bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence for a Sensitive Period for Acculturation
Authors: Cheung Benjamin Y. , Chudek Maciej , Heine Steven J.
Published: December 2010

Though recent adult immigrants often seem less acculturated to their new society than people who immigrated as children, it is not clear whether this difference is driven by duration of exposure or exposure during a sensitive developmental period. In a study aimed at disambiguating these influences, community and student samples of Hong Kong immigrants to Vancouver, Canada, completed the Vancouver Index of Acculturation, a measure that assesses respondents’ identification with their mainstream and heritage cultures. A longer duration of exposure was found to be associated with greater identification with Canadian culture only at younger ages of immigration, but not at later ages of immigration. Conversely, identification with Chinese culture was unaffected by either age of immigration or length of exposure to Canadian culture. These findings provide evidence for a sensitive period for acculturation: People are better able to identify with a host culture the longer their exposure to it, but only if this exposure occurs when they are relatively young.
Disclosure of HIV Infection Among Israeli Men Who Have Sex With Men
Authors: Ben Natan Merav , Zeltzer Ira , Melnikov Katia
Published: December 2010

A descriptive, cross-sectional study was conducted to explore disclosure decisions regarding potential HIV infection by men who have sex with men (MSM). The sample consisted of 104 Israeli MSM. A questionnaire based on the theory of reasoned action was used for data determination. The questionnaire deals with beliefs, attitudes, and disclosure intentions. Results showed that only 30% of respondents intended to disclose potential HIV infection. A total of 70% of those who intended to disclose would choose to disclose the information to their brother/sister, two thirds to their mother, and only about 50% to their father. All components of the theory have an effect on MSM intentions of disclosure to others. In addition, behavioral beliefs, that is, MSM beliefs of the consequences of disclosure, were found to be the most significant predictor of behavioral intention. Research recommendations include the promotion of positive behavioral attitudes toward disclosure, leading to an increase in behavioral intentions of disclosure.
A Guide to Developing a Culturally Competent Organization
Authors: Purnell Larry , Davidhizar Ruth E. , Giger Joyce Newman , Strickland Ora L. , Fishman Dorothy , Allison Dale M.
Published: December 2010

The journey to organizational cultural competence for a health care organization, educational setting, freestanding clinic, or long-term-care organization is a process that requires the collaborative efforts from people at all levels in every department as well as external consumers such as public policy officials, students, and community leaders. Broadly speaking, four main but overlapping areas must be considered in institute activities and strategies to accomplish a comprehensive culturally competent organization. These four areas are (a) administration and governance, (b) orientation and education, (c) language, and (d) staff competencies. This article presents key content areas and activities to consider on the journey to cultural competence. Tables with suggested departmental responsibilities for implementation are included. In some cases, the journey may best be facilitated by a consultant who is well versed in cultural competence and organizational dynamics.
Fa’afaletui: A Framework for the Promotion of Renal Health in an Australian Samoan Community
Authors: McCarthy Alexandra , Shaban Ramon , Stone Cassandra
Published: December 2010

Purpose: Samoan communities in Australia exhibit a disproportionate rate of kidney disease compared with other Australians. This article describes a research project that used a culturally sensitive framework, Fa’afaletui, to help reduce the barriers of language and culture and increase our understanding of the factors contributing to kidney disease, in one Samoan community in Australia. Design: Semistructured group interviews were undertaken with Samoan community families and groups. The interviews were analyzed according to key concepts embedded in the Fa’afaletui framework. Findings: Four factors associated with health risks in this Samoan community emerged: diet and exercise, issues related to the collective (incorporating the village, church, and family), tapu or cultural protocols, and the importance of language. Conclusions: The findings suggest that future kidney health promotion initiatives within this Samoan community will be more effective if they are sensitive to Samoan cultural norms, language, and context.
Disorganizing Experiences in Second- and Third-Generation Holocaust Survivors
Authors: Scharf Miri , Mayseless Ofra
Published: December 2010

Second-generation Holocaust survivors might not show direct symptoms of posttraumatic stress disorder or attachment disorganization, but are at risk for developing high levels of psychological distress. We present themes of difficult experiences of second-generation Holocaust survivors, arguing that some of these aversive experiences might have disorganizing qualities even though they do not qualify as traumatic. Based on in-depth interviews with 196 second-generation parents and their adolescent children, three themes of disorganizing experiences carried across generations were identified: focus on survival issues, lack of emotional resources, and coercion to please the parents and satisfy their needs. These themes reflect the frustration of three basic needs: competence, relatedness, and autonomy, and this frustration becomes disorganizing when it involves stability, potency, incomprehensibility, and helplessness. The findings shed light on the effect of trauma over the generations and, as such, equip therapists with a greater understanding of the mechanisms involved.
Diabetes Management at School
Authors: Bobo Nichole , Kaup Tara , McCarty Patricia , Carlson Jessie Parker
Published: December 2010

Every child with diabetes deserves a school nurse with the capacity to effectively manage the disease at school. The school nurse needs knowledge and skills to confidently provide care and communicate with health care providers and families. The Healthy Learner Model for Chronic Condition Management provided a framework to eliminate the disjointed approach to diabetes management at school, replacing it with a consistent, evidence-based approach. A diabetes resource nurse was a key component, providing support for the school nurse and collaboration between the school, community, family, and health care providers. Funded by a cooperative agreement from the Centers for Disease Control and Prevention (CDC), the National Association of School Nurses (NASN) chose five sites from across the country to implement this program—a project titled Managing and Preventing Diabetes and Weight Gain (MAP). This article describes the experience of two sites.
Understanding Local Adoption and Implementation of Climate Change Mitigation Policy
Authors: Sharp Elaine B. , Daley Dorothy M. , Lynch Michael S.
Published: December 2010

Increasingly, local governments are crafting policy to tackle climate change. This article examines why cities develop and implement climate change programs. The authors consider the impact of interest group pressure, political institutions, and problem severity on a city’s decision to develop and implement climate protection programs. Their results suggest that organized interests influence both adoption and implementation of climate mitigation programs. This effect, however, is contingent on political institutions. In general, organized interests are more effective in mayoral as opposed to city manager forms of governments. Interestingly, while financially strapped cities may adopt climate mitigation programs to advance cobenefits or cost savings, fiscal stress also impedes program implementation.
Social Norms and the Relationship Between Cigarette Use and Religiosity Among Adolescents in the United States
Authors: Gryczynski Jan , Ward Brian W.
Published: December 2010

This study investigated the social dynamics that underlie the negative association between religiosity and cigarette use among U.S. adolescents. Using data from the 2007 National Survey on Drug Use and Health, the authors used a theory-based conceptual model (vicarious learning networks [VLN]) to examine the role that key reference group norms play in the religiosity—smoking relationship. This relationship is partially mediated by parents’ and close friends’ perceived disapproval for smoking. However, religiosity maintains a strong negative association with smoking. Consistent with the VLN model, cigarette use varied substantively based on reference group normative configurations. To the extent that the protective effects of religiosity arise from its influence in structuring the social milieu, some of religiosity’s benefits could potentially be leveraged through interventions that promote healthy norms among reference groups within the social network. The VLN model may be a useful tool for conceptualizing the transmission of health behavior through social learning processes.
Strategies to Facilitate Exposure to Internet-Delivered Health Behavior Change Interventions Aimed at Adolescents or Young Adults: A Systematic Review
Authors: Crutzen Rik , de Nooijer Jascha , Brouwer Wendy , Oenema Anke , Brug Johannes , de Vries Nanne K.
Published: December 2010

The Internet is considered to be a promising delivery channel of interventions aimed at promoting healthful behaviors, especially for adolescents and young adults. Exposure to these interventions, however, is generally low. A more extensive exploration of methods, strategies, and their effectiveness with regard to facilitating exposure is therefore timely, because this knowledge is crucial to improve the use of such interventions and, subsequently, to increase behavioral change. Therefore, a systematic review of the literature was conducted, resulting in 838 studies based on title selection, of which 26 studies met the eligibility criteria. The systematic review resulted in an overview of methods and strategies that have been used to facilitate exposure. Patterns of effective strategies could be observed, such as the combination of tailored communication and the use of reminders and incentives. Nevertheless, exposure-specific theories need to be developed and objective exposure measures should be tracked and reported in future studies.
Taxpayer Behavior When Audit Rules Are Known: Evidence from Italy
Authors: Santoro Alessandro , Fiorio Carlo V.
Published: December 2010

Italy adopted in 1998 a peculiar audit scheme (Studi di Settore), for small and medium enterprises and the self-employed. This scheme is based on a particular interaction between the tax agency and taxpayers, where the agency unveils only part of the information used to develop its audit rule. The authors study this scheme by means of a simple theoretical model and they test it using a sample of 23,000 firms in manufacturing sectors in the 2005 tax year. A number of theoretically relevant relations are confirmed. In particular, reports made by taxpayers seem to be positively associated to the firm’s size. When taxpayers know that the probability to be audited decreases, they tend to report less. Other factors that are expected to influence the behavior of taxpayers have no or an ambiguous impact on reporting behavior.
Dynamic Scoring, Tax Evasion, and the Shadow Economy
Authors: Stinespring John Robert
Published: December 2010

Measuring the impact of tax policy on tax evasion is crucial in estimating government revenues. In the United States, the government estimates that $300—$400 billion is lost each year to tax evasion. This article combines dynamic scoring with household preferences for tax evasion à la Feige and McGee to measure the macroeconomic feedback effects from tax cuts to changes in output and government revenues. Using a simple dynamic scoring model based on Mankiw and Weinzierl (2006), the feedback effects are divided into their constituent substitution, income, and evasion effects for an analysis of individual behavior at the microeconomic level. Calibrating the model to U.S. data reveals that the growth effects of income tax rate cuts can offset a significant percentage of the potential revenue losses.
Penalties in the Theory of Equilibrium Tax Evasion: Solving King John’s Problem
Authors: Neumärker Bernhard , Pech Gerald
Published: December 2010

The authors characterize equilibria of an income reporting game with bounded returns and no commitment where detected tax evaders are charged the maximally feasible amount. Introducing partial commitment to punishment relief eliminates multiplicity of equilibria. The authors identify a unique limit equilibrium where the poorest citizens evade, intermediate citizens are honest, and the richest citizens are indifferent between evading and truth telling. For small tax rates and auditing cost, committing to a discretionary punishment relief scheme increases expected tax revenue.
Developing and Using a Codebook for the Analysis of Interview Data: An Example from a Professional Development Research Project
Authors: DeCuir-Gunby Jessica T. , Marshall Patricia L. , McCulloch Allison W.
Published: December 2010

This article gives specific steps on how to create a codebook for coding interview data. The authors examine the development of theory- and data-driven codes through the discussion of a professional development (PD) research project. They also discuss how to train others to code using the codebook, including how to establish reliability. The authors end with practical suggestions from their experiences in creating a codebook.
Red Cards
Authors: Mechtel Mario , Bäker Agnes , Brändle Tobias , Vetter Karin
Published: December 2010

A popular soccer myth states that teams affected by a sending-off perform better than they would have performed without it. Based on economic theory, the authors analyze the course of soccer matches using data from the German Bundesliga from 1999 to 2009. The results show that sending-offs against home teams have a negative impact on their performance. However, for guest teams, the impact depends on the time remaining after the sending-off and can be positive if the sending-off occurs late in the game. Thus, the “ten do it better” myth seems to hold for guest teams to a certain extent.
Mega-Events: Is Baylor Football to Waco What the Super Bowl is to Houston?
Authors: Coates Dennis , Depken, Craig A.
Published: December 2010

Using monthly data describing 23 cities in Texas from January, 1990, through December, 2008, the net impacts of various professional and collegiate sporting events on sales tax revenues are estimated. Contrary to the rhetoric offered by those who argue in favor of public subsidies to host professional sports franchises and mega-events, the authors find that regular season and many postseason games actually correspond with net decreases in economic activity in the host city, from which we infer that a professional sports franchise generates considerable substitution effects for the local population. The authors find that college football games have a positive impact on local host-city tax revenues and that the relative impact of a season of college football might be roughly equivalent to the relative impact of the Super Bowl.
Fighting the War against Blight: Columbia University, Morningside Heights, Inc., and Counterinsurgent Urban Renewal
Authors: Carriere Micheal
Published: December 2010

During the post—World War II era, Columbia University undertook a bold and comprehensive expansion and redevelopment initiative to remake their immediate surroundings. Drawing upon the language of Cold War anticommunism, the university—in partnership with such redevelopment groups as Morningside Heights Inc.—undertook such a self-proclaimed ‘‘war on blight’’ in an attempt to ‘‘liberate’’ the surrounding community from the horrors of urban decay. This essay positions the 1968 student—community campaign against a proposed gymnasium in Morningside Park within this longer narrative of university-sponsored urban renewal. In light of such a history, those that campaigned against the university’s expansion efforts also adopted a language clearly influenced by the imagery of warfare in the mid-twentieth century: the language of anticolonialism.
Prevention of 3 “Never Events” in the Operating Room: Fires, Gossypiboma, and Wrong-Site Surgery
Authors: Zahiri Hamid R. , Stromberg Jeffrey , Skupsky Hadas , Knepp Erin K. , Folstein Matthew , Silverman Ronald , Singh Devinder
Published: December 2010

Background: This study sought to identify and provide preventative recommendations for potentially devastating safety violations in the operating room. Methods: A Medline database search from 1950 to current using the terms patient safety and operating room was conducted. All topics identified were reviewed. Three patient safety violations with potential for immediate and devastating outcomes were selected for discussion using evidence-based literature. Results: The search identified 2851 articles, 807 of which were directly related to patient safety in the operating room. Topics addressed by these 807 included infectious complications (26%), fires (11%), communication/teamwork (6%), retained foreign objects (3%), safety checklists (1%), and wrong-site surgery (1%). Fires, gossypiboma, and wrong-site surgery were selected for discussion. Conclusions: Although fire, gossypiboma, and wrong-site surgery should be “never events” in the operating room, they continue to persist as 3 common patient safety violations. This study provides the epidemiology, common etiologies, and evidence-based preventative recommendations for each.
Alteration of Topoisomerase II–Alpha Gene in Human Breast Cancer: Association With Responsiveness to Anthracycline-Based Chemotherapy
Authors: Press Michael F. , Sauter Guido , Buyse Marc , Bernstein Leslie , Guzman Roberta , Santiago Angela , Villalobos Ivonne E. , Eiermann Wolfgang , Pienkowski Tadeusz , Martin Miguel , Robert Nicholas , Crown John , Bee Valerie , Taupin Henry , Flom Kerry J. , Tabah-Fisch Isabelle , Pauletti Giovanni , Lindsay Mary-Ann , Riva Alessandro , Slamon Dennis J.
Published: December 2010

Purpose

Approximately 35% of HER2-amplified breast cancers have coamplification of the topoisomerase II-alpha (TOP2A) gene encoding an enzyme that is a major target of anthracyclines. This study was designed to evaluate whether TOP2A gene alterations may predict incremental responsiveness to anthracyclines in some breast cancers.

Methods

A total of 4,943 breast cancers were analyzed for alterations in TOP2A and HER2. Primary tumor tissues from patients with metastatic breast cancer treated in a trial of chemotherapy plus/minus trastuzumab were studied for amplification/deletion of TOP2A and HER2 as a test set followed by evaluation of malignancies from two separate, large trials for changes in these same genes as a validation set. Association between these alterations and clinical outcomes was determined.

Results

Test set cases containing HER2 amplification treated with doxorubicin and cyclophosphamide (AC) plus trastuzumab, demonstrated longer progression-free survival compared to those treated with AC alone (P = .0002). However, patients treated with AC alone whose tumors contain HER2/TOP2A coamplification experienced a similar improvement in survival (P = .004). Conversely, for patients treated with paclitaxel, HER2/TOP2A coamplification was not associated with improved outcomes. These observations were confirmed in a larger validation set, where HER2/TOP2A coamplification was again associated with longer survival when only anthracycline-containing chemotherapy was used for treatment compared with outcome in HER2-positive cancers lacking TOP2A coamplification.

Conclusion

In a study involving nearly 5,000 breast malignancies, both test set and validation set demonstrate that TOP2A coamplification, not HER2 amplification, is the clinically useful predictive marker of an incremental response to anthracycline-based chemotherapy. Absence of HER2/TOP2A coamplification may indicate a more restricted efficacy advantage for breast cancers than previously thought.
Risk Factors for the Development of Secondary Malignancy After High-Dose Chemotherapy and Autograft, With or Without Rituximab: A 20-Year Retrospective Follow-Up Study in Patients With Lymphoma
Authors: Tarella Corrado , Passera Roberto , Magni Michele , Benedetti Fabio , Rossi Andrea , Gueli Angela , Patti Caterina , Parvis Guido , Ciceri Fabio , Gallamini Andrea , Cortelazzo Sergio , Zoli Valerio , Corradini Paolo , Carobbio Alessandra , Mulé Antonino , Bosa Marco , Barbui Anna , Di Nicola Massimo , Sorio Marco , Caracciolo Daniele , Gianni Alessandro M. , Rambaldi Alessandro
Published: December 2010

Purpose

High-dose chemotherapy with peripheral blood progenitor cell (PBPC) autograft is effective in high-risk lymphoma, particularly with the addition of rituximab; however, it is associated with risk of secondary malignancy. These issues have been addressed in a series of 1,347 patients with lymphoma treated with a high-dose sequential (HDS) program.

Patients and Methods

A total of 1,024 patients with B-cell lymphoma, 234 patients with Hodgkin's lymphoma, and 89 patients with T-cell lymphoma were treated with HDS between 1985 and 2005 at 11 Gruppo Italiano Terapie Innovative Linfomi centers. HDS was given as salvage treatment to 707 patients (52%); 655 patients (49%) received a modified HDS, with high-dose cytarabine and two consecutive PBPC harvests. Rituximab-supplemented HDS was given to 523 patients (39%).

Results

At a median follow-up of 7 years, the median overall survival (OS) was 16.2 years; in B-cell lymphoma the OS was significantly superior with rituximab HDS compared to HDS alone. The cumulative incidence at 5 and 10 years of secondary myelodysplasia/acute leukemia (sMDS/AL) were 3.09% and 4.52%, respectively, that of solid tumors were 2.54% and 6.79%, respectively. Factors associated with sMDS/AL were male sex and use of the second harvest PBPC for the graft; factors found to be associated with solid tumor were advanced age, post-HDS radiotherapy, and rituximab addition to HDS. Despite the increased risk of solid tumors, rituximab addition to HDS was still associated with survival advantages.

Conclusion

This analysis has relevant implications for the design and use of intensive chemoimmunotherapy with autograft. In addition, it offers useful insights toward the understanding and prevention of tumor development.
What Is the True Number Needed to Screen and Treat to Save a Life With Prostate-Specific Antigen Testing?
Authors: Loeb Stacy , Vonesh Edward F. , Metter E. Jeffrey , Carter H. Ballentine , Gann Peter H. , Catalona William J.
Published: December 2010

Purpose

The European Randomized Study of Screening for Prostate Cancer (ERSPC) reported a 20% mortality reduction with prostate-specific antigen (PSA) screening. However, they estimated a number needed to screen (NNS) of 1,410 and a number needed to treat (NNT) of 48 to prevent one prostate cancer death at 9 years. Although NNS and NNT are useful statistics to assess the benefits and harms of an intervention, in a survival study setting such as the ERSPC, NNS and NNT are time specific, and reporting values at one time point may lead to misinterpretation of results. Our objective was to re-examine the effect of varying follow-up times on NNS and NNT using data extrapolated from the ERSPC report.

Materials and Methods

On the basis of published ERSPC data, we modeled the cumulative hazard function using a piecewise exponential model, assuming a constant hazard of 0.0002 for the screening and control groups for years 1 to 7 of the trial and different constant rates of 0.00062 and 0.00102 for the screening and control groups, respectively, for years 8 to 12. Annualized cancer detection and drop-out rates were also approximated based on the observed number of individuals at risk in published ERSPC data.

Results

According to our model, the NNS and NNT at 9 years were 1,254 and 43, respectively. Subsequently, NNS decreased from 837 at year 10 to 503 at year 12, and NNT decreased from 29 to 18.

Conclusion

Despite the seemingly simplistic nature of estimating NNT, there is widespread misunderstanding of its pitfalls. With additional follow-up in the ERSPC, if the mortality difference continues to grow, the NNT to save a life with PSA screening will decrease.
Phase II Study of Modified Docetaxel, Cisplatin, and Fluorouracil With Bevacizumab in Patients With Metastatic Gastroesophageal Adenocarcinoma
Authors: Shah Manish A. , Jhawer Minaxi , Ilson David H. , Lefkowitz Robert A. , Robinson Edric , Capanu Marinela , Kelsen David P.
Published: December 2010

Purpose

To evaluate the safety and efficacy of a modified administration schedule of docetaxel, cisplatin, and fluorouracil (mDCF) with bevacizumab in patients with advanced gastroesophageal malignancies.

Patients and Methods

Previously untreated patients with metastatic gastroesophageal adenocarcinoma received bevacizumab 10 mg/kg, docetaxel 40 mg/m2, fluorouracil 400 mg/m2, leucovorin 400 mg/m2 on day 1, fluorouracil 1,000 mg/m2/d × 2 days intravenous continuous infusion beginning on day 1, and cisplatin 40 mg/m2 on day 3. The primary objective was to improve 6-month progression-free survival (PFS) from 43% (historical DCF control) to 63% with the addition of bevacizumab. The target accrual was 44 patients to have 10% type I and II error rates.

Results

In total, 44 eligible patients with cancer were enrolled from October 2006 to October 2008: 22 gastric, 20 gastroesophageal junction (GEJ), and two esophagus. In 39 patients with measurable disease, the confirmed response rate was 67% (95% CI, 50% to 81%). Six-month PFS was 79% (95% CI, 63% to 88%), and median PFS was 12 months (95% CI, 8.8 to 18.2 months). With 26-month follow-up, median overall survival (OS) was 16.8 months (95% CI, 12.1 to 26.1 months), and 2-year survival was 37%. Treatment-related grade 3 to 4 toxicity was as follows: neutropenia without fever (50%), fatigue (25%), venous thromboembolism (39%), and nausea, vomiting, mucositis, neuropathy, and febrile neutropenia less than 10% each. In subset analysis, diffuse gastric cancer had significantly worse PFS and OS, and the response rate in proximal/GEJ tumors was 85% (95% CI, 62% to 97%).

Conclusion

mDCF with bevacizumab appears tolerable and has notable patient outcomes in patients with advanced gastroesophageal adenocarcinoma. Six-month PFS was 79%, surpassing our predefined efficacy end point, and median and 2-year OS were 16.8 months and 37%, respectively.
The Enemy Within: Academic Freedom in 1960s and 1970s American Social Sciences
Authors: Mata Tiago
Published: December 2010

In the 1960s and 1970s, the social science associations (anthropology, sociology, economics, political science, and history) were faced by a string of academic freedom controversies. I review debates at association meetings and the reports and policy statements of committees on ethics and political discrimination. The ethics committees dealt with the involvement of association members with nonuniversity patrons, in the wake of revelations about Project Camelot. The committees on political discrimination examined allegations that university administrations were discriminating against radical scholars for their advocacy against the war in Vietnam and other revolutionary causes of the time. I argue that in both instances social scientists sought to accommodate the new roles of universities in American society by developing codes of conduct for social scientists that were voluntary and nonenforceable. Implied in the response of social science associations was that threats to academic freedom arose in social scientists' misguided behavior and not by fault of the new institutional setting of the university in the 1960s.
Tool Shock: Technique and Epistemology in the Postwar Social Sciences
Authors: Isaac Joel
Published: December 2010

This essay explores a form of reflexivity peculiar to the postwar social sciences. The mobilization of science in the United States during World War II released across the social sciences a wave of new research tools: mathematical models and calculation techniques ranging from game theory to cybernetics. As this profusion of analytical technologies gathered pace in the early years of the Cold War, practitioners of economics and cognate disciplines began to register what I term tool shock. Foundational debates about the epistemological properties and scientific legitimacy of the new tools were conducted in various fields. Focusing on economics and sociology, and in particular on economic theory and social theory, I track these debates across the immediate postwar years. I show that the intensity and location of tool shock varied noticeably in these two disciplines. Such differences, I argue, can be explained by the extent to which the postwar techniques were built into the pedagogical and research practices of the two fields in question.
Foreign-Trade Zones and the Cultural Logic of Frictionless Production
Authors: Orenstein Dara
Published: December 2010

How do places of enclosure facilitate processes of enclosure? The case of free trade zones—or, rather, foreign-trade zones—suggests one means. Thanks to megawatt duos such as Walmart and Kathie Lee Gifford, free trade zones rank among the most archetypal spaces of neoliberalism. At over thirty-five hundred strong, ranging from Honduras to Indonesia, these fenced enclaves of “labor warehouses,” in the words of a Filipino labor organizer, constitute the legal and material infrastructure of the global assembly line. Yet contrary to the cognitive maps of Buy Americanists, a sizeable number of free trade zones are located not offshore but onshore, planted firmly on U.S. soil, if not entirely on U.S. territory. Known as foreign-trade zones, or FTZs, Uncle Sam's enclaves are much older than their counterparts in the Global South: first proposed in 1894, they were authorized by Congress in 1934, at the dawn of the New Deal. This article sketches how zones inside the United States have come to connect to zones outside the United States by revisiting the literal and figurative construction of the first FTZ on ninety-two acres in Staten Island.
Confronting the Enclosure of the Cultural Commons
Authors: Chazkel Amy
Published: December 2010

The cartoonist and filmmaker Nina Paley became a vociferous opponent of proprietary control of creative work under U.S. copyright law following her experiences in making her award-winning Sita Sings the Blues (2009), an animated feature film based largely on the ancient Indian epic story of the Ramayana set to music from the 1920s, whose rights are owned by media corporations. Paley released her film, and all subsequent work, under a Creative Commons license, which not only made it freely available to anyone who wished to view, share, and add to her creative work but also legally protected her work as part of the cultural commons in perpetuity. In this interview with Amy Chazkel, Paley explains her travails as she tried to “free” her work, the artistic and creative benefit of doing so, and the rationale behind her political conviction. She also probes the connections between the enclosure of the cultural and the material commons.
Towards the Perfect Operating List: 5 Steps to Safer Surgery
Authors: Marx Clare
Published: December 2010

Of course we all want safer surgery for our patients, to run more efficient lists and to have less hassle before, during and after operating – who wouldn't? So what have we actually done to ensure that happens? Reflecting on your own experiences, how close do you come to achieving an ideal operating day and, if not, how about trying some small steps that have been shown to assist?
Anatomy teaching: the cruellest cut – a progress report
Authors: Standring Susan , Larvin Michael
Published: December 2010

A high-level round-table discussion, jointly sponsored by the College and the Anatomical Society and chaired by Richard Collins, College Vice-president, was held at the College in October 2010. The main purpose of the meeting was to determine what progress if any had been made in achieving the outcomes of Anatomy teaching – the cruellest cut of all, a conference held at the College in 2007.
Undergraduate Anatomy Teaching: Are we Failing a Generation of Future Surgeons?
Authors: Bagley Caroline HM , Gillott Elizabeth , Gunasekera Ayanthi
Published: December 2010

A sound knowledge of human anatomy underpins good clinical practice. However, changes to the undergraduate curriculum in recent years, in particular a reduced emphasis on applied anatomy, have raised concerns among clinicians that a new generation of doctors are qualifying from medical school with insufficient anatomical knowledge. This is a particularly important concern for those junior doctors wishing to pursue a surgical career and has implications for their early postgraduate training.
Surgeons in training – a financial burden or benefit to NHS trusts?
Authors: Clamp Philip J , Malpas Gemma , Mason Katrina A , Giddings Charles E
Published: December 2010

Surgical training is a form of apprenticeship. Trainees work alongside established specialists in order to acquire the knowledge, technical skills and judgement required to practise surgery. This training is undertaken within the NHS and runs concomitantly with a service commitment to the clinical care delivered by the surgical team.
Would the MRCS Written Papers Benefit from Computerisation? The University of Nottingham Experience
Authors: Baylem NJ , Wilkinson S , Dennick R
Published: December 2010

Modern technology and computing are playing an ever larger role in education in general and in medicine in particular. Computerisation of assessments has been used at a basic level for nearly 50 years, with optical mark readers (still used in many institutions, including on the Advanced Life Support and Advanced Trauma Life Support® courses) first being used in the 1960s. A huge increase in the use of information technology as a teaching aid has been mirrored by an increase in its use in assessment. There are at least four major drivers behind this move towards computer-based assessment (CBA): efficiency, transparency, reliability and validity.
Developing Surgical Research in the Modern NHS: A Call to Arms
Authors: Scholefield JH , Lobo DN
Published: December 2010

Change is an everyday occurrence in the modern NHS and many new initiatives apparently conspire to make the surgeon's life ever more difficult. Many surgeons wish to take part in clinical research but either do not know how to get involved or lack support. This article describes recent developments that promise to make the participation of surgeons in clinical research easier.
Surgery – turning the clock back forwards
Authors: Rosin R David
Published: December 2010

Following on from last month's issue on international surgery, we are delighted to publish the first in our series of articles on surgery overseas. Professor David Rosin, former Vice-president of The Royal College of Surgeons of England, here gives an account of his work as Professor of Surgery in Barbados, with telling contrasts to the UK surgical experience, both past and present.
Supporting the Education of Surgical Trainees: The Well Come Museum of Anatomy and Pathology
Authors: Phillips Carina , Cooke Martyn
Published: December 2010

The Wellcome Museum is going from strength to strength following refurbishment last year. Work is now under way on a complete reorganisation of the specimen collection into anatomical regions, designed to provide greater support to the surgical trainee.
FDSRCS by assessment
Authors: Walls Angus
Published: December 2010

Fellowship of the College has always been regarded as the pinnacle of achievement within the organisation. With the change of the original FDS into MFDS and then MJDF many of our current members will have a membership rather than a fellowship of this College. Indeed, fellowship is now only available to those few who go on to complete a consultant-level training pathway and the intercollegiate exit examination.
In the newspapers again
Authors: Black John
Published: December 2010

It is an inescapable fact that to influence politicians and policy makers a high media profile is necessary. To that end the College has developed a highly effective policy and communications function. Our media relations team is on call 24 hours a day, 7 days a week and (horror of horrors) it must be possible that some of our staff work in breach of the European Working Time Regulations (EWTR). Our surveys tell us that you like to see the College putting forward your concerns in the national press, on radio and on television and I am sure this gives us greater influence than we would otherwise have.
Networking at home, abroad, online: FGDP(UK) in 2010
Authors: Worker Charlotte
Published: December 2010

The 'global village' is a concept that organisations need to embrace if they wish to extend their reach and influence. During 2010, the Faculty of General Dental Practice (UK) (FGDP(UK)) has continued to advance initiatives that raise its profile and strengthen its communication activities, as well as developing technical innovations to support information exchange between students, tutors, Faculty Board and members.
The Vascular MDT: An Essential Element in the Treatment of Patients with Vascular Disease
Authors: Earnshaw JJ , Beard JD
Published: December 2010

Multidisciplinary team (MDT) meetings are well established in the management of malignant disease. They were created to ensure that standard management pathways were used to treat patients in the expectation that regularising treatments to the best evidence-based techniques would improve outcomes. There was also an implicit recognition that cancer management was most effectively done by a multiprofessional team composed of all the disciplines involved in the care of the patient, including surgeons, oncologists, radiologists and nurses. The management of cancer is now effected through regular meetings of the MDT in which individual patients are discussed, treatment planned and any variation from common pathways explained and agreed.
Octreotide for Symptomatic Treatment of Diarrhea due to Cytomegalovirus Colitis
Authors: Bartels Michael C , Mergenhagen Kari A
Published: December 2010

Objective

To report the improvement of diarrhea in a patient with cytomegalovirus (CMV) colitis who was treated with octreotide after failure of loperamide.

Case Summary:

An 84-year-old male presented with chronic diarrhea and CMV colitis; he had been experiencing protracted diarrhea since 2006. In October 2009 he failed a 21 -day course of valgancyclovir 900 mg orally twice daily. Several months later, due to continuing diarrhea and progressive malnutrition, a colonoscopy and subsequent biopsy again showed CMV. In March 2010 he was started on a 28-day course of intravenous ganciclovir 130 mg daily. Three weeks into treatment he continued with copious amounts of diarrhea, with no relief from loperamide, which was titrated from 2 mg/day to 2 mg every 6 hours. On day 20 of ganciclovir treatment he was started on octreotide 50 μg subcutaneously every 8 hours; within a few days, the patient began to experience decreased stool frequency and consistency. He completed the full 28-day course of ganciclovir, with octreotide continuing unchanged, with much improvement in his diarrheal symptoms and improvement in appetite, nutritional status, and quality of life.

Discussion:

Studies regarding the treatment of CMV colitis-associated diarrhea are scarce, and are typically limited to treating the underlying cause with antiviral medications and with the addition of antimolility agents. Three cases have been reported in the literature in which octreotide was used for the symptomatic treatment of diarrhea, none of which was refractory to loperamide.

Conclusions:

This is the first known case of a patient with chronic diarrhea due to CMV colitis that was unresponsive to loperamide, required protracted antiviral treatment (valgancyclovir and gancyclovir), and subsequently experienced relief by the use of octreotide 50 μg subcutaneously every 8 hours.
A Potential Interaction between Warfarin and Atovaquone
Authors: Hidalgo Kathleen , Lyles Adraine , Dean Stacey R
Published: December 2010

Objective

To report a case of increased international normalized ratio (INR) in a patient established on warfarin therapy who was then initiated on atovaquone therapy.

Case Summary:

A 53-year-old African American male with HIV was prescribed warfarin 5 mg/day for 12 months after diagnosis of idiopathic deep vein thrombosis and bilateral pulmonary emboli (target INR 2.5 [range 2.0-3.0]). The patient required Pneumocystis jiroveci pneumonia prophylaxis and was prescribed atovaquone instead of trimethoprim/sulfamethoxazole therapy because of the latter drug's known interaction with warfarin. The patient's INR rose by greater than 50% (from 2.3 to 3.5) after 7 days of concomitant warfarin and atovaquone. In response, the patient's total weekly warfarin dose was decreased by 5%. Eight days later, the patient's INR was still supratherapeutic at 3.1. Approximately 4 weeks later, his INR was 4.2. One dose of warfarin was withheld and then the total weekly warfarin dosage was decreased by another 10%. Eight days later, the patient discontinued atovaquone therapy but continued on warfarin as prescribed One day after atovaquone discontinuation, his INR decreased to 1.7. Due to this subtherapeutic INR level, 8 days later the total weekly warfarin dose was increased by 5%. Although a follow-up appointment was scheduled, no further INR values were obtained because the patient's 12-month course of anticoagulation therapy was completed and warfarin was discontinued. The patient did not report any adverse effects or signs or symptoms of hemorrhage while his INR values were supratherapeutic.

Discussion:

Warfarin's potential for interactions with other highly protein-bound drugs, such as atovaquone, can result in displacement from protein binding sites and increased serum concentrations of warfarin. Based on a search of MEDLINE/PubMed, International Pharmaceutical Abstracts, and the Food and Drug Administration MedWatch Adverse Event Reporting Program (all through July 31, 2010), no cases were found of an interaction between atovaquone and warfarin. The Horn Drug Interaction Probability Scale calculated this to be a probable interaction between warfarin and atovaquone.

Conclusions:

Although current medication references do not report an interaction between atovaquone and warfarin, knowledge of their pharmacodynamic properties can enable practitioners to anticipate the consequences of a possible transient increase in warfarin serum concentration, such as that seen in our patient, when given concomitantly.
The Body Politic and Its Parts in El médico de su honra
Authors: Prendergast Ryan
Published: December 2010

This article examines how the representation of threats to and damage inflicted upon the physical body in Calderón de la Barca's El médico de su honra correlate with the text's problematic depiction and incisive critique of Spain's political body. It explores the modes in which homosocial relations determine the infliction of violence on those excluded from the bonds between noblemen. The play demonstrates how male and female physical bodies—seen in different stages of injury—have clear ties with the health of the body-state. There is a critique of the self-interested and politically driven means by which the aristocratic male characters, namely, Pedro, Enrique, and Gutierre, negotiate their own relationships and form the basis of the political body. These characters attempt to further establish and solidify their status and protect their interests, despite the cost to themselves and other subjects, that is, the body politic's "parts," and as a result, to the well-being of the kingdom as a whole. Through the various damaged bodies, El médico reveals a connection between its characters' physical health and the pervasive sickness of the nation controlled by some problematic parts. And it suggests that the relations between and among noblemen are at the heart of the sociopolitical ills.
Dating Calderón's Autobiographical Ballad "Curiosísima señora"
Authors: Voght Geoffrey M.
Published: December 2010

In 1853, Juan Eugenio Hartzenbusch published a 187-verse fragment of an autobiographical ballad by Calderón de la Barca on which Cotarelo y Mori relied at times in his 1924 biography of the famous dramatist. In 1962, E. M. Wilson printed an altered but more complete version of this romance attributed to Don Carlos Alberto de Cepeda y Guzmán, a poet from Sevilla born in 1640, concluding that someone adapted Cepeda's original poem to make it refer to Calderón. Doubts regarding who composed the comic self-portrait persisted until 2003 when Professor Agustín de la Granja of the University of Granada reestablished Calderonian authorship, published our most reliable text of the 244-verse ballad, and argued that it was composed for a poetic contest held after a bullfight on 4 May 1623. The main purpose of the present study is to review briefly some of de la Granja's reasons for believing that the poem was composed in 1623, to summarize problems with this early dating, and to explain why composition in the 1637-1640 period may better fit some elements found in Calderón's poem. The texts of the incomplete version published in the nineteenth century by Hartzenbusch and of a manuscript of the complete ballad from the Biblioteca Nacional in Madrid are published in the appendix to this article.
Songs, Song-Texts, and Lovesickness in Agustín Moreto's Yo por vos y vos por otro
Authors: Porras George Yuri
Published: December 2010

In recent years, a considerable amount of scholarship has been produced on the function of music in the drama of Lope de Vega and Calderón de la Barca. But songs, dances, instruments, and other music references abound in the works of other important Spanish Golden Age dramatists. Because of the significant role music plays in many of his plays, special attention should be devoted to the repertoire of the preeminent dramatists Agustín Moreto. This essay focuses on the relationship between music and text in Yo por vos y vos por otro (1676), and particularly on how music is utilized during critical junctures as a way to underscore, on the one hand, the work's references to period notions of lovesickness, and on the other, to support the work's dramatic structure and technique. The function of music in this play is an example of the need for further study and reevaluation of a significant portion of Moreto's repertoire.
A Study of Women's Intelligence in Moreto's No puede ser
Authors: Magro Tania de Miguel
Published: December 2010

Critics of Moreto commonly highlight his characteristic development of strong female characters and his tendency to prioritize reasoning over action. This article connects both tendencies by analyzing what I call "women's intellect" in the play No puede ser , in order to better understand Moreto's representation of women. In a world in which women are supposed to remain obedient and silent and in which action is reserved for men, Moreto presents women who, in order to fulfill their needs and desires without threatening the status quo, are forced to rely on their wits. The damas in No puede ser have intellectual abilities that surpass male understanding, not because they are superior, but simply because, as they point out, society has forced them to develop certain survival strategies. To all outward appearances they seem obedient and never lose their decorum, but, through the use of reason, they are able to figure out a way to impose their own will on a recalcitrant world.