bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-Term Reorganization of Auditory Analysis Induced by Phonetic Experience
Authors: Liebenthal Einat , Binder Jeffrey R. , Piorkowski Rebecca L. , Remez Robert E.
Published: May 2003

Sine wave replicas of spoken words can be perceived both as nonphonetic auditory forms and as words, depending on a listener's experience. In this study, brain areas activated by sine wave words were studied with fMRI in two conditions: when subjects perceived the sounds spontaneously as nonphonetic auditory forms (“naïve condition”) and after instruction and brief practice attending to their phonetic attributes (“informed condition”). The test items were composed such that half replicated natural words (“phonetic items”) and the other half did not, because the tone analogs of the first and third formants had been temporally reversed (“nonphonetic items”). Subjects were asked to decide whether an isolated tone analog of the second formant (T2) presented before the sine wave word (T1234) was included in it. Experience in attending to the phonetic properties of the sinusoids interfered with this auditory matching task and was accompanied by a decrease in auditory cortex activation with word replicas but not with the acoustically matched nonphonetic items. Because the activation patterns elicited by equivalent acoustic test items depended on a listener's awareness of their phonetic potential, this indicates that the analysis of speech sounds in the auditory cortex is distinct from the simple resolution of auditory form, and is not a mere consequence of acoustic complexity. Because arbitrary acoustic patterns did not evoke the response observed for phonetic patterns, these findings suggest that the perception of speech is contingent on the presence of familiar patterns of spectral variation. The results are consistent with a short-term functional reorganization of auditory analysis induced by phonetic experience with sine wave replicas and contingent on the dynamic acoustic structure of speech.
A Cortical Mechanism for Triggering Top-Down Facilitation in Visual Object Recognition
Authors: Bar Moshe
Published: May 2003

The majority of the research related to visual recognition has so far focused on bottom-up analysis, where the input is processed in a cascade of cortical regions that analyze increasingly complex information. Gradually more studies emphasize the role of top-down facilitation in cortical analysis, but it remains something of a mystery how such processing would be initiated. After all, top-down facilitation implies that high-level information is activated earlier than some relevant lower-level information. Building on previous studies, I propose a specific mechanism for the activation of top-down facilitation during visual object recognition. The gist of this hypothesis is that a partially analyzed version of the input image (i.e., a blurred image) is projected rapidly from early visual areas directly to the prefrontal cortex (PFC). This coarse representation activates in the PFC expectations about the most likely interpretations of the input image, which are then back-projected as an “initial guess” to the temporal cortex to be integrated with the bottom-up analysis. The top-down process facilitates recognition by substantially limiting the number of object representations that need to be considered. Furthermore, such a rapid mechanism may provide critical information when a quick response is necessary.
The Children's Treatment of Animals Questionnaire (CTAQ): A Psychometric Investigation
Authors: Thompson Kelly , Gullone Eleonora
Published: April 2003

Recognizing the importance of increasing the levels of children's humane behavior toward animals other than humans relates to the developing of valid and reliable measures of such behavior. This study reports the psychometric properties of the Children's Treatment of Animals Questionnaire (CTAQ), which assesses children's humane behavior toward nonhuman animals. The findings, based on self-reports by 61 elementary school children (25 boys; 36 girls), showed that the 13-item scale has adequate internal consistency. In addition, comparing two administrations of the scale over a five-week period demonstrated good test-retest reliability. The scale's convergent validity was demonstrated with significant correlations between responses on the CTAQ and two previously validated measures of empathy. The study concluded that the CTAQ is a valid and reliable measure for assessing the degree to which children's behavior toward nonhuman animals is humane. Determining the sensitivity of the measure to change (following humane education) and the predictive validity of the measure (identification of children who are cruel to animals) will require further research.
Companion Animal Attitude and its Family Pattern in Kuwait
Authors: Al-Fayez Ghenaim , Arikawa Hiroko , Awadalla Abdelwahid , Templer Donald
Published: April 2003

The Pet Attitude Scale (PAS) score of Kuwaiti adolescents correlated more highly with that of their fathers than with the score of their mothers. This contrasts with a similar American study in which the PAS score of adolescents correlated more highly with the score of their mothers. The different pattern seemed to be congruent with the father's more dominant role in Arab families. This study found that Kuwaiti family members had scores on the PAS about a standard deviation lower than that of American family members, a finding viewed as consistent with the less positive attitude toward companion animals in Muslim countries.
"Would You Let Your Child Die Rather than Experiment on Nonhuman Animals?" A Comparative Questions Approach
Authors: Perlo Katherine
Published: April 2003

By placing the title question alongside five comparative questions and offering answers to the whole set as given by seven imaginary respondents, this paper analyzes the question's deceptiveness and the inconsistency of its implied claims. Apart from ambiguities of situation, history, and agency, the question's demand for a choice between "your child" and "nonhuman animals" obscures a field of other values regarding (1) species, (2) family ties, and (3) the wrongness-in-itself (or otherwise) of the experiments envisioned. This paper argues that while a "No" answer to the title question does not, as intended by the questioner, support the experimental status quo, even a "Yes" answer does not reflect a choice between one's own child and animals.
The Labor Process: How the Underdog is Kept Under
Authors: Dickens Peter
Published: April 2003

"Marxism and the Underdog" is an impressive paper. It usefully outlines the strengths and weaknesses of the Marxist (what I would prefer to term "historical materialist") perspective on animals. As the paper rightly suggests, much of Marx's own work was predicated on the opposition between humans and animals other than humans. Yet, as the paper also points out, many of his concepts and critiques are useful for addressing contemporary concerns. Among the most important recent examples is Benton's critique of liberal and individualist "animal rights." It is a perspective on Marx and his assertion that much human rights discourse offers little or no fundamental challenge to the patterns of economic, social, and political power that pervade capitalist society. There is little point in allocating rights to humans (and to animals) if the kind of society in which they live systematically denies the realization of these rights. I mention Benton here because his important perspective on animal rights is not fully explained in the paper under review here.
Immigrant Women and Domestic Violence
Authors: MENJÍVAR CECILIA , SALCIDO OLIVIA
Published: May 2003

In this article, the authors assess the still limited literature on domestic violence among immigrant women in major receiving countries so as to begin delineating a framework to explain how immigrant-specific factors exacerbate the already vulnerable position—as dictated by class, gender, and race—of immigrant women in domestic violence situations. First, a review of this scholarship shows that the incidence of domestic violence is not higher than it is in the native population but rather that the experiences of immigrant women in domestic violence situations are often exacerbated by their specific position as immigrants, such as limited host-language skills, isolation from and contact with family and community, lack of access to dignified jobs, uncertain legal statuses, and experiences with authorities in their origin countries. The authors then examine the various responses at the national and local community levels to this issue in receiving countries.
Mapping a Global Labor Market
Authors: COLLINS JANE L.
Published: May 2003

This article examines the ways that managers in a rapidly globalizing industry use gendered discourses of skill to justify and frame their search for inexperienced workers in low-wage regions, using a case of a U.S.-based apparel firm that relocated and subcontracted its sewing operations in the 1990s. It uses feminist theory to examine managers' claims that women's sewing skills in the United States were disappearing and that they needed to seek out these skills in parts of the world where women were not yet active participants in labor markets. Feminist researchers have long understood the ways that naturalization of skill cheapens women's labor. The case presented here highlights the way in which the portrayal of certain skills as naturally occurring resources justifies the movement of capital in search of new pools of workers without labor market experience or union representation.
Paradoxes of Professionalization
Authors: MARKOWITZ LISA , TICE KAREN W.
Published: May 2003

During the past two decades, opportunities for women's social movement organizations to expand their scope of engagement have often been accompanied by greater vulnerability to donor discipline and scrutiny. Efforts by activists to accommodate the demands for accountability and institutional sustainability by professionalizing their organizations have been instrumental in moving feminist concerns into the political mainstream. However, such institutionalization has frequently contributed to the persistence or creation of social hierarchies within and between women's organizations, as well as to shifts in their social change agendas and action strategies. This article examines the common dilemmas of activists in Latin America and the United States, bringing together two usually separate domains of scholarship to analyze the course, costs, and possibilities of organizational transformation.
CD2 engagement induces dendritic cell activation: implications for immune surveillance and T-cell activation
Authors: Crawford Keith , Stark Aleksandra , Kitchens Betsy , Sternheim Kerry , Pantazopoulos Vassilios , Triantafellow Ellen , Wang Zhigang , Vasir Baldev , Larsen Charles E. , Gabuzda Dana , Reinherz Ellis , Alper Chester A.
Published: April 2003

We have shown previously that primary dendritic cells and monocytes express equal levels of CD14 but are distinguishable by the presence of CD2 on dendritic cells. CD2 is known to mediate the activation of T and natural killer (NK) cells through its interaction with CD58. CD2 epitopes recognized by anti-T111, -T112, and -T113 monoclonal antibodies (mAbs) are present on dendritic cells. Here we show that CD2 engagement significantly increases class II, costimulatory (CD40, CD80, CD86), adhesion (CD54, CD58), and CCR7 molecule expression on primary dendritic cells. Conversely, minimal or no change in the expression of the above antigens occurs on monocyte-derived dendritic cells, because these molecules are already maximally expressed. However, both kinds of dendritic cells release interleukin-1β (IL-1β) and IL-12 after CD2 engagement. Lastly, interference with dendritic cell CD2–T-cell CD58 engagement decreases naive CD4+CD45RA+ T-cell proliferation. Collectively, our results suggest another role of the CD2-CD58 pathway that allows nonimmune and immune cells to interact directly with dendritic cells and initiate innate and adaptive immune responses.
Ex vivo induction of multiple myeloma–specific cytotoxic T lymphocytes
Authors: Hayashi Toshiaki , Hideshima Teru , Akiyama Masaharu , Raje Noopur , Richardson Paul , Chauhan Dharminder , Anderson Kenneth C.
Published: April 2003

Multiple myeloma (MM) is an incurable plasma cell malignancy characterized by immunosuppression. In this study, we identified factors in patients' bone marrow (BM) sera inhibiting autologous anti-MM immunity and developed an ex vivo strategy for inducing MM-specific cytotoxic T lymphocytes (CTLs). We found that sera from BM of MM patients inhibited induction of dendritic cells (DCs), evidenced by both phenotype and only weak stimulation of T-cell proliferation. Anti–vascular endothelial growth factor (anti-VEGF) and/or anti–interleukin 6 (anti–IL-6) antibodies neutralized this inhibitory effect, confirming that VEGF and IL-6, at least in part, mediate immunosuppression in MM patients. To induce MM-specific CTLs ex vivo, immature DCs were generated by culture of adherent mononuclear cells in medium containing granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-4 for 5 days and then cocultured with apoptotic MM bodies in the presence of tumor necrosis factor α (TNF-α) for 3 days to induce their maturation. Autologous BM or peripheral blood mononuclear cells were stimulated weekly with these DCs, and cytotoxicity was examined against the MM cells used to pulse DCs. DCs cultured with apoptotic bodies stimulated significantly greater T-cell proliferation (stimulation index [SI] = 23.2 at a T-DC ratio of 360:1) than T cells stimulated by MM cells only (SI = 5.6), DCs only (SI = 9.3), or MM lysate–pulsed DCs (SI = 13.5). These CTLs from MM patients demonstrated specific cytotoxicity (24.7% at the effector-target [E/T] ratio of 40:1) against autologous primary MM cells. These studies therefore show that CTLs from MM patients can recognize and lyse autologous tumor cells and provide the framework for novel immunotherapy to improve patient outcome in MM.
Placenta growth factor activates monocytes and correlates with sickle cell disease severity
Authors: Perelman Natalya , Selvaraj Suresh K. , Batra Sandeep , Luck Lori R. , Erdreich-Epstein Anat , Coates Thomas D. , Kalra Vijay K. , Malik Punam
Published: April 2003

Sickle cell disease (SCD) results in chronic hypoxia and secondarily increased erythropoietin concentrations. Leukocytosis and activated monocytes are also observed in SCD in absence of infection or vaso-occlusion (steady state), the reasons for which are unknown. We found that erythroid cells produced placenta growth factor (PlGF), an angiogenic growth factor belonging to the vascular endothelial growth factor (VEGF) family, and its expression was induced in bone marrow CD34+ progenitor cells in the presence of erythropoietin. Furthermore, the steady state circulating PlGF levels in subjects with severe SCD (at least 3 vaso-occlusive crises [VOCs] per year) were 18.5 ± 1.2 pg/mL (n = 9) compared with 15.5 ± 1.2 pg/mL (n = 13) in those with mild SCD (fewer than 3 VOCs per year) and 11.3 ± 0.7 pg/mL (n = 9) in healthy controls (P < .05), suggesting a correlation between PlGF levels and SCD severity. In addition, PlGF significantly increased mRNA levels of the proinflammatory cytochemokines interleukin-1β, interleukin-8, monocyte chemoattractant protein-1, and VEGF in peripheral blood mononuclear cells (MNCs) of healthy subjects (n = 4; P < .05). Expression of these same cytochemokines was significantly increased in MNCs from subjects with SCD at steady state (n = 14), compared with healthy controls. Of the leukocyte subfractions, PlGF stimulated monocyte chemotaxis (P < .05, n = 3). Taken together, these data show for the first time that erythroid cells intrinsically release a factor that can directly activate monocytes to increase inflammation. The baseline inflammation seen in SCD has always been attributed to sequelae secondary to the sickling phenomenon. We show that PlGF contributes to the inflammation observed in SCD and increases the incidence of vaso-occlusive events.
Induction of FucT-VII by the Ras/MAP kinase cascade in Jurkat T cells
Authors: Barry Sheila M. , Zisoulis Dimitrios G. , Neal Joel W. , Clipstone Neil A. , Kansas Geoffrey S.
Published: May 2003

Induction of the α1,3-fucosyltransferase FucT-VII in T lymphocytes is crucial for selectin ligand formation, but the signaling and transcriptional pathways that govern FucT-VII expression are unknown. Here, using a novel, highly phorbol myristate acetate (PMA)–responsive variant of the Jurkat T-cell line, we identify Ras and downstream mitogen-activated protein (MAP) kinase pathways as essential mediators of FucT-VII gene expression. PMA induced FucT-VII in only a subset of treated cells, similar to expression of FucT-VII in normal activated CD4 T cells. Introduction of constitutively active Ras or Raf by recombinant retroviruses induced FucT-VII expression only in that subset of cells expressing the highest levels of Ras, suggesting that induction of FucT-VII required a critical threshhold of Ras signaling. Both PMA treatment and introduction of active Ras led to rolling on E-selectin. Pharmacologic inhibition studies confirmed the involvement of the classic Ras-Raf-MEK–extracellular signal-regulated kinase (Ras-Raf-MEK-ERK) pathway in FucT-VII induction by PMA, Ras, and Raf. These studies also revealed a second, Ras-induced, Raf-1–independent pathway that participated in induction of FucT-VII. Strong activation of Ras represents a major pathway for induction of FucT-VII gene expression in T cells.
TGFβ inhibits LPS-induced chemokine mRNA stabilization
Authors: Dai Yalei , Datta Shyamsree , Novotny Michael , Hamilton Thomas A.
Published: April 2003

The mechanisms involved in anti-inflammatory action of transforming growth factor β (TGFβ) have been examined by evaluating its effect on chemokine gene expression in mouse macrophages. Lipopolysaccharide (LPS)–stimulated expression of the CXC chemokines KC and MIP-2 was selectively reduced by TGFβ in a time- and protein synthesis–dependent process. While TGFβ had a modest effect on transcription of the KC and MIP-2 mRNAs as measured by nuclear run-on, it had no effect on LPS-stimulated luciferase expression driven by the KC promoter nor on the activation of nuclear factor κB (NFκB) DNA-binding activity and transactivation function. Interestingly, KC mRNA levels were markedly reduced by TGFβ treatment in cells transfected with KC genomic or cDNA constructs driven from either the KC or cytomegalovirus (CMV) promoters, demonstrating the importance of sequences within the mature mRNA and suggesting that suppression may involve a posttranscriptional mechanism. In support of this possibility, LPS stimulation prolonged the half-life of KC mRNA and this stabilization response was blocked in cells treated with TGFβ. Examination of KC mRNA expressed under control of a tetracycline-responsive promoter demonstrated that TGFβ prevented stabilization of KC mRNA, in response to LPS but did not alter KC mRNA half-life directly. KC mRNA stabilization by LPS was dependent on activation of p38 mitogen-activated protein kinase (MAPK) activity, and TGFβ treatment inhibited p38 MAPK activation. These findings support the hypothesis that TGFβ-mediated suppression of chemokine gene expression involves antagonism of LPS-stimulated KC mRNA stabilization via inhibition of p38 MAPK.
Antiapoptotic effect of coagulation factor VIIa
Authors: Sorensen Brit B. , Vijaya Mohan Rao L. , Tornehave Ditte , Gammeltoft Steen , Petersen Lars C.
Published: May 2003

Binding of factor VIIa (FVIIa) to its cellular receptor tissue factor (TF) was previously shown to induce various intracellular signaling events, which were thought to be responsible for TF-mediated biologic effects, including angiogenesis, tumor metastasis, and restenosis. To understand the mechanisms behind these processes, we have examined the effect of FVIIa on apoptosis. Serum deprivation–induced apoptosis of BHK(+TF) cells was characterized by apoptotic blebs, nuclei with chromatin-condensed bodies, DNA degradation, and activation of caspase 3. FVIIa markedly decreased the number of cells with apoptotic morphology and prevented the DNA degradation as measured by means of TdT-mediated dUTP nick end labeling (TUNEL). The antiapoptotic effect of FVIIa was confirmed by the observation that FVIIa attenuated caspase 3 activation. FVIIa-induced antiapoptotic effect was dependent on its proteolytic activity and TF but independent of factor Xa and thrombin. FVIIa-induced cell survival correlated with the activation of Akt and was inhibited markedly by the specific PI3-kinase inhibitor, LY294002. Blocking the activation of p44/42 mitogen-activated protein kinase (MAPK) by the specific mitogen-induced extracellular kinase (MEK) inhibitor, U0126, impaired modestly the ability of FVIIa to promote cell survival. In conclusion, FVIIa binding to TF provided protection against apoptosis induced by growth factor deprivation, primarily through activation of PI3-kinase/Akt pathway, and to a lesser extent, p44/42 MAPK pathway.
Hematopoietic stimulation by a dipeptidyl peptidase inhibitor reveals a novel regulatory mechanism and therapeutic treatment for blood cell deficiencies
Authors: Jones Barry , Adams Sharlene , Miller Glenn T. , Jesson Michael I. , Watanabe Takeshi , Wallner Barbara P.
Published: May 2003

In hematopoiesis, cytokine levels modulate blood cell replacement, self-renewal of stem cells, and responses to disease. Feedback pathways regulating cytokine levels and targets for therapeutic intervention remain to be determined. Amino boronic dipeptides are orally bioavailable inhibitors of dipeptidyl peptidases. Here we show that the high-affinity inhibitor Val-boro-Pro (PT-100) can stimulate the growth of hematopoietic progenitor cells in vivo and can accelerate neutrophil and erythrocyte regeneration in mouse models of neutropenia and acute anemia. Hematopoietic stimulation by PT-100 correlated with increased cytokine levels in vivo. In vitro, PT-100 promoted the growth of primitive hematopoietic progenitor cells by increasing granulocyte–colony-stimulating factor (G-CSF), interleukin-6 (IL-6), and IL-11 production by bone marrow stromal cells. Two molecular targets of PT-100 are expressed by stromal cells— CD26/DPP-IV and the closely related fibroblast activation protein (FAP). Because PT-100 was active in the absence of CD26, FAP appears to be the hematopoietic target for PT-100. Interaction of PT-100 with the catalytic site seems to be required because amino-terminal acetylation of PT-100 abrogated enzyme inhibition and hematopoietic stimulation. PT-100 is a therapeutic candidate for the treatment of neutropenia and anemia. The data support increasing evidence that dipeptidyl peptidases can regulate complex biologic systems by the proteolysis of signaling peptides.
Bacterial lipopolysaccharide directly induces angiogenesis through TRAF6-mediated activation of NF-κB and c-Jun N-terminal kinase
Authors: Pollet Ingrid , Opina Christy J. , Zimmerman Carla , Leong Kevin G. , Wong Fred , Karsan Aly
Published: April 2003

The intracellular pathways by which inflammatory mediators transmit their angiogenic signals is not well studied. The effects of a potent inflammatory mediator, bacterial lipopolysaccharide (LPS), are transmitted through Toll-like receptors (TLRs). A major, although not exclusive, LPS/TLR intracellular signaling pathway is routed through TNF (tumor necrosis factor) receptor associated factor 6 (TRAF6). In this report we demonstrate that LPS directly stimulates endothelial sprouting in vitro. By blocking TRAF6 activity using retroviral expression of a dominant-negative TRAF6 in endothelial cells, we show that TRAF6 is absolutely required for the LPS-initiated angiogenic response in vitro and in vivo. Inhibition of either c-Jun N-terminal kinase (JNK) activity or nuclear factor κB (NF-κB) activity, downstream of TRAF6, is sufficient to inhibit LPS-induced endothelial sprouting. In contrast, only inhibition of NF-κB, but not JNK, activity blocks basic fibroblast growth factor (bFGF)–induced angiogenesis. Our findings thus demonstrate a direct endothelial-stimulatory role of LPS in initiating angiogenesis through activation of TRAF6-dependent signaling pathways.
Autologous transplantation of granulocyte colony-stimulating factor–primed bone marrow is effective in supporting myeloablative chemotherapy in patients with hematologic malignancies and poor peripheral blood stem cell mobilization
Authors: Lemoli Roberto M. , de Vivo Antonio , Damiani Daniela , Isidori Alessandro , Tani Monica , Bonini Alessandro , Cellini Claudia , Curti Antonio , Gugliotta Luigi , Visani Giuseppe , Fanin Renato , Baccarani Michele
Published: April 2003

We assessed the hematopoietic recovery and transplantation-related mortality (TRM) of patients who had failed peripheral blood stem cell mobilization and subsequently received high-dose chemotherapy supported by granulocyte colony-stimulating factor (G-CSF)–primed bone marrow (BM). Studied were 86 heavily pretreated consecutive patients with acute leukemia (n = 21), refractory/relapsed non-Hodgkin lymphoma (n = 41) and Hodgkin disease (n = 17), and multiple myeloma (n = 7). There were 78 patients who showed insufficient mobilization of CD34+ cells (< 10 cells/μL), whereas 8 patients collected less than 1 × 106 CD34+ cells/kg. BM was primed in vivo for 3 days with 15 to 16 μg/kg of subcutaneous G-CSF. Median numbers of nucleated cells, colony-forming unit cells (CFU-Cs), and CD34+ cells per kilogram harvested were 3.5 × 108, 3.72 × 104, and 0.82 × 106, respectively. Following myeloablative chemotherapy, median times to achieve a granulocyte count higher than 0.5 × 109/L and an unsupported platelet count higher than 20 and 50 × 109/L were 13 (range, 8-24), 15 (range, 12-75), and 22 (range, 12-180) days, respectively, for lymphoma/myeloma patients and 23 (range, 13-53), 52 (range, 40-120), and 90 (range, 46-207) days, respectively, for leukemia patients. Median times to hospital discharge after transplantation were 17 (range, 12-40) and 27 (range, 14-39) days for lymphoma/myeloma and acute leukemia patients, respectively. TRM was 4.6%, whereas 15 patients died of disease. G-CSF–primed BM induces effective multilineage hematopoietic recovery after high-dose chemotherapy and can be safely used in patients with poor stem cell mobilization.
A double-blind placebo-controlled study of botulinum toxin in upper limb spasticity after stroke or head injury
Authors: Smith S J , Ellis E , White S , Moore A P
Published: May 2003

Objective: To assess dose–response relationships to a single dose of botulinum toxin ‘A’ in upper limb spasticity associated with stroke or head injury.

Design: A double-blind placebo-controlled randomized dose ranging study.

Setting: A regional centre for neuroscience and a neurorehabilitation outpatient clinic.

Subjects: Twenty-one hemiplegic patients with troublesome upper limb spasticity. Nineteen with stroke and two with head injury.

Main outcome measures: Spasticity (modified Ashworth), range of movement, posture (postural alignment and finger curl), disability (upper body dressing time and Frenchay Arm Test), patient-reported global assessment scale.

Results: Combining data from all doses of botulinum toxin there was a significant reduction in spasticity at the wrist and fingers associated with a greater range of passive movement at the wrist and less finger curl at rest. There was a tendency for a further reduction in spasticity at elbow and wrist to occur with increasing dose but not for finger spasticity or curl. Effects present at six weeks were lost by 12 weeks except for a small improvement in elbow range of movement at the 1500 Mu dose. There was no change in upper limb disability but a significant increase in patients' global assessment of benefit.

Conclusion: Botulinum toxin produced beneficial effects in spasticity and passive range of movement in the hemiplegic upper limb. Increasing the dose increased the magnitude of response for impairments in some muscle groups but had little effect on duration of response.
Ulnar nerve lesions: functional outcome after five years
Authors: van Nispen Fcm , Dijkstra P U , Geertzen J HB , Groothoff J W , Eisma W H
Published: May 2003

Objective: To analyse perceived impairments, disability, job restrictions and job changes in subjects with a neurapraxia and neurotmesis of the ulnar nerve five years after trauma.

Design: Retrospective, descriptive follow-up study.

Setting: Department of Rehabilitation of a University Hospital.

Subjects: Sixteen subjects with a neurotmesis (NT-group) and 20 subjects with a neurapraxia (NP-group) were compared by means of a structured interview assessing perceived impairments and change in job and a questionnaire assessing disabilities (Groningen Activity Restriction Scale: GARS).

Results: The NP-group perceived significantly more pain, loss of strength and sensation, loss of dexterity and perceived more job-related restrictions than the NT-group. The NP-group had significantly higher scores on the GARS. There was a moderate correlation between the visual analogue score of the pain and the GARS in the NP- and NT-groups. No significant difference was found between the groups with respect to job changes.

Conclusions: This study shows that subjects with a neurapraxia of the ulnar nerve perceive more impairments and disabilities compared with those subjects with a neurotmesis.
Distribution of muscle strength impairments following stroke
Authors: Andrews A Williams , Bohannon Richard W
Published: May 2003

Objective: The purpose of this study was to quantify the distribution of strength impairments soon after stroke. We were specifically interested in differences in impairments between proximal and distal actions, flexion and extension actions, and upper and lower limb actions.

Design: We conducted a retrospective chart review of strength scores of patients with acute stroke.

Setting: Inpatient rehabilitation unit.

Subjects: Forty-eight patients with a primary diagnosis of stroke underwent initial testing on admission; 31 of the same patients underwent final testing prior to discharge.

Main outcome measures: The strength of eight muscle actions was assessed bilaterally using hand-held dynamometry. Force measurements obtained were expressed in newtons and as a percentage of normal.

Results: Strength was impaired bilaterally but more so on the side contralateral to the brain lesion. Distal muscle actions were less impaired than proximal muscle actions on the stronger side. Extension actions were less impaired than flexion actions bilaterally but primarily in the upper limbs. Upper limb actions were less impaired than lower limb actions only on the stronger side.

Conclusions: With a few exceptions, our results do not support common clinical assumptions regarding the distribution of strength impairments following stroke.
An observational study of the Stroke Association family support organizer service
Authors: Harding Jennifer , Lincoln Nadina B
Published: May 2003

Objective: The aim was to investigate the role of Stroke Association family support organizers, in order to decide what outcome measures would be appropriate for evaluating their service.

Design: Family support organizers (FSOs) were observed on home and hospital visits by an independent observer. Every two minutes recordings were made of the location, individuals present and activity taking place.

Setting: FSOs working in the North-West and Midland regions of Britain.

Results: The majority (71%) of visits took place in the patient's home, with both patients and carers (39%). The most frequently occurring activities were enquiry (17%), task-related conversation (14%) and support-related conversations (14%). Comparison of FSOs showed variation in the time dedicated to each activity.

Conclusions: FSOs spend more time engaged in practical rather than emotional activities. The role of the FSO is multifaceted. Evaluation of the FSO service needs to measure the patient's mood and functional abilities, the carer's mood and strain, and patients' and carers' knowledge and satisfaction with information and services.
A multicentre randomized controlled trial of leisure therapy and conventional occupational therapy after stroke
Authors: Parker C J , Gladman J RF , Drummond A ER , Dewey M E , Lincoln N B , Barer D , Logan P A , Radford K A
Published: May 2003

Objective: To evaluate the effects of leisure therapy and conventional occupational therapy (OT) on the mood, leisure participation and independence in activities of daily living (ADL) of stroke patients 6 and 12 months after hospital discharge.

Design: Multicentre randomized controlled trial.

Setting and participants: Four hundred and sixty-six stroke patients from five UK centres.

Main outcome measures: The General Health Questionnaire (12 item), the Nottingham Extended ADL Scale and the Nottingham Leisure Questionnaire, assessed by post, with telephone clarification.

Results: Four hundred and forty (94%) and 426 (91%) subjects were alive at 6 and 12 months, respectively. Three hundred and seventy-four (85% of survivors) and 311 (78% of survivors) responded at 6 and 12 month follow-up respectively. At six months and compared to the control group, those allocated to leisure therapy had nonsignificantly better GHQ scores (–1.2: 95% CI –2.9, +0.5), leisure scores (+0.7, 95% CI –1.1, +2.5) and Extended ADL scores (+0.4: 95% CI –3.8, +4.5): the ADL group had nonsignificantly better GHQ scores (–0.1: 95% CI –1.8, +1.7) and Extended ADL scores (+1.4: 95% CI –2.9, +5.6) and nonsignificantly worse leisure scores (–0.3: 95% CI –2.1, +1.6). The results at 12 months were similar.

Conclusion: In contrast to the findings of previous smaller trials, neither of the additional OT treatments showed a clear beneficial effect on mood, leisure activity or independence in ADL measured at 6 or 12 months.
Functional level of young adults with cerebral palsy
Authors: van der Dussen L , Nieuwstraten W , Roebroeck M , Stam H J
Published: May 2003

Objective: To acquire insight into the level of functioning of young adults with cerebral palsy (CP).

Design: Descriptive cross-sectional study.

Setting: Rehabilitation Centre Den Haag, The Netherlands.

Method: A structured questionnaire, including the Barthel Index was mailed to 134 young adults (aged 21–31 years) with cerebral palsy.

Results: Eighty subjects responded (60%). Of these, 60 (75%) were largely or fully independent in activities of daily living, 72 (90%) moved independently indoors, 56 (70%) outdoors. In 67 (77.5%) of the group the level of communication was adequate for telephone conversation. Twenty-four (30%) lived with their parents, 10 (12.5%) with a partner and 26 (32.5%) lived alone. Almost half lived in an unadapted house. Forty-two (53%) completed some form of secondary education and 29 (36.3%) had paid employment.

Conclusion: Despite their considerable impairments, the large majority of this group of young adults with cerebral palsy are independent in activities of daily living, mobility and communication. Regarding the level of education, participation in paid employment and sports activities, however, young adults with CP are poorly integrated.
Electrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review
Authors: Price C IM , Pandyan A D
Published: May 2003

Background: Shoulder pain after stroke is common and disabling. The optimal management is uncertain, but electrical stimulation (ES) is often used to treat and prevent pain.

Objectives: The objective of this review was to determine the efficacy of any form of surface ES in the prevention and/or treatment of pain around the shoulder at any time after stroke.

Search strategy: We searched the Cochrane Stroke Review Group trials register and undertook further searches of Medline, Embase and CINAHL. Contact was established with equipment manufacturers and centres that have published on the topic of ES.

Selection criteria: We considered all randomized trials that assessed any surface ES technique (functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) or other), applied at any time since stroke for the purpose of prevention or treatment of shoulder pain.

Data collection and analysis: Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.

Main results: Four trials (a total of 170 subjects) fitted the inclusion criteria. Study design and ES technique varied considerably, often precluding the combination of studies. Population numbers were small. There was no significant change in pain incidence (odds ratio (OR) 0.64; 95% CI 0.19–2.14) or change in pain intensity (standardized mean difference (SMD) 0.13; 95% CI –1.0–1.25) after ES treatment compared with control. There was a significant treatment effect in favour of ES for improvement in pain-free range of passive humeral lateral rotation (weighted mean difference (WMD) 9.17; 95% CI 1.43–16.91). In these studies ES reduced the severity of glenohumeral subluxation (SMD –1.13; 95% CI –1.66 to –0.60), but there was no significant effect on upper limb motor recovery (SMD 0.24; 95% CI –0.14–0.62) or upper limb spasticity (WMD 0.05; 95% CI –0.28–0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.
An audit of the provision of environmental control systems in Northern Ireland, 1992–1997
Authors: Maguire S M , McCann J P , Swallow M
Published: May 2003

Objective: To evaluate the provision of environmental control systems (ECS) in Northern Ireland with regard to assessment and prescription, installation and review and propose guidelines for future service delivery.

Design: Structured interview, physical examination, Barthel ADL Index, demonstration and assessment of suitability of ECS for patient.

Subjects: Prescriptions for ECS from April 1992 to 1997 were identified from centrally held records. Current users were assessed in their own homes.

Results: Forty-six out of 49 current users identified were assessed. All were severely disabled (Barthel 0–9); 24% were living alone; 7 (15%) were not utilizing the system; 96% were satisfied with their initial assessment. Prior to prescription 52% had information about ECS and 20% had a practical demonstration; 78% felt that this would have been useful; 52% of users were not under routine clinical review; 41% of ECS had been altered since installation. Repairs had taken longer than 7 days in 11% of cases. In 45 cases the ECS was essential and in 43 it was appropriate to the users' needs and abilities.

Conclusions: ECS are a valuable tool for severely disabled persons and are appropriately prescribed in Northern Ireland. A multidisciplinary team should perform assessment and prescription. All patients should have a practical trial of the equipment to assist in prescriptions. Regular review by the team should be performed to identify changes in need and alter systems appropriately. Users who live alone should represent a priority for repairs.
A randomized efficacy and feasibility study of imagery in acute stroke
Authors: Page Stephen J , Levine Peter , Sisto SueAnn , Johnston Mark V
Published: May 2003

Objective: To compare the feasibility and efficacy of a programme combining imagery and occupational therapy with a programme of therapy only.

Design: Randomized, controlled case series.

Setting: Subacute outpatient clinic.

Subjects: Thirteen consecutively admitted patients between four weeks and one year post stroke exhibiting stable motor deficits in their affected upper limbs.

Intervention: All patients received an hour of therapy three times a week for six weeks administered by the same physical and occupational therapists. During the same period, eight patients participated in 10-minute guided imagery sessions after each therapy session, as well as practising imagery at home twice each week. Five patients participated in a control intervention consisting of exposure to stroke information.

Main outcome measures: The Fugl-Meyer Assessment of Motor Recovery (Fugl-Meyer) and Action Research Arm Test (ARA).

Results: After intervention, Fugl-Meyer and ARA scores of patients in the therapy only group remained virtually the same; therapy plus imagery group scores improved by 13.8 and 16.4 points, respectively, on the Fugl-Meyer and ARA.

Conclusions: Imagery is a clinically feasible, cost-effective complement to therapy that may improve outcomes more than participation in therapy only.
Translation and adaptation of a questionnaire to assess the group processes of rehabilitation team conferences
Authors: Roelofsen Eline E , Lankhorst Gustaaf J , Bouter Lex M
Published: May 2003

Objective: To investigate the internal consistency, the domain structure and the influence of social desirability with regard to a questionnaire translated and adapted to assess the quality of rehabilitation team conferences in the Netherlands.

Study design: A questionnaire to determine group decision-making processes was translated and adapted to rehabilitation and completed by 44 rehabilitation professionals.

Results: The internal consistency of the domains Personal participation, Negative socio-emotional behaviour, Result satisfaction and Process satisfaction was found to be satisfactory (Cronbach’s α ranges from 0.70 to 0.84). The domain structure is confirmed by item–total and item–rest correlations. From the original English questionnaire, one question concerning the domain Personal participation was omitted. The domain Informal leadership has been deleted from the questionnaire, because informal leadership is not an issue in a situation in which the Chairman is already known. Response to the questionnaire did not seem to be biased by social desirability.

Conclusion: The translated and adapted questionnaire can be used to assess the group processes of rehabilitation team conferences. Results from the literature concerning the original questionnaire suggest that the translated and adapted questionnaire might be able to detect changes in the group process of rehabilitation team conferences.
Do associated reactions in the upper limb after stroke contribute to contracture formation?
Authors: Ada Louise , O'Dwyer Nicholas
Published: May 2003

Objective: To establish (1) whether associated reactions could contribute to contracture formation and (2) whether the presence of spasticity was essential for their expression, after stroke.

Subjects: Subjects were 24 hemiparetics within 13 months of a stroke, unselected for contracture or spasticity.

Main outcome measures: Associated reactions were identified by the presence of muscle activity in the affected biceps brachii and quantified as the amount of affected elbow flexor torque produced during a moderate contraction of either the contralateral biceps brachii or the contralateral quadriceps muscles. Contracture was measured as loss of elbow joint range of motion and spasticity as the presence of abnormal reflex activity.

Results: Associated reactions were present in at least one testing condition in seven subjects. During contractions of the contralateral biceps brachii, the median amount of elbow flexor torque produced was 0.39 (interquartile range, IQR 2.5) Nm while during contractions of the contralateral quadriceps muscle it was 0.19 (IQR 1.6) Nm. Associated reactions were not associated with contracture (p = 0.39) which was present in over half of the subjects. The incidence of associated reactions was about the same as that of spasticity, but the two were not related (p = 0.61).

Conclusions: Even though associated reactions were present in 29% of the subjects during moderate contraction of the contralateral muscles, they were not large, nor were they associated with contracture or spasticity, suggesting that this phenomenon is not usually a major problem for everyday function after stroke.
Effectiveness of dynamic cognitive intervention in rehabilitation of clients with schizophrenia
Authors: Hadas-Lidor N , Katz N , Tyano S , Weizman A
Published: May 2003

Objective: To examine the efficacy of dynamic cognitive treatment in rehabilitation of schizophrenic clients.

Subjects: Fifty-eight schizophrenic clients that were matched equally into two groups: a study group (n = 29) (treated by Instrumental Enrichment) and a control group (treated with traditional occupational therapy methods).

Setting: The subjects were treated in a day rehabilitation centre in the community.

Study design: The programme lasted one year, the same schedule was provided for both groups. Subjects were randomly assigned and assessed before and after intervention with the same battery and at a follow-up six months later, work and residence status were evaluated.

Main outcome measures: Instruments included: (1) memory and thought processes, measured by a battery of structured tests from the Learning Potential Assessment Device (LPAD), Raven Progressive Matrices and General Aptitude Test Battery (GATB); (2) functional outcomes, instrumental activities of daily living (IADL), measured by a questionnaire; work and residence status; (3) self-concept measured with Fitts questionnaire.

Results: Results showed significant differences between the groups on almost all the cognitive tests (MANOVA revealed significant differences between the two groups for both memory and thought process (F(2.52) = 13.75, p < 0.001; and F(1.46) = 7.28, p < 0.001, respectively) as well as in work (χ2 = 14.30, p < 0.001), and residence (χ2 = 3.86, p < 0.05) status. There were no significant differences in IADL questionnaire or the self-concept scale.

Conclusions: The successful outcome points to the importance of including long-term cognitive intervention in rehabilitation of schizophrenic clients. This work suggests that the classic view of schizophrenia as a progressive irreversible decline that cannot be altered may be wrong.
Differences in treatment outcome between subgroups of patients with chronic low back pain using lumbar dynamometry and psychological aspects
Authors: Hutten M MR , Hermens H , Zilvold G
Published: May 2003

Objective: To investigate whether subgroups of patients with chronic low back pain show differences in treatment outcome, measured with the Roland Disability Questionnaire. (RDQ).

Setting: The study was carried out in a rehabilitation centre.

Subjects: Eighty-four patients with chronic low back pain participated in this study.

Intervention: Patients followed a multidisciplinary treatment programme that primarily targets physical aspects.

Design and main outcome measure: Based on pretreatment lumbar dynamometry results and Symptom Checklist (SCL-90) scores, patients were divided into subgroups. The dynamometry subgroups were: performances lower than healthy subjects (expected performance), performances comparable with those of healthy subjects (normal performance) and inconsistent performances (submaximal performance). The SCL-90 subgroups were: a total score of ‘average’ or lower compared with a population of chronic pain patients (low psychological score) and a total score of ‘above average’ or higher compared with this population (high psychological score). Patients answered the RDQ in the week before (RDQ1; n = 84) and after treatment (RDQ2; n = 78) to investigate whether the subgroups show differences in outcome expressed as the percentage change between RDQ2 and RDQ1 (%RDQ2–1). A%RDQ2–1 ≥ 20% was classified as an improvement.

Results: Improvement on disability level ≥20% is shown in 64% and 55% of the patients with ‘normal’ and ‘expected’ lumbar dynamometry performances and low psychological scores compared with only 33% and 25% of those with high psychological scores. Patients with submaximal performances show hardly any changes in disability level and there are no differences between those with low psychological scores (14%) and those reporting high scores (0%).

Conclusion: The fact that patient subgroups with differences in treatment outcome can be defined using lumbar dynamometry and psychological questionnaires suggests that these instruments might facilitate treatment indication in clinical practice.