bluuebunny/crossref_metadata_2025 huggingface dataset:
Programmed cell death and new discoveries in the genetics of parkinsonism
Authors: Burke Robert E.
Published: August 2008

The concept that activation of cellular pathways of programmed cell death (PCD) may lead to the death of neurons has been an important hypothesis for adult neurodegenerative diseases. For Parkinson’s disease (PD), up until now, the evidence for this hypothesis has largely been of two types: clear evidence of a role for PCD in neurotoxin models of the disease, and somewhat controversial evidence from human postmortem studies. With the rapid pace of discoveries in recent years of the genetic basis of PD, a new form of evidence has emerged. The prevailing concept of the role for PCD in PD has been that its mediators are ‘downstream’ effectors of more proximate and specific causes related to genetic or environmental factors. However, recent studies of three genes which cause autosomal recessive forms of parkinsonism, parkin, PTEN‐induced kinase, and DJ‐1, suggest that they may have more intimate relationships with the mediators of PCD and that loss‐of‐function mutations may result in an increased propensity for neurons to die. Intriguingly, independent studies of the function of these genes have suggested that they may share roles in regulating survival signaling pathways, such as those mediated by the survival signaling kinase Akt. Further elucidation of these relationships will have implications for the pathogenesis and neuroprotective treatment of PD.
Interaction of caveolin‐1, nitric oxide, and nitric oxide synthases in hypoxic human SK‐N‐MC neuroblastoma cells
Authors: Shen Jiangang , Lee Waisin , Li Yue , Lau Chi Fai , Ng Kwong Man , Fung Man Lung , Liu Ke Jian
Published: August 2008

Neuroblastoma cells are capable of hypoxic adaptation, but the mechanisms involved are not fully understood. We hypothesized that caveolin‐1 (cav‐1), a plasma membrane signal molecule, might play a role in protecting neuroblastoma cells from oxidative injury by modulating nitric oxide (NO) production. We investigated the alterations of cav‐1, cav‐2, nitric oxide synthases (NOS), and NO levels in human SK‐N‐MC neuroblastoma cells exposed to hypoxia with 2% [O2]. The major discoveries include: (i) cav‐1 but not cav‐2 was up‐regulated in the cells exposed to 15 h of hypoxia; (ii) NO donor 1‐[N, N‐di‐(2‐aminoethyl) amino] diazen‐1‐ium‐1, 2‐diolate up‐regulated the expression of cav‐1, whereas the non‐selective NOS inhibitor NG‐nitro‐l‐arginine methyl ester and inducible NOS (iNOS) inhibitor 1400W each abolished the increase in cav‐1 expression in the hypoxic SK‐N‐MC cells. These results suggest that iNOS‐induced NO production contributes to the up‐regulation of cav‐1 in the hypoxic SK‐N‐MC cells. Furthermore, we studied the roles played by cav‐1 in regulating NO, NOS, and apoptotic cell death in the SK‐N‐MC cells subjected to 15 h of hypoxic treatment. Both cav‐1 transfection and cav‐1 scaffolding domain peptide abolished the induction of iNOS, reduced the production of NO, and reduced the rates of apoptotic cell death in the hypoxic SK‐N‐MC cells. These results suggest that increased expression of cav‐1 in response to hypoxic stimulation could prevent oxidative injury induced by reactive oxygen species. The interactions of cav‐1, NO, and NOS could be an important signal pathway in protecting the neuroblastoma cells from oxidative injury, contributing to the hypoxic tolerance of neuroblastoma cells.
Cocaine regulates protein kinase B and glycogen synthase kinase‐3 activity in selective regions of rat brain
Authors: Perrine Shane A. , Miller Jonathon S. , Unterwald Ellen M.
Published: August 2008

Protein kinase B (also known as Akt) signaling regulates dopamine‐mediated locomotor behaviors. Here the ability of cocaine to regulate Akt and glycogen synthase kinase 3 (GSK3) was studied. Rats were injected with cocaine or saline in a binge‐pattern, which consisted of three daily injections of 15 mg/kg cocaine or 1 mL/kg saline spaced 1 h apart for 1, 3, or 14 days. Amygdala, nucleus accumbens, caudate putamen, and hippocampus tissues were dissected 30 min following the last injection and analyzed for phosphorylated and total Akt and GSK3(α and β) protein levels using western blot analysis. Phosphorylation of Akt on the threonine‐308 (Thr308) residue was significantly reduced in the nucleus accumbens and increased in the amygdala after 1 day of cocaine treatment; however, these effects were not accompanied by a significant decrease in GSK3 phosphorylation. Phosphorylation of Akt and GSK3 was significantly reduced after 14 days of cocaine administration, an effect that was only observed in the amygdala. Cocaine did not alter Akt or GSK3 phosphorylation in the caudate putamen or hippocampus. The findings in nucleus accumbens may reflect dopaminergic motor‐stimulant activity caused by acute cocaine, whereas the effects in amygdala may be associated with changes in emotional state that occur after acute and chronic cocaine exposure.
Survival‐promoting activity of pituitary adenylate cyclase‐activating polypeptide in the presence of phosphodiesterase inhibitors on rat motoneurons in culture: cAMP–protein kinase A‐mediated survival
Authors: Tomimatsu Naoko , Arakawa Yoshihiro
Published: August 2008

Pituitary adenylate cyclase‐activating polypeptide (PACAP) has been shown to be neurotrophic or neuroprotective in various neurons in culture. It is expressed in spinal motoneuronsin vivoand its expression is increased markedly after axotomy, suggesting a neuroprotective role via an autocrine mechanism. However, neurotrophic activity of PACAP has not been reported for motoneurons. In the present study, we investigated the effects of PACAP on rat motoneurons in culture. In the presence of a phosphodiesterase inhibitor, PACAP showed significant neurotrophic activity at concentrations as low as 0.01 nM. Previously, we found that glutamate was excitotoxic to motoneurons even in the presence of brain‐derived neurotrophic factor, which is neurotrophic for motoneurons. PACAP with a phosphodiesterase inhibitor protected motoneurons against this excitotoxicity. The activity of PACAP was inhibited by the protein kinase A inhibitorN‐[2‐(p‐bromocinnamylamino) ethyl]‐5‐isoquinolinesulfonamide dihydrochloride, as was the case with the activity of forskolin, suggesting downstream involvement of a cAMP–protein kinase A signaling pathway. The present results may suggest a physiological role of PACAPin vivo, and implicate the PACAP–cAMP signaling pathway for the possible therapeutic target of amyotrophic lateral sclerosis as glutamate excitotoxicity was suggested in sporadic amyotrophic lateral sclerosis.
Comparison of nurses’ and physicians’ documentation of functional abilities of older patients in acute care – patient records compared with standardized assessment
Authors: Jensdóttir Anna‐Birna , Jónsson Pálmi , Noro Anja , Jonsén Elisabeth , Ljunggren Gunnar , Finne‐Soveri Harriet , Schroll Marianne , Grue Else , Björnsson Jan
Published: August 2008

Aim:  To compare nurses’ and physicians’ documentation of geriatric issues and explore double documentation and undocumented areas of importance in an acute care setting in two Nordic countries.

Method:  158 participants, aged 75+, of whom the Minimum Data Set for Acute Care (MDS‐AC) instrument was conducted at admission and from which 56 variables were taken in comparison with notes from patient records documented by nurses and/or physicians in two acute care hospitals, in Finland and Iceland.

Findings:  Documentation of the impairment of personal Activities of Daily Living (ADL) was missing in 40–60% of the nurses’ reports and 80–97% of the physician’s reports. Even poorer was the documentation of the impairment of Instrumental Activities of Daily Living (IADL), of which 75% was not reported by the nurses and 85–96% by the physicians . Cognitive function was recorded in only 30–40% of the cases.

Conclusions:  The traditional patient record in acute care setting lacks several variables of functional abilities of the older patients. Nurses took more responsibility in the documentation of functional abilities, compared with physicians, but they could improve. Using a standardized instrument such as the MDS‐AC can improve documentation and make a basis for a clearer delineation in responsibilities for documentation between nurses and physicians and thereby improve outcome of care.
Outcome analysis of a research‐based didactic model for education to promote culturally competent nursing care in Sweden – a questionnaire study
Authors: Gebru Kerstin , Khalaf Azzam , Willman Ania
Published: August 2008

Aims and objectives:  To describe and analyse to what extent the goals of the education in promoting culturally competent nursing care have been achieved from a student perspective.

Background:  As Sweden has transformed into a multicultural society over the past 50 years, there is a need to specify, at all levels of the nursing programme, transcultural concepts for the success of integration. A research‐based didactic model was designed for the nursing programme at Malmö University and this was followed by investigations of its outcome.

Design and methods:  The study is a prospective cohort study with an outcome analysis. A descriptive research study with a longitudinal design was performed, with the focus on Swedish nursing students’ experiences of transcultural nursing knowledge and their attitudes before and after implementation of the didactic model. The students evaluate highly their competence to meet demands of multicultural health and medical service. Additionally, their ability to recognise and understand the consequences of international migration on health also received a high mean.

Conclusions:  The study revealed the knowledge and experience acquired by Swedish students in transcultural nursing. The assumption was that a visible development of knowledge should occur during the three years of education. Interpreting the findings, such effectiveness can be found and hopefully the students will be able to give holistic nursing care based on a person’s individual culture.
Anthroposophic health care – different and home‐like
Authors: Arman Maria , Ranheim Albertine , Rehnsfeldt Arne , Wode Kathrin
Published: August 2008

Anthroposophic health care is rooted in the work of Steiner and Wegman in Switzerland during the 1920s. The Swedish hospital in this study offers integrated conventional and anthroposophic health care therapies which are conceptualized as an extended and integrative variant of health care and not as CAM. In anthroposophic care, health is viewed as a matter of body, soul and spirit in balance. Therapeutic resources include nursing care, therapeutic conduct (art and body therapies) and medicines based on natural remedies. This study aims to deepen the understanding of what constitutes good care from a patient’s perspective to alleviate patients’ suffering and to identify clinical markers for good care. As anthroposophic care is associated with theory and holistic ideas, this study aims at exploring whether or not anthroposophic care has a beneficial effect. A qualitative method was used, and the analysis was conducted with a phenomenological hermeneutic approach. Sixteen former patients, of whom nine were diagnosed with various kinds of cancer and seven with burnout syndrome, were interviewed regarding their experience of anthroposophic care. Patients especially noted the benefits of the holistic caring environment; the empathetic approach and true caring offered, as well as the peaceful atmosphere and rest. A turning point or shift in perspectives, implying a home coming in relation to inner aspects was discussed as an outcome. Although patients in general were overwhelmingly impressed and positive they were also ambivalent. One interpretation is that there is a gap between the anthroposophic and conventional paradigm that affects patients negatively. As mutual scepticism still prevents any real integration between integrative and conventional care, the onus appears to be on the patient to take the risk and act as bridge‐builder. From a caring science perspective, the study shows that appropriation of specific values and theory makes it possible to create a true caring culture.
Managing consequences and finding hope – experiences of Swedish women and men 4–6 months after myocardial infarction
Authors: Kristofferzon Marja‐Leena , Löfmark Rurik , Carlsson Marianne
Published: August 2008

Research has focused more on symptoms, risk factors and treatment, than on individuals’ experiences of illness and recovery after myocardial infarction (MI). Therefore, the aim of the study was to describe the experiences of present everyday life of women and men 4–6 months after MI and their expectations for the future. Semi‐structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed with content analysis. Two themes, ‘Managing consequences of MI’ and ‘Finding a meaning in what had happened’, were generated. The first theme reveals that many of the patients had not established a stable health condition, even if symptoms and emotional distress had diminished over time. They had to manage health problems, lifestyle modifications, emotional reactions and changes in social life. The support from their social network encouraged them to move on. The second theme shows that patients also found positive consequences of what they had gone through, new life values and hopes in the future. The conclusions were that most of the patients moved on and began to regain a balance in everyday life, but some patients still struggled hard to find this balance. Those patients experienced large difficulties with managing their everyday life and felt a lack of support from their social network. Health professionals can be an important resource in helping patients in their adaptation to changes if they are more sensitive to patients’ needs of support both in a short‐ and long‐term perspective.
‘Nobody likes a back bore’– exploring lay perspectives of chronic pain: revealing the hidden voices of nonservice users
Authors: Campbell Carol , Cramb Georgia
Published: August 2008

Chronic pain is pain that persists beyond 12 weeks or that lasts beyond the expected duration of healing. The chronic pain sufferer also often experiences associated anxiety, depression and stress. An exploratory qualitative approach was adopted by the authors to explore what it is like to live with chronic pain from a sample of people who had not accessed secondary or tertiary health services. Semi‐structured interviews were undertaken utilizing a ‘snowball’ sample of 12 participants. The complex issues presented by living with chronic pain that face sufferers in their personal and social worlds emerged from participant narratives. Three main themes which reflected individual variation in the ways that participants’ had adapted to their pain were extracted from the data: dependence and social withdrawal; being ‘normal’ in comparison to others; and striving for self‐management. Issues of coping and control were related to the theme of self‐management. By capturing the voices of a previously unheard group our findings support and extend previous research by detailing the difficulties that need to be overcome by sufferers to finally accept the persistence of their pain. Moreover, it is this acceptance of, and adaptation to their pain, that may distinguish the participants in our sample from the majority of pain sufferers who engage and re‐engage with secondary and tertiary healthcare facilities.
Fatigue in relation to perceived health: people with multiple sclerosis compared with people in the general population
Authors: Flensner Gullvi , Ek Anna‐Christina , Landtblom Anne‐Marie , Söderhamn Olle
Published: August 2008

Fatigue is not only a complex phenomenon accompanying different illness conditions but is also a common complaint among individuals in the general population. Among individuals diagnosed with the chronic neurological disease multiple sclerosis (MS), one‐third describe fatigue as the very first symptom, however it is invisible to others. When adopting an action‐theoretic approach to health, fatigue may be considered to influence the individual’s goals of life and subjectively perceived health. The aim of this study was to describe perceived fatigue in relation to perceived health among working‐aged individuals diagnosed with MS (n = 155), and in a comparative group of individuals randomly selected from the general population living in the same geographical area (n = 190). A self‐report questionnaire including the Fatigue Impact Scale, a checklist of six symptoms, questions covering perceived health and levels of and perceptions of fatigue was used for the data collection. The responses on perceived health were dichotomized into two categories: ‘good health’ and ‘ill health’. Of the individuals with MS, 50% graded their perceived health as ill compared with 18% in the reference group (p < 0.001), and 68% graded fatigue as one of their worst symptoms compared with 21% in the reference group. In both groups, higher presence of symptoms and impact of fatigue in daily activities correlated negatively to perceived health. Compared with the individuals in the reference group, the individuals with MS reported higher impact of fatigue in physical areas in both the category of ‘good health’ (p < 0.001) and ‘ill health’ (p < 0.01). The perceived impact of fatigue was mirrored in increased problems in social and family activities. In conclusion, individuals with MS perceive fatigue as one of their worst symptoms three times as often as individuals in the general population. However, individuals with MS probably also adapt themselves or shift in their response to fatigue more than individuals in the general population.
Assaulted victims of nondomestic violence in Norway – injury, crime characteristics and emotions during the assault
Authors: Johansen Venke A. , Wahl Astrid K. , Weisaeth Lars
Published: August 2008

Violence is a negative and depressing part of human relationships, whereas consequences related to interpersonal violence cause a number of health problems in the world. The aim of this paper is to describe socio‐demographic characteristics, injury, crime characteristics and emotions during the event in assault victims of nondomestic violence, and further evaluate possible associations between these factors. Data were collected from 149 victims by questionnaires and semi‐structured interviews. Our results show that most of the victims were young men assaulted by unknown attackers in public places. The educational levels and the levels of employment in the present sample are high compared with those of other studies. Seventy‐six per cent of the participants suffered injuries to the head, face or eyes. About one‐third of the sample had serious injuries that required specialist treatment. Anxiety was the most frequent emotion felt during the assault, followed by aggression. Female victims were more likely to experience shock (p < 0.01) and anxiety (p < 0.01) during the incident than men. Nineteen per cent of the participants reported feeling shocked and frightened simultaneously. About 60% experienced a combination of subjective factors, such as fear of serious injury, being killed during the assault and actual physical injury. It is reasonable to expect a high occurrence of future psychopathology among our participants.
Connectedness, belonging and feelings about school among healthy and chronically ill Icelandic schoolchildren
Authors: Svavarsdottir Erla Kolbrun
Published: August 2008

The purpose of this research was to evaluate the level of school connectedness and feelings about school among Icelandic preteenagers who were either with or without a chronic health condition. The study is cross‐sectional with 480 children of 10–12 years old (209 boys and 271 girls) and 38 teachers participating from 12 randomly selected public elementary schools in Reykjavik, Iceland. Data were collected from March 2004 to early June 2004. Independentt‐tests and multivariate regression analyses were used to test the hypotheses. Girls were found to report significantly higher connectedness to their school and significantly higher positive feelings about their school than the boys. Children with chronic illnesses were found to report significantly lower school connectedness and significantly lower positive feelings about their school than children without chronic illness(es). Further, Icelandic preteenagers with a mental illness or learning disabilities were found to report significantly lower school connectedness and significantly lower positive feelings about their school than their school mates who had physical chronic illness(es). The teachers’ perception of children’s social competence significantly predicted both the girls’ and the boys’ perception of their connectedness to school and feelings about school. Preventive actions need to be taken by school nurses and other school personnel to prevent disengagement in schools, especially for preteenage boys and for chronically ill children, specifically children dealing with mental illnesses or learning disabilities.
Quality of life among long‐term gynaecological cancer survivors
Authors: Rannestad Toril , Skjeldestad Finn E. , Platou Toril F. , Hagen Bjørn
Published: August 2008

Background:  The population of gynaecological cancer survivors is growing. However, there is little knowledge of the long‐term quality of life among these former patients. The aim of this study was to investigate the long‐term quality of life in women treated successfully for gynaecological cancer and a control group of representative women selected from the general population.

Material and methods:  The study comprised women aged 30–75 years residing in the central part of Norway. Cases were 319 gynaecological cancer survivors treated at St Olav’s Hospital Trondheim, Norway, between 1987 and 1996, whereas 1276 age‐matched women selected at random from the general population served as controls. The study population was identified and the respondents were invited to answer a postal questionnaire. After one reminder, the response rate was 55% (176/319) and 41% (521/1276) for cases and controls, respectively. Sixteen cases and 28 controls had incomplete responses to most questions and were excluded from the analyses. Eligible for the final analyses were 160 cases and 493 controls. Ferrans & Powers’ Quality of Life Index (QLI) was used. All analyses were performed in SPSS version 13.0 with chi‐square (categorical variables) and Mann–Whitney (continuous variables) tests. p ≤ 0.05 is the level of statistical significance.

Results:  Cases had on an average, a complete recurrence‐free period of 12 years (range 7–18). No differences were detected between cases and controls in the global quality of life or in any of the four sub‐dimensions of QLI. Furthermore, no difference was found in co‐morbidity, but cases consulted more often hospital physicians than controls did.

Interpretation:  Long‐term gynaecological cancer survivors enjoy the same quality of life as women in the general population.
Repeatability and agreement in the measurement of horizontal fusional vergences
Authors: Antona B. , Barrio A. , Barra F. , Gonzalez E. , Sanchez I.
Published: August 2008

Purpose:  This study was designed to determine the repeatability of fusional vergence ranges measured using the rotary prisms in the phoropter and in free space using the prism bar. The level of agreement between the two methods was also investigated.

Methods:  In two separate sessions, negative and positive fusional vergence ranges (NFV and PFV, respectively) were measured at distance and near in 61 young adults (mean age 19.74, S.D. 2.5 years) who were unfamiliar with the methods used. Base‐in and base‐out blur, break and recovery points were sequentially determined. Both sets of measurements were obtained by the same examiner. At each distance, NFV was determined first and then PFV. The repeatability of the tests and agreement between measurements made with the phoropter rotary prisms and the prism bar were estimated by the Bland and Altman method.

Results:  For both the phoropter rotary prisms and prism bar, NFV measurements showed better repeatability than PFV at both near and distance. Mean differences recorded for the NFV break and recovery points were non‐significant (under 0.5Δ), while those observed for PFV were generally greater than 2Δ. When agreement between the two tests was assessed, it was found that break points were higher when determined using the phoropter rotary prisms, while recovery points were generally higher for the prism bar method. In clinical terms, according to the expected values of the NFV and PFV, agreement between the two techniques can be described as fair, because although mean differences were never greater than 5.5Δ, 95% agreement intervals were as wide as ±8.00Δ for NFV and ±13.19Δ for PFV.

Conclusions:  The two methods used to measure fusional vergences showed fairly good inter‐session repeatability for measuring NFV but repeatability was reduced for PFV measurements. The level of agreement observed between the two methods was such that their interchangeable use in clinical practice is not recommended.
A biometric investigation of ocular components in amblyopia
Authors: Cass Kevin , Tromans Cindy
Published: August 2008

The aim of this study was to investigate the ocular parameters and their contribution to total axial length, and any inter‐ocular differences when compared to the fellow non‐amblyopic eye, in a population of paediatric amblyopes. Inter‐ocular differences in visual acuity, refractive error, corneal curvature, anterior chamber depth and their contribution to total axial length were analysed in four populations: adult controls (n = 26), paediatric controls (n = 24), paediatric strabismic amblyopes (n = 18) and paediatric anisometropic amblyopes (n = 27). In the two control groups, there were small inter‐ocular differences between the components, none of which were statistically or clinically significant. Anisometropic amblyopic eyes were found to have statistically and clinically significant differences in refractive error, crystalline lens power, vitreous chamber depth and total axial length when compared to the fellow eye. Anterior and vitreous chamber depths, when expressed as a percentage of the anterior and vitreous chambers in the non‐amblyopic fellow eye, were approximately 95% of the size. When parameters were normalised by expressing as a percentage of total axial length, the contribution of the anterior chamber, crystalline lens and vitreous chamber to total axial length in both eyes were comparable, suggesting that all components of the anisometropic amblyopic eye are proportionately reduced in size. The strabismic amblyopic eyes were in the main isometropic. There were however statistically significant differences in anterior chamber depth, crystalline lens power, vitreous chamber depth and total axial length, but not in crystalline lens thickness. When the components were expressed as a percentage of the component in the non‐amblyopic fellow eye, the anterior and vitreous chambers were approximately 90% of the size of the fellow non‐amblyopic eye and made a significantly smaller contribution to total axial length when normalised. Crystalline lens thickness contributed significantly more to the total axial length in a strabismic eye. This suggests that, unlike control eyes or anisometropic amblyopic eyes, the strabismic eye is physically, though not proportionately, reduced in size.
Lower threshold estimates at the onset of automated perimetry causing artefacts in perimetrically naive subjects
Authors: Preetha M. M. , George Ronnie , Ve Ramesh S. , Raju Prema , Vijaya L.
Published: August 2008

Reduction in the threshold value of the primary points resulting in depressed points on the pattern deviation plot of Humphrey visual fields was observed in a series of four perimetrically naive subjects. The defect disappeared on repeated testing. This primary point defect could be attributed to the patient’s poor understanding of the test, response bias or poor instruction by the perimetrist.
The content of optometric eye examinations for a young myope with headaches
Authors: Shah Rakhee , Edgar David F. , Rabbetts Ronald , Blakeney Susan L. , Charlesworth Peter , Harle Deacon E. , Evans Bruce J. W.
Published: August 2008

Background:  A recent review found standardised patient (SP) methodology to be the gold standard methodology for evaluating clinical care. We used this to investigate the content of optometric eye care for a young myopic patient with headaches suggestive of migraine.

Methods:  We recruited 100 community optometrists who consented to be visited by an unannounced actor for an eye examination and to have that eye examination recorded. The actor received extensive training to enable accurate reporting of the content of the eye examinations, via an audio recording and a checklist completed for each clinical encounter. The actor presented as a 20‐year‐old student seeking a private eye examination and complaining of symptoms suggestive of migraine headaches. The results of each clinical encounter were recorded on a pre‐designed checklist based on evidence‐based reviews on headaches, clinical guidelines and the views of an expert panel of optometrists.

Results:  The presence of headache was detected in 98% of cases. Eight standard headache questions were considered to be the gold standard for primary care headache investigation. Although none of the optometrists asked all of these questions, 22% asked at least four of the eight questions. Sixty‐nine per cent of practitioners asked the patient to seek a medical opinion regarding the headaches. The proportion of the tests recommended by the expert panel that was carried out varied from 33% to 89% and the durations of the eye examination varied from 5 to 50 min.

Conclusion:  SP encounters are an effective way of measuring clinical care within optometry and should be considered for further comparative measurements of quality of care. As in research using SPs in other healthcare disciplines, our study has highlighted substantial differences between different practitioners in the duration and depth of their clinical investigations. This highlights the fact that not all eye examinations are the same and that there is no such thing as a ‘standard sight test’. We recommend that future optometric continuing education could usefully focus on migraine diagnosis and assessment.
The technique, validity and clinical use of the sweep VEP
Authors: Almoqbel Fahad , Leat Susan J. , Irving Elizabeth
Published: August 2008

Vision scientists have concentrated on studying two visual functions when it comes to assessing the sensory visual development in human: visual acuity and contrast sensitivity. The methods used to measure these visual functions can be either behavioral or electrophysiological. A relatively new technique for measuring the visual acuity and contrast sensitivity electrophysiologically is the sweep visual evoked potential (sVEP). This paper is a review of the literature on the sVEP technique: stimulus parameters, threshold determination, validity and reliability of sVEP are discussed. Different studies using the sVEP to study the development of visual acuity, contrast sensitivity, and vernier acuity are presented. Studies have demonstrated that the sVEP is a potentially important tool for assessing visual acuity and contrast sensitivity in non‐verbal individuals with disorders affecting their visual system.
The effect of age‐related lens yellowing on Farnsworth–Munsell 100 hue error score
Authors: Beirne Raymond O. , McIlreavy Lee , Zlatkova Margarita B.
Published: August 2008

Purpose:  To investigate the effects of real and simulated age‐related changes in crystalline lens yellowing on Farnsworth–Munsell (FM) 100 hue performance.

Methods:  FM 100 hue total and partial error scores (PES) were measured in a group of younger (n = 10, mean age = 22.2 ± 2.65 years) and a group of older (n = 10, mean age = 54.5 ± 2.64 years) normal observers along with psychophysical estimates of crystalline lens optical density and pupil size. Three younger observers underwent repeated FM 100 hue testing under a variety of simulated age‐related lens yellowing conditions, using filters with well‐defined transmittance properties which attempted to mimic the real age‐related lens yellowing changes of the older group.

Results:  FM 100 hue total and PES were significantly higher in the older age group compared with the younger group (p < 0.01). Lens density measures were significantly higher in the older age group compared with the young group (p < 0.01), but showed less scatter than individual FM 100 hue error scores. Simulated lens yellowing in the three younger observers, equivalent to the level of that of the older observers, did not affect any of their FM 100 hue total or PES.

Conclusions:  Simulation of age‐related lens yellowing in younger observers has little effect on FM 100 hue error score. A variety of other factors such as pupil size, background illuminaton level, iris colour and macular pigment density may contribute to the age‐related increase in FM 100 hue scores.
Use of continuous renal replacement therapy for treatment of dogs and cats with acute or acute‐on‐chronic renal failure: 33 cases (2002–2006)
Authors: Diehl Shenandoah H. , Seshadri Ravi
Published: August 2008

Objective: To describe the indications, clinical features, outcomes and complications associated with use of continuous renal replacement therapy (CRRT) in 17 client‐owned dogs and 16 client‐owned cats with acute or acute‐on‐chronic renal failure refractory to aggressive medical management.

Series summary: Twenty‐nine percent of dogs and 44% of cats had evidence of pre‐existing chronic kidney disease (CKD). Median duration of CRRT was 16.3 hours (range 0.3–83.0 hours) in dogs and 11.5 hours (range 1.0–35.5 hours) in cats. Median canine blood urea nitrogen (BUN) improved from 41.0 mmol/L (115.0 mg/dL) to 11.8 mmol/L (33.0 mg/dL) and creatinine from 636.5 mmol/L (7.2 mg/dL) to 274 mmol/L (3.1 mg/dL). Median feline BUN improved from 46.4 mmol/L (130 mg/dL) to 13.9 mmol/L (39.0 mg/dL) and creatinine from 1069.6 mmol/L (12.1 mg/dL) to 291.7 mmol/L (3.3 mg/dL). Metabolic acidosis resolved in 80% of affected dogs and 71% of affected cats. Hyperkalemia resolved in 100% of affected dogs and 88% of affected cats. Complications noted with CRRT included iatrogenic hypokalemia, iatrogenic metabolic alkalosis, clinical hypocalcemia, total hypercalcemia, filter clotting, anemia, hypothermia, and neurologic complications. Forty‐one percent of dogs and 44% of cats survived to discharge. No dogs and only 1 cat developed newly diagnosed CKD.

New or unique information provided: CRRT can be a viable option for the management of acute or acute‐on‐chronic renal failure in dogs and cats that are refractory to aggressive medical management. The frequency of complications associated with CRRT in this study warrants further experience with this modality before its widespread use can be recommended.
Upper airway obstruction caused by a nasopharyngeal polyp and brachycephalic airway syndrome in a Chinese Shar‐Pei puppy
Authors: Smart Lisa , Jandrey Karl E.
Published: August 2008

Objective: To describe the case management for a dog diagnosed with a nasopharyngeal polyp.

Case summary: A 9‐week‐old Shar‐Pei puppy presented for progressive dyspnea and collapse. Clinical signs were consistent with an upper airway obstruction (UAO) and a temporary tracheostomy was performed. The puppy was at first diagnosed with and treated for brachycephalic airway syndrome but continued to exhibit signs of an UAO after soft palate resection. Nasopharyngoscopy revealed a nasopharyngeal polyp causing the UAO, which was surgically removed. The puppy has been free of clinical signs for 1 year after removal of the polyp.

New or unique information provided: This is the first report of a nasopharyngeal polyp causing a life‐threatening UAO in a puppy. It emphasizes the importance of examining the nasopharyngeal space in neonates presenting with UAO.
Socioeconomic Status as a Modifier of the Relationship between Antibiotic Use During Pregnancy and Birthweight
Authors: Nelson Jessica W. , Werler Martha M.
Published: August 2008

ABSTRACT:  Background:
Antibiotics taken during pregnancy treat underlying maternal infections that may otherwise contribute to poor birth outcomes, including decreased birthweight. This study investigated whether antibiotics taken by a diverse sample of North American women were associated with increased mean infant birthweight and whether this relationship was modified by socioeconomic status. The study hypothesized that women of low socioeconomic status, whose babies are at highest risk of low birthweight perhaps due to long‐standing undiagnosed infections, might benefit from antibiotic use more than women of higher socioeconomic status.
Methods:
The sample was 868 control women from a case‐control study of hemifacial microsomia, a craniofacial birth defect. Participants reported information on antibiotic use during pregnancy (type, indication, and timing) and baby’s birthweight in telephone interviews.
Results:
Nineteen percent of women reported taking at least one antibiotic in the first half of pregnancy, but average birthweights were similar among users and nonusers. However, low–socioeconomic status women who reported taking antibiotics to treat genitourinary infections had babies that were 286 g heavier than those who did not (p = 0.01). No association was seen among higher socioeconomic status women. Differences by socioeconomic status were also seen in treatment for respiratory conditions and use of penicillin antibiotics.
Conclusions:
These findings suggest that socioeconomic status might modify the association between antibiotics taken during pregnancy and infant birthweight. They emphasize the need to consider socioeconomic status in studies of antibiotic use and birth outcomes and extend previous studies of socioeconomic disparities in birth outcomes. (BIRTH 35:3 September 2008)
Recommendations for Routine Reporting on Indications for Cesarean Delivery in Developing Countries
Authors: Stanton Cynthia , Ronsmans Carine ,   the Baltimore Group on Cesarean
Published: August 2008

ABSTRACT:  Background:
Cesarean delivery rates are increasing rapidly in many developing countries, particularly among wealthy women. Poor women have lower rates, often so low that they do not reach the minimum rate of 1 percent. Little data are available on clinical indications for cesarean section, information that could assist in understanding why cesarean delivery rates have changed. This paper presents recommendations for routine reporting on indications for cesarean delivery in developing countries. These recommendations resulted from an international consultation of researchers held in February 2006 to promote the collection of comparable data to understand change in, or composition of, the cesarean delivery rate in developing countries.
Methods:
Data are presented from selected countries, categorizing cesareans by three classification systems.
Results:
A single classification system was recommended for use in both high and low cesarean delivery rate settings, given that underuse and overuse of cesarean section are evident within many populations. The group recommended a hierarchical categorization, prioritizing cesareans performed for absolute maternal indications. Categorization among the remaining nonabsolute indications is based on the primary indication for the procedure and include maternal and fetal indications and psychosocial indications, required for high cesarean delivery rate settings.
Conclusions:
Data on indications for cesarean sections are available everywhere the procedure is performed. All that is required is compilation and review at facility and at higher levels. Advocacy within ministries of health and medical professional organizations is required to advance these recommendations since researchers have inadequately communicated the health effects of both underuse and overuse of cesarean delivery. (BIRTH 35:3 September 2008)
Encouraging Women to Consider a Less Medicalized Approach to Childbirth Without Turning Them Off: Challenges to Producing Our Bodies, Ourselves: Pregnancy and Birth
Authors: Zeldes Kiki , Norsigian Judy
Published: August 2008

ABSTRACT:  Within the United States, women routinely confront negative and distorted ideas about birth, and highly medicalized births are the norm. The writers and editors of Our Bodies, Ourselves: Pregnancy and Birth discuss their efforts to write a book that provides women with accessible, evidence‐based information; examines the social, economic, and political factors that shape and constrain childbirth choices; and inspires women to work toward ensuring that all women have access to the full range of safe and satisfying birthing options. (BIRTH 35:3 September 2008)
Implant Technology and Usability
Authors: Meadows Paul M.
Published: August 2008

Abstract:  Implanted electrical stimulation technology has changed greatly in the roughly five decades of its existence. Many factors determine the viability of the technology and whether the systems and products developed ultimately go on to help the target patient population. This article describes the successful introduction of an implanted system and the challenges to implanted system development, acceptance, and usability of these systems by the patient and clinical communities.
Design of an Implant for Preventing Incontinence After Spinal Cord Injury
Authors: Donaldson Nick , Perkins Tim , Pachnis Ioannis , Vanhoest Anne , Demosthenous Andreas
Published: August 2008

Abstract:  An implanted device is being designed and tested which has the main function of suppressing hyperreflexic bladder contractions by stimulating the pudendal afferent pathway. The concept is that the contractions will be detected by recording natural nerve signals. This is challenging because the changes in neural signal are very small (sub‐microvolt), and the device must run 24 h per day, which means that for convenience it must be battery‐powered. The energy budget is therefore tight. Furthermore, because the patient must be able to intervene to occasionally empty the bladder, a radio link is needed to the device. Within the EU project Healthy Aims, most aspects of the design have been made and tested. This includes the battery, battery charger, neural amplifier, and the package incorporating the Medical Implant Communication System (MICS) antenna, which are briefly described here. This article is a progress report.
Restoration of Muscle Volume and Shape Induced by Electrical Stimulation of Denervated Degenerated Muscles: Qualitative and Quantitative Measurement of Changes in Rectus Femoris Using Computer Tomography and Image Segmentation
Authors: Gargiulo Paolo , Vatnsdal Brynjar , Ingvarsson Páll , Knútsdóttir Sigrún , Gudmundsdóttir Vilborg , Yngvason Stefán , Helgason Thórdur
Published: August 2008

Abstract:  This study demonstrates in a novel way how volume and shape are restored to denervated degenerated muscles due to a special pattern of electrical stimulation. To this purpose, Spiral Computer Tomography (CT) and special image processing tools were used to develop a method to isolate the rectus femoris from other muscle bellies in the thigh and monitor growth and morphology changes very accurately. During 4 years of electrical stimulation, three‐dimensional (3D) reconstructions of the rectus femoris muscles from patients with long‐term flaccid paraplegia were made at different points in time. The growth of the muscle and its changes through the time period are seen in the 3D representation and are measured quantitatively. Furthermore, changes in shape are compared with respect to healthy muscles in order to estimate the degree of restoration. The results clearly show a slow but continuing muscle growth induced by electrical stimulation; the increase of volume is accompanied by the return of a quasi‐normal muscle shape. This technique allows a unique way of monitoring which provides qualitative and quantitative information on the denervated degenerated muscle behavior otherwise hidden.
A Finite Element Model of the Electrically Stimulated Human Thigh: Changes due to Denervation and Training
Authors: Stickler Yvonne , Martinek Johannes , Hofer Christian , Rattay Frank
Published: August 2008

Abstract:  The complete denervation of muscles leads to changes in the muscle fibers as well as in the surrounding tissue. Concerning excitability the most important changes are reductions in fiber diameter, in muscle cross‐sectional area, and in electrical conductivity of the muscle tissue. These changes can be partially reversed by intensive electrical stimulation.

Evaluation of a 3D finite element axial symmetric model of the human thigh shows that the training leads to a reduction in threshold values between 17 and 51 percent, depending on the position of the fiber in the thigh. Single parameter variation clarifies the influence of each of the different factors. The electrode position was found to be most effective with the electrodes as far apart from each other as possible. Due to (i) comparatively higher changes in potentials at the distal electrode; and (ii) variations in sodium channel dynamics, lowest threshold values can be reached with a hyperpolarizing first phase of the biphasic impulse at the distal electrode. The tissue of the denervated muscle is known to be highly inhomogeneous. Simulations demonstrate that the related irregularities in the field can actually initiate fiber activation.

3D finite element simulations show the overall positive effects of FES on muscle tissue, especially an improved excitability of the muscle fibers. Furthermore the method gives an insight into the relations between potential distribution, electrode position, geometric effects, and muscle fiber activation that cannot be obtained by measurements.
Assessment of Finger Forces and Wrist Torques for Functional Grasp Using New Multichannel Textile Neuroprostheses
Authors: Lawrence Marc , Gross Gion‐Pitschen , Lang Martin , Kuhn Andreas , Keller Thierry , Morari Manfred
Published: August 2008

Abstract:  New multichannel textile neuroprotheses were developed, which comprise multiple sets of transcutaneous electrode arrays and connecting wires embroidered into a fabric layer. The electrode arrays were placed on the forearm above the extrinsic finger flexors and extensors. Activation regions for selective finger flexion and wrist extension were configured by switching a subset of the array elements between cathode, anode, and off states. We present a new isometric measurement system for the assessment of finger forces and wrist torques generated using the new neuroprostheses. Finger forces (from the middle phalanxes) were recorded using five load cells mounted on a “grasp handle” that can be arbitrarily positioned in space. The hand and the grasp handle were rigidly mounted to a 6‐degree of freedom load cell, and the forces and torques about the wrist were recorded. A vacuum cushion was used to comfortably fixate the forearm. The position and orientation of the forearm, wrist, fingers, and handle were recorded using a new three‐dimensional position measurement system (accuracy <±1 mm). The measurement system was integrated into the real‐time multichannel transcutaneous electrode environment, which is able to control the spatiotemporal position of multiple activation regions. Using the combined system and textile neuroprosthesis, we were able to optimize the activation regions to produce selective finger and wrist articulation, enabling improved functional grasp.