bluuebunny/crossref_metadata_2025 huggingface dataset:
Dementia Undiagnosed in Poor Older Adults with Functional Impairment
Authors: Wilkins Consuelo H. , Wilkins Kenneth L. , Meisel Marie , Depke Marilyn , Williams James , Edwards Dorothy F.
Published: October 2007

OBJECTIVES: To identify variables associated with diagnosing dementia in poor older adults by comparing older people with dementia who were diagnosed by their primary care physicians (PCPs) with those not diagnosed by their PCP.

DESIGN: Observational study.

SETTING: Community‐based, in‐home cognitive assessment program.

PARTICIPANTS: Four hundred eleven adults aged 55 and older with cognitive impairment.

MEASUREMENTS: Instrumental activities of daily living (IADLs), activities of daily living (ADLs), Mini‐Mental State Examination, Short Blessed Memory Orientation and Concentration Test, and Clinical Dementia Rating.

RESULTS: Alzheimer's disease was the most common diagnosis in this group of primarily African‐American (73%) older people. Of the 411 participants, 232 (56%) were not diagnosed by their PCP. Participants without a previous diagnosis were older (mean age 81.7 vs 78.7, P=.01), more independent in IADLs (P<.001), and more likely to live alone (P=.001) than persons diagnosed by their PCP. Of the 201 who lived alone, 66% were not diagnosed with dementia by their PCP. Variables associated with PCP diagnosis were more severe cognitive impairment (P<.001), spouse caregiver (P=.009), younger age (P=.02) and care from a university‐based PCP (P=.04).

CONCLUSION: Persons with dementia who were older and lived alone were less likely to be diagnosed by their PCP. Although persons not diagnosed by their PCP had less cognitive impairment, they had substantial impairment in activities, including handling finances, cooking, and managing medications.
A Randomized Trial of Depression Assessment Intervention in Home Health Care
Authors: Bruce Martha L. , Brown Ellen L. , Raue Patrick J. , Mlodzianowski Amy E. , Meyers Barnett S. , Leon Andrew C. , Heo Moonseong , Byers Amy L. , Greenberg Rebecca L. , Rinder Susan , Katt Wendy , Nassisi Pamela
Published: October 2007

OBJECTIVES:To determine whether an educational intervention would improve depression assessment and appropriate referral. Secondary analyses tested whether referral led to depression improvement.

DESIGN:Training in the Assessment of Depression (TRIAD) was a three‐group, nurse‐randomized trial. Researchers interviewed randomly selected patients at baseline and 8 weeks.

SETTING:Three certified home healthcare agencies in Westchester County, New York.

PARTICIPANTS:Fifty‐three medical/surgical nurses were randomized within agency to three intervention groups: full, minimal, or control. Research contact with nurses' patients (aged >65; N=477) yielded 256 (53.7%) enrolled subjects, 84 (17.6%) ineligibles, and 120 (25.2%) refusals; 233 of the 256 (87.1%) enrolled patients completed follow‐up interviews.

INTERVENTION:Nurse training in clinically meaningful use of depression sections of Medicare's mandatory Outcome and Assessment Information Set (OASIS).

MEASUREMENTS:Nurse‐assessed mood or anhedonia (OASIS) versus research assessments using the Structured Clinical Interview for Axis IDiagnostic and Statistical Manual of Mental Disorders, Fourth EditionDisorders (SCID); referrals for mental health evaluation (agency records), and depression severity (24‐item Hamilton Depression Rating Scale; HDRS).

RESULTS:Referral rates for patients with (SCID) depressed mood or anhedonia (n=75) varied according to nurse group: 50.0% full intervention, 18.5% minimal, 21.4% control (P=.047). Rates for nondepressed patients (n=180) did not differ (4.9%, 2.0%, 5.8%, respectively;P=.60). In patients with major or minor depression (n=37), referral was associated with symptom improvement. Change in HDRS was 5 points greater in referred patients than others (P=.04). Concordance between OASIS and SCID did not differ between intervention groups.

CONCLUSION:TRIAD showed that training nurses to assess for depression using an approach developed in partnership with home healthcare agencies led to appropriate referral and care for depressed patients.
Bath Aids and the Subsequent Development of Bathing Disability in Community‐Living Older Persons
Authors: Gill Thomas M. , Han Ling , Allore Heather G.
Published: October 2007

OBJECTIVES: To determine whether the availability of bath aids may forestall the subsequent development of bathing disability.

DESIGN: Prospective cohort study.

SETTING: Greater New Haven, Connecticut.

PARTICIPANTS: Five hundred one nondisabled (required no personal assistance in bathing) community‐living residents aged 73 and older.

MEASUREMENTS: The availability of five bath aids (grab bars, bath seat, nonskid mat or abrasive strips, handheld shower spray, and long‐handled brush or sponge) was ascertained during a comprehensive home‐based assessment. Subsequently, participants were followed with monthly telephone interviews to determine the onset of persistent (i.e., present for at least 2 consecutive months) disability in bathing and were evaluated for disability in three bathing subtasks (bathing transfers, washing whole body, and drying whole body) during the next home‐based assessment, which was completed 18 months after the initial assessment.

RESULTS: The presence of a bath seat was associated with a greater likelihood of developing persistent disability in bathing and disability in each of the three bathing subtasks, although these associations were not statistically significant after adjustment for potential confounders. Nonsignificantly greater risk was also observed for grab bars, handheld shower spray, and long‐handled brush or sponge. In the adjusted analysis, the presence of nonskid mats or abrasive strips was associated with a 23% lower risk (nonsignificant) of persistent bathing disability and a lower likelihood of developing disability in washing and drying one's whole body, with corresponding odds ratios of 0.28 (P=.003) and 0.38 (P=.030), respectively.

CONCLUSION: In this longitudinal study, the presence of bath aids, with the exception of nonskid mats or abrasive strips, did not forestall the subsequent development of bathing disability. Because it may not be possible to fully account for the effects of self‐selection, clinical trials may be necessary to demonstrate the potential value of bath aids in community‐living older persons.
Capital, Trade, and the Political Economies of Reform
Authors: Brooks Sarah M. , Kurtz Marcus J.
Published: October 2007

Existing approaches to the study of economic reform have focused on the mobilization of special interests that oppose liberalization and have tended to assume that reform dynamics follow a similar logic across distinct policy arenas. Analysis of the dynamics of capital account and trade liberalization in 19 Latin American countries between 1985 and 1999 demonstrates otherwise. Movement toward liberalization is shaped systematically by the timing and salience of each reform's distributional costs and partisan political dynamics. In turn, the timing and magnitude of costs are mediated by the economic context, while salience depends on the informational environment. Our findings thus differ from the conventional wisdom on several scores, particularly by emphasizing the ways in which good rather than bad economic conditions can facilitate reforms, the conditionality of legislative politics of reform enactment on whether reforms are characterized by ex ante conflict or fears of ex post blame, and how the type of reform shapes its political dynamics.
The Armed Peace: A Punctuated Equilibrium Theory of War
Authors: Leventoğlu Bahar , Slantchev Branislav L.
Published: October 2007

According to a leading rationalist explanation, war can break out when a large, rapid shift of power causes a credible commitment problem. This mechanism does not specify how inefficient fighting can resolve this cause, so it is an incomplete explanation of war. We present a complete information model of war as a sequence of battles and show that although opportunities for a negotiated settlement arise throughout, the very desirability of peace creates a commitment problem that undermines its likelihood. Because players have incentives to settle as soon as possible, they cannot credibly threaten to fight long enough if an opponent launches a surprise attack. This decreases the expected duration and costs of war and causes mutual deterrence to fail. Fighting's destructiveness improves the credibility of these threats by decreasing the benefits from continuing the war and can eventually lead to peace. In equilibrium players can only terminate war at specific windows of opportunity and fighting results in escalating costs that can leave both players worse off at the time peace is negotiated than a full concession would have before the war began.
The Turnover Trap: New Leaders, Reputation, and International Conflict
Authors: Wolford Scott
Published: October 2007

A formal model of crisis bargaining in the shadow of leadership turnover is analyzed where (1) successive leaders of the same state may differ in their resolve, (2) their resolve is private information, and (3) the probability of leadership turnover depends on bargaining behavior and conflict outcomes. The model provides novel answers to a number of questions about the relationship between an incumbent's time in office, the prospects of losing office, the anticipated behavior of future leaders, and the current probability of conflict. Taken together, these results add further weight to recent claims that leaders, not states, should be considered the fundamental units of analysis in international relations.
Bribing Voters
Authors: Dal Bó Ernesto
Published: October 2007

We present a model of influence over collective decisions made through voting. We show how an outside party offering incentives to a committee can manipulate the committee's decisions at no cost and induce inefficient outcomes. A key condition is that the outsider be able to reward decisive votes differently. Inefficiency results from voting externalities. We relax all initial assumptions to investigate how to insulate committees. We study different information settings, credibility assumptions, payoff structures (voters caring about the collective decision and about their own votes), and incentive schemes (offers contingent on pivotal votes, individual votes, vote shares, and the collective decision). We analyze when voting should be made secret; we elucidate the role of individual accountability and various political institutions in preventing vote buying. We discuss implications for lobbying, for clientelism, for decisions in legislatures, boards, and central banks, and for the efficiency of democracy.
Generation, Age, and Time: The Dynamics of Political Learning during Russia's Transformation
Authors: Mishler William , Rose Richard
Published: October 2007

When the Soviet Union collapsed, most Russians had lived their entire lives in a quintessentially authoritarian culture. Having been socialized in this environment, how could citizens acquire the attitudes and behaviors necessary to support a new, more pluralistic regime? Cultural theories of political learning emphasize the primacy of childhood socialization and hold that altering initial attitudes is a decades‐long process that depends on generational replacement. Institutional theories emphasize adult relearning in response to changing circumstances regardless of socialization. Lifetime learning integrates the competing perspectives. Multilevel models using New Russia Barometer data from 1992 to 2005 confirm the persistence of some generational differences in Russian political attitudes but demonstrate even larger effects resulting from adult relearning. Lifetime learning provides the most comprehensive account and suggests that Russians would quickly acquire the attitudes and behaviors appropriate to democracy—if Russian elites supply more authentic democratic institutions.
Regulatory Errors with Endogenous Agendas
Authors: Carpenter Daniel , Ting Michael M.
Published: October 2007

How do a regulator's decisions depend on the characteristics and strategies of its external clients? We develop a theory of approval regulation in which an uninformed regulator may veto the submission of a better‐informed firm. The firm can perform publicly observable experiments to generate product information prior to submission. We find that when experimentation is short, Type I errors (approving bad products) are more likely for products submitted by firms with lower experimentation costs (larger firms), while Type II errors (rejecting good products) should be concentrated among smaller firms. These comparative statics are reversed when experimentation is long. We perform a statistical analysis on FDA approvals of new pharmaceutical products using two different measures of Type I error. We find consistent support for the counterintuitive hypothesis that, under particular conditions, errors are decreasing in the size of the firm submitting the product.
Agenda Control, the Median Justice, and the Majority Opinion on the U.S. Supreme Court
Authors: Bonneau Chris W. , Hammond Thomas H. , Maltzman Forrest , Wahlbeck Paul J.
Published: October 2007

Some scholars argue that the author of the majority opinion exercises the most influence over the Court's opinion‐writing process and so can determine what becomes Court policy, at least within the limits of what some Court majority finds acceptable. Other students of the Court have suggested that the Court's median justice effectively dictates the content of the majority opinion: whatever policy the median justice most wants, she can get. We test these competing models with data on Supreme Court decision making during the Burger Court (1969–86). While we find substantial evidence for both models, the agenda control model gains greater support. This suggests that opinions on the Court on each case are driven, in general, by the interaction of three key variables: the policy preferences of the majority opinion author, the policy preferences of the median justice, and the location of the legal status quo.
Present but Not Accounted For? Gender Differences in Civic Resource Acquisition
Authors: Djupe Paul A. , Sokhey Anand E. , Gilbert Christopher P.
Published: October 2007

We investigate the sources of an important form of social inequality: the social processes by which men and women acquire participatory resources in organizations. In particular, we investigate the extent to which men and women acquire civic skills and are targets for political recruitment within churches. Integrating theory about social interaction within an organizational structure, we hypothesize that the ways in which women gain politically relevant resources from the church are simply different from those of men. Three factors explain the institutional treatment of women in churches: (1) women's political contributions are devalued; (2) women respond to social cues more than men do; (3) women respond to political cues from clergy—especially female clergy—whereas men do not. Our findings of gender differences in civic resource acquisition provide a more nuanced treatment of the mobilization process and have broad implications for the relationship between political difference and participatory democracy.
Leading by Example: Female Members of Parliament as Political Role Models
Authors: Wolbrecht Christina , Campbell David E.
Published: October 2007

One argument advanced in favor of descriptive representation is that female politicians serve as role models, inspiring other women to political activity. While previous research finds female role models affect women's psychological engagement, few studies report an impact on women's active participation, and none have done so in cross‐national research. Our work also is the first to consider whether the impact of female role models is, as the term implies, greater among the young. Using three cross‐national datasets, we find that where there are more female members of parliament (MPs), adolescent girls are more likely to discuss politics with friends and to intend to participate in politics as adults, and adult women are more likely to discuss and participate in politics. The presence of female MPs registers the same effect on political discussion regardless of age, but the impact on women's political activity is far greater among the young than the old.
Identifying the Persuasive Effects of Presidential Advertising
Authors: Huber Gregory A. , Arceneaux Kevin
Published: October 2007

Do presidential campaign advertisements mobilize, inform, or persuade citizens? To answer this question we exploit a natural experiment, the accidental treatment of some individuals living in nonbattleground states during the 2000 presidential election to either high levels or one‐sided barrages of campaign advertisements simply because they resided in a media market adjoining a competitive state. We isolate the effects of advertising by matching records of locally broadcast presidential advertising with the opinions of National Annenberg Election Survey respondents living in these uncontested states. This approach remedies the observed correlation between advertising and both other campaign activities and previous election outcomes. In contrast to previous research, we find little evidence that citizens are mobilized by or learn from presidential advertisements, but strong evidence that they are persuaded by them. We also consider the causal mechanisms that facilitate persuasion and investigate whether some individuals are more susceptible to persuasion than others.
Unanimity, Discord, and the Communication of Public Opinion
Authors: Huckfeldt Robert
Published: October 2007

This article is concerned with the political communication of opinion that occurs through networks of associated citizens. Its primary attention focuses on opinion variance within populations and networks and how such variance affects communication among and between individuals. Particularly in the context of ambiguous or infrequent communication, people may experience difficulty in forming judgments regarding the opinions of others. In such situations, environmental priors become useful devices for reaching these judgments, but a problem arises related to the utility of these environmental priors when discord rather than unanimity characterizes the contextual distribution of opinion. The article's argument is that dyadic discussions between two citizens are most enlightening, and environmental priors least enlightening, when surrounding opinion is marked by higher levels of disagreement. The analyses are based on data taken from the 1996 Indianapolis‐St. Louis study.
Persuasion and Resistance: Race and the Death Penalty in America
Authors: Peffley Mark , Hurwitz Jon
Published: October 2007

Although there exists a large and well‐documented “race gap” between whites and blacks in their support for the death penalty, we know relatively little about the nature of these differences and how the races respond to various arguments against the penalty. To explore such differences, we embedded an experiment in a national survey in which respondents are randomly assigned to one of several argument conditions. We find that African Americans are more responsive to argument frames that are both racial (i.e., the death penalty is unfair because most of the people who are executed are black) and nonracial (i.e., too many innocent people are being executed) than are whites, who are highly resistant to persuasion and, in the case of the racial argument, actually become more supportive of the death penalty upon learning that it discriminates against blacks. These interracial differences in response to the framing of arguments against the death penalty can be explained, in part, by the degree to which people attribute the causes of black criminality to either dispositional or systemic forces (i.e., the racial biases of the criminal justice system).
Beyond Dialogue: The Role of Science Within Theology
Authors: Simmons Ernest L.
Published: October 2007

Abstract:  The purpose of this article is to provide background overview and contemporary context for the theme of this issue of Dialog, the role of science within theology. Over the last fifty years, this role has primarily involved dialogue and the drive to mutual understanding. That discussion has now reached a new stage seeking to move beyond dialogue toward what some are referring to as hypothetical consonance. One of the most serious constructive proposals moving beyond dialogue is Creative Mutual Interaction (CMI), proposed by Robert John Russell. The first five ways he discusses in CMI specifically address the role of science in theological reflection. It is argued that these five ways will assist the reader in contextualing the discussion found in the articles in this issue. Elaboration of each way is given, concluding with a constructive theological example of the heuristic use of scientific concepts found in quantum field theory.
Five Key Topics on the Frontier of Theology and Science Today
Authors: Russell Robert John
Published: October 2007

Abstract:  This article explores the creative mutual interaction between Christian theology and the natural sciences through five key issues: (1) the relation between creation ex nihilo and Big Bang cosmology; (2) biological evolution and continuous creation; (3) the search for non‐interventionist objective divine action in light of physics and biology; (4) the problem of suffering in nature and with it the turn to redemption theology via the bodily Resurrection of Jesus; and (5) the challenge raised for its eschatological implications by scientific predictions for the future of the universe. The article concludes with a brief suggestion for the ways Christian theology, reformulated in light of these sciences, might offer creative suggestions for future scientific research, and, in doing so, complete the loop promised by the phrase “mutual creative interaction.”
Science and Constraint: The Role of Science within Theology
Authors: Hallanger Nathan J.
Published: October 2007

Abstract:  The conversation between theology and science has accomplished much, yet the question of how to determine the limits of such dialogue—and whether there are limits at all—remains open. Key questions involve the degree to which science should constrain theology and the manner in which theology can influence science. Arthur Peacocke and Robert J. Russell provide sample methods by which theology can engage science. Peacocke's method emphasizes the influence of science on theology, while Russell's focuses on theology's influence on science. Both emphases will be required for theology's continued engagement with science.
Reforming Theology, Reframing Science
Authors: Pederson Ann Milliken , Hefner Philip
Published: October 2007

Abstract:  What is the role of science in theology? What internal dynamics compel theology to take science seriously? Those are the questions—posed in a characteristically cautious academic fashion. There is a back‐story that needs to be told, however, if we are to get at these questions with the vigor they require: Without radical reformation of theology, there is little chance that we can even begin to work on the agenda that science poses to Christian faith and life. Faith is a journey in which we seek to make sense of the world and our lives in it in the light of the gospel we have received. The gospel is about God, God's presence and redemptive work in Jesus Christ and God's continuing presence in the Holy Spirit. But since it is God's presence and work in the world and for us, the gospel is also about the world and about human being—and that is where science comes in, provoking its reformation. Science is now an irreplaceable source of knowledge about the world and ourselves, and in some respects its knowledge is normative. Scientific knowledge has reshaped our view of the world and ourselves in ways that are so commonly known that it is unnecessary to elaborate. To relate our gospel to our actual lives in the empirical world—that is theology's motivation for taking science seriously. But theology must be reformed and reshaped if it is to be capable of taking science seriously. In this essay we focus on this reforming of theology.
Natures, Human Nature, Genes and Souls: Reclaiming Theological Anthropology Through Biological Structuralism
Authors: Moritz Joshua M.
Published: October 2007

Abstract:  Within the field of Theology and Science, discussions regarding the relationship between biology and theological anthropology have tended to focus on the themes of ‘human uniqueness’ and ‘human nature’. These ideas have continued among theologians and anthropologists despite the widespread agreement among neo‐Darwinian evolutionary biologists that such general or universal accounts of ‘natures’ in general, or ‘human nature’ in particular, have no proper place within the neo‐Darwinian evolutionary framework. In view of this neo‐Darwinian rejection of universal human nature and the subsequent undermining of theological anthropologies based on such, Biological Structuralism is proposed as an alternative theoretical framework through which to construct a theological anthropology in light of evolution. Within the Structuralist framework scientific resources are provided which facilitate fresh perspectives on ancient theological discussions regarding the nature of the soul and the place of nonhuman animals within theological anthropology.
“The End of Faith?” Science and Theology as Process
Authors: Herzfeld Noreen
Published: October 2007

Abstract:  A spate of recent books would claim that science's only role vis a vis theology is to discredit it. Sam Harris, in The End of Faith, credits religious faith as the source of much of the violence in today's world. Richard Dawkins, in The God Delusion, views religion as, at best, a profound misunderstanding, and at worst a form of madness. Both find an antidote to such irrationality in science. To Harris and Dawkins religion is a body of accumulated knowledge. However, religion can also be thought of as a process, one based on experience, questions, and results. One group that has systematized such a process is the Society of Friends, or Quakers. The Quaker tradition shows that it is quite possible for religion to rest on experience and questioning, and for these to form the basis for an active and involved faith, one that need never reject science and its findings, but will temper their use with the best wisdom that can be gained from personal and communal experience.
Religion and Science: What Is at Stake?
Authors: Lorenzen Lynne
Published: October 2007

Abstract:  “Religion and Science: What Is at Stake” looks at the latest information available on global warming from the International Panel on Climate Change and puts it in the context of the current culture war between progressives and conservatives. We worry that the science will become captive to ideological concerns that are theological, economic, and therefore political. The ideological domination of science may make a sustainable response to global warming even more difficult. It is vitally important that Christian theologians learn enough about the science to be articulate and support the scientists in their endeavors to promote our care of the creation.
Do the Left Atrial Substrate Properties Correlate with the Left Atrial Mechanical Function? A Novel Insight from the Electromechanical Study in Patients with Atrial Fibrillation
Authors: SUNG SHIH‐HSIEN , CHANG SHIH‐LIN , HSU TSUI‐LIEH , YU WEN‐CHUNG , TAI CHING‐TAI , LIN YENN‐JIANG , LO LI‐WEI , WONGCHAROEN WANWARANG , TUAN TA‐CHUAN , HU YU‐FENG , UDYAVAR AMEYA , CHEN SHIH‐ANN
Published: October 2007

Background: The atrial substrate is the determinant of occurrence and maintenance of atrial fibrillation (AF), which can induce remodeling of atrial function and structure. This study investigated the relationship between the left atrial (LA) substrate properties and LA mechanical function.

Methods: Forty‐four consecutive patients (50.3 ± 10.7 years old, 33 men) who presented with sinus rhythm during echocardiographic study before receiving catheter ablation for AF were enrolled. The LA diameter, LA volume, ratio of early and late transmitral filling flow velocities (E/A), LA appendage flow velocity, and transmitral velocity‐time integral (VTI) were measured by the echocardiography. The LA empty fraction (LAEF), which was obtained via dividing the difference between maximal and minimal LA volume by maximal LA volume, was calculated as a parameter of the global LA contractile function. The LA global contact voltage mapping (NavX system) was performed before pulmonary vein isolation.

Results: Mean LA voltage and LA low voltage zone index (LVZ index, area with voltage < 0.5 mV, divided by total LA surface area) showed significant correlation with LA diameter and volume, but only the LA LVZ index showed significant correlation with A‐wave velocity, transmitral A‐wave VTI, and LAEF (r =–0.340, –0.411, –0.426; P = 0.024, 0.006, 0.005, respectively). We divided the LA LVZ index into three groups (< 10%, 10–20%, > 20%). The LAEF got worse and the transmitral A‐wave VTI percentage (divided by transmitral VTI) decreased as LA LVZ index increased.

Conclusions: The LA substrate properties showed close correlation with LA size, but only the LA LVZ index correlated with the LA mechanical function.
Electrocardiographic Optimization of Interventricular Delay in Cardiac Resynchronization Therapy: A Simple Method to Optimize the Device
Authors: VIDAL BÀRBARA , TAMBORERO DAVID , MONT LLUIS , SITGES MARTA , DELGADO VICTORIA , BERRUEZO ANTONIO , DÍAZ‐INFANTE ERNESTO , TOLOSANA JOSE M. , PARÉ CARLES , BRUGADA JOSEP
Published: October 2007

Introduction: Echocardiography is widely used to optimize CRT programming, but it is time‐consuming. This study aimed to correlate the optimal interventricular pacing (V‐V) interval obtained by echo with the optimal V‐V interval obtained by a simpler method based on the surface ECG.

Methods and Results: Three V‐V intervals were tested: LV preactivation at –30 ms, simultaneous biventricular pacing (0 ms), and RV preactivation at +30 ms. The one that achieved the best LV synchrony was chosen as the optimal V‐V. This result was then compared with two different ECG measurements. The first ECG method considered the best V‐V to be that which achieved the narrowest QRS. The second V‐V method consisted in measuring the interval from the pacing spike to the beginning of the fast deflexion of the QRS complex in leads V1, V2, first pacing from the LV (T1), and after from the RV (T2). The T2‐T1 interval was considered as a surrogate measurement of interventricular delay and defined as the best V‐V. A cohort of 31 consecutive patients treated with CRT was studied. Optimal V‐V interval obtained by echo was –30 ms in 25 patients (80%), +30 ms in three patients (10%), and 0 ms in the remaining three patients (10%). Echo results had 32% coincidence with the first ECG method (r = 0.2, P = NS) and 83% coincidence with the second ECG method (r = 0.81 P< 0.001).

Conclusions: The time difference in the fast ventricular depolarization observed between RV and LV stimulation in the surface ECG shows a good correlation with the V‐V optimization chosen according to echo.
High Diagnostic Yield and Accuracy of History, Physical Examination, and ECG in Patients with Transient Loss of Consciousness in FAST: The Fainting Assessment Study
Authors: VAN DIJK NYNKE , BOER KIMBERLY R. , COLMAN NANCY , BAKKER ANNEMIEKE , STAM JAN , VAN GRIEKEN JOHANNES J.M. , WILDE ARTHUR A.M. , LINZER MARK , REITSMA JOHANNES B. , WIELING WOUTER
Published: October 2007

Background: Transient loss of consciousness (TLOC) is a common clinical problem.

Objective: The aim of this study was to assess the yield and accuracy of the initial evaluation, consisting of standardized history, physical examination, and ECG performed by attending physicians in patients with TLOC.

Methods and Results: Five hundred and three adult patients (mean age 53 ± 19; 56% male) presenting with TLOC to the Academic Medical Center Amsterdam between February 2000 and May 2002 were included in this study. After initial evaluation, the physician made a certain, a highly likely (>80% certain), or no initial diagnosis. Initially undiagnosed patients received additional cardiological testing, additional history taking, and autonomic function tests. After 2 years of follow‐up, an expert committee determined the final diagnoses.

Two‐year follow‐up was obtained in 99% of the patients. The yield of certain diagnoses after the initial evaluation was 24%, increasing to 63% after including the highly likely diagnoses. The diagnostic accuracy of the initial certain diagnoses was 93% (95% CI 87–97%), decreasing to 88% (95% CI 84–91%) after inclusion of the initial highly likely diagnoses.

Conclusion: Attending physicians can make a diagnosis based on initial evaluation in 63% of patients with TLOC, with an overall diagnostic accuracy of 88%. The use of additional testing, beyond history, physical examination, and ECG can be avoided in many patients with TLOC.
The Experiences of Bystanders of Workplace Ethnic Harassment
Authors: Low K. S. Douglas , Radhakrishnan Phanikiran , Schneider Kimberly T. , Rounds James
Published: October 2007

The present research examined the experiences of individuals who witnessed or knew about ethnic harassment of their coworkers. Through 3 studies, we found that knowledge of other people's harassment was differentiated from personal experiences as a target and was associated with deleterious occupational, health‐related, and psychological consequences beyond those accounted for by direct harassment and affective disposition. Ethnicity and gender did not moderate these relationships. Knowledge of others' ethnic harassment can therefore be construed as bystander harassment. Results also indicated that bystander and direct harassment were relatively common occurrences. Both harassment types contributed to how ethnic conflict is experienced. The consequences of ethnic harassment are not restricted to ethnic minority employees. Rather, everyone is at risk from such behaviors.
Advance Directives: Assessing Stage of Change and Decisional Balance in a Community‐Based Educational Program
Authors: Medvene Louis J. , Base Michelle , Patrick Renée , Wescott JoVeta
Published: October 2007

This study assessed the applicability of the transtheoretical model (TTM) to completing/revising advance directives (ADs). Participants in a community‐based educational program completed pre‐ and post‐program questionnaires concerning the completing/revising of ADs. Multiple‐item scales were constructed to categorize participants into a stage of change: precontemplation (8%), contemplation (44%), preparation (4%), action (22%), and maintenance (19%). A decisional balance scale was constructed using 5 positive and 5 negative perceptions of ADs. The findings provided support for the applicability of the TTM to completing/revising ADs. The cons outweighed the pros among participants in the precontemplation stage, while the pros outweighed the cons among those in the action stage. One pro was that an AD would relieve family members of decision‐making burdens.
Psychological Crisis in a Marathon and the Buffering Effects of Self‐Verbalizations1
Authors: Schüler Julia , Langens Thomas A.
Published: October 2007

In the present study, we investigated the effects of psychological crises on goal striving and the buffering effects of self‐verbalizations in the context of a marathon race. Study 1 showed that during a marathon, a psychological crisis—which is characterized by a strong impulse of goal disengagement and thoughts about benefits and costs—occurred at about Kilometer 30 and that this crisis had negative effects on race performance. Study 2 experimentally induced the use of self‐verbalizations. The results confirmed the hypothesis that self‐verbalizations are an effective strategy to buffer against negative effects of psychological crisis on race performance. Self‐verbalizations are discussed as a general self‐regulatory tool in goal striving.
In the Eyes of the Beholder: Personality and the Perception of Leadership1
Authors: Schyns Birgit , Sanders Karin
Published: October 2007

This series of studies focuses on the extent to which the personality of followers is related to their perception of transformational leadership. Followers from 3 different companies and students from a Dutch university were questioned on their personality characteristics and their perception of a described leader (students) or the perception of their actual leader (employees). Although the results differ for the different samples, we found a relationship between followers' personality and the perception of transformational leadership for all of the different samples. The different relationship that we found may hint to the impact of context on the relationship between personality and the perception of leadership. In the discussion, we explain our results in light of these different contexts.
Real Donors, Real Consent: Testing the Theory of Reasoned Action on Organ Donor Consent
Authors: Weber Keith , Martin Matthew M. , Corrigan Michael ,   Members of COMM 160
Published: October 2007

In an attempt to apply the theory of reasoned action (TRA) to the process underlying organ donor consent, participants completed questionnaires concerning their affective responses to organ donation, as well as their intentions to donate. Participants were given the opportunity to sign an organ donor card. Those who chose to sign the card had more positive attitudes about donation, perceived donation as something that their reference group would encourage, and had stronger intentions to consent to signing a card. The current investigation extends the organ donor literature by using a true behavioral outcome measure indicating consent. Moreover, the pattern of results between attitudes, norms, intention, and behavior illustrates the usefulness of applying the TRA to yet another health‐related behavior.
Diversity, Merit, Fairness, and Discrimination Beliefs as Predictors of Support for Affirmative‐Action Policy Actions1
Authors: Aberson Christopher L.
Published: October 2007

This paper explores support for hiring policies associated with affirmative action (AA) using a model including beliefs regarding the fairness of AA, merit, value of diversity, prevalence of discrimination, personal self‐interest, and demographic characteristics. Participants (n = 212) evaluated 8 hiring policies ranging from the use of strong preferential treatment to race‐blind policies. Beliefs affected support for policies differently. For example, diversity valuation predicted support for policies involving preferences and recruitment, but predicted opposition to race‐blind approaches, whereas support for the merit principle predicted opposition to preferences and support for race‐blind approaches. Results suggest that established predictors of attitudes toward AA do not necessarily predict support for specific forms of AA.
Interaction of anaesthetic drugs and UV‐B irradiation in the anterior segment of the rat eye
Authors: Zhang Fengju , Löfgren Stefan , Söderberg Per G.
Published: October 2007

Purpose:  To determine the impact of anaesthesia on acute transient cataractogenesis and ultraviolet radiation (UVR)‐induced cataractogenesis.

Methods:  Sprague‐Dawley rats were anaesthetized with pentobarbital, which caused almost full eyelid closure, or xylazine/ketamine, which caused eyelid retraction and proptosis. The eyelids of one eye were kept open with either a suture or adhesive tape, or both. The other eye was kept closed with either a suture or tape. Cataract was graded clinically and quantified in vitro as intensity of forward light scattering. In two UVR experiments, anaesthetized rats were irradiated unilaterally with 5 kJ/m2 UVR‐B 300 nm for 15 mins. The difference between the two UVR experiments was the degree of proptosis in the pentobarbital group. Corneal drying was judged clinically with a grading scale.

Results:  Within 60 mins of anaesthesia induction in the first experiment, almost all lenses in open eyes developed cataract, whereas all lenses in closed eyes remained clear. In the first UVR experiment the lens light scattering was significantly higher in the xylazine/ketamine group. In the second UVR experiment the pentobarbital group was treated to achieve proptosis similar to that in the xylazine/ketamine group, which led to a smaller difference in lens light scattering between the two anaesthesia groups. Lens light scattering in the pentobarbital groups was significantly higher with forced proptosis than without prominent proptosis.

Conclusions:  Xylazine/ketamine anaesthesia facilitates the development of UVR‐induced cataract, whereas pentobarbital anaesthesia does not. Xylazine/ketamine anaesthesia induces more proptosis and therefore leads to increased exposure of the cornea and, secondarily, the lens.
Jamming of 25‐gauge instruments in the cannula during vitrectomy for vitreous haemorrhage
Authors: Shinoda Hajime , Nakajima Takeshi , Shinoda Kei , Suzuki Kotaro , Ishida Susumu , Inoue Makoto
Published: October 2007

Purpose:  To report the jamming of 25‐gauge instruments in the cannula during vitreous surgery for non‐clearing vitreous haemorrhage.

Methods:  Forty‐five eyes underwent vitrectomy with 25‐gauge instruments for non‐clearing vitreous haemorrhage (VH group). The incidence of 25‐gauge instruments jamming in the cannula was determined retrospectively and compared with that in 112 eyes that underwent vitrectomy for epiretinal membrane (ERM group), also using 25‐gauge instruments.

Results:  The 25‐gauge vitreous cutter or light pipe became jammed in the cannula in three eyes (7%) in the VH group and the instrument locked inside the cannula had to be removed with the cannula. None of the 25‐gauge instruments in the ERM group jammed (p = 0.022, Fisher's exact probability test). Two of three eyes developed giant retinal breaks near the sclerotomy but no retinal break related to the sclerotomy was detected in the ERM group. Examination of the cutter revealed blood trapped between the cutter and the cannula.

Conclusions:  Twenty‐five gauge instruments may become jammed in the cannula in eyes with non‐clearing vitreous haemorrhage. Clinicians should be aware of this surgical complication when 25‐gauge instruments are used in vitreous haemorrhage.
Resolution of macular oedema in occult choroidal neovascularization under oral Sorafenib®treatment
Authors: Kernt Marcus , Staehler Michael , Stief Christian , Kampik Anselm , Neubauer Aljoscha S.
Published: October 2007

Purpose: To report on the effect of oral nexavar (Sorafenib®) treatment in one patient with neovascular age‐related macular degeneration (AMD) and advanced renal cell cancer (RCC).

Methods: After two intravitreal injections of bevacizumab (1.25 mg) for occult choroidal neovascularization (CNV) in AMD, the patient was started on oral Sorafenib®(400 mg twice daily) treatment for RCC.

Results: Visual acuity (VA) was 20/80 in the left eye and optical coherence tomography (OCT) demonstrated persistent central thickening to 251 µm after bevacizumab. After 6 weeks of oral Sorafenib®treatment, VA had increased to 20/70 and a significant decrease in retinal thickness to 208 µm was observed on OCT. The patient remained stable during a further 3 months of follow‐up.

Conclusions: Resolution of macular oedema and stabilization of VA under oral treatment with the multikinase inhibitor Sorafenib®was observed. This observation warrants further investigation.
Soft‐shell technique using Viscoat® and Healon®5: a prospective, randomized comparison between a dispersive‐viscoadaptive and a dispersive‐cohesive soft‐shell technique
Authors: Sato Masaki , Sakata Chiho , Yabe Mikako , Oshika Tetsuro
Published: October 2007

Purpose:  To compare the efficacy of the dispersive‐viscoadaptive soft‐shell technique using Viscoat® and Healon®5 to the dispersive‐cohesive soft‐shell technique in reducing corneal endothelial cell damage during cataract surgery.

Methods:  In this prospective randomized study, 207 eyes of 171 cataract patients underwent phacoemulsification using the dispersive‐viscoadaptive soft‐shell technique (V‐group, 102 eyes) with Viscoat and Healon5 or the dispersive‐cohesive soft‐shell technique (C‐group, 105 eyes) with Viscoat and a cohesive agent (Opegan‐Hi®). Each group was divided into two subgroups depending on the amount of ultrasound (%Min) used during phacoemulsification. Corneal endothelial cell density was examined preoperatively and 3 months postoperatively. The endothelial cell loss was compared between the two groups, and also between the subgroups.

Results:  The mean endothelial cell loss 3 months after surgery was 8.4 ± 5.6% standard deviation (SD) in the V‐group and 8.2 ± 6.2% in the C‐group (P = 0.787). In the subgroups with ultrasound of 10 %Min or less, the mean endothelial cell loss 3 months after surgery was 6.6 ± 4.6% in the V‐group and 5.5 ± 5.0% in the C‐group (P = 0.104). In the subgroups with ultrasound of over 10 %Min, this value was 10.6 ± 6.3% in the V‐group and 11.9 ± 5.7% in the C‐group (P = 0.413). The correlation coefficient of the endothelial cell loss rate and %Min was 0.245 (P = 0.0129) in the V‐group and 0.501 (P < 0.0001) in the C‐group.

Conclusion:  The dispersive‐viscoadaptive soft‐shell technique is as effective as the dispersive‐cohesive soft‐shell technique in protecting corneal endothelial cells during phacoemulsification regardless of the amount of ultrasound energy used.
Comparison of triamcinolone acetonide, 11‐deoxycortisol and other lipid formulae for the visualization of vitreous body in the anterior chamber after posterior capsule rupture in animal models
Authors: Kaji Yuichi , Hiraoka Takahiro , Okamoto Fumiki , Asano Hiroki , Oshika Tetsuro
Published: October 2007

Purpose:  The efficacy and toxicity of triamcinolone acetonide and other lipid formulae – calcium palmitate, cholesterol and 11‐deoxycortisol –in the visualization of the prolapsed vitreous body in the anterior chamber after posterior capsule rupture were investigated in animal models.

Methods:  In porcine eyes, a suspension of calcium palmitate, cholesterol, triamcinolone acetonide and 11‐deoxycortisol was injected into the anterior chamber after intentionally creating posterior capsule rupture. Following gentle irrigation and aspiration, the vitreous body prolapsed in the anterior chamber was removed using an anterior vitrectomy cutter. In phakic rabbit eyes, the side‐effects of the reagents were assessed for biomicroscopic appearance, intraocular pressure (IOP) and corneal histology.

Results:  The suspension of calcium palmitate, cholesterol, triamcinolone acetonide and 11‐deoxycortisol was effective in the visualization of the vitreous body prolapsed in the anterior chamber after posterior capsule rupture. When cholesterol and calcium palmitate were injected into the anterior chamber, they remained there; this induced a significant increase in IOP and corneal oedema. In contrast, most of the triamcinolone acetonide and 11‐deoxycortisol that was injected into the anterior chamber had disappeared a day after the injection without affecting IOP or corneal endothelial density. When injected into the intravitreous cavity, triamcinolone led to a significant increase in IOP 2 and 4 weeks after the injection. However, calcium palmitate, cholesterol and 11‐deoxycortisol injected into the vitreous cavity had no effect on IOP at 4 weeks.

Conclusion:  The suspension of triamcinolone acetonide and 11‐deoxycortisol was effective in visualizing the vitreous body prolapsed in the anterior chamber after posterior capsule rupture. However, the amount of the reagent must be kept to a minimum to prevent the potential risk of ocular toxicities and postoperative late‐onset ocular hypertension.