bluuebunny/crossref_metadata_2025 huggingface dataset:
Full‐genome nucleotide sequence and analysis of a Chinese swine hepatitis E virus isolate of genotype 4 identified in the Guangxi Zhuang autonomous region: evidence of zoonotic risk from swine to human in South China
Authors: Li Lingjun , Zhu Yonghong , Fu Hongwei , Wei Xianfei , Wang Ling , Liang Jingrui , Ji Yanli , Tang Ronglan , Zhuang Hui
Published: April 2009

Background: Hepatitis E virus (HEV) is one of the leading causes of the enteric‐transmitted acute hepatitis. Many studies have found high identities between human and animal HEV isolates using partial sequence comparison analysis.

Aims: To determine and phylogenetically analyse the complete genome of the swGX40 isolate from the Guangxi Zhuang autonomous region.

Methods: The overlapping fragments of HEV isolate swGX40 were amplified with reverse transcription‐nested polymerase chain reaction (PCR) and the 5′ and 3′ ends of viral genome were amplified with rapid amplification of cDNA ends. The PCR products were cloned and sequenced. The sequence and phylogenetic analysis of swGX40 were performed.

Results: The full genome of the swGX40 strain consisted of 7233 nucleotides, excluding the poly (A) tail of 36 residues. There are three open reading frames (ORFs), encoding 1705, 674 and 114 amino acids (aa) respectively. The full‐genomic sequencing showed that the swGX40 strain shared similarity with all known HEV genotype 1, 2 and 3 isolates by 73.4–76.5% and with an identity of 83.1–91.2% among genotype 4 HEV isolates. The partial ORF2 sequencing (249 nt) showed that swGX40 shared a high nucleotide identity of 94 and 97% with the Chinese human strain LZ‐105 and the Vietnamese human strain HE‐JVN‐1 respectively.

Conclusions: The swine isolate swGX40 was closely related to the human isolate LZ‐105, both of which were collected from Liuzhou, the same district in the Guangxi Zhuang autonomous region. This molecular biological evidence strongly supported the zoonosis hypothesis of hepatitis E.
Health Problems and Health Behaviors of Korean Preschoolers Living With Parents and Under Guardianship
Authors: Kim Hee‐Soon , Ham Ok‐Kyung , Lee Chung‐Yul , Lee Tae‐Wha
Published: April 2009

ABSTRACT
Purpose: A comparative analysis was conducted to identify and compare the health status and behaviors of preschoolers attending daycare centers in South Korea between children living with parents and those under guardianship.

Design: The study design was descriptive and correlational.

Sample: Data were collected from 152 parents and 85 guardians of preschool children using a structured questionnaire.

Results: Of 237 children, 23.9–32.5% were overweight or obese, while 13.8–30.0% were underweight. Boys under guardianship were more likely to be obese. Hand‐foot‐mouth disease and atopic dermatitis were more prevalent among children living with parents, while those under guardianship were less likely to have dentistry visits, more likely to be absent from childcare due to pneumonia, and had significantly fewer health‐related conversations with their guardians. In relation to health behaviors, the frequency of tooth‐brushing and high‐calcium food consumption was significantly lower among children under guardianship than among those living with parents.

Conclusion: Compared with children living with parents, those under guardianship were exposed to unfavorable circumstances in terms of health management practices and health behaviors, which implies that the guardians were less interested in health care and dealt inappropriately with the health problems of their foster children.
Workplace Health Promotion Activities of Finnish Occupational Health Nurses
Authors: Naumanen Paula , Liesivuori Jyrki
Published: April 2009

ABSTRACT
Objective: This study describes workplace centered activities performed by occupational health professionals, as well as difficulties linked to workplace centered activities, cooperation with client workplaces, and participation both in risk assessment and in the development of working environment.

Design: The design is a cross‐sectional prevalence study.

Sample: The questionnaires were sent to 250 occupational health professionals, of whom 176 (70%) returned the completed forms and of whom 99% were nurses.

Measurements: Their activities, difficulties, cooperation, and participation in risk assessment and development of safe and healthy working conditions.

Analytic strategy: The data were analyzed by using frequencies, means, 1‐way ANOVA, and the Kruskal‐Wallis test.

Results: Workplace focused activity hours were mainly spent on risk assessment and counseling. One workplace visit took approximately 4 hr. The greatest difficulties were encountered with participation in development projects and in monitoring the effectiveness of improvement activities, especially in health care centers. Occupational health nurses cooperated with client enterprises and participated in risk assessment more often than the other occupational health professionals. Also workplace representatives participated actively in risk assessment. The most difficult modules were considered to be the risk assessment of chemicals, biological factors, and perceived stress, this being especially so in health care centers.

Conclusions: It is essential that occupational health professionals visit more often in their client enterprises and improve their skills in preventing harms caused by chemical and biological factors, and perceived stress.
Effects of a Cognition‐Oriented Breast Self‐Examination Intervention for Korean Women and Their Spouses
Authors: Park SoMi , Song Hee‐Young , Hur Hea Kung , Kim GiYon
Published: April 2009

ABSTRACT
Objective: This study evaluated the effectiveness of a cognition‐oriented breast self‐examination (BSE) intervention program that is based on the Transtheoretical Model and reflects individual characteristics according to BSE stage among Korean women and their spouses.

Design: A time‐series nonequivalent control group design was used.

Sample and Measurement: Twenty‐four couples in each of 2 groups completed a preintervention test and were evaluated 1, 3, and 6 months later for their knowledge of breast cancer and BSE, spousal encouragement for BSE, perceived confidence in BSE methods, change in BSE stage, and perceived benefits and barriers to BSE. The intervention involved husbands as well as women, and consisted of lectures on breast cancer and BSE, demonstrations and practice with models while being videotaped, and feedback.

Results: There were significant differences between the control and experimental groups for all variables. Change of BSE stage in experimental group showed significantly advancement over time.

Conclusions: This intervention program was effective in promoting regular BSE practice and in enhancing confidence in BSE. The intervention also raised awareness among husbands of the importance of breast health for their wives. Educational interventions for breast cancer prevention should be specified to an individual's stage of BSE.
Social Support and Cervical and Breast Cancer Screening in Argentinean Women From a Rural Population
Authors: Gamarra Carmen Justina , Paz Elisabete Pimenta Araújo , Griep Rosane Harter
Published: April 2009

ABSTRACT Objective:To examine whether emotional social support influences the use of 3 cancer screening tests in females.

Design:Cross‐sectional study.

Sample:Data were collected via a household survey of a random sample of 200 Argentinean women.

Measurements:The questionnaire included self‐reported data about the cancer screening tests (Papanicolaou [Pap] test for cervical cancer, breast self‐examination, and clinical examination for breast cancer), and socioeconomic background information. Social support was measured by the Duke‐UNC‐11 questionnaire.

Analysis:Logistic models were used to investigate the association between social support and cancer screening tests.

Results:Emotional social support was associated with having participated in Pap screening within 3 years before this study, but a link between social support and self or clinical breast examination was not supported.

Conclusion:Emotional social support may play a role in early cervical cancer detection among Argentinean females, specifically by encouraging performance of the Pap test. The educational practices accomplished by nurses should include actions that involve the family and community; therefore, emphasizing the importance of social ties on health and promoting interactions between target women and existent social groups in the community.
Do Specialist Community Public Health Nurses Assess Risk Factors for Depression, Suicide, and Self‐Harm Among South Asian Mothers Living in London?
Authors: Baldwin Sharin , Griffiths Peter
Published: April 2009

ABSTRACTEvidence indicates that suicide rates are higher in South Asian women in the United Kingdom compared with other ethnic groups, suggesting increased vulnerability to attempted suicide and mental distress in these women. Specialist Community Public Health Nurses (SCPHNs, including health visitors) are in an ideal position to assess such risk. The objectives are to determine whether SCPHNs assess known risk factors for depression, self‐harm, and suicide during initial contact with South Asian mothers in London; the extent to which these risk factors are documented in the nursing records; and whether their assessments of South Asian women differ from those of other ethnic groups. Structured content analysis of semistructured interviews with 8 SCPHNs and analysis of 60 matched pairs of SCPHN records were carried out in an inner London community. The results revealed that SCPHNs assessed general risk factors for postnatal depression and some culture‐specific factors when assessing South Asian mothers. Documentation of risk factors was under‐represented in the SCPHN records and there was a significant difference between the documented risk factors for South Asian women and women from other ethnic groups. While SCPHNs understood some aspects of South Asian culture, service improvements must be made to ensure better care provision.
The Retirement of a Public Health Nurse Leader
Authors: Abrams Sarah E.
Published: April 2009

ABSTRACT
Elizabeth Gordon Fox was a distinguished member of the profession and an influential advocate for visiting nurse services at the time of her retirement. The dinner guests who came to honor her 20 years as director of the New Haven, Connecticut Visiting Nurse Association included luminaries in public health including Thomas Parran, Ira V. Hiscock, Ruth Hubbard, and Anna Fillmore. Dr. C.‐E. A. Winslow, an eminent leader in public health, and Annie Warburton Goodrich, the retired dean of the Yale School of Nursing were also present. The occasion was marked by an address by Thomas Parran, former U. S. Surgeon General, who focused attention on nursing leadership in public health. Speeches by both Parran and Fox addressed the challenges faced at mid‐century—challenges of public accountability, of a widespread nursing shortage, and of the need to distribute knowledge and services with both efficiency and compassion. Dr. Parran's talk and an excerpt from Fox's comments that evening were published in Public Health Nursing in December 1949. Selected passages from each of their speeches recall for contemporary readers the concerns of the era and the hopes of those who had dedicated their professional careers to improvement of the health of the public.
The Pursuit of Social Equity in the Federal Government: A Road Less Traveled?
Authors: Riccucci Norma M.
Published: April 2009

This descriptive study examines the extent to which the federal government has achieved social equity in its workforce. In particular, the author addresses the degree to which white women and people of color have been successful in reaching the upper, higher‐paying levels of nonpostal federal government jobs. The study shows that, with few exceptions, these groups, despite continued calls for greater equity, remain in lower‐level, lower‐paying, less prestigious jobs.
Are Public Service Nonprofit Boards Meeting Their Responsibilities?
Authors: Herman Robert D.
Published: April 2009

Public service nonprofit organizations have long been “partners” in the delivery of public services. Such nonprofit organizations are governed by boards, typically composed of citizen volunteers, that are expected to meet substantial standards of accountability and performance. Previous research has raised questions about how well such boards are meeting their responsibilities. A 2007 Urban Institute study, based on the first large representative sample of U.S. public benefit nonprofits, provides important evidence about the extent to which nonprofit boards are meeting certain accountability and performance standards.
Budget Transparency, Fiscal Performance, and Political Turnout: An International Approach
Authors: Benito Bernardino , Bastida Francisco
Published: April 2009

This paper attempts, for the first time, to assess the relationships between budget transparency, fiscal situation, and political turnout using a comparative international approach. With this aim, the authors build a comprehensive index of budget transparency encompassing 40 budget features based on international standards for a sample of 41 countries. They find a positive relationship between national government fiscal balance and budget transparency: The more information the budget discloses, the less the politicians can use fiscal deficits to achieve opportunistic goals. The univariate analysis shows a positive relationship between political turnout and transparency. This result gives some evidence of a positive answer to the question raised by James Alt and David Dreyer Lassen: Does transparency affect political outcomes such as turnout? To some extent, that the more transparent the budget reports are, the more incentives people have to vote. With respect to three variables—transparency, government fiscal balance, and electoral turnout—three clusters of countries arise: low transparency–fiscal imbalance, low transparency–small fiscal imbalance and high transparency–fiscal surplus.
Regulatory Stringency, Green Production Offsets, and Organizations' Financial Performance
Authors: Darnall Nicole
Published: April 2009

Some scholars have argued that environmental regulatory pressures constrain organizations' financial opportunities, while others maintain that environmental regulations can spur product and technology innovations and encourage greater operational efficiencies. Advocates on both sides have evidence in support of their positions. However, considering both perspectives in tandem and recognizing that other factors may be associated with improved financial performance, we may find that neither position is valid, or that both are. Relying on data for manufacturing facilities in seven countries, this study shows that more stringent environmental policy regimes are related to diminished firm profits. Yet organizations that are motivated by a green production focus—defined as enhancing internal efficiencies and new product and technology development—are more likely to improve their environmental performance. They also demonstrate a greater probability of benefiting financially, thereby offsetting the cost of regulation or accruing a net gain.
NOAA's Resurrection of Program Budgeting: Déjà Vu All Over Again?
Authors: West William F. , Lindquist Eric , Mosher‐Howe Katrina N.
Published: April 2009

The National Oceanic and Atmospheric Administration instituted a Planning, Programming, Budgeting, and Execution System (PPBES) in 2002. As supplemented by matrix management, PPBES was appealing as an effort to rationalize the performance of an agency with an especially high degree of functional overlap among its component parts. Although PPBES has had some salutary effects, the agency's experience to date consistent with accounts of the difficulties that led to the abandonment of program budgeting by the civilian bureaucracy almost 40 years ago. As such, it speaks to the limits of performance assessment as a means of reallocating resources and responsibilities across organizational boundaries.
The Administrative Costs of Congressional Earmarking: The Case of the Office of Naval Research
Authors: Savage James D.
Published: April 2009

Discussions about congressional earmarking often focus on their direct costs in the federal government's appropriations bills. This article shows that this conventional view neglects the administrative costs of earmarking by examining the extensive transaction and opportunity costs that come with the political, budgetary, and programmatic management of these earmarked projects in Congress and in the Office of Naval Research. One policy conclusion from this study is that the executive branch should make these costs transparent, as they remain largely hidden from public discussion and the consideration of the federal budget.
Mayoral Quality and Local Public Finance
Authors: Avellaneda Claudia N.
Published: April 2009

In most local developing settings, the political leader and the municipal manager are embodied in the same figure, the directly elected mayor. This research explores the impact of mayoral quality on local public finances in a developing country. Mayoral quality is operationalized as educational background and job‐related expertise to analyze its impact on two local financial indicators: property tax collection and social spending per capita. The mayoral quality thesis is tested across 40 Colombian municipalities over five years (2000–2004). After considering other political, economic, and external influences, the findings reveal that mayoral quality is associated with greater property tax collection and more social spending per capita. This positive influence, however, decreases under external constraints—such as presence of illegal armed groups. This study demonstrates how much influence the mayor can have when circumstances permit. The findings point to the significance of electing qualified mayors, as decentralization may not directly improve subnational finance. Instead, through decentralization, qualified mayors contribute to improved local public finance.
Can Citizen Governance Redress the Representative Bias of Political Participation?
Authors: John Peter
Published: April 2009

Can a more collaborative form of public management correct for the historical link between social and economic status (SES) and political participation? New initiatives to involve the citizen directly in public decision making—citizen governance—aim to include a wider representation of groups in society because they draw from service users and seek to recruit hard‐to‐reach groups. To test the claim that citizen governance may be more representative than other acts of political participation, this essay reports data from the 2005 English and Welsh Citizenship Survey. Using descriptive statistics and regression analysis, it finds evidence that citizen governance is more representative than civic activities, especially for young people and ethnic minority communities. Policy makers can fine‐tune their interventions to reach underrepresented groups without believing the citizen governance is a panacea for long‐running biases in civic participation.
Paternalistic or Participatory Governance? Examining Opportunities for Client Participation in Nonprofit Social Service Organizations
Authors: LeRoux Kelly
Published: April 2009

Nonprofits represent a substantial group of third‐party agents that deliver public services, yet little is known about the extent to which these organizations embrace participatory governance practices. Using survey data from nonprofit social service agencies in Michigan, the author examines how these organizations provide opportunities for client participation and identifies factors that contribute to these practices. Four methods of securing client involvement are examined: participation in agency work groups, client feedback surveys, advisory boards and committees, and client service on the agency board of directors. The results indicate that government funding plays a systematic role in promoting these activities within nonprofits. These findings carry important implications for the government–nonprofit contract relationship by demonstrating that government funding shapes the practices of nonprofits in ways that promote democratic governance.
Entrepreneurship Research on Network Processes: A Review and Ways Forward
Authors: Slotte–Kock Susanna , Coviello Nicole
Published: April 2009

Although entrepreneurship research on networks has studied issues pertaining to network content, governance and structure, we believe it requires a greater understanding of network processes. In this paper, we review how the entrepreneurship literature interprets and applies the concept of process to the study of networks. This allows us to identify areas for future investigation. Our work is also informed by social network theory and research on dyadic interactions in business networks. The paper concludes by presenting a theoretical framework for conceptualizing and studying the various processes associated with network development.
Storm Clouds and Silver Linings: Responding to Disruptive Innovations Through Cognitive Resilience
Authors: Dewald Jim , Bowen Frances
Published: April 2009

Incumbent firms facing disruptive business model innovations must decide whether to respond through inaction, resistance, adoption, or resilience. We focus on resilient responses to simultaneous perceived threat and opportunity by managers of small incumbent firms. Using cognitive framing arguments, we argue that risk experience moderates perceptions of opportunity, whereas perceived urgency moderates situation threat. We test our framework in the real estate brokerage context, where small incumbents face considerable challenges from disruptive business model innovations, such as discount brokers. Analysis of data from 126 real estate brokers broadly confirms our framework. We conclude with implications of our research for small business incumbents.
Beyond Simple Utility: Incentive Design and Trade–Offs for Corporate Employee–Entrepreneurs
Authors: Monsen Erik , Patzelt Holger , Saxton Todd
Published: April 2009

To strengthen the theoretical foundations of incentive system design for corporate entrepreneurship, we develop a moderated model of new venture participation, integrating financial, risk, and effort factors to more comprehensively understand the limits of economic utility maximization theory. We make explicit the trade–offs and opportunity costs for corporate employee–entrepreneurs. We use a conjoint field experiment to collect data on 1952 decisions made by 61 corporate employees to test how risk and effort moderate an employee's decision to participate in a new corporate venture. We find that these factors do interact to affect the choice to engage in corporate entrepreneurship projects.
Entrepreneurial Orientation and the Performance of Religious Congregations as Predicted by Rational Choice Theory
Authors: Pearce John A. , Fritz David A. , Davis Peter S.
Published: April 2009

Empirical and anecdotal evidence suggests that businesses that act with an entrepreneurial orientation enjoy superior performance. Our research investigates whether nonprofit, religious congregations can benefit from similar initiatives. We based our hypotheses on the Rational Choice Theory of Religion, which was developed by social scientists to bring economic analysis to the understanding of the effects of competition among nonprofit organizations. Using a sample of 250 religious congregations in five different geographical markets, an entrepreneurial orientation is found to be positively associated with organizational performance. A hypothesized interaction effect between environmental munificence and entrepreneurial orientation is assessed.
The Power and Effects of Entrepreneurship Research
Authors: Connelly Brian L. , Ireland R.D. , Reutzel Christopher R. , Coombs Joseph E.
Published: April 2009

This study summarizes and analyzes average statistical power and effect sizes in empirical entrepreneurship research. Results show that statistical power was higher than expected, and was particularly high in studies employing archival measures. Statistical power has also increased over time. Effect sizes were higher than expected, a finding that remained consistent for different levels of analysis and across multiple subdomains. We discuss these findings, compare them to related disciplines, and draw implications for the design of future studies.
Angiographic Quantification of Thrombus in ST‐Elevation Acute Myocardial Infarction Presenting with an Occluded Infarct‐Related Artery and Its Relationship with Results of Percutaneous Intervention
Authors: MIRANDA‐GUARDIOLA FAUSTINO , ROSSI ANGELICA , SERRA ANTONIO , GARCIA BRUNO , RUMOROSO JOSÉ RAMÓN , ÍÑIGUEZ ANDRÉS , VAQUERIZO BEATRIZ , TRIANO JOSÉ LUIS , SIERRA GILBERTO , BRUGUERA JORDI ,   On behalf of the Spanish AMIcath Registry
Published: April 2009

Introduction: Routine thrombectomy has been advocated for ST‐segment‐elevation myocardial infarction (STEMI), but it is unknown how many patients present with a large thrombus. We aimed to quantify the intracoronary thrombus in STEMI and to correlate it with procedure results.

Methods: In 98 patients with STEMI and TIMI flow grades 0–2 in the infarct‐related artery, thrombus was qualified as small (ST) when its maximal dimension was <2 vessel diameters and large (LT) when ≥2. Main outcome measures were TIMI flow, myocardial blush grade (MBG), corrected TIMI frame count (cTFC), and ST‐segment elevation resolution (STSER).

Results: Only a third of the patients presented with an LT. Thrombus grade was independent of the initial vessel patency. Diabetes (OR 3.1, 95% CI 1.20–8.02, P = 0.027) and pretreatment with clopidogrel (OR 0.27, 95% CI 0.08–0.86, P = 0.034) were independent predictors of LT. LT was an independent predictor of unfavorable results: <3 TIMI flow (OR 2.87, 95% CI 1.04–8.00, P = 0.043), MBG 0–1 (OR 3.36, 95% CI 1.10–10.26, P = 0.033), cTFC > 21 (OR 2.86, 95% CI 1.09–7.49, P = 0.033) and <50% STSER (OR 3.19, 95% CI 1.06–9.63, P = 0.039).

Conclusion: Only a third of STEMI patients present with an LT, being diabetes and lack of clopidogrel pretreatment independent predictors. An LT is strongly associated with worse PCI results.
Limitations of Embolic Protection in Saphenous Vein Graft Intervention: Insights from 202 Consecutive Patients
Authors: MATAR FADI A. , SMITH KAREN , ROSSI PETER , VANDORMAEL MICHEL , SULLEBARGER JOHN.T. , TAYLOR MARC , CARUNCHO CHARMAINE , ALI TARIK , KERENSKY RICK
Published: April 2009

Between January 2003 and September 2006, a total of 2,541 patients had percutaneous coronary intervention (PCI). Of these, 202 (226 grafts) had at least one saphenous vein graft (SVG) intervention. Adjunctive distal embolic protection (DEP) devices were attempted in 123 SVGs (54.4%). The 30‐day major adverse cardiac event (occurrence of death, myocardial infarction, or target vessel revascularization) rate in the overall group was 11.9%. The presence of angiographic thrombus independently predicted DEP use while the presence of in‐stent restenosis predicted no DEP use. Although the presence of all angiographic technical feasibility criteria independently predicted DEP use, only 72 (32.4%) and 33 (14.6%) of the SVGs would have been eligible for the occlusive balloon‐ and filter‐based distal embolic criteria, respectively. The most common technical reason for ineligibility was a graft size smaller than 3.0 mm, followed by the lack of a long enough landing zone. In a subset of 21 (9.3%) completely occluded lesions which would have excluded DEP use, angiographic success was 66.7%, and that was predicated on successful debulking with rheolytic thrombectomy in 13 (61.9%) with subsequent DEP in 5 (23.8%). In conclusion, not all grafts can be protected, and even in those that can, such protection may be incomplete. Newer embolic protection devices, such as the Proxis®, were recently introduced to expand the applicability to a wider population of vein grafts. However, further design improvements such as device miniaturizations applicable to sub‐3.0‐mm vessels and better particle removing/filtering mechanisms are needed in order to expand the use of embolic protection to reduce the persistently high complication rates associated with this difficult‐ to‐treat subset of patients.
Clinical Manifestation and Prognosis of Early versus Late Stent Thrombosis of Drug‐Eluting Stents
Authors: LEMESLE GILLES , DE LABRIOLLE AXEL , BONELLO LAURENT , MALUENDA GABRIEL , TORGUSON REBECCA , XUE ZHENYI , SATLER LOWELL F. , LINDSAY JOSEPH , PICHARD AUGUSTO D. , WAKSMAN RON
Published: April 2009

Background: Stent thrombosis (ST) is a serious complication of drug‐eluting stents (DES), leading to catastrophic events. ST can occur early or late following the percutaneous coronary intervention (PCI) with different possible consequences.

Methods: The records of 91 consecutive patients who presented with a definite ST (as defined by the Academic Research Consortium) from 2003 to 2007 were reviewed. Clinical presentation and outcome were compared based on the time of the event. Fifty‐one patients presented with an early ST versus 40 with a late ST. The primary end‐point was a composite of death‐recurrent myocardial infarction (MI)‐recurrent ST at 1 year.

Results: Baseline characteristics were similar. Patients with early ST had more initial stent implantation for an acute MI indication and presented more with cardiogenic shock when compared to patients with late ST: 43.1% versus 17.5% (P = 0.007) and 39.2% versus 20% (P = 0.042), respectively. There was no difference in the ST treatment except for more intraaortic balloon pump (IABP) use in the early ST group (28% vs. 10%, P = 0.034). Angiographic success rates were similar. The incidence of the composite primary end‐point was 52.9% in the early ST group versus 30% in the late ST group (P = 0.034).

Conclusion: Early definite ST is associated with more dramatic presentation and worse long‐term prognosis when compared with definite late ST. This could be explained at least in part by the occurrence of two successive MIs within 30 days in almost 45% of the patients with early ST, leading to a higher rate of cardiogenic shock.
Nationwide Trends in the Utilization of Multivessel Percutaneous Coronary Intervention (MVPCI) in the United States across Different Gender and Ethnicities
Authors: MOVAHED MOHAMMAD REZA , RAMARAJ RADHAKRISHNAN , JAMAL M. MAZEN , HASHEMZADEH MEHRTASH
Published: April 2009

Background:
To evaluate nationwide trends in the utilization of Multivessel Percutaneous Coronary Intervention (MVPCI) in the past compared to recent years using a large database from 1988 to 2004.

Method: The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age‐adjusted rate for multivessel percutaneous coronary intervention (MVPCI) from 1988 to 2004. Specific ICD‐9‐CM codes for MVPCI were used to compile the data. Patient demographic data were also analyzed from the database.

Results: According to the NIS database, MVPCI was performed in 241,319 patients from 1988 to 2004. Males underwent MVPCI twice as many as compared to females (male: 67.87%, female 32.13%). The mean age for these patients was 64.89 ± 11.84 years old. From 1988, the age‐adjusted rate for MVPCI gradually increased to more than three times in 1998 [(6.62 per 100,000 (95%CI = 5.92–7.33) in 1988 to 23.92 per 100,000 (95%CI = 21.62–26.22, P < 0.01) in 1998] and accelerated to more than 6 times that of 1988 at the end of the study in 2004 (41.50 per 100,000 (95%CI = 37.84–45.16). In recent years, this trend was similar for both genders and ethnicities.

Conclusion: The utilization of MVPCI has increased six times from 1988 to 2004, with acceleration in recent years. The cause of this acceleration is most likely related to the advancement in the percutaneous coronary interventional techniques.
High‐Speed Cell Sorting of Infectious Trophic and Cystic Forms of Pneumocystis carinii
Authors: MARTINEZ ANNA , ALIOUAT EL MOUKHTAR , POTTIER MURIEL , GANTOIS NAUSICÂA , PINÇON CLAIRE , STANDAERT‐VITSE ANNIE , DEI‐CAS EDUARDO , ALIOUAT‐DENIS CÉCILE‐MARIE
Published: April 2009

ABSTRACT. The separation of Pneumocystis carinii life‐cycle stages while preserving infectivity is a hitherto unresolved challenge. We describe an original, reproducible, and efficient method for separating trophic from cystic forms of P. carinii using a high‐speed cell sorter. The large amounts of highly purified (99.6±0.3%) infectious trophic and cystic forms can now be used to elucidate the poorly understood P. carinii life cycle.
Novistrombidium sinicum n. sp. and Novistrombidium orientale n. sp. (Protozoa: Ciliophora): Two New Oligotrich Ciliates from a Mangrove Wetland, South China
Authors: LIU WEIWEI , XU DAPENG , LIN XIAOFENG , LI JIQIU , GONG JUN , AL‐RASHEID KHALED A.S. , SONG WEIBO
Published: April 2009

ABSTRACT. The morphology and infraciliature of two new marine oligotrich ciliates, Novistrombidium sinicum n. sp. and Novistrombidium orientale n. sp., isolated from a mangrove wetland near Guangzhou, southern China, were studied from live and protargol‐stained specimens. Novistrombidium sinicum is different from its congeners by the combination of the following characters: three posteriorly directed thigmotactic membranelles, one ellipsoidal macronucleus, the extrusomes equidistantly arranged, and the ventral kinety commencing below the right end of the girdle kinety. The small‐sized N. orientale can be separated from its congeners by two posteriorly directed thigmotactic membranelles, one ellipsoidal macronucleus, the extrusomes equidistantly arranged, and the ventral kinety commencing below the right end of the girdle kinety.
Hybrid Simulation Combining a High Fidelity Scenario with a Pelvic Ultrasound Task Trainer Enhances the Training and Evaluation of Endovaginal Ultrasound Skills
Authors: Girzadas Jr Daniel V. , Antonis Michael S. , Zerth Herb , Lambert Michael , Clay Lamont , Bose Sudip , Harwood Robert
Published: April 2009

Objectives:  In this study, an endovaginal ultrasound (US) task trainer was combined with a high‐fidelity US mannequin to create a hybrid simulation model. In a scenario depicting a patient with ectopic pregnancy and hemorrhagic shock, this model was compared with a standard high‐fidelity simulation during training sessions with emergency medicine (EM) residents. The authors hypothesized that use of the hybrid model would increase both the residents’ self‐reported educational experience and the faculty’s self‐reported ability to evaluate the residents’ skills.

Methods:  A total of 45 EM residents at two institutions were randomized into two groups. Each group was assigned to one of two formats involving an ectopic pregnancy scenario. One format incorporated the new hybrid model, in which residents had to manipulate an endovaginal US probe in a task trainer; the other used the standard high‐fidelity simulation mannequin together with static photo images. After finishing the scenario, residents self‐rated their overall learning experience and how well the scenario evaluated their ability to interpret endovaginal US images. Faculty members reviewed video recordings of the other institution’s residents and rated their own ability to evaluate residents’ skills in interpreting endovaginal US images and diagnosing and managing the case scenario. Visual analog scales (VAS) were used for the self‐ratings.

Results:  Compared to the residents assigned to the standard simulation scenario, residents assigned to the hybrid model reported an increase in their overall educational experience (Δ VAS = 10, 95% confidence interval [CI] = 4 to 18) and felt the hybrid model was a better measure of their ability to interpret endovaginal US images (Δ VAS = 17, 95% CI = 7 to 28). Faculty members found the hybrid model to be better than the standard simulation for evaluating residents’ skills in interpreting endovaginal US images (Δ VAS = 13, 95% CI = 6 to 20) and diagnosing and managing the case (Δ VAS = 10, 95% CI = 2 to 18). Time to reach a diagnosis was similar in both groups (p = 0.053).

Conclusions:  Use of a hybrid simulation model combining a high‐fidelity simulation with an endovaginal US task trainer improved residents’ educational experience and improved faculty’s ability to evaluate residents’ endovaginal US and clinical skills. This novel hybrid tool should be considered for future education and evaluation of EM residents.
Reliability of the Color Analog Scale: Repeatability of Scores in Traumatic and Nontraumatic Injuries
Authors: Bulloch Blake , Garcia‐Filion Pam , Notricia David , Bryson Matt , McConahay Tom
Published: April 2009

Objectives:  The objective was to assess in a pediatric emergency department (ED) the reliability of the color analog scale (CAS) for acute pain assessment, overall and between traumatic and nontraumatic pain etiology.

Methods:  This was a prospective study of children aged 5 to 16 years in the ED of a children’s hospital who had a complaint of pain. The CAS was administered to the patient at admission and at 30 minutes. To evaluate repeatability, a second measurement was obtained 1 minute following each assessment. This assumed there would be no substantial change in pain intensity within 1 minute. The authors used the intraclass correlation coefficient (ICC) to evaluate the repeatability of 1‐minute interval measurements.

Results:  A total of 170 patients were enrolled. The origin of pain was traumatic in 81 cases (48%). Regardless of pain etiology, the CAS scores were highly repeatable (r = 0.97, 95% confidence interval [CI] = 0.95 to 0.98).

Conclusions:  The color analog scale is both a valid and a reliable self‐reporting tool in the assessment of acute pain in children.
Development and Validation of the Excess Mortality Ratio–adjusted Injury Severity Score Using the International Classification of Diseases 10th Edition
Authors: Kim Jaiyong , Shin Sang Do , Im Tai Ho , Lee Kug Jong , Ko Sang Back , Park Ju Ok , Ahn Ki Ok , Song Kyoung Jun
Published: April 2009

Objectives:  This study aimed to develop and validate a new method for measuring injury severity, the excess mortality ratio–adjusted Injury Severity Score (EMR‐ISS), using the International Classification of Diseases 10th Edition (ICD‐10).

Methods:  An injury severity grade similar to the Abbreviated Injury Scale (AIS) was converted from the ICD‐10 codes on the basis of quintiles of the EMR for each ICD‐10 code. Like the New Injury Severity Score (NISS), the EMR‐ISS was calculated from three maximum severity grades using data from the Korean National Injury Database. The EMR‐ISS was then validated using the Hosmer‐Lemeshow goodness‐of‐fit chi‐square (HL chi‐square, with lower values preferable), the area under the receiver operating characteristic curve (AUC‐ROC), and the Pearson correlation coefficient to compare it with the International Classification of Diseases 9th Edition–based Injury Severity Score (ICISS). Nationwide hospital discharge abstract data (DAD) from stratified‐sample general hospitals (n = 150) in 2004 were used for an external validation.

Results:  The total number of study subjects was 29,282,531, with five subgroups of particular interest identified for further study: traumatic brain injury (TBI, n = 3,768,670), traumatic chest injury (TCI, n = 1,169,828), poisoning (n = 251,565), burns (n = 869,020), and DAD (n = 26,374). The HL chi‐square was lower for EMR‐ISS than for ICISS in all groups: 42,410.8 versus 55,721.9 in total injury, 7,139.6 versus 20,653.9 in TBI, 6,603.3 versus 4,531.8 in TCI, 2,741.2 versus 9,112.0 in poisoning, 764.4 versus 4,532.1 in burns, and 28.1 versus 49.4 in DAD. The AUC‐ROC for death was greater for EMR‐ISS than for ICISS: 0.920 versus 0.728 in total injury, 0.907 versus 0.898 in TBI, 0.675 versus 0.799 in TCI, 0.857 versus 0.900 in poisoning, 0.735 versus 0.682 in burns, and 0.850 versus 0.876 in DAD. The Pearson correlation coefficient between the two scores was −0.68 in total injury, −0.76 in TBI, −0.86 in TCI, −0.69 in poisoning, −0.58 in burns, and −0.75 in DAD.

Conclusions:  The EMR‐ISS showed better calibration and discrimination power for prediction of death than the ICISS in most injury groups. The EMR‐ISS appears to be a feasible tool for passive injury surveillance of large data sets, such as insurance data sets or community injury registries containing diagnosis codes. Additional further studies for external validation on prospectively collected data sets should be considered.
The Undeserving Rich: “Moral Values” and the White Working Class1
Authors: Prasad Monica , Perrin Andrew J. , Bezila Kieran , Hoffman Steve G. , Kindleberger Kate , Manturuk Kim , Powers Ashleigh Smith , Payton Andrew R.
Published: April 2009

White working‐class citizens who vote for the Republican Party have been fodder for much political discussion and speculation recently, and a debate has arisen about the role that “moral values” played in the political decision making of this segment of voters. In this article, we defend a version of the moral values claim. We show that although the Republicans’ policies are unpopular, they are bundled with an overarching moral framework that is extremely resonant to this set of voters, and we use in‐depth interviews to uncover this framework. A key feature of this framework, on which in the 2004 presidential election George W. Bush scored high and John Kerry scored low, is the appropriate attitude to wealth, which serves as an indicator for a candidate’s general moral philosophy and as a heuristic about whether the candidate will govern with working‐class voters’ interests in mind. National Election Studies data support the argument that this was a key influence on the voting decision in 2004, even controlling for voters’ partisan identification.
Stop the Beat: Quiet Regulation and  Cultural Conflict1
Authors: Tepper Steven J.
Published: April 2009

This article explores a recent conflict over the youth phenomenon known as “raving” in the City of Chicago. By interviewing participants involved in the conflict, I set out to understand the extent to which the crackdown on raves in Chicago was similar to earlier social reactions to jazz, comic books, rock and roll, and Dead Head culture, as well as to more recent conflicts over punk, rap music, and raves in other cities. While most previous research on cultural conflict has focused on moral crusades, campaigns, and panics, the Chicago conflict represents an example of “quiet regulation.” Opponents refrained from highly visible, morally charged attacks; instead, in the absence of media hype and visible public discourse, public officials justified the crackdown in highly bureaucratic terms—avoiding risk, collecting taxes, enforcing codes. Nonetheless, they also drew on cultural schemas that linked raves and raving with drugs, sex, and deviance. As a result, officials selected a course of regulation that criminalized DJs and discredited the artform. In the absence of a highly visible moral campaign, the rave participants were unable to mobilize and resist the regulation and defend their lifestyle. Sociologists must move beyond highly visible campaigns and crusades and pay greater attention to quiet regulation, both because such regulation is likely to increase in the future and because it has significant consequences for power, cultural expression, and identity.
Understanding the Alteration and Decline of a Music Scene: Observations from Rave Culture1
Authors: Anderson Tammy L.
Published: April 2009

The sociological study of scenes—music and otherwise—has flourished in the latter twentieth and early twenty‐first centuries. Most research has documented a scene’s origins or its “evolution” into mainstream culture. Fewer studies have systematically addressed what leads to a scene’s alteration and decline, although many scholars have partially addressed it in authenticity studies anchored in the Frankfurt School’s claims about culture and economics. Are culture industries sufficient in explaining music scene transformation? The present article attempts to explain the cultural transformation of the Philadelphia rave scene and to articulate its relevance for other kinds of social worlds. Using a multimethod ethnographic approach, I show that five forces (generational schism, commercialization, cultural otherness/deviance and self destruction, social control, and genre‐based scene fragmentation) help explain the alteration and decline of the rave scene from its high point in the mid to late 1990s to its diminished and fragmented state presently. In describing these forces, I hope to move beyond culture industry narratives toward a broader explanation of cultural change, one that is lacking not only in music scene studies, but also in literatures on many other kinds of social worlds.
State Building as a Source of Islamic Political Organization1
Authors: Beck Colin J.
Published: April 2009

Previous research on political Islam in the Middle East and North Africa has been limited in providing a generalizable theory of its origins and systematically account for the cross‐national variation in the prevalence of Islamic movements. Following a state‐centered approach, this study argues that state‐building activities are a primary origin of Islamic movements. Regimes adopt religious symbolism and functions that legitimate the role of Islam in the public sphere. State incorporation of religion thus creates Islam as a frame for political action, with increased access to mobilizing resources and better able to withstand repression and political exclusion. To provide an explicit and systematic test of cross‐national variation, data on 170 political and militant organizations across the region are analyzed. Results indicate that state incorporation of religion is a crucial factor in the religiosity of movement organizations. Mixed effects of political exclusion and repression are found. No support is found for theories of economic grievances or foreign influence as causes of Islamic mobilization. In sum, analysis suggests that a state‐centered perspective is the most fitting account of political Islam.
Untangling Inequalities: Gender, Race, and Socioeconomic Differences in Depression1
Authors: Roxburgh Susan
Published: April 2009

In their important paper, Link and Phelan (1995) argue that socioeconomic status is a fundamental cause of variation in well‐being and that the social resources associated with socioeconomic status constitute the fundamental cause of variation in well‐being. In this article, I elaborate on the fundamental cause perspective in three respects: by suggesting an expansion of the definition of resources, by examining how race and gender influence variation in the relationship between resources and mental health, and by developing a model of the relationship between social class, race, and gender that takes account of the potential asymmetry in the influence of resources across race and gender. Using the 2003 National Health Interview Survey and ordinary least squares regression, I find that black and white men are significantly less depressed than black and white women. However, women accrue greater mental health advantage from marriage, home ownership, and education. African‐American men experience less depression as a result of being unmarried and non‐Hispanic white women experience less benefit from full‐time employment, relative to African‐American women and men. Results are discussed in terms of implications for future research on race, class, and gender differences in health.