bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraosseous and Extraosseous Blood Supply to the Medial Cuneiform
Authors: Kraus Jonathan C. , McKeon Kathleen E. , Johnson Jeffrey E. , McCormick Jeremy J. , Klein Sandra E.
Published: December 2013

Background:

Osteotomies of the medial cuneiform are commonly used to correct forefoot deformity. Bone healing occurs despite periosteal stripping of the dorsal and medial surfaces of this widely articulated bone followed by osteotomy in the midsection of the bone. The objective of this study was to characterize the blood supply of the medial cuneiform.

Methods:

Thirty matched pairs of adult cadaver legs, 60 legs total, were amputated below the knee, and arterial casts were created with India ink and latex. Soft tissues were debrided, allowing visualization of the extraosseous blood vessels. In 53 specimens the vascular supply to the medial cuneiform was photographed and recorded. Forty-nine specimens were then cleared using a modified Spälteholz technique. The intraosseous vascularity of the medial cuneiform was successfully characterized and reviewed in 48 of these specimens.

Results:

The extraosseous blood supply was similar to previous reports with a middle pedicle branch originating from the dorsalis pedis artery. The medial plantar and superficial medial plantar artery supplied the plantar aspect of the bone. Intraosseous analysis showed a dense capillary network throughout the cuneiform, with typically one central medial major and several minor nutrient arteries noted. Areas of hypovascularity were infrequent and when noted occurred at inconsistent locations.

Conclusion:

These findings support the clinical suspicion that the medial cuneiform is well vascularized from multiple sources. The plantar blood supply is likely sufficient to allow bone healing after dorsal periosteal exposure and possible injury to the middle pedicle branch of the distal medial tarsal artery.

Clinical Relevance:

A medial cuneiform opening wedge osteotomy can be used to correct forefoot deformity. This study investigates the blood supply to that bone to better characterize the healing potential of the medial cuneiform.
Depression Makes the Golden Years Not So Golden
Authors: Alpert Patricia T.
Published: December 2013

Depression is a major mental health problem that robs affected individuals of their quality of life and increases their morbidity and mortality including suicides in older White males. The current thinking is that vulnerable individuals are at risk of major depressive disorders, which are the result of genetic, age, gender, ethnicity, and environmental factors. According to Healthy People 2020 mental health objective for intervention for depression,health care providers should be provide early screening so multiple treatment modalities can be initiated. This column discusses the recent thinking of depressive disorder and secondary and tertiary treatment options.
Vulnerability at the End of Life
Authors: O’Connor Margaret , Brennan Bronwyn , Bloomer Melissa J. , Shimoinaba Kaori
Published: December 2013

In Australia, veterans are a vulnerable group, because of ageing, and high rates of chronic or life-threatening illnesses and poor mental health .This retrospective pilot study explored the home-based palliative care needs of veterans as they face the end of their life, compared to non-veterans. Medical records of ten deceased veterans and ten non-veterans in a home-based palliative care service were analyzed both for demographic data, and qualitative content. Veterans had significantly more comorbidities and were older at death. Qualitative data indicated common concerns, including the role of families and practical aspects of care. Some differences were found between veterans and non-veterans in their end-of-life care requirements. More awareness of veterans’ status may assist in care more tailored to their specific needs.
Who Is Afraid of Evaluation? Ethics in Evaluation Research as a Way to Cope With Excessive Evaluation Anxiety
Authors: Bechar Shlomit , Mero-Jaffe Irit
Published: December 2013

In this paper we share our reflections, as evaluators, on an evaluation where we encountered Excessive Evaluation Anxiety (XEA). The signs of XEA which we discerned were particularly evident amongst the program head and staff who were part of a new training program. We present our insights on the evaluation process and its difficulties, as well as our suggestions for coping with them. We suggest that signs of XEA and its consequences can be reduced by means of developing a detailed contract based on clear rules that is acceptable to all parties (evaluators, evaluands, clients and stakeholders) and would address ethical as well as technical issues. Finally, we propose a guide for formulating such evaluation contracts.
Noteworthy matters for attention in reflective journal writing
Authors: Cowan John
Published: December 2013

The principles advocated in the widely acclaimed keynote texts on reflection have nominally been followed for over 30 years in educational programmes and schemes for professional development. This article was prompted by the impression that practice and theorising reported in publications about journal writing does not consistently endorse the advice in the seminal literature, and is potentially confusing for those who seek advice and direction. In particular, some writers tolerate or encourage narrative reporting without significant reflection thereon; many articles only feature aspects of the reflective cycle, and metacognitive forward planning that aims to validate the emerging generalisation is often neglected. Noteworthy matters are identified for attention and suggestions made for an approach that today’s journal writers and their mentors may find useful to employ, in order to better focus reflections and validate their generalisations.
Student response systems and learner engagement in large classes
Authors: Heaslip Graham , Donovan Paul , Cullen John G
Published: December 2013

The use of student response systems is becoming more prevalent in higher level education. Evidence on the effectiveness of this technology can be an important resource for tutors seeking to engage with learners and raise the quality of learning experiences. Student response systems have been found to increase student engagement and participation in the classroom, yet few studies examine why this is so. This research seeks to explore the effects of student response systems on student participation in large classes. The methods used included both quantitative and qualitative data. A pre-test/mid-test/post-test design (quantitative approach) was deployed to examine the effects of a classroom response system on interactivity. Students involved in a final year undergraduate business course took part in investigating the use of student response systems from the student perspective. Qualitative data were collected to identify the strengths and weaknesses of using a classroom response system to enhance classroom interaction through semi-structured interviews. This research builds on previous studies by investigating why students become more participatory, interactive and engaged during learning sessions which utilise student response systems. Implications for teaching practice are discussed, and avenues for future research on student response systems and student engagement in large class scenarios are outlined.
Summative co-assessment: A deep learning approach to enhancing employability skills and attributes
Authors: Deeley Susan J
Published: December 2013

Service-learning is a pedagogy that combines academic study with service to the community. Voluntary work placements are integral to service-learning and offer students an ideal opportunity to develop their employability skills and attributes. In a service-learning course, it was considered good practice to raise students’ awareness of the development of these skills and attributes. To enable this, the assessment in the course was adapted accordingly, and thus an innovative, summatively co-assessed oral presentation was introduced. This study investigates the effects of using this type of assessment, in which students were required to give an oral presentation of their critical reflections on the employability skills and attributes they had developed during the course. This practitioner research study was a small project using qualitative semi-structured interviews and a focus group with students engaged in service-learning. Although this study uses service-learning pedagogy as its basis, the concept and practice of summative co-assessment is transferable to other academic courses.
Life stress and academic burnout
Authors: Lin Shu-Hui , Huang Yun-Chen
Published: December 2013

Stress has been shown to negatively affect learning. Academic burnout is a significant problem associated with poor academic performance. Although there has been increased attention on these two issues, literature on the relationship between students’ life stress and burnout is relatively limited. This study surveys academic burnout and life stresses among college students and further assesses whether reports of life stresses can serve as a predictor of academic burnout. The “Undergraduate Life Stress Scale” and “Learning Burnout Scale” are used as research tools, and data from 2640 students were collected. The results showed that both the level of students’ burnout and stress are in general not serious. Female students and upper year students reported higher values of life stresses. The self-identity stress, interpersonal stress, future development stress, and academic stress could jointly predict student academic burnout.
Music and consciousness: A continuing project
Authors: Clarke David , Clarke Eric
Published: December 2013

If there is a topic on which the humanities might make a distinctive claim, it is that of consciousness—an essential aspect of human being. And within the humanities, music might make its own claims in relation to both consciousness and being human. To investigate this connection, David Clarke and Eric Clarke brought together a wide variety of contributors in the book Music and Consciousness: Philosophical, Psychological, and Cultural Perspectives (OUP, 2011). The collection contributes to debates in consciousness studies at large, but also maps out areas peculiar to music and consciousness. Additionally, it lays bare the sheer multiplicity of discourses that emerges when consciousness is approached from even a single field of inquiry, such as music. If this poses a challenge for arriving at any agreed notion of consciousness (in relation to music or otherwise), this instability is something that might be best embraced rather than ‘resolved’. While the study of music and consciousness affirms the importance of the humanities, this is not to foreclose dialogue with scientific disciplines, even as this means maintaining awareness of how the different discursive formations of the humanities and sciences may connote different—and frequently incommensurable—sensibilities and values.
Trained Community Providers Conduct Fall Risk Screenings With Fidelity
Authors: Schrodt Lori A. , Garbe Kathie C. , Shubert Tiffany E.
Published: December 2013

Reliable and valid tools are available for health care providers to screen older adults for fall risk. Proficient administration of these tools by lay or community providers (individuals without formal medical training) may be a viable channel to expand the reach of fall risk screenings. However, the ability of community providers to administer screens is not known. This project examines community providers’ ability to proficiently administer a fall risk screening following a standardized training. Forty community providers were trained and then performed community screenings. Knowledge and confidence were assessed with pre- and postsurveys. A standardized skills checklist assessed proficiency in fall risk screening administration immediate posttraining and at onsite community screenings. Knowledge and confidence surveys demonstrated improvements pre- and posttraining ( p < .001). In all, 66% of participants demonstrated screening skill proficiency at their first onsite screening. With further coaching, 91% participants demonstrated proficiency by their third onsite screening. Participants achieving early proficiency were on average younger. Community providers can reliably administer a fall risk screening algorithm with training and coaching. This is a low-cost model and can extend the reach and dissemination of fall risk screenings, potentially providing early identification and interventions to those at risk of falling.
“Welfare Queens” and “Teen Moms”: How the Social Construction of Fertile Women Impacts Unintended Pregnancy Prevention Policy in the United States
Authors: James E. Angel , Rashid Moira
Published: December 2013

In the United States, unintended pregnancy is a serious health, social, and economic concern. However, the existing prevention policies have proven ineffective at decreasing the rate of unintended pregnancy at a national level. This lack of effective national prevention policy is better understood when viewed through the lens of a policy theory that incorporates an understanding of social construction and its effects on policy development. Through the application of one such policy theory, this article explores how the social construction of fertile women in the United States affects previous and recently enacted unintended pregnancy prevention policies.
Vascular Risk Factors and Mild Cognitive Impairment in the Elderly Population in Southwest China
Authors: Zou Yan , Zhu Qinlan , Deng Yongtao , Duan Jingxi , Pan Ling , Tu Qi , Dai Rong , Zhang Xuemei , Chu Leung-Wing , Lü Yang
Published: December 2013

Objectives:

Increasing evidence has demonstrated that vascular risk factors (VRFs) contribute to cognitive impairment in the elderly population. Prevention and administration of VRFs can be a vital strategy for delaying cognitive impairment. This study aimed to determine the impact of VRFs on cognitive function of the aged people from Chongqing, Southwest China.

Methods:

A total of 597 participants (≥60 years) from hospital and community population were enrolled in the cross-sectional study. Participants were screened for hypertension, coronary heart disease (CHD), and cerebrovascular disease (CVD). Blood pressure (BP) and blood lipid were also measured. Cognitive function was assessed with Mini-Mental State Examination and Clinical Dementia Rating. Logistic regression analysis was used to look for VRFs impacting mild cognitive impairment (MCI). Then we investigated the relationship between different types of vascular diseases and MCI.

Results:

A total of 457 participants showed normal cognitive function and 140 participants showed MCI. After adjusting for age, gender, and education, logistic regression analysis demonstrated that hypertension, CHD, systolic BP, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) were independently associated with MCI; however, CVD, diastolic BP, triglyceride, and high-density lipoprotein cholesterol were not associated with MCI. Moreover, vascular diseases significantly contributed to MCI compared with no vascular disease; however, no significant difference in incident MCI was found among different combinations of vascular diseases.

Conclusions:

Hypertension, CHD, TC, and LDL-C are independent risk factors for MCI. Moreover, patients with vascular diseases have a higher risk of MCI; however, the amount of vascular diseases does not increase the risk of MCI.
Musical Training and Late-Life Cognition
Authors: Gooding Lori F. , Abner Erin L. , Jicha Gregory A. , Kryscio Richard J. , Schmitt Fredrick A.
Published: December 2013

This study investigated the effects of early- to midlife musical training on cognition in older adults. A musical training survey examined self-reported musical experience and objective knowledge in 237 cognitively intact participants. Responses were classified into low-, medium-, and high-knowledge groups. Linear mixed models compared the groups’ longitudinal performance on the Animal Naming Test (ANT; semantic verbal fluency) and Logical Memory Story A Immediate Recall (LMI; episodic memory) controlling for baseline age, time since baseline, education, sex, and full-scale IQ. Results indicate that high-knowledge participants had significantly higher LMI scores at baseline and over time compared to low-knowledge participants. The ANT scores did not differ among the groups. Ability to read music was associated with higher mean scores for both ANT and LMI over time. Early- to midlife musical training may be associated with improved late-life episodic and semantic memory as well as a useful marker of cognitive reserve.
Handgrip-Related Activation in the Primary Motor Cortex Relates to Underlying Neuronal Metabolism After Stroke
Authors: Cirstea Carmen M. , Savage Cary R. , Nudo Randolph J. , Cohen Leonardo G. , Yeh Hung-Wen , Choi In-Young , Lee Phil , Craciunas Sorin C. , Popescu Elena A. , Bani-Ahmed Ali , Brooks William M.
Published: December 2013

Background. Abnormal task-related activation in primary motor cortices (M1) has been consistently found in functional imaging studies of subcortical stroke. Whether the abnormal activations are associated with neuronal alterations in the same or homologous area is not known. Objective. Our goal was to establish the relationships between M1 measures of motor-task-related activation and a neuronal marker, N-acetylaspartate (NAA), in patients with severe to mild hemiparesis. Methods. A total of 18 survivors of an ischemic subcortical stroke (confirmed on T2-weighted images) at more than six months post-onset and 16 age- and sex-matched right-handed healthy controls underwent functional MRI during a handgrip task (impaired hand in patients, dominant hand in controls) and proton magnetic resonance spectroscopy (1H-MRS) imaging. Spatial extent and magnitude of blood oxygen level–dependent response (or activation) and NAA levels were measured in each M1. Relationships between activation and NAA were determined. Results. Compared with controls, patients had a greater extent of contralesional (ipsilateral to impaired hand, P < .001) activation and a higher magnitude of activation and lower NAA in both ipsilesional ( P = .008 and P < .001, respectively) and contralesional ( P < .0001, P < .05) M1. There were significant negative correlations between extent of activation and NAA in each M1 ( P = .02) and a trend between contralesional activation and ipsilesional NAA ( P = .08) in patients but not in controls. Conclusions. Our results suggest that after stroke greater neuronal recruitment could be a compensatory response to lower neuronal metabolism. Thus, dual-modality imaging may be a powerful tool for providing complementary probes of post-stroke brain reorganization.
Comparison of Structured Skill and Unstructured Practice During Intensive Bimanual Training in Children With Unilateral Spastic Cerebral Palsy
Authors: Brandão Marina B. , Ferre Claudio , Kuo Hsing-Ching , Rameckers Eugene A. A. , Bleyenheuft Yannick , Hung Ya-Ching , Friel Kathleen , Gordon Andrew M.
Published: December 2013

Background. High-intensity training aims to improve hand function in children with unilateral spastic cerebral palsy (USCP). However, the extent to which skill training is required is not known. Objectives. To compare the effects of intensive bimanual training with and without structured progression of skill difficulty, on manual dexterity, bimanual hand use, daily functioning, and functional goals in children with USCP. Method. Twenty-two children were randomized to structured practice group (SPG) or unstructured practice group (UPG), and received 6 h/d training during 15 days. Children from the SPG were engaged in fine and gross motor bimanual activities, with skill progression and goal training. Children from UPG performed the same activities without skill progression or goal training. Participants were evaluated before, immediately and 6 months after training by a physical therapist blinded to group allocation. The primary outcomes were the Jebsen-Taylor Test of Hand Function (JTTHF) and Assisting Hand Assessment (AHA). Secondary outcomes included the Canadian Occupational Performance Measure (COPM), Pediatric Evaluation of Disability Inventory (PEDI), and ABILHAND-Kids. Results. Both groups showed similar improvements in the JTTHF, AHA, ABILHAND-Kids, COPM-satisfaction, and PEDI ( P < .05). A significant interaction in the COPM-performance scale ( P = .03) showed superior improvements of the SPG immediately, but not 6 months, after the intervention. Conclusions: Children from both groups demonstrated improvements in dexterity and functional hand use. This suggests that for intensive bimanual approaches, intensive training at such high doses may not require structured practice to elicit improvements. However, there may be immediate added benefit of including goal training.
Presence of Motor-Intentional Aiming Deficit Predicts Functional Improvement of Spatial Neglect With Prism Adaptation
Authors: Goedert Kelly M. , Chen Peii , Boston Raymond C. , Foundas Anne L. , Barrett A. M.
Published: December 2013

Background. Spatial neglect is a debilitating disorder for which there is no agreed on course of rehabilitation. The lack of consensus on treatment may result from systematic differences in the syndrome's characteristics, with spatial cognitive deficits potentially affecting perceptual-attentional “Where” or motor-intentional “Aiming” spatial processing. Heterogeneity of response to treatment might be explained by different treatment impacts on these dissociated deficits: prism adaptation, for example, might reduce Aiming deficits without affecting Where spatial deficits. Objective. Here, we tested the hypothesis that classifying patients by their profile of Where-versus-Aiming spatial deficit would predict response to prism adaptation and specifically that patients with Aiming bias would have better recovery than those with isolated Where bias. Methods. We classified the spatial errors of 24 subacute right stroke survivors with left spatial neglect as (1) isolated Where bias, (2) isolated Aiming bias, or (3) both. Participants then completed 2 weeks of prism adaptation treatment. They also completed the Behavioral Inattention Test and Catherine Bergego Scale (CBS) tests of neglect recovery weekly for 6 weeks. Results. As hypothesized, participants with only Aiming deficits improved on the CBS, whereas those with only Where deficits did not improve. Participants with both deficits demonstrated intermediate improvement. Conclusion. These results support behavioral classification of spatial neglect patients as a potential valuable tool for assigning targeted, effective early rehabilitation.
Reducing Abnormal Muscle Coactivation After Stroke Using a Myoelectric-Computer Interface
Authors: Wright Zachary A. , Rymer W. Zev , Slutzky Marc W.
Published: December 2013

Background. A significant factor in impaired movement caused by stroke is the inability to activate muscles independently. Although the pathophysiology behind this abnormal coactivation is not clear, reducing the coactivation could improve overall arm function. A myoelectric computer interface (MCI), which maps electromyographic signals to cursor movement, could be used as a treatment to help retrain muscle activation patterns. Objective. To investigate the use of MCI training to reduce abnormal muscle coactivation in chronic stroke survivors. Methods. A total of 5 healthy participants and 5 stroke survivors with hemiparesis participated in multiple sessions of MCI training. The level of arm impairment in stroke survivors was assessed using the upper-extremity portion of the Fugl-Meyer Motor Assessment (FMA-UE). Participants performed isometric activations of up to 5 muscles. Activation of each muscle was mapped to different directions of cursor movement. The MCI specifically targeted 1 pair of muscles in each participant for reduction of coactivation. Results. Both healthy participants and stroke survivors learned to reduce abnormal coactivation of the targeted muscles with MCI training. Out of 5 stroke survivors, 3 exhibited objective reduction in arm impairment as well (improvement in FMA-UE of 3 points in each of these patients). Conclusions. These results suggest that the MCI was an effective tool in directly retraining muscle activation patterns following stroke.
Building the Leaders of Tomorrow
Authors: Luthans Brett C. , Luthans Kyle W. , Avey James B.
Published: December 2013

The now widely recognized core construct of psychological capital (PsyCap) consists of the state-like positive psychological resources of hope, efficacy, resilience, and optimism. PsyCap has been empirically shown in the research literature to be related to various employee attitudinal, behavioral, and performance outcomes and open to development and change. Most recently, PsyCap has also been shown to be significantly related to business student academic performance. Using a pretest, posttest control group design, the present study tested whether the PsyCap of business students can be developed through a micro-training intervention. Results from this quasi-experimental study provide initial support that the Academic PsyCap of business students can be positively affected by a short training intervention.
A dynamic evaluation of how kick point location influences swing parameters and related launch conditions
Authors: Joyce Christopher , Burnett Angus , Reyes Alvaro , Herbert Stephen
Published: December 2013

In golf, many parameters of the driver can be modified to maximise hitting distance. The main objective of this study was to determine whether drivers fitted with shafts having high and low kick points would alter selected swing parameters and related launch conditions. In total, 12 elite male golfers (handicap score = 1.2 ± 1.8) had three shots analysed for two drivers fitted with ‘stiff’ shafts with differing kick point location. Stiffness profiles of these shafts were also measured. Five swing and related launch parameters were measured using a real-time launch monitor. The locations of the low and high kick points on each shaft during the golf swing (the dynamic kick points) were confirmed via motion analysis. The driver fitted with the shaft containing the high kick point displayed a more negative (steeper) angle of attack ( p < 0.01), a lower launch angle ( p < 0.01) and an increased spin rate ( p < 0.01) when compared to a driver fitted with a low kick point shaft. It is possible that the attack angle differed between drivers due to the greater amount of shaft bending found late in the downswing (80% of the downswing and just before impact). Future work is needed in this under-researched area to determine why these differences occurred.
An Investigation into the Relationship between Hospitality Employees’ Work–Family Conflicts and Their Leisure Intentions
Authors: Zhao Xinyuan (Roy) , Qu Hailin , Liu Jingyan
Published: December 2013

A study of 271 employees in four full-service hotels in China found that work–family conflict directly influences hospitality employees’ social and relaxation intentions. Moreover, these relationships are not mediated by job tension. In practical application, hospitality organizations can maximize return from these results by encouraging employees to take (or by providing) appropriate leisure activities that will help them to effectively cope with work and family role conflicts.
Civil Society Organizations at the Gates? A Gatekeeping Study of News Making Efforts by NGOs and Government Institutions
Authors: Van Leuven Sarah , Joye Stijn
Published: December 2013

This article applies a combination of an input–output content analysis and in-depth interviews with nongovernmental organization (NGO) communication professionals to determine whether the growing incorporation of press releases in editorial print content could be a new public forum through which international political actors, such as NGOs, could gain wider news access by serving as emerging key players in global civil society. The study indicates that Belgian news coverage of international aid issues is more often based on NGO press releases than government press releases. We also found that the agenda-building capacities of NGOs and government institutions are enhanced as journalists present information subsidies as original journalistic work in most cases. Nonetheless, we must tone down prevailing one-sided conclusions, as most press releases are not just copy-pasted. Instead, most are supplemented with additional sources and information. The data, moreover, identify different journalistic roles of NGOs according to their objectives. While some issue press releases to raise short-term public awareness and donations for humanitarian crises (mobilization), others have developed into established expert news source organizations that provide background information and reliable eyewitness accounts to journalists.
Political Agenda Setting as Mediatized Politics? Media–Politics Interactions from a Party and Issue Competition Perspective
Authors: Thesen Gunnar
Published: December 2013

The paper puts forward, and empirically explores, claims on how the literature on political agenda setting could inform the concept of mediatized politics. It uses as a starting point the lack of empirical research within mediatization studies, arguing that the field of political agenda setting offers important supplements through systematic investigations of the media’s role in promoting social problems on the political agenda. However, this does not imply a straightforward merging of the two traditions. Instead, I discuss how agenda-setting perspectives offer a more active and visible role for political actors and political logics in the media–politics relationship, presenting analyses that find media influence on political issue attention to be conditioned by policy responsibility and the competition between opposition and government. Furthermore, the paper takes issue with the zero-sum game interpretation of the media–politics relationship, where mediatization necessarily implies decreasing political influence. Future research, on both mediatization and agenda setting, need to address how the media (re)distributes power between different actors or institutions in politics. As a first step toward this goal, I show that opposition parties (in some respects) are more mediatized than government but that this constitutes an opposition strength in party competition.
Providing Health Services for Children With Special Health Care Needs on Out-of-State Field Trips
Authors: Erwin Karen , Clark Sandi , Mercer Sharon Eli
Published: December 2013

An increasing number of children attend school with special health care needs. Title II of the Americans with Disabilities Act (ADA) requires all school-sponsored activities to be easily accessible to all students. School-sponsored field trips enhance students’ education, and students who require health services may not be excluded. For students with special health care needs, fully participating in the field trip experience presents unique challenges. These challenges are further complicated by out-of-state field trips due to variances in nurse practice acts, variances in delegation regulations, and most recently, state-by-state participation or nonparticipation in the Nurse Licensure Compact. Review of state laws, regulations, and nursing scope of practice for school health services is critical when planning and problem solving for students requiring health services on out-of-state field trips.
Adolescents and Child Maltreatment
Authors: Beard Joyce W.
Published: December 2013

Child maltreatment is a very complex medical and social problem. Many children have died as a result of child maltreatment; others are depressed, engaging in risky behaviors and substance abuse and running away from home. The purpose of this article is to provide an overview of child maltreatment in the United States. Characteristics and contributing factors of maltreatment are described, and health and behavior problems associated with maltreated adolescents will be reviewed. Additionally, the role of the school nurse will be discussed. It is imperative that school nurses are aware of the significance of the problem and the effects that child maltreatment has on children as they mature into early adulthood.
Career and Romantic Relationship Goals and Concerns During Emerging Adulthood
Authors: Ranta Mette , Dietrich Julia , Salmela-Aro Katariina
Published: December 2013

This study examined emerging adults’ personal goals and concerns in the domains of career (including education, work, and financial issues) and romantic relationship. A particular focus was on goal and concern hierarchies, that is, individuals’ profiles of goals and concerns. A total of 1,052 Finnish emerging adults (63% female) were followed at ages 20 and 23. Latent class analyses yielded goal and concern profiles that were primarily related to career, whereas romantic relationships were less central in individuals’ goal and concern hierarchies. Career and romantic relationship goals and concerns were associated with life status in these domains, especially prioritizing career goals and concerns predicted being in education and/or employment. Our findings suggest that given the diversity of goals and concerns in emerging adulthood, it is crucial to take a holistic approach and investigate the interdependences and prioritizations among different career and romantic relationship goals and concerns.
Intrinsic Predictive Factors of Noncontact Lateral Ankle Sprain in Collegiate Athletes
Authors: Kobayashi Takumi , Yoshida Masahiro , Yoshida Makoto , Gamada Kazuyoshi
Published: December 2013

Background:

Lateral ankle sprain (LAS) is one of the most common injuries in sports. Despite extensive research, intrinsic factors that predict initial and recurrent noncontact LAS remain undefined.

Purpose:

To identify the predictive factors of initial and recurrent noncontact LAS, focusing on ankle flexibility and/or alignment in collegiate athletes.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 191 athletes were assessed during the preseason for factors predictive of noncontact LAS. The baseline measurements included weightbearing dorsiflexion range of motion (ROM), leg-heel angle, foot internal rotation angle in plantar flexion, classification according to the mortise test, and navicular–medial malleolus (NMM) distance. Occurrence of noncontact LAS and participation in practice and games were prospectively recorded for 11 months.

Results:

Of the 191 athletes assessed, 169 (145 males, 24 females) completed the study; 125 athletes had a history of ankle sprain. During the observational period, 16 athletes suffered noncontact LAS (0.58 per 1000 athlete-exposures) consisting of 4 initial sprains and 12 recurrences. The hazard ratio estimated by a Cox regression analysis showed that athletes with an NMM distance ≥4.65 cm were 4.14 times more likely to suffer an initial noncontact LAS than were athletes with a shorter NMM distance (95% confidence interval, 1.12-14.30) and that athletes with a weightbearing dorsiflexion ROM >49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS compared with athletes with a lower ROM (95% confidence interval, 1.05-1.20).

Conclusion:

NMM distance predicts initial noncontact LAS, and weightbearing dorsiflexion ROM predicts recurrent noncontact LAS.
Impact of Cardiac Ultrasound Screening on Body Mass Index in Community Health Centers
Authors: Dettman Richard H. , Rohrer Jim , Anderson Cheryl L.
Published: December 2013

Body mass index is an important indicator in primary care as a measure of a specific health care outcome. As such, it can provide a quantitative basis for clinicians to achieve improvement in care and the process by which patient care is delivered. The potential impact of cardiac sonographic screening on body mass index in disadvantaged primary care patients is unknown. Changes in body mass index (BMI), blood pressure, and low density lipoprotein cholesterol (LDL-C) levels in patients who had cardiac sonographic screening were compared to changes in a control group of similar patients treated in a clinic where cardiac sonographic screening was not available. Control patients gained weight (BMI 27.8 at baseline vs. 28.3 at follow-up), while cardiac screening patients maintained weight (BMI 27.9 at baseline vs. 27.8 at follow-up, P < .05). In overweight patients those who had cardiac screening experienced better outcomes in the quality indicator BMI than control patients, yielding a statistically significant result for some subgroups of patients. Additional effort should be directed toward refining the motivational impact of cardiac sonographic screening. It appears in this particular study that cardiac screening in a community health center was associated with better control of BMI. Such screening may have a significant impact on motivating patients to take a greater interest in personal health maintenance.
Gadd45a regulates hematopoietic stem cell stress responses in mice
Authors: Chen Yulin , Ma Xiaoming , Zhang Meimei , Wang Xiaomin , Wang Changxin , Wang Hu , Guo Peng , Yuan Weiping , Rudolph Karl Lenhard , Zhan Qimin , Ju Zhenyu
Published: December 2013

Key Points

Loss of Gadd45a enhances HSC reconstitution on hematopoietic stress. Gadd45a regulates DNA damage responses in HSCs.
Reconstruction of the lipid metabolism for the microalga Monoraphidium neglectum from its genome sequence reveals characteristics suitable for biofuel production
Authors: Bogen Christian , Al-Dilaimi Arwa , Albersmeier Andreas , Wichmann Julian , Grundmann Michael , Rupp Oliver , Lauersen Kyle J , Blifernez-Klassen Olga , Kalinowski Jörn , Goesmann Alexander , Mussgnug Jan H , Kruse Olaf
Published: December 2013

Background

Microalgae are gaining importance as sustainable production hosts in the fields of biotechnology and bioenergy. A robust biomass accumulating strain of the genus Monoraphidium (SAG 48.87) was investigated in this work as a potential feedstock for biofuel production. The genome was sequenced, annotated, and key enzymes for triacylglycerol formation were elucidated.

Results

Monoraphidium neglectum was identified as an oleaginous species with favourable growth characteristics as well as a high potential for crude oil production, based on neutral lipid contents of approximately 21% (dry weight) under nitrogen starvation, composed of predominantly C18:1 and C16:0 fatty acids. Further characterization revealed growth in a relatively wide pH range and salt concentrations of up to 1.0% NaCl, in which the cells exhibited larger structures. This first full genome sequencing of a member of the Selenastraceae revealed a diploid, approximately 68 Mbp genome with a G + C content of 64.7%. The circular chloroplast genome was assembled to a 135,362 bp single contig, containing 67 protein-coding genes. The assembly of the mitochondrial genome resulted in two contigs with an approximate total size of 94 kb, the largest known mitochondrial genome within algae. 16,761 protein-coding genes were assigned to the nuclear genome. Comparison of gene sets with respect to functional categories revealed a higher gene number assigned to the category “carbohydrate metabolic process” and in “fatty acid biosynthetic process” in M. neglectum when compared to Chlamydomonas reinhardtii and Nannochloropsis gaditana, indicating a higher metabolic diversity for applications in carbohydrate conversions of biotechnological relevance.

Conclusions

The genome of M. neglectum, as well as the metabolic reconstruction of crucial lipid pathways, provides new insights into the diversity of the lipid metabolism in microalgae. The results of this work provide a platform to encourage the development of this strain for biotechnological applications and production concepts.
Lessons learnt recruiting to a multi-site UK cohort study to explore recovery of health and well-being after colorectal cancer (CREW study)
Authors: Fenlon Deborah , Chivers Seymour Kim , Okamoto Ikumi , Winter Jane , Richardson Alison , Addington-Hall Julia , Corner Jessica L , Smith Peter W , May Christine M , Breckons Matthew , Foster Claire
Published: December 2013

Background

The UK leads the world in recruitment of patients to cancer clinical trials, with a six-fold increase in recruitment during 2001–2010. However, there are large variations across cancer centres. This paper details recruitment to a large multi-centre prospective cohort study and discusses lessons learnt to enhance recruitment.

Methods

During CREW (ColoREctal Wellbeing) cohort study set up and recruitment, data were systematically collected on all centres that applied to participate, time from study approval to first participant recruited and the percentage of eligible patients recruited into the study.

Results

30 participating NHS cancer centres were selected through an open competition via the cancer networks. Time from study approval to first participant recruited took a median 124 days (min 53, max 290). Of 1350 eligible people in the study time frame, 78% (n = 1056) were recruited into the study, varying from 30-100% eligible across centres. Recruitment of 1056 participants took 17 months.

Conclusion

In partnership with the National Cancer Research Network, this successful study prioritised relationship building and education. Key points for effective recruitment: pre-screening and selection of centres; nurses as PIs; attendance at study days; frequent communication and a reduced level of consent to enhance uptake amongst underrepresented groups.
Natural antibody response to Plasmodium falciparum merozoite antigens MSP5, MSP9 and EBA175 is associated to clinical protection in the Brazilian Amazon
Authors: Medeiros Márcia M , Fotoran Wesley L , dalla Martha Rosimeire C , Katsuragawa Tony H , Pereira da Silva Luiz Hildebrando , Wunderlich Gerhard
Published: December 2013

Background

Antibodies have an essential role in the acquired immune response against blood stageP. falciparuminfection. Although several antigens have been identified as important antibody targets, it is still elusive which antigens have to be recognized for clinical protection. Herein, we analyzed antibodies from plasmas from symptomatic or asymptomatic individuals living in the same geographic area in the Western Amazon, measuring their recognition of multiple merozoite antigens.

Methods

Specific fragments of genes encoding merozoite proteins AMA1 and members of MSP and EBL families from circulatingP. falciparumfield isolates present in asymptomatic and symptomatic patients were amplified by PCR. After cloning and expression of different versions of the antigens as recombinant GST-fusion peptides, we tested the reactivity of patients’ plasmas by ELISA and the presence of IgG subclasses in the most reactive plasmas.

Results

11 out of 24 recombinant antigens were recognized by plasmas from either symptomatic or asymptomatic infections. Antibodies to MSP9 (X2DF=1 = 9.26/p = 0.0047) and MSP5 (X2DF=1 = 8.29/p = 0.0069) were more prevalent in asymptomatic individuals whereas the opposite was observed for MSP1 block 2-MAD20 (X2DF=1 = 6.41/p = 0.0206, Fisher’s exact test). Plasmas from asymptomatic individuals reacted more intensely against MSP4 (U = 210.5,p < 0.03), MSP5 (U = 212,p < 0.004), MSP9 (U = 189.5,p < 0.002) and EBA175 (U = 197, p < 0.014, Mann-Whitney’s U test). IgG1 and IgG3 were predominant for all antigens, but some patients also presented with IgG2 and IgG4. The recognition of MSP5 (OR = 0.112, IC95% = 0.021-0.585) and MSP9 (OR = 0.125, IC95% = 0.030-0.529, cross tab analysis) predicted 8.9 and 8 times less chances, respectively, to present symptoms. Higher antibody levels against MSP5 and EBA175 were associated by odds ratios of 9.4 (IC95% = 1.29-69.25) and 5.7 (IC95% = 1.12-29.62, logistic regression), respectively, with an asymptomatic status.

Conclusions

Merozoite antigens were targets of cytophilic antibodies and antibodies against MSP5, MSP9 and EBA175 were independently associated with decreased symptoms.
Maternal infection and risk of intrapartum death: a population based observational study in South Asia
Authors: Iwamoto Azusa , Seward Nadine , Prost Audrey , Ellis Matthew , Copas Andrew , Fottrell Edward , Azad Kishwar , Tripathy Prasanta , Costello Anthony
Published: December 2013

Background

Approximately 1.2 million stillbirths occur in the intrapartum period, and a further 717,000 annual neonatal deaths are caused by intrapartum events, most of which occur in resource poor settings. We aim to test the ‘double-hit’ hypothesis that maternal infection in the perinatal period predisposes to neurodevelopmental sequelae from an intrapartum asphyxia insult, increasing the likelihood of an early neonatal death compared with asphyxia alone. This is an observational study of singleton newborn infants with signs of intrapartum asphyxia that uses data from three previously conducted cluster randomized controlled trials taking place in rural Bangladesh and India.

Methods

From a population of 81,778 births in 54 community clusters in rural Bangladesh and India, we applied mixed effects logistic regression to data on 3890 singleton infants who had signs of intrapartum asphyxia, of whom 769 (20%) died in the early neonatal period. Poor infant condition at five minutes post-delivery was our proxy measure of intrapartum asphyxia. We had data for two markers of maternal infection: fever up to three days prior to labour, and prolonged rupture of membranes (PROM). Cause-specific verbal autopsy data were used to validate our findings using previously mentioned mixed effect logistic regression methods and the outcome of a neonatal death due to intrapartum asphyxia.

Results

Signs of maternal infection as indicated by PROM, combined with intrapartum asphyxia, increased the risk of an early neonatal death relative to intrapartum asphyxia alone (adjusted odds ratio (AOR) 1.28, 95% CI 1.03 – 1.59). Results from cause-specific verbal autopsy data verified our findings where there was a significantly increased odds of a early neonatal death due to intrapartum asphyxia in newborns exposed to both PROM and intrapartum asphyxia (AOR: 1.52, 95% CI 1.15 – 2.02).

Conclusions

Our data support the double-hit hypothesis for signs of maternal infection as indicated by PROM. Interventions for pregnant women with signs of infection, to prevent early neonatal deaths and disability due to asphyxia, should be investigated further in resource-poor populations where the chances of maternal infection are high.