bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultura, manejo del conflicto e identificación grupal en los grupos de trabajo
Authors: Reoyo Ana María
Published: June 2003

En este estudio se analiza la influencia de la cultura y de la identificación de los grupos de trabajo en los estilos de manejo del conflicto definidos por Thomas y Kilman (competición, colaboración, compromiso, evitación, conformidad). Los estudiantes universitarios trabajaron en tareas complejas durante 10 sesiones semanales. Combinando los resultados obtenidos en la escala de Triandis y en la escala de Hofstede, obtuvimos 4 estilos de cultura (individualista o colectivista con alta o baja distancia de poder). En el momento de la formación de los grupos, de los 225 sujetos, 178 pertenecían a culturas colectivistas y se sentían altamente identificados con su grupo y poco dispuestos a competir, mientras que los sujetos de las culturas individualistas (47) se sentían más competitivos que identificados con su grupo. Una vez que los grupos trabajaron en las tareas complejas, se produjo un incremento de sujetos en las culturas individualistas(113). El porcentaje de sujetos con alto nivel de colaboración fue mayor en la cultura individualista con baja distancia de poder que en la cultura colectivista con alta distancia de poder, lo que demuestra que no es necesaria una cultura colectivista para conseguir que los miembros de un grupo colaboren para la realización de una tarea.
Perfiles de grupalidad de unidades laborales en organizaciones burocráticas profesionales
Authors: Roca-Cortés Neus
Published: June 2003

Se analizan las condiciones de desarrollo de la grupalidad del trabajo en grupo en las organizaciones educativas como organizaciones de profesionales, estimándose una línea base más cercana al grupo difuso que al grupo maduro o equipo. Se usa la teoría del colectivo y el cuestionario sobre el desarrollo de la grupalidad. Se estudian los niveles de grupalidad y su dinámica en una muestra de 31 unidades laborales de centros educativos. Los resultados estiman un nivel medio de desarrollo grupal con una notable variabilidad. Se explora la presencia de factores estimulantes añadidos a las condiciones iniciales mostrándose significativos el tipo de tarea, la unidad de orientaciones valorativa y la presencia de identidad en el entorno. Se derivan criterios para el diagnóstico y desarrollo de equipos de trabajo que complementan la intervención grupal tecnológica.
La influencia de la inducción afectiva sobre el prejuicio racial
Authors: Torres Ramón Rodríguez
Published: June 2003

El objetivo de este trabajo es estudiar la influencia del afecto inducido sobre el prejuicio racial. Para ello se activó, mediante fotos, el estereotipo de la categoría racial «negros» y de «blancos». Posteriormente, se observó el efecto de esta activación en un test de evaluación de palabras que se presentó como una tarea no relacionada con lo anterior, y que los participantes debían responder en situaciones de inducción afectiva. 38 sujetos participaron en un diseño factorial de 2 × 2 × 3, con las dos primeras variables intragrupo (Priming: foto de blanco vs. negro, y Tipo de palabra: positiva vs. negativa) y una variable intergrupo (estado afectivo: positivo vs. negativo vs. neutro). La variabledependientefue el Tiempo de Reacción utilizadopor los sujetos para decidir la respuesta adecuada en cada asociación Priming (Foto)-palabra.

Los resultados muestran cómo el priming mediante fotos produjo un efecto sobre la respuesta de los participantes de modo que las fotos de los negros fueron asociadas más rápidamente a los estímulos negativos que a los positivos. Por otra parte, los sujetos a los que se indujo un estado afectivo negativo manifestaron mayor grado de prejuicio que los otros dos grupos experimentales. Los resultados son discutidos de acuerdo al modelo asociativo (Bower, 1981).
Permisos de salida para presos: ¿una cuestión jurídica o ideológica?
Authors: Sacau Ana María , Sobral Jorge
Published: June 2003

Trataremos de establecer la ideología sociolegal subyacente a toda decisión judicial como elemento explicativo de la discrepancia existente entre jueces de vigilancia penitenciaria y equipos técnicos penitenciarios a la hora de conceder un permiso de salida. Tomando la figura del psicólogo como elemento representativo de dichos equipos técnicos de los centros penitenciarios encargados de remitir al juez de vigilancia los informes sobre la conveniencia o no de la autorización de un permiso de salida, este estudio trata de comparar las distintas concepciones sociolegales de unos y otros, indagando la posibilidad de que tales creencias estén en la base de diferentes plataformas conceptuales desde las que se abordan las decisiones relativas a los permisos penitenciarios.
Aspectos psicosociales del turismo
Authors: Martín Jesús Emilio San
Published: June 2003

El objetivo de esta intervención es plantear la relación existente entre la psicología social y elfenómeno turístico, así como el modo en el que se defiende que debe producirse. Esto, se ejemplifica a través del estudio de la influencia del turismo en los participantes en la experiencia, turistas y residentes. En primer lugar, se trata la influencia del turismo en el cambio de actitud de los turistas; planteándose esta relación desde una óptica intergrupal, concretamente desde la teoría de la identidad social, se comprueba que el cambio de actitud resultante de una experiencia turística está mediado por la comparación social entre el grupo de turistas y el de los residentes. En segundo lugar se aborda la percepción social en el contexto turístico; a través de la actitud hacia el impacto turístico que desarrollan los residentes en destinos turísticos. Se observa como los residentes en zonas turísticas maduras suelen mostrar una actitud claramente positiva hacia el desarrollo turístico.
Responsabilidad del psicólogo en la acción social: ¿quién es el “cliente”?
Authors: Vidal Alipio Sánchez
Published: June 2003

La búsqueda de prestigio científico ha llevado la acción social (AS) a ignorar o menospreciar sus dimensiones valorativas. Esas dimensiones son particularmente importantes y complejas en una forma de acción globalizaday plural dirigida al cambio social y personal a través de la influencia externa. Núcleo temático central es la responsabilidad, cuya orientación (ante quién es responsable el psicólogo) se plantea y discute brevemente en este artículo.

Comunidad, grupo más vulnerable, gobierno y cliente nominal, son los destinatarios posibles según los campos y preferencias valorativas (elegir destinatario es cuestión esencial de justicia social). Es erróneo designar un destinatario único para todos los contextos y procesos interventivos: como escenario complejo en términos de actores, intereses y contextos, en la AS existen siempre varios destinatarios. Elegir un destinatarioprimario ni excluye responsabilidades hacia el resto ni exime de evaluar las particularidades de cada caso. Sí exige clarificar los valores implicados para poder jerarquizar los destinatariosposibles optimizando los criterios de vulnerabilidad (o injusticia relativa) y alcance o impacto social.
Ignorancia pluralista, atribución de causalidad y sesgos cognitivos en el caso
Authors: Ugarte Íñigo , Rodríguez Beatriz , Paz Pedro M. , Páez Darío , de Lucas Juncal
Published: June 2003

Las personas en ocasiones atribuyen una actitud mayoritaria al grupo falsamente, ya que éste en privado contesta de forma mayoritaria lo) contrario. De ahí el nombre de Ignorancia Pluralista: todos comparten pluralmente una visión falsa de la realidad, que al compartirlapermite que actitudes y conduct as abandonadas privadamente sigan subsistiendo. Una encuesta sobre la actitud personal y la actitud general hacia lo gitano llevada a cabo en el País Vasco (N=120) confirma esta ignorancia pluralista en relación al prejuicio antigitano. La ignorancia pluralista se asocia a la falsa unicidad o ilusión de control y la percepción que la mayoría tiene de forma homogénea la actitud percibida. También se confirma que la Ignorancia Pluralista produce un efecto de extrañamiento o sensación de desviación cultural. Sin embargo, ni la atribución de causalidad interna ni la inhibición de conductas pro-gitanas están relacionadas con la Ignorancia Pluralista.
Cloud Timescales and Orographic Precipitation
Authors: Jiang Qingfang , Smith Ronald B.
Published: June 2003

Orographic precipitation is studied by analyzing the sensitivity of numerical simulations to variations in mountain height, width, and wind speed. The emphasis is on upslope lifting over isolated mountains in cold climates. An attempt is made to capture the essential steady-state volume-averaged cloud physics in a pair of coupled nonlinear algebraic equations. To do this, single-pathway snow formation models are analyzed with both linear and nonlinear accretion formulations.

The linear model suggests that the precipitation efficiency is determined by three timescales—the advection timescale (τa), fallout timescale (τf), and a constant timescale for snow generation (τcs). Snow generation is controlled by the ratio of τcs/τa and the fraction of the snow that falls to the ground is controlled by the ratio of τf/τa.

Nonlinear terms, representing accretion, reduce the utility of the timescale concept by introducing a threshold or “bifurcation” point, that is, a critical condensation rate that separates two states: a precipitating state and a nonprecipitating state. If the condensation rate is below the threshold value, no snow is generated. As it surpasses the threshold value, the snow generation rate increases rapidly. The threshold point is a function of advection and fallout timescales, low-level water content, mountain height, and a collection factor, which is further dependent on the geometries, terminal velocity, and density of snow particles. An approximate formula for precipitation efficiency is given in closed form.
The Diurnal Cycle of Outgoing Longwave Radiation from Earth Radiation Budget Experiment Measurements
Authors: Smith G. Louis , Rutan David A.
Published: June 2003

The diurnal cycle of outgoing longwave radiation (OLR) from the earth is analyzed by decomposing satellite observations into a set of empirical orthogonal functions (EOFs). The observations are from the Earth Radiation Budget Experiment (ERBE) scanning radiometer aboard the Earth Radiation Budget Satellite, which had a precessing orbit with 57° inclination. The diurnal cycles of land and ocean differ considerably. The first EOF for land accounts for 73% to 85% of the variance, whereas the first EOF for ocean accounts for only 16% to 20% of the variance, depending on season. The diurnal cycle for land is surprisingly symmetric about local noon for the first EOF, which is approximately a half-sine during day and flat at night. The second EOF describes lead–lag effects due to surface heating and cloud formation. For the ocean, the first EOF and second EOF are similar to that of land, except for spring, when the first ocean EOF is a semidiurnal cycle and the second ocean EOF is the half-sine. The first EOF for land has a daytime peak of about 50 W m−2, whereas the first ocean EOF peaks at about 25 W m−2. The geographical and seasonal patterns of OLR diurnal cycle provide insights into the interaction of radiation with the atmosphere and surface and are useful for validating and upgrading circulation models.
The Seasonal Cycle of Interannual Variability and the Dynamical Imprint of the Seasonally Varying Mean State
Authors: Branstator Grant , Frederiksen Jorgen
Published: June 2003

Various aspects of the seasonal cycle of interannual variability of the observed 300-hPa streamfunction are documented and related to dynamical influences of the seasonality of the mean circulation. The stochastically excited nondivergent barotropic vorticity equation linearized about upper-tropospheric climatological mean states from each month of the year is used to identify characteristics of interannual variability that the seasonal cycle of the mean state should modulate. The result is interannual variability with (a) extratropical centers of variance that are much stronger in winter than summer and that are confined to midlatitudes during the warm season, (b) an annual cycle of preferred scales in midlatitudes with largest scales occurring during winter and a semiannual cycle of scales in the subtropics, and (c) streamfunction tendencies from interannual fluxes that adjust to the seasonally varying climatological eddies in such a way as to damp them. Because these same properties are also shown to exist in nature, it is concluded that the linear framework is a useful means of understanding the seasonality of interannual disturbances and that seasonality of the mean state leaves a pronounced imprint on interannual variability.

Analysis of an ensemble of general circulation model integrations indicates the signatures of seasonality produced in the stochastically driven linear framework are more useful for understanding intrinsic interannual variability than variability caused by seasonally varying sea surface temperature anomalies. Furthermore, it is found that the intrinsic variability of the GCM has properties very much like those in nature, another indication that organization resulting from anomalous forcing structure is not required for production of many aspects of the observed seasonality of interannual variability.
Transcultural Concepts in Nursing Care
Authors: Andrews Margaret M. , Boyle Joyceen S.
Published: June 2003

Margaret M. Andrews and Joyceen S. Boyle, coauthors of Transcultural Concepts in Nursing Care, provide a comprehensive framework for providing culturally competent nursing care for individuals, families, groups, communities, and institutions. The book is divided into four parts: Part 1 introduces the theoretical foundations of TCN and cultural competence. Part 2 uses a developmental approach in providing culturally competent care across the life span from infancy to old age. Part 3 examines the application of transcultural concepts in selected settings. Part 4 critically analyzes contemporary TCN challenges related to nutrition, pain, religion, ethics, the multicultural health care workforce, and international nursing. Transcultural Concepts in Nursing Care has received the American Journal of Nursing Book of the Year Award and Sigma Theta Tau International’s Best Pick Award.
The Giger and Davidhizar Transcultural Assessment Model
Authors: Giger Joyce Newman , Davidhizar Ruth
Published: June 2003

The Giger and Davidhizar Transcultural Assessment Model was developed in 1988 in response to the need for nursing students in an undergraduate program to assess and provide care for patients that were culturally diverse. The model includes six cultural phenomena: communication, time, space, social organization, environmental control, and biological variations. These provide a framework for patient assessment and from which culturally sensitive care can be designed.
Cultural Diversity in Health and Illness
Authors: Spector Rachel E.
Published: June 2003

The purpose of this article is to describe the theoretical models that underlie the book Cultural Diversity in Health and Illness. The book’s internal structure; functional structure; conceptual relationships; scope; knowledge antecedents; applications to theory, research, and practice; and areas for further development are discussed.
Caregiving between Two Cultures: An Integrative Experience
Authors: Jones Patricia S. , Zhang Xinwei Esther , Jaceldo-Siegl Karen , Meleis Afaf I.
Published: June 2003

In 1995, more than half of elderly immigrants to the United States were born in Asia or the Pacific region. The purpose of this study was to describe the process of caring for elderly parents by Asian American women. Forty-one women (22 Chinese American and 19 Filipino American) caring for elderly parents were interviewed in a study based on Strauss and Corbin’s grounded theory methodology (1990). Although the women were moderately acculturated, indications of being in transition were evident. Analysis of interview data led to development of a substantive theory of caregiving between two cultures, reflecting the paradox of living and caregiving by two sets of standards and worldviews. The primary strategies used to manage the caregiving challenges were connecting and calibrating. Through personal growth and finding meaning, the caregivers integrated the caregiver role into their lives and became more connected with their families and within themselves.
Health Perceptions of Mexican American Women
Authors: Mendelson Cindy
Published: June 2003

This article describes the health perceptions of a sample of moderately to highly acculturated Mexican American women. Using an ethnographic design, the author interviewed 13 women to determine their health perceptions. The interviews were guided by the domains of health described in the World Health Organization (WHO) definition of health. Three broad categories of health perceptions were identified: the physical body, the emotional component, and finding balance. With the addition of a spiritual component, the WHO definition was a useful tool for uncovering health perceptions. The process of in-depth ethnographic interviewing provided a contextual view of health in which the complexity of intrafamilial relationships was revealed, as were the importance of spirituality as a coping mechanism and the perception of health as an integrated, holistic experience.
A Cross-Cultural Comparison of Family Resiliency in Hemodialysis Patients
Authors: White Nancy , Richter Judy , Koeckeritz Jane , Lee Youngae , Munch Kristy L.
Published: June 2003

The purpose of this descriptive comparative survey was to examine differences in family resiliency between hemo-dialysis patients and caregivers across three ethnically diverse samples that included Anglo-Americans, Mexican Americans, and South Koreans. The study was based on the Family Resiliency Model developed by McCubbin, Thompson, and McCubbin. The patients were in end-stage renal disease and were receiving hemodialysis treatments at either a freestanding hemodialysis unit or a 30-bed dialysis hospital unit. South Korean patients on hemodialysis and their caregivers perceived the stressors imposed by their illness to be significantly greater than either of the other ethnic groups, and they also scored lower on the resiliency measure than the other two groups. Findings of the study support the need to understand the dynamics of family resiliency from a cultural perspective.
Exhaled nitric oxide during acute changes of airways calibre in asthma
Authors: Garnier P , Fajac I , Dessanges JF , Dall'Ava-Santucci J , Lockhart A , Dinh-Xuan AT
Published: June 2003

It has been shown that endogenous nitric oxide (NO), measured in exhaled air, is increased in asthmatic subjects and after allergen challenge in sensitized animals. NO is also a paracrine molecule with some, though weak, bronchodilator effects. However, whether the amount of endogenous NO that originates in the lungs can reflect the degree of bronchial tone and airways calibre in asthmatic subjects has not yet been investigated. The aim of this study was, therefore, to determine whether NO production could be modified by acute changes of airways calibre in mild, nonatopic, asthmatic subjects. NO output was measured in the exhaled air of 14 steroid-free asthmatics, 8 steroid-treated asthmatics and 21 control subjects. In seven steroid-free asthmatics, exhaled NO was measured after methacholine challenge, and then after salbutamol-induced bronchial dilatation. Exhaled tidal breathing was collected for 30 s and NO in the exhaled air was measured with a chemiluminescence analyser. Both NO concentration and its output were significantly higher in the steroid-free asthmatic patients (15.6 +/- 1.5 parts per billion (ppb) and 6.3 +/- 0.7 nmol.min-1, respectively) as compared with the control subjects (8.9 +/- 1.0 ppb and 3.5 +/- 0.3 nmol.min-1, respectively; p < 0.001 for both) and with the steroid-treated asthmatic patients (11.3 +/- 3.3 ppb and 3.7 +/- 0.9 nmol.min-1, respectively; p < 0.05 for both). Neither methacholine-induced bronchial obstruction nor salbutamol-induced bronchial dilatation caused a significant change in exhaled NO. We conclude that NO production is higher in steroid-free than in steroid-treated asthmatics and in control subjects. Furthermore, NO production is not affected by acute pharmacologically-induced changes of airways calibre in asthmatic subjects. Our results suggest that NO production is a marker of airways inflammation rather than an endogenous modulator of bronchial tone in asthma.
Changes in neurokinin A airway responsiveness with inhaled lysine-acetylsalicylate in asthma
Authors: Crimi N , Polosa R , Prosperini G , Magri S , Ciamarra I , Mistretta A
Published: June 2003

Endogenously released cyclooxygenase products modulate the bronchoconstrictor response to various stimuli in asthma. Little is known of the change in airway responsiveness to neurokinin A (NKA) after cyclooxygenase blockade. In this randomized, double-blind, placebo-controlled study, we have investigated the effect of the potent cyclooxygenase inhibitor, lysine acetylsalicylate (L-ASA) administered by inhalation, on the bronchoconstrictor response both to neurokinin A (NKA) and methacholine in nine asthmatic subjects. Subjects attended the laboratory on four separate occasions to receive nebulized L-ASA (solution of 90 mg.mL-1) or matched placebo (glycine, solution of 30 mg.mL-1) 15 min prior to bronchial challenge with NKA or methacholine, in a randomized, double-blind order. Changes in airway calibre were followed as forced expiratory volume in one second (FEV1) and agonist responsiveness, expressed as the provocative concentration causing a 20% fall in FEV1 from baseline (PC20). L-ASA elicited a significant fall in FEV1 from baseline. When compared with placebo, inhaled L-ASA reduced the airway responsiveness to NKA in 8 of the 9 subjects studied, the geometric mean (range) values for PC20 NKA increasing significantly from 153.2 (52.0-258.9) to 303.1 (83.4-668.5) micrograms.mL-1 after placebo and L-ASA, respectively. However, no significant change in airway responsiveness to methacholine was recorded after L-ASA, their geometric mean (range) PC20 values being 1.60 (0.17-9.59) and 1.53 (0.09-14.01) mg.mL-1 after placebo and L-ASA, respectively. The small decrease in airway responsiveness to neurokinin A after administration of lysine acetylsalicylate by inhalation suggests that endogenous prostaglandins may play a contributory protective role in the airway response to neurokinin A in human asthma.
Changes in respiratory drive account for the magnitude of dyspnoea during bronchoconstriction in asthmatics
Authors: Bellofiore S , Ricciardolo FL , Ciancio N , Sapienza MA , Patane A , Mistretta A , Maria GU
Published: June 2003

To evaluate whether the interindividual differences in dyspnoea perceived by asthmatic subjects for the same level of airway narrowing could depend on different changes in respiratory drive, we assessed the relationship between changes in airway calibre, changes in neuromuscular output, and dyspnoea rate during progressive bronchoconstriction induced by methacholine. We studied 18 asymptomatic asthmatic subjects (aged 18-36 yrs; 11 males and 7 females) with normal lung function. Dyspnoea (Borg scale), mouth occlusion pressure (P0.1), and forced expiratory volume in one second (FEV1) were measured at baseline and after inhalation of aerosols of doubling concentrations of methacholine (MCh). The progressive bronchoconstriction induced by MCh was associated with a progressive increase both of P0.1 and dyspnoea. Dyspnoea score was linearly related either to the fall in FEV1, or to the increase in P0.1. However, the slope values of the relationship between dyspnoea score and the corresponding percent fall in FEV1 showed a large interindividual variability (0.05-0.32; coefficient of variability (CoV) 43%). By contrast, the slope values of the relationship between dyspnoea score and the corresponding percent increase in P0.1 ranged 0.02-0.05 (CoV = 14%), indicating a more homogeneous response to dyspnoea for the same change in P0.1. At the highest MCh concentration, the dyspnoea score was linearly related to the corresponding change in P0.1 (r = 0.91; p < 0.01), but not to the corresponding percentage fall in FEV1 (r = 0.28). These results show that the interindividual differences in dyspnoea perceived by asthmatic subjects for the same level of airway narrowing are associated with different changes in respiratory drive during bronchoconstriction.
Validity and reliability of the St George's Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example
Authors: Ferrer M , Alonso J , Prieto L , Plaza V , Monso E , Marrades R , Aguar MC , Khalaf A , Anto JM
Published: June 2003

We describe the adaptation into Spanish of the St George's Respiratory Questionnaire (SGRQ), a self-administered questionnaire developed by Jones et al. (1991) covering three domains of health in airways disease patients: symptoms, activity and impacts. For the adaptation, the forward and back-translation method by bilinguals was used, together with professional committee and lay panel. Once tested for feasibility and comprehension, 318 male chronic obstructive pulmonary disease (COPD) patients with a wide range of disease severity completed the Spanish version of the SGRQ. The clinical status of the patients was evaluated concurrently with the measurement of health status. Lung function was assessed in the 2 months before or after the questionnaire administration. The Spanish version of the SGRQ was acceptable and easy to understand. Cronbach's alpha reliability coefficient was 0.94 for the overall scale and 0.72 for "Symptoms", 0.89 for "Activity", and 0.89 for "Impacts" subscales. Correlation coefficients between the overall score and dyspnoea and % forced expiratory volume in one second (FEV1) were 0.59 and -0.45, respectively, and these correlations were higher than those observed between the clinical variables and the Nottingham Health Profile, a generic measure of health-related quality of life. Results of the study suggest that the Spanish version of the SGRQ is conceptually equivalent to the original, and similarly reliable and valid. Although further studies should complete the adaptation work, results suggest that the SGRQ may already be used in Spain and in international studies involving Spanish respiratory patients. According to the present approach, it appears to be feasible to adapt a specific questionnaire on health-related quality of life in respiratory disease to another language and culture.
The Asthma Impact Record (AIR) index: a rating scale to evaluate the quality of life of asthmatic patients in France
Authors: Letrait M , Lurie A , Bean K , Mesbah M , Venot A , Strauch G , Grandordy BM , Chwalow J
Published: June 2003

Asthma is a chronic disease, which affects patients' daily lives. The goal of this study was the development of a disease-specific scale to evaluate quality of life in asthmatic patients in France: The Asthma Impact Record Index (AIR Index). The study was conducted with the participation of 486 asthmatic patients using the following steps: 1) selection of dichotomous items; 2) reduction of the number of items; 3) study of reproducibility of the questionnaire; 4) weighting of items; 5) study of the reliability and validity of the final version of the AIR Index. The final version of the AIR Index contains 63 unweighted items. The items were classified into subscales representing the main dimensions of quality of life: 1) physical, which was itself split into two subscales: a) physical activities; and b) symptoms; 2) psychological; and 3) social or relational. The internal consistency, measured by Cronbach's alpha coefficients, was found to be high, for the global scale and all subscales (range 0.79-0.94). The concurrent validity, evaluated by studying the relationship between the score values on the global scale and the subscales, and the parameters reflecting disease severity, was also high. We conclude that the AIR Index might represent a useful evaluative and discriminant instrument in studying quality of life in asthma in French populations.
Measurement of inflammatory indices in induced sputum: effects of selection of sputum to minimize salivary contamination
Authors: Pizzichini E , Pizzichini MM , Efthimiadis A , Hargreave FE , Dolovich J
Published: June 2003

Sputum examination is being used increasingly as a noninvasive method to assess airway inflammation. Expectorated sputum has variable contamination with saliva. Methods of processing have included the selection of portions of the sample considered to be representative of pulmonary origin versus use of the whole specimen, which is confounded by varying volumes of saliva. We compared cell profiles and eosinophilic cationic protein (ECP) concentration in sputum selected from the expectorate and in the usually discarded residual portion to determine to what degree salivary contamination is minimized and if the results are representative of lower respiratory secretions. Sputum was induced with hypertonic saline in six healthy and nine asthmatic subjects. All portions considered to be of pure lower respiratory tract origin were selected from the residual. The selected and residual portions were treated with dithiothreitol, total cell counts and cell viability were obtained, cytospins were made for differential cell counts and supernatant was collected for ECP assay. Selected portions of the specimens, in comparison with the residual portion showed: little squamous cell contamination (median 1.2 vs 70%; p < 0.001); higher total cell counts.mL-1 (5.1 vs 0.5 x 10(6) cells.mL-1; p < 0.001); higher number of viable nonsquamous cells per sample (1.9 vs 0.6 x 10(6) cells; p < 0.001); higher slide quality score (7 vs 4; p < 0.001); and higher levels of ECP (768 vs 136 micrograms.L-1; p < 0.001). There were no differences in the differential cell counts of eosinophils (1.3 vs 3.8%), neutrophils (44 vs 32%), and lymphocytes (0.6 vs 0.6%). While the proportion of macrophages was lower (36 vs 54%; p < 0.05), the absolute number (41 vs 19 x 10(4) cells; p < 0.05) was higher in the selected portion. In summary, selection of all portions of induced sputum from the expectorate minimized the confounding influence of saliva. Loss of nonsquamous cells in the residual portion was variable but usually less than one third of those in the selected portion. With one exception, this loss had little influence on the differential counts of inflammatory cells. Similar observations apply to eosinophilic cationic protein levels. We conclude that, in healthy subjects and treated asthmatics, inflammatory markers in the selected portion of the expectorate can be used to represent those in the lower respiratory tract in general.
Human blood monocytes, but not alveolar macrophages, reveal increased CD11b/CD18 expression and adhesion properties upon receptor-dependent activation
Authors: Lundahl J , Hallden G , Skold CM
Published: June 2003

The beta 2 integrin receptor CD11b/CD18 mediates adhesion to the endothelial lining as well as to extracellular matrix components. The present study was undertaken to investigate peripheral human blood monocytes (BMs) and alveolar macrophages (AMs) with respect to quantitative levels of CD11b/CD18 and adhesion properties in relation to the state of activation. BMs and AMs were recruited from healthy subjects. Quantitative analysis of the surface expression of CD11b/CD18 by flow cytometric technique and adhesion properties to albumin-coated surfaces were performed both on resting and N-formyl-methionyl-leucyl-phenylalanine (fMLP)-activated cells. Receptor independent stimuli (phorbol-12-myristate-13-acetate (PMA) and ionomycin) were used in additional experiments. Intracellular stored CD11b/CD18 was evaluated by flow cytometry and immunofluorescence microscopy. The surface expression of CD11b/CD18 on resting BMs increased fivefold (p < 0.01) upon fMLP activation. On resting AMs, the surface expression of CD11b/CD18 was significantly higher (p < 0.01) compared to resting BMs but did not increase further upon activation with fMLP, PMA or ionomycin. In contrast to BMs, no evidence for an additional intracellular pool of CD11b/CD18 was found in AMs. The adherence of resting BMs did not significantly differ from the adherence of resting AMs. After fMLP activation, the adherence of BMs, but not AMs, increased significantly (p < 0.05). Our results indicate that in vivo differentiation of human blood monocytes into alveolar macrophages implies reduced responsiveness to fMLP in terms of CD11b/CD18 upregulation and adhesion properties, and that the lack of upregulation of CD11b/CD18 on alveolar macrophages presumably depends on the absence of an additional intracellular pool.
Undetected viral infection in diffuse alveolar damage associated with bone marrow transplantation
Authors: Barbera JA , Martin-Campos JM , Ribalta T , Carreras E , Liopart A , Sierra J , Rozman C , Rodriguez-Roisin R
Published: June 2003

To investigate the presence of nondiagnosed viral lung infections in patients who developed acute respiratory failure and diffuse pulmonary infiltrates after bone marrow transplantation (BMT), we studied necropsy-obtained lung specimens with features of diffuse alveolar damage (DAD) where no other specific histological diagnosis could be established, by using in situ hybridization and immunohistochemistry. Lung tissue samples obtained at necropsy from 19 patients (12 males and 7 females; 31 +/- 11 yrs mean +/- SD age) who died 56 +/- 36 days after BMT (12 allogeneic and 7 autologous), were studied retrospectively using specific deoxyribonucleic acid (DNA) probes to detect cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein-Barr virus (EBV), and adenovirus genomes. Tissue samples were additionally processed with antibodies to CMV and HSV antigens. Cells infected by CMV were detected by in situ hybridization in five cases, and by immunohistochemistry in four cases. Combining the results of both procedures, a previously undiagnosed CMV infection was found in six patients. All of them had received an allogeneic BMT and had developed graft-versus-host disease (GVHD). No evidence of cells infected by HSV, EBV, or adenovirus was found in any case. No viral infection was detected either in recipients of autologous marrow or in recipients of allogeneic BMT without GVHD. These results indicate that pulmonary cytomegalovirus infection not detected by conventional histological examinations may be present in patients with diffuse alveolar damage associated with bone marrow transplantation, especially in recipients of allogeneic marrow who develop graft-versus-host disease. Furthermore, the use of in situ hybridization and/or immunohistochemistry on pulmonary histology might improve the diagnosis of viral lung infections in patients receiving bone marrow transplantation.
Uveitis as a presenting feature of chronic sarcoidosis
Authors: Rizzato G , Angi M , Fraioli P , Montemurro L , Pilotto E , Tommasini A
Published: June 2003

Uveitis is often a manifestation of sarcoidosis. Less well-recognized, however, is the development of uveitis several years before the diagnosis of systemic sarcoidosis. The possibility that presentation of uveitis is a marker for the chronicity of sarcoidosis has never been investigated. The aim of this work was to evaluate, in a Caucasian population, the epidemiology of uveitis as the primary manifestation of sarcoidosis with long-term follow-up, and the relationship of uveitis to the chronicity of sarcoidosis. The records of 1,156 Caucasian patients with histologically proven sarcoidosis, first seen in the period 1976-1992, were reviewed. In patients in whom uveitis was the primary feature of sarcoidosis, the following parameters were identified: systemic manifestations; time interval between the diagnosis of uveitis and sarcoidosis; therapy; the evolution of chest radiographic image over time; chronicity; the relationship between sarcoidosis and uveitis; and, finally, status in October 1994. In nine patients, uveitis was the reason for seeking medical treatment, resulting in the discovery of systemic sarcoidosis, which was then found to be chronic in 7 out of 9 cases. In an additional eight patients, uveitis preceded the diagnosis of systemic sarcoidosis by 1-11 yrs, and yet most subjects had systemic manifestations that went unrecognized during this time period, with chest radiograph at the time of diagnosis suggesting a long-standing chronic disease. Thus, uveitis appeared to be the primary manifestation of sarcoidosis in 17 of the 1,156 patients studied (1.5%). In conclusion, any uveitis of unknown origin may be due to sarcoidosis, although its systemic manifestations may not occur for up to 11 yrs. Uveitis patients need a very long-term follow-up, including periodic diagnostic tests for systemic sarcoidosis. Furthermore, when uveitis precedes the systemic symptoms and diagnosis of sarcoidosis by more than one year, it may be regarded as a marker of the chronicity of sarcoidosis.
Malignant pleural mesothelioma from nonoccupational asbestos exposure in Metsovo (north-west Greece): slow end of an epidemic?
Authors: Sakellariou K , Malamou-Mitsi V , Haritou A , Koumpaniou C , Stachouli C , Dimoliatis ID , Constantopoulos SH
Published: June 2003

Inhabitants of the Metsovo area, north-west Greece have been exposed since childhood to inhalation of asbestos, from a material containing tremolite, used for whitewashing ("luto soil"). This has resulted in endemic pleural calcifications (47% of adult population) and increased incidence of malignant pleural mesothelioma (MPM). In 1987, we reported that the incidence of MPM between 1981-1985 was around 300 times higher than expected in a nonasbestos exposed population (seven cases in 5 yrs in a population of 4,000-5,000). The present study is an updated report regarding this "mesothelioma epidemic", in conjunction with the diminished use and final abandonment of "luto soil" in the early 1980s. It appears that the incidence of MPM in Metsovo has dropped considerably since our first report. Between 1985-1994, we diagnosed six such cases (incidence rate = 1.4 cases per 10,000 person-years), whilst between 1980-1984 eight cases had been diagnosed (incidence rate = 3.7 cases per 10,000 person-years). Although, because of the small number of cases, this did not reach statistical significance (p = 0.08), we note that the incidence is now considerably lower than before. Had it remained unchanged, we would have expected 17 cases of MPM instead of six. This drop follows the diminished use of "luto" whitewash (by 92% of the population in 1950 and only 18% in 1980). If we take into account a 30-40 year latency period for mesothelioma, we expect that the "Metsovo mesothelioma epidemic" will fade away by the year 2020-2030, since the material has not been used since 1985.
Interleukin-1 receptor antagonist in pleural effusion due to inflammatory and malignant lung disease
Authors: Yanagawa H , Yano S , Haku T , Ohmoto Y , Sone S
Published: June 2003

Interleukin (IL)-1 is a key cytokine in inflammatory reactions. To clarify the mechanism of inflammation in the pleural cavity, we investigated the contribution of IL-1 and its antagonism to inflammatory processes in the pleural cavity. Interleukin-1 receptor antagonist (IL-1Ra) levels as well as IL-1 beta and interferon-gamma (IFN-gamma) levels were measured by enzyme immunoassay in pleural effusions from 70 patients. Pleural macrophages were also examined as possible sources of these cytokines in 10 patients. IL-1Ra was detectable in 28 patients (40%) out of 70 patients with pleural effusions. Patients with tuberculosis had significantly higher IL-1Ra as well as IFN-gamma levels in pleural effusion than patients with lung cancer. Transudative pleural effusions had low or undetectable IL-IRa levels. On the other hand, IL-1 beta levels were low, except in cases of parapneumonic pleural effusion. Spontaneous production of IL-1Ra pleural macrophages was observed in six patients, and IL-4 significantly augmented its production. Although spontaneous production of IL-1 beta was observed in only two patients, pleural macrophages produced significant amounts of IL-1 beta in response to lipopolysaccharide in all 10 patients examined. These results suggest that interleukin-1 receptor antagonist regulates various reactions by interleukin-1 in pleural effusion, and that pleural macrophages may act in situ as a source of interleukin-1 receptor antagonist.
Effects of different treatment regimens of methylprednisolone on rat diaphragm contractility, immunohistochemistry and biochemistry
Authors: van Balkom RH , van der Heijden HF , van Moerkerk HT , Veerkamp JH , Fransen JA , Ginsel LA , Folgering HT , van Herwaarden CL , Dekhuijzen PN
Published: June 2003

Systemic corticosteroid therapy may affect diaphragm structure and function. We postulated that functional, immunohistochemical and biochemical characteristics of rat diaphragm were less affected by alternate-day methylprednisolone (MP) administration, and more by repeated bursts of MP, in comparison to daily s.c MP. Sixty adult rats were randomized into four groups: saline s.c.; MP continuously (MP-C), 1 mg.kg-1 daily, MP alternate-day therapy (MP-A), 2 mg.kg-1 every other day; or MP in bursts (MP-B), MP 2 mg.kg-1 daily for 2 weeks, saline for 4 weeks, MP 2 mg.kg-1 daily for 2 weeks. The total treatment period was 8 weeks. Contractile properties of isolated diaphragm strips were measured. Antibodies reactive with type I, IIa, IIx and IIb myosin heavy chains were used for immunohistochemical analysis. Biochemical evaluation included markers of fast energy supply, glycogenolytic activity, beta-oxidation capacity and oxidative capacity. The force-frequency curve was depressed in all MP groups. Fibre type I, IIx and IIb cross-sectional area (CSA) decreased in all MP groups. Burst therapy decreased the contribution of type IIb fibres to total diaphragm muscle area. MP-A affected glycogenolytic activity less than MP-C. Burst MP therapy reduced creatine kinase (CK) activity and beta-oxidation capacity compared to MP-C. Oxidative capacity was increased in all MP groups. In conclusion, although the methylprednisolone treatment regimens affected diaphragm muscle morphology and bioenergetic enzyme activities in different ways, force generation decreased in all methylprednisolone treated groups to the same extent.
Assessment of the voluntary activation of the diaphragm using cervical and cortical magnetic stimulation
Authors: Similowski T , Duguet A , Straus C , Attali V , Boisteanu D , Derenne JP
Published: June 2003

The twitch occlusion technique is a promising tool for use in accessing central drive to the diaphragm and determining maximal transdiaphragmatic pressure (Pdi) from submaximal efforts. It clinical use is limited by difficulties inherent to bilateral electrical stimulation (BES) of the phrenic nerves. This study was designed to revisit the technique using cervical magnetic stimulation (CMS). In addition, the effects of a voluntary contraction on diaphragm response to magnetic stimulation of the cortex (CxMS) were studied. Seven volunteers aged 23-33 yrs were studied. Pdi was determined at relaxed functional residual capacity (FRC) in response to BES (Pdi,P-ES) and CMS (Pdi,p-CMS), and the effects of an increasing voluntary contraction (Pdi, vol) were assessed, The same procedure was applied to CxMS. Pdi,p-CMS at relaxed FRC was 27.5 +/- 2.2 cmH2O (mean+/-SEM), about 20% higher than Pdi,p-ES, and reported previously. Pd,p-CMS linearly decreased with Pdi, vol, and six out of seven subjects were capable of producing voluntary contractions sufficient to extinguish the twitch. More complex patterns were observed with CxMS. Cervical magnetic stimulation provides diaphragmatic twitch occlusion data very similar to bilateral electrical phrenic stimulation. Magnetic stimulation, be it cervical or cortical, could probably be helpful for the assessment of central and peripheral mechanisms of diaphragmatic dysfunction in the clinical setting.
Chest wall and lung contribution to the elastic properties of the respiratory system in patients with chronic obstructive pulmonary disease
Authors: Ranieri VM , Giuliani R , Mascia L , Grasso S , Petruzzelli V , Bruno F , Fiore T , Brienza A
Published: June 2003

Conflicting data are available on the relative contribution of the chest wall (cw) to the intrinsic positive end-expiratory pressure of the total respiratory system (PEEPi,rs) in patients with chronic obstructive pulmonary disease (COPD). In order to assess the chest wall and lung contribution to the elastic properties of the respiratory system in COPD patients during acute ventilatory failure, using the "interrupter technique", static inflation volume-pressure (V-P) curves of the total respiratory system (rs), lung (L) and cw were obtained in seven mechanically-ventilated COPD patients during application of zero end-expiratory pressure (ZEEP) and different levels (0-15 cmH2O) of PEEP. On ZEEP, PEEPi,rs was present in all patients (range 10.5-13.1 cmH2O), to which PEEPi,cw and PEEPi,L contributed 17 +/- 2 and 83 +/- 1%, respectively. The static V-P curves of the rs, L, and cw on ZEEP were concave toward the horizontal axis, indicating that elastance increased with inflating volume. Application of PEEP did not affect lung and chest wall mechanics until PEEP levels exceeding 90% of PEEPi,cw on ZEEP (critical value of PEEP (Pcrit)). At PEEP levels higher than Pcrit, and relative to the V-P curves on ZEEP, we observed that: 1) the V-P curve of the rs showed an initial shift along the curve on ZEEP followed by a downward displacement with inflating volume; 2) the V-P curve of the L was shifted along the curve on ZEEP throughout inflating volume; and 3) the V-P curve of the cw was initially displaced along the curve on ZEEP, whilst a downward displacement appeared at higher lung volume. In conclusion, our data show that, in chronic obstructive pulmonary disease patients with flow limitation, the increase in pleural pressure does not make a significant contribution to the intrinsic positive end-expiratory pressure of the total respiratory system. However, during tidal ventilation, a substantial increase in elastance of the chest wall is present. The critical values of positive end-expiratory pressure below which there are no changes in chest wall and lung mechanics amount to 90% of the total PEEPi,rs on ZEEP. Positive end-expiratory pressure levels higher than such critical value cause important alterations of the elastic properties of the lung and chest wall.