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This paper presents the results of a systematic review of the empirical literature, reported in research journals, on Mathematics Learner Identity (MLI). In the mathematics education research field, arguments have been made that the conceptualization of Mathematics Identity (MI) is inconsistent and this makes the literature as a whole incoherent. This study aims to summarize how the concept has been employed and to develop an integrative model for analyzing concept-definitions and concept-operationalizations of MLI. An analysis of 69 papers revealed 3 main dimensions that characterized how identity is conceptually defined in any research literature (social/subjective, enacted/representational and change/stability) and 5 main categories that describe how the literature has implemented these dimensions operationally (identity as individual attributes; identity as narratives; identity as a relationship with specific practices; identity as ways of acting; and identities as afforded and constrained by local practices). An emphasis on representational aspects of identities, particularly during higher education, and enacted and practice-related identities during primary and secondary education research was found. The discussion shows how the field would be clarified if studies made their choices of conceptualization clear in terms of these dimensions and categories, and if research as a whole becomes more aware of restrictions/limitations in identity research, particularly at different points of the educational trajectory of students.

In this editorial we explain the background to the research papers reported in this special issue, and to some extent how each paper relates to this body of work. In particular we outline the research projects and research teams that worked together between 2006 and 2014 on projects that related to the theme of transition, and we provide the knowledge base on which these papers build.

There are many nonsurgical treatment options for patients with upper limb spasticity. This article presents an algorithmic approach to management, encompassing evidence-based rehabilitation therapies, medications, and promising new orthotic and robotic innovations.

Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.

The construct of identity has been used widely in mathematics education in order to understand how students (and teachers) relate to and engage with the subject (Kaasila, 2007; Sfard & Prusak, 2005; Boaler, 2002). Drawing on cultural historical activity theory (CHAT), this paper adopts Leont’ev’s notion of leading activity in order to explore the key ‘significant’ activities that are implicated in the development of students’ reflexive understanding of self and how this may offer differing relations with mathematics. According to Leont’ev (1981), leading activities are those which are significant to the development of the individual’s psyche through the emergence of new motives for engagement. We suggest that alongside new motives for engagement comes a new understanding of self—a leading identity—which reflects a hierarchy of our motives. Narrative analysis of interviews with two students (aged 16–17 years old) in post-compulsory education, Mary and Lee, are presented. Mary holds a stable ‘vocational’ leading identity throughout her narrative and, thus, her motive for studying mathematics is defined by its ‘use value’ in terms of pursuing this vocation. In contrast, Lee develops a leading identity which is focused on the activity of studying and becoming a university student. As such, his motive for study is framed in terms of the exchange value of the qualifications he hopes to obtain. We argue that this empirical grounding of leading activity and leading identity offers new insights into students’ identity development.

This paper reports how students talk about their aspirations in regard to higher education (HE) and their mathematics, what ‘repertoires’ they use to mediate this discourse, and how students’ predominant ‘repertoire style’ relates to their cultural background. Our analyses draw on an interview sample (n=40) of students selected because they are ‘on the cusp’ of participation or non‐participation in mathematically demanding programmes in further and higher education. The interviews explored the students’ aspirations for their future in general and HE in particular, influences on these choices, and the place of mathematics in these. Thematic analysis revealed four interpretative repertoires commonly in use, which we call ‘becoming successful’, ‘personal satisfaction’, ‘vocational’, and ‘idealist’ repertoires. Most of the sample was found to use a single, predominant repertoire, which we call their repertoire ‘style’: what is more, this style is found to be strongly related to background factors independentl...

Background Botulinum toxin type B (BTX-B, Myobloc™, San Francisco, CA, USA) was FDA-approved for the treatment of cervical dystonia in December 2000. It has since been used off-label for the treatment of axillary hyperhidrosis. However, there are sparse data in the medical literature evaluating the safety and efficacy of Myobloc™ (botulinum toxin type B) for this indication. Objective To assess the safety, efficacy and duration of action of Myobloc™ (botulinum toxin type B) in the treatment of bilateral axillary hyperhidrosis. Methods This study was a double-blinded, randomized, pilot study conducted in an outpatient office setting at a private academic medical center beginning in November 2001. Twenty-three male and female volunteers between the ages of 18 and 80 were screened for participation; 20 participants with primary axillary hyperhidrosis were enrolled. Participants were injected subcutaneously with either Myobloc™ (botulinum toxin type B) (2500 U, or 0.5 ml, per axilla) or 0.5 ml vehicle (100 mM NaCl, 10 mM succinate, and 0.5 mg/ml human albumin) into bilateral axillae. Participants who received placebo were rolled over and received Myobloc™ (botulinum toxin type B) at subsequent visits. All participants were followed until sweating returned to baseline levels. This trial was initially conceived as a placebo-controlled study; however, owing to the insufficient size of the placebo group, the placebo arm of this trial was dropped during data analysis. The main outcome measures were safety, efficacy, and duration of effect. Results According to participant assessment of axillary hyperhidrosis improvement (A-HI) and quality of life (A-HQOL) scores and the physician assessment scores, a significant difference was observed in treatment response at Day 30 in the participants receiving Myobloc™ (botulinum toxin type B) injections. Duration of action ranged from 2.2 to 8.1 months (mean 5.0 months). The adverse event profile included bruising, flu-like symptoms, and dry eyes. Conclusion Myobloc™ (botulinum toxin type B) proved to be safe and efficacious for the treatment of bilateral axillary hyperhidrosis. More studies are needed to assess the duration of response using different doses of Myobloc™ (botulinum toxin type B).

Myobloc, known as Neurobloc in Europe, is a member of the botulinum toxin family. It has been used for a myriad of problems since its approval in the United States in December 2000. It is currently not approved for cosmetic use but has been used for this purpose. This article reviews what is currently known about botulinum toxin type B and its efficacy and safety.

Crow's feet develop with age and are one of the earliest signs of the normal aging process. Botulinum toxin type A, approved by the Food and Drug Administration for the treatment of glabellar wrinkles in April 2002, has been used off-label to treat facial wrinkles since 1981. Botulinum toxin type B (BTX-B, Myobloc) was Food and Drug Administration-approved for use in cervical dystonia in the United States in December 2000 and has subsequently been used in an off-label indication to treat facial wrinkles. There are sparse data in the literature evaluating the safety and efficacy of BTX-B for the treatment of facial wrinkles. In this pilot study, participants with moderate or severe crow's feet wrinkles were treated with Myobloc versus placebo. The duration of correction and side effect profile are reported.

Since SCN1A is expressed in the motor neuron initial segment, we explored whether motor neuron dysfunction could contribute to gait disturbance and orthopedic misalignment in patients with Dravet syndrome due to SCN1A mutations.We assessed 12 consecutive patients who presented to our institution between January and March 2013. All of them were older than 2 years and were positive for the SCN1A mutation. We performed nerve conduction velocity studies and needle EMG recordings.We included 4 females and 8 males aged 2 to 17 years (median 7.5 years). All 12 patients showed gait disturbance regardless of age. Tendon reflexes were decreased in 4 of 12 patients. None presented cerebellar signs such as tremor, dysmetria, or adiadochokinesia. Nerve conduction study was normal or nearly normal in all patients, but EMG showed features of chronic denervation. Motor neuropathy/neuronopathy was definite in 7 patients and probable in 3.SCN1A mutations may alter axonal function, causing motor neuropathy/neuronopathy. This may contribute to gait disturbance and orthopedic misalignment, which is characteristic of patients with Dravet syndrome.

Purpose. Despite increasing evidence that anger may play a contributing role in the violent behaviour of psychiatric patients, as yet there is a dearth of evidence concerning the utility of anger control treatment procedures with this population. This paper describes the development and preliminary evaluation of an anger treatment protocol modified to meet the needs of secure hospital patients. Method. Four patients having recurrent problems of anger and aggression were provided with anger control treatment based on the new protocol. Evaluation of the intervention was based on clinical assessments and by quantified structured interviews obtained post-treatment with each patient's psychiatrist, key worker, and day-care worker. Results. Therapist assessment and clinical staff ratings testifiy to modest but significant treatment gains for patients. Experience from clinical implementation highlights key issues in treatment process and institutional system integration for achieving efficacy. Conclusions. The results support the application of anger control treatment procedures to severely disordered psychiatric patients in a forensic institution. Given the preliminary nature of this evidence, and in the absence of a controlled clinical trial, continued work is needed on treatment and research protocols.

Vorapaxar is an orally active protease-activated receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet aggregation. This open-label study assessed the pharmacokinetics and pharmacodynamics of single-dose warfarin in the presence/absence of multiple-dose vorapaxar in 12 healthy men.Subjects received two treatments separated by ≥ 7-day washout: Treatment A warfarin 25 mg (Day 1); Treatment B vorapaxar 2.5 mg/day on Days 1-6 and vorapaxar 40 mg coadministered with warfarin 25 mg (Day 7). R-warfarin, S-warfarin, and prothrombin time (PT) were assayed predose and up to 120 h postdose.The geometric mean ratio (GMR) as a percentage (warfarin + vorapaxar/warfarin) was calculated. The GMR (90 % CIs) estimates of C(max) were 105 (99, 111) and 105 (99, 112) for R- and S-warfarin, respectively. The GMR (90 % CIs) estimates of AUC(0-∞) were 108 (101, 116) and 105 (96, 115) for R- and S-warfarin, respectively. The GMR (95 % CIs) estimates of AUC(0-120 h) for PT and INR were 97 (95, 98) and 96 (94, 98), respectively.Results of this study indicate that vorapaxar has no meaningful effect on the pharmacokinetics or pharmacodynamics of warfarin, suggesting that the coadministration of these two drugs or vorapaxar coadministered with other CYP2C9/CYP2C19 substrates is unlikely to cause a clinically significant pharmacokinetic drug interaction.

1. Although nurses are at considerable risk for assaults, there are few practical and specific guidelines for controlling anger and aggression. 2. A training course was developed to give staff the necessary skills and knowledge to cope with clients who have the potential to become angry and assaultive, or those who have already become violent. 3. Participants in the training course felt more confident in managing potentially violent situations, and they reported relying on methods to de-escalate the situation to halt a sequence that would ultimately lead to violence.

Background Palmar hyperhidrosis is a problem of unknown etiology that affects patients both socially and professionally. Botulinum toxin type B (Myobloc), approved by the Food and Drug Administration for use in the treatment of cervical dystonia in the United States in December 2000, has subsequently been used effectively in an off-label indication to treat hyperhidrosis. There are sparse data, however, in the literature evaluating the safety and efficacy of BTX-B for the treatment of palmar hyperhidrosis. Objective We evaluated the safety and efficacy of Myobloc in the treatment of bilateral palmar hyperhidrosis. This was a double-blind, randomized, placebo-controlled study to report on the safety and efficacy of Myobloc. Methods Twenty participants (10 men, 10 women) diagnosed with palmar hyperhidrosis were injected with either Myobloc (5,000 U per palm) or a 1.0 mL vehicle (100 mM NaCl, 10 mM succinate, and 0.5 mg/mL human albumin) into bilateral palms (15 Myobloc, 5 placebo). The participants were followed until sweating returned to baseline levels. The main outcome measures were safety, efficacy versus placebo, and duration of effect. Results A significant difference was found in treatment response at day 30, as determined by participant assessments, between 15 participants injected with Myobloc and 3 participants injected with placebo. The duration of action, calculated in the 17 participants who received Myobloc injections and completed the study, ranged from 2.3 to 4.9 months, with a mean duration of 3.8 months. The single most reported adverse event was dry mouth or throat, which was reported by 18 of 20 participants. The adverse event profile also included indigestion or heartburn (60%), excessively dry hands (60%), muscle weakness (60%), and decreased grip strength (50%). Conclusion Myobloc proved to be efficacious for the treatment of palmar hyperhidrosis. Myobloc had a rapid onset, with most participants responding within 1 week. The duration of action ranged from 2.3 to 4.9 months, with a mean of 3.8 months. The adverse event profile included dry mouth, indigestion or heartburn, excessively dry hands, muscle weakness, and decreased grip strength. MYOBLOC WAS PROVIDED FOR THIS STUDY BY ELAN PHARMACEUTICALS.