bluuebunny/crossref_metadata_2025 huggingface dataset:
Abdominal Aortic Aneurysm or Aortic Occlusive Disease: Role of Trace Element Imbalance
Authors: Koksal Cengiz , Ercan Meltem , Bozkurt A. Kursat , Cortelekoglu Tansel , Konukoglu Dildar
Published: May 2007

The nature of the relationship between atheromatous disease and degenerative aneurysm is yet to be defined. The purpose of this study was to compare tissue Fe, Cu, Zn, and thiobarbituric acid reactive substances (TBARS) levels (as a marker of lipid peroxidation) in the abdominal aorta in relation to the development of aneurysmal and occlusive disease in the infrarenal aorta. This was a prospective clinical study in an institutional referral center, in hospitalized patients. Eighty male patients who underwent surgery for abdominal aortic aneurysm (AAA) or aortic occlusive disease (AOD) were included in the study. Age, risk factors and comorbid conditions were recorded, including diabetes mellitus, hypertension, coronary artery disease, smoking, and chronic obstructive pulmonary disease. Aortic wall biopsies were collected at operation from the anterolateral section of the infrarenal aorta. Tissue Fe, Cu, Zn, and TBARS levels were determined. The mean age of the AAA group was 66.2 (56—75) years and of the AOD group 57.8 (47—72) years (p <0.001). There was a higher prevalence of hypertension in AAA patients compared to AOD patients (62.5%, 35% respectively; p <0.05). The comparison of tissue Zn levels showed no significant difference. Tissue levels of Fe, Cu, and TBARS were found to be higher in the AAA group, compared with the AOD group (p<0.001 for each). These results suggest that higher oxidative stress as a result of higher Fe and Cu levels in the AAA, compared with AOD, may be one of the contributing factors in aneurysmal formation as a result of promoted wall erosion.
Afterload Reduction May Halt and Beta-Adrenergic Blockade May Worsen Progression of Left Ventricular Dysfunction in Patients With Chronic Compensated Mitral Regurgitation: A Retrospective Cohort Study
Authors: Oh Stacie H. , Meyers David G.
Published: May 2007

Severe chronic mitral regurgitation (MR) is associated with progressive left ventricular (LV) systolic dysfunction. Both afterload reduction and beta-adrenergic blockade have been suggested as methods for preventing LV dysfunction in asymptomatic patients with MR and normal LV function, who are therefore not yet candidates for surgical intervention. The objective of this study was to determine if afterload reduction reduces progression of LV dysfunction in patients with severe MR. The reports of echocardiographic studies performed 20 ±14 months apart were compared in a retrospective cohort of 134 asymptomatic patients with moderate-severe chronic MR and baseline ejection fraction (LVEF) >50%. Groups were defined by exposure to any afterload-reducing drug: Group 0, no exposure; Group 1, exposure beginning after the first echocardiogram; and Group 2, drug exposure beginning before the baseline echocardiogram. The groups differed importantly only in treatment duration. In 72 patients not exposed to beta-adrenergic blockade, LVEF decreased by a relative —3.2% in Group 0, while Group 1 increased by 3.4% and Group 2 increased by 5.1%, p <0.01. Among 62 patients exposed to beta-adrenergic blockade, LVEF consistently worsened (Group 0, 4.8%; Group 1, —3.3%; Group 2, —1.7%; p = 0.71) compared to the 72 patients without beta-adrenergic blockade. In a multivariate model that included treatment duration and exposure to other medications, the beneficial effect of afterload reduction (p <0.03) and the deleterious effect of beta-adrenergic blockade (p < 0.02) were significant. Afterload reduction halted or reversed the progressive worsening of left ventricular function while beta-adrenergic blockade had a deleterious effect.
Success, Safety, and Efficacy of Implantation of Diamond-Like Carbon-Coated Stents
Authors: Salahas Anastasios , Vrahatis Antonios , Karabinos Ilias , Antonellis Ioannis , Ifantis Georgios , Gavaliatsis Isidoros , Anthopoulos Prodromos , Tavernarakis Antonios
Published: May 2007

The aim of this study was to evaluate safety and clinically defined efficacy of the implantation of a new stent coated with diamond-like carbon (DLC stent), in a group of patients who underwent percutaneous transluminal coronary revascularization procedures in two hemodynamic centers. This study was an observational prospective nonrandomized study that included 196 patients with a total of 236 significant de novo atheromatous coronary lesions, in which 245 DLC stents were implanted. The primary end point of this study was a composite of major cardiovascular events (death or acute myocardial infarction with or without Q) and need for target lesion revascularization (TLR) or target vessel revascularization (TVR) procedure during the first 48 hours and at 6 months after the DLC stent implantation. All patients had a myocardial perfusion imaging study with Tl201 at 6 months after DLC stent implantation. Only patients with a myocardial perfusion imaging study indicative of myocardial ischemia were then submitted for a new coronary angiogram. No major cardiovascular event or emergency TVR occurred during hospitalization. At 6-month follow-up no major cardiovascular event occurred either, whereas the rate for TLR was 5.6% and that for TVR was 7.65%. This preliminary study provides enough clinical evidence that implantation of intracoronary bare metal stents coated with diamond-like carbon is associated with high success rates, safety, and efficacy, both in the hospital and at the 6-month follow-up after the interventional procedure.
The Effects of Acute Passive Smoke Exposure on Endothelium-Dependent Brachial Artery Dilation in Healthy Individuals
Authors: Giannini D. , Leone A. , Di Bisceglie D. , Nuti M. , Strata G. , Buttitta F. , Masserini L. , Balbarini A.
Published: May 2007

Passive smoking has both short-term and long-term vascular effects. It is not clear whether impairment of endothelial function reflects the acute effects of passive smoke exposure or the chronic effects. The purpose of this study was to assess the hypothesis that short-term exposure to passive smoke impairs endothelium-dependent vasodilation in healthy nonsmokers. Eighteen healthy young never smokers (12 men, 6 women) 21 to 55 years old (mean ± SD: 34 ±9 years) underwent ultrasonography measuring baseline brachial-artery diameter and brachial-artery diameter during hyperemia and after sublingual administration of nitroglycerin, twice: in a smoke-free environment, and then in the same environment polluted by 30 to 35 ppm carbon monoxide. Each subject served as his/her control. Carboxyhemoglobin was measured in blood samples of subjects tested. Mean value of carboxyhemoglobin was 0.6 ±0.5% in a smoke-free environment and 1.4 ± 0.5% in a smoking environment (p <0.02). Mean values of flow-mediated dilation (FMD) were 12.6% ± 7.8% in a smoke-free environment versus 6.8 ± 7.8% in a smoking environment (p <0.01). On the contrary, nitroglycerin-induced vasodilation did not show any statistical difference (21 ± 9.8% versus 23 ±1.4%). Finally, the increase of carboxyhemoglobin was related statistically to the impairment of flow-mediated dilation (r = 0.51; p <0.002). Passive smoking impaired flow-mediated vasodilation in healthy never smokers in a smoking environment. The impairment was strongly related to carboxyhemoglobin level.
Coronary-Subclavian Steal: Case Series and Review of Diagnostic and Therapeutic Strategies
Authors: Costa Steven M. , Fitzsimmons Patrick J. , Terry Edwin , Scott Robert C.
Published: May 2007

Due to the increased use of internal mammary artery grafts for coronary revascularization, proximal subclavian stenosis resulting in coronary-subclavian steal has become an important clinical entity. Patients present with varying signs and symptoms of recurrent myocardial ischemia that not only can limit lifestyle but also be life-threatening. A careful history and physical examination with the identification of risk factors such as peripheral vascular disease and arm blood pressure differential >20 mm Hg can identify patents at high risk for developing this syndrome. Identifying these patients before coronary artery bypass grafting can prevent this important problem by altering the therapeutic approach to coronary revascularization. When patients present after coronary artery bypass grafting with coronary-subclavian steal, therapeutic options of percutaneous transluminal angioplasty and stent placement to the subclavian artery, carotid-subclavian bypass, and axillary-axillary bypass all have high success rates with excellent long-term patency rates. The choice for the type of revascularization needs to be individualized based on the lesion morphology and clinical comorbidities. Three patients who presented with signs and symptoms of myocardial ischemia due to coronary subclavian steal are presented. All 3 patients had incapacitating symptoms, and all 3 were treated successfully with different revascularization techniques due to other medical conditions or comorbidities.
Intracavitary Mass as the Initial Manifestation of Primary Pericardial Mesothelioma
Authors: Peregud-Pogorzelska Małgorzata , Kaźmierczak Jarosław , Wojtarowicz Andrzej
Published: May 2007

A 31-year-old woman presented with a 3-month history of progressing fatigue and effort dyspnea. Echocardiography depicted a tumor within the free wall of the right ventricle and right atrium, located on both sides of the tricuspid annulus. Computed tomography showed disseminated circular shadows sized up to 7 mm—most likely metastatic lesions—in both lungs. The diagnosis of low-grade mesothelioma bifasicum was confirmed with histopathologic and immunohistochemical studies of the samples taken by thoracoscopy from parietal pleura, lung tumor, and diaphragm region. Chemotherapy, which included gemcitabine and carboplatin, resulted in transient improvement of the clinical status of the patient and reduction of the tumor mass lasting several months followed by progression of the disease. Significant amounts of pleural fluid and huge tumors within both pleural cavities emerged. The patient died due to respiratory and circulatory insufficiency 11 months following the diagnosis.
Congenital Rubella Syndrome in a Child Born to Liberian Refugees: Clinical and Public Health Perspectives
Authors: Plotinsky Rachel N. , Talbot Elizabeth A. , Kellenberg Joan E. , Reef Susan E. , Buseman Sandra K. , Wright Karen D. , Modlin John F.
Published: May 2007

We describe a case of congenital rubella syndrome with typical stigmata in an infant born in New Hampshire to Liberian refugees. The infant's clinical specimens were tested for rubella. Rubella immunity status was sought for contacts. The infant's specimen cultures grew wild-type rubella virus; serum immunoglobulin M and G were positive. Eighteen of 20 contacts were rubella-immune. Family's transit history, mother's vaccination history, and infant's estimated gestational age supported congenital infection acquired overseas. Clinicians should maintain vigilance for congenital rubella syndrome in infants with relevant stigmata, particularly those whose mothers are from countries with nonexistent or recently implemented rubella vaccination programs.
Parent Perspectives on Pain Management, Coping, and Family Functioning in Pediatric Sickle Cell Disease
Authors: Mitchell Monica J. , Lemanek Kathleen , Palermo Tonya M. , Crosby Lori E. , Nichols Alisha , Powers Scott W.
Published: May 2007

Pediatric sickle cell disease is a chronic illness for which recurrent pain is a ubiquitous experience. This study used quantitative and qualitative methods to examine relationships between patient and family coping and health care utilization in children with sickle cell disease and to assess parents' recommendations for ensuring patient and family-centered care. Participants were 53 parents of children aged 7 to 13 with sickle cell disease across three large urban children's hospitals. Data showed that positive patient coping was related to positive family functioning and lower health utilization. In addition, parents report the need for comprehensive health care approaches that meet the physical and psychologic needs of patients and families.
Is Syrup of Ipecac Still for Sale? Comparison of Pharmacies in a Large Urban Area—2003 Versus 2005
Authors: Kelly Nancy R. , Sanchez Sarai H.
Published: May 2007

There has been considerable publicity about the lack of benefit and potential dangers of syrup of ipecac. In November 2003, the American Academy of Pediatrics recommended against its use. Pharmacies in Houston, Texas were surveyed by telephone before (survey 1) and after (survey 2) the American Academy of Pediatrics' recommendation to determine whether ipecac availability changed. There were 126 pharmacies interviewed at survey 1, and 128 interviewed at survey 2. Pharmacies in survey 1 were more likely than those in survey 2 to sell ipecac (79% versus 64%, P < .01) and to have it in stock (75% versus 48%, P < .001). Pharmacies mostly stored ipecac on the shelves (67%, survey 1; 59%, survey 2, P = .27). Although syrup of ipecac availability has declined significantly, it is still available in more than 50% of pharmacies. Health care providers should advise against its use and advocate that pharmacies remove it.
Posttransplant Lymphoproliferative Disease: A Case Report and Review for the General Pediatrician
Authors: Kincaid Christine R. , Nield Linda S. , Moore Renee S. , Keller Frank G.
Published: May 2007

This report describes a case of posttransplant lymphoproliferative disease in a 19-year-old male patient with an initial diagnosis of peritonsillar abscess. As the number of children receiving transplants continues to increase, the pediatrician must become familiar with the possible presentations of posttransplant lymphoproliferative disease and at least consider it as a diagnosis in any ill child under long-term treatment with immunosuppressive agents. The epidemiology, pathogenesis, clinical presentations, evaluation, prognosis, and treatment of posttransplant lymphoproliferative disease are reviewed for the primary care pediatrician.
Incomplete and Atypical Kawasaki Disease in a Young Infant: Severe, Recalcitrant Disease Responsive to Infliximab
Authors: O'Connor Matthew J. , Saulsbury Frank T.
Published: May 2007

This report describes a 7-week-old infant with incomplete and atypical Kawasaki disease, an acute vasculitis that predominantly affects infants and children. The patient was refractory to 2 doses of intravenous immunoglobulin and to high-dose intravenous methylprednisolone. He became afebrile only after 2 doses of infliximab. His prolonged, recalcitrant course was complicated by the development of peripheral gangrene and giant coronary artery aneurysms. Infants with incomplete and atypical Kawasaki disease are prone to intravenous immunoglobulin treatment failure and are at risk for the development of coronary artery aneurysms. In such patients, we suggest that consideration be given to early aggressive therapy with corticosteroids or infliximab added to intravenous immunoglobulin.
The Possible Role of Circumcision in Newborn Outbreaks of Community-Associated Methicillin-Resistant Staphylococcus aureus
Authors: Van Howe Robert S. , Robson Wm. Lane M.
Published: May 2007

Outbreaks of community-associated methicillin-resistant Staphylococcus aureus were recently reported in newborns at 3 major urban centers. Boys were disproportionately infected. A literature review and a statistical analysis confirmed that male newborns are significantly more likely to be infected with Staphylococcus aureus. Circumcision is a possible explanation for the recent outbreaks.
Neonatal Circumcision and Penile Inflammation in Young Boys
Authors: Van Howe Robert S.
Published: May 2007

This study prospectively documents the incidence of penile inflammation in a consecutive sample of boys according to circumcision status whose visit with the physician included a genital examination in a private primary care pediatric practice in rural northern Wisconsin. Penile inflammation was more common in circumcised than noncircumcised boys, especially in the first 3 years of life (exact odds ratio, 8.01, 95% confidence interval, 31-329.15). When adjusted for the number of genital examinations and age younger than 3 years, exact logistic regression found an adjusted exact odds ratio of 7.91 (95% confidence interval, 1.76-77.66). The study found that rather than protecting against penile inflammation, neonatal circumcision increases the risk of penile inflammation, particularly in boys younger than 3 years old.
Parent Perceptions of the Specialty Pediatric Emergency Medicine and Their Understanding of the Provider Roles in a Pediatric Emergency Department
Authors: Greenberg Richard A. , Kadish Howard , Schunk Jeff
Published: May 2007

This study was conducted to assess parents' understanding of Pediatric Emergency Medicine and the roles of different providers in a pediatric emergency department. Parents were surveyed regarding these subjects and given a sheet explaining provider roles. Of 102 questionnaires completed, 82% of questions on attending roles were answered correctly and 70% of questions about pediatric emergency medicine were answered correctly. Ninety percent of parents felt the information sheet made understanding provider roles easier. Many parents were informed regarding emergency department provider roles. Certain aspects of these roles and the practice of pediatric emergency department are less well understood. An informational sheet can help educate parents about provider roles and the practice of pediatric emergency medicine.
School Nurse Knowledge and Perceptions of Recurrent Abdominal Pain: Opportunity for Therapeutic Alliance?
Authors: Youssef Nader N. , Murphy Thomas G. , Schuckalo Stephanie , Intile Charlotte , Rosh Joel
Published: May 2007

Recurrent abdominal pain of childhood affects up to 15% of school-age children, who face significant psychosocial consequences, including school absence. Because assessment of recurrent abdominal pain is frequently made at the school nurse level, a questionnaire was sent to 425 school nurses to evaluate perceptions about recurrent abdominal pain. Among the responses, 47.1% believed children were faking or seeking attention; 3.6% considered it a serious disease, 77.9% stated that affected children should see a physician, 51.5% believed they should relax, and 25.0% believed they needed medicine. Results indicated that school nurses were unclear on epidemiologic and etiologic features of recurrent abdominal pain and had negative views that may inadvertently contribute to the anxiety felt by affected children. Education of school nurses and communication from physicians may advance strategies designed to reduce the fiscal and social costs associated with this common childhood condition.
Penicillin Failure in the Treatment of Acute and Relapsing Tonsillopharyngitis Is Associated With Copathogens and Alteration of Microbial Balance: A Role for Cephalosporins
Authors: Brook Itzhak
Published: May 2007

The causes of penicillin failure in eradicating group A β-hemolytic streptococcal (GABHS) pharyngotonsillitis that are due to microbiological interactions are described. These include the presence of β-lactamase— producing bacteria that protect GABHS from penicillins, the absence of bacteria that interfere with the growth of GABHS, and coaggregation between GABHS and Moraxella catarrhalis. Antimicrobials that can overcome and modulate these phenomena achieve better cure of the infection than penicillins. The agents more effective than penicillins in the treatment of acute infections included the cephalosporins and macrolides, and those more effective in the treatment of chronic infections included clindamycin and amoxicillin-clavulanate.
The Importance of Bacteriologic Eradication in the Treatment of Group A Streptococcal Tonsillopharyngitis
Authors: Pichichero Michael E.
Published: May 2007

Eradication of the group A β-hemolytic streptococci from the tonsillopharynx by use of antibiotics is the essential outcome to prevent suppurative and nonsuppurative sequelae, abate symptoms, and prevent contagion. The minimum criterion standard for eradication rate is 85% or better according to the United States Food and Drug Administration. From 1991 to present less than 20% of clinical trials have shown penicillin to meet or exceed the minimum standard compared with 100% for various cephalosporins, amoxicillin/clavulanate, and macrolides/azalides, when appropriately dosed. Efficacy alone cannot produce optimal treatment outcomes in clinical practice because nonadherence frequently results in failed therapy, persistence of infection, and morbidity. Poor taste and the need for 10 days of therapy with penicillin are adherence barriers. The evidence base supporting the selection of cephalosporins in preference to penicillin for treatment of group A β-hemolytic streptococci tonsillopharyngitis is very strong (type A), and these agents have a better tolerability and adherence profile.
Selecting the Optimal Antibiotic in the Treatment of Group A β-Hemolytic Streptococci Pharyngitis
Authors: Casey Janet R.
Published: May 2007

Treatment guidelines from the Infectious Diseases Society of America, the American Heart Association, and the American Academy of Pediatrics recommend only oral penicillin V or intramuscular benzathine penicillin G as the treatments of choice for group A β-hemolytic streptococcal pharyngitis. Practitioners prescribe amoxicillin most frequently for children. Ten-day treatment courses with first-generation oral cephalosporins or erythromycin are recommended as suitable alternatives in patients who are allergic to penicillin. Yet oral cephalosporins are used as drugs of choice for many patients with group A β-hemolytic streptococcal pharyngitis. This review examines the evidence in order to help the practitioner choose the optimal antibiotic treatment for their patients.
A survey of 14 to 16 year olds as to their attitude toward and use of sunbeds
Authors: Mackay H. , Lowe D. , Edwards D. , Rogers S.N.
Published: May 2007

Objective Sunbeds pose a potential risk to health. Although not recommended for children under 16 years of age they are used by this age group. The purpose of this study was to assess the awareness of suntanning guidelines, the use of sunbeds and the attitude towards tanning in children aged between 14 and 16 years.

Design and method 499 pupils aged 14 to 16 years responded to a questionnaire survey in two schools in a mixed urban part of Merseyside.

Results Overall, sunbeds had been used by 43 per cent of pupils. Girls had used them much more than boys with use increasing by age for both sexes. Overall, 65 per cent said they were aware of guidelines. About half thought that guidelines advising people how often to use a sunbed were a good thing. One in 10 of those using a sunbed also said they had had problems with their eyes or skin. Most boy and girl users thought using sunbeds made them look healthy, made them more attractive and confident, that they created a base tan before a holiday and that they were a good treatment for spots.

Conclusion There is considerable awareness of sunbed guidelines; however, sunbed use in the under 16 year age group remains high. This poses a public health issue and better education and enforcement strategies are required.
The Rhetoric of a New Essentialism versus Multiple Worlds: Isidore Okpewho's Call Me by My Rightful Name and Buchi Emecheta's The New Tribe in Conversation
Authors: Cooper Brenda
Published: May 2007

This paper contrasts two recently published novels by Nigerian writers living in the Diaspora — Isidore Okpewho's Call Me by My Rightful Name and Buchi Emecheta's The New Tribe. It demonstrates how Emecheta, long resident in London, embeds her fiction in the concrete realities of the everyday. She rejects the myths attached to an idealized Africa. In so doing, she relies on the rhetoric of metonymy. Okpewho, by contrast, a relatively recent migrant to the USA, harnesses a strategic form of essentialism, as he calls for black people everywhere to return, metaphorically, to the language and culture of their African homeland. This call is understood within the context of the racist American culture Okpewho, and some of his colleagues from Ibadan, confront. However, ultimately, the paper critiques this essentialism and the metaphoric language attached to it, in terms of its reproduction of some of the old, idealized ways of representing Africa and also in gender terms, given how patriarchal this revival of roots turns out to be. Finally, it demonstrates the profound difference in gender terms between Okpewho's and Emecheta's manipulations of a story taken from the oral tradition.
R.K. Narayan: A Personal View
Authors: Deshpande Shashi
Published: May 2007

Delivered as an opening address at the International Seminar on R.K. Narayan, held in Mysore to mark the centenary of Narayan's birth, this is an attempt to see what his writing meant to me as a reader at a time when, for an Indian writer, fiction in English meant British fiction and when Indian writing in English was a rarity. The address also considers how my view of Narayan altered, when I began writing in English myself. And finally, as one who lives in the same region as Narayan did and who writes, as he did, surrounded by the same milieu of Kannada literature, I examine the curious fact of Narayan's total disjunction from that entire literary world that he lived and worked in, and the way in which he completely disregarded this literary tradition, which was, at the time, very vibrant.
Colonial Ambivalence in R. K. Narayan's Waiting for the Mahatma
Authors: Aikant Satish C.
Published: May 2007

The Gandhian phase of the anti-colonial movement for India's freedom finds frequent expression in literary representations of the period. There was large-scale support among Indians for Gandhi's intervention in the civil disobedience and Quit India movements. However, R. K. Narayan's novel Waiting for the Mahatma (1955) reflects a certain ambivalence towards the freedom movement. There were many who were impressed by the more benign aspects of the British presence in India and Narayan's own writing came to depend heavily on patronage by British publishers and readers. He was ostensibly writing for an English audience and could not upset the colonial English system which supported him. This article examines the issues of colonial ambivalence in Narayan's fiction, comparing Waiting for the Mahatma with Raja Rao's Kanthapura (1938), in which the author's commitment to Gandhian ideology is firm and unambiguous.
The World of Nagaraj
Authors: Saha Nandini
Published: May 2007

In his last novel The World of Nagaraj (1990), R.K.Narayan re-presents the quintessential South Indian village of Malgudi, which he had created and re-created over and over again in one novel after another since its genesis in 1935 in Swami and Friends. In The World of Nagaraj the infiltration of postmodern self-reflexive metafictional elements that commingle with the portrayal of Malgudi life produces a new kind of Malgudi novel. In the novel Narayan focuses on the art of storytelling and the world of a storyteller through the protagonist Nagaraj's sole obsession with writing a magnum opus on the celestial storyteller Narada. This paper traces a very different phase in Narayan's career, which starts with Talkative Man (1986) and sadly ends with this last novel.
The Cultural Geography of Malgudi
Authors: Thieme John
Published: May 2007

A comment by Narayan on the “false geography” of his “imaginary town” provides the departure-point for a discussion of Malgudi, which argues against the frequently held view that it is a metonym for a quintessential India, or South India. Taking its cue from the cultural geographer Doreen Massey's assertion that “The identities of places are always unfixed, contested and multiple”, the paper contends that Malgudi is a multifaceted and transitional site, an interface between older conceptions of “authentic” Indianness and contemporary views that stress the ubiquity and inescapability of change in the face of modernity. It argues that Malgudi is far more than a physical locus, viewing it as an episteme that incorporates numerous ways of perceiving India — social, spiritual, mythological and psychological among them. Focusing on Narayan's representation of heterotopias, it considers the demarcations between “pure” and “polluted” space in The English Teacher , the simultaneity of different layers of Indian culture in The Financial Expert and the contrast between Malgudi and a larger Indian world in The Painter of Signs.
Employer Matters in 2006
Authors: Mackinnon Bruce Hearn
Published: May 2007

If 2005 was a watershed year with the passing of the Work Choices legislation, then 2006 may well be considered year zero, symbolizing the beginning of a new era of Australian industrial relations under the employer friendly legislative regime. Employer groups were actively engaged in lobbying the Federal Government for further industrial relations reform, particularly in relation to the award rationalization process, and in pressuring the government for codification of the definition of `independent contractors', as a means of immunizing them from many of the rigours currently imposed by employment and labour law. Key employer groups made significant submissions to the newly formed Australian Fair Pay Commission in the lead up to its inaugural minimum wages decision, and though generally urging caution in raising minimum wages, there were nevertheless some differences of emphasis and approach apparent between a number of them. Despite an absence of widespread industrial disputation, the year witnessed a number of employers exercising their newfound powers — including some enhanced legal options — to either by-pass unions or to constrain union activity.
Getting to We
Authors: Donnell Kelly
Published: May 2007

How do beginning teachers experience the complex process of learning to teach in an urban setting? This article contributes to the literature on teaching in urban settings by theorizing the process of learning to teach based on longitudinal interview data generated from practitioners who were viewed by the researcher as critical informants. The author argues that beginning urban teachers' sense of efficacy is enhanced if they develop a transformative teaching practice focused on “we,” highlighting the mutual learning between teacher and pupils. Findings highlight critical components of “getting to we:” bi-directional learning, relational knowing, humanizing pedagogy, and reflective, dialogic discourse.
NGOs, Corporations and Security Transformation in Africa
Authors: Avant Deborah
Published: May 2007

Transnational non-state actors interested in maintaining a presence in parts of the world where the state is weak are an important part of the privatization of security that has not been well analyzed. In this article I lay out propositions about how an increasing role for non-state actors in security may transform the conceptualization of security and the use of violence more generally. I argue that international NGOs and transnational corporations conceptualize security and how to achieve it differently than states have traditionally done and that these differences have potential consequences for which problems are addressed, as well as for whether and how violence is used in the communities where they operate.
Controlling Crime and Corruption from Below: Sungusungu in Kenya
Authors: Heald Suzette
Published: May 2007

This article deals with the history and development of sungusungu organisations in Kenyan Kuria from 1998 to the present time and the radical changes it has initiated. Developing out of indigenous organisation, sungusungu arose initially to provide a means of controlling theft, particularly cattle raiding. Operating with the sanction of the district administration, local norms of crime, trial and punishment were developed, distinct from those embodied in the national penal code. Guarding their independence, groups have kept their distance from the police and judiciary to avoid the systemic corruption of those institutions. In distancing themselves from the more corrupt aspects of the state, and acting against it within their areas of operation, these groups have had far-reaching effects on local security, to the extent that their success holds out possibilities for them to extend their activities into other spheres.
Fentanyl Clearance and Volume of Distribution Are Increased in Patients With Major Burns
Authors: Han Taehyung , Harmatz Jerold S. , Greenblatt David J. , Martyn J. A. Jeevendra
Published: May 2007

This study examined the pharmacokinetics of fentanyl in burned patients during the hyperdynamic phase. Twenty adults, aged 37 ± 2 years (mean ± SE), with 49 ± 3% total body surface area burn, were studied at 17 ± 2 days after the injury and compared to demographically matched controls. After a 200‐μg IV bolus of fentanyl, blood samples (n = 20) were collected for 4.5 hours. Concentration‐time curves were fitted to a 2‐compartment model. Burned patients had a higher cardiac index. Median fentanyl clearance (CL, 21.0 vs 29.4 mL/kg/min), central compartment volume (V1, 0.37 vs 0.61 L/kg), and total volume of distribution (Varea, 3.6 vs 5.8 L/kg) were higher in burned patients. Cardiac index was unrelated to CL. The increased V1 and Varea are likely due to large intravenous fluid replacement and tissue edema. Higher CL and larger V1 and Varea leading to a lower fentanyl plasma concentration may partially explain the increased opiate requirement previously observed after burn injury.
Single‐Dose Pharmacokinetics of Multilayer‐Release Methylphenidate and Immediate‐Release Methylphenidate in Children With Attention‐Deficit/Hyperactivity Disorder
Authors: Quinn Declan , Bode Ms Twyla , Reiz Joseph L. , Donnelly Graeme A. E. , Darke Andrew C.
Published: May 2007

The objective of this study was to compare the single‐dose pharmacokinetics of multilayer‐release and immediate‐release methylphenidate in children with attention‐deficit/hyperactivity disorder. Patients 6‐ to 12‐years‐old with a DSM‐IV diagnosis of attention‐deficit/hyperactivity disorder were randomized to receive multilayer‐release methylphenidate (qd) or immediate‐release methylphenidate (bid) at equivalent doses, with a 14‐day washout between treatments. Plasma samples were collected predosing and 1, 2, 3, 4, 5, 6, 8, 10, 12, and 24 hours postdose. Pharmacokinetic analysis was conducted on 14 patients (1 female, 13 male; mean age: 9.6 ± 2.5 years [range, 6–12]). The mean dose of methylphenidate received by these patients in both phases of the study was 38.6 mg/d (range, 20–80 mg/d). The relative AUC0–t and Cmax 0–4 ratios for multilayer‐release compared with immediate‐release methylphenidate were 100.8% and 78.8%, respectively. Multilayer‐release methylphenidate produces a biphasic concentration‐time profile, with a rapid initial increase in plasma concentration that is maintained throughout the school day.
Caffeine Accelerates Absorption and Enhances the Analgesic Effect of Acetaminophen
Authors: Renner Bertold , Clarke Geoff , Grattan Tim , Beisel Angelika , Mueller Christian , Werner Ulrike , Kobal Gerd , Brune Kay
Published: May 2007

The aim of this study was to determine the analgesic effect of acetaminophen compared to a combination of both caffeine and acetaminophen or caffeine alone using tonic and phasic pain stimulation. Twenty‐four subjects were treated orally with 1000 mg acetaminophen, 130 mg caffeine, and a combination of both in a 4‐way crossover, double‐blind, placebo‐controlled study. Pharmacokinetics and analgesic effects were assessed by means of an experimental pain model based on pain‐related cortical potentials after phasic stimulation of the nasal mucosa with CO2and based on pain ratings after tonic stimulation with dry air. Analgesic effects of acetaminophen and acetaminophen plus caffeine but not caffeine alone caused a significant reduction of pain‐related cortical potentials beginning 30 minutes after medication. The combination demonstrated an enhanced effect throughout the observation time up to 3 hours. Caffeine accelerated acetaminophen absorption, indicated by enhanced early AUCs. Significant analgesic effects of the combination on tonic pain ratings were found throughout the observation time as compared to acetaminophen and placebo. In this study, caffeine enhanced and prolonged the analgesic activity of acetaminophen.
Pharmacokinetic and Pharmacodynamic Properties of Inhaled Ciclesonide
Authors: Derendorf Hartmut
Published: May 2007

Inhaled corticosteroids are recommended first‐line therapy for persistent asthma of all severities; however, oropharyngeal and systemic adverse events can be a concern. Inhaled corticosteroids exert their therapeutic and adverse effects by interacting with glucocorticoid receptors within and outside the lungs, respectively. Ciclesonide is a novel inhaled corticosteroid that possesses a unique pharmacokinetic and pharmacodynamic profile. Ciclesonide is inactive itself and converted to its pharmacologically active metabolite, desisobutyryl‐ciclesonide, in the target organ, the lungs. Pulmonary activation combined with low oral deposition may minimize oropharyngeal adverse events, and low oral bioavailability, rapid clearance, and high protein binding may reduce systemic exposure. In addition, high pulmonary deposition due to the highly respirable particles, combined with the potential for prolonged lung retention via lipid conjugation, provides for effective therapeutic action.
The Pharmacokinetics of Taurolidine Metabolites in Healthy Volunteers
Authors: Gong Li , Greenberg Howard E. , Perhach James L. , Waldman Scott A. , Kraft Walter K.
Published: May 2007

Taurolidine is an experimental antibacterial and antiendotoxic compound whose clinical utility as an antitumor agent is being investigated in human clinical trials. Taurolidine in aqueous solution exists in equilibrium with taurultam. Taurultam is subsequently transformed to taurinamide. The pharmacokinetic profiles of these metabolites are not well established. In this study, 18 healthy volunteers were administered 5.0 g of taurolidine in 250 mL of 5% polyvinylpyrrolidone in water over 2, 1, or 0.5 hours by intravenous infusion in a parallel‐group design. All subjects noted discomfort at the infusion site, although there were no serious adverse events. tmax generally occurred at the end of infusion for taurinamide, whereas that of taurultam was reached before completion of infusion. The taurolidine metabolite taurultam demonstrated a shorter half‐life and lower systemic exposure than taurinamide. Shortening of infusion duration increased the Cmax and AUC of taurultam. Changes in infusion rate did not substantially change the pharmacokinetic parameters of taurinamide.
Effect of the Rate of Niacin Administration on the Plasma and Urine Pharmacokinetics of Niacin and Its Metabolites
Authors: Menon Rajeev M. , González Mario A. , Adams Marijke H. , Tolbert Dwain S. , Leu Jocelyn H. , Cefali Eugenio A.
Published: May 2007

The metabolic profile of niacin is influenced by the rate of niacin administration. This study characterizes the effect of administration rate on the pharmacokinetics of niacin and its metabolites. Twelve healthy males were enrolled in an open‐label, dose‐rate escalation study and received 2000 mg niacin at 3 different dosing rates. Plasma was analyzed for niacin, nicotinuric acid, nicotinamide, and nicotinamide‐N‐oxide. Urine was analyzed for niacin and the metabolites nicotinuric acid, nicotinamide, nicotinamide‐N‐oxide, N‐methylnicotinamide, and N‐methyl‐2‐pyridone‐5‐carboxamide. Cmax and AUC0–t for niacin and nicotinuric acid increased with an increase in dosing rate. The changes observed in plasma nicotinamide and nicotinamide‐N‐oxide parameters, however, did not correlate to dosing rate. The total amount of niacin and metabolites excreted in urine was comparable for all 3 treatments. However, with the increase in dosing rate, urine recovery of niacin and nicotinuric acid showed a significant increase, whereas N‐methyl‐2‐pyridone‐5‐carboxamide and N‐methylnicotinamide showed a significant decrease.
Coadministration of Estradiol/Drospirenone and Indomethacin Does Not Cause Hyperkalemia in Healthy Postmenopausal Women: A Randomized Open‐Label Crossover Study
Authors: Schütt Barbara , Kunz Michael , Blode Hartmut
Published: May 2007

The effect of drospirenone on plasma potassium when coadministered with nonsteroidal anti‐inflammatory drugs, such as indomethacin, is unknown. An open‐label crossover study investigated the effects of estradiol/drospirenone and indomethacin coadministration on plasma potassium levels in 32 postmenopausal women. Each participant received 2 treatments in random order: indomethacin alone for 5 days and estradiol/drospirenone alone for 12 days, then estradiol/drospirenone plus indomethacin for 5 days. Plasma potassium profiles (24 hours) were measured on the first and last days of indomethacin administration. No difference was seen between treatments in the area under the curve or maximum concentration of plasma potassium. No participant experienced hyperkalemia (potassium >5.5 mmol/L). Twenty‐seven participants had at least 1 potassium value above the upper limit of normal (4.4 mmol/L), but these occurred during both treatments. Coadministration of estradiol/drospirenone and a nonsteroidal anti‐inflammatory drug such as indomethacin is not expected to result in increased plasma potassium or hyperkalemia in healthy postmenopausal women.
Interorganizational Networks at the Network Level: A Review of the Empirical Literature on Whole Networks
Authors: Provan Keith G. , Fish Amy , Sydow Joerg
Published: May 2007

This article reviews and discusses the empirical literature on interorganizational networks at the network level of analysis, or what is sometimes referred to as “whole” networks. An overview of the distinction between egocentric and network-level research is first introduced. Then, a review of the modest literature on whole networks is undertaken, along with a summary table outlining the main findings based on a thorough literature search. Finally, the authors offer a discussion concerning what future directions might be taken by researchers hoping to expand this important, but understudied, topic.
Shifting Subject Positions
Authors: Kerr Anne , Cunningham-Burley Sarah , Tutton Richard
Published: May 2007

Public dialogue about science, technology and medicine is an established part of the activities of a range of charities, private corporations, governmental departments and scientific institutions. However, the extent to which these activities challenge or bridge the lay—expert divide is questionable. Expertise is contested, by the public and the community of scholars who study and/or facilitate public engagement. In this paper, we explore the dynamics of expertise and their implications for the lay—expert divide at a series of public events about the new genetics. We examine participants' claims to expertise and consider how this relates to their claims to credibility and legitimacy and the way in which these events unfolded. Using a combination of ethnographic and discursive analysis, we found that participants supplemented technical expertise with other expert and lay perspectives. We can also link participants' claims to expertise to their generally positive appraisal of genetic research and services. The colonization of lay positions by expert speakers and the hybrid positioning of lay—experts was characteristic of the consensus and conservatism that emerged. This leads us to conclude that public engagement activities will not challenge the dominance of technical expertise in decision-making about science, technology and medicine without more explicit and reflexive problematization of the dynamics of expertise therein.
Deadly Dingoes
Authors: Healy Stephen
Published: May 2007

This paper elaborates a relational framework for `political ecology', based on an analysis of a controversy over the aggressive behaviour of the dingoes on Fraser Island and brought to prominence by the death of a 9-year-old tourist in 2001. In contrast to the authorities' treatment of Fraser's environment as an essentially enduring entity, readily compliant with instrumental interventions, the `partial perspectives' of their local critics emphasize co-constitutive relationships between people and non-humans, including dingoes. This latter view — that the form, character and content of human activities and the world are intimately interdependent — resonates with Latour's `experimental metaphysics', which is intended to achieve the `progressive composition' of people and their worlds. However, while Latour's framework relies on conventional notions of knowledge at odds with these local `situated knowledges', Haraway illuminates how their experiential and affective qualities ensure the ethical character of `progressive composition'. I call this consolidation of Latour and Haraway's ideas `affirmative cosmopolitics', and briefly discuss its broader implications and resonance with Australian Aboriginal cosmology.
Biotech in Court
Authors: Swanson Kara
Published: May 2007

This paper examines the American legal system's reliance upon the unity of science through a close study of the testimony presented in a biotech patent trial, explicated through the context of the legal practice of patent drafting and the history of the American biotechnology industry. In order to decide whether a key patent related to the polymerase chain reaction (PCR) was invalid, the court needed to decide whether the inventing scientists had made intentional misrepresentations in the process of drafting and prosecuting the patent. I analyze the various images of science presented to the court by scientists testifying about how scientists report their experimental results in scientific publications. By setting this testimony about scientific authorship in the context of the legal understanding of patent authorship, I explain why the court was prepared to accept a universal notion of science and of the scientist that rendered unimportant any distinctions between papers and patents, or between professors and biotech scientists. This image of universal science was opposed at trial by local and specific images of sciences which have been institutionalized in industrial science throughout the 20th century, and which I argue were adopted and adapted by the American biotech industry of the 1970s to the 1990s in ways that contributed both to the trial court's finding against the patent, and to the instability of that ruling.
Parameterizations as Boundary Objects on the Climate Arena
Authors: Sundberg Mikaela
Published: May 2007

This paper analyses the relationship between field experimentalists and simulation modellers in meteorological research on the one hand, and how this is related to climate change as a common arena of concern on the other. Climate has become the central topic in meteorological research and it is imperative to link specific research problems to climate change in order to receive funding and attract talent. In addition, climate models have become gatekeepers for claims about climate change. Hence, active participation in climate modelling processes is valuable for all parties. Observational data are used in order to develop new components — so-called parameterizations — for the climate models and these novel components therefore emerge as important boundary objects. While they serve different purposes for experimentalists and modellers in terms of translation processes, they also serve to connect these groups and reinforce their mutual dependence.