University Avenue Research Articles

Mental Health Needs of Patients Living with Diabetes in the Long-Term Care Context: A Comment on Sears and Schmidt.

In their recent review, Sears and Schmidt (1) noted the nature and frequency of mental health concerns among older individuals living with diabetes. We agree that the needs of older adults with diabetes are important to consider, for reasons both medical and relating to quality of life. One gap in the literature pertains to how confident and knowledgeable front-line workers (i.e. registered nurses, registered practical nurses and personal support workers) are with respect to the mental health needs of this group of patients in the long-term care setting. We recently conducted a survey of front-line diabetes clinicians (registered nurses, registered practical nurses, personal support workers) in 2 publicly funded long-term care facilities in southern Ontario, Canada (N=87; response rate 79%) (2). As part of this survey, front-line workers estimated the proportion of long-term care patients with diabetes in need of psychological or psychiatric services and rated their own confidence in their abilities to manage patients’ mental health needs. The perceived need for psychological/ psychiatric services was quite high: nearly two-thirds of patients were estimated to be in need (62.83%); a full 34.5% of front-line workers believed that all (i.e. 100%) of long-term care residents with diabetes were in need of some psychological/psychiatric assistance. Confidence levels in managing the mental health needs of patients with diabetes in this setting were variable; 68.9% reported being moderately confident, but only 6.9% reported being very confident and 11.5% reported being not at all confident. According to respondents, access to mental health service providers was variable. Respondents indicated that 62.2% had access to a psychiatrist consultation, and 64.8% had access to a psychiatric nursing consultation. Only 26.5% reported having access to a psychologist, and only 34.8% reported having access to a mental health counselor. The greater access to medically trained mental health professionals is not surprising, but it does not take into consideration patients’ preferences, which may or may not match this bias in access. It is often assumed that older adult patients would prefer medication, but that assumption is mostly untested. Moreover, from a strictly medical perspective, theremay be some concern about adding psychotropic medications to treatment profiles for patients with diabetes who already have complex regimens. Barriers to effective psychiatric and psychological management identified by respondents included perceived compliance issues (n=11), referral time problems (n=8) and lack of staffing (n=6). Communication problems and presence of comorbidities were also identified as barriers. However, the most commonly endorsed response was “unknown,” indicating a lack of certainty about the barriers that stood in the way of effective management of psychiatric/ psychological issues. Suggestions for improvement were similarly inconclusive, with “unknown” being the most common response. Beyond this, more staff (n=7) and increased access to existing staff (n=8) were the most common solutions proposed. Additional proposed solutions included reduced referral time (n=3), staff education (n=2) and communication assistance (n=1). Perhaps 1 of the more important questions to ask in relation to the needs of long-term care residents with diabetes is the following: Why do they need mental health services in the first place? As indicated by Sears and Schmidt, those living with diabetes have higher rates of anxiety and depressive disorders than the general population. Such affective syndromes are common manifestations of adjustment problems (changes in life circumstances, roles or daily routines), but it is also the case that long-term care residents are typically older and have poorer health status than their communitydwelling counterparts. They also struggle with multiple comorbid medical conditions beyond the diagnosis of diabetes, most commonly obesity, hypertension and renal disease as well as a variety * Address for correspondence: Peter A. Hall, PhD, CPsych, University of Waterloo, Applied Health Sciences, BMH 1117, 200 University Avenue West, Waterloo, Ontario, N2L3G1, Canada. E-mail address: pahall@uwaterloo.ca Can J Diabetes 40 (2016) 490–491

Global Workers and the Unmaking and Remaking of Class in the Twenty-First CenturyBlood and Fire: Toward a Global Anthropology of Labor. Edited by Sharryn Kasmir and August Carbonella. New York: Berghahn, 2014.

Previous articleNext article No AccessBook and Film ReviewsGlobal Workers and the Unmaking and Remaking of Class in the Twenty-First Century Blood and Fire: Toward a Global Anthropology of Labor. Edited by Sharryn Kasmir and August Carbonella. New York: Berghahn, 2014.Pauline Gardiner BarberPauline Gardiner BarberDepartment of Sociology and Social Anthropology, Dalhousie University, 6135 University Avenue, Halifax, Nova Scotia B3H 4R2, Canada ([email protected]) Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Current Anthropology Volume 57, Number 3June 2016 Sponsored by the Wenner-Gren Foundation for Anthropological Research Article DOIhttps://doi.org/10.1086/686535 Views: 162Total views on this site HistoryAccepted February 28, 2016 For permission to reuse, please contact [email protected]PDF download Crossref reports no articles citing this article.

The Relationship Between 25-hydroxy Vitamin D, Parathyroid Hormone and Glycemia During Pregnancy and Postpartum.

The Relationship Between 25-hydroxy Vitamin D, Parathyroid Hormone and Glycemia During Pregnancy and Postpartum.

Retinopathy in the Era of Routine Hydroxychloroquine Monitoring

To the Editor: Hydroxychloroquine (HCQ) is a vital component of systemic lupus erythematosus (SLE) treatment, but it carries a significant risk of irreversible blindness from HCQ retinopathy. HCQ retinopathy is relatively rare, but new, more sensitive diagnostic techniques report a prevalence of up to 7.5%1. Moreover, HCQ retinopathy may progress even after cessation of therapy2, so early detection and primary prevention are critical. Currently, primary prevention consists of controlling the daily dose and/or cumulative dose to prevent overdosage3. We therefore read with great interest “Hydroxychloroquine Blood Levels in Systemic Lupus Erythematosus: Clarifying Dosing Controversies and Improving Adherence” by Durcan, et al 4 in The Journal of Rheumatology . We point out the implications of their findings for the use of weight-based dosing and the evidence base for HCQ retinopathy prevalence. In their study, Durcan, et al described how regularly measuring blood levels of HCQ in patients with SLE resulted in a higher … Address correspondence to E. Weinlander, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 2870 University Avenue, Suite 206, Madison, Wisconsin 53705, USA. E-mail: eweinlander{at}wisc.edu

The College Avenue Corridor Study - Coordinated Approach for Integrating Health in Wisconsin

The College Avenue Corridor Study - Coordinated Approach for Integrating Health in Wisconsin

Influences of depth and pelagic subsidies on the size-based trophic structure of Beaufort Sea fish communities

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 549:153-166 (2016) - DOI: https://doi.org/10.3354/meps11709 Influences of depth and pelagic subsidies on the size-based trophic structure of Beaufort Sea fish communities Ashley D. Stasko1,*, Heidi Swanson1, Andrew Majewski2, Sheila Atchison2, James Reist2, Michael Power1 1Department of Biology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada 2Fisheries and Oceans Canada, 501 University Crescent, Winnipeg, Manitoba R3T 2N6, Canada *Corresponding author: astasko@uwaterloo.ca ABSTRACT: The quality and quantity of food reaching the seafloor is negatively related to water column depth. Lower food availability at depth may in turn affect trophic structure and result in depth-related patterns in biomass and body size (size spectra) in demersal fish communities. Here, we used demersal fishes collected from 4 habitat depths in the Beaufort Sea, spanning 18 to 1000 m, to investigate depth-related changes in the slopes of biomass size-spectra relationships and whether they are related to benthic resource use. Significant positive relationships between biomass-weighted trophic level (estimated from δ15N) and log2 body mass classes demonstrated strongly size-structured fish food webs at all habitat depths, with larger individuals occupying higher trophic levels. Total fish community biomass peaked between 350 and 500 m. The decline in biomass production beyond 500 m was greater for smaller size classes, resulting in significantly shallower (less negative) size-spectra slopes with increasing habitat depth. Large size classes in deep habitats were dominated by species known to obtain pelagic subsidies. Lower isotopic distinction between benthic and benthopelagic fish species, based on 13C measurements, suggested lower dietary differentiation between feeding guilds in deeper habitats. We suggest pelagic subsidies allow high relative biomass production in larger size classes of fishes in deeper habitats, whereas decreasing availability of benthic resources limit biomass production in smaller size classes. Size spectra of demersal fish communities may provide an important indicator of structure in both pelagic and benthic Arctic environments, and be a useful parameter to include in long-term monitoring programs. KEY WORDS: Benthic-pelagic coupling · Biomass · Size distribution · Demersal fishes · Arctic marine ecology · Pelagic subsidies Full text in pdf format PreviousNextCite this article as: Stasko AD, Swanson H, Majewski A, Atchison S, Reist J, Power M (2016) Influences of depth and pelagic subsidies on the size-based trophic structure of Beaufort Sea fish communities. Mar Ecol Prog Ser 549:153-166. https://doi.org/10.3354/meps11709 Export citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 549. Online publication date: May 10, 2016 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2016 Inter-Research.

Promoting Research-driven Oral Health Care.

DOI: 10.1177/2380084416636566. Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; University of Florida, Gainesville, FL, USA; Biologic and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor, MI, USA. Corresponding author: J.S. Feine, McGill University, Faculty of Dentistry, 2100 McGill College Avenue, Suite 500, Montreal, QC H3A 2A7, Canada. Email: jfeine@iadr.org

The Peripartum Anesthesiologist

The association between pregnancy and cardiomyopathy has been evident since 1870. Moreover, the incidence of peripartum cardiomyopathy (PPCM) is thought to range from 1 in 2,400 to 1 in 15,000 pregnancies; however, a more recent review suggests an incidence of one in 3,000 to 4,000 pregnancies in western countries. Peripartum cardiomyopathy is more prevalent in older multiparous patients of African descent who have multiple gestations, chronic hypertension or preeclampsia, and have received prolonged tocolytic therapy. There are four principal diagnostic features of PPCM: the development of heart failure in the last month of pregnancy or within five months of delivery; absence of an identifiable cause; absence of underlying heart disease prior to the last month of pregnancy; and evidence of left ventricular systolic dysfunction. Recently, echocardiographic criteria were established, including an ejection fraction 45% and an end-diastolic dimension [ 2.72 cm m. Basic principal treatment of PPCM includes a reduction of both preload and afterload along with the administration of inotropic therapy. Severe cases may require mechanical support and consideration for heart transplantation. Delivery of the fetus is usually indicated when the cardiac failure is intractable. In this month’s edition of the Journal, Ituk et al. report on the peripartum anesthetic management and outcomes of 25 women with dilated cardiomyopathy four of whom were designated as having PPCM. With an average age of 32 and a history of hypertension and diabetes, these patients represent a higher risk group than the overall obstetrical population, which is in keeping with previous reports of PPCM risk factors. This challenging group of patients was optimally managed by a multidisciplinary team with a distinct knowledge of peripartum care a team that followed their patients’ clinical progress at regular multidisciplinary case conferences. Fetal delivery in PPCM is dictated by the obstetric indications and occurs in consultation with the anesthesia team. Vaginal delivery offers minimal blood loss, hemodynamic stability, and avoidance of additional Cesarean delivery-related surgical stresses with an overall reduced chance of postoperative complications. Regional anesthesia is advantageous for reducing preload and afterload and minimizing the fluctuations in cardiac output associated with labour. Cesarean delivery is best reserved for indications such as breech presentation, fetal distress, or failure to progress. Prognostic information of PPCM is limited and often confounded by the inclusion of patients with heart failure of differing etiologies. The reported mortality ranges from 18-50% and it increases as a function of age, ejection fraction 25%, multiparity, African American ethnicity, and delayed diagnosis. The recurrence rate of 50-100% is influenced by the severity of PPCM during the index pregnancy and by left ventricular systolic function at the beginning of pregnancy. Echocardiography may be helpful in delineating future risk in patients considering future pregnancies. Long-term prognosis is related to recovery of left ventricular function with 80% of women recovering partially or completely, and the remaining 20% either dying or undergo cardiac transplantation. In our view, the obstetric anesthesiologist functions as a vital member of the interdisciplinary team caring for women with complicated obstetric issues and, as such, A. Munro, MD R. B. George, MD (&) Department of Women’s & Obstetric Anesthesia, IWK Health Centre, Dalhousie University, 5850/5980 University Avenue, P.O. Box 9700, Halifax, NS B3K 6R8, Canada e-mail: rbgeorge@dal.ca

Proceedings of the AMSUS Summit for Federal and Civilian Orthopedic Rehabilitation Programs.

INTRODUCTION In its 2015 report, “Sustainment and Advancement of Amputee Care,” the Defense Health Board (DHB) found that the interdisciplinary team approach to the treatment of service members with traumatic limb injuries has resulted in unprecedented innovation in amputee care and technology. Over the past 13 years, more than 1,640 members of the U.S. Armed Forces have suffered a traumatic injury requiring a limb amputation as a result of the five operations in Iraq and Afghanistan since 2001. The good news is that more of these soldiers have survived than in the past, in part because of better equipment, improved battlefield first-aid, and more sophisticated surgical care. Despite facing more severe orthopedic injuries from high-velocity weapons and improvised explosive devices, this unique cohort has achieved higher levels of function than those from past battles. In 2008, an above-the-knee amputee, SFC Daniel Metzdorf, became the first and only Wounded Warrior to graduate from the Golden Knights, the elite Army parachute team. Service members with double amputations walk and run using stateof-the-art prosthetic limbs, while hundreds of amputees have returned to active duty. Among active-duty members who lost limbs during the recent conflicts, 71 have redeployed. These wounded service members also are living productive civilian lives, running marathons, competing in obstacle races, and raising their families while adapting to the “New Normal” of their lives. These improved outcomes can be attributed in part to advances in medical and surgical infrastructure across the continuum of amputee care. Groundbreaking technologies and approaches to patient care developed by the Department of Defense (DoD) and Department of Veterans Affairs (VA) have dramatically improved outcomes for those with traumatic limb loss, as well as for their overall quality of life. The DHB report noted, “It is apparent that DoD is leading the Nation and the world in extremity trauma and amputee science and care through its infrastructure, systems, and approach.” But in order to continue providing this level of excellence, collaborations across military, academic, and civilian institutions need to be further developed and expanded, even as the conflicts overseas wind down. This 134-page report provided the needed foundation to launch a robust conference discussing both the current state of orthopedic rehabilitation services for service members and civilians with extremity trauma and amputation as well as the needs for the future. Representatives from the DoD, VA, and civilian community came together during the AMSUS Annual Continuing Education Meeting in San Antonio, Texas, to talk about how military, academic, civilian, and industry partners can work together to help military amputees recover and reach their full potential. Discussions focused on how the DoD/VA can best address the lifelong needs of the amputee population, including those who have been injured during these recent conflicts as well as service members who may suffer traumatic limb injuries in future conflicts. Three sponsored events highlighted the need for continued collaboration among orthopedic rehabilitation teams. The first, “WARfighters Receiving Innovative Orthopedic Rehabilitation (WARRIOR) Symposium: Research and Treatment of Patients with Extremity Trauma and Amputation,” discussed the state-of-the-art programs that currently exist and how they use research to impact amputee care in the federal and civilian communities. A midweek breakfast program sponsored by the Mayo Clinic featured SFC Metzdorf sharing his own experiences as a Wounded Warrior to show the impact of integrated clinical care with a holistic, patient-centered approach. Finally, an end-of-week panel featuring officials from the DoD, VA, and National Institutes of Health (NIH), along with industry experts, discussed ways of sustaining this high-level amputee care within the framework of the “New Normal.” These three events were sponsored by an interdisciplinary group that highlights the power of an integrative model: the Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium, a DoD-funded cooperative agreement awarded to the University of Delaware, the Mayo Clinic, the American Orthotic & Prosthetic Association, the Orthotic and Prosthetic Group of America, and the American Academy of Orthotists and Prosthetists. One of the goals of the group was to bring these vested groups together to see what can be accomplished through collaboration. As such, the BADER Consortium supported the travel of 37 individuals to the AMSUS conference. The overarching theme of the week’s events focused on the need for outcomes research to better evaluate patient care, encourage technology development, and facilitate clinical approaches. To that end, speakers at the three events overwhelmingly supported a DHB recommendation to develop and maintain a centralized registry of amputees to better understand *BADER Consortium, University of Delaware, 540 S. College Avenue, Newark, DE 19713. †Brownian Consulting LLC, 104 Blueberry Hill Drive, Hanover, NH 03755. ‡Thought Leadership and Innovation Foundation, 16775 Whirlaway Court, Leesburg, VA 20176. doi: 10.7205/MILMED-D-15-00580

History and Land Use Change: The New Brunswick Copper Mining and Processing Complex, Rutgers University, and Johnson & Johnson

This paper is the end result of a historical study of the New Brunswick Copper Mining and Processing Complex, which was formerly sited within what is now the City of New Brunswick in Middlesex County, New Jersey.The New Brunswick Copper Mining and Processing Complex was active during the final decades of the colonial period and included both extractive and water-powered industrial components that were focused within the area bounded on the east by the Raritan River, north by Seminary Place, west by College Avenue, and south by Hamilton Street/Johnson Drive. This area was redeveloped during the 19th and 20th centuries, with the lands formerly utilized for the mining and processing of copper eventually coming to be occupied by Rutgers University and Johnson & Johnson. The discovery of a mine shaft formerly associated with this early copper mining and processing complex during the demolition of a building within the Johnson & Johnson Corporate Headquarters led to the commissioning of this study by Johnson & Johnson.This paper provides a discussion of the history of the New Brunswick Copper Mining and Processing Complex and of the subsequent changing land uses that ultimately led to the current presence of Rutgers University and Johnson & Johnson.

Gentle Gassing by S.S. Cox, Not S.S. White

a Medical Student, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0144, USA b Clinical Associate Professor, Department of Anesthesiology and Perioperative Medicine, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA c Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, Case Western Reserve University School of Dental Medicine, 2124 Cornell Rd, Cleveland, OH 44106, USA d Honorary Curator, Wood Library-Museum of Anesthesiology, 1061 American Lane, Schaumburg, IL 60173-4973, USA

Adaptive hydrological flow field modeling based on water body extraction and surface information

Suranaree University of Technology, School of Computer Engineering,111 University Avenue, Muang, Nakhon Ratchasima 30000, ThailandAbstract. Hydrological flow characteristic is one of the prime indicators for assessing flood.It plays a major part in determining drainage capability of the affected basin and also in thesubsequent simulation and rainfall-runoff prediction. Thus far, flow directions were typicallyderived from terrain data which for flat landscapes are obscured by other man-made structures,hence undermining the practical potential. In the absence (or diminutive) of terrain slopes, waterpassageshaveamorepronouncedeffectonflowdirectionsthanelevations.Thispaper,therefore,presents detailed analyses and implementation of hydrological flow modeling from satellite andtopographicimages.Herein,gradualassignmentbasedonsupportvectormachinewasappliedtomodified normalized difference water index and a digital surface model, in order to ensure reli-able water labeling while suppressing modality-inherited artifacts and noise. Gradient vectorflow was subsequently employed to reconstruct the flow field. Experiments comparing theproposed scheme with conventional water boundary delineation and flow reconstruction werepresented. Respective assessments revealed its advantage over the generic stream burning.Specifically, it could extract water body from studied areas with 98.70% precision, 99.83%recall, 98.76% accuracy, and 99.26% F-measure. The correlations between resultant flowsand those obtained from the stream burning were as high as 0.80 0.04 (p ≤ 0.01 in all res-olutions).

Infant feeding and maternal guilt: The application of a feminist phenomenological framework to guide clinician practices in breast feeding promotion

a Dalhousie University School of Nursing, 5869 University Avenue, Halifax, Nova Scotia, Canada B3H 4R2 b Centre for Pediatric Pain Research, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, Canada B3K 6R8 c Caritas Coach, Watson Caring Science Centre, University of Colorado, 13120 East 19th Avenue, Aurora, CO 80045, USA d Women and Newborn Program, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, Canada B3K 6R8

An Avuncular Stereotype Advertises Dr. George Hill's Laughing Gas

a School of Medicine, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0144, USA b Department of Anesthesiology and Perioperative Medicine, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA c Department of Oral and Maxillofacial Surgery, Case Western Reserve University School of Dental Medicine, 2124 Cornell Rd, Cleveland, OH 44106, USA d Honorary Curator, American Society of Anesthesiologists, Wood Library-Museum of Anesthesiology, 1061 American Lane, Schaumburg, IL 60173-4973, USA

Neonatal resuscitation beyond the delivery room - does one protocol fit all?

Acta PaediatricaVolume 104, Issue 10 p. 971-973 A Different View Neonatal Resuscitation beyond the delivery room – Does one protocol fit all? Kaarthigeyan Kalaniti, Corresponding Author Kaarthigeyan Kalaniti Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada Correspondence Dr Kaarthigeyan Kalaniti, Clinical Fellow - Neonatology/Neonatal Transport, Division of Neonatology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. Tel: +1 (416) 813-7654 Extn: 202975 | Fax: +1 (416) 813-6866 | Email: [email protected]Search for more papers by this authorGeorg M Schmölzer, Georg M Schmölzer orcid.org/0000-0001-9798-2415 Center for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandria Hospital, Edmonton, AB, Canada Department of Pediatrics, University of Alberta, Edmonton, AB, CanadaSearch for more papers by this authorPatrick J McNamara, Patrick J McNamara Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada Department of Physiology & Experimental Medicine Program, Hospital for Sick Children, Toronto, ON, CanadaSearch for more papers by this author Kaarthigeyan Kalaniti, Corresponding Author Kaarthigeyan Kalaniti Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada Correspondence Dr Kaarthigeyan Kalaniti, Clinical Fellow - Neonatology/Neonatal Transport, Division of Neonatology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. Tel: +1 (416) 813-7654 Extn: 202975 | Fax: +1 (416) 813-6866 | Email: [email protected]Search for more papers by this authorGeorg M Schmölzer, Georg M Schmölzer orcid.org/0000-0001-9798-2415 Center for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandria Hospital, Edmonton, AB, Canada Department of Pediatrics, University of Alberta, Edmonton, AB, CanadaSearch for more papers by this authorPatrick J McNamara, Patrick J McNamara Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada Department of Physiology & Experimental Medicine Program, Hospital for Sick Children, Toronto, ON, CanadaSearch for more papers by this author First published: 14 July 2015 https://doi.org/10.1111/apa.13116Citations: 6 Articles in the series A Different View are edited by William Meadow ([email protected]). We encourage you to offer your own different view either in response to A Different View you do not fully agree with, or on an unrelated topic. Send your article to Dr. Meadow ([email protected]). Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume104, Issue10October 2015Pages 971-973 RelatedInformation

A Systematic Review Of The Use Of Bupropion For Hypoactive Sexual Desire Disorder In Premenopausal Women.

Objective: To assess the efficacy of bupropion therapy for hypoactive sexual desire disorder (HSDD) in women. Methods: A systematic review was performed utilizing the standard databases. Data were abstracted for study quality, characteristics, and outcomes. Due to the small number of studies and lack of consistently reported outcomes, a meta-analysis was not performed. Results: Two studies (289 women) met inclusion criteria. While one study had low risk of bias, the other had areas of high risk of bias. Both trials reported improvement in sexual function domains with treatment ranging from 12 weeks to 112 days. Conclusions: Despite two trials demonstrating benefit with bupropion treatment for premenopausal women with HSDD, the evidence is limited and not of adequate quality to recommend the therapy. More trials are needed in this area. Corresponding author: David M. Haas, MD, MS Dept. of OB/GYN, 550 N University Blvd, UH 2440, Indianapolis, IN 46202 (317)880-3959 (office), dahaas@iupui.edu DOI : 10.14302/issn.2381-862X.jwrh-14-546 Freely Available Online www.openaccesspub.org | JWRH CC-license DOI : 10.14302/issn.2381-862X.jwrh-14-546 Vol-1 Issue 1 Pg. no.15 INTRODUCTION Female sexual dysfunction is a prevalent problem worldwide with reported rates of 10-30% . Hypoactive sexual desire disorder (HSDD) is a common form of sexual dysfunction affecting females more often than males at rates of 30% and 15%, respectively 2, . HSDD is defined in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as “the persistent or recurrent deficiency or absence of sexual fantasies/thought, and/or desire for sexual activity that causes personal distress or interpersonal difficulties”. It is not uncommon for women with HSDD to also have concomitant sexual arousal and/or orgasmic disorders . Additionally, HSDD and low sexual desire in general are believed to be underestimated by health care providers and are associated with decreased relationship satisfaction and distress for many women and their partners 1, . Furthermore, impaired sexual desire has been shown to be associated with depressed mood. While studies have shown improvement in sexual function with relief of depressive symptoms, additional investigation into the psychological and physiological effects of antidepressants has provided evidence of antidepressant-induced sexual dysfunction as an adverse effect of many of these medications . Despite ongoing research into female sexual dysfunction and HSDD, the exact etiology of these disorders is yet to be determined. There have been many trials conducted to determine the efficacy of various therapies in the treatment of HSDD. Decreased androgen levels have been shown to be associated with a decline in libido. Testosterone therapy (oral, transdermal patch, or topical) has been investigated through randomized controlled trials (RCTs) indicating statistically significant improvement in sexual desire . Testosterone transdermal patches have been approved for HSDD treatment in Europe. However, the U.S. Food and Drug Administration did not approve testosterone therapy for the treatment of HSDD due to the unknown long term adverse events (Moynihan 2004). In addition to testosterone therapies, investigations of genital vasodilators, dopaminergic therapies, estrogen therapies, and melanocortin receptor-acting bremelanotide have been conducted 1, . However, despite these investigations, there continues to be no FDA approved treatment for HSDD in the United States. Bupropion is a centrally-acting medication that is currently approved for use in the treatment of major depressive disorder, seasonal affective disorder, and smoking cessation (Bupriopion package insert 2014). The exact mechanism of action of bupropion has yet to be determined, however, it is believed to act centrally on both dopaminergic and norepinephrine systems with no serotonergic action . In addition to its role in mood improvement, bupropion has been shown to be effective in the reversal of SSRI-induced sexual dysfunction when supplemented to current therapy as well as a (Continued on page 16) Freely Available Online www.openaccesspub.org | JWRH CC-license DOI : 10.14302/issn.2381-862X.jwrh-14-546 Vol-1 Issue 1 Pg. no.16 substitution therapy . In addition to treatment of iatrogenic sexual dysfunction, study results indicate prosexual effects through the use of bupropion 12, . The objective of this study was to systematically review the data regarding bupropion treatment for HSDD treatment and to perform a meta-analysis to synthesize the trial results to determine if bupropion is effective

The challenges facing corporate universities in dealing with open innovation

Purpose – This paper aims to illustrate the quick rise in the popularity of corporate universities since the 1990s. Because knowledge management is becoming imperative to the survival and growth of firms in most industries, better management of corporate universities is becoming more and more critical. The purpose of this paper is to analyze three objectives: Why invest in corporate universities? Which model to adopt? and What are the key challenges facing corporate universities in dealing with the adoption of an open innovation approach? Design/methodology/approach – The article provides a general review of corporate universities dealing with open innovation by using a creative synthesis. Findings – This paper analyzes the challenges involved in the development of corporate universities and examines how they can deal with open innovation. While few corporate universities have a real strategic role, several initiatives have failed or have been seriously compromised. To create competitive advantages through a corporate university, upper management must dedicate significant resources and have a plan for building the corporate curriculum in order to deal with innovation management. Research limitations/implications – Due to the lack of scientific articles on the topic, most of the published articles made by practitioners was used. Further studies are needed to test the recommendations and models. Practical implications – This paper identifies some development models and growth avenues for corporate universities. It helps provide an understanding of the challenges associated with open innovation as well as their limits. Originality/value – It is among the first papers to link the development of corporate universities with the open innovation approach. It also provides practical advice for managers and academics.

Improved Arterial Tissue Differentiation by Spectroscopic Optical Coherence Tomography

University of Toronto, 610 University Avenue, Toronto, Ontario, M5G 2M9, CanadaOptical coherence tomography (OCT) is a relatively new imaging modality similar with ultrasound where the sound waves are replaced by ballistic photons. OCT provides images at high spatial resolution which allow for the identification of micron size morphological tissue structures. A high impact application is visualization of arterial wall and atherosclerotic plaques. Despite high spatial resolution to complete the transfer of this imaging modality into clinical environment there is a need for markers which would quantify the physiological condition of the sample. Finding the proper markers is a topic of high interest for many research groups. A potential marker suggested by the OCT community is the optical attenuation coefficient. Although OCT image itself provides important diagnostic and structural information there are also new methods of tissue characterization that have been developed through spectroscopic OCT and quantitative OCT. Spectroscopic OCT investigates the spectral response while the quantitative OCT extends the investigation to non-spectral parameters. Here we investigate two procedures for calculation of optical attenuation coefficient dependence versus wavelength. The wavelength analysis will provide new insight into the chemical nature of the sample, because the spectral backreflected signal depends on sample absorption and scattering properties. In this study we demonstrate the application of OCT for quantitative and spectral analysis of vulnerable plaque morphology on Watanabe heritable hyperlipidemic – myocardial infarction (WHHLMI) rabbit model. The results suggest that the spectral dependence of the derived OCT attenuation coefficient can be used for tissue differentiation. We demonstrated that differences and the spectral dependence of the optical attenuation coefficient are linked to the macrophage content of the region of interest.Key words: optical coherence tomography; quantitative and spectral analysis; WHHLMI rabbits.Corresponding author: Costel Flueraru, e-mail: costel.flueraru@nrc-cnrc.gc.ca

Understanding ‘The Panty Shanty’: off-campus house signs as cultural texts on gender and sexuality

Students at a large, prestigious, public university in the Midwestern region of the USA have a long-standing tradition of naming their rented houses off campus and communicating those names to the student body through displaying prominent and eye-catching house signs. Examples of signs names and visual characteristics are: ‘Betty Ford Clinic’ (featuring an image of a martini glass); ‘Morning Wood’ (referencing male sexual arousal and depicting a tent with a man's legs sticking out); ‘Time Well Wasted’ (written in pink over a beach scene and a martini glass); ‘Fox Den’ (images of a fox tail and a well-known sorority symbol); ‘Tequila Mockingbird’ (a play on words); and ‘Down on U’ (the sign references a sexual act for a house located on University Avenue). Through a socio-feminist and social constructionist perspective, the researchers use content analysis to explore how these house signs serve as cultural texts on gender and sexuality norms in the American undergraduate college setting. Based on our data, house signs reinforce dominant forms of gender ideologies, including hegemonic masculinity and emphasized femininity, both of which are associated with upholding and promoting institutionalized patriarchy (Connell, R. W., & Messerschmidt, J. W. (2005). Hegemonic masculinity: Rethinking the concept. Gender & Society, 19, 829–859). These house signs are also shown through the data to promote a campus culture of heteronormativity where partying, drinking, and casual sex are standards for social belonging, and where high rates of sexual assault persist. As opposed to viewing house signs as simply manifestations of student wit and harmless humor, the researchers critically evaluate if and how these visual displays serve as a mechanism through which gender and sexuality-related inequalities are perpetuated within a higher education institutional setting. Implications for students and their college campuses are discussed.

A meeting of mice and men: rodent impacts on food security, human diseases and wildlife conservation; ecosystem benefits; fascinating biological models

International Rice Research Institute, DAPO Box 7777, Metro Manila, 1301, Philippines. Natural Resources Institute, University of Greenwich, Central Avenue, Chatham Maritime, Kent ME4 4TB, UK. Julius Kuehn Institute, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Toppheideweg 88, 48161 Muenster, Germany. Department of Zoology, University of British Columbia, 6270 University Boulevard, Vancouver, B.C. V6T 1Z4, Canada. Department of Biological Sciences, University of Swaziland, Private Bag 4, Kwaluseni, Swaziland. Corresponding author. Email: g.singleton@irri.org