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This article examines the work of two diasporic memory organizations, Kresy-Siberia and Houshamadyan, which have both developed Internet platforms to collect and share information about lost homelands: in the former case, the pre-Second World War eastern borderlands of Poland; in the latter, the Armenian communities of the Ottoman Empire that were destroyed by genocide. The article draws on interviews undertaken with participants in order to examine the activism of these two diasporic memory groups and to analyse the relationship between memory practice and the online space. The article asks what difference the creation of an online platform makes to such groups, both for individuals and for the wider diaspora, and seeks to understand how the possibilities offered by these platforms shape diasporic practice. The article shows how, despite the apparent similarities between the online presences of these two organizations, their use of the Internet facilitates diverse forms of memory practice, which are influenced by the historically specific needs of participants in these different diasporic communities. [ABSTRACT FROM AUTHOR]

I write into the haecceity of recent events in and around my teaching in environmental education to explore the concept of thisness as pedagogy. [ABSTRACT FROM AUTHOR]

Background: We report a case of an intraosseous cavernous hemangioma originating from the middle turbinate that expanded into the anterior skull base, without traversing the cribriform plate. Methods: The mass was found incidentally after a computed tomography head was ordered for unrelated reasons. On questioning, the patient denied any nasal symptoms. Magnetic resonance imaging showed an enhancing mass and the radiological imaging supported a broad differential. Results: The lesion was removed by endoscopic image-guided surgery, and the pathology was that of a benign intraosseous cavernous hemangioma. There was no residual hemangioma on postoperative imaging and the nasal mucosa healed well. This is the first report of an intraosseous cavernous hemangioma of the middle turbinate showing superior expansion to the anterior skull base. Conclusion: This case demonstrates the extent to which cavernous hemangiomas may expand into surrounding tissues. While these lesions are uncommon, they can be considered as part of a broad differential diagnosis of sinonasal tumors. [ABSTRACT FROM AUTHOR]

ICH S6 (R1) states that safety evaluation of biotherapeutics should normally include 2 relevant species when available (i.e., a rodent and non-rodent species in which the test material is pharmacologically active), at least for short-term toxicology studies (generally supporting Phase I trials). For subsequent long-term toxicology studies (e.g., chronic studies up to 6 months dosing duration), there are options to reduce to only one species when justified, including when the mechanism of action of the biologic is well-understood or the toxicity findings in the short-term studies are "similar" in both the rodent and non-rodent species. Across the industry, around 25 to 33% of biologics assess multiple species within short-term toxicity studies but it is often unclear how different companies and regulators are applying the ICH S6 (R1) principles of "similar toxicity profiles" to progress with either 1 or 2 species in the long-term studies, in particular whether the absence of toxicities is considered within this definition. Sponsors may potentially continue to use 2 species to avoid regulatory risk and potential delays in development timelines, representing missed opportunities for reducing animal use, particularly of non-human primates, during drug development. This article summarizes presentations from a symposium at the 41st Annual meeting of the American College of Toxicology (ACT) in November 2020, in which industry case studies and regulatory perspectives addressed considerations and decisions for using 1 or 2 species for long-term toxicity studies, highlighting any common themes or experience that could be applicable for use in future decision-making. [ABSTRACT FROM AUTHOR]

The Female Athlete Triad (Triad) and the more encompassing Relative Energy Deficiency in Sport (RED-S) are disorders caused by low energy availability (LEA). LEA is a state of insufficient energy intake by an athlete relative to their energy expenditure. Persistent LEA results in the deleterious consequences to health and performance that comprise RED-S. With respect to both the Triad and RED-S, researchers have called for more education of those involved with sport, particularly coaches, to help reduce the incidence of these disorders. Recent studies have shown that as few as 15% of coaches are aware of the Triad, with up to 89% unable to identify even one of its symptoms. RED-S is a more recently established concept such that coach knowledge regarding it has only begun to be assessed, but the results of these initial studies indicate similar trends as for the Triad. In this review, we synthesize research findings from 1986 to 2021 that pertains to LEA and RED-S, which coaches should know so they can better guide their athletes. [ABSTRACT FROM AUTHOR]

Every year, more children and youths are sent to Secure Children's Homes while moving through the criminal justice system. Aggressive and violent incidents in these settings are common, and staff are often required to intervene and restrain violent individuals. The research literature has many examples of aggression and violence questionnaires and measures; however, for staff in communal areas it is the observable behaviors that they react to most. The current research, therefore, analyzed observable behaviors leading-up to violent episodes, and used Behavior Sequence Analysis to highlight the typical chains of behaviors that tend toward violence. The outcomes of this research show pathways to violence that staff can use to highlight potential spirals of aggression and violence. The current results show the links between non-confrontational behaviors (e.g., talking) through to more confrontational (staring, approaching, and pushing others). Overall, the research forms the foundation for future investigation into these and similar settings and outlines a novel approach to understanding violence escalation in a way that can be interpreted and used by service staff. [ABSTRACT FROM AUTHOR]

This article performs the becoming intimacy of a reading (and, later, writing) group who met once a month for 2 years to discuss Deleuze and Guattari's A Thousand Plateaus. Through this collaborative piece, we explore the question of intimacy as both a form of activism and a mode of inquiry. We ask, "Where is activism as we subvert the hierarchy of academia by meeting as an assemblage of differing perspectives and positions in the university?" Furthermore, we ask, "What does the intimacy that occurred, that is occurring, do for both inquiry and activism?." This article contains two sets of writing from our monthly meetings that we offered as performative conference texts. We contend that it is affect that brings our theorizing to life, and transfers it meaningfully between each other. We are affected by Deleuze and Guattari, by A Thousand Plateaus, and by how we form linkages with our lives to these bodies. Intimacy is what sustains and gives life to our collective inquiry, without which our affect might be more constrained. The complexity of the becoming of "intimacy as inquiry" becomes twofold, as it is not only a becoming of intimacy, love, and care for those in our assemblage but also a reterritorialization of the act of inquiry. Through the act of disrupting power structures in the group of "We 5," the act of writing and presenting this work in an academic context pushes against the striated spaces that exist in the academy, that course through the milieu we occupy, and provides the means and necessity for reterritorializing the epistemic space. "Epistemic intimacy," then, becomes a manifestation of engaging with the inquiry process and embodies an active resistance to the business transaction that the act of inquiry has become in the neoliberal development of the academy. [ABSTRACT FROM AUTHOR]

Background: Stroke patients are often inactive outside of structured therapy sessions – an enduring international challenge despite large scale organizational changes, national guidelines and performance targets. We examined whether experienced-based co-design (EBCD) – an improvement methodology – could address inactivity in stroke units. Aims: To evaluate the feasibility and impact of patients, carers, and staff co-designing and implementing improvements to increase supervised and independent therapeutic patient activity in stroke units and to compare use of full and accelerated EBCD cycles. Methods: Mixed-methods case comparison in four stroke units in England. Results: Interviews were held with 156 patients, staff, and carers in total; ethnographic observations for 364 hours, behavioral mapping of 68 patients, and self-report surveys from 179 patients, pre- and post-implementation of EBCD improvement cycles. Three priority areas emerged: (1) 'Space' (environment); (2) 'Activity opportunities' and (3) 'Communication'. More than 40 improvements were co-designed and implemented to address these priorities across participating units. Post-implementation interview and ethnographic observational data confirmed use of new social spaces and increased activity opportunities. However, staff interactions remained largely task-driven with limited focus on enabling patient activity. Behavioral mapping indicated some increases in social, cognitive, and physical activity post-implementation, but was variable across sites. Survey responses rates were low at 12–38% and inconclusive. Conclusion: It was feasible to implement EBCD in stroke units. This resulted in multiple improvements in stroke unit environments and increased activity opportunities but minimal change in recorded activity levels. There was no discernible difference in experience or outcome between full and accelerated EBCD; this methodology could be used across hospital stroke units to assist staff and other stakeholders to co-design and implement improvement plans. [ABSTRACT FROM AUTHOR]

Introduction: Relationships between people with dementia and their carers can prove challenging over the trajectory of the disease. Interventions with a potential to address this include arts and music-based activities. This research project aimed to evaluate a community engagement programme (Carers Create) where both people with dementia and their carers participate together in singing and other activities. A specific focus was on the impact of the sessions on the dyadic relationship. Methods: A grounded theory approach involved conducting three focus group interviews with carers of people with dementia (n = 16) facilitated by members of a local U3A (University of the Third Age) who were trained and supported by university researchers. Recorded conversations were transcribed and analysed using a three-stage coding and thematic development technique. Results: Four overarching themes were identified from the discourse: remembering the positive qualities of the cared-for, the physical and emotional demands of caring, Carers Create as a shared, beneficial activity and the enduring value of Carers Create. Conclusion: Carers found the sessions to positively influence the relationship with the person they cared for through offering some relief from the day-to-day pressures of caring and, in some cases, restoring elements of a previously strong relationship. Crucial to the experience was the fact that the sessions included both carer and cared-for, offering activities to do together, and that they took place within a group, thereby offering a degree of mutual support. In addition, some carers were able to build on learning which had taken place and use certain techniques, such as singing, to help manage care, thus extending the improved relationship. [ABSTRACT FROM AUTHOR]

The objectives were to characterize the kinetics of acute phase proteins (APPs) α-2 macroglobulin (A2M), α-1 acid glycoprotein (A1AGP), and fibrinogen (FIB), and injection site macroscopic and microscopic findings following intramuscular administration of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (TDaP; Adacel); adjuvants (aluminum phosphate [AlPO4]; aluminum hydroxide, Al[OH]3; CpG/Al[OH]3; or Quillaja saponaria 21 [QS-21]); or saline to female Wistar Han rats. Intravascular lipopolysaccharide (LPS) was a positive control. Injection sites and lymph nodes were evaluated microscopically, using hematoxylin and eosin (H&E) stained sections, 48 hours postdose (HPD) and compared with APP concentrations; A2M and A1AGP were measured using Meso Scale Discovery analyzer. Fibrinogen was measured on STA Compact analyzer. In a time-course study, APP peaked at 24 or 48 HPD. In a subsequent study at 48 HPD, injection site microscopic changes included inflammation and muscle degeneration/necrosis, which was different in severity/nature between groups. The APPs were not increased in rats administered saline, Al(OH)3, or AlPO4. Fibrinogen and A1AGP increased in rats administered CpG/Al(OH)3, QS-21, or TDaP; and A2M increased in rats administered QS-21. Fibrinogen, A2M, and A1AGP increased after LPS administration. Acute phase proteins can be used to monitor inflammatory responses to adjuvants; however, some adjuvants may induce inflammation without higher APPs. [ABSTRACT FROM AUTHOR]

To understand the role of symptom attribution in treatment-seeking behaviours, survey results of 1356 veterans (age = 38–72 years) were analysed. Controlling for symptom frequency, significant relationships were found for specialist and psychological-related consultations. Those who favoured psychological explanations for symptoms were more likely to attend specialist and psychology-related consultations and filled significantly more prescriptions than people who predominantly explained symptoms by situational factors (normalisers). Veterans who favoured somatic explanations attended more general practitioner consultations than normalisers. Attributional style should be considered part of the constellation of factors influencing healthcare usage. Normalisers, the predominant group, used fewest health services and filled fewest prescriptions; this may have important implications for healthcare considering their tendency to minimise or downplay symptoms. [ABSTRACT FROM AUTHOR]

Taking the Vereinigung der Opfer des Stalinismus (Association of the Victims of Stalinism) as a case study, this article argues that civil society organisations which claim to represent the interests of victims of historical injustice must seek to construct and propagate notions of the political and social relevance of victimhood. They must do so in such a way that victimhood both offers a coherent point of identification for individual victims and speaks to the concerns of the political system on which victims rely for compensation and recognition. By examining the discourse of officials of this organisation over time, it is possible to demonstrate the extent to which victims’ representatives must adapt their conception of victimhood in order to respond to changing circumstances. The article also points to the challenges these organisations face in remaining relevant in the new political contexts. [ABSTRACT FROM AUTHOR]

Objective: To identify why the National Clinical Guideline recommendation of 45 minutes of each appropriate therapy daily is not met in many English stroke units. Design: Mixed-methods case-study evaluation, including modified process mapping, non-participant observations of service organisation and therapy delivery, documentary analysis and semi-structured interviews. Setting: Eight stroke units in four English regions. Subjects: Seventy-seven patients with stroke, 53 carers and 197 stroke unit staff were observed; 49 patients, 50 carers and 131 staff participants were interviewed. Results: Over 1000 hours of non-participant observations and 433 patient-specific therapy observations were undertaken. The most significant factor influencing amount and frequency of therapy provided was the time therapists routinely spent, individually and collectively, in information exchange. Patient factors, including fatigue and tolerance influenced therapists' decisions about frequency and intensity, typically resulting in adaptation of therapy rather than no provision. Limited use of individual patient therapy timetables was evident. Therapist staffing levels were associated with differences in therapy provision but were not the main determinant of intensity and frequency. Few therapists demonstrated understanding of the evidence underpinning recommendations for increased therapy frequency and intensity. Units delivering more therapy had undertaken patient-focused reorganisation of therapists' working practices, enabling them to provide therapy consistent with guideline recommendations. Conclusion: Time spent in information exchange impacted on therapy provision in stroke units. Reorganisation of therapists' work improved alignment with guidelines. [ABSTRACT FROM AUTHOR]

Background: HPV-associated OSCC (HPV-OSCC) has been determined to be a distinct disease entity from non-HPV associated OSCC. Patients affected by HPV-OSCC generally have a more favourable prognosis, with improved rates of locoregional control and survival compared with their non-HPV counterparts. Despite this, HPV-OSCC has a similar rate of distant metastases. Interestingly, recent evidence has emerged that demonstrates more frequent atypical metastasis patterns when compared to non-HPV associated disease. To the best of our knowledge, this report describes the first case of a confirmed HPV-OSCC with distant metastasis to the cavernous sinus. Case Presentation: A 62-year-old non-smoking male presented to the head and neck oncology clinic with a five-month history of enlarging right neck mass causing neck pain, dysphagia, and dysphonia. HPV-associated base of tongue squamous cell carcinoma (cT4aN2c) was diagnosed, and he was treated with primary chemoradiation. Shortly after treatment, he presented with progressive bilateral cranial nerve palsies including left cranial nerve III and right cranial nerve VI involvement. Imaging identified masses in the left cavernous sinus with extension of tumor into the sella and in the right cavernous sinus at the level of Dorello’s canal. Endoscopic Image Guided Transsphenoidal biopsy of the left sellar mass confirmed distant metastases from the previously treated HPV-OSCC primary to the cavernous sinus. The patient was palliated with carboplatin and paclitaxel. Conclusion: The presented report is the first documented case of confirmed HPV-associated oropharyngeal squamous cell carcinoma metastasizing to the cavernous sinus, and the only HPV confirmed head and neck cancer case to present with metastasis to the cavernous sinus and limited extracranial disease. This case demonstrates the importance of recognizing presentations of atypical metastasis that are possible in HPV-associated oropharyngeal cancer. Given the rarity of metastasis to this region, vigilance in follow up is instrumental in early identification and treatment for these patients. [ABSTRACT FROM AUTHOR]

Six young adults (aged 19–21 years) with repeat self-harm for over 5 years were interviewed about their self-harm, why they continued and what factors might help them to stop. Interpretative phenomenological analysis identified six themes: keeping self-harm private and hidden; self-harm as self-punishment; self-harm provides relief and comfort; habituation and escalation of self-harm; emotional gains and practical costs of cutting, and not believing they will stop completely. Young adults presented self-harm as an ingrained and purposeful behaviour which they could not stop, despite the costs and risks in early adulthood. Support strategies focused on coping skills, not just eradicating self-harm, are required. [ABSTRACT FROM AUTHOR]

Despite the use of rabbits in biomedical research, including regulatory toxicology and cardiovascular studies, little data exist on heart findings in this species. This study was designed to document myocardial findings in female rabbits and the impact of study-related procedures typical for vaccine toxicology studies. One hundred and forty 6- to 8-month-old female New Zealand White rabbits were divided equally into 2 groups, high and low study procedure groups (group 1 and group 2, respectively). All animals received intramuscular (IM) injections of sterile saline every 2 weeks for 5 times and were necropsied 2 days after the final IM injection. Clinical chemistry, hematology, and urinalysis were evaluated. Blood for stress biomarkers (norepinephrine, epinephrine, cortisol, and corticosterone), C-reactive protein, cardiac troponin I, and creatine kinase were collected at time 0 (just before dose administration) and then at 4, 24, and 48 hr after dose administration in group 1 only. Hearts were assessed histologically. Focal to multifocal minimal inflammatory cell infiltrates were common (∼80%), particularly in the left ventricle and interventricular septum, and were similar to the types of infiltrates identified in other laboratory animal species. Additionally, study-related procedures elevated serum stress biomarkers and exacerbated the frequency and severity of myocardial inflammatory cell infiltrates. [ABSTRACT FROM AUTHOR]

Over the last 10 years, evidence has emerged that too much sedentary time (e.g. time spent sitting down) has adverse effects on health, including an increased risk of cardiovascular disease incidence and mortality. A considerable amount of media attention has been given to the topic. The current UK activity guidelines recommend that all adults should minimize the amount of time spent being sedentary for extended periods. How best to minimize sedentary behavior is a focus of ongoing research. Understanding the impact of sedentary behaviors on the health of people with stroke is vital as they are some of the most sedentary individuals in society. Implementing strategies to encourage regular, short breaks in sedentary behaviors has potential to improve health outcomes after stroke. Intervention work already conducted with adults and older adults suggests that sedentary behaviors can be changed. A research priority is to explore the determinants of sedentary behavior in people with stroke and to develop tailored interventions. [ABSTRACT FROM AUTHOR]

From 1859 to 1864, both visual and audio one o’clock time signals operated in Glasgow. Although the University carried a remit to provide the city’s time, following convoluted processes of establishment, a local chronometer-maker operated a time ball for 4 years. Towards the end of the period, time guns were triggered by telegraph from the Royal Observatory Edinburgh. Both exercises caused aggravation for the University. For the ball, the Professor of Astronomy, John Pringle Nichol, failed to convince the City Council that the “drop” control should originate from the University’s Observatory. For the guns, Robert Grant, the newly appointed Astronomy Chair holder, was aggrieved by the Astronomer Royal for Scotland, Piazzi Smyth, appearing to operate above his station. Rather than having only a once per day reference, both projects were abandoned as the University laid a dedicated telegraph cable from its observatory to control many public clocks and additional clocks with large sweep fingers indicating exact time to the second. [ABSTRACT FROM AUTHOR]

Objective: To describe the nature of psychiatric morbidity in patients admitted to a critical care unit of a general hospital and referred to a consultation-liaison psychiatry service.Method: Analysis of clinical records on all patients admitted to a critical care unit and referred to consultation-liaison between 2010 to end of 2011. Descriptive statistics only are reported.Results: The referrals represented all age groups. Of those referred, 63.9% had a pre-existing psychiatric diagnosis and 64.7% had been admitted for intentional or accidental overdose.Conclusion: Those identified to have a pre-existing mental illness and who had engaged in treatment were found to be inadequately supervised. They require more extended care and monitoring for suicidality and co-morbid physical conditions. [ABSTRACT FROM AUTHOR]

The use of minipigs in preclinical safety testing of pharmaceuticals is considered an alternative to the more traditional dog and nonhuman primate (NHP) nonrodent species. Substantial evidence exists to suggest that the anatomy, physiology, and biochemistry of minipigs are similar enough to humans to consider them as valid nonrodent models for pharmaceutical safety testing. Since the utilization of minipigs was last assessed over 5 years ago, the Preclinical Safety Leadership Group (DruSafe) of the International Consortium for Innovation and Quality in Pharmaceutical Development conducted this survey to provide an updated assessment of the utility, perceived value, and impediments to the use of minipigs in preclinical safety testing. Of the 32 participating members of DruSafe, 15 responded to the survey representing both large and small companies. Respondents indicated that the minipig has been utilized mostly for short-term safety assessment studies with dermal, oral, and parenteral routes of administration. Minipigs are widely accepted as appropriate models for cardiovascular assessments and have been used to a limited extent for reproductive toxicology testing. Overall responses indicated that safety testing for large molecules using this species is relatively low due to a lack of background data, reagents or biomarkers, concerns regarding immune system characterization and poor suitability for developmental toxicity assessments. Most companies utilized contract research organizations for definitive safety toxicity assessment studies. Conclusions of this survey indicate that minipig is an acceptable nonrodent species largely limited to studies using small molecules, primarily dermal products, and results are comparable to those reported 5 years ago. [ABSTRACT FROM AUTHOR]

Finnish–Estonian author Sofi Oksanen’s novel Purge (2008) explores one woman’s experience of political violence and its repercussions in Estonia from the 1930s to the 1990s. The novel’s reception in Estonia included accusations that the text painted a simplified version of history, setting ‘good’ Estonian victims against ‘bad’ Russian perpetrators. However, a close reading of the text shows a much more complex and subtle representation of victimhood, which challenges such dichotomies. Seen in the context of current scholarly debates about the meaning of victimhood in contemporary society, the novel offers a warning against the contemporary nationalist tendency to found political community on a shared experience of suffering or persecution which excludes others, pointing instead to the creation of solidarities among different kinds of victims, which potentially transcend national boundaries. [ABSTRACT FROM AUTHOR]

The article presents a study on Apolipoprotein E (ApoE) alleles in patients suffering from mild cognitive impairment (MCI) in Cuba. It mentions that the genotype is attested as a risk factor for Alzheimer's disease (AD). It also notes the rapid progression of the disease and dementia in people with the syndrome.

If there is a topic on which the humanities might make a distinctive claim, it is that of consciousness—an essential aspect of human being. And within the humanities, music might make its own claims in relation to both consciousness and being human. To investigate this connection, David Clarke and Eric Clarke brought together a wide variety of contributors in the book Music and Consciousness: Philosophical, Psychological, and Cultural Perspectives (OUP, 2011). The collection contributes to debates in consciousness studies at large, but also maps out areas peculiar to music and consciousness. Additionally, it lays bare the sheer multiplicity of discourses that emerges when consciousness is approached from even a single field of inquiry, such as music. If this poses a challenge for arriving at any agreed notion of consciousness (in relation to music or otherwise), this instability is something that might be best embraced rather than ‘resolved’. While the study of music and consciousness affirms the importance of the humanities, this is not to foreclose dialogue with scientific disciplines, even as this means maintaining awareness of how the different discursive formations of the humanities and sciences may connote different—and frequently incommensurable—sensibilities and values. [ABSTRACT FROM PUBLISHER]

Background. The overriding importance of patient safety, the complexity of surgical techniques, and the challenges associated with teaching surgical trainees in the operating room are all factors driving the need for innovative surgical simulation technologies. Technical development. Despite these issues, widespread use of virtual reality simulation technology in surgery has not been fully implemented, largely because of the technical complexities in developing clinically relevant and useful models. This article describes the successful use of the NeuroTouch neurosurgical simulator in the resection of a left frontal meningioma. Conclusion. The widespread application of surgical simulation technology has the potential to decrease surgical risk, improve operating room efficiency, and fundamentally change surgical training. [ABSTRACT FROM PUBLISHER]

Against a backdrop of nostalgia for a lost utopia, the paper adopts the standpoint that utopia has been achieved. Yet its accomplishment serves only to place the utopian imaginary in question. The basic plotline concerns utopia's entrapment behind the mirror, and the consequences that ensue from the subsequent implosion of the real and the imaginary. Reflecting on Baudrillard's association of utopia with the figure of Lichtenberg's knife, as well as Mann's assimilation of the utopic to the neutral, the paper examines the relations between the real, the symbolic, and the imaginary with respect to utopian thought and characterises the achievement of a minimal utopia. [ABSTRACT FROM AUTHOR]

One hundred and fifty-three cats undergoing surgery in seven veterinary practices in Great Britain were studied. They were randomly allocated to receive either 10–20μg/kg buprenorphine or 0.4mg/kg butorphanol with acepromazine before anaesthesia with propofol, Saffan or thiopentone and isoflurane or halothane. Routine monitoring was undertaken. Pain and sedation were assessed blind using a four point (0–3) simple descriptive scale (SDS) at 1, 2, 4, 8 and 24h. Pain and sedation data were compared using non-parametric statistical tests and continuous data using t tests or analysis of variance (ANOVA). Anaesthesia and surgery were uneventful, and cardiorespiratory data were within normal limits. After surgery, overall, more cats had pain score 0 after buprenorphine and more had pain score 3 after butorphanol (P =0.0465). At individual time points, more cats had lower pain scores after buprenorphine at 2 (P =0.040) and 24 (P =0.036)h. At 24h 83% after buprenorphine and 63% after butorphanol had pain score 0 (P <0.04). Buprenorphine provided better and longer lasting postoperative analgesia than butorphanol. [Copyright &y& Elsevier]

The dominant literature on research synthesis methods has positivist and neopositivist origins. In recent years, the landscape of research synthesis methods has changed rapidly to become inclusive. This article highlights methodologically inclusive advancements in research synthesis methods. Attention is drawn to insights from interpretive, critical, and participatory traditions for enhancing trustworthiness, utility, and/or emancipatory potential for research syntheses. Also noted is a paucity of the literature that builds connections between methodologically diverse segments of the literature on research synthesis methods. Salient features of a methodologically inclusive research synthesis (MIRS) framework are described. The MIRS framework has been conceptualized by distilling and synthesizing ideas, theories, and strategies from the extensive literatures on research synthesis methods and primary research methods. Rather than prescribe how a research synthesis should be conducted or evaluated, this article attempts to open spaces, raise questions, explore possibilities, and contest taken-for-granted practices. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to examine the effect of changes to a consultation-liaison (C-L) service at Maroondah Hospital on referral and service delivery patterns across a period of 7 years. There is no national benchmarking of C-L service. Local services respond to local political and service demands. There have been significant changes to the C-L service at Maroondah Hospital between 1999 and 2006. During the intervening years, psychogeriatric referrals have been included and gazetting of general hospital beds has resulted in detention of patients under the Mental Health Act (MHA). Method: Clinical audit data from assessments by the C-L service during the above period were entered into a database and analysed. Results: The annual referral rate increased as did the mean age of referred patients. The main reason for referral changed from suicide evaluation and history of psychotic symptoms to depression. Referral lag time did not change significantly. A higher proportion of patients received a single consultation and a greater number required psychiatric inpatient care. Conclusion: The nature of referral changed towards older, sicker patients and away from younger, suicidal patients which, together with an increased referral rate, significantly increased demand on available resources. [ABSTRACT FROM AUTHOR]

There is an increasing acceptance in the education literature and in classroom settings for 'best practice' to be linked with verbal clarification of knowledge and reasoning, ideally in collaborative contexts where students construct both group and individual knowledge. Problem-based learning (PBL) is one such classroom context in which participation is viewed as leading to learning and where the nature of 'good' participation is verbal contribution. Students who choose to participate without speaking, or 'silent' students, are often seen as failing to learn, and significant tutor time is devoted to encouraging verbal input. This article examines the experience of four 'silent participants' (two overseas-educated and two local Australian) in a PBL context. The analysis reported in this article suggests that students' choice to be silent is a consequence of multiple constraints - personal, contextual and cultural - and that silence should not be taken to signify lack of learning. [ABSTRACT FROM AUTHOR]

The article discusses the Portugal's return of Macau to Chinese sovereignty in 1999 and the process of cultural transition that followed that event. The reclamation and commodification of space in Macau is explored, as are the territory's attempts to reconnect with China by rebuilding its infrastructure. A preoccupation with the spectacular, particularly in Macau's gaming industry, is also examined.

In this paper we argue that montage is at the heart of contemporary human geography. We demonstrate the centrality of montage in a wide variety of domains, including the analysis of modernity, the critique of political economy, and the practice of spatial science, before drawing out the implications of this centrality in the wake of so-called ‘nonrepresentational’ theory. While nonrepresentational styles of thought ordinarily veer off into considerations of performance, practice, and enactment, the ontological and epistemological play of montage plunges theoretical practice into what Agamben, Baudrillard, and Benjamin call ‘imagelessness’, ‘obscenity’, and the ‘optical unconscious’. Each of these is addressed in turn, and each is illustrated with stills taken from the films of Jim Jarmusch. The overall aim of the paper is to sensitize human geographers to the duplicitous operation of the discipline's cinematic optical unconscious, and in so doing to open up a space for a more considered engagement with geography's much-vaunted visuality. [ABSTRACT FROM AUTHOR]

The international (and, increasingly, global) nature of grocery retailing is promoting the need to consider developments across numerous markets in order to understand fully any given country's market characteristics. However, compared with the breadth of research on various aspects of UK grocery retailing, there is a relative paucity of work across the same range of topics and scales in European contexts (broad national-level comparisons excepted). The paper therefore extends work on UK retail change, assessing the extent of corresponding or diverging development trajectories elsewhere in Europe. Key indicators are used to map spatial variations in competition, saturation, and internationalization at a subnational scale. Inferences are made regarding likely patterns of future development through the identification of growth opportunities that may be exploited by organic expansion or merger-and-acquisition activity. Some speculative merger-and-acquisition scenarios are also considered, which suggest the validity of regulatory concerns over local competition and spatial monopoly. [ABSTRACT FROM AUTHOR]

This study was performed to determine the effect of a drinking water additive on reducing plaque and calculus accumulation in cats. A two-period, parallel crossover design was used with each period consisting of a 56-day test phase. Results demonstrated that the addition of xylitol to the drinking water was effective in reducing plaque and calculus accumulation in cats. [ABSTRACT FROM AUTHOR]

Objective: To assess the acceptability and benefits to general practitioners (GPs) of a short course on the management of depression and anxiety. Method: One hundred and twenty-two GPs from southeast metropolitan Melbourne participated in a five-session short course. Pre- and post-measures of knowledge, attitude and self-evaluated clinical practice and a post-measure of participant satisfaction were completed. Results: The course was overwhelmingly appreciated by participating GPs. In the group as a whole, knowledge, attitude and certain elements of clinical practice changed in a positive and predicted direction. General practitioners affirmed the use of an interpersonal and problem-solving framework for patients more commonly than a cognitive-behavioural one. Conclusions: Brief educational interventions are useful and, through improving GP knowledge, attitude and clinical practice, have an important role to play in enhancing the capacity of GPs to assist people with depression and anxiety. [ABSTRACT FROM AUTHOR]

This article examines the sequential, temporal, and interactional aspects of sexual assaults using sequential analysis. Fourteen statements taken from victims of bedroom-based assaults were analyzed to provide a comprehensive account of the behavioral patterns of individuals in sexually charged conflict situations. The cases were found to vary in the sexual severity of assault, distinguishing a variety of motivations and behavioral repertoires of offender and victim. Two quite distinct styles of offense were identified: multiple and single, which may have very different implications for research into rapist taxonomies and rape prevention strategies. [ABSTRACT FROM AUTHOR]

Objective: To review the value provided when health care systems independently manage medical and psychiatric care. Method: The authors draw on data from the world literature, their own experiences and reflections (one author as an international consultant in the coordination of physical and behavioural health care), and input from colleagues throughout the world who face similar challenges to improve outcomes for complex, high cost patients in their own health care systems. Results: Most health care systems in the world approach the administration and delivery of mental health care separately from that of general medical care. This practice is no longer supported as effective, efficient or inexpensive. Rather accumulating data indicates that concurrent and coordinated medical and psychiatric care, which can only be accomplished by integrating physical and behavioural health through infrastructure change, should replace the present system of independently provided sequential care; that is, one which provides first medical and then psychiatric treatment, or vice versa, with little communication between clinicians in the two sectors. Conclusions: By making mental health treatment an integral part of general medical care through reorganization of the funding system, a higher percentage of those now untreated for their psychiatric disorders, both within and outside of the medical setting, can have their mental health needs addressed in coordination with their physical disorders. At the same time, the number of patients that can be treated within the same budget will be expanded. [ABSTRACT FROM AUTHOR]

To compare two self-report questionnaires for identifying possible depression in women with metastatic breast cancer. We conducted structured psychiatric interviews and administered the Beck Depression Inventory Short Form (BDI-SF) and Hospital Anxiety and Depression Scale (HADS) to 227 women with stage IV breast cancer. The accuracy for identifying DSM-IV-defined major and minor depression was examined. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated and receiver operating characteristic curves plotted. Seventy-four (32.6%) patients satisfied DSM-IV criteria for a depressive disorder. With a cut-off of 4, the BDI-SF had a sensitivity of 0.84, specificity of 0.63, and PPV of 0.52. A cut-off of 11 on the HADS-Depression scale (HADS-D) resulted in sensitivity, specificity, and PPV of 0.16, 0.97, and 0.75, respectively. For major depression alone, the BDI-SF with a cut-off of 5 had excellent sensitivity but poor PPV; the HADS, with a cut-off of 7, had weak sensitivity and PPV. Overall, the two scales perform similarly in identifying major depression, while the BDI-SF is the more useful in screening for DSM-IV major or minor depression categories in this clinical group. [ABSTRACT FROM AUTHOR]

Objective: To assess psychosocial morbidity in women with breast cancer and to compare the differential rates between women with early stage and advanced disease. Method: In this report, 303 women with early stage breast cancer, psychiatrically assessed at baseline (as part of a study of cognitive-existential group therapy during adjuvant chemotherapy), are compared with 200 women with advanced breast cancer (similarly assessed in a trial of supportive-expressive group therapy). A structured psychiatric interview plus self-report measures were used to assess psychiatric morbidity, quality of life and cognitive attitude to cancer. Results: The early stage patients, whose mean age was 46 years, were on average 3 months post-surgery and had an overall prevalence of DSM-IV psychiatric diagnosis of 45%. The metastatic patients, whose mean age was 51 years, were on average 63 months post-primary diagnosis and had an overall prevalence of DSM-IV diagnosis of 42%; the difference between the two rates was not statistically significant. Of women with early stage breast cancer, 36.7% had mood disorders, 9.6% suffering from major depression and 27.1% from minor depression. in the metastatic sample 31% had mood disorders, 6.5% having major depression and 24.5% with minor depression. Anxiety disorders were present in 8.6% of the early stage group and 6% of women with advanced disease. Fatigue, a past history of depression, and cognitive attitudes of helplessness, hopelessness or resignation were significantly associated with depression in both groups. The women from the metastatic sample were significantly less distressed by hair loss but more dissatisfied with body image, and had higher rates of lymphoedema and hot flushes than the early stage women. Conclusions: The rates of psychosocial distress are high, and similar, across patients with both early and advanced stage breast cancer, although the illness related causes of distress are different. These data present a challenge to clinical services to provide a comprehensive range of support services to ameliorate this distress. [ABSTRACT FROM AUTHOR]

Objective: To test the ability of a previously generated logistic regression model to predict caregiver strain from carer mood, negative affectivity and perceived patient functional ability. Design: Postal prospective survey. Setting: Spouses of community-residing patients identified from hospital stroke registers. Method: Spouses were assessed at three and six months after stroke. A previously derived equation was used to make predictions at three months of their level of strain at six months, which were compared with observed outcomes. Measures: Spouses were asked to complete the Caregiver Strain Index (CSI), the General Health Questionnaire (GHQ-12), the Positive and Negative Affectivity Schedule (PANAS) and to assess patients' independence in activities of daily living on the Extended Activities of Daily Living Scale (EADL). Results: Of 409 stroke patients, 276 had an identifiable co-resident spouse and 116 (42%) completed the measures. At three months after stroke, 39 carers (34%) were under significant strain with 40 (35%) under strain at six months. The predictive model using the GHQ-12, PANAS and EADL at three months was 78% accurate in predicting levels of caregiver strain at six months. Conclusion: Carers at risk of later strain could be identified for further follow-up. Services to provide emotional support to carers might be effective in the reduction of carer strain. [ABSTRACT FROM AUTHOR]

Objective: To further examine the screening capabilities (sensitivity, specificity, etc.) of the 12-item Somatic and Psychological Health Report (SPHERE) questionnaire. Method: A more extensive examination was carried out on data presented in a recent report. Results: The sensitivities of the questionnaire, scored in three different ways, ranged from 100% to 47%. Specificities ranged from 18% to 72%. As a global screen for mental disorder it had a very high false-positive rate, with, in one sample, 83% of patients screening positive while only 27% had a current psychiatric diagnosis, and in the other sample 55% screened positive with only 13% having a current psychiatric diagnosis. The PSYCH-6 scale used by itself had similar properties to the 30-item General Health Questionnaire from which it was derived. The addition of the scale measuring fatigue (SOMA-6) increased or decreased specificity depending on how it was combined with the PSYCH-6 scale. Conclusion: The evidence is insufficient to recommend the 12-item SPHERE, in its current form, as a screening instrument for DSM-IV mental disorders in general practice, as the specificity is inadequate. Ways of raising the threshold for caseness need to be explored. The argument for adding a measure of fatigue to a general screening measure is not supported. [ABSTRACT FROM AUTHOR]

Objective: Demoralization, as described by Jerome Frank, is experienced as a persistent inability to cope, together with associated feelings of helplessness, hopelessness, meaninglessness, subjective incompetence and diminished self-esteem. It is arguably the main reason people seek psychiatric treatment, yet is a concept largely ignored in psychiatry. The aim here is to review and summarize the literature pertaining to demoralization in order to examine the validity of the construct. Method: A narrative review of demoralization and the related concepts of hope, hopelessness, and meaning is presented, drawing on a range of empirical and observational studies in the medical and psychiatric literature. Results: An examination of the concepts of the ‘Giving Up-Given Up’ syndrome (George Engel), ‘suffering’ (Eric Cassell), and demoralization (Jerome Frank), demonstrate considerable convergence of ideas. Demoralization has been commonly observed in the medically and psychiatrically ill and is experienced as existential despair, hopelessness, helplessness, and loss of meaning and purpose in life. Although sharing symptoms of distress, demoralization is distinguished from depression by subjective incompetence in the former and anhedonia in the latter. Demoralization can occur in people who are depressed, cancer patients who are not depressed and those with schizophrenia. Hopelessness, the hallmark of demoralization, is associated with poor outcomes in physical and psychiatric illness, and importantly, with suicidal ideation and the wish to die. Conclusions: Demoralization is an important construct with established descriptive and predictive validity. A place needs to be found for it in psychiatric nomenclature. [ABSTRACT FROM AUTHOR]