bluuebunny/crossref_metadata_2025_split huggingface dataset:
State-of-the-Science Symposium on Postacute Rehabilitation: Setting a Research Agenda and Developing an Evidence Base for Practice and Public Policy—Executive Summary
Authors: Heinemann Allen W. 
Published: October 2007

Purpose
The Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness along with academic, professional, provider, and accreditor organizations sponsored a symposium with the aim of serving as a catalyst for expanded research on postacute care (PAC) rehabilitation. The goals were to describe the state of our knowledge regarding utilization, organization, and outcomes of postacute rehabilitation settings, identify methodological and measurement challenges, foster the exchange of ideas among stakeholders, and identify researchable questions.

Method

The symposium was organized around 4 themes: (a) the need for improved
measurement
of rehabilitation variables and
methods
to collect and analyze this information, (b) factors that influence
access
to rehabilitation care, (c) similarities and differences in services across PAC
settings,
and (d)
effectiveness
of rehabilitation services.

Results
Key themes included the need for improved measures, particularly of case-mix factors and treatment ingredients; the need for a uniform and coherent system of PAC; the need to attend to under- and overutilization of rehabilitation services; the need for cooperation among stakeholders to advance an effectiveness research agenda; and the desire to develop payment policies that are based on research evidence.

Conclusions

The symposium articles appear in the November 2007 issue of
Archives of Physical Medicine and Rehabilitation.
Developing a Clinician-Friendly Aphasia Test
Authors: Marshall Robert C. , Wright Heather Harris 
Published: October 2007

Purpose
The Kentucky Aphasia Test (KAT) is an objective measure of language functioning for persons with aphasia. This article describes materials, administration, and scoring of the KAT; presents the rationale for development of test items; reports information from a pilot study; and discusses the role of the KAT in aphasia assessment.

Method
The KAT has 3 parallel test batteries, KAT-1, KAT-2, and KAT-3. Each battery contains the same orientation test and 6 subtests, each with 10 items, assessing expressive and receptive language functions. Subtests for KAT-1, KAT-2, and KAT-3 systematically increase in difficulty so that it is possible to assess individuals with severe, moderate, and mild aphasia, respectively. The KAT was administered to 38 participants with aphasia and 31 non-brain-damaged (NBD) participants.

Results

Results with the KAT clearly differentiated the language performance of individuals with and without aphasia. NBD participants made few errors, and overall scores on the test for individuals with aphasia were rarely within 1
SD
of the NBD group. Performance of the participants with aphasia administered KAT-1, KAT-2, and KAT-3 suggested that the 3 versions of the test represent a hierarchy of difficulty.

Conclusions
The KAT remains in its early stages of development. However, it does appear to meet the requirements for a “clinician-friendly” aphasia test and, as such, offers a rapid, convenient means of obtaining an objective score to determine changes in language functioning during the early postonset period.
Communication Disorders: Prevalence and Comorbid Intellectual Disability, Autism, and Emotional/Behavioral Disorders
Authors: Pinborough-Zimmerman Judith , Satterfield Robert , Miller Judith , Bilder Deborah , Hossain Shaheen , McMahon William 
Published: October 2007

Purpose
To determine a population-based estimate of communication disorders (CDs) in children; the co-occurrence of intellectual disability (ID), autism, and emotional/behavioral disorders; and the impact of these conditions on the prevalence of CDs.

Method

Surveillance targeted 8-year-olds born in 1994 residing in 2002 in the 3 most populous counties in Utah (
n
= 26,315). A multiple-source record review was conducted at all major health and educational facilities.

Results
A total of 1,667 children met the criteria of CD. The prevalence of CD was estimated to be 63.4 per 1,000 8-year-olds (95% confidence interval = 60.4–66.2). The ratio of boys to girls was 1.8:1. Four percent of the CD cases were identified with an ID and 3.7% with autism spectrum disorders (ASD). Adjusting the CD prevalence to exclude ASD and/or ID cases significantly affected the CD prevalence rate. Other frequently co-occurring emotional/behavioral disorders with CD were attention deficit/hyperactivity disorder, anxiety, and conduct disorder.

Conclusions
Findings affirm that CDs and co-occurring mental health conditions are a major educational and public health concern.
Characteristics of Physician Relocation Following Hurricane Katrina
Authors: Madamala Kusuma , Campbell Claudia R. , Hsu Edbert B. , Hsieh Yu-Hsiang , James James 
Published: October 2007

ABSTRACTIntroduction: On August 29, 2005, Hurricane Katrina made landfall along the US Gulf Coast, resulting in the evacuation of >1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned.Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency–designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with χ2 or Fisher exact test was used to determine factors associated with plans to return to original practice.Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6% lived in Louisiana and 14.4% resided in Mississippi before the hurricane struck. By spring 2006, 75.6% (n = 236) of the respondents had returned to their original homes, whereas 24.4% (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95% CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95% CI 0.13–0.42; P < .001).Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return. (Disaster Med Public Health Preparedness. 2007;1:21–26)
Prevalence of and Sex Disparities in Posttraumatic Stress Disorder in an Internally Displaced Sri Lankan Population 6 Months After the 2004 Tsunami
Authors: Ranasinghe Padmini D. , Levy Becca R. 
Published: October 2007

ABSTRACTBackground:When the 2004 Indian Ocean tsunami suddenly hit unsuspecting coastal populations in Sri Lanka, it inflicted unprecedented devastation including 35,000 deaths and 500,000 people displaced. Evaluating the psychological impact of this natural disaster provides valuable insights into planning interventions and disaster preparedness.Methods:A cross-sectional survey was conducted among 264 adult males and females ≥16 years old living in temporary shelters housing tsunami survivors at 6 months. Interviewer-administered structured interviews were conducted to measure posttraumatic stress disorder (PTSD) and its risk factors.Results:The participation rate was 97%. Of the subjects, 56% met criteria for symptoms of PTSD, with females at 64% and males at 42%. Females had at least twice the risk of experiencing PTSD (odds ratio [OR] 2.27, 95% confidence interval [CI] 1.37–3.76). This sex difference persisted after adjusting for age, marital status, being a parent, loss of family members, amount of social support, education level, and level of depression (OR 2.14, 95% CI 1.21–3.80). Depression was significantly associated with PTSD (OR 7.19, 95% CI 3.83–13.52).Conclusions:In this directly affected population, a majority met criteria for PTSD, indicating a significant long-term public health burden. The findings also confirm that females are at much higher risk for PTSD than males, suggesting that special mental health efforts should be targeted at women exposed to trauma. (Disaster Med Public Health Preparedness. 2007;1:34–43)
Excess Mortality in the Aftermath of Hurricane Katrina: A Preliminary Report
Authors: Stephens Kevin U. , Grew David , Chin Karen , Kadetz Paul , Greenough P Gregg , Burkle Frederick M. , Robinson Sandra L. , Franklin Evangeline R. 
Published: October 2007

ABSTRACTBackground: Reports that death notices in the Times-Picayune, the New Orleans daily newspaper, increased dramatically in 2006 prompted local health officials to determine whether death notice surveillance could serve as a valid alternative means to confirm suspicions of excess mortality requiring immediate preventive actions and intervention.Methods: Monthly totals of death notices from the Times-Picayune were used to obtain frequency and proportion of deaths from January to June 2006. To validate this methodology the authors compared 2002 to 2003 monthly death frequency and proportions between death notices and top 10 causes of death from state vital statistics.Results: A significant (47%) increase in proportion of deaths was seen compared with the known baseline population. From January to June 2006, there were on average 1317 deaths notices per month for a mortality rate of 91.37 deaths per 100,000 population, compared with a 2002–2004 average of 924 deaths per month for a mortality rate of 62.17 deaths per 100,000 population. Differences between 2002 and 2003 death notices and top 10 causes of death were insignificant and had high correlation.Discussion: Death notices from local daily newspaper sources may serve as an alternative source of mortality information. Problems with delayed reporting, timely analysis, and interoperability between state and local health departments may be solved by the implementation of electronic death registration. (Disaster Med Public Health Preparedness. 2007;1:15–20)
Building Resistance, Resilience, and Recovery in the Wake of School and Workplace Violence
Authors: Nucifora Frederick , Langlieb Alan M. , Siegal Everett , Everly George S. , Kaminsky Michael 
Published: October 2007

ABSTRACTIncidents of school and workplace violence are rare but devastating events that can result in significant psychological consequences in communities. The majority of people in the United States will experience some type of traumatic event in their lifetime, but most of them will have no disruption or only transient disruption in functioning. They are either resistant to the development of symptoms or resilient, able to bounce back quickly. By enhancing resistance and promoting resilience, even fewer individuals may develop mental disorders. This article takes a closer look at the concepts of resistance, resilience, and recovery and the need for research on interventions that promote them, in the hope of applying the concepts and interventions to schools and the workplace. (Disaster Med Public Health Preparedness. 2007;1(Suppl 1):S33–S37)
Mass Murder in a University Setting: Analysis of the Medical Examiner's Response
Authors: Fierro Marcella F. 
Published: October 2007

ABSTRACTBackground: Seung-Hui Cho, a student at Virginia Polytechnic Institute and State University (Virginia Tech), shot and killed 33 students and faculty, including himself, on the morning of April 16, 2007.Methods: A retrospective review of the medical examiner system response to this multiple fatality event was undertaken to identify which procedures were and were not effective. Case records, spreadsheets, telephone call logs, notes, and after-action interviews of staff were reviewed and analyzed. Recommendations were developed to improve the management of the multiple components of a high-profile multiple fatality event.Results: One autopsy took place on Monday, April 16, 12 on Tuesday, April 17, and 20 on Wednesday, April 18. Pathologists archived the biopsies of major organs in formalin. Slides were made of entrance wounds that exhibited residues. Blood for alcohols was collected from victims. Blood for alcohols, acid, base, and neutral drugs was collected from Cho for analysis.Conclusions: Standard forensic pathology procedures worked and timely postmortem examinations were completed. The victim identification component of the family assistance center must be established and staffed at the time of the initial response. Public information officers need training in morgue and medicolegal death management and in ways to effectively communicate with different audiences about multiple fatality management procedures. (Disaster Med Public Health Preparedness. 2007;1(Suppl1):S25–S30)
Sensitization to human milk
Authors: Schulmeister U. , Swoboda I. , Quirce S. , De La Hoz B. , Ollert M. , Pauli G. , Valenta R. , Spitzauer S. 
Published: October 2007

SummaryBackground
Allergy to milk is one of the earliest manifestations of IgE‐mediated allergies and affects about 2.5% of newborn children. Several reports indicate that milk‐allergic patients may be sensitized also to human milk proteins.Objective
To analyse the specificity and possible biological relevance of IgE reactivity to human milk antigens in milk‐allergic patients.Methods
The specificity of IgE reactivity to cow's milk and human milk antigens was analysed with sera from milk‐allergic children and adults by IgE immunoblotting. IgE cross‐reactivity between milk antigens was studied by immunoblot inhibition experiments. That IgE reactivity to human milk antigens is not due to alloreactivity or due to the transmission of foreign antigens into mother's milk was demonstrated through the analysis of milk samples from genetically unrelated mothers before and after intake of dietary milk products. The biological relevance of IgE reactivity to human milk was confirmed by skin testing.Results
IgE antibodies to human milk were found in more than 80% of the tested milk‐allergic patients. Cross‐reactive IgE‐reactive human antigens such as α‐lactalbumin and non‐cross‐reactive human milk antigens were identified. Immediate‐type skin reactions could be elicited with human milk samples in patients with IgE reactivity to human milk.Conclusion
IgE reactivity to human milk in milk‐allergic patients can be due to cross‐ sensitization and genuine sensitization to human milk and may cause allergic symptoms. IgE‐mediated sensitization to human milk is common in milk‐allergic patients and may require diagnostic testing and monitoring.
Homocysteine threshold value based on cystathionine beta synthase and paraoxonase 1 activities in mice
Authors: Hamelet J. , Aït‐Yahya‐Graison E. , Matulewicz E. , Noll C. , Badel‐Chagnon A. , Camproux A‐C. , Demuth K. , Paul J‐L. , Delabar J. M. , Janel N. 
Published: October 2007

AbstractBackground  Hyperhomocysteinaemia is a metabolic disorder associated with the development of premature atherosclerosis. Among the determinants which predispose to premature thromboembolic and atherothrombotic events, serum activity of paraoxonase 1, mainly synthesized in the liver, has been shown to be a predictor of cardiovascular disease and to be negatively correlated with serum homocysteine levels in human. Even though treatments of hyperhomocysteinaemic patients ongoing cardiovascular complications are commonly used, it still remains unclear above which homocysteine level a preventive therapy should be started.Materials and methods  In order to establish a threshold of plasma homocysteine concentration we have analyzed the hepatic cystathionine beta synthase and paraoxonase 1 activities in a moderate to intermediate murine model of hyperhomocysteinaemia. Using wild type and heterozygous cystathionine beta synthase deficient mice fed a methionine enriched diet or a control diet, we first studied the link between cystathionine beta synthase and paraoxonase 1 activities and plasma homocysteine concentration.Results  Among the animals used in this study, we observed a negative correlation between plasma homocysteine level and cystathionine beta synthase activity (ρ = –0·52, P = 0·0008) or paraoxonase 1 activity (ρ = –0·49, P = 0·002). Starting from these results, a homocysteine cut‐off value of 15 µm has been found for both cystathionine beta synthase (P = 0·0003) and paraoxonase 1 (P = 0·0007) activities.Conclusions  Our results suggest that both cystathionine beta synthase and paraoxonase 1 activities are significantly decreased in mice with a plasma homocysteine value greater than 15 µm. In an attempt to set up preventive treatment for cardiovascular disease our results indicate that treatments should be started from 15 µm of plasma homocysteine.
Platelet deposition in remote cardiac regions after coronary occlusion
Authors: Barrabés J. A. , Mirabet M. , Agulló L. , Figueras J. , Pizcueta P. , Garcia‐Dorado D. 
Published: October 2007

AbstractBackground  Activated platelets might contribute to endothelial dysfunction in non‐ischaemic territories during acute myocardial infarction. We assessed platelet deposition, coronary flow reserve and contractile function in remote cardiac regions after transient coronary occlusion and their association with systemic platelet activation.Materials and methods  In 10 pigs (series A) subjected to 48‐min occlusion of the left anterior descending coronary artery (LAD), 99mTc‐platelet content in the right coronary artery (RCA) and its dependent myocardium was counted after reflow. In 10 pigs (series B) receiving the same occlusion of the RCA, the hyperaemic response at the LAD and systolic shortening in LAD‐dependent myocardium were monitored after reperfusion. P‐selectin expression on circulating platelets was assessed in both series by flow cytometry.Results  In series A, platelet counts in the RCA and non‐ischaemic myocardium were correlated with platelet content, polymorphonuclear leukocyte infiltration and infarct size in the reperfused zone, as well as with the percentage of P‐selectin‐positive platelets after reflow. In series B, a transient reduction in peak hyperaemic response in the LAD and sustained contractile dysfunction in non‐ischemic myocardium were observed after releasing the RCA occlusion, these changes being also correlated with platelet activation status.Conclusions  Ischaemic injury triggers macro‐ and microvascular platelet deposition and causes an impairment in coronary flow reserve and contractile function in distant regions of the heart, which are related to activation of circulating platelets.
High‐order kernels for Riemannian wavefield extrapolation
Authors: Sava Paul , Fomel Sergey 
Published: October 2007

ABSTRACTRiemannian wavefield extrapolation is a technique for one‐way extrapolation of acoustic waves. Riemannian wavefield extrapolation generalizes wavefield extrapolation by downward continuation by considering coordinate systems different from conventional Cartesian ones. Coordinate systems can conform with the extrapolated wavefield, with the velocity model or with the acquisition geometry.When coordinate systems conform with the propagated wavefield, extrapolation can be done accurately using low‐order kernels. However, in complex media or in cases where the coordinate systems do not conform with the propagating wavefields, low order kernels are not accurate enough and need to be replaced by more accurate, higher‐order kernels. Since Riemannian wavefield extrapolation is based on factorization of an acoustic wave‐equation, higher‐order kernels can be constructed using methods analogous to the one employed for factorization of the acoustic wave‐equation in Cartesian coordinates. Thus, we can construct space‐domain finite‐differences as well as mixed‐domain techniques for extrapolation.High‐order Riemannian wavefield extrapolation kernels improve the accuracy of extrapolation, particularly when the Riemannian coordinate systems does not closely match the general direction of wave propagation.
Hypogonadism in men receiving methadone and buprenorphine maintenance treatment
Authors: Hallinan R. , Byrne A. , Agho K. , McMahon C. G. , Tynan P. , Attia J. 
Published: October 2007

SummaryThe aim of this study was to determine the prevalence and investigate the aetiology of hypogonadism in men on methadone or buprenorphine maintenance treatment (MMT, BMT). 103 men (mean age 37.6 ± 7.9) on MMT (n = 84) or BMT (n = 19) were evaluated using hormone assays, body mass index (BMI), serological, biochemical, demographic and substance use measures. Overall 54% of men (methadone 65%; buprenorphine 28%) had total testosterone (TT) <12.0 nm; 34% (methadone 39%; buprenorphine 11%) had TT <8.0 nm. Both methadone‐ and buprenorphine‐treated men had lower free testosterone, luteinising hormone and estradiol than age‐matched reference groups. Methadone‐treated men had lower TT than buprenorphine‐treated men and reference groups. Prolactin did not differ between methadone, buprenorphine groups, and reference groups. Primary testicular failure was an uncommon cause of hypogonadism. Yearly percentage fall in TT by age across the patient group was 2.3%, more than twice that expected normally. There were no associations between TT and opioid dose, cannabis, alcohol and tobacco consumption, or chronic hepatitis C viraemia. On multiple regression higher TT was associated with higher alanine aminotransferase and lower TT with higher BMI. Men on MMT have high prevalence of hypogonadotrophic hypogonadism. The extent of hormonal changes associated with buprenorphine needs to be explored further in larger studies. Men receiving long term opioid replacement treatment, especially methadone treatment, should be screened for hypogonadism. Wide interindividual differences in methadone metabolism and tolerance may in a cross‐sectional study obscure a methadone dose relationship to testosterone in individuals. Future studies of hypogonadism in opioid‐treated men should examine the potential benefits of dose reduction, choice of opioid medication, weight loss, and androgen replacement.
Factors affecting the evaluation of biomonitoring data for human exposure assessment
Authors: Calafat Antonia M. , Needham Larry L. 
Published: October 2007

SummaryMeasuring trace levels of multiple environmental chemicals in biological tissues (i.e., biomonitoring) with a high degree of accuracy and precision is possible thanks to sophisticated analytical chemistry techniques and highly trained laboratory personnel. Selection and validation of biomarkers of exposure are critical. We present examples of the use of biomonitoring in exposure assessment for non‐persistent chemicals using phthalates as model compounds. We also discuss several factors relevant to interpreting and understanding biomonitoring data, including the impact of metabolism of the chemicals and matrix composition in the selection of biomarkers of exposure, as well as temporal stability considerations that may affect the biomarkers’ concentrations.