February Issue Research Articles

Gastric dilation–volvulus syndrome in dogs

GASTRIC dilation–volvulus (GDV) is a challenging but rewarding condition to treat. Appropriate decision making and management can help to achieve a success rate of up to 95 per cent in...

Another major win for physiotherapy — curing patellofemoral pain

Thanks for the positive feedback about BJSM ’s recent articles – particularly the January (http://bjsm.bmj.com/content/vol43/issue1) and February (http://bjsm.bmj.com/content/vol43/issue2) issues edited by Professor Steven Blair. Many emails supported the claims that...

Everyday ethics

THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is...

EpCAM: Another Surface-to-Nucleus Missile

The epithelial-specific cell adhesion molecule (EpCAM) modulates cell adhesion and proliferation. Its overexpression correlates with tumor cell proliferation, and EpCAM is a therapeutic target. In the February issue of Nature Cell Biology, Maetzel et al. demonstrate that proliferative responses to EpCAM require regulated intramembrane proteolysis and a nucleocytoplasmic intracellular domain fragment.

Defining Dysphagia Following Stroke

Defining Dysphagia Following Stroke

From the February Issue of the Journal of the American Medical Directors Association

From the February Issue of the Journal of the American Medical Directors Association

Ending the Vicious Cycle

Introduction to the February issue of Virtual Mentor on the theme of professional responsibility to prevent violence and abuse. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.

Selected Abstracts from the February Issue of the Journal of Vascular Surgery

Selected Abstracts from the February Issue of the Journal of Vascular Surgery

"Writing on the Screen": An Interview with Emmanuel Burdeau

This interview took place at the offices of Cahiers du cinema, Paris, February 29, 2008 Dudley Andrew: I am writing a book that traces something I call Cahiers from Roger Leenhardt through Bazin past the New Wave to Serge Daney and now on to you. I understand that Cahiers du cinema in all its periods had several directions, but I'm concerned to find out if Cahiers du cinema today feels a pressure from the past as it chooses what films to discuss, who will write about them and what subjects it will adopt. Here's a hint: what have been your thoughts about certain kinds of new media, cinema of animation, cinema of entertainment media, new kinds of spectacle, and new entertainment regimes? These are very important cultural phenomena and Cahiers du cinema should address them, I presume, but it seems that these appear to stand to the side of the Line that I take to be the backbone of the journal all these years. How do you take up these issues? From what stance do you approach them? Emmauel Burdeau: The question of working on the Cahiers has almost always been a question of inheritance. How does one work on a review that has known a Golden Age which no one will ever surpass-the '50s and the New Wave? That is not to be repeated. How to continue in a not so unfaithful way, that is the first step. The only step in a way. Both the first and the next step: both trying and failing to continue the Golden Age and the eras after, the eras just before you. It's of course a question of deciding on what an interpretation of Cahiers was-at the beginning or just yesterday-and therefore of what it must be today. So what is Cahiers? Is there indeed a kind of continuity? Perhaps there is, even if only a fictional one. Serge Daney-editor from 1974 to 1981, the master, obviously, some even call him a genius-has an idea that can summarize a part of what constitutes the continuity of Cahiers from '51 to today, above and beyond all the changes. It is in an interview that he did with the great Bill Krohn at the end of the '70s when Cahiers Week was being organized in New York. This interview was first published in . . . Thousand Eyes, I believe, and then, a couple of years ago, as an introduction for the first volume for POL, La Maison cinema et le monde. Daney says that in his opinion, throughout all its eras Cahiers was always interested in a type of cinema: the cinema that is haunted by the written. Haunted as though by a ghost. In French: HANTE PAR L'ECRIT, in capital letters. Among other things, it is a good way to suggest that the singularity of Cahiers du cinema, what radically distinguishes it from Positif, for instance, is not the mise-en-scene. It is rather the role of writing (ecriture). There is something in cinema that calls upon a very particular kind of critical writing that has little to do with literature or literary criticism or musical criticism. Film criticism is the way to answer and to understand that call. It is an echo of that call. In other words, the page translates the screen. Daney added that Cahiers had always defended filmmaker-writers such as Duras, Cocteau, Guitry, Pagnol. Besides, the New Wave was also a movement of somewhat failed writers, or so they pretended to call themselves. But all the filmmakers of the New Wave were in their own way great writers: Rohmer, Godard, and then Demy, Eustache . . . (by the way, that can explain why it is that often one might find the texts from Cahiers difficult to read). Insofar as concerns Cahiers, writing might be just as important as cinema. That is not to say that we consider ourselves writers, in the sense of genuine literary authors. Next there is another aspect that you evoked, the question of new media: Internet, video games, and so on. There again one can give a schematic answer. In February's issue, we placed on the cover Brian De Palma's film REDACTED, which is a film that seems to have been made through the Internet. …

Clinical Response of Renal Cell Carcinoma to Dexamethasone

Dear Editor,With interest we read the article of Arai Y. et al. ([1]) in the February issue of Cancer Investigations. The group from Osaka has reported very interesting data on the growth-inhibitor...

Optimal Preoperative Imaging of Spinal Cord Blood Supply: Fig 1.

With great interest, we read the article by Uotani and colleagues[1][1] in the February issue of the American Journal of Neuroradiology . The authors compared intravenous and intra-arterial contrast agent application for the localization of the Adamkiewicz artery (AKA) in different patients

Editor’s Choice

Editor’s Choice

Biofuels: Effects on Land and Fire

IN THEIR REPORTS IN THE 29 FEBRUARY ISSUE ('LAND CLEARING AND THE BIOFUEL CARBON debt,' J. Fargione et al., p. 1235, and 'Use of U.S. croplands for biofuels increases greenhouse gases through emissions from land-use change,' T. Searchinger et al., p. 1238), the authors do not provide adequate support for their claim that biofuels cause high emissions due to land-use change. The conclusions of both papers depend on the misleading premise that biofuel production causes forests and grasslands to be converted to agriculture. However, field research, including a meta-analysis of 152 case studies, consistently finds that land-use change and associated carbon emissions are driven by interactions among cultural, technological, biophysical, political, economic, and demographic forces within a spatial and temporal context rather than by a single crop market. Searchinger et al. assert that soybean prices accelerate clearing of rainforest based on a single citation for a study not designed to identify the causal factors of land clearing. The study analyzed satellite imagery from a single state in Brazil over a 4-year period and focused on land classification after deforestation. Satellite imagery can measure what changed but does little to tell us why. Similarly, Fargione et al. do not rely onmore » primary empirical studies of causes of land-use change. Furthermore, neither fire nor soil carbon sequestration was properly considered in the Reports. Fire's escalating contribution to global climate change is largely a result of burning in tropical savannas and forests. Searchinger et al. postulate that 10.8 million hectares could be needed for future biofuel, a fraction of the 250 to 400 million hectares burned each year between 2000 and 2005. By offering enhanced employment and incomes, biofuels can help establish economic stability and thus reduce the recurring use of fire on previously cleared land as well as pressures to clear more land. Neither Searchinger et al. nor Fargione et al. consider fire as an ongoing land-management tool. In addition, deep-rooted perennial biofuel feedstocks in the tropics could enhance soil carbon storage by 0.5 to 1 metric ton per hectare per year. An improved understanding of the forces behind land-use change leads to more favorable conclusions regarding the potential for biofuels to reduce greenhouse gas emissions.« less

Erratum

An error appeared in the author names in an Editorial published in the February issue (1). The first author was printed as `Kerrsens’ but the correct spelling is `Kerssens’. The author name and affiliation appears correctly below.

Re: S Gabrysch et al: The role of context: neighbourhood characteristics strongly influence HIV risk in young women in Ndola, Zambia. TMIH 2008, February issue

Dear Sirs, Gabrysch et al (2008) reported on the importance of context in our understanding of HIV in Zambia by their secondary analysis and presenting of data. While such direction of focus should be welcomed, there are a number of areas where the reader may wish for clarity in conceptualization of the problem and presentation. The first limitation of the analysis is that the authors focus on “neighborhoods” without explicitly giving their definition of the term. Neighborhoods can be demarcated by mere geography, by administrative or political criteria, by historical attributes or by the study participants’ own definition of what constitutes their neighborhood. It seems the authors did not sufficiently consider these differences (Diez Roux 2001). In HIV research, a neighborhood defined by study participants as the area within which they normally find sexual partners may be conceptually more relevant than an administrative neighborhood such as a census track or township. In Table 2, the authors report male circumcision as a binary variable i.e. >8% and <8%, justifying the cut-off because the levels were “very low.” But variables that may have low prevalence values may still be categorized differently than binary. Even if the prevalence of circumcision was higher, the variable could still be dichotomized. What should matter is the underlying assumption as the role of this variable within the broader conceptual framework of the study. As the authors only used <8% and >8%; in which category was 8%, which is not reported? It would appear reasonable to dichotomize this variable at the median prevalence of circumcision (for the 16 “neighborhoods”) rather than at an arbitrary value. The paper’s terminology is sometimes imprecise and thus has the potential to limit the reader’s understanding. For instance, neighborhoods are categorized as having “a market nearby”, electricity or water uniformly distributed and being located near a health center. Was universal access to water in a neighborhood required for it to be described as having water (versus not)? If not, what were the cut-off values? How near is near? Is nearness (by distance) to market similar to nearness to health center? Whose assessment matters - the study participants’, the interviewer’s or measurements taken and then categorized at analysis? These are important considerations because if the focus is on context, we should be able to hypothesize which risk behaviours an individual is exposed to because of his or her nearness to a community facility. Finally, it appears the authors have used aggregate measures to highlight compositional aspects of the “neighborhoods” rather than context (Diez Roux 2001). In the Discussion section, there are limited suggestions as to how “contextual” factors such as water and electricity availability, closeness to health center or market are related to being HIV-infected. How would being close to a health center affect the risk of infection? Does residence in a poor neighborhood affects one’s behaviours? Attention to these concerns would have shed more light on the mediating factors that readers need to consider in a neighborhood study.

Corrections

Corrections| April 01 2008 Corrections Crit Care Nurse (2008) 28 (2): 19. https://doi.org/10.4037/ccn2008.28.2.19 Connected Content Errata: Critical Care Nurse: Unreported Errors in the Intensive Care Unit: A Case Study of the Way We Work Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Cite Icon Cite Get Permissions Citation Corrections. Crit Care Nurse 1 April 2008; 28 (2): 19. doi: https://doi.org/10.4037/ccn2008.28.2.19 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentCritical Care Nurse Search Advanced Search The CE test following the article Unreported Errors in the Intensive Care Unit: A Case Study of the Way We Work (October 2007;27:27–35) should list Category: O, Synergy CERP C instead of Category: A, Synergy CERP A. The correct URL in the reference following the letter to the editor regarding Enteral Feedings and a Common Problem in the February issue (February 2008;28:14) is http://www.criticalcarenutrition.com/docs/tools/Diarrhea%20Algorithm.pdf. View Original Article You do not currently have access to this content.

Letter

Back to table of contents Previous article Next article LetterFull AccessLetterJeffrey Borenstein M.D.Jeffrey Borenstein M.D.Search for more papers by this authorPublished Online:1 Apr 2008https://doi.org/10.1176/ps.2008.59.4.448AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Teaching Tool to Reduce Restraint and SeclusionTo the Editor: The Open Forum ( 1 ) in the February issue and an accompanying commentary ( 2 ) both made an important and fundamental point. Restraint and seclusion are emergency interventions that should be used as infrequently as possible and only when less restrictive methods are considered and are not feasible. There is much that hospital caregivers can do—other than resort to restraint and seclusion—to prevent and deescalate potentially dangerous situations so that patients can continue treatment successfully and effectively. This is a message that was delivered by the professional and hospital communities in a landmark teaching tool called Learning From Each Other: Success Stories and Ideas for Reducing Restraint/Seclusion in Behavioral Health. The 42-page document was developed by the American Psychiatric Association, American Psychiatric Nurses Association, and National Association of Psychiatric Health Systems (NAPHS), with support from the American Hospital Association Section for Psychiatric and Substance Abuse Services. It is available on the Web sites of these associations, including the NAPHS site at www. naphs.org. The hospital field has come a long way in changing both thinking about and practice of the use of restraint and seclusion, and the field now looks to the future. The final federal regulations are one aspect of this future view. All the protections incorporated by the Centers for Medicare and Medicaid Services (CMS) in the proposed rule on restraint and seclusion remain in effect—and are strengthened—in the final rule. The final rule ensures that only qualified, trained professionals can order and evaluate restraint or seclusion. It recognizes the skills and training of registered nurses as well as licensed independent practitioners as part of the clinical leadership team. The final rule also enhances patient safety because it comes with added CMS training requirements that will ensure more on-site professional expertise.Many components beyond regulation have led to dramatic changes in clinical practice. Consumers' voices have been heard, professionals have worked to share knowledge, and cultures are being changed as hospital leaders continuously take action to ensure patient safety.The field has undertaken a major effort to gather data to inform and improve clinical practice. The Hospital-Based Inpatient Psychiatric Services (HBIPS) core measures initiative has completed a year-long pilot-testing phase, with the goal of identifying measures that will be incorporated into the accreditation process of the Joint Commission (JC) as early as 2009. Several of the core measures being tested are related to restraint and seclusion. For the first time we will have national data to help facilities understand how they are operating in relation to their peers. The HBIPS was launched as a public-private partnership among NAPHS, the National Association of State Mental Health Program Directors (NASMHPD), the NASMHPD Research Institute, Inc., and the JC. These measures are being developed with the same scientific rigor as measures for heart failure and other medical conditions.NAPHS members are committed to patient safety, to accountability, and to continuously improving practice. We look forward to continuing to work with our colleagues on these critical issues.Dr. Borenstein is president of the National Association of Psychiatric Health Systems, Washington, D.C., and chief executive officer and medical director of Holliswood Hospital, Holliswood, New York.

Teaching Tool to Reduce Restraint and Seclusion

Back to table of contents Previous article Next article LetterFull AccessLetterJeffrey Borenstein M.D.Jeffrey Borenstein M.D.Search for more papers by this authorPublished Online:1 Apr 2008https://doi.org/10.1176/ps.2008.59.4.448AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Teaching Tool to Reduce Restraint and SeclusionTo the Editor: The Open Forum ( 1 ) in the February issue and an accompanying commentary ( 2 ) both made an important and fundamental point. Restraint and seclusion are emergency interventions that should be used as infrequently as possible and only when less restrictive methods are considered and are not feasible. There is much that hospital caregivers can do—other than resort to restraint and seclusion—to prevent and deescalate potentially dangerous situations so that patients can continue treatment successfully and effectively. This is a message that was delivered by the professional and hospital communities in a landmark teaching tool called Learning From Each Other: Success Stories and Ideas for Reducing Restraint/Seclusion in Behavioral Health. The 42-page document was developed by the American Psychiatric Association, American Psychiatric Nurses Association, and National Association of Psychiatric Health Systems (NAPHS), with support from the American Hospital Association Section for Psychiatric and Substance Abuse Services. It is available on the Web sites of these associations, including the NAPHS site at www. naphs.org. The hospital field has come a long way in changing both thinking about and practice of the use of restraint and seclusion, and the field now looks to the future. The final federal regulations are one aspect of this future view. All the protections incorporated by the Centers for Medicare and Medicaid Services (CMS) in the proposed rule on restraint and seclusion remain in effect—and are strengthened—in the final rule. The final rule ensures that only qualified, trained professionals can order and evaluate restraint or seclusion. It recognizes the skills and training of registered nurses as well as licensed independent practitioners as part of the clinical leadership team. The final rule also enhances patient safety because it comes with added CMS training requirements that will ensure more on-site professional expertise.Many components beyond regulation have led to dramatic changes in clinical practice. Consumers' voices have been heard, professionals have worked to share knowledge, and cultures are being changed as hospital leaders continuously take action to ensure patient safety.The field has undertaken a major effort to gather data to inform and improve clinical practice. The Hospital-Based Inpatient Psychiatric Services (HBIPS) core measures initiative has completed a year-long pilot-testing phase, with the goal of identifying measures that will be incorporated into the accreditation process of the Joint Commission (JC) as early as 2009. Several of the core measures being tested are related to restraint and seclusion. For the first time we will have national data to help facilities understand how they are operating in relation to their peers. The HBIPS was launched as a public-private partnership among NAPHS, the National Association of State Mental Health Program Directors (NASMHPD), the NASMHPD Research Institute, Inc., and the JC. These measures are being developed with the same scientific rigor as measures for heart failure and other medical conditions.NAPHS members are committed to patient safety, to accountability, and to continuously improving practice. We look forward to continuing to work with our colleagues on these critical issues.Dr. Borenstein is president of the National Association of Psychiatric Health Systems, Washington, D.C., and chief executive officer and medical director of Holliswood Hospital, Holliswood, New York.

Revisiting the MacArthur Study

Back to table of contents Previous article Next article LetterFull AccessLetterJ. Steven Lamberti M.D.J. Steven Lamberti M.D.Search for more papers by this authorPublished Online:1 Apr 2008https://doi.org/10.1176/ps.2008.59.4.445AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Revisiting the MacArthur StudyTo the Editor: I read the debate in the February issue ( 1 ) revisiting the MacArthur Violence Risk Assessment Study with interest. It presented opposing views of the results of the MacArthur study that was conducted between 1992 and 1995 to determine the prevalence of community violence in a cohort of patients discharged from psychiatric hospitals. On the basis of follow-up data from 951 patients, the study essentially found no significant difference in the prevalence of violence between the patients and other people living in the same neighborhoods ( 2 ). In the February debate, Dr. Torrey and Mr. Stanley presented several points on which they disagree with the findings or the methodology of the MacArthur study. Dr. Monahan, Dr. Steadman, and the MacArthur Study Group then responded to each point. Dr. Torrey and Mr. Stanley argued at one point that the results of the MacArthur study are not applicable to all patients with mental illness. To illustrate their concern, they cited press coverage of the MacArthur study and a reference to the study in my 2007 article on criminal recidivism ( 3 ) as implying that "the results were applicable to all psychiatric patients." As noted by Dr. Monahan and Dr. Steadman in their response, the MacArthur study did not make that claim. Neither did my article. My article discussed eight central risk factors that are predictive of criminal behavior, including violent crimes—albeit to a lesser extent because such crimes are low-frequency events. These risk factors broadly apply to individuals whether or not they are mentally ill, and they have been established through an extensive body of research ( 4 ). However, this research has received relatively little attention in the psychiatric literature. The risk factors are substance abuse, family problems, lack of healthy recreational pursuits, low levels of performance or satisfaction with school or work, history of antisocial behavior, antisocial personality pattern, antisocial cognition, and antisocial attitudes, including associating with criminal companions. The MacArthur study's negative finding is consistent with the established relationship between known risk factors and criminal behavior. In particular, the study used an appropriate control group of individuals who lived in the same neighborhoods as the study patients and were therefore likely to share many of the same risk factors. My article also made the point, which was based on a review of recent literature, that active psychosis is an additional risk factor for violent crime. Since publication of the landmark MacArthur study, several studies have been published that provide new evidence that active psychosis is a risk factor independent of substance abuse or other known risk factors. For example, a rigorous national prospective study of 1,410 adults with schizophrenia recently found that "psychotic symptoms were strongly associated with both minor and serious violence" ( 5 ). Given the predictive strength of identifiable risk factors and the fact that some are modifiable, the important question for the field is no longer whether persons with mental illness are more violent than others. Rather, the question is how to engage high-risk individuals in treatments that effectively target modifiable risk factors for criminal behavior. Thanks to the authors for an interesting debate and to the journal for this opportunity for clarification.Dr. Lamberti is associate professor of psychiatry and director of the Severe Mental Disorders Program at the University of Rochester Medical Center, Rochester, New York.

Metabolically Halting Sugar Adducts Improves Protein Yields from E. coli

Specially targeted, metabolic tweaking greatly boosts protein yields from a strain of Escherichia coli that already has proved itself as a workhorse for both research and industrial applications, according to Juan C. Aon and his colleagues at GlaxoSmithKline (GSK) in King of Prussia, Pa. That tweaking overrides a biochemical pathway whereby recombinant proteins are improperly glycosylated— that is, “decorated” with sugar molecules—in ways that interfere with their activity and, thus, require removal. Now, by implementing a novel strategy, the GSK researchers induce the bacterial cells not to make those sugar adducts in the first place. This change not only avoids downstream sugar-removal steps but also improves initial yields of the sought-after proteins. Details of their research appear in the February issue of Applied and Environmental Microbiology (74:950–958).