bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fulminant infection by uncommon organisms in animal bite wounds
Authors: Dutta J K 
Published: December 2008

Summary
In 1995 and 1996, 215 patients exposed to different species of animals were treated at the Amarnath Polyclinic, Balasore, in India. Among them were two children infected by uncommon organisms, i.e., Capnocytophaga canimorsus and Pasteurella multocida; the patients recovered with appropriate antibiotic therapy.
Management of inguinal herniae in patients on continuous ambulatory peritoneal dialysis: an audit of current UK practice
Authors: Morris-Stiff G J , Bowrey D J , Jurewicz W A , Lord R H H 
Published: December 2008

Summary
Patients receiving continuous ambulatory peritoneal dialysis are at increased risk for the development of inguinal herniae, with a reported prevalence of 14%. Elective hernia repair is indicated for these patients as strangulation is associated with a high mortality in this population. There are currently no national guidelines relating to the optimal peri-operative management of these patients, in particular the appropriate pre- and post-operative dialysis regimen. The aim of the current study was to evaluate current practice in the UK by means of a postal questionnaire sent to all centres undertaking renal transplantation. Replies were received from 34/37 centres. The principal study finding was the wide variation in surgical practice between different centres with regard to pre- and post-operative dialysis regimes. Only 44% of centres had an established protocol. Based upon the study findings we have devised a protocol that we hope to see implemented into UK practice. Following its introduction, a re-assessment will be performed and the audit cycle completed.
Management of the unexpected result: compensated hypothyroidism
Authors: Benediktsson R , Toft A D 
Published: December 2008

Summary
The combination of elevated serum thyrotropin and normal serum thyroxine is called compensated or subclinical hypothyroidism. This most commonly represents clinically silent autoimmune thyroiditis. Whether this condition warrants treatment or simply observation is still debated. The risk of developing overt hypothyroidism is high in females with elevated thyrotropin above 10 mU/l and/or positive thyroid microsomal antibodies. Males are also at high risk of progression towards overt hypothyroidism, regardless of antibody status or degree of thyrotropin elevation. We advise routine treatment of only those at high risk of developing overt hypothyroidism.
Teachers' Views of the Treatability of Children's School Adjustment Problems'
Authors: DeStefano Michael A. , Gesten Ellis L. , Cowen Emory L. 
Published: December 2008

One-hundred thirty-four primary grade teachers rated each of nine hypothetical referrals, depicting three predominant types of school adjustment problems (acting-out, shy-anxious, learning), on four dimensions: (a) appropriateness of referring the child to the school's mental health services, (b) ease or difficulty for a mental health person to work with such a child, (c) how much a mental health person would enjoy working with the child, and (d) a treatment-prognosis estimate. Shy-anxious children generally received the most positive ratings. Teacher judgments were compared to prior, similar judgments made by mental health personnel. The latter gave significantly higher appropriateness ratings, indicated that the children would be significantly less difficult and more enjoyable to work with, and judged prognosis to be more favorable. An important deviation from this pattern of findings is considered.
How many body locations need to be tested when assessing sensation after stroke? An investigation of redundancy in the Rivermead Assessment of Somatosensory Performance
Authors: Busse Monica , Tyson Sarah F 
Published: December 2008

Objective: Assessing sensation after stroke is time consuming. This study aimed to identify how many body locations need to be tested to establish whether sensation is `intact', `impaired' or `absent' and to assess validity of that classification. Design: Participants' sensation was tested in a single assessment session. Agreement between the scores for individual anatomical sites and those for the whole limb was calculated using a weighted kappa and percentage agreement for each modality. High agreement between tests indicated redundancy, suggesting that the number of anatomical sites tested could be reduced. The Kruskal—Wallis test assessed the validity of classification by comparing a range of measures of functional ability in people with intact, impaired and absent sensation. Setting: Hospital-based stroke care. Subjects: One hundred and two patients tested 2—4 weeks after stroke. Main measures: Four proprioceptive and tactile modalities were measured using the Rivermead Assessment of Somatosensory Performance. Results: Agreement between the total limb score and individual anatomical sites was substantial to excellent for all modalities and anatomical sites. Agreement was greater than 90% when sensation was intact or absent. The comparison between patients with intact, impaired and absent sensation showed significant differences in functional mobility, independence in the activities of daily living, balance and weakness in people with stroke. Conclusions: Sensory impairment can be classified as `intact', `impaired' or `absent'. There is a high redundancy between anatomical sites when the patient's sensation is `intact' or `absent' and not all sites need to be tested. Reducing the number of sites tested will improve usability of the Rivermead Assessment of Somatosensory Performance in day-to-day clinical practice.
Training patients in Time Pressure Management, a cognitive strategy for mental slowness
Authors: Winkens Ieke , Van Heugten Caroline M , Wade Derick T , Fasotti Luciano 
Published: December 2008

Purpose: To provide clinical practitioners with a framework for teaching patients Time Pressure Management, a cognitive strategy that aims to reduce disabilities arising from mental slowness due to acquired brain injury. Time Pressure Management provides patients with compensatory strategies to deal with time pressure in daily life. Application of the training in clinical practice is illustrated using two case examples from a randomized controlled trial on the effectiveness of Time Pressure Management for patients with stroke. Rationale: The Time Pressure Management approach is based on Michon's task analysis, describing levels of decision-making in complex cognitive tasks. Decisions with little or no time pressure are not impaired by mental slowness. Therefore, patients should try to transfer actions from situations with high time pressure to situations where the preserved decision levels with little or no time pressure can work. Theory into practice: Several factors are required to teach patients to use Time Pressure Management. First, sufficient awareness is needed to recognize that there is a deficit and behavioural change is necessary. Sufficient awareness is also required to recognize and anticipate time pressure situations and to realize that the strategy is helpful and might also be useful in new and more difficult circumstances. Second, adequate motivation is needed to learn the strategy. And finally, the training should be adjusted to the patient's individual learning abilities and cognitive skills.
Evidence for the retraining of sensation after stroke: a systematic review
Authors: Schabrun SM , Hillier S. 
Published: December 2008

Objective: Retraining of sensory function following stroke is frequently overlooked in rehabilitation protocols despite more than 60% of patients presenting with sensory deficits. Methods to train sensory function include both passive and active training protocols. Here we examined the volume and quality of the evidence available for both passive and active sensory training following stroke. In addition, we aimed to quantify the effect of sensory training on impairment and function. Data sources: Databases searched included MEDLINE, AMED, CINAHL, Academic search elite, Scopus and the Cochrane library. Unpublished articles were identified using a search engine. Review methods: Studies utilizing passive or active sensory training paradigms post stroke were identified. Methodological quality was examined using the National Health and Medical Research Council hierarchy of evidence and the McMaster University critical appraisal tool. Results: Fourteen studies met the inclusion criteria; 8 examined passive and 6 active sensory training. Methodological quality scores ranged from 11 to 18.5 (maximum 20). Meta-analysis was performed using three studies examining hand function, demonstrating a moderate effect in favour of passive sensory training. Other studies were unable to be pooled due to heterogeneity of measures or insufficient data. Conclusion: Meta-analyses and single studies offer some support for the effectiveness of passive sensory training in relation to sensory impairment and motor function. However, empirical evidence for active sensory training is limited. Further high-quality studies with greater statistical power and meaningful clinical measures are required in order to accurately determine the effectiveness of sensory retraining following stroke.
Staff Development
Authors: Klein Nancy , Sheehan Robert 
Published: December 2008

The dramatic increase in the number of mothers of young children currently in the work force has resulted in an increased demand for child care outside the home, including care for handicapped children. To meet this need, we propose the integration of handicapped children into community child care centers as adjunct services to specialized early intervention programs. The successful integration of handicapped children into day care settings requires a planned program of staff development. Several models of staff development are presented that have been found effective for teachers of school-age children in mainstreamed settings. Several features of these models are incorporated in the special education consultation model described here. This model provides on-site consultation to day care providers as they acquire the skills to adapt and modify activities to facilitate the social integration of handicapped children in all activities of the center. And, finally, case studies are presented that document the staff development process.
Changes in Technology Use in California's Special Education Programs
Authors: Lewis Rena B. 
Published: December 2008

Abstract This study investigated changes in technology use in california's special education programs between the late 1980s and mid-1990s. two groups representing districts that participated in an earlier study were surveyed: special education administrators ( n = 149) and special educators who routinely use technology in instruction ( n = 189). Results suggest that computers and other technologies are more available today and used more often by administrators, teachers, and students with disabilities. Students are more likely to have technology goals on their individualized education programs, interact with technology in general education settings, and use computers as tools rather than for drill-and-practice. Administrators and teachers remain enthusiastic about technology's benefits. However, although technologies used in school programs have become more sophisticated and more plentiful, barriers to full implementation still exist.
Beyond the Capitalist Labor Process Workplace Change, the State and Globalisation'
Authors: Thompson Paul , Smith Chris 
Published: December 2008

Analysis within or influenced by a labor process tradition has largely failed to capture the complexities of relations between capital, labor and the state, and has tended to leave policy issues to the optimistic scenarios of post-Fordist and related perspectives. Focusing on the political requires a comparative perspective. In this paper we want to examine the interplay between international competitiveness, national institutions and workplace politics. The central paradox facing us is that just as the nation has been written into debate, the power of the global marketplace and what some see as the 'hollowing out' of the national economy has increased significantly. We explore that paradox analytically by exploring the multi-faced transactions between the nation, state, and international political economy that condition changes in labour-capital relations at workplace level Empirically we focus on a comparison between British and Australian experiences: a sharp contrast between a form of economic restructuring not only without, but explicitly aimed at the expense of labor, and one of the few cases of a modernizing project that was labor-led or at least mediated. We argue that proponents of the globalisation theses and universalist paradigms of production systems underestimate the resilience of institutional diversity within nation states. Secondly, that the operations and choices of TNCs themselves help to shape the diversity in that they do not simply accommodate to local 'rules of the game' (Sorge, 1995: 122) nor their own home-country practices, but create 'hybrid' forms of adaptation which local capital may seek to emulate. Thirdly, we argue that state industry policies are not simply barriers or filters to the homogenising effects of corporate interests, but through their own competitiveness strategies, can remake their own 'niche' within the international division of labor.
Some medical uses of radiation from lamps
Authors: Jewess B.W. 
Published: December 2008

In this paper the term 'light' will be extended to cover that part of the electromagnetic spectrum between 250-770 nm. The paper deals with the division of the ultra-violet spectrum into the A, B and C bands. The medical effects of light may roughly be divided into two groups. The first is where the radiation acts directly such as the germicidal effect of UVC, the erythemal properties of UVB for the production of vitamin D and the treatment of neo-natal jaundice by blue light. The second is where the radiation works in the presence of a photosensitiser, taken orally or applied externally. Examples are the photo-therapy treatment of vitiligo and psoriasis with UVA and the treatment of herpes virus with white fluorescent light. The design of luminaires for these purposes will also be mentioned.
Children Have More Need of Models Than Critics
Authors: THOMPSON TRAVIS 
Published: December 2008

A review of Betty Hart and Todd Risley, Meaningful Differences in the Everyday Experience of Young American Children. Baltimore: Brookes. 1995. 268 pp. ISBM 1-55766-197-9. Hardcover; $22.00. Travis Thompson is Director of the John F. Kennedy Center. This manuscript was prepared in part with funds provided by P30 HD15052 from the National Institute of Child Health and Human Development to Vanderbilt University. The author expresses his gratitude to Ford Ebner, Director of the Institute of Developmental Neuroscience and Averill King of the Susan Gray School for Children of the John F. Kennedy Center, as well as Ann M. Neely, Assistant Provost and Professor of Education, Vanderbilt University, and David Lubinski, Co-Director of the Center for Gifted Youth, Iowa State University, for their thoughtful suggestions and comments.
Inbred Strain-Specific Response to Biglycan Deficiency in the Cortical Bone of C57BL6/129 and C3H/He Mice
Authors: Wallace Joseph M , Golcuk Kurtulus , Morris Michael D , Kohn David H 
Published: December 2008

Abstract
Inbred strain-specific differences in mice exist in bone cross-sectional geometry, mechanical properties, and indices of bone formation. Inbred strain-specific responses to external stimuli also exist, but the role of background strain in response to genetic deletion is not fully understood. Biglycan (bgn) deficiency impacts bone through negative regulation of osteoblasts, resulting in extracellular matrix alterations and decreased mechanical properties. Because osteoblasts from C3H/He (C3H) mice are inherently more active versus osteoblasts from other inbred strains, and the bones of C3H mice are less responsive to other insults, it was hypothesized that C3H mice would be relatively more resistant to changes associated with bgn deficiency compared with C57BL6/129 (B6;129) mice. Changes in mRNA expression, tissue composition, mineral density, bone formation rate, cross-sectional geometry, and mechanical properties were studied at 8 and 11 wk of age in the tibias of male wildtype and bgn-deficient mice bred on B6;129 and C3H background strains. Bgn deficiency altered collagen cross-linking and gene expression and the amount and composition of mineral in vivo. In bgn's absence, changes in collagen were independent of mouse strain. Bgn-deficiency increased the amount of mineral in both strains, but changes in mineral composition, cross-sectional geometry, and mechanical properties were dependent on genetic background. Bgn deficiency influenced the amount and composition of bone in mice from both strains at 8 wk, but C3H mice were better able to maintain properties close to wildtype (WT) levels. By 11 wk, most properties from C3H knockout (KO) bones were equal to or greater than WT levels, whereas phenotypic differences persisted in B6;129 KO mice. This is the first study into mouse strain-specific changes in a small leucine-rich proteoglycan gene disruption model in properties across the bone hierarchy and is also one of the first to relate these changes to mechanical competence. This study supports the importance of genetic factors in determining the response to a gene deletion and defines biglycan's importance to collagen and mineral composition in vivo.
Lipid Levels: A Link Between Cardiovascular Disease and Osteoporosis?
Authors: Buizert Petra J , van Schoor Natasja M , Lips Paul , Deeg Dorly JH , Eekhoff Elisabeth M 
Published: December 2008

Abstract
Epidemiological observations support a positive relationship between cardiovascular diseases (CVD) and osteoporosis, where cholesterol has been indicated to be a possible link. Only a few studies have investigated the relation between lipids and BMD, but the association remains unclear. We studied the relationship between serum lipids and BMD of the calcaneus. A cross-sectional population-based study was performed, based on data from the Longitudinal Aging Study Amsterdam, including 620 men and 635 women, 65–88 yr of age. BMD was measured by quantitative ultrasound (QUS), velocity of sound (VOS; m/s), and broadband ultrasound attenuation (BUA; dB/MHz). Models were adjusted for age, body mass index, physical activity, smoking, alcohol, diabetes mellitus, hypertension, testosterone, and 25-hydroxyvitamin D. No association was found between total cholesterol (TC) and QUS. Men and women in the highest quartile of high-density lipoprotein cholesterol (HDL-c) had a significantly lower QUS (men—VOS: β = −20.8, p = 0.00; BUA: β = −5.2, p = 0.02; women—VOS: β = −18.6, p = 0.00) compared with men and women in the lowest quartile. An even stronger positive association was seen between TC/HDL-c ratio and QUS (men—VOS: β = 21.8, p = 0.00; BUA: β = 5.5, p = 0.01; women—VOS: β = 19.2, p = 0.00; BUA: β = 3.6, p = 0.05). Our analysis shows that the lipid profile that is favorable in the prevention of CVD (i.e., high levels of HDL-c and low TC/HDL-c ratio) is unfavorable for QUS. These results indicate that HDL-c levels do not explain the association between osteoporosis and CVD.
Cost-effectiveness of Early Treatment for Retinopathy of Prematurity
Authors: Kamholz Karen L. , Cole Cynthia H. , Gray James E. , Zupancic John A. F. 
Published: December 2008

BACKGROUND. The Early Treatment for Retinopathy of Prematurity trial demonstrated that peripheral retinal ablation of eyes with high-risk prethreshold retinopathy of prematurity (early treatment) is associated with improved visual outcomes at 9 months' corrected gestational age compared with treatment at threshold disease (conventional management). However, early treatment increased the frequency of laser therapy, anesthesia with intubation, treatment-related systemic complications, and the need for repeat treatments.OBJECTIVE. To determine the cost-effectiveness of an early treatment strategy for retinopathy of prematurity compared with conventional management.DESIGN/METHODS. We developed a stochastic decision analytic model to assess the incremental cost of early treatment per eye with severe visual impairment prevented. We derived resource-use and efficacy estimates from the Early Treatment for Retinopathy of Prematurity trial's published outcome data. We used a third-party payer perspective. Our primary analysis focused on outcomes from birth through 9 months' corrected gestational age. A secondary analysis used a lifetime horizon. Parameter uncertainty was quantified by using probabilistic and deterministic sensitivity analyses.RESULTS. The incremental cost-effectiveness of early treatment was $14200 per eye with severe visual impairment prevented. There was a 90% probability that the cost-effectiveness of early treatment would be less than $40000 per eye with severe visual impairment prevented and a 0.5% probability that early treatment would be cost-saving (less costly and more effective). Limiting early treatment to more severely affected eyes (eyes with “type 1 retinopathy of prematurity” as defined by the Early Treatment for Retinopathy of Prematurity trial) had a cost-effectiveness of $6200 per eye with severe visual impairment prevented. Analyses that considered long-term costs and outcomes found that early treatment was cost-saving.CONCLUSIONS. Early treatment of retinopathy of prematurity is both efficacious and economically desirable. Because of the high lifetime costs of severe visual impairment, the early treatment strategy provides long-term cost savings.
Construction of a Parent-Derived Questionnaire to Measure End-of-Life Care After Withdrawal of Life-Sustaining Treatment in the Neonatal Intensive Care Unit
Authors: Williams Constance , Cairnie Janice , Fines Valerie , Patey Colleen , Schwarzer Karla , Aylward Jennifer , Lohfeld Lynne , Kirpalani Haresh ,   for the With Care team
Published: December 2008

OBJECTIVES. The objective of this study was to develop and pretest a questionnaire to assess the practice of withdrawal of life-sustaining treatment in the NICU on the basis of the experiences of bereaved parents.METHODS. We conducted semistructured interviews with 11 parents whose infants had undergone withdrawal of life-sustaining treatment in the NICU at McMaster University Medical Centre to obtain their views on helpful practices. Interviews continued until no new items were obtained (ie, saturation point). A total of 370 items were distilled into 82 questionnaire statements on care by a multidisciplinary team and grouped for analysis into 6 domains: communication, quality of care, quality of life, shared decision-making, withdrawal of life-sustaining treatment process, and bereavement care. Respondents were asked to rank how frequently events occurred on a 7-point Likert scale anchored from 1 = never to 7 = always. A score of &gt;5 was considered favorable. The questionnaire was distributed to a pretest sample of perinatal social workers who attended a bereavement workshop at an international conference.RESULTS. The response rate was 48%. Respondents ranked items that pertained to the withdrawal of life-sustaining treatment process highest, indicating that items were done well. Items related to quality of care and bereavement care ranked lowest. Other domains ranked as follows: communication, shared decision-making, and quality of life. Consistency of items within domains was tested by Cronbach's α and split-half testing and were &gt;0.6 for most domains.CONCLUSIONS. Parents' views on important aspects of end-of-life care in the NICU were incorporated into a quality assurance questionnaire. Pretesting assessed the performance of the instrument and the perceptions of social workers on the effectiveness of end-of-life practices. Respondents identified that parents' practical needs were met during the withdrawal process but were not consistently met in regard to the quality of in-hospital and follow-up bereavement care.