that is, Cap stage, Early Bell stage and Bell stage), as well as the duration of infection. CMV infection of embryonic mouse mandibular first molars in vitro induces tooth dysmorphogenesis and enamel defects in a developmental stage- and duration-dependent manner. Cap stage- and Early Bell stage-infected molars exhibit enamel agenesis and Bell stage-infected molars exhibit enamel hypoplasia. This viral-induced pathology is coincident with stage-dependent changes in Amelx, Enam and Dspp gene expression, distribution of amelogenin, enamelin and DSP proteins, cell proliferation localization and dedifferentiation of secretory ameloblasts. Importantly, our data indicate that specific levels of Amelx and Dspp gene expression define whether mouse CMV induces enamel agenesis or hypoplasia.
Emergency Hospital Admissions from Care-Homes: Who, Why and What Happens? A Cross-Sectional Study
Authors: Quinn Terence
Published: May 2010

Background: An increasing number of adults are resident in care-homes. Poor prognosis is often assumed; however, outcomes in this group are not well described. We hypothesised that the clinical characteristics of emergency admissions from care-homes are no different from those of age-matched, community-dwelling elders. Objectives: To determine the clinical characteristics of unscheduled hospital admissions from care-homes in terms of severity of illness, admission diagnosis and outcome. To put these data into context, we compare them with data from age-matched, non-care-home resident, emergency admissions. Methods: The definition of care-home was a residential facility providing full-time care. We prospectively studied consecutive, unscheduled hospital admissions from care-homes to all receiving wards (medical, surgical and orthopaedic) in a central, urban, teaching hospital. Controls matched by age (±1 year), gender, ward and admission date were independently collated. Basic descriptive statistics were employed for the analysis of clinical and demographic variables. Data were non-parametric and comparative analyses were based on χ2 or Mann-Whitney tests as appropriate. Results: Over a 3-month period, there were 114 care-home admissions representing 80 patients (82 medical ward, 17 orthopaedic and 15 surgical). Demographics, co-morbidities and medication number were equivalent for cases and controls, as was the severity of the presenting illness (Modified Early Warning System scoring, serum albumin and C-reactive protein). Presenting diagnoses were heterogeneous with the majority of care-home admissions being secondary to sepsis (24; 29%) and falls (16; 19%). Care-home admissions and controls had similar inpatient mortality (14 vs. 15%; p = 0.84) and duration of stay (5 vs. 5 days; p = 0.73). There were a greater number of readmissions of patients from care-homes compared to the controls (26 vs. 3%; p < 0.0001). Conclusion: Care-home residents admitted for unscheduled hospital care have similar outcomes to age-matched, community dwelling admissions; however, their risk of readmission is substantially higher.
Immediate Percutaneous Coronary Intervention Is Associated With Better Survival After Out-of-Hospital Cardiac Arrest
Authors: Dumas Florence , Cariou Alain , Manzo-Silberman Stéphane , Grimaldi David , Vivien Benoît , Rosencher Julien , Empana Jean-Philippe , Carli Pierre , Mira Jean-Paul , Jouven Xavier , Spaulding Christian
Published: May 2010

Background—

Acute coronary occlusion is the leading cause of cardiac arrest. Because of limited data, the indications and timing of coronary angiography and angioplasty in patients with out-of-hospital cardiac arrest are controversial. Using data from the Parisian Region Out of hospital Cardiac ArresT prospective registry, we performed an analysis to assess the effect of an invasive strategy on hospital survival.

Methods and Results—

Between January 2003 and December 2008, 714 patients with out-of-hospital cardiac arrest were referred to a tertiary center in Paris, France. In 435 patients with no obvious extracardiac cause of arrest, an immediate coronary angiogram was performed at admission followed, if indicated, by coronary angioplasty. At least 1 significant coronary artery lesion was found in 304 (70%) patients, in 128 (96%) of 134 patients with ST-segment elevation on the ECG performed after the return of spontaneous circulation, and in 176 (58%) of 301 patients without ST-segment elevation. The hospital survival rate was 40%. Multivariable analysis showed successful coronary angioplasty to be an independent predictive factor of survival, regardless of the postresuscitation ECG pattern (odds ratio, 2.06; 95% CI, 1.16 to 3.66).

Conclusions—

Successful immediate coronary angioplasty is associated with improved hospital survival in patients with or without ST-segment elevation. Therefore, our findings support the use of immediate coronary angiography in patients with out-of-hospital cardiac arrest with no obvious noncardiac cause of arrest regardless of the ECG pattern.
Catheter-Based Left Atrial Appendage (LAA) Ligation for the Prevention of Embolic Events Arising From the LAA
Authors: Lee Randall J. , Bartus Krzysztof , Yakubov Steven J.
Published: May 2010

Background—

Surgical ligation of the left atrial appendage (LAA) has been shown to be an effective alternative to warfarin therapy in patients with atrial fibrillation. A novel catheter-based approach for LAA ligation was evaluated for safety and effectiveness in a canine model.

Methods and Results—

A total of 26 healthy mongrel dogs underwent ligation of the LAA through a catheter-based approach. Intracardiac echocardiography and contrast fluoroscopy were used to position a marker balloon at the origin of the LAA. An over-the-wire approach was used to guide the LARIAT snare device over the LAA to enable ligation of the LAA. Sixteen dogs were euthanized acutely. The LAA was examined to assess the placement and completeness of the ligation. The remaining 10 dogs were used for long-term follow-up. The snare delivery device was able to completely capture, advance, and close the anatomic base of the LAA in all cases. In all animals, complete LAA exclusion through this closed-chest approach was achieved without complications. Chronic follow-up revealed healthy active dogs. Examination of the LAA at 7 days, 1 month, and 3 months demonstrated completely endothelialized orifice of the LAA.

Conclusions—

Using a closed-chest approach in the canine model, the catheter-based snare delivery device achieved safe and reliable ligation of the entire LAA. The clinical application of this novel approach may provide an alternative to warfarin or to permanent device implants in patients with nonvalvular atrial fibrillation for the prevention of embolic events originating from the LAA.
The Roles of Precipitation Increases and Rural Land-Use Changes in Streamflow Trends in the Upper Mississippi River Basin
Authors: Kochendorfer J. P. , Hubbart J. A.
Published: May 2010

Recent trends in precipitation and streamflow in the United States have become a particular focus of hydroclimatic research. The U.S. Hydro-Climatic Data Network (HCDN) has proven to be especially useful for the analysis of long-term streamflow trends. The U.S. Geological Survey (USGS) scientists selected sites for inclusion in the HCDN from the USGS stream-gauge network on the basis of streamflows being relatively free of nonclimatic anthropogenic influences. Consequently, most previous analyses of flow trends at those sites have either implicitly or explicitly attributed the trends to climate change and variability. In this paper, trends in seasonal and annual precipitation, and annual 7-day low, mean, and peak flows are examined for 48 medium-sized HCDN streams in the upper Mississippi (UM) water-resource region over 1939–2008. Using the concept of precipitation elasticity of flow, it is shown that the observed magnitudes of statistically significant increases in mean and low flows were up to a factor of 3 greater than expected from observed precipitation increases alone. Peak flows increased less than expected, and in the case of the Driftless Area at the center of the UM basin, decreased despite increased precipitation. It is proposed that the differences between expected and observed changes in streamflow can be explained by rural land-use changes in this principally agricultural region.
An Experimental Field Dataset with Buoyant, Neutral, and Dense Gas Atmospheric Releases and Model Comparisons in Low–Wind Speed (Diffusion) Conditions
Authors: Wannberg Veronica E. , Williams Gustavious , Sawyer Patrick , Venedam Richard
Published: May 2010

A unique field dataset from a series of low–wind speed experiments, modeling efforts using three commonly used models to replicate these releases, and statistical analysis of how well these models were able to predict the plume concentrations is presented. The experiment was designed to generate a dataset to describe the behavior of gaseous plumes under low-wind conditions and the ability of current, commonly used models to predict these movements. The dataset documents the release and transport of three gases: ammonia (buoyant), ethylene (neutral), and propylene (dense) in low–wind speed (diffusion) conditions. Release rates ranged from 1 to 20 kg h−1. Ammonia and ethylene had five 5-min releases each to represent puff releases and five 20-min releases each to represent plume releases. Propylene had five 5-min puffs, six 20-min plumes, and a single 30-min plume. Thirty-two separate releases ranging from 6 to 47 min were conducted, of which only 30 releases generated useful data. The data collected included release rates, atmospheric concentrations to 100 m from the release point, and local meteorological conditions. The diagnostics included nine meteorological stations on 100-m centers and 36 photoionization detectors in a radial pattern. Three current state-of-the-practice models, Aerial Locations of Hazardous Atmospheres (ALOHA), Emergency Prediction Information code (EPIcode), and Second-Order Closure Integrated Puff (SCIPUFF), were used to try to duplicate the measured field results. Low wind speeds are difficult to model, and all of the models had difficulty replicating the field measurements. However, the work does show that these models, if used correctly, are conservative (overpredict concentrations) and can be used for safety and emergency planning.
Snow Studies. Part II: Average Relationship between Mass of Snowflakes and Their Terminal Fall Velocity
Authors: Szyrmer Wanda , Zawadzki Isztar
Published: May 2010

This study uses a dataset of low-density snow aggregates measurements collected by a ground-based optical disdrometer that provides particle size and terminal fall speed for each size interval from which the velocity–size and area ratio–size relationships can be derived. From these relationships and relations between the Best and Reynolds numbers proposed in the literature, the mass power-law coefficients are obtained. Then, an approximate average relation between the coefficients in the experimentally determined velocity–size power law (with exponent fixed at 0.18) and the coefficients in the estimated mass power law (with exponent fixed at 2) is obtained. The validation of the retrieved relation is made by comparing, for each snowfall event, the time series of the reflectivity factor calculated from the derived mass–size relationship for a snowflake and from the size distribution measured by the optical disdrometer, with the reflectivity obtained from measurements. Using the measured snow size distribution and the retrieved mass–velocity relationship, a few useful relations between the bulk quantities of snow are derived. This study considers relations suitable for the microphysical modeling consistent with radar measurements of precipitating snow composed of unrimed or lightly rimed aggregate snowflakes.
Annual, Interannual, and Intraseasonal Variability of Tropical Tropopause Transition Layer Cirrus
Authors: Virts Katrina S. , Wallace John M.
Published: May 2010

Cloud fields based on the first three years of data from the Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) mission are used to investigate the relationship between cirrus within the tropical tropopause transition layer (TTL) and the Madden–Julian oscillation (MJO), the annual cycle, and El Niño–Southern Oscillation (ENSO).

The TTL cirrus signature observed in association with the MJO resembles convectively induced, mixed Kelvin–Rossby wave solutions above the Pacific warm pool region. This signature is centered to the east of the peak convection and propagates eastward more rapidly than the convection; it exhibits a pronounced eastward tilt with height, suggestive of downward phase propagation and upward energy dispersion. A cirrus maximum is observed over equatorial Africa and South America when the enhanced MJO-related convection enters the western Pacific. Tropical-mean TTL cirrus is modulated by the MJO, with more than twice as much TTL cirrus fractional coverage equatorward of 10° latitude when the enhanced convection enters the Pacific than a few weeks earlier, when the convection is over the Indian Ocean.

The annual cycle in cirrus clouds around the base of the TTL is equatorially asymmetric, with more cirrus observed in the summer hemisphere. Higher in the TTL, the annual cycle in cirrus clouds is more equatorially symmetric, with a maximum in the boreal winter throughout most of the tropics. The ENSO signature in TTL cirrus is marked by a zonal shift of the peak cloudiness toward the central Pacific during El Niño and toward the Maritime Continent during La Niña.
Spatial Structure, Forecast Errors, and Predictability of the South Asian Monsoon in CFS Monthly Retrospective Forecasts
Authors: Lee Drbohlav Hae-Kyung , Krishnamurthy V.
Published: May 2010

The spatial structure of the boreal summer South Asian monsoon in the ensemble mean of monthly retrospective forecasts by the Climate Forecast System of the National Centers for Environmental Prediction is examined. The forecast errors and predictability of the model are assessed. Systematic errors in the forecasts consist of deficient rainfall over India, excess rainfall over the Arabian Sea, and a dipole structure over the equatorial Indian Ocean. On interannual time scale during 1981–2003, two different characteristics of the monsoon are recognized—both in observation and forecasts. One feature seems to indicate that the monsoon is regionally controlled, while the other shows a strong relation with El Niño–Southern Oscillation (ENSO). The spatial structure of the regional monsoon can be characterized by the dominant rainfall between the latitudes of 15°N and 5°S in the western Indian Ocean. The maximum precipitation anomalies in the northern Arabian Sea are associated with the cyclonic circulation, while the precipitation anomalies in the equatorial western Indian Ocean accompany the easterlies over the equatorial Indian Ocean. In the ENSO-related monsoon, strong positive precipitation anomalies prevail from the equatorial eastern Indian Ocean to the western Pacific, inducing westerlies over the equatorial Indian Ocean. The spatial structure of the forecast error shows that the model is inclined to predict the ENSO-related feature more accurately than the regional feature.

The predictability is found to be lower over certain areas in the northern and equatorial eastern Indian Ocean. The predictability errors in the northern Indian Ocean diminish for longer forecast leads, presumably because the impact of different initial conditions dissipates with time. On the other hand, predictability errors over the equatorial eastern Indian Ocean grow as the forecast lead increases.
A Pseudoproxy Evaluation of the CCA and RegEM Methods for Reconstructing Climate Fields of the Last Millennium*
Authors: Smerdon Jason E. , Kaplan Alexey , Chang Diana , Evans Michael N.
Published: May 2010

Canonical correlation analysis (CCA) is evaluated for paleoclimate field reconstructions in the context of pseudoproxy experiments assembled from the millennial integration (850–1999 c.e.) of the National Center for Atmospheric Research Community Climate System Model, version 1.4. A parsimonious method for selecting the order of the CCA model is presented. Results suggest that the method is capable of resolving multiple (3–13) climatic patterns given the estimated proxy observational network and the amount of observational uncertainty. CCA reconstructions are compared to those derived from the regularized expectation maximization method using ridge regression regularization (RegEM-Ridge). CCA and RegEM-Ridge yield similar skill patterns that are characterized by high correlation regions collocated with dense pseudoproxy sampling areas in North America and Europe. Both methods also produce reconstructions characterized by spatially variable warm biases and variance losses, particularly at high pseudoproxy noise levels. RegEM-Ridge in particular is subject to significantly larger variance losses than CCA, even though the spatial correlation patterns of the two methods are comparable. Results collectively indicate the importance of evaluating the field performance of methods that target spatial climate patterns during the last several millennia and indicate that the results of currently available climate field reconstructions should be interpreted carefully.
A Modeling Study of Circulation and Eddies in the Persian Gulf
Authors: Thoppil Prasad G. , Hogan Patrick J.
Published: May 2010

The circulation and mesoscale eddies in the Persian Gulf are investigated using results from a high-resolution (∼1 km) Hybrid Coordinate Ocean Model (HYCOM). The circulation in the Persian Gulf is composed of two spatial scales: basin scale and mesoscale. The progression of a cyclonic circulation cell dominates the basin-scale circulation in the eastern half of the gulf (52°–55°E) during March–July. This is primarily the consequence of density-driven outflow–inflow through the Strait of Hormuz and strong stratification. A northwestward-flowing Iranian Coastal Current (ICC; 30–40 cm s−1) between the Strait of Hormuz and north of Qatar (∼52°E) forms the northern flank of the cell. Between July and August the ICC becomes unstable because of the baroclinic instability mechanism by releasing the potential energy stored in the cross-shelf density gradient. As a result, the meanders in the ICC evolve into a series of mesoscale eddies, which is denoted as the Iranian coastal eddies (ICE). The ICE have a diameter of about 115–130 km and extend vertically over most of the water column. Three cyclonic eddies produced by the model during August–September 2005 compared quite well with the Moderate Resolution Imaging Spectroradiometer (MODIS) SST and chlorophyll-a observations. The remnants of ICE are seen until November, after which they dissipate as the winter cooling causes the thermocline to collapse.
Evaluation of a Roughness Length Model and Sea Surface Properties with Data from the Baltic Sea
Authors: Carlsson Björn , Papadimitrakis Yiannis , Rutgersson Anna
Published: May 2010

The exchange of momentum between the oceans and atmosphere is important for many atmospheric and oceanic processes and is mainly governed by the roughness of sea surface. The roughness can be expressed by a roughness length z0. A roughness length model, based on the concept that z0 is determined by stochastic wave breaking, is presented. The model performance is evaluated using measurements from the Östergarnsholm site, in the Baltic Sea, and pertinent information from other recent investigations. The wave field and the roughness length variations are investigated during various sea state conditions dominated by wind-driven waves. It is found that several parameters, describing the characteristics of the wave field, are dependent on the amount of energy that long waves have relative to the energy of short, wind-driven waves of the sea spectrum (called the swell ratio). The impact of swell ratio on z0 can explain the discrepancies found in various results among relevant investigations. The roughness length model can well reproduce the observed roughness length.
Summertime Precipitation Regimes Associated with the Sea Breeze and Land Breeze in Southern Mississippi and Eastern Louisiana
Authors: Hill Christopher M. , Fitzpatrick Patrick J. , Corbin James H. , Lau Yee H. , Bhate Sachin K.
Published: May 2010

This study assesses the monthly climatology of the timing and placement of convective precipitation events induced by sea and land breezes in the Louisiana–Mississippi–Alabama region, and determines possible reasons for the monthly differences. These objectives were achieved through surface wind climatologies and radar composites from 2003 to 2005, supplemented by statistically significant tests. It is shown that June had an easterly–southeasterly wind regime, whereas July and August featured more southerly flow. These wind regimes may have influenced monthly diurnal wind patterns along the coast. While all months showed a typical pattern of sea-breeze evolution, the land breeze demonstrated monthly variations off the Mississippi and Louisiana coasts. July and August feature a westerly land breeze from Louisiana, while the Mississippi land breeze was stronger in August than in July. A daily wind speed minimum offshore from Mississippi indicates a local transition of influence from the land breeze to the sea breeze, and precedes the peak of the sea breeze at the coastline by about 2 h. During the nighttime hours, radar composites show that precipitation is most prevalent offshore of the Louisiana and Mississippi coastline. By 1100 central daylight time (CDT), precipitation is observed over coastal regions. Local afternoon precipitation is widespread throughout the inland areas, while precipitation is minimal offshore. Statistical significance tests show that areal precipitation coverage (APC) increases in mid- to late summer on the Mississippi coast are due to higher precipitable water and, to a lesser extent, additional CAPE. Greater offshore APC in July and August results from the influence of the local land-breeze setup. Convergence of a land breeze from eastern Louisiana and a stronger land breeze from Mississippi provides the additional lift needed to generate convection over a greater area.
Negotiating Implementation of High-Stakes Performance Assessment Policies in Teacher Education: From Compliance to Inquiry
Authors: Peck Charles A. , Gallucci Chrysan , Sloan Tine
Published: May 2010

Teacher education programs in the United States face a variety of new accountability policies at both the federal and the state level. Many of these policies carry high-stakes implications for students and programs and involve some of the same challenges for implementation as they have in the P-12 arena. Serious dilemmas for teacher educators arise in these contexts, as compliance with prescriptive state mandates is often interpreted by faculty to signify a demoralizing loss of program autonomy and integrity, whereas noncompliance may result in loss of program accreditation. The authors describe how one teacher education program negotiated these dilemmas in a fashion responsive to local values and concerns while also meeting state requirements. Results are discussed in terms of tensions between (a) policy goals seeking alignment and coherence across institutions of higher education and (b) motivational conditions likely to engage faculty in the difficult work of programmatic renewal and change in teacher education.
Quantile Regression Estimates of Hong Kong Real Estate Prices
Authors: Mak Stephen , Choy Lennon , Ho Winky
Published: May 2010

Linear regression is a statistical tool used to model the relation between a set of housing characteristics and real estate prices. It estimates the mean value of the response variable, given levels of the predictor variables. The quantile regression approach complements the least squares by identifying how differently real estate prices respond to a change in one unit of housing characteristic at different quantiles, rather than estimating the constant regression coefficient representing the change in the response variable produced by a one-unit change in the predictor variable associated with that coefficient. It estimates the implicit price for each characteristic across the distribution of prices and allows buyers of higher-priced properties to behave differently from buyers of lower-priced properties, even if they are within one single housing estate. Thus, it provides a better explanation of the real-world phenomenon and offers a more comprehensive picture of the relationship between housing characteristics and prices.
Why Does a City Grow? Specialisation, Human Capital or Institutions?
Authors: Storper Michael
Published: May 2010

Why are there persistent differences in income between metropolitan areas? The answer to this question has evaded much of the scholarship on the topic. Some of the frameworks that drive empirical research in this field are based on ad hoc combinations of explanatory factors, ranging from natural climate, to business climate, to land and labour costs. Theoretical approaches emphasise economic specialisation: some activities have higher rates of growth than others and this translates into divergence in interurban growth and income. Yet specialisation itself needs to be explained. International economics explains different growth rates and income levels among countries by emphasising specialisation, human capital and institutions. This framework can be adapted to the analysis of metropolitan growth. The thorniest aspect of doing so is to consider recursive relationships among the three, as well as decisive events that might introduce irreversible path-dependent outcomes that differentiate cities.
Opening up or Closing down Opportunities?: The Role of Social Networks and Attachment to Place in Informing Young Peoples’ Attitudes and Access to Training and Employment
Authors: White Richard J. , Green Anne E.
Published: May 2010

Drawing on case study evidence from three deprived urban neighbourhoods in England, this paper explores the influence of social networks and attachment to place on young people’s access to training and employment opportunities. The findings presented contribute to the emerging literature which highlights the importance that place-based social networks have in facilitating young people’s access to training and employment opportunities through provision of trusted information, references and role models. Moreover, the evidence also demonstrates how both social networks and attachment to place may constrain geographical and social horizons, and therefore limit the available opportunities in employment and training that young people perceive are open to them. The paper concludes by focusing on policy implications. In particular, it is argued that it is important that the influence of social networks, place attachment and associated subjective geographies is recognised by academics and policy-makers seeking a better understanding of the attitudes and perceptions of young people towards training and employment—especially in deprived areas.
Steve Fuller and Intelligent Design
Authors: Shearmur Jeremy
Published: May 2010

This essay offers a critical introduction to the intellectual issues involved in the Kitzmiller case relating to intelligent design, and to Steve Fuller’s involvement in it. It offers a brief appraisal of the intelligent design movement stemming from the work of Phillip E. Johnson, and of Steve Fuller’s case for intelligent design in a rather different sense.
Do metronomes improve the quality of life in people with Parkinson’s disease? A pragmatic, single-blind, randomized cross-over trial
Authors: Elston Julian , Honan Will , Powell Roy , Gormley Joe , Stein Ken
Published: May 2010

Objective: To evaluate the effect of acoustic cueing using metronomes on the quality of life of people with moderate to severe Parkinson’s disease.

Study design: Pragmatic, single-blind, randomized cross-over trial.

Participants: Forty-two people aged 50—85 years, in Hoehn and Yahr stage II—IV and on stable medication. Eight were lost to follow-up.

Intervention: Participants were randomized using concealed allocation to either an early group (n = 21) to receive an electronic metronome without therapy but limited support (5—10 minutes instruction and on-demand telephone assistance) for four weeks, or a late group (n = 21) to receive the same intervention at 10 weeks. In both groups the beat frequency was initially set to be comfortable for walking.

Outcomes measures: Primary and secondary outcomes were measured at baseline, 4, 10 and 14 weeks using the Parkinson’s Disease Questionnaire 39 (PDQ-39), the Short Form 36 version 2 (SF-36 version 2) and a falls diary.

Results: There were positive effects in six domains of the SF-36 version 2 and eight domains of the PDQ-39, although only one mean difference was clinically important: the role limitation (emotional) domain of SF-36 version 2 (a mean difference of 3.77, 95% confidence interval (CI), —2.68 to 10.22), a secondary outcome. None of these changes were statistically significant. There were no statistically significant differences in falls rates over the study period. Ten participants (24%) wanted to continue with their metronomes at the end of the study.

Conclusion: To demonstrate metronomes are beneficial on the role limitation domain of the SF-36 version 2 in people with moderate to severe Parkinson’s disease a sample size of 600 would be required.
Cross-cultural validation and psychometric evaluation of the Dutch language version of the Children’s Assessment of Participation and Enjoyment (CAPE) in children with and without physical disabilities
Authors: Bult MK , Verschuren O. , Gorter JW , Jongmans MJ , Piškur B. , Ketelaar M.
Published: May 2010

Objective: To assess construct validity, test—retest reliability and inter-interviewer reliability of the intensity dimension of the Children’s Assessment of Participation and Enjoyment (CAPE) for children with and without physical disabilities in the Netherlands.

Subjects: In total, 232 children aged 6—18 years (110 male, 122 female) participated. Seventy-four children with various physical disabilities and 158 without a disability.

Design: Participants completed the CAPE and the Peabody Picture Vocabulary Test. In addition, parents of 142 children were interviewed using the Vineland Adaptive Behavior Scales and the Family Environment Scale. For 71 children test— retest reliability and for 60 children inter-interviewer reliability were assessed. Validity was examined by assessing differences in participation intensity in children with disabilities versus without a physical disability, boys versus girls, and younger versus older children. In addition, 13 hypotheses regarding participation, child and family variables were examined.

Results: Validity of the CAPE was supported by significant differences in participation for subgroups. Participation differed significantly in children with and without disabilities. Girls participated more in all activities. Older children participated more in social activities and self-improvement activities, younger children participated more in recreational activities. Validity of the CAPE was further supported with significant correlation coefficients in 8 out of 13 hypotheses. Both test—retest and inter-interviewer reliability were good to excellent.

Conclusions: The findings indicate that the Dutch language version of the CAPE is a reliable and valid instrument to measure participation in recreation and leisure activities for children with and without physical disabilities aged 6—18 years.
Do Men Make Informed Decisions about Prostate Cancer Screening? Baseline Results from the “Take the Wheel” Trial
Authors: Allen Jennifer D. , Othus Megan K. D. , Hart Alton , Mohllajee Anshu P. , Li Yi , Bowen Deborah
Published: May 2010

Background. The efficacy of prostate cancer (CaP) screening with the prostate-specific antigen (PSA) test is debated. Most medical organizations recommend that men make individual, informed decisions about whether to undergo screening. Informed decision making (IDM) requires adequate knowledge about CaP as well as the risks and benefits of screening; confidence in the ability to participate in decision making at a personally desired level (decision self-efficacy); and decision making that reflects one’s values and preferences (decisional consistency). Methods. Baseline data from a randomized trial in 12 worksites were analyzed. Men aged 45+ ( n = 812) completed surveys documenting screening history, screening preferences and decisions, CaP knowledge, decision self-efficacy, and decisional consistency. Psychosocial and demographic correlates of IDM were also assessed. Results. Approximately half of the sample had a prior PSA test, although only 35% reported having made an explicit screening decision. Across the sample, CaP knowledge was low (mean = 56%), although decision self-efficacy was high (mean = 78%), and the majority of men (81%) made decisions consistent with their stated values. Compared with those who were undecided, men who made an explicit screening decision had significantly higher levels of knowledge, greater decisional self-efficacy, and were more consistent in terms of making a decision in alignment with their values. They tended to be white, have high levels of income and education, and had discussed screening with their health care provider. Conclusions. Many men undergo CaP screening without being fully informed about the decision. These findings support the need for interventions aimed at improving IDM about screening, particularly among men of color, those with lower levels of income and education, and those who have not discussed screening with their provider.
Effect of Adding a Values Clarification Exercise to a Decision Aid on Heart Disease Prevention: A Randomized Trial
Authors: Sheridan Stacey L. , Griffith Jennifer M. , Behrend Lindy , Gizlice Ziya , Jianwen Cai  , Pignone Michael P.
Published: May 2010

Background. Experts have called for the inclusion of values clarification (VC) exercises in decision aids (DAs) as a means of improving their effectiveness, but little research has examined the effects of such exercises. Objective. To determine whether adding a VC exercise to a DA on heart disease prevention improves decision-making outcomes. Design. Randomized trial. Setting. UNC Decision Support Laboratory. Patients. Adults ages 40 to 80 with no history of cardiovascular disease. Intervention. A Web-based heart disease prevention DA with or without a VC exercise. Measurements. Pre- and postintervention decisional conflict and intent to reduce coronary heart disease (CHD) risk and postintervention self-efficacy and perceived values concordance. Results. The authors enrolled 137 participants (62 in DA; 75 in DA + VC with moderate decisional conflict (DA 2.4; DA + VC 2.5) and no baseline differences among groups. After the interventions, they found no clinically or statistically significant differences between groups in decisional conflict (DA 1.8; DA + VC 1.9; absolute difference VC—DA 0.1, 95% confidence interval [CI]: —0.1 to 0.3), intent to reduce CHD risk (DA 98%; DA + VC 100%; absolute difference VC—DA: 2%, 95% CI: —0.02% to 5%), perceived values concordance (DA 95%; DA + VC 92%; absolute difference VC—DA —3%, 95% CI: —11% to +5%), or self-efficacy for risk reduction (DA 97%; DA + VC 92%; absolute difference VC—DA —5%, 95% CI: —13% to +3%). However, DA + VC tended to change some decisions about risk reduction strategies. Limitations. Use of a hypothetical scenario; ceiling effects for some outcomes. Conclusions. Adding a VC intervention to a DA did not further improve decision-making outcomes in a population of highly educated and motivated adults responding to scenario-based questions. Work is needed to determine the effects of VC on more diverse populations and more distal outcomes.
Changing Revenue and Expenditure Structure and the Reliance on User Charges and Fees in American Counties, 1972-2002
Authors: Jung Changhoon , Bae Suho
Published: May 2010

This article examines changing revenue and expenditure structures in a panel of 2,698 American counties during the past 30 years (1972-2002) at 5-year intervals. It also investigates factors affecting the degree of reliance on user charges in counties. The findings show that property taxes and total taxes as a percentage of total own source revenue began trending downward, whereas sales tax, user charges, and other taxes trended upward since 1977. The downward trend of property taxes and total taxes increased rapidly in the wake of tax and expenditure limitation (TEL) movements, which started in the late 1970s. With respect to the county expenditure structure and the growing role of counties as service delivery agents, the relative share of spending on traditional county services decreased slightly, whereas the share of municipal-type (local services) and regional-type services in general increased slightly. The findings also show that the presence of binding local TELs and the presence of state-level TELs led to an increase in the share of user charges and fees for traditionally charge-financed services. The findings also show that a modernized county structure led to an increase in the degree of reliance on user charges in counties.
The Role of Whistle-Blowing in Governing Well: Evidence From the Australian Public Sector
Authors: Smith Rodney
Published: May 2010

The role of the whistle-blower in promoting good government is a troubling one. Commentators often argue both that whistle-blowing is a sign of deep failure within organizations and that whistleblowers inevitably experience reprisals and other negative consequences. This paper argues that this negative depiction of whistle-blowing is misleading. It is often drawn from a small number of prominent cases of whistle-blowing, which are noteworthy precisely because things have gone badly wrong.When the experiences of a wider range of public sector whistle-blowers, managers and case-handlers are explored, a more nuanced picture of whistle-blowing is presented. This paper presents evidence from ‘Whistling While They Work’, a study conducted across 304 public sector agencies in Australia. This evidence allows us to identify key factors that lead to good outcomes from whistleblowing and approaches that can make whistle-blowing a normal part of organizations governing well.
The State of Public Strategic Management Research: A Selective Literature Review and Set of Future Directions
Authors: Bryson John M. , Berry Frances S. , Kaifeng Yang
Published: May 2010

Strategic planning and related strategic management elements have become ubiquitous practices at all levels of U.S. government and many nonprofit organizations over the past 25 years. The authors review strategic planning and management research over that time period using the premises of practice theory to guide the discussion. The review is organized according to 10 research directions proposed by Bryson, Freeman, and Roering (1986). Important gains have been made in a number of areas, but much more remains to be done. The authors also propose four new research directions, including the need to (1) attend more fully to the nature of strategic management practice, (2) focus on learning and knowledge management generally as part of strategic management, (3) focus specifically on how strategy knowledge develops and is used, and (4) understand how information and communication technologies can be best integrated into strategic management. The fruits of further concentrated research can be improved public strategic management practice, including enhanced organizational capacity for addressing current and future challenges and improvements in long-term performance.
Strategic Management Research in the Public Sector: A Review, Synthesis, and Future Directions
Authors: Poister Theodore H. , Pitts David W. , Hamilton Edwards Lauren
Published: May 2010

Although there is considerable literature on strategic planning and management in the public sector, there has been little effort to synthesize what has been learned concerning the extent to which these tools are used in government, how they are implemented, and the results they generate. In this article, the authors review the research on strategic planning and management in the public sector to understand what has been learned to date and what gaps in knowledge remain. In examining the 34 research articles in this area published in the major public administration journals over the past 20 years, the authors find substantial empirical testing of the impacts of environmental and institutional/organizational determinants on strategic management, but efforts to assess linkages between strategic planning processes and organizational outcomes or performance improvements are sparse. Large- N quantitative analyses and comparative case studies could improve the knowledge base in this critical area.
Tibiofemoral Joint Kinematics of the Anterior Cruciate Ligament-Reconstructed Knee During a Single-Legged Hop Landing
Authors: Deneweth Jessica M. , Bey Michael J. , McLean Scott G. , Lock Terrence R. , Kolowich Patricia A. , Tashman Scott
Published: May 2010

Background: Abnormal 3-dimensional tibiofemoral joint kinematics have been identified in anterior cruciate ligament-reconstructed knees during functional gait tasks, which is suggested to directly affect risk of knee osteoarthritis. However, the extent to which similar high-risk abnormalities are present during more demanding maneuvers, such as single-legged hopping, is largely unknown.

Hypothesis: When performing a single-legged forward hop landing, the reconstructed knee will demonstrate altered sagittal, frontal, and transverse plane kinematics compared with the contralateral limb.

Study Design: Controlled laboratory study.

Methods: High-speed biplane radiography was used to quantify bilateral 3-dimensional tibiofemoral joint kinematics in 9 subjects with unilaterally reconstructed anterior cruciate ligaments (mean time after surgery, 4 months) during 3 single-legged, forward hop landing trials. Mean subject-based initial foot contact and maximum stance (0-250 ms) values were calculated for each kinematic variable. Two-tailed paired t tests were subsequently applied to examine for the main effect of limb (reconstructed vs contralateral).

Results: The reconstructed knees exhibited significantly greater extension ( P = .04), external tibial rotation ( P = .006), and medial tibial translation ( P = .02) than the contralateral knees at initial contact. Reconstructed knees underwent significantly greater maximum flexion ( P = .05), maximum external tibial rotation ( P = .01), and maximum anterior tibial translation ( P = .02). No significant differences existed between limbs for initial contact ( P = .65) or maximum adduction-abduction ( P = .55).

Conclusion: Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee are significantly different from those of the uninjured contralateral limb during a single-legged hop landing. This altered kinematic profile, in conjunction with the large impact loads associated with hopping, may further contribute to the risk of posttraumatic knee osteoarthritis.

Clinical Relevance: Returning to sports involving dynamic single-legged landings at 4 months after anterior cruciate ligament reconstruction surgery may contribute to accelerated knee joint degeneration.
Critical Resilience, Schooling Processes, and the Academic Success of Mexican Americans in a Community College
Authors: Campa Blanca
Published: May 2010

This qualitative study adds new dimensions to the traditional paradigm of resilience through the lives of five Mexican American community college students. The term critical resilience emerges as a result of using ideology from a feminist critical perspective. In-depth interviews, classroom observations, and focus groups were used to learn how this group of students overcame many obstacles and achieved success at Camino Real Community College (a pseudonym). The findings demonstrate that the participants’ critical resilience is promoted by focusing on the cultivation of a larger purpose connected to the social uplift of their families and communities. The author describes strategies situated within a sociocultural context used by the participants to cultivate a larger purpose. The strategies of “playing the game” and showing respeto (respect) shed light on the academic success of Mexican Americans who attend community colleges.