bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe Sepsis and its Impact on Outcome in Elderly and Very Elderly Patients Admitted in Intensive Care Unit
Authors: Nasa Prashant , Juneja Deven , Singh Omender , Dang Rohit , Arora Vikas
Published: March 2011

Received October 7, 2010, and in revised form November 10, 2010. Accepted for publication December 7, 2010. Background: Elderly patients comprise an increasing proportion of intensive care unit (ICU) admissions. Advanced age and multiple comorbidities compromise their immunity and hence they may be more prone to succumbing to severe infection and have poorer outcome. We undertook this study to review impact of severe sepsis on mortality in the elderly patients. Methods: All patients admitted to a medical ICU of a tertiary care institute with severe sepsis or septic shock were prospectively included. Patients were divided into young (age below 60 years), old (age between 60 and 80 years), and very old (age above 80 years) groups. Data regarding baseline patient characteristics, admission APACHE II score, and ICU course including need for organ support and ICU length of stay were noted. Categorical data were analyzed using χ 2 or Fisher Exact test as appropriate and continuous data were analyzed using Student t test. Primary outcome measure was the ICU mortality. Results: Of 387 patients with sepsis, 132 patients who fulfilled the criteria for severe sepsis/septic shock were included in the analysis. The most common suspected site of infection was lungs (45.5%), followed by urinary tract (21.2%) and abdomen (16.7%). Intensive care unit mortality in younger patients was 45.6% as compared to 60.7% in old and 78.9% in very old patients ( P = .035). The relative risk (RR) for dying in the old age was 1.125 and RR for dying in the very old age group was 1.487 as compared to the young patients. There was an increased need for organ support in the elderly and very elderly population as compared to the younger population. On multivariate analysis, only age of the patient was found to be independently predicting ICU mortality ( P = .002, OR: 1.038, 95% CI: 1.014-1.062). Conclusions: The risk of dying from severe sepsis is considerably higher in the elderly and very elderly subgroup of patients with age as an independent risk factor for mortality. Hence, early aggressive care to recognize and manage severe sepsis is required to improve outcome.
Profile and Outcome of Patients With Liver Cirrhosis Requiring Mechanical Ventilation
Authors: Juneja Deven , Gopal Palepu B , Kapoor Dharmesh , Raya Ravichandra , Sathyanarayanan Mohan
Published: March 2011

Objective:

Few studies have addressed the outcome of patients with cirrhosis requiring mechanical ventilation (MV). We aimed to investigate the short-term outcome of such patients.

Methods:

Retrospective review of data of 73 consecutive patients with cirrhosis requiring MV over a 2-year period (2006-2008). Data on patient’s characteristics, reason for MV, the presence of other organ failure, and first day Acute Physiology Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA), Child-Pugh (CP), and Model for End-Stage Liver Disease (MELD) scores were collected, with 30-day mortality being the primary outcome measure.

Results:

Observed mortality in ICU and at 30 days was 75.3% and 87.7%, respectively. Area under curve was 0.77 (95% CI, 0.65-0.86) for APACHE II, 0.94 (95% CI, 0.85-0.98) for SOFA, 0.83 (95% CI, 0.7-0.96) for CP, and 0.93 (95% CI, 0.85-0.98) for MELD ( P = .096) in predicting 30-day mortality. By univariate analysis, indication for intubation ( P = .001), need for vasopressor support ( P = .002), the presence of renal failure ( P < .03), and duration of MV ( P < .001) were significantly associated with mortality. On multivariate analysis, only duration of MV (adjusted odds ratio 0.63, 95% CI: 0.42-0.95, P = .03) was the independent predictor of mortality with a majority of patients, 51/64 (79.7%), dying in the first 48 hours of intubation.

Conclusions:

Patients with cirrhosis requiring MV have a dismal prognosis. Such patients and their families should be informed about the overall outcome to assist their decisions about life support and intensive care, outside the transplant setting. Prognostic scores, especially SOFA and MELD, may aid in determining which patients may benefit from aggressive therapy.
Rhabdomyolysis in the Intensive Care Unit
Authors: Shapiro Mark L. , Baldea Anthony , Luchette Fred A.
Published: March 2011

Rhabdomyolysis is a clinical syndrome defined by muscle breakdown and subsequent release of intracellular contents. There are many etiologies of rhabdomyolysis, classified here as congenital and acquired; compartment syndrome secondary to trauma with reperfusion injury is one common precipitating factor. Regardless of the underlying etiology, the pathophysiology follows a similar pathway via myocyte destruction and release of myoglobin into the systemic circulation. Rhabdomyolysis-induced renal failure is caused by the precipitation of myoglobin in the renal tubules which is enhanced under acidic conditions. A high index of clinical suspicion is required to promptly recognize rhabdomyolysis, especially in the unconscious patient. Presenting symptoms include tea-colored urine and muscle weakness or fatigue. The diagnosis is confirmed most reliably with the finding of elevated serum creatine kinase levels. Early, aggressive resuscitation with either normal saline or lactated Ringer’s solution to maintain an adequate urine output is the most important intervention in preventing the development of acute renal failure. There is insufficient clinical evidence supporting the routine administration of diuretics and bicarbonate to protect against the development of acute renal failure.
The Pharmacology of Airway Management in Critical Care
Authors: Consilvio Christian , Kuschner Ware G. , Lighthall Geoffrey K.
Published: March 2011

This review provides an update on the pharmacology of airway management, emphasizing medications and management strategies widely used in an intensive care unit setting. Induction agents, muscle relaxants, opioids, sedative-hypnotics, and adjunctive agents are reviewed in the context of emergent airway management. Throughout this review, we emphasize the utility of considering a broad set of pharmacologic agents and approaches for airway management of the critically ill patient.
Intravenous Ibandronate Acutely Reduces Bone Hyperresorption in Chronic Critical Illness
Authors: Via Michael A. , Potenza Matthew V. , Hollander Jason , Liu Xuan , Peng Yuanzhen , Li Jianhua , Sun Li , Zaidi Mone , Mechanick Jeffrey I.
Published: March 2011

Objective:

Patients who remain critically ill for prolonged periods and require tracheotomy, defined as chronic critical illness (CCI), display elevated levels of bone resorption. The measurement of bone turnover markers reveals that osteoclastic bone resorption is not only enhanced but also uncoupled from osteoblastic bone formation. We examine the effect of ibandronate on bone turnover in patients with CCI.

Methods:

This study is a prospective, double-blind, placebo-controlled trial, in which 20 postmenopausal female participants with CCI were followed for an 11-day period after the administration of a single intravenous dose of ibandronate (3 mg). All participants were treated with ergocalciferol (2000 IU daily), calcium carbonate (1250 mg daily), and calcitriol (0.25 μg daily).

Results:

The ibandronate group showed a 34% decrease in serum C-telopeptide (CTX) levels (a marker of osteoclastic activity) on day 6, while the placebo group showed a 13% increase ( P = .01). By day 11, CTX levels in ibandronate group were not significantly different than baseline or from the placebo group. Osteocalcin (OCN) levels (a marker of osteoblast activity) increased by 78% compared to baseline in the ibandronate group ( P = .01) and by 42% in the placebo group ( P = .05). There were no significant differences in OCN between the 2 groups throughout the study. Parathyroid hormone levels remained constant throughout the study. No adverse events were observed.

Conclusion:

A single dose of intravenous ibandronate causes a significant but transient reduction in osteoclast activity in patients with CCI, which persists over a 6-day period.
Culture and Self-Determination: A Synthesis of the Literature and Directions for Future Research and Practice
Authors: Shogren Karrie A.
Published: March 2011

Self-determination has received significant attention in the special education field, but scholars’ knowledge of how culturally and linguistically diverse learners and their families perceive interventions to promote self-determination remains limited. Understanding how the construct is perceived in diverse cultures is critically important given the growing diversity of society. This article reviewed existing research and scholarship examining the relation between culture and self-determination in students with disabilities. In all, 10 theoretical, review, and research articles that specifically addressed this topic were identified. Generally, the body of scholarship suggests that the self-determination construct could have universal value if a flexible framework that considers cultural and systems-level variables is utilized to develop individualized interventions. Implications for future research and practice are discussed.
Critical Perspectives on Adolescent Vocational Guidance in Chile
Authors: McWhirter Ellen Hawley , McWhirter Benedict T.
Published: March 2011

In this article, the lens of critical psychology is applied to adolescent career development and vocational guidance in Chile. The authors describe and critique the status of adolescent vocational guidance in Chile, the reproduction of extant social inequities in Chilean education, and offer recommendations for enhancing vocational guidance practice, training, and research. The authors’ recommendations may be applicable to other contexts in which social disparities limit the vocational potential of significant groups in society.
Trajectories of Functional Change Among Long Stayers in Nursing Homes
Authors: Banaszak-Holl Jane , Liang Jersey , Quiñones Ana , Cigolle Christine , Lee I-Cha , Verbrugge Lois M.
Published: March 2011

Objectives: This study reports findings on functional change trajectories for long-stay residents by examining the effects of baseline medical conditions and functional status on changes in physical impairment across residents’ length of stay (LOS). Method: A 5% sample of nursing home residents from Michigan from 1999 through 2003 was used to create longitudinal episodes of care including Minimum Data Set (MDS) assessments. Data were analyzed using hierarchical linear models. Results: On average, physical impairment increases throughout a resident’s stay and is more rapid later in the stay. Greater physical and cognitive impairment at baseline leads to increasing impairment for residents whereas presence of baseline medical conditions, including heart disease and hip fracture, leads to slower rates of impairment. Discussion: Baseline functional status is critical to predicting changes in impairment while the impact of medical diagnoses is significant but weaker than the effect of baseline impairment.
Workplace bullying and the employment relationship
Authors: Beale David , Hoel Helge
Published: March 2011

Previous research strongly indicates that the perpetrators of workplace bullying in Britain are mainly managers. Contrary to the predominant view in workplace bullying literature and despite cost implications for employers, this article proposes an agenda for future empirical research focused on whether employers may also benefit significantly from bullying. It outlines a definition of workplace bullying, key debates and prescriptions suggested in previously published literature for management to contest and prevent it. When bullying is perceived in terms of managerial control of labour and the core concepts of the labour process – an approach not previously embraced in the established psychological and social psychological analyses of the issue – bullying is better understood as an endemic feature of the capitalist employment relationship. Existing secondary material and future research possibilities are then explored and discussed, with some conclusions that are aimed to take the research in this field in new directions.
Young people’s aspirations for education, work, family and leisure
Authors: McDonald Paula , Pini Barbara , Bailey Janis , Price Robin
Published: March 2011

Young people are arguably facing more ‘complex and contested’ transitions to adulthood and an increasing array of ‘non-linear’ paths. Education and training have been extended, identity is increasingly shaped through leisure and consumerism and youth must navigate their life trajectories in highly individualised ways. The study utilises 819 short essays compiled by students aged 14–16 years from 19 schools in Australia. It examines how young people understand their own unique positions and the possibilities open to them through their aspirations and future orientations to employment and family life. These young people do not anticipate postponing work identities, but rather embrace post-school options such as gaining qualifications, work experience and achieving financial security. Boys expected a distant involvement in family life secondary to participation in paid work. In contrast, around half the girls simultaneously expected a future involving primary care-giving and an autonomous, independent career, suggesting attempts to remake gendered inequalities.
Under the clean surface
Authors: Lundberg Helena , Karlsson Jan Ch.
Published: March 2011

This is a reflexive ethnographic study of cleaners at a Finnish hotel. There were grounds in the cleaners’ working conditions for resistance and organisational misbehaviour to arise, but almost no collective actions or protests were performed. The needed common identity and problem definition was lacking because of two important impediments: each hotel cleaner had to perform her work alone and there were few other opportunities to meet and discuss conditions; and they were divided into ethnic cliques with close to no communication between them. Instead resistance took individual forms, such as fiddling with cleaning standards and thefts.
The importance of pleasure reading in the lives of young teens: Self-identification, self-construction and self-awareness
Authors: Howard Vivian
Published: March 2011

This paper reports on a research study investigating the role of pleasure reading in the lives of 12—15 year old residents of an eastern Canadian regional municipality. Pleasure reading was found to fulfil three broad functions: it enhanced academic performance, social engagement and personal development. In conclusion, the study confirms that teens, like adults, unconsciously use pleasure reading as a means of everyday life information seeking and the reasons for personal salience identified in the foregoing discussion have a strong developmental theme: in their pleasure reading, teens gain significant insights into mature relationships, personal values, cultural identity, physical safety and security, aesthetic preferences, and understanding of the physical world, all of which aid teen readers in the transition from childhood to adulthood.
High-sensitivity C-reactive protein and erythrocyte sedimentation rate in systemic lupus erythematosus
Authors: Firooz N , Albert DA , Wallace DJ , Ishimori M , Berel D , Weisman MH
Published: March 2011

Levels of C-reactive protein (CRP) have been shown to rise in acute illnesses such as infections and some autoimmune diseases, but not in flares of systemic lupus erythematosus (SLE). Our goal was to investigate the high-sensitivity CRP (hsCRP) response to infection versus disease flare in patients with SLE, and to compare this with the erythrocyte sedimentation rate (ESR) response in these patients. We aimed to determine the hsCRP level that distinguishes between infection and flare in SLE, and investigated the correlation between hsCRP and organ involvement in SLE. We reviewed electronic medical records of all patients with SLE admitted to Cedars Sinai Medical Center between 28 August 2001 and 27 April 2008. Patients were divided into three groups based on the reason for hospitalization: 1) lupus flare; 2) active infection; and 3) both lupus flare and active infection. Data were collected on patient demographics, medication use, microbial culture results, organ involvement in lupus flare, ESR and CRP levels. Data were collected on 85 eligible patients, of whom 54 had a lupus flare, 22 had active infection and eight had both. While the ESR levels did not differ significantly between patients with disease flare and active infection, the hsCRP level was significantly lower in the lupus flare group than in the infection group. Most patients in the lupus flare group who had a significantly high hsCRP level had serositis. We found that at a cut-off of above 5 mg/dl, hsCRP level was correlated with infection with a specificity of 80%. At a cut-off of above 6 mg/dl, hsCRP correlated with infection with a specificity of 84%. hsCRP level was found to be significantly higher in patients with pulmonary involvement than without. hsCRP levels are significantly lower in SLE patients with disease flare than in those with active infection. Elevated hsCRP levels can be used as a predictor of active infection in SLE patients with a high specificity. We review the relationship between IL-6 and hsCRP production in lupus patients.
IgM, but not IgA rheumatoid factor interferes with anti-cardiolipin and anti-β2 glycoprotein I measurements: a quantitative analysis
Authors: Lakos G , Teodorescu M
Published: March 2011

IgM rheumatoid factor (RF) is sometimes referred to as capable of causing interference in the IgM anti-cardiolipin (aCL) testing. Published guidelines are, however, inconsistent, and evidence regarding the interference is limited. Our goal was investigate IgM and IgA RF cross-reactivity and/or interference in IgM and IgA aCL and anti-β2 glycoprotein I (aβ2GPI) testing. Serum specimens with high IgM and IgA RF levels were tested for IgG, IgA and IgM aCL and aβ2GPI antibodies to examine cross-reactivity. Samples containing IgG aCL and aβ2GPI antibodies were spiked with IgM (and IgA) RF, and samples with high RF levels were spiked with IgG aCL antibodies. The mixtures were tested for IgM and IgA aCL and aβ2GPI antibodies. Specimens with high IgM and IgA RF concentrations did not test positive for IgM or IgA aCL and aβ2GPI antibodies (except one weak positive IgA aβ2GPI result), indicating the lack of cross-reactivity. In the spiked specimens, addition of IgM RF caused significant positive bias in the measurement of both aCL and aβ2GPI antibodies of IgM isotype in the presence of IgG aCL and aβ2GPI antibodies. The threshold for triggering significant interference was 318 IU/ml for IgM RF, and 77 GPLU/ml for IgG aCL. Neither IgM, nor IgA RF, however, affected the IgA antiphospholipid (aPL) antibody testing. IgM RF can cause a false-positive IgM aCL result in the presence of IgG aCL antibodies. In studies on the prevalence and clinical significance of IgM aPL antibodies, RF interference should be considered and RF testing should be performed.
Thyroid disease in pregnant women with systemic lupus erythematosus: increased preterm delivery
Authors: Stagnaro-Green A , Akhter E , Yim C , Davies Terry F , Magder LS , Petri M
Published: March 2011

Thyroid disease is common in pregnancy and is associated with miscarriage, preterm delivery and postpartum thyroiditis (PPT). Systemic lupus erythematosus (SLE) is associated with miscarriage and preterm delivery. The hypotheses of the study are (1) pregnant women with SLE will have a high prevalence of undiagnosed hypothyroidism and a high prevalence of PPT, and (2) women with SLE and thyroid disease will have an increased incidence of adverse pregnancy outcomes as compared with pregnant women with SLE who do not have thyroid disease. This was a retrospective study of the Hopkins Lupus Cohort. All women had thyroid-stimulating hormone and thyroid antibodies assayed on frozen sera. In total, 63 pregnant women who met the ACR classification for SLE were evaluated. Outcome measures were the prevalence of thyroid disease during pregnancy and postpartum, and pregnancy outcomes. Some 13% of the women were on thyroid hormone prior to becoming pregnant, 11% were diagnosed with hypothyroidism during pregnancy, and 14% developed PPT. The prevalence of preterm delivery was 67% in women with thyroid disease and 18% in women who were thyroid disease free ( p = 0.002). The presence of thyroid antibodies was not correlated with preterm delivery. Pregnant women with SLE have an increased prevalence of thyroid disease. Women with SLE and thyroid disease have an increased prevalence of preterm delivery.
Bayesian sample size calculation for estimation of the difference between two binomial proportions
Authors: Pezeshk Hamid , Nematollahi Nader , Maroufy Vahed , Marriott Paul , Gittins John
Published: March 2011

In this study, we discuss a decision theoretic or fully Bayesian approach to the sample size question in clinical trials with binary responses. Data are assumed to come from two binomial distributions. A Dirichlet distribution is assumed to describe prior knowledge of the two success probabilities p1 and p2. The parameter of interest is p =  p1 −  p2. The optimal size of the trial is obtained by maximising the expected net benefit function. The methodology presented in this article extends previous work by the assumption of dependent prior distributions for p1 and p2.
Performance Appraisal Challenges at Sui National Gas Pipelines Ltd (SNGPL)
Authors: Alvi Sara , Qureshi Zafar Iqbal
Published: March 2011

The case describes the multifarious challenges confronted by the management of SNGPL. First, the Senior General Manager, HR, has to identify the main objectives that the management would like to realize through its performance appraisal system (PAS). Second, SGM, HR, also needs to recommend the main features of a robust PAS. Third, what changes need to be made in the current appraisal form to make it user friendly. Fourth, should the company shift from its current absolute appraisal system to a relative grading system? If so, would a relative grading system help in discriminating between the ‘solid’ and ‘not-so-solid’ performers? Lastly, would the problem of strictness versus leniency be resolved through the adoption of relative grading system?
Telangana
Authors: Bhaskaran P. Bala
Published: March 2011

The case is set around the dilemma that the Government of India faced in the early weeks of 2010, that is, whether to create the new state of Telangana or not. It traces the history and evolution of state reorganization in India from independence to the year 2000. With this as background, the case examines the desirability or otherwise of the demand for newer and smaller states. The case offers an opportunity to examine the problems and prospects of articulating the aspirations of people towards development and effective governance. It explores the critical factors to be considered in designing the governance and administrative structures in a democratic polity, and also explores the contours of managing in situations of abundant diversity.
Wizards, Muggles and Economic Exploitation
Authors: Husain Zakir
Published: March 2011

The huge popularity of the Harry Potter novels has surprised many. The series initially won considerable critical acclaim. Over time, the adulation is somewhat tempered, and reviewers have turned to more critical examination of class, racism, gender and similar elements in the series. In this article, we reevaluate the relations between Wizards and Muggles, and show that this relation can be interpreted in terms of the dependency literature prevalent in development studies to explain the relation between developed and developing countries. This article will focus on three principles of dependency relations that are present in the novels of Rowling: ( a) flow of agricultural goods from the periphery to the centre; ( b) flow of skilled labour from the periphery to the centre; and ( c) prevalence of a ‘we–they’ relation between the centre and the periphery. It is argued that the economy and society of the Wizards sustains itself based on a neo-colonial mode of exploitation, operating through these channels.
Examining the Relationship of Organizational Communication and Job Satisfaction in Indian Organizations
Authors: Kumar B. Pavan , Giri Vijai N.
Published: March 2011

This article investigates the relationship between organizational communication and job satisfaction. Data were collected from 380 employees at junior, middle and top level management from various telecom and banking sectors. Results reveal that there is a significant correlation between organizational communication and job satisfaction. It was observed that trust and communication satisfaction predicted significantly pay, promotion, supervision and fringe benefits. Job satisfaction differed significantly across hierarchy. However, organizational communication did not differ across hierarchy. Thus, it can be implicated that there are some aspects of communication like trust and communication satisfaction that can be given more priority in order to get high levels of job satisfaction in Indian organizations.
Quality Evaluation of Banana Skin Extract Jellies
Authors: Borges S.V. , Valente W.A. , Figueiredo L.P. , Dias M.V. , Pereira P.P. , Pereira A.G.T. , Clemente P.R.
Published: March 2011

Due to the great volume of banana skin resulting from the industrialization of banana and to their high pectin content, the objectives of the present study were to evaluate the effect of the following factors: extract/sugar, pectin and citric acid on the chemical, physical and sensory qualities of the jellies obtained. A complete factorial experimental design was used (23) with 3 central points to evaluate the influence of the factors on the dependent variables, testing the linear models. The chemical properties underwent few alterations and the instrumental and sensory texture attributes were mainly affected by the extract/sugar ratio and the pectin level. The brittleness, elasticity and gumminess increased with increases in the extract/ sugar ratio and pectin level. According to the sensory analysis and the purchasing intention, the best formulations were those obtained using a higher extract/sugar ratio (60/40) and lower pectin level (0.5 g/ 100), combined with the highest (20 mL) or lowest volumes of citric acid (15 mL), with scores for all the attributes in the range from ‘I liked slightly’ to ‘I liked moderately’.
Effect of Packaging Conditions on the Shelf-life of Chicken Frankfurters With and Without Lactate Addition
Authors: Tovunac I. , Galić K. , Prpić T. , Jurić S.
Published: March 2011

Shelf-life of frankfurters depends on various factors such as its composition, packaging material and method used as well as the effect of external conditions (temperature). The objective of this study was to determine the shelf-life of packaged (vacuum, shrink and modified atmosphere, MA) chicken frankfurters during storage at different temperatures. For this purpose regular and with sodium lactate addition chicken frankfurters were produced. For MA packaging (MAP), under gas mixture of 70% N2 and 30% CO2, a package consisting of container and heat sealable cover was used. Different laminate composition was used for vacuum and shrink packaging of frankfurters. During frankfurters storage physico-chemical (pH, aw), and microbiological (aerobic mesophiles, lactic acid bacteria and total bacterial count) analyses were performed. Packaging materials were analyzed for their barrier characteristic (oxygen permeability). The shelf-life of frankfurters can be extended if packaged in MA (54 days) and shrink (45 days) packaging compared to 36 days of shelf-life in vacuum packaging, at 3 °C. Higher shelf-life is obtained for frankfurters with lactate addition, in all packaging conditions, stored at 6 °C.
Increased peripheral blood CD5+ B cells predict earlier conversion to MS in high-risk clinically isolated syndromes
Authors: Villar Luisa M , Espiño Mercedes , Roldán Ernesto , Marín Nieves , Costa-Frossard Lucienne , Muriel Alfonso , Álvarez-Cermeño José C
Published: March 2011

Clinically isolated syndrome patients (CIS) with oligoclonal IgG bands (OCGB) are at high risk for clinically definite multiple sclerosis (MS). However, the outcome for individual patients is unpredictable and the search for reliable blood markers predicting early conversion to multiple sclerosis (MS) has clinical relevance. CD5+ B cells (CD5+Bc) are involved in some autoimmune diseases. This study investigated whether high blood CD5+Bc percentage can predict CIS conversion to MS. Fifty-five consecutive CIS showing OCGB were prospectively studied. Every patient underwent a brain MRI study and a flow cytometry analysis of CD5+Bc percentage. Conversion to MS was studied during follow-up. The CD5+Bc percentage was assessed in 40 controls and a cut-off value of 3.5% (mean + 2 SD) was calculated. A blood CD5+Bc percentage above this value predicted earlier conversion to MS in the whole group (hazard ratio [HR]: 3.40; 95% confidence interval [CI]: 1.69–6.68; p = 0.0005) and in CIS patients fulfilling three or more Barkhof–Tintoré criteria plus OCGB, who showed higher risk for MS (HR: 3.79; 95% CI: 1.86–15.32; p = 0.0018). Multivariate analysis also showed a predictive value for high blood CD5+Bc count (HR: 4.3; 95% CI: 1.9–9.5; p < 0.0001). It was concluded that high percentages of CD5+Bc independently associate with increased risk of early conversion to MS in CIS patients with OCGB and Barkhof–Tintoré criteria.
When and why does extended contact work?
Authors: Cameron Lindsey , Rutland Adam , Hossain Rosa , Petley Rebecca
Published: March 2011

This research examines quasi-experimentally for the first time whether direct contact moderates the extended contact effect amongst children, and whether the extended contact effect is mediated by either in-group or out-group norms about cross-ethnic friendships. We tested two forms of extended contact (Dual identity and Common in-group identity) among ethnic majority children aged 6–11 years (white–English, n = 153) with differing levels of high quality (i.e., cross-ethnic friendships) or low quality (i.e., acquaintances) direct contact with the Indian–English out-group. As expected, the extended contact effect was demonstrated only amongst children who reported less high quality direct contact. Furthermore, we found the effect of extended contact was mediated by out-group norms. We also found evidence of moderated mediation, with the indirect effect of extended contact through in-group norms being significantly stronger amongst older children. The implications for extended contact theory and the future development of prejudice-reduction interventions amongst children are discussed.
Improving intergroup relations through direct, extended and other forms of indirect contact
Authors: Dovidio John F. , Eller Anja , Hewstone Miles
Published: March 2011

The benefits of direct, personal contact with members of another group are well established empirically. This Special Issue complements that body of work by demonstrating the effects of various forms of indirect contact on intergroup attitudes and relations. Indirect contact includes (a) extended contact: learning that an ingroup member is friends with an outgroup member, (b) vicarious contact: observing an ingroup member interact with an outgroup member, and (c) imagined contact: imagining oneself interacting with an outgroup member. The effects of indirect contact not only occur independently of direct contact, they often involve distinct psychological mechanisms. The present article briefly reviews work on direct intergroup contact and then discusses recent theoretical and empirical developments in the study of extended contact, vicarious contact, and imagined contact. We consider the similarities and distinctions in the dynamics of these forms of indirect contact and conclude by identifying promising directions for future research.
Attributional processes underlying imagined contact effects
Authors: Crisp Richard J. , Husnu Shenel
Published: March 2011

Recent research has demonstrated that mentally simulating positive intergroup encounters can promote tolerance and more positive intergroup attitudes. We explored the attributional processes underlying these effects. In our study participants who imagined intergroup contact subsequently reported greater intentions to engage in future contact, a relationship that was mediated by participants’ attribution, to themselves, of a more positive attitudinal orientation towards outgroup contact. Consistent with this attributional account, the perspective taken when imagining the encounter qualified this effect. Participants who imagined the encounter from a third-person perspective reported heightened intentions to engage in future contact relative to control participants, while this was not the case when the encounter was imagined from a first-person perspective. These findings suggest that attributional processes are key to observing the benefits that accrue from imagining intergroup contact. We speculate that these attributions may distinguish the approach from extended and actual forms of contact and help researchers to further capitalize on the benefits of mental imagery for improving intergroup relations.
When extended contact opens the door to future contact
Authors: Gómez Angel , Tropp Linda R. , Fernández Saulo
Published: March 2011

The present research tests whether extended contact can predict positive intergroup expectancies, as well as positive intergroup attitudes, among majority and minority group members. Our results replicate and extend prior work by showing that extended contact predicts both positive intergroup attitudes and intergroup expectancies among both majority (Spanish) and minority (immigrant) participants, even when controlling for direct friendship and the quantity and quality of prior intergroup contact. These effects are partially mediated by intergroup anxiety, perceived ingroup norms, and perceived outgroup norms, and the positive effects of extended contact on intergroup attitudes were also partially mediated by the inclusion of ingroup in the self. Additionally, the mediating role of outgroup norms was stronger among immigrant participants than among Spanish participants. Implications of these findings and the value of extended contact for promoting positive intergroup expectancies and preparing people for future contact are discussed.
Two degrees of separation
Authors: Eller Anja , Abrams Dominic , Zimmermann Anja
Published: March 2011

Extended contact theory proposes that knowledge of ingroup-outgroup friendships leads to reductions of intergroup bias by reducing ignorance about the outgroup and intergroup anxiety, and by increasing awareness of positive outgroup exemplars (e.g., observation of friendly behavior towards an ingroup member), and inclusion of other in the self. Over a one-year period we examined extended contact among home country friends of international students who had direct contact with British people through their study period in Britain. This provides a stringent test of extended contact theory, both due to the longitudinal design, and the inclusion of both actual and perceived naturally arising extended contact. As predicted by extended contact theory, increases in extended contact over time predicted all variables but intergroup anxiety. There was also some evidence for (weaker) reversed causal influence between prejudice and other variables. Importantly, the quality of contact experienced by the direct contact sample (international students) predicted all dependent measures in the matched extended contact sample in their home countries. Results are discussed in terms of the promise of extended contact theory for intergroup relations.
Direct contact and authoritarianism as moderators between extended contact and reduced prejudice
Authors: Dhont Kristof , Van Hiel Alain
Published: March 2011

Using a representative sample of Dutch adults ( N = 1238), we investigated the moderating influence of direct contact and authoritarianism on the potential of extended contact to reduce prejudice. As expected, direct contact and authoritarianism moderated the effect of extended contact on prejudice. Moreover, the third-order moderation effect was also significant, revealing that extended contact has the strongest effect among high authoritarians with low levels of direct contact. We identified trust and perceived threat as the mediating processes underlying these moderation effects. The present study thus attests to the theoretical and practical relevance of reducing prejudice via extended contact. The discussion focuses on the role of extended contact in relation to direct contact and authoritarianism as well as on the importance of trust in intergroup contexts.
Internet and social support among Chinese migrants in Singapore
Authors: Chen Wenli , Choi Alfred Siu Kay
Published: March 2011

With the mounting importance of the internet for interpersonal communication and increasing migration brought about by globalization, it is timely to examine computer-mediated social support (CMSS) among international migrants. A survey was conducted among a random sample of 710 Chinese migrants in Singapore, to measure the extent the migrants participate in CMSS and to identify factors that affect their CMSS-seeking behavior. This study found that CMSS has become an efficient and valuable supplement to the migrants’ traditional/offline social support and that the migrants actively seek CMSS, especially in the early migration stage. Factors affecting CMSS-seeking behavior include length of migration, availability of traditional social support, and level of satisfaction resulting from the CMSS seeking experience. This study took the Uses and Gratifications theory from a different angle to look into the relationship between the level of satisfaction on the CMSS received and the possible continued seeking of CMSS.
Practice-ing behaviour change: Applying social practice theory to pro-environmental behaviour change
Authors: Hargreaves Tom
Published: March 2011

This article applies the insights of social practice theory to the study of proenvironmental behaviour change through an ethnographic case study (nine months of participant observation and 38 semi-structured interviews) of a behaviour change initiative — Environment Champions — that occurred in a workplace. In contrast to conventional, individualistic and rationalist approaches to behaviour change, social practice theory de-centres individuals from analyses, and turns attention instead towards the social and collective organization of practices — broad cultural entities that shape individuals’ perceptions, interpretations and actions within the world. By considering the planning and delivery of the Environment Champions initiative, the article suggests that practice theory provides a more holistic and grounded perspective on behaviour change processes as they occur in situ. In so doing, it offers up a wide range of mundane footholds for behavioural change, over and above individuals’ attitudes or values. At the same time, it reveals the profound difficulties encountered in attempts to challenge and change practices, difficulties that extend far beyond the removal of contextual ‘barriers’ to change and instead implicate the organization of normal everyday life. The article concludes by considering the benefits and shortcomings of a practice-based approach emphasizing a need for it to develop a greater understanding of the role of social interactions and power relations in the grounded performance of practices.
Relative kidney hyperfiltration in primary aldosteronism: a meta-analysis
Authors: Kuo Chin-Chi , Wu Vin-Cent , Tsai Ching-Wei , Wu Kwan-Dun ,   The Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group)
Published: March 2011

Introduction: Since the phenomenon of hyperfiltration in primary aldosteronism (PA) was first noted in 1996, subsequent clinical studies have produced conflicting results. To determine the development of relative hyperfiltration in PA, we performed a meta-analysis.

Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched through to July 2009. Reference sections of original articles, meta-analyses, and reviews on hyperfiltration in PA were reviewed. Hypertensive patients provided the controlled data for hyperfiltration. Two authors independently extracted the data.

Results: A total of seven studies were included. One study was from the data of the TAIPAI group. Overall, there was strong evidence that relative kidney hyperfiltration existed in PA (fixed-effects model: standardised mean difference (SMD), 0.13; 95% confidence interval (CI), 0.03—0.22, p = 0.007; random-effects model: SMD, 0.35; 95% CI, -0.01—0.71, p = 0.05), though with a significant heterogeneity ( p < 0.0001). In the secondary meta-analysis with five top-quality studies, the relative kidney hyperfiltration was more significant. Mean age in each enrolled study was the only factor significantly associated with the existence of heterogeneity among the selected studies in the meta-regression analysis.

Conclusions: Current evidence suggests that relative kidney hyperfiltration is the hallmark in PA and the phenomenon is beyond the effect of hypertension of PA. Clinicians should be aware of the possibility of occult renal damage in patients with PA.
Polymorphisms of the angiotensin-converting enzyme and angiotensinogen gene in patients with atrial fibrillation
Authors: Topal Nurdan Papila , Ozben Beste , Hancer Veysel Sabri , Tanrikulu Azra Meryem , Diz-Kucukkaya Reyhan , Fak Ali Serdar , Basaran Yelda , Yesildag Osman
Published: March 2011

Activation of the renin–angiotensin system (RAS) is associated with atrial fibrillation (AF). The aim of this study was to investigate the relation between AF and polymorphisms in RAS. One hundred and fifty patients with AF, 100 patients with no documented episode of AF and 100 healthy subjects were consecutively recruited into the study. The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism, and the M235T, A-20C, and G-6A polymorphisms of the angiotensinogen gene were genotyped. Patients with AF had significantly lower frequency of II genotype of ACE I/D and higher frequency of angiotensinogen M235T polymorphism T allele and TT genotype and G-6A polymorphism G allele and GG genotype compared with the controls. AF patients had significantly larger left atrium, higher left ventricular mass index (LVMI) and higher frequency of significant valvular pathology. ACE I/D polymorphism II genotype, angiotensinogen M235T polymorphism TT genotype and G allele and GG genotype of angiotensinogen G-6A polymorphism were still independently associated with AF when adjusted for left atrium, LVMI and presence of significant valvular pathology. Genetic predisposition might be underlying the prevalence of acquired AF. Patients with a specific genetic variation in the RAS genes may be more liable to develop AF.
Association of oxidative stress markers and C-reactive protein with multidimensional indexes in COPD
Authors: Folchini F. , Nonato NL , Feofiloff E. , D'Almeida V. , Nascimento O. , Jardim JR
Published: March 2011

To evaluate the oxidative stress and the C-reactive protein (CRP) in chronic obstructive pulmonary disease (COPD) patients and their correlation between the severity of the disease according to GOLD criteria and multidimensional indexes such as BODE index. A blood sample was collected for thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase, glutathione (GSH), homocysteine (HCY) and CRP analysis from 45 stable COPD patients. Lung function, body nutritional status, dyspnea and 6-min walk test (6MWT) were evaluated. Patients with GOLD stage IV presented a higher value for the TBARS than stage I patients (4.47 + 1.58 versus 2.27 + 1.04 nmol/mL, p < 0.05). CRP was higher for GOLD IV (2.46 + 3.68 mg/dL) than other stages (GOLD I: 0.39 + 0.25, GOLD II: 0.39 + 0.18 and GOLD III: 0.48 + 0.36 mg/dL, p < 0.05). Oxidative stress markers measured as TBARS presented a negative correlation between forced expiratory volume in the first second (FEV1) post bronchodilatador (% predicted; r = -0.39, p = 0.01) and positive correlations with Modified Medical Research Council Scale (MMRC) dyspnea index (r = 0.40, p = 0.01), multidimensional index (r = 0.49, p = 0.001) and BODE index (r = 0.51, p = 0.001).
Comparison of the Timed 25-Foot and the 100-Meter Walk as Performance Measures in Multiple Sclerosis
Authors: Phan-Ba Rémy , Pace Amy , Calay Philippe , Grodent Patrick , Douchamps Frédéric , Hyde Robert , Hotermans Christophe , Delvaux Valérie , Hansen Isabelle , Moonen Gustave , Belachew Shibeshih
Published: March 2011

Background. Ambulation impairment is a major component of physical disability in multiple sclerosis (MS) and a major target of rehabilitation programs. Outcome measures commonly used to evaluate walking capacities suffer from several limitations. Objectives. To define and validate a new test that would overcome the limitations of current gait evaluations in MS and ultimately better correlate with the maximum walking distance (MWD). Methods. The authors developed the Timed 100-Meter Walk Test (T100MW), which was compared with the Timed 25-Foot Walk Test (T25FW). For the T100MW, the subject is invited to walk 100 m as fast as he/she can. In MS patients and healthy control volunteers, the authors measured the test–retest and interrater intraclass correlation coefficient. Spearman rank correlations were obtained between the T25FW, the T100MW, the Expanded Disability Status Scale (EDSS), and the MWD. The coefficient of variation, Bland–Altman plots, the coefficient of determination, and the area under the receiver operator characteristic curve were measured. The mean walking speed (MWS) was compared between the 2 tests. Results. A total of 141 MS patients and 104 healthy control volunteers were assessed. Minor differences favoring the T100MW over the T25FW were observed. Interestingly, the authors demonstrated a paradoxically higher MWS on a long (T100MW) rather than on a short distance walk test (T25FW). Conclusion. The T25FW and T100MW displayed subtle differences of reproducibility, variability, and correlation with MWD favoring the T100MW. The maximum walking speed of MS patients may be poorly estimated by the T25FW since MS patients were shown to walk faster over a longer distance.