bluuebunny/crossref_metadata_2025_split huggingface dataset:
The dilemma for staff in ‘playing a game’ with a person with profound intellectual disabilities: empowerment, inclusion and competence in interactional practice
Authors: Finlay W.M.L. , Antaki Charles , Walton Chris , Stribling Penny 
Published: August 2010

AbstractGames between staff and people with intellectual disabilities serve to promote social engagement and inclusion. However, when the person has limited and idiosyncratic communicative abilities, it may be hard to gauge what his/her own view of the matter is. We examine video‐taped records of two episodes in which a staff member of a group home prompted a resident with profound intellectual disabilities to play a verbal and a non‐verbal ‘game’. We examine how the staff member in these two cases designs her actions to solve the dilemma she faces between, on the one hand, abandoning an activity when the resident does not provide clear indications that she/he wants to continue or, on the other hand, persisting with it until the resident begins to enjoy it or, at least, participate more fully. The solution lies in a pervasive institutional practice: treat resistance or ambiguity as temporary reluctance. We discuss these interactions as examples of how principles of empowerment, inclusion and independence play out in the details of everyday interaction.
Making monsters: heterosexuality, crime and race in recent Western media coverage of HIV
Authors: Persson Asha , Newman Christy 
Published: August 2010

AbstractIn the early HIV epidemic, Western media coverage encouraged the idea that infection was linked to ‘other’ identities located outside the ‘mainstream’; outside ‘proper’ heterosexuality. Today, however, HIV has become repositioned as a global heterosexual epidemic. Analyses show that since the 1990s Western media have shifted away from blame and hysteria to an increasingly routinised reporting of HIV as a health story and social justice issue. But recent years have seen the emergence of a new media story in many Western countries; the criminal prosecution for HIV‐related offences, and with it a reframing of old discourses of ‘innocence’ and ‘guilt’, but now with heterosexuals in focus. We examine this story in recent domestic media coverage in Australia, a country where heterosexual HIV transmission is rare by global comparison. Echoing similar stories in other Western media, in Australian coverage the idea of criminal intent converges with the symbolic weight of black sexuality and African origins to produce a ‘monstrous’ masculinity, which at the local level taps into contemporary racial tensions and, in so doing, conjures an imagined Anglo‐heterosexuality at once vulnerable to and safe from HIV in a globalised epidemic and world.
Birds of a feather flock together – and fall ill? Migrant homophily and health in Sweden
Authors: Rostila Mikael 
Published: August 2010

AbstractAlthough studies show that health inequities between ethnic groups exist, few have expressed interest in the origins of these disparities. As homophily (the phenomenon that people principally form relationships with those who are similar to them) influences people’s norms and interactions, it might be an important property of migrants’ networks, and have implications on their health. The aim of this study is to examine health inequities between natives and immigrants in Sweden and the health consequences arising from participation in homogenous migrant networks. Using total population registers and representative survey data initial analyses show that migrants experience poorer health than native Swedes. The findings further suggest that homophily is a prominent feature of migrant social networks and that migrants in networks with a high proportion of other migrants experience poorer health than those who include a high proportion of natives in their networks. However, unhealthy behaviour and disadvantaged social conditions may account for a considerable share of their excess risk. Hence, network closure may reinforce and maintain norms leading to negative behaviour and social conditions in such networks.
The clinical assessment of patients admitted to hospital following an episode of self‐harm: a qualitative study
Authors: Redley Marcus 
Published: August 2010

AbstractBased upon qualitative interviews with clinicians responsible for assessing patients admitted to hospital following an episode of self‐harm by overdose, this paper documents interactional factors that shape both how clinicians conduct these assessments and their understanding of what ‘causes’ someone to harm themselves. The analysis first documents how the patients’ overdoses are framed as essentially impulsive acts committed in response to adverse circumstances. This is achieved by clinicians’ avoidance of any engagement with, or assessment of, a patient’s reasons for taking an overdose. Secondly, the analysis considers why the patients’ reasons for taking an overdose do not feature in the clinicians’ assessments, and shows, by an examination of two deviant cases, that clinicians avoid engaging with patients’ motivations so as to: minimise the risk of generating bedside disagreements; avoid the possibility of being drawn into the emotional life of a patient, and shield themselves from the social and economic inequalities that are a feature of many patients’ lives. The paper concludes with a discussion of how bedside assessments that do not engage with patients’ reasons for taking an overdose might be experienced by the patients themselves and the deleterious effect this could have upon their clinical management.
Diagnostic ambivalence: psychiatric workarounds and the Diagnostic and Statistical Manual of Mental Disorders
Authors: Whooley Owen 
Published: August 2010

AbstractIn 1980 the American Psychiatric Association (APA), faced with increased professional competition, revised the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric expertise was redefined along a biomedical model via a standardised nosology. While they were an integral part of capturing professional authority, the revisions demystified psychiatric expertise, leaving psychiatrists vulnerable to infringements upon their autonomy by institutions adopting the DSM literally. This research explores the tensions surrounding standardisation in psychiatry. Drawing on in‐depth interviews with psychiatrists, I explore the ‘sociological ambivalence’ psychiatrists feel towards the DSM, which arises from the tension between the desire for autonomy in practice and the professional goal of legitimacy within the system of mental health professions. To carve a space for autonomy for their practice, psychiatrists develop ‘workarounds’ that undermine the DSM in practice. These workarounds include employing alternative diagnostic typologies, fudging the numbers (or codes) on official paperwork and negotiating diagnoses with patients. In creating opportunities for patient input and resistance to fixed diagnoses, the varied use of the DSM raises fundamental questions for psychiatrists about the role of the biomedical model of mental illness, especially its particular manifestation in the DSM.
Vulvovaginal Candida infection: current perspectives
Authors: Odds F.C. 
Published: August 2010

AbstractCandida Vulvovaginitis remains the subject of considerable research attention. Yeast species other than Candida albicans are being incriminated with increasing frequency as causes of vaginitis in some recent publications, while analysis of C. albicans strain types by DNA fingerprinting has provided preliminary evidence that the fungus may be able to make minor adaptations of its genotype that facilitate vaginal colonization. The current perception of C. albicans as a potentially virulent microbe relates several molecular factors to invasive processes. These include secretion of hydrolytic enzymes, in particular a proteolytic enzyme, and an inherent tendency to rapid phenotypic switching. Molecular biological experimentation with the genes determining secretion of enzymes should be able to demonstrate definitively the role played by such proteins in the pathogenetic process.
Prevention and early diagnosis of melanoma: a regional experience in Italy
Authors: Arcangeli F. , Catrani S. , Greco I. , Pierleoni M. , Landi G. 
Published: August 2010

AbstractBackground Over the 1980s several education campaigns for prevention and early diagnosis of cutaneous melanoma have been reported from various parts of the world.Aim To improve incidence and prognosis of cutaneous melanoma in 1985 we started, in our area, an information and health education campaign aimed at identifying precursors of melanoma (congenital melanocytic nevi), suspicious lesions (changing moles) and subjects with increased risk of melanoma.Method Precursors and suspicious lesions were promptly removed, and high‐risk persons entered the follow‐up program.Result As a general effect of these activities the percentage of thin melanomas diagnosed in our division after 1985 increased from 25 to 37.Conclusion We believe that education campaigns and screening of a targeted population, particularly of subjects presenting increased risk of melanoma, may be helpful in the early diagnosis of melanoma.
Skin changes in epilepsy
Authors: Yell J.A. , Marren P.M. 
Published: August 2010

AbstractAims To establish the skin changes found in epileptics, and to relate these changes to drug therapy.Background Skin changes in epileptics, although welt acknowledged, have been subjected to few recent large‐scale surveys. Newer anti‐epileptic drugs, in addition to the older therapies, including phenytoin, phenobarbitone and primidone, are now popular. In an effort to update our knowledge of skin changes in epileptics, a study of 200 patients in a long‐term epilepsy hospital was performed.Methods The study included taking a history, recording drug therapy and examining the skin of 200 patients.Results Patients ranged in age from 21 to over 70. 60% were men and 40% women. Their epilepsy was mostly well controlled, varying in length from less than 10 to greater than 40 years. 57.5% had post traumatic scars. 32.5% had gum hypertrophy, only half having dental caries. Dupuytren's contracture occurred in 24.5%. Seborrheic dermatitis was seen in 15%. 12.5% had coarse facial features and 11.5% had acne. 57.5% of women had facial hirsutes. 17.5% of all patients had sacral hirsutes, which is an unique feature in this group of patients. These clinical findings were correlated with drugs taken at the time, the age of the patients and length of epilepsy. 52% were on carbamazepine, 48% on phenytoin and 42% on primidone or phenobarbitone, singly or in combination.Conclusions A number of skin conditions are more common among epileptics. Phenytoin and phenobarbitone are linked to gingival hypertrophy, palmar fibromatosis, hypertrichosis, coarse fades and acne. Carbamazepine, too, may be implicated in gum hypertrophy, palmar fibromatosis, hypertrichosis, more specifically sacral hirsutes, seborrheic dermatitis, acne and coarse facies.
Mometasone furoate in the treatment of atopic dermatitis in children
Authors: Rafanelli Arturo , Rafanelli Silvia , Stanganelli Ignazio , Marchesi Enrico 
Published: August 2010

AbstractBackground Efforts are being made to find a non‐fluorinated topical corticosteroid with higher anti‐inflammatory activity for use in chronic dermatoses.Patients and methods In a third‐party blind evaluation study we compared Mometasone cream, 0.1% once a day, with Clobetasone cream, 0.05% twice daily, in 60 children with atopic dermatitis treated for 3 weeks. At each visit carried out at days 0, 7, 14. 21 we evaluated signs and symptoms, therapeutic response and skin atrophy. Further visits were carried out at days 2, 3, 4 to evaluate the onset of action. During the first and last visit we also carried out laboratory tests including blood cortisol.Results Mometasone was more effective and rapid in reducing signs and symptoms than Clobetasone. The difference between the two drugs was statistically significant (P < 0.05) from the fourth day of treatment for pruritus, and from days 7 and 14 for induration and eythema, respectively. At the end of the study 50% of the patients treated with Mometasone showed no symptoms vs 6.7% of those treated with Clobetasone. Topical and systemic tolerability were very good and laboratory tests were not significantly affected by either drug.Conclusions Monometasone cream seems to represent an interesting therapeutic approach to chronic dermatoses, i.e., atopic dermatitis.
Monolateral atrophoderma vermiculatum
Authors: Lorusso B. , Benci M. , Lotti T. 
Published: August 2010

AbstractAn extremely rare disease is reported. An 11‐year‐old boy presented with atrophoderma vermiculatum. The condition occurred autonomously only on the right cheek; the lesions were rounded, pit‐like atrophic scars without the typical ‘worm eaten’ aspect.
Autoimmune progesterone dermatitis with summertime remission
Authors: Acay M. Coşkun , Doǧruöz Keramettin , Harmanyeri Yavuz 
Published: August 2010

AbstractAn unusual case of autoimmune progesterone dermatitis is reported. The lesions followed a cyclical pattern, with premenstrual flares and a tendency to improve spontaneously at the start of menstruation, but the patient did not experience any exacerbation of her skin lesions in the summer months (June, July, August).
The spectrum of psoriasis in an Irish HIV population
Authors: Healy Eugene , Mulcahy Fiona , Barnes Louise 
Published: August 2010

AbstractObject Report of the pattern of psoriasis and response to therapy in psoriatic patients infected with HIV‐1.Setting Department of Dermatology, St. James's Hospital, DublinSubjects Seven HIV‐positive patients with psoriasis: six seen as part of a prospective dermatological assessment of all HIV‐positive patients; one separately referredObservations Three patients had psoriasis vulgaris which was limited and responsive to conventional therapy; one also had flexural psoriasis which proved difficult to control.Four patients had features of keratodermia blennorrhagicum; their skin disease was severe and warranted systemic treatment in three cases, without adverse affects. However, only one patient fulfilled the complete criteria for Reiter's syndrome.As six of the seven cases occurred in a prospective age‐ and sex‐matched controlled study of skin disease in 92 HIV‐1‐infected patients in which only two controls had psoriasis, it would suggest that there may be an increased prevalence of psoriasis in the HIV‐1 population.
The effect bathing in a thermal lagoon in Iceland has on psoriasis. A preliminary study
Authors: Ólafsson Jón Hjaltalín , Sigurgeirsson Báòur , Pálsdóttir Rannveig 
Published: August 2010

AbstractObjective To investigate if bathing in a unique thermal lagoon in Iceland has a therapeutic effect on psoriasis.Design An open study where twenty‐seven psoriasis patients bathed for three weeks in the lagoon. Psoriasis Area and Severity Index (PASI) was used to evaluate the severity of the disease before during and after bathing.Results The mean PASI score decreased from 16.1 to 8.1 (p= 0.01). The PASI score decreased most in the first week. The area of the lesions did not diminish but scaling erythema and infiltration decreased. Only very limited UV‐radiation was observed during the bathing period.Conclusions Bathing in the lagoon has a favourable effect on psoriasis although in some cases it may not be sufficient as a single treatment. Further studies over longer period are needed.
Clinico‐pathological study and five‐year follow‐up of 10 cases of hypopigmented mycosis fungoides
Authors: Ratnam K.V. , Pang Bryan K. 
Published: August 2010

AbstractBackground Hypopigmented (HMF) macular lesions are extremely rare manifestations of Mycosis fungoides (MF) with a predilection for blacks. Little is known of its prevalence, natural history and response to therapy in Asians.Objective The aim of the study was to investigate the natural history and clinicopathotogical aspects of HMF in an Asian population.Study Design A retrospective study of patient records from 1982 to 1989 was carried out and $100 immunostain was performed on sun exposed skin and covered skin of HMF patients and, as control, of healthy volunteers.Result 10 HMF patients (eight males and two females), of 18 (51.8%) who were seen for mycosis fungoides during this period, were studied. The majority were skin type III and IV, buttocks and limbs being important sites of predilection. Mean age at presentation and duration of disease prior to diagnosis were 20 and 4 years, respectively. Reduced melanin granules in basal keratinocytes and melanocytes, lymphocytic epidermotrophism and increased Langerhan's cell density were the most consistent microscopic findings. Response of patients to PUVA was excellent, with post treatment biopsy showing normal histology. Two patients with frequent relapse had extensive involvement and change in clinical pattern. On 5‐year follow‐up, HMF patients remained in stage 1. HMF variant is a common mode of presentation in young Asians, especially in males. It responds well to PUVA and has an excellent prognosis.
Low‐dose cyclosporin A in palmoplantar psoriasis: evaluation of efficacy and safety
Authors: Peter Ralf U. , Färber Lothar , Weiβ Jürgen , Kohnen Ralf , Weidinger G. , Ruzicka Thomas 
Published: August 2010

AbstractBackground The immunosuppressant cyclosporin A has been used with success in the treatment of chronic plaque‐type psoriasis; little is known about its effect on palmoplantar psoriasis.Subjects and methods Thirty‐three patients (12 women, 21 men; mean age = 44.2 years, range 22‐68 years) with palmoplantar psoriasis were treated with oral cyclosporin A, (CyA), 2.5 mg/kg/day, which could be increased to 5 mg/kg/day, for 12 weeks. Patients were followed up for a further 4 weeks without CyA treatment. A total of 26 patients completed the 12‐week treatment course, an additional six patients were followed up during 4 weeks after premature withdrawal. Efficacy was assessed by calculating the Psoriasis Area and Severity Index (PASl). a Local Psoriasis Severity Index (LPS1), and estimation of the area involved.Results Clinical response, being defined as at least 50% reduction of these parameters at the end of the therapeutic phase compared to baseline before treatment, was reached in 84% of the patients; 61% of the patients showed clinical response after only 6 weeks of treatment. No signs of severe hepatic or renal toxicity were noted during the study period; mild hypertension, which developed in one case, resolved after termination of the treatment. Relapses after treatment never reached the pretreatment baseline levels.Conclusions It is concluded that palmoplantar psoriasis can be treated effectively and safely with oral CyA at the low‐dose range of 2.5‐5 mg/kg/day. The results demonstrate the necessity for evaluation of a maintenance treatment in this special form of psoriasis, the doses and safety of which remain to be determined in future controlled clinical trials.
Dirofilariasis in Turkey: a case of subcutaneous dirofilariasis
Authors: Öztek İbrahim , Yenen Osman Şadi , Özertürk Yusuf , Uçmakh Ergün , Harmanyeri Yavuz 
Published: August 2010

AbstractA case of dirofilariasis is presented. The disease showed in our case subcutaneous location and was identified 9 years after the initial admittance of the patient. The mass was finally removed surgically.
Lateral displacement of the nipples and unilateral renal hypoplasia: another mammo‐renal syndrome?⋆
Authors: Urbani Carlo Enrico 
Published: August 2010

AbstractBackground of study Polythelia is a cutaneous marker of congenital diseases of the kidneys. Lateral displacement of the nipples (e.g. laterally located to their respective midclavicular lines) is considered a further sign of renal disorders, particularly of bilateral renal hypoplasia, as reported by Fleisher in a detailed study on seven infants.Subject We observed a 45‐year‐old white man with his morphologically normal nipples displaced on the lateral aspects of the trunk without any other consistent clinical features such as accessory nipples or areolae, gonadal dysgenesis, face or car anomalies.Aims and methods In order to reveal congenital abnormalities of the kidneys and the urinary collecting systems the following investigations were undertaken: renal ultrasound, intravenous pyelography. abdomen CT and NMR scans, urethrocystography, transurethral cystoscopy, urinalysis, laboratory tests including karyotype, ECG and cardiovascular evaluation.Results Instrumental findings disclosed a hypoplastic left kidney in an ectopic site, located below the right kidney (cross type of renal ectopy) without any connection between their urinary‐ collecting systems. Complex malformations of the urinary tract such as an orthotopic narrow right ureteral orifice and ridge, a large‐sized diverticulum on the left wall of the bladder were also present. Moreover, a tumour on the upper pole of the right kidney, 20 mm in diameter, with a histological picture of renal‐cell carcinoma was detected.Conclusions A lateral displacement of the nipples is a clue for the presence of renal hypoplasia both bilateral and unilateral. The significance of this association is unclear and its occurrence is probably underestimated.
Amyopathic dermatomyositis (dermatomyositis sine myositis) and cutaneous dermatomyositis with mild muscle disease
Authors: Haustein U.‐F. 
Published: August 2010

AbstractWe report on one patient suffering from amyopathic dermatomyositis, and two patients with transient or mild muscle involvement, respectively. The rare subset of amyopathic dermatomyositis is characterized by benign clinical course and prognosis. Leading cutaneous symptoms are heliotropic rash, periorbital violaceous‐red erythema and edema, erythematous lichenoid plaques at the dorsum of the hands and fingers, hyperkeratotic, hyperesthetic eponychium, nailfold capillary abnormalities and the skin histology, while itching and photosensitivity are optional features. On the other hand, clinical or laboratory evidence of muscle involvement is absent for at least 2 years. The two patients with transient or mild muscle involvement point to transitional forms between amyopathic and classical dermatomyositis. As differential diagnosis lupus erythematosus, (photo)contact eczema, lichen planus, psoriasis, seborrhoic dermatitis and atopic dermatitis, as well as polymorphic light eruption and erythroderma, should be considered. Association with internal malignancy is rare, but is to be excluded. Waiting, hydroxychlorochine and systemic glucocorticoids are the steps of treatment, depending on the clinical course.
Skin diseases in children with type 1 diabetes mellitus
Authors: Verrotti A. , Chiarelli F. , Amerio P.L. , Morgese G. 
Published: August 2010

AbstractAim To evaluate the presence of skin diseases in diabetic children and adolescents and analyse the risk factors involved.Background There are few studies in pediatric population with type 1 diabetes mellitus and these present conflicting resultsSetting and Patients The Department of Pediatrics and Dermatology, University of Chieti, Italy. A group of 146 (86 female, 60 male) children. Their mean age ± SD was 13.9 ± 7.8 (range: 2.1‐18.0) years; their duration of disease was 10.7 ± 8.8 (range: 1.5‐17.3) years.Results Thirty‐six patients showed skin problems: the most frequent disease was skin infection, followed by necrobiosis lipoidica; this last disorder is linked to the presence of microvascular complications.Conclusions The skin problems were more frequent in children with long duration of disease than in patients with a duration less than 7 years. All the patients who had limited joint mobility showed sclerodema, Dermatological evaluation is strongly reccomended in children with type 1 diabetes mellitus.