bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender Wage Gap And Earnings: Predicted By Tenure In the Czech Republic
Authors: Ioakimidis Marilou
Published: April 2012

This paper examines the gender wage gap as well as male and female earnings as a function of within-firm tenure in the Czech Republic during 2004-2008. Using segmented regression, the wage gap and tenure were found positively correlated for approximately the first five years of within-firm employment, after which the correlation was near zero. Returns on tenure were greater for men than women, with a statistically significant breakpoint at the seven-year mark for men. These findings confirmed the outcome of other researchers who attributes the gender wage gap to the life and work cycles of women. The model of deferred compensation, in which women are more likely to select out of companies that defer compensation, may help explain the results.
Productivity Growth in Indian Cement Industry: A Panel Estimation of Stochastic Production Frontier
Authors: Mandal Sabuj Kumar , Madheswaran S.
Published: April 2012

The economic policy reform in respect of Indian cement industry, during the early 80's, resulted in a phenomenal growth of this sector. Cement industry being highly energy intensive in nature, further development of this industry, without increasing pressure on energy demand, would require growth in productivity. Thus, aim of this paper is to estimate Total Factor Productivity (TFP) growth in Indian cement industry as growth in TFP could ensure growth of this sector which is less dependent on energy and other inputs. Applying Stochastic Frontier Approach, the study first estimates TFP growth and then decomposes it into its components for the period 1989-90 to 2006-07. Empirical results show that the industry has experienced TFP growth during the study period and this growth is driven mainly by scale component and technical progress and not by technical efficiency change as technical efficiency has come out to be time invariant in this context. In the light of empirical results, the policy implication is that an industrial policy of exploiting the existing economies of scale is required to be implemented; and to boost the growth of this sector, priority should be given to enhance firms' capability of catching-up by adopting efficiency oriented action plans.
Gender Inequality, Economic Development, and Globalization: A State Level Analysis of India
Authors: Arora Rashmi Umesh
Published: April 2012

This study using access to education and health as the indicators of gender inequality examines gender inequality and state level openness in the different states of India. Further, the study's findings show that at the sub-national level in India higher per capita income is accompanied with lower gender inequality. However, in some high income states gender inequality is also very high. High gender inequality was also observed in the states which score high in the openness index.
Importing the Unusable: The Quantity Theory and the LDC's
Authors: Rashid Salim
Published: April 2012

The relevance of the Quantity Theory of Money to Developing economies is questioned. A skeptical examination of the facts upon which the theory is based, as well as of the theory itself , reveals much weakness. Indeed, it is the evidence from the developed economies that suffices to justify skepticism about the Quantity Theory. Money is a means to effect transactions and savings; what will be used as money depends upon such a miscellany of factors that no 'theory' can be expected to emerge. Monetary policy will be dependent on so many specific factors that most LDC's are probably better off using the general principles to develop their own 'theory'.
Comparing South African Inflation Volatility Across Monetary Policy Regimes: An Application of Saphe Cracking
Authors: Gupta Rangan , Uwilingiye Josine
Published: April 2012

Recent empirical evidence on the direct link of inflation targeting and inflation volatility is at best mixed. However, comparing inflation volatility across alternative monetary policy regimes within a country based on conventional ways, used in previous studies, begs the question. The question is not whether the volatility of inflation has changed, but rather whether the volatility is different than it otherwise would have been. In such a backdrop, this paper uses the cosine-squared cepstrum to provide evidence that CPI inflation in South Africa has become more volatile since the first quarter of 2000, when the country moved into an inflation targeting regime, than it would have been had the South African Reserve Bank (SARB) continued with the more eclectic monetary policy approach pursued in the pre-targeting era.
The Relationship Between Commercial Energy Consumption and Gross Domestic Income in Kenya
Authors: Onuonga Susan M.
Published: April 2012

The causal relationship between economic growth and energy consumption represents a widely studied topic in energy economics literature. Although it is well known that there is a strong correlation between energy consumption and economic growth, the issue of causality is still controversial. The paper investigated the causal relationship between energy consumption and economic growth in Kenya using published data. By using the Ganger-causality Error Correction Model, the results suggest that economic growth causes energy consumption in Kenya. The implication of the study is that energy conservation measures would not lead to negative effects on the country's economic growth.
The Information World of Parents: A Study of the Use and Understanding of Information by Parents of Young Children
Authors: Walker Christopher
Published: April 2012

Recent decades have seen change in social attitudes toward parenting within the United Kingdom. During this time, parenting has received an unprecedented amount of attention from government, through legislation and policy initiatives, as well as becoming a regular topic in the news media, television programs, and for book publishers. The consequence of this social change is that parents today, arguably, face far greater pressure in terms of sifting and weighing the wide range of messages, opinions, and information targeted at them. Despite these social changes, parents and parenting have received comparatively little attention from researchers specifically examining their information literacy needs. This article is based upon research conducted using constructivist grounded theory and examines how a group of thirty-three parents in Leeds, United Kingdom looked for, accessed, and assessed information. The primary outcome of the research is a substantive grounded theory, which is framed within five categories: being a parent (core category); connectivity; trust; picture of self; weighing. These five categories describe how parents look for, access, and weigh information on a daily basis. This theory has implications for how organizations, services, and professionals convey information to parents. It also supports the notion of a need to view information literacy as part of a complex socially constructed paradigm.
Teen Content Creators: Experiences of Using Information to Learn
Authors: Harlan Mary Ann , Bruce Christine , Lupton Mandy
Published: April 2012

As access to networked digital communities increases, a growing number of teens participate in digital communities by creating and sharing a variety of content. The affordances of social media—ease of use, ubiquitous access, and communal nature—have made creating and sharing content an appealing process for teens. Teens primarily learn the practices of encountering and using information through social interaction and participation within digital communities. This article adopts the position that information literacy is the experience of using information to learn. It reports on an investigation into teens’ experiences in the United States, as they use information to learn how to create content and participate within the context of social media. Teens that participate in sharing art on sites such as DeviantArt, website creation, blogging, and/or posing edited videos via YouTube and Vimeo, were interviewed. The interviews explored teens’ information experiences within particular social and digital contexts. Teens discussed the information they used, how information was gathered and accessed, and explored the process of using that information to participate in the communities.
Helping the Non-Scholar Scholar: Information Literacy for Lifelong Learners
Authors: Birdsong Lark , Freitas Jennifer
Published: April 2012

The Information Literacy Initiative (ILI) at the University of Washington Information School provides services to populations outside of traditional academic environments that are in need of either information literacy training for the first time or a refresher course on new concepts and technologies. They are adult learners in need of just-in-time education and not credits or a degree. The ILI uses both classes and videos to teach information literacy. The populations receiving training are able to learn information literacy skills that are both practical and useful, which gives them the ability to find quality information for their business, professional, health, and daily needs. Participants include owners of small- to medium-sized businesses, adults over the age of fifty, and women without homes who are experiencing extreme poverty. While steps have been taken to determine the effectiveness of these programs, there is still more to be done to find appropriate assessments for these particular demographics. Initial results are promising in the effectiveness and need for quality just-in-time education for the non-scholar scholar.
Exploring Health Information Use by Older Australians within Everyday Life
Authors: Yates Christine , Stoodley Ian , Partridge Helen , Bruce Christine , Cooper Helen , Day Gary , Edwards Sylvia L.
Published: April 2012

Exploring information use within everyday or community contexts is a recent area of interest for information literacy research endeavors. Within this domain, health information literacy (HIL) has emerged as a focus of interest due to identified synergies between information use and health status. However, while HIL has been acknowledged as a core ingredient that can assist people to take responsibility for managing and improving their own health, limited research has explored how HIL is experienced in everyday community life. This article will present the findings of ongoing research undertaken using phenomenography to explore how HIL is experienced among older Australians within everyday contexts. It will also discuss how these findings may be used to inform policy formulation in health communication and as an evidence base for the design and delivery of consumer health information resources and services.
From Lampitt to Libraries: Formulating State Standards to Embed Information Literacy across Colleges
Authors: DaCosta Jacqui Weetman , Dubicki Eleonora
Published: April 2012

In September 2007, the Lampitt Law was passed in the state of New Jersey, formalizing the requirements for students transferring between institutions. This led to a 2008 statewide articulation agreement to facilitate the seamless transfer of students’ courses and credits between county colleges and four-year public institutions of higher education. In response to this articulation agreement, three professional librarian groups combined to create information literacy standards utilizing progression as a core principle. The Information Literacy Progression Standards were launched in January 2010. They consist of a four-page document comprising an introduction; the standards defining competencies at a Novice/Introductory (Year 1) level and at a Gateway/Developing (Year 2) level; and some sample assignments demonstrating the Standards in Practice. This article outlines how the Standards were developed and successfully disseminated and implemented. As well as describing the creation of the Standards, the article highlights initiatives at several academic institutions where librarians have attempted to address information literacy at an organizational level, utilizing successful collaborations with faculty and administrators.
Information and Health Literacy in the Balance: Findings from a Study Exploring the Use of ICTs in Weight Management
Authors: Marshall Audrey , Henwood Flis , Guy Elizabeth S.
Published: April 2012

This article uses findings from a UK Department of Health funded research study known as Net.Weight to reflect on the concept of information literacy as it relates to consumer health. It explores how the results support and develop an understanding of information and health literacy and it offers recommendations for policy and practice. The study was located in the city of Brighton & Hove and examined the potential for information and communication technologies (ICTs) to support people who were self-managing their weight. The research comprised five interlocking components, at the heart of which was a series of participatory learning workshops designed to develop participant skills in relation to ICTs, information, and health literacy. The results indicate that a broader and more social understanding of information literacy is needed to ensure a better “fit” between the provision and use of health information. They also indicate that ICTs can augment information provision and support activities, but that a “blended” approach is necessary, where online and “real world” communication work in tandem.
Student Learning and Workplace IL: A Case Study
Authors: D’Angelo Barbara
Published: April 2012

This article reports on a case study that analyzed portfolios composed by technical communication undergraduate majors at a research university in the United States. Results showed that students, who are also practicing professionals in their field, exhibited information literacy (IL) outcomes more typical of the workplace than academia. The categories of research engaged in by students to complete course work included academic, applied, and experiential. These categories grounded the students’ research in rhetorical and contextually situated practices. They indicate that it may be important to broaden the way that information literacy is articulated, taught, and learned to bridge the gap between academia and the workplace.
Supporting Informed Learners in the Twenty-first Century
Authors: Bruce Christine , Hughes Hilary , Somerville Mary M.
Published: April 2012

This article elaborates the concept of informed learning and locates it in educational, workplace, and community settings. Drawing on existing research into people’s experience of information literacy, it identifies critical experiences of informed learners in each of these three settings. It also explores the support required in educational, community, and workplace contexts, which makes informed learning possible. Recognizing strong implications for policy makers in different sectors, the article presents a set of guiding principles for developing informed learning and learners. The idea of informed learning represents and advances understandings of information literacy that incorporate the broader concept of using information to learn : those understandings that go beyond the functional or generic information literacy paradigm and draw attention to the transformational, situated, and critical aspects of information literacy. Using information to learn is a natural, but often implicit part of all formal and informal learning environments, and is a vital component of the lifelong learning agendas of many nations worldwide. Supporting informed learning requires conscious attention to the use of information in the learning process, by educators, managers, trainers, and policy makers in all sectors. It requires a far reaching response to policy directions involving a wide range of stakeholders.
Demaenetus and the Trireme
Authors: Simonsen Kathryn
Published: April 2012

The London fragments of the Hellenica Oxyrhynchia begin with an account of how Demaenetus, an Athenian, stole a trireme from the Piraeus and used it to sail to Cyprus to join up with the Persian navy led by the exiled Athenian commander, Conon. The historian links this action with other evidence for increasing dissatisfaction with the Spartans in Athens and other poleis in the early 390s bc . Xenophon, whose Hellenica also covers this time period, does not mention the incident at all. This paper explores what Demaenetus’ act might have meant, why the Oxyrhynchus historian includes it and why Xenophon does not.

Les fragments de Londres des Helléniques d’Oxyrhynchos commencent avec le compte rendu du vol, par l’athénien Demaenetus, d’une trirème qu’il fit traverser du Pirée à Chypre pour rejoindre la flotte perse commandée par l’Athénien exilé Conon. L’historien rapproche cet épisode d’autres témoignages du mécon-tentement grandissant exprimé à Athènes et ailleurs face aux Spartiates au début des années 390 bc . Cet événement, toutefois, est passé sous silence par Xénophon qui, pourtant, couvre la même période dans ses Helléniques . La présente étude s’interroge sur la signification du geste de Demaenetos et sur les motivations qui ont conduit l’auteur des Helléniques d’Oxyrhynchos à lui donner une place dans son récit, et sur celles de Xénophon à l’ignorer.
The Numeric Practice of the Hellenica Oxyrhynchia
Authors: Rubincam Catherine
Published: April 2012

A study of all the numbers in the more complete portions of the Florentine and London fragments of the Hellenica Oxyrhynchia , using a methodology that captures a standard constellation of aspects of each number, makes it possible to create a statistical profile of that work’s numeric practice. Comparison of the Hellenica Oxyrhynchia ’s numeric profile with those of the six earliest extant works of Greek history (Herodotus, Thucydides, Xenophon’s Anabasis and Hellenica , Polybius, and Diodorus Siculus) makes one more aware both of this author’s position in the development of Greek historiographic tradition and of his individuality. More specifically, it generates some new observations on particular passages of this much-studied text, which call into question some of the restorations proposed by editors who strove to produce the closest possible correspondence between the narrative of the papyrus historian and that of Diodorus.

Une étude systématique des nombres dans les parties les mieux préservées des fragments de Florence et de Londres des Helléniques d’Oxyrhynchos , au moyen d’une méthodologie rigoureuse, permet l’élaboration d’un profil statistique de l’utilisation des nombres dans cette œuvre. Si on compare les résultats obtenus avec les données correspondantes dans les six œuvres historiques grecques les plus anciennes à avoir survécu (Hérodote, Thucydide, l’ Anabase et les Helléniques de Xénophon, Polybe et Diodore de Sicile), on saisit mieux non seulement la position de l’auteur anonyme des Helléniques dans le développement de la tradition historiographique grecque, mais aussi son individualité. En outre, et quoique ce texte ait déjà été l’objet de nombreuses études, on peut faire de nouvelles observations sur certains passages et remettre en question certaines restitutions justifiées par le désir de produire une correspondance aussi parfaite que possible entre ce texte et celui de Diodore.
« Partis politiques », cites, etats federaux: Le temoignage de l’historien d’Oxyrhynchos
Authors: Bearzot Cinzia
Published: April 2012

La question de l’existence de véritables « partis politiques » dans la Grèce ancienne a été l’objet d’un grand débat dans la critique moderne. L’auteur des Helléniques d’Oxyrhynchos (P) nous donne à ce propos un témoignage particulièrement intéressant qu’on peut rattacher à son intérêt marqué pour la terminologie relative aux « partis » et pour la politique intérieure des cités grecques. Les rensei-gnements que P nous fournit sur la situation politique de la Béotie sont particu-lièrement intéressants et nous permettent de mieux comprendre la nature des oppositions entre les partis dans les états fédéraux. La dénomination de « parti » convient bien aux factions car leurs programmes politiques étaient aisément identifiables et leurs chefs étaient assez puissants pour leur assurer une certaine continuité. En outre, ces factions bénéficiaient d’un appui populaire soutenu et se distinguaient par des positions nettement rangées sur les questions de politique internationale.

The existence of political “parties” in ancient Greece has been widely discussed by scholars. Since he employs highly refined terminology and provides much information on the internal politics of Greek cities, the author of the Hellenica Oxyrhynchia offers a particularly interesting insight into this problem. Information is particularly ample on Boeotia, and thus within the peculiar context of a federal state distinct factions can be identified : they are characterized by continuity in political programs and leadership and by a certain numerical consistency, as well as by different constitutional ideologies and federal policies, and by different positions in international matters. Because of these features, these factions can be con-sidered “parties” despite the scepticism of many scholars.
BANDITS, ELVIS, AND OTHER MYSTICS: An Interview with Paul Vanderwood
Authors: Young Eric Van
Published: April 2012

Paul Vanderwood, Professor Emeritus of History at San Diego State University, died in San Diego onOctober 10, 2011, at the age of 82. A distinguished and innovative historian of modern Mexico, Vanderwood authored or co-authored several books, mostly dealing with the political, social, and cultural history of Mexico between about 1860 and the mid-twentieth century. The four works for which he is best known are Disorder and Progress (1982), The Power of God Against the Guns ofGovernment (1998), Juan Soldado (2004), and Satan's Playground (2010), and they are discussed extensively in this interview.
FLEEING INTO SLAVERY: The Insurgent Geographies of Brazilian Quilombolas (Maroons), 1880-1881
Authors: Miki Yuko
Published: April 2012

On July 26, 1880, Benedito, the most notorious quilombola, or maroon, in São Mateus, the northern region of Espírito Santo province, Brazil, disappeared from the public prison in a flamboyant escape. After his drunken guards fell asleep, Benedito placed a cleaning bucket on top of his cot and employed it as a stepping-stone in tandem with a rope made from his bedsheet to scale the back wall enclosing the cell. He leapt to the other side, opened the back door, and slipped out noiselessly. Rendering the situation even more preposterous to those who discovered him gone were the handcuffs that lay on the floor smeared with sheep fat, which he had used to slip his hands out without forcing the locks.
A CATHOLIC ALTERNATIVE TO REVOLUTION: The Survival of Social Catholicism in Postrevolutionary Mexico
Authors: Andes Stephen J.C.
Published: April 2012

Alfredo Méndez Medina, writing from Belgium in January 1911, was possessed by the idea that Mexico's social and economic organization required radical change. Méndez Medina, a Mexican Jesuit priest and developing labor activist, had spent just a few years in Europe, sent by his superiors to learn the techniques, strategies, and ideology of Catholic social action. What he saw and experienced there helped shape his vision for Mexico and guided his work upon his return in late 1912. In Europe, the young Méndez Medina observed firsthand the Catholic unions, ministries, and propagandists of L'Action Populaire, an influential French social Catholic institution founded by Gustave Desbuquois, S.J. (1869-1959) in Reims. In a few brief notes, Méndez Medina wrote that Desbuquois's earthy, no-nonsense way of speaking to ordinary workers, and his profound spirituality, had impressed him deeply. To Méndez Medina, Desbuquois appeared to link seamlessly his religious faith, his social commitments, his sense of duty, and his politics.
APL-1, the Alzheimer’s Amyloid Precursor Protein inCaenorhabditis elegans, Modulates Multiple Metabolic Pathways Throughout Development
Authors: Ewald Collin Y , Raps Daniel A , Li Chris
Published: April 2012

Mutations in the amyloid precursor protein (APP) gene or in genes that process APP are correlated with familial Alzheimer’s disease (AD). The biological function of APP remains unclear. APP is a transmembrane protein that can be sequentially cleaved by different secretases to yield multiple fragments, which can potentially act as signaling molecules. Caenorhabditis elegans encodes one APP-related protein, APL-1, which is essential for viability. Here, we show that APL-1 signaling is dependent on the activity of the FOXO transcription factor DAF-16 and the nuclear hormone receptor DAF-12 and influences metabolic pathways such as developmental progression, body size, and egg-laying rate. Furthermore, apl-1(yn5) mutants, which produce high levels of the extracellular APL-1 fragment, show an incompletely penetrant temperature-sensitive embryonic lethality. In a genetic screen to isolate mutants in which the apl-1(yn5) lethality rate is modified, we identified a suppressor mutation in MOA-1/R155.2, a receptor-protein tyrosine phosphatase, and an enhancer mutation in MOA-2/B0495.6, a protein involved in receptor-mediated endocytosis. Knockdown of apl-1 in an apl-1(yn5) background caused lethality and molting defects at all larval stages, suggesting that apl-1 is required for each transitional molt. We suggest that signaling of the released APL-1 fragment modulates multiple metabolic states and that APL-1 is required throughout development.
Investigating Natural Variation inDrosophilaCourtship Song by the Evolve and Resequence Approach
Authors: Turner Thomas L , Miller Paige M
Published: April 2012

A primary goal of population genetics is to determine the genetic basis of natural trait variation. We could significantly advance this goal by developing comprehensive genome-wide approaches to link genotype and phenotype in model organisms. Here we combine artificial selection with population-based resequencing to investigate the genetic basis of variation in the interpulse interval (IPI) of Drosophila melanogaster courtship song. We performed divergent selection on replicate populations for only 14 generations, but had considerable power to differentiate alleles that evolved due to selection from those that evolved stochastically. We identified a large number of variants that changed frequency in response to selection for this simple behavior, and they are highly underrepresented on the X chromosome. Though our power was adequate using this experimental technique, the ability to differentiate causal variants from those affected by linked selection requires further development.
Functional Genomic Architecture of Predisposition to Voluntary Exercise in Mice: Expression QTL in the Brain
Authors: Kelly Scott A , Nehrenberg Derrick L , Hua Kunjie , Garland Theodore , Pomp Daniel
Published: April 2012

The biological basis of voluntary exercise is complex and simultaneously controlled by peripheral (ability) and central (motivation) mechanisms. The accompanying natural reward, potential addiction, and the motivation associated with exercise are hypothesized to be regulated by multiple brain regions, neurotransmitters, peptides, and hormones. We generated a large (n = 815) advanced intercross line of mice (G4) derived from a line selectively bred for increased wheel running (high runner) and the C57BL/6J inbred strain. We previously mapped multiple quantitative trait loci (QTL) that contribute to the biological control of voluntary exercise levels, body weight, and composition, as well as changes in body weight and composition in response to short-term exercise. Currently, using a subset of the G4 population (n = 244), we examined the transcriptional landscape relevant to neurobiological aspects of voluntary exercise by means of global mRNA expression profiles from brain tissue. We identified genome-wide expression quantitative trait loci (eQTL) regulating variation in mRNA abundance and determined the mode of gene action and the cis- and/or trans-acting nature of each eQTL. Subsets of cis-acting eQTL, colocalizing with QTL for exercise or body composition traits, were used to identify candidate genes based on both positional and functional evidence, which were further filtered by correlational and exclusion mapping analyses. Specifically, we discuss six plausible candidate genes (Insig2, Socs2, DBY, Arrdc4, Prcp, IL15) and their potential role in the regulation of voluntary activity, body composition, and their interactions. These results develop a potential initial model of the underlying functional genomic architecture of predisposition to voluntary exercise and its effects on body weight and composition within a neurophysiological framework.
Belowground herbivory increases vulnerability of New England salt marshes to die‐off
Authors: Coverdale Tyler C. , Altieri Andrew H. , Bertness Mark D.
Published: April 2012

Belowground herbivory is commonly overlooked as a mechanism of top‐down control in vegetated habitats, particularly in aquatic ecosystems. Recent research has revealed that increased densities of the herbivorous crab Sesarma reticulatum have led to runaway herbivory and widespread salt marsh die‐off on Cape Cod, Massachusetts, USA. Aboveground herbivory is a major driver of this cordgrass habitat loss, but the role of belowground grazing is poorly understood. Sesarma live in communal burrows typically consisting of 1–2 openings and containing 2–3 crabs. However, at die‐off sites, burrow complexes can cover >90% of the low marsh zone, with crab densities as high as 50 crabs/m2 and burrow opening densities of 170 openings/m2. The magnitude of belowground Sesarma activity in association with salt marsh die‐off provides an excellent opportunity to extend our knowledge of belowground herbivory impacts in coastal wetlands. Since Sesarma burrows allow access to cordgrass roots and rhizomes, and Sesarma are frequently restricted to burrows by thermal stress and predation, we hypothesized that belowground herbivory would be widespread in die‐off areas. We experimentally demonstrate that Sesarma readily eat belowground roots and rhizomes in addition to aboveground cordgrass leaves. We then partitioned above‐ and belowground herbivory with field manipulations and found that belowground grazing is not only common, but can cause total plant mortality. Additional experiments revealed that plants remain vulnerable to belowground herbivory even after reaching a size refuge from aboveground grazing. This suggests that belowground herbivory contributes to salt marsh die‐offs and adds to growing evidence that belowground herbivory is a widespread structuring force in plant communities that can limit habitat persistence.
Challenging the Diagnosis of Primary Angiitis of the Central Nervous System: A Single-center Retrospective Study
Authors: NÉEL ANTOINE , AUFFRAY-CALVIER ELISABETH , GUILLON BENOIT , FONTENOY ANNE-MAELLE , LOUSSOUARN DELPHINE , PAGNOUX CHRISTIAN , HAMIDOU MOHAMED A.
Published: April 2012

Objective.

(1) To describe a series of adults assessed for suspected primary angiitis of the central nervous system (PACNS) and their final diagnosis; (2) to describe and compare presenting features of PACNS and reversible cerebral vasoconstriction syndrome (RCVS); and (3) to evaluate the specificity of the presenting features of RCVS.

Methods.

Patients evaluated at our institution between 2000 and 2008 for a possible CNS vasculitis and investigated by conventional angiography and/or brain biopsy were retrospectively analyzed. The inclusion criteria were a clinicoradiological presentation and cerebral angiography and/or brain biopsy raising the hypothesis of isolated cerebral vasculitis; and absence of identifiable etiology at the time of conventional angiogram and/or brain biopsy.

Results.

Among 58 cases evaluated, 37 met the inclusion criteria and 33 were included in the study. Thirteen patients had RCVS. Thunderclap headaches, the absence of a focal neurological deficit, a convexal subarachnoid hemorrhage and/or normal brain parenchyma on magnetic resonance imaging, and “string of beads” appearance on conventional angiography had high diagnostic value. Six patients had other noninflammatory vascular disorders (intracranial atherosclerosis, cryptogenic embolism, and genetic vasculopathy). Six patients had infection or malignancy. Eight patients were diagnosed with PACNS; their clinical presentation and disease course were heterogeneous. Brain biopsy was performed in 3 cases (positive in 1).

Conclusion.

RCVS is an important differential diagnosis of CNS vasculitis. Its particular presentation should allow rapid identification in order to avoid pointless investigations and treatment. The frequent lack of histological proof and heterogeneous presentation of PACNS illustrated the nosological uncertainties of this label.
Effect of Gastrointestinal Manifestations on Quality of Life in 87 Consecutive Patients with Systemic Sclerosis
Authors: OMAIR MOHAMMED A. , LEE PETER
Published: April 2012

Objective.

To assess the effect of gastrointestinal (GI) manifestation on the quality of life in patients with systemic sclerosis (SSc).

Methods.

The University of California, Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2 questionnaire was completed by 87 consecutive patients with SSc attending the scleroderma clinic at a single center. Their clinical features and current therapies were recorded; 100 patients with rheumatologic disorders other than SSc were used as controls. Individual scores were compared between SSc and controls, and between SSc subgroups.

Results.

Of 87 patients, 76 (90%) were women. Median age was 55 years and disease duration 105 months. Thirty-three (38%) had diffuse and 54 (62%) had limited SSc. Patients with SSc had a higher score than controls in all domains (p < 0.05). Numbers of patients who responded positively to individual questionnaire components are as follows: any GI symptom 86 (99%), reflux 77 (89%), distension 73 (84%), soilage 19 (22%), diarrhea 44 (51%), constipation 51 (59%), well-being 43 (49%), and social 43 (49%). There was no difference between the scores of patients with diffuse and limited disease subtypes. The use of calcium channel blockers did not significantly increase the constipation score (p = 0.99). Patients who responded positively to the reflux, distension, diarrhea, and constipation domains had lower scores in the well-being and social domains.

Conclusion.

GI manifestations, especially fecal incontinence (affecting 22% of patients), have a negative influence on the quality of life of patients with SSc. There was no difference between SSc disease subtypes.
Validity and Responsiveness of the Dutch McMaster Toronto Arthritis Patient Preference Questionnaire (MACTAR) in Patients with Osteoarthritis of the Hip or Knee
Authors: BARTEN DI-JANNE J.A. , PISTERS MARTIJN F. , TAKKEN TIM , VEENHOF CINDY
Published: April 2012

Objective.

To determine the content validity, the construct validity, and the responsiveness of the Dutch McMaster Toronto Arthritis Patient Preference Questionnaire (MACTAR) in patients with osteoarthritis (OA) of the hip or knee.

Methods.

The MACTAR comprises 2 parts: a transitional part and a status part. Content validity was investigated by comparing patient-elicited activities to items on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study Short-Form 36 (SF-36). Construct validity was determined by correlating MACTAR outcomes with WOMAC/SF-36 outcomes. Responsiveness was investigated by correlating MACTAR, WOMAC, and SF-36 change scores with patient global assessment (PGA) scores and plotting a receiver-operating characteristics (ROC) curve.

Results.

Eleven percent of the 894 impaired activities, identified by 192 patients, were not represented in either the WOMAC or the SF-36. The correlations (rs) investigated for the MACTAR transitional part varied between 0.27 and −0.40; the status part correlated moderately with the general health scale of the SF-36 (rs = 0.44). MACTAR change scores correlated better with PGA than with WOMAC/SF-36 change scores. The area under the ROC curve amounted to 0.90.

Conclusion.

Our results suggest that the MACTAR exhibits moderate construct validity and good responsiveness in a population of patients with OA of the hip or knee. The MACTAR is potentially better able to detect changes over time in activities that are important to individual patients compared to other tools measuring physical function (WOMAC, SF-36). Clinicians could use the MACTAR to evaluate clinically relevant changes over time in patient-specific physical functioning.
Tumor Necrosis Factor-α Inhibitor Use Is Not Associated with Lipid Changes in Rheumatoid Arthritis
Authors: BILI ANDRONIKI , MORRIS STEPHANIE J. , SARTORIUS JENNIFER A. , KIRCHNER H. LES , ANTOHE JANA L. , DANCEA SORINA , WASKO MARY CHESTER
Published: April 2012

Objective.

To determine the association of use of tumor necrosis factor-α (TNF-α) inhibitors with differences in lipid levels in patients with rheumatoid arthritis (RA).

Methods.

We studied 807 patients with incident RA to compare differences in lipid levels in TNF-α inhibitor users versus nonusers, with adjustment for relevant covariables.

Results.

TNF-α inhibitor use was not associated with differences in levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides, LDL:HDL, or TC:HDL compared to nonusers.

Conclusion.

Use of TNF-α inhibitor was not associated with differences in lipid levels in patients with RA.
Longterm Retention of Tumor Necrosis Factor-α Inhibitor Therapy in a Large Italian Cohort of Patients with Rheumatoid Arthritis from the GISEA Registry: An Appraisal of Predictors
Authors: IANNONE FLORENZO , GREMESE ELISA , ATZENI FABIOLA , BIASI DOMENICO , BOTSIOS COSTANTINO , CIPRIANI PAOLA , FERRI CLODOVEO , FOSCHI VALENTINA , GALEAZZI MAURO , GERLI ROBERTO , GIARDINA ANNARITA , MARCHESONI ANTONIO , SALAFFI FAUSTO , ZIGLIOLI TAMARA , LAPADULA GIOVANNI ,   Gruppo Italiano di Studio sulle Early Arthritides (GISEA)
Published: April 2012

Objective.

To evaluate 4-year retention rates of tumor necrosis factor-α (TNF-α) inhibitors adalimumab, etanercept, and infliximab among patients with longstanding rheumatoid arthritis (RA), as derived from an Italian national registry.

Methods.

The clinical records of 853 adult patients with RA in the GISEA (Gruppo Italiano Studio Early Arthritis) registry were prospectively analyzed to compare drug survival rates and the baseline factors that may predict adherence to therapy.

Results.

In 2003 and 2004, 324 patients started treatment with adalimumab, 311 with etanercept, and 218 with infliximab. After 4 years, the global retention rate of anti-TNF-α therapy was 42%. Etanercept survival (51.4%) was significantly better than that of infliximab (37.6%) or adalimumab (36.4%; p < 0.0001). Accordingly, the mean duration of therapy was significantly longer for etanercept (3.1 ± 2 yrs) than for adalimumab (2.6 ± 2 yrs) or infliximab (2.7 ± 2 yrs; p < 0.05). The use of concomitant disease-modifying antirheumatic drugs, mainly methotrexate, and the presence of comorbidities significantly predicted drug continuation (p < 0.01), whereas a high Disease Activity Score did not.

Conclusion.

The 4-year global drug survival of adalimumab, etanercept, and infliximab was lower than 50%, with etanercept having the best retention rate. The main positive predictor of adherence to anti-TNF-α therapy was the concomitant use of methotrexate. Our study provides further evidence that the real-life treatment of patients with RA may be different from that of randomized clinical trials.
Treating Rheumatoid Arthritis to Target: A Canadian Physician Survey
Authors: HARAOUI BOULOS , BENSEN WILLIAM , BESSETTE LOUIS , LE CLERCQ SHARON , THORNE CARTER , WADE JOHN
Published: April 2012

Objective.

To assess agreement and application of Treat to Target (T2T) recommendations in Canadian practice.

Methods.

A survey of Canadian rheumatologists was conducted on the recommendations of T2T, an international initiative toward reaching specific therapeutic goals in rheumatoid arthritis. Agreement with each recommendation was measured on a 10-point Likert scale (1 = fully disagree, 10 = fully agree). A 4-point Likert scale (never, not very often, very often, always) assessed application of each recommendation in current practice. Responders who answered “never” or “not very often” were asked whether they were willing to change their practice according to the particular recommendation.

Results.

Seventy-eight rheumatologists responded (24% of the 330 who were contacted). The average agreement scores ranged from 6.92 for recommendation #5 (the frequency of measures of disease activity) to 9.10 for recommendation #10 (the patient needs to be involved in the decision-making process). A majority of participants indicated that they apply the T2T recommendations in their practice. Recommendations dealing with frequency of visits and the use of composite measures received the highest number of “never” or “not very often” responses. Busy practices and lack of confidence in composite outcome measures were the main reasons for objections to certain components of the recommendations.

Conclusion.

Although a majority of Canadian rheumatologists agreed with and supported the T2T recommendations, there was resistance toward specific aspects of these recommendations. Efforts are needed to better understand the reasons behind identified disagreements. Action plans to encourage the application of T2T recommendations in Canada are in development.
Interreader Reliability in Assessment of Nailfold Capillary Abnormalities by Beginners: Pilot Study of an Intensive Videocapillaroscopy Training Program
Authors: GUTIERREZ MARWIN , BERTOLAZZI CHIARA , TARDELLA MARIKA , BECCIOLINI ANDREA , DI CARLO MARCO , DOTTORI MARTA , GRASSI WALTER , De ANGELIS ROSSELLA
Published: April 2012

Objective.

To test the learning curve of rheumatologists with different experience in videocapillaroscopy (VCP) attending an intensive training program focused on interpretation of the main capillary nailfold abnormalities, the scleroderma (systemic sclerosis, SSc) pattern, and the normal pattern, and to determine their interreader agreement with an experienced investigator.

Methods.

Five investigators (1 senior, 1 junior, and 3 beginners) participated in the exercise. The study was composed of 2 steps. First, an independent investigator selected representative VCP images of normal patterns and capillary abnormalities. The second step included the training program, which ran 4 hours per day for 7 days. The senior rheumatologist taught investigators to recognize and interpret the normal pattern, the capillary abnormalities, and the different types of SSc pattern. These abnormalities were considered: homogeneously enlarged capillaries, giant capillaries, irregularly enlarged capillaries, microhemorrhages, neoangiogenesis, avascular areas, and capillary density.

Results.

A total of 300 VCP images were read from all the investigators. Both κ values and overall agreement percentages of qualitative and quantitative assessments showed progressive improvement from poor to excellent from the beginning to the end of the exercise. The sensitivity and specificity of the participants in the assessment of SSc pattern at the last lecture session were high.

Conclusion.

Our pilot study suggests that after an intensive 1-week training program, novice investigators with little or no experience in VCP are able to interpret the main capillary abnormalities and SSc pattern and to achieve good interreader agreement rates.
Heterogeneity of Anticitrullinated Peptide Antibodies and Response to Anti-Tumor Necrosis Factor Agents in Rheumatoid Arthritis
Authors: FISHER BENJAMIN A. , PLANT DARREN , LUNDBERG KARIN , CHARLES PETER , BARTON ANNE , VENABLES PATRICK J. ,   The Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate (BRAGGSS)
Published: April 2012

Objective.

To examine fine specificity of anticitrullinated peptide antibodies (ACPA) in relation to responsiveness to anti-tumor necrosis factor (anti-TNF) agents in rheumatoid arthritis (RA).

Methods.

Samples from 450 patients with RA treated with anti-TNF agents were analyzed for antibodies to citrullinated α-enolase, vimentin, and fibrinogen peptides. The Disease Activity Score-28 was measured at baseline and 6 months.

Results.

Both anti-cFib antibodies and the number of citrullinated peptides recognized were associated with a poorer response. These findings were not significant following stratification for anti-cyclic citrullinated peptide 2 antibodies.

Conclusion.

The presence of any ACPA rather than individual ACPA specificities was associated with a poorer response to anti-TNF agents. We suggest that this reflects distinctive differences in the pathogenesis of ACPA-positive and negative RA.
Clinical Correlates of CENP-A and CENP-B Antibodies in a Large Cohort of Patients with Systemic Sclerosis
Authors: HUDSON MARIE , MAHLER MICHAEL , POPE JANET , YOU DANIEL , TATIBOUET SOLENE , STEELE RUSSELL , BARON MURRAY ,   Canadian Scleroderma Research Group, FRITZLER MARVIN
Published: April 2012

Objective.

To study the clinical phenotypes of centromeric proteins (CENP)-A- and CENP-B-positive patients with systemic sclerosis (SSc) and to compare them to anticentromere antibody (ACA)-positive and negative SSc patients.

Methods.

Sera samples were collected from 802 patients with SSc enrolled in a multicenter cohort study. Antibodies to CENP-A and B were detected by ELISA, and ACA by indirect immunofluorescence. Associations with clinical and other serological manifestations of SSc were investigated.

Results.

CENP-A antibodies were detected in 276 (34%), CENP-B in 286 (36%), and ACA in 279 (35%) patients. Patients having ACA, CENP-A, and/or CENP-B resembled each other and differed from the remainder of the cohort in the following respects: older chronologically and at disease onset; more commonly women; more likely to have limited disease and lower skin scores; less likely to have finger ulcers, digital tuft resorption, or finger contractures; more likely to have pulmonary hypertension; less likely to have interstitial lung disease, scleroderma renal crisis, inflammatory arthritis, and inflammatory myositis; and having lower overall disease severity. CENP-A and/or B status was predictive of the extent of skin involvement over time. Patients with limited disease who were CENP-A-negative at baseline were more likely to progress to diffuse disease compared to CENP-A-positive patients (OR 2.55, 95% CI 1.37, 4.85, p = 0.004).

Conclusion.

Clinical immunology laboratories are increasingly using high-throughput ELISA tests for CENP antibodies, with or without ACA detected by indirect immunofluorescence. The phenotype of CENP-A and/or B-positive patients is generally similar to that associated with ACA.
Surveillance: A Strategy for Improving Patient Safety in Acute and Critical Care Units
Authors: Henneman Elizabeth A. , Gawlinski Anna , Giuliano Karen K.
Published: April 2012

Surveillance is a nursing intervention that has been identified as an important strategy in preventing and identifying medical errors and adverse events. The definition of surveillance proposed by the Nursing Intervention Classification is the purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making. The term surveillance is often used interchangeably with the term monitoring, yet surveillance differs significantly from monitoring both in purpose and scope. Monitoring is a key activity in the surveillance process, but monitoring alone is insufficient for conducting effective surveillance. Much of the attention in the bedside patient safety movement has been focused on efforts to implement processes that ultimately improve the surveillance process. These include checklists, interdisciplinary rounds, clinical information systems, and clinical decision support systems. To identify optimal surveillance patterns and to develop and test technologies that assist critical care nurses in performing effective surveillance, more research is needed, particularly with innovative approaches to describe and evaluate the best surveillance practices of bedside nurses.