bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of congenital heart defects on language development in toddlers with Down syndrome
Authors: Visootsak J. , Hess B. , Bakeman R. , Adamson L. B.
Published: September 2012

Background

Down syndrome (DS, OMIM #190685) is the most commonly identified genetic form of intellectual disability with congenital heart defect (CHD) occurring in 50% of cases. With advances in surgical techniques and an increasing lifespan, this has necessitated a greater understanding of the neurodevelopmental consequences of CHDs. Herein, we explore the impact of CHD on language development in children with DS.

Methods

Twenty‐nine children with DS were observed systematically in parent–child interactions using the Communication Play Protocol to evaluate their language use; they also completed the Mullen Scales of Early Learning and MacArthur Communication Development Inventory. Mean ages were 31.2 months for children with DS and CHD (DS + CHD, n = 12) and 32.1 months for children with DS and a structurally normal heart (DS − CHD, n = 17).

Results

Compared with the DS − CHD controls, the DS + CHD group revealed lower scores in multiple areas, including fine motor skills and expressive and receptive vocabulary. Whereas most differences were not statistically significant, the Communication Development Inventory word count and symbol‐infused joint engagement differed significantly (P < 0.01) and marginally (P = 0.09) between groups.

Conclusions

Finding that CHDs may account for part of the variation in language delay allows us to consider the specific mechanisms underlying the impact of CHDs on language acquisition in children with DS. Conclusions from this first study on early language outcomes of children with DS + CHD may be useful for clinicians in providing developmental surveillance and early intervention programmes with specific emphasis on language therapy as part of long‐term follow‐up for children with DS + CHD.
Caregiving of children with intellectual disabilities in China – an examination of affiliate stigma and the cultural thesis
Authors: Chiu M. Y. L. , Yang X. , Wong F. H. T. , Li J. H. , Li J.
Published: September 2012

Background

While caregivers of children with intellectual disabilities are burdened in every part of the world, it is suspected that particular contexts may make the situation worse. There is little literature on caregivers in China, where familial and clan responsibility rather than individual effort is emphasised, and where communal support, while treasured, is often lacking.

Method

A total of 211 caregivers in two cities, one with and the other without randomised design, participated in a survey study that assessed affiliated stigma, loss of face, anxiety, mental health and empowerment.

Results

A proportion of 60.6% of participants were found to be conspicuous cases with mental disturbance of a level which required further professional attention. Participants with better resource appeared to have coped better, enjoying lower psychological distress, lower anxiety and a higher level of personal empowerment. Multiple regression analysis revealed that mental health is related to the affective dimension of affiliated stigma, loss of face and anxiety level. This was found to account for more than half the variance (55%).

Discussion

The subjective burden of care occurs not in isolation but in a cultural field. Chinese caregiving is characterised by a lack of formal support, and such cultural concerns as loss of face and strong affiliated stigma. This socio‐political context makes caregiving all the more challenging. The situation has to be addressed by both practitioners and policy makers if family caregiving is to be valued and made sustainable.
Quantitative 3D evaluation of step ascent and descent in individuals with Down syndrome – analysis of a daily challenging task
Authors: Galli M. , Cimolin V. , Ferrario D. , Patti P. , Heaney G. , Freedland R. , Albertini G. , Brown W. T.
Published: September 2012

Background

Step ascent and descent can perturb stability increasing the incidence of falls, especially in older individuals with functional limitations and intellectual disabilities, such as those with Down syndrome (DS). The aim of this study was to investigate the biomechanics and motor coordination of step ascent and descent in adults with DS and compare them with a group of healthy individuals, considering movement kinematics and kinetics.

Method

Fourteen adults with DS and 12 similarly aged adults without DS who were free of known motor problems were quantitatively assessed during ascending and descending a step using an optoelectronic system (BTS SMART‐D), force platforms and video recording. Kinematic and kinetic parameters were identified and calculated for each study participant and comparisons were made between the DS and a control group (CG).

Results

Despite similar age ranges, subjects in the DS group performed the step ascent and descent movements slower, with longer duration and with a more accentuated range of motion of the trunk and of the ankle joint than those in the CG. Additionally, the double stance phase on the step was substantially longer in the DS group when represented as a percentage of the entire stepping sequence (ascent, double stance on the step and descent). In terms of kinetics, ground force platform data revealed that the DS subjects showed higher instability in the medio‐lateral direction during double support phase than similarly aged CG subjects and cannot be attributed to age‐associated changes in stability.

Conclusions

These findings help to elucidate the complex biomechanical strategy of people with DS during a step ascent and descent movement task and may have a major role in the multidimensional evaluation and tailored management for them.
Recommendations for utilizing and reporting population genetic analyses: the reproducibility of genetic clustering using the program structure
Authors: Gilbert Kimberly J. , Andrew Rose L. , Bock Dan G. , Franklin Michelle T. , Kane Nolan C. , Moore Jean‐Sébastien , Moyers Brook T. , Renaut Sébastien , Rennison Diana J. , Veen Thor , Vines Timothy H.
Published: September 2012

Reproducibility is the benchmark for results and conclusions drawn from scientific studies, but systematic studies on the reproducibility of scientific results are surprisingly rare. Moreover, many modern statistical methods make use of ‘random walk’ model fitting procedures, and these are inherently stochastic in their output. Does the combination of these statistical procedures and current standards of data archiving and method reporting permit the reproduction of the authors' results? To test this, we reanalysed data sets gathered from papers using the software package structure to identify genetically similar clusters of individuals. We find that reproducing structure results can be difficult despite the straightforward requirements of the program. Our results indicate that 30% of analyses were unable to reproduce the same number of population clusters. To improve this, we make recommendations for future use of the software and for reporting structure analyses and results in published works.
Detecting genes for variation in parasite burden and immunological traits in a wild population: testing the candidate gene approach
Authors: Brown E. A. , Pilkington J. G. , Nussey D. H. , Watt K. A. , Hayward A. D. , Tucker R. , Graham A. L. , Paterson S. , Beraldi D. , Pemberton J. M. , Slate J.
Published: September 2012

Identifying the genes underlying phenotypic variation in natural populations can provide novel insight into the evolutionary process. The candidate gene approach has been applied to studies of a number of traits in various species, in an attempt to elucidate their genetic basis. Here, we test the application of the candidate gene approach to identify the loci involved in variation in gastrointestinal parasite burden, a complex trait likely to be controlled by many loci, in a wild population of Soay sheep. A comprehensive literature review, Gene Ontology databases, and comparative genomics resources between cattle and sheep were used to generate a list of candidate genes. In a pilot study, these candidates, along with 50 random genes, were then sequenced in two pools of Soay sheep; one with low gastrointestinal nematode burden and the other high, using a NimbleGen sequence capture experiment. Further candidates were identified from single nucleotide polymorphisms (SNPs) that were highly differentiated between high‐ and low‐resistance sheep breeds. A panel of 192 candidate and control SNPs were then typed in 960 individual Soay sheep to examine whether they individually explained variation in parasite burden, as measured as faecal egg count, as well as two immune measures (Teladorsagia circumcincta‐specific antibodies and antinuclear antibodies). The cumulative effect of the candidate and control SNPs were estimated by fitting genetic relationship matrices (GRMs) as random effects in animal models of the three traits. No more significant SNPs were identified in the pilot sequencing experiment and association study than expected by chance. Furthermore, no significant difference was found between the proportions of candidate or control SNPs that were found to be significantly associated with parasite burden/immune measures. No significant effect of the candidate or control gene GRMs was found. There is thus little support for the candidate gene approach to the identification of loci explaining variation in parasitological and immunological traits in this population. However, a number of SNPs explained significant variation in multiple traits and significant correlations were found between the proportions of variance explained by individual SNPs across multiple traits. The significant SNPs identified in this study may still, therefore, merit further investigation.
The impact of increasing the upper age limit of donation on the eligible blood donor population in Canada
Authors: Fan W. , Yi Q.‐L. , Xi G. , Goldman M. , Germain M. , O'Brien S.F.
Published: September 2012

Objectives

Using population prevalence data for deferrable diseases/conditions we estimated the Canadian population eligible to donate according to three upper‐age limit scenarios.

Background

The donor selection criteria limit the number of potential blood donors but relaxing the upper age criteria could mitigate this.

Methods and Materials

Forty deferral criteria were identified and their corresponding prevalence data obtained to estimate the number of people excluded by the criteria. The eligible blood donor population was estimated from national census data taking the age limits, deferral criteria and deferral time‐period into account. As more than one disease/condition may co‐exist, the estimate was adjusted to avoid over‐representation.

Results

Of about 33 million Canadians aged 17 (18 in Québec) to 65, 15·1 million (45·8%) are eligible to donate blood. This number increases to 15·7 million when including people up to 71 years and to 17·1 million in the absence of an upper age limit.

Conclusion

As about 1·2 million units are collected from 600 000 donors annually, there are more than enough eligible people to meet the need. However, recruitment of donors is challenging and the absence of an upper age limit allows an additional 2 million people to donate. Other countries may wish to consider modification of the upper age criterion to address the effect of an aging population on the blood supply.
Self‐pollination and parthenocarpic ability in developing ovaries of self‐incompatible Clementine mandarins (Citrus clementina)
Authors: Mesejo Carlos , Yuste Roberto , Martínez‐Fuentes Amparo , Reig Carmina , Iglesias Domingo J. , Primo‐Millo Eduardo , Agustí Manuel
Published: September 2012

This study aimed to determine if self‐pollination is needed to trigger facultative parthenocarpy in self‐incompatible Clementine mandarins (Citrus clementina Hort. ex Tan.). ‘Marisol’ and ‘Clemenules’ mandarins were selected, and self‐pollinated and un‐pollinated flowers from both cultivars were used for comparison. These mandarins are always seedless after self‐pollination and show high and low ability to develop substantial parthenocarpic fruits, respectively. The time‐course for pollen grain germination, tube growth and ovule abortion was analyzed as well as that for carbohydrates, active gibberellins (GA1 and GA4), auxin (IAA) and abscisic acid (ABA) content in the ovary. ‘Clemenules’ showed higher pollen grain germination, but pollen tube development was arrested in the upper style 9 days after pollination in both cultivars. Self‐pollination did not stimulate parthenocarpy, whereas both un‐pollinated and self‐pollinated ovaries set fruit regardless of the cultivar. On the other hand, ‘Marisol’ un‐pollinated flowers showed greater parthenocarpic ovary growth than ‘Clemenules’ un‐pollinated flowers, i.e. higher ovule abortion rate (+21%), higher fruit set (+44%) and higher fruit weight (+50%). Further, the greater parthenocarpic ability of ‘Marisol’ paralleled higher levels of GA1 in the ovary (+34% at anthesis). ‘Marisol’ ovary also showed higher hexoses and starch mobilization, but lower ABA levels (−64% at anthesis). Self‐pollination did not modify carbohydrates or GA content in the ovary compared to un‐pollination. Results indicate that parthenocarpy in the Clementine mandarin is pollination‐independent with its ability to set depending on the ovary hormone levels. These findings suggest that parthenocarpy in fertile self‐incompatible mandarins is constitutively regulated.
A smaller endotracheal tube combined with intravenous lidocaine decreases post‐operative sore throat – a randomized controlled trial
Authors: XU Y. J. , WANG S. L. , REN Y. , ZHU Y. , TAN Z. M.
Published: September 2012

Background

Post‐operative sore throat (POST) has increasingly been a common clinical complication particularly in thyroid surgery. We conducted a trial to evaluate the effect of non‐pharmacological [smaller‐sized endotracheal tube (ETT)] combined with pharmacological intervention [lidocaine intravenous (i.v.)] on POST in women undergoing thyroid surgery.

Methods

Two hundred and forty patients scheduled for thyroid surgery were randomly divided into four groups: Group A, ETT size 7.0 with saline; Group B, ETT size 6.0 with saline; Group C, ETT size 7.0 with lidocaine; Group D, ETT size 6.0 with lidocaine. Patients in Groups C and D received i.v. 1.5 mg/kg lidocaine that was filled in syringe up to 10 ml 5 min before induction of anaesthesia; whereas patients in Groups A and B received an equal volume of saline. The incidence and severity of POST were evaluated at 1, 6 and 24 h after tracheal extubation.

Results

The highest incidence of POST occurred at 6 h after extubation in all groups. The incidence of POST was significantly lower in Group D compared with Groups A (23% vs. 62%, P < 0.01), B (23% vs. 42%, P = 0.03) and C (23% vs. 43%, P = 0.02) at 6 h after extubation. Group D had significantly decreased severity of POST compared with Groups A, B and C 6 and 24 h after extubation (P < 0.05).

Conclusion

Use of smaller‐sized ETT combined with i.v. lidocaine decreases the incidence and severity of POST in women undergoing thyroid surgery.
Interdiction of a blood donation containing varicella‐zoster virus by donor self‐report of chickenpox
Authors: Chan H. M. H. , Ho P. L. , Chan K. H. , Lin C. K. , Lee C. K.
Published: September 2012

Nowadays, risk of transfusion‐transmitted infection has been substantially minimized by stringent donor eligibility screening and infectious disease testing. However, we report an interdiction of a blood donation containing varicella‐zoster virus (VZV) by donor self‐reporting of chickenpox. The donor developed varicella infection shortly after blood donation despite vaccination. Varicella‐zoster virus DNA was detected in her fresh‐frozen plasma before the blood components were issued for clinical transfusion. The report indicates the importance of donors’ education and awareness of their obligation to report any symptoms developed shortly after blood donation in order to further secure blood safety.
Balance outcomes from two small rural hospitals
Authors: Downs Stephen , Marquez Jodie , Chiarelli Pauline
Published: September 2012

Objectives:  To describe predicted and measured balance changes in patients receiving physiotherapy in two rural hospitals, and to explore the relationship among balance at discharge, carer availability and patients' discharge destination.

Design:  Prospective measurement study.

Setting:  Two rural Australian hospitals.

Participants:  Eighty‐nine inpatients with a median age of 84.

Main outcome measures:  Berg Balance Scale (BBS) on admission and the treating physiotherapist's estimate at admission of individual patient's discharge BBS. Follow‐up measures included discharge BBS, carer availability after discharge and patient discharge destination.

Results:  Although change in measured balance of study participants had wide variability, balance measured by the BBS displayed a statistically and clinically significant improvement. A strong relationship was found between balance scores and discharge destination. However, no relationship was found between carer availability and discharge destination. Physiotherapists' estimates of discharge BBS displayed an average error of 7/56.

Conclusions:  The strong relationship between measured balance and discharge destination in these elderly study participants suggests that maximising their balance might minimise admissions to nursing home. The high variability of measured balance change suggests outcomes are difficult to predict. The study results suggest that premature assessment of patient's suitability for nursing home placement should be avoided. The accuracy of physiotherapist's estimates of discharge BBS suggests that greater weight might be placed on their input to facilitate the discharge planning process.
Culture and rural health
Authors: Farmer Jane , Bourke Lisa , Taylor Judy , Marley Julia V. , Reid John , Bracksley Stacey , Johnson Nicole
Published: September 2012

This paper considers the role of culture in rural health, suggesting that the concept and its impacts are insufficiently understood and studied. It reviews some of the ways that culture has been considered in (rural) health, and states that culture is either used ambiguously and broadly – for example, suggesting that there is a rural culture, or narrowly – indeed perhaps interchangeably with ethnicity, for example Aboriginal culture as a unity. The paper notes that, although culture is a dynamic social concept, it has been adopted into a biomedical research paradigm as though it is fixed. Culture is often treated as though it is something that can be addressed simplistically, for example, through cultural sensitivity education. Authors suggest that culture is an unaddressed ‘elephant in the room’ in rural health, and that exploring cultural differences and beliefs and facing up to cultural differences are vital in understanding and addressing rural health and health system challenges.
Children who experience difficulties with learning: Mother and child perceptions of social competence
Authors: Carman Sarah N. , Chapparo Christine J.
Published: September 2012

There is an emphasis on the social competence of children who have difficulties with learning as a significant percentage also experience reduced social skills. Social competence in the classroom is becoming increasingly important as the school curriculum incorporates group work and socially directed activities for purposes of learning. A goal of occupational therapy for children with learning difficulties and their parents is that they ‘fit’ into their social group and form friendships. While teachers are able to identify social skills that are required for life at school, less is known about how children perceive their interactions. This study aimed to explore social interaction during occupational performance at school and at home from the perception of children with learning difficulties and their mothers. Participants included 10, 8‐ to 12‐year‐old children who had difficulties with learning and their 10 mothers. Children were interviewed using semi‐structured focus groups. Mothers participated in semi‐structured interviews. Four main themes emerged from this study, including the importance of social skills, effects of poor social skills, difficulties with planning and problem solving in social situations and impact of social competence on a child's occupational performance. The study revealed that social participation is perceived to be an integral part of the child's ability to participate in occupational performance, and that children have definite perspectives on the importance of social competence. Children in this study indicated that their social skills were adequate when in an one‐to‐one situation but not in a group.
Inter‐rater reliability of three adult handwriting legibility instruments
Authors: Au Eunice H. , McCluskey Annie , Lannin Natasha A.
Published: September 2012

Background/aim

Legibility is important for functional, handwritten communication. Deficits in legibility can impair occupational performance following stroke or trauma. Few instruments are available to assess adult handwriting legibility during rehabilitation. The aim of this study was to compare inter‐rater reliability of a new four‐point legibility rating instrument with two existing instruments, and describe scale structure and item difficulty of each instrument.

Methods

Three trained raters scored 60 handwriting samples using: (i) a Four‐Point Scale (FPS); (ii) the modified Evaluation Tool of Children's Handwriting (mETCH); and (iii) the new modified FPS. Rater concordance and exact agreement were investigated using the intra‐class correlation coefficient (ICC3,1), multi‐rater kappa (κ) and Krippendorff's alpha (α). Cronbach's alpha was calculated to examine internal consistency reliability, and Rasch modelling was used to examine scale structure and item difficulty.

Results

Rater concordance for the FPS was fair (ICC3,1 = 0.37); exact agreement was poor (κ = 0.19; α = 0.19). Rater concordance for the two mETCH subtests was fair to moderate (ICC3,1 = 0.39–0.50), but with no exact agreement (κ < 0.00). Rater concordance for three subtests of the modified FPS was slight to moderate (ICC3,1 = 0.16–0.51); exact agreement ranged from nil to fair (κ = −0.06–0.30; α = −0.05–0.30). Rasch modelling confirmed internal consistency of instruments, but was low between‐rater consistency (rater severity variability).

Conclusions

A reliable instrument for measuring change over time remains elusive. In the meantime, these instruments can be used by individual clinicians to diagnose and rate legibility.
Body image and depressive symptoms in 13‐year‐old adolescents
Authors: Almeida Sandra , Severo Milton , Araújo Joana , Lopes Carla , Ramos Elisabete
Published: September 2012

Aims:  To evaluate the prevalence of body dissatisfaction and the association with depressive symptoms in 13‐year‐old adolescents, according to gender, and also to analyse the possible modifying effect of body mass index on this association.

Methods:  We evaluated 1868 adolescents as part of a population‐based study in an urban community in Porto, Portugal. Using the Figure Rating Scale, participants choose their perceived and their desired figures; body dissatisfaction was measured by the difference between these values. The Beck Disorder Inventory II was used to measure depressive symptoms. Weight and height were measured by trained interviewers. To quantify the association between depressive symptoms and body dissatisfaction, regression parameters and 95% confidence intervals (CIs) were obtained by linear regression and bootstrapping.

Results:  Among females, 15.8% desired a bigger figure and 41.4% desired a thinner figure. Among males, this occurred for 34.1% and 33.5%, respectively. After adjustment, we found that body dissatisfaction was associated with increased depressive symptoms, in both genders, especially in those participants who wish to be thinner and in those presenting higher discrepancy between figures (B = 6.5, 95% CI 4.1;9.3 for females, B = 3.3, 95% CI 1.3;6.8 for males). The association between body dissatisfaction and depressive symptoms was stronger among non‐overweight (for participants who wish to be thinner: B = 5.18 95% CI 3.56; 6.95 vs. B = 3.49, 95% CI 1.70; 5.29 among females and B = 2.47, 95% CI 0.73; 4.76 vs. B = 1.60, 95% CI 0.34; 2.88 among males).

Conclusions:  The direct association between the wish to be thinner and depressive symptoms was stronger among the non‐overweight youth.
Safe introduction of a new surgical technique: remote telementoring for posterior retroperitoneoscopic adrenalectomy
Authors: Miller Julie A. , Kwon David S. , Dkeidek Amira , Yew Ming , Hisham Abdullah An , Walz Martin K. , Perrier Nancy D.
Published: September 2012

Background

Posterior retroperitoneoscopic adrenalectomy (PRA) is a safe and effective approach to adrenalectomy, offering less pain and faster recovery than open or laparoscopic surgery. Although the popularity of PRA is increasing, few surgical centres have extensive experience with the procedure. The ideal approach to achieve proficiency with any new technique involves on‐site observation of an experienced surgeon‐mentor, followed by mentored hands‐on experience of the surgeon‐learner. However, it is not always feasible for a surgeon‐mentor to offer on‐site supervision to the surgeon‐learner in his or her home institution. Advances in Internet applications have made remote telementoring a viable alternative to on‐site mentoring in selected situations.

Methods

We describe our experience in safely introducing PRA to Melbourne, Australia, where no highly experienced surgeon‐mentors were available. A surgeon with experience of 12 PRA procedures attended from interstate, along with live telementoring via Skype video link by an overseas surgeon who had performed more than 200 PRA procedures, to mentor the surgeon‐learner performing her first three cases.

Results

The operating surgeon's first three PRA procedures proceeded uneventfully, with no complications, relatively short operative times and one‐night hospital stays for all three patients. Twenty‐two more have been performed since, without complications.

Conclusion

Remote telementoring is a safe and feasible way to assist surgeons in safely introducing new techniques. This strategy is particularly applicable in centres where no surgeon‐mentor is locally available. It is important that the surgeon‐learner has the skills and experience to complete the procedure using alternative techniques in the case of complications or technical failure.
Evaluation of teaching methods for students on hernias: an observational study
Authors: Peacock Oliver , Watts Edward , Foreman David , Lund Jonathan N. , Tierney Gillian M.
Published: September 2012

Background

Teaching may be delivered through different media in different settings. We aimed to evaluate four teaching modalities for medical students on a common surgical topic. We compared learning, student preferences and experiences as outcome measures.

Methods

This is a prospective observational study of all medical students undertaking their first attachment in surgery. Students were randomly allocated into four groups: lecture, handout, website and patient‐based tutorial, all on the management of an inguinal hernia. Baseline knowledge was assessed prior to group allocations through a questionnaire. Students completed a 24‐h post‐intervention questionnaire and satisfaction survey.

Results

One hundred fifty‐four students participated. There was no difference in the pre‐intervention knowledge scores between the groups. The post‐intervention knowledge scores significantly improved in the lecture and website groups. However, the website was significantly less engaging and clinically relevant form of teaching compared with the lecture. Despite being engaging and relevant, the tutorial group failed to improve knowledge scores. The handout did not improve knowledge scores, nor was it considered engaging or relevant.

Conclusion

Knowledge scores significantly improved with the lecture and website teaching methods. The lecture was more engaging, clinically relevant and instilled confidence. Students preferred the website/podcasts as additional information to facilitate their learning and increased their knowledge equivalent or superior to other standard media. However, despite being effective, the student experience was less positive than for non‐reusable contact teaching. If student satisfaction is to be a factor in achievement of learning outcomes, a balance has to be struck between different media delivery.
Shorter preparation to procedure interval for colonoscopy improves quality of bowel cleansing
Authors: Bryant R. V. , Schoeman S. N. , Schoeman M. N.
Published: September 2012

Background

The timing of bowel preparation for colonoscopy influences the quality of bowel cleansing and the success of the procedure.

Aim

We aimed to determine whether the interval between the end of bowel preparation and the start of colonoscopy influences preparation quality.

Methods

We retrospectively analysed 1785 colonoscopies performed between January 2010 and January 2011. The quality of bowel cleansing was compared between those who had a less than 8‐h interval between the end of bowel preparation to the start of the procedure versus those who had a greater than 8‐h interval. Univariate and multivariate logistic regression analyses evaluated quality of bowel cleansing, preparation to procedure time, age, gender, hospital inpatient or outpatient status, indication for colonoscopy, caecal intubation rate, and segmental polyp detection.

Results

Fifty‐three per cent of the cohort was male. Eighty‐nine per cent were outpatients. Bowel cleansing was reported as satisfactory/good in 87% and poor in 13%. A <8‐h preparation to procedure time was associated with a higher rate of satisfactory/good cleansing than a >8‐h interval (odds ratio (OR) 1.3, P = 0.04). In a multivariate analysis, female gender (OR 1.4, P = 0.02), outpatient status (OR 3.1 P = 0.001) and indication for procedure (P < 0.01) were significant predictors of adequate bowel preparation. Adequate bowel preparation was associated with a significant increase in caecal intubation rates (OR 5.3, P = 0.001).

Conclusions

A shorter (<8 h) interval between end of bowel preparation and start of colonoscopy yielded better bowel cleansing than a longer (>8 h) interval. Adequate bowel preparation led to improved caecal intubation rates.
Rural Women's Survivalist Livelihoods and State Interventions in Ga‐Ramogale Village, Limpopo Province
Authors: Tsheola Johannes
Published: September 2012

Abstract: Women constitute the majority of rural dwellers experiencing the worst effects of poverty while carrying the responsibility of securing a living for their households. Historically, rural women have practised a multiplicity of livelihoods that have always remained survivalist and less effective in generating cash income. However, well‐intended state interventions through Poverty Alleviation Programme (PAP) projects for women's empowerment have instead removed women from their practice of survivalist livelihoods without offering them the necessary enabling conditions to establish independent biographies for practice of ‘modern’ cash generating strategies. Based on a systematic sample of 177 households and interviews with women in Ga‐Ramogale, this article concludes that PAP projects have, rather than empowering women for sustainable participation in rural development, deepened their poverty and deprivation by enticing them away from the practice of livelihoods for which they had developed experience, skills and knowledge over years, and thereby effectively engendering increased reliance on dependency‐oriented livelihoods.
Remittances' Influence on Housing Construction Demand in Sub‐Saharan Africa: The Case of Kenya
Authors: Kagochi John M. , Kiambigi Maina
Published: September 2012

Abstract: Although it is well documented that immigrants maintain economic and social ties with their communities of origin through remittances, the role of remittances in asset acquisition for most African countries is yet to be documented. This study provides empirical estimates for the impact of remittances from abroad on housing construction demand in Kenya using time series data for the period 1970–2008. An autoregressive distributed lag (ARDL) modelling process is employed to capture the effect of remittances and other variables on housing construction demand. The computed short‐ and long‐run elasticities indicate that inbound remittances are one of the determinants of housing construction demand in Kenya. Other significant determinants include income, interest rates and urbanization growth.
COOPERATION: THE POWER OF A SINGLE WORD? SOME EXPERIMENTAL EVIDENCE ON WORDING AND GENDER EFFECTS IN A GAME OF CHICKEN
Authors: Cabon‐Dhersin Marie‐Laure , Etchart‐Vincent Nathalie
Published: September 2012

Framing has been widely shown to affect decision making. In this paper, we investigate experimentally whether, and to what extent, cooperative behaviour in a Game of Chicken may be impacted by a very basic change in the labelling of the strategies. Our within‐subject experimental design involves two treatments. The only difference between them is that we introduce either a socially‐oriented wording (I cooperate/I do not cooperate) or colours (red/blue) to designate strategies. The level of cooperation appears to be higher in the socially‐oriented context, but only when uncertainty as regards the type of the partner is manipulated, and especially among females.
CALCULATING WELFARE COSTS OF INFLATION IN A SEARCH MODEL WITH PREFERENCE HETEROGENEITY: A CALIBRATION EXERCISE
Authors: de Araujo Pedro
Published: September 2012

Using US cross‐sectional data, this paper calculates the welfare cost of a 10 percent inflation for different individuals and finds that the difference in cost between the poorest 20 percent, measured by their net worth, and the richest 20 percent is in the order of 102 percent. That is, a poor person is on average willing to forgive 102 percent more of their total consumption in order to have inflation reduced from 10 percent to 0. In absolute terms this represents a cost of 0.461 percent of consumption for the poorest and 0.228 percent for the richest. I accomplish this by introducing preference heterogeneity in a monetary search model first developed by Lagos and Wright, and calibrate the model to match each agent's type of cash holdings, approximated by their holdings in transactional accounts that bear almost no interest, as a fraction of their net worth using data from the Survey of Consumer Finances. I also show that this welfare difference increases to 130 percent (2.28 percent for the poorest 20 percent and 0.992 percent for the richest 20 percent) whenever frictions in the use of money are imposed (holdup problem). This distributional effect is further augmented if more frictions in the terms of trade are present. The ability to explicitly model these frictions is the advantage of using this model. Hence, inflation in this framework, as other studies have shown, acts as a regressive consumption tax; and this regressiveness is augmented with the holdup problem.
Why Assertion and Practical Reasoning Must be Governed By the Same Epistemic Norm
Authors: Montminy Martin
Published: September 2012

I argue that assertion and practical reasoning must be governed by the same epistemic norm. This is because the epistemic rule governing assertion derives from the epistemic rule governing practical reasoning, together with a plausible rule regarding assertion, according to which assertion must manifest belief.
HIV‐associated fatigue in the era of highly active antiretroviral therapy: novel biological mechanisms?
Authors: Payne BAI , Hateley CL , Ong ELC , Premchand N , Schmid ML , Schwab U , Newton JL , Price DA
Published: September 2012

Objective

The aim of the study was to determine the prevalence and risk factors for HIV‐associated fatigue in the era of highly active antiretroviral therapy (HAART).

Methods

A cross‐sectional survey of 100 stable HIV‐infected out‐patients was carried out. Severity of fatigue was measured using the Fatigue Impact Scale (FIS). Symptoms of orthostatic intolerance (dysautonomia) were evaluated using the Orthostatic Grading Scale (OGS). Data for HIV‐infected patients were compared with those for 166 uninfected controls and 74 patients with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (encephalopathy) (ME).

Results

Ninety‐one per cent of HIV‐infected patients were on HAART and 78% had suppressed plasma HIV viral load (≤ 40 HIV‐1 RNA copies/mL). Fifty‐one per cent of HIV‐infected patients reported excessive symptomatic fatigue (FIS ≥ 40), and 28% reported severe fatigue symptoms (FIS ≥ 80). The mean FIS score among HIV‐infected patients was 50.8 [standard deviation (SD) 41.9] compared with 13.0 (SD 17.6) in uninfected control subjects, and 92.9 (SD 29.0) in CFS patients (P < 0.001 for comparison of HIV‐infected patients and uninfected controls). Among HIV‐infected patients, fatigue severity was not significantly associated with current or nadir CD4 lymphocyte count, HIV plasma viral load, or whether on HAART. Prior dideoxynucleoside analogue (d‐drug) exposure (P = 0.016) and the presence of clinical lipodystrophy syndrome (P = 0.011) were associated with fatigue. Additionally, fatigue severity correlated strongly with symptomatic orthostatic intolerance (r = 0.65; P < 0.001).

Conclusions

Fatigue is very common and often severe in HIV‐infected out‐patients, despite viral suppression and good immune function. In a subgroup of patients, prior d‐drug exposure may contribute to fatigue, suggesting a metabolic basis. Dysautonomia may also drive fatigue associated with HIV infection, as in other chronic diseases, and CFS/ME, and should be further evaluated with the potential for a shared therapeutic approach.
Managerial Overconfidence and Share Repurchases
Authors: Shu Pei‐Gi , Yeh Yin‐Hua , Chiang Tsui‐Lin , Hung Jui‐Yi
Published: September 2012

Following prior studies, we use keywords in press portrayals to gauge managerial overconfidence. We hypothesize that managerial overconfidence is related to a manager's perception that the firm is undervalued. Results from 2744 share repurchase programs launched by 783 listed firms in Taiwan confirm this hypothesis. We find that managerial overconfidence is positively correlated with the intensity of share repurchasing, which is measured by scale, execution, frequency, and the difference between the announced price and post‐execution price. Moreover, the programs launched by overconfident managers were not undervalued and therefore were associated with reduced post‐announcement returns.
How to Reverse the Organ Shortage
Authors: Rippon Simon
Published: September 2012

Thousands of lives are lost each year because of a lack of organs available for transplant, but currently, in the UK and many other countries, organs cannot be taken from a deceased donor without explicit consent from the donor or his or her relatives. Switching to an ‘opt‐out’ (or ‘presumed consent’) system for organ donation could substantially increase the supply of organs, and save many lives. However, it has been argued in some quarters that there are serious ethical objections to an opt‐out policy, and that it would be better to adopt a different policy known as the ‘presumptive approach’, that requires explicit consent while also attempting to sway the choices of potential donors and family in the direction of donating, using various persuasive techniques. This article shows how reflection on the impact of a well‐known cognitive bias known as ‘status quo bias’ can explain (i) why moving from the status quo to an opt‐out policy might be effective in increasing organ availability, even without impinging on anyone's autonomous choices, (ii) why we might have overestimated the strength of the objections to an opt‐out policy, and (iii) why the presumptive approach is morally objectionable, while an opt‐out policy is not.
Alien and endangered plants in the Brazilian Cerrado exhibit contrasting relationships with vegetation biomass and N : P stoichiometry
Authors: Lannes Luciola S. , Bustamante Mercedes M. C. , Edwards Peter J. , Venterink Harry Olde
Published: September 2012

Although endangered and alien invasive plants are commonly assumed to persist under different environmental conditions, surprisingly few studies have investigated whether this is the case. We examined how endangered and alien species are distributed in relation to community biomass and N : P ratio in the above‐ground community biomass in savanna vegetation in the Brazilian Cerrado.

For 60 plots, we related the occurrence of endangered (Red List) and alien invasive species to plant species richness, vegetation biomass and N : P ratio, and soil variables.

Endangered plants occurred mainly in plots with relatively low above‐ground biomass and high N : P ratios, whereas alien invasive species occurred in plots with intermediate to high biomass and low N : P ratios. Occurrences of endangered or alien plants were unrelated to extractable N and P concentrations in the soil.

These contrasting distributions in the Cerrado imply that alien species only pose a threat to endangered species if they are able to invade sites occupied by these species and increase the above‐ground biomass and/or decrease the N : P ratio of the vegetation. We found some evidence that alien species do increase above‐ground community biomass in the Cerrado, but their possible effect on N : P stoichiometry requires further study.
Inborn errors of metabolism causing epilepsy
Authors: RAHMAN SHAMIMA , FOOTITT EMMA J , VARADKAR SOPHIA , CLAYTON PETER T
Published: September 2012

Seizures may be the first and the major presenting feature of an inborn error of metabolism (IEM), for example in a neonate with pyridoxine‐dependent epilepsy. In other IEMs, seizures may be preceded by other major symptoms: by a reduced level of consciousness in a child with an organic acidaemia or urea cycle defect; or by loss of skills, progressive weakness, ataxia, and upper motor signs in a child with a lysosomal storage disorder or peroxisomal leukodystrophy. This review concentrates on those IEMs for which specific treatment is available. The common metabolic causes of seizures vary according to the age at presentation. Features from the history, examination, imaging, and first line biochemical investigations can all provide clues to an inborn error. This review attempts to delineate these and to provide a guide to the specific tests that can be used to make the diagnosis of disorders with specific treatment.
Spinal cord injuries in young children: a review of children injured at 5 years of age and younger
Authors: SCHOTTLER JENNIFER , VOGEL LAWRENCE C , STURM PETER
Published: September 2012

Aim  To determine the epidemiology and complications of spinal cord injuries (SCIs) in children injured at 5 years of age and younger who were seen between 1981 and 2008 at a children’s hospital in the USA.

Method  Complications studied were scoliosis, hip dysplasia, latex allergies, autonomic dysreflexia, pressure ulcers, spasticity, deep venous thrombosis, and kidney stones. Demographic and injury‐related factors included age at injury, etiology, level of injury, American Spinal Injury Association Impairment Scale (AIS), and SCIs without radiological abnormalities (SCIWORA).

Results  Of the 159 individuals seen (92 males, 67 females) median age at injury was 2 years (range 0y–5y 11mo). Forty‐nine percent were injured in vehicular accidents, 60% had complete injuries, 66% had paraplegia, and 72% had SCIWORA. Ninety‐six percent developed scoliosis, 57% had hip dysplasia, and 7% had latex allergy. Thirty‐four percent with injuries at or above T6 experienced autonomic dysreflexia, 41% developed pressure ulcers, and 61% experienced spasticity. Of those without bowel or bladder control, 82% were on intermittent catheterization and 69% were on a bowel program. Median age of initiating wheelchair use was 3 years 4 months (range 1y 2mo–12y 5mo). Twenty‐four were community ambulators, and they were more likely to have AIS D lesions (half the key muscle functions below the level of injury have a muscle grade 3 or greater) and less likely to have skeletal complications.

Interpretation  The epidemiology, complications, and manifestations of SCIs in children injured at a young age are unique and differ distinctively from adolescent and adult‐onset SCIs.
The effect of pediatric traumatic brain injury on behavioral outcomes: a systematic review
Authors: LI LINDA , LIU JIANGHONG
Published: September 2012

Aim  To review systematically the empirical evidence on traumatic brain injury (TBI) during childhood and subsequent behavioral problems.

Method  An initial literature search with keywords ‘brain injury,’‘children,’ and ‘behavior’ was conducted using Web of Knowledge and PubMed databases. Ancestry was also used. Original research studies published between 1990 and February 2012 focusing on behavioral outcomes of children sustaining TBI from ages 0 to 18 years were included.

Results  Fifty studies, varying considerably in methodologies, were included in the review. Findings showed that up to 50% of brain‐injured children are at risk for presenting with specific behavioral problems and disorders. These problems may emerge shortly or several years after injury and often persist and even worsen with time. These behavioral impairments appear to be moderated by the family environment.

Interpretation  Survivors of childhood TBI are at risk for developing and sustaining behavioral impairments. Stronger research is needed to identify cognitive and environmental factors that contribute to the onset and maintenance of these problems. Healthcare providers should ensure adequate follow‐up and assessment of a child’s behavioral, social, and neurocognitive domains. Caregivers should be encouraged to provide positive environments and parenting styles, which may help reduce chronic behavioral problems after brain injury.
Cyclophilin Participates in Responding to Stress Situations in Porphyra haitanensis (Bangiales, Rhodophyta)
Authors: Jia Zhaojun , Niu Jianfeng , Huan Li , Wu Xiaojie , Wang Guangce , Hou Zhaojun
Published: September 2012

Porphyra haitanensis (T. J. Chang & B. F. Zheng) is an important economic alga found off the southern coast of China. It has evolved a strong tolerance against stress, which is an important survival characteristic. Cyclophilin has been shown to be involved in the stress response of plants and algae. To investigate the tolerance against stress in Porphyra, we isolated the cyclophilin PhCYP18 gene (Accession number JQ413239) and measured its expression over different generations and stress conditions. In P. haitanensis, cyclophilin PhCYP18 accumulated more in the filamentous sporophyte generation than in the blade gametophyte generation. This difference was thought to be due to harsh environments and a gene dosage effect. It has been found, however, that PhCYP18 expression was dysregulated in blades under high salt stress, strong irradiance stress and multifactorial stress compared to blades under normal conditions. Moreover, the changes were not linearly related to the degree of stress. It was therefore thought that PhCYP18 actively responded to stress situations and induced strong stress tolerance, which is evident in P. haitanensis.