bluuebunny/crossref_metadata_2025 huggingface dataset:
The Future of Genomic Nursing Research
Authors: Conley Yvette P. , Tinkle Mindy B.
Published: February 2007

Purpose: To look toward the future of genomics research and identify genomic‐based resources and opportunities for nurse scientists to incorporate genomic concepts into their programs of research.

Organizing Framework: Five research themes for the future, developed by the National Institute of Nursing Research in collaboration with nurse scientists, are the framework for this article: (a) changing lifestyle behaviors for better health; (b) managing the effects of chronic illness to improve health and quality of life; (c) identifying effective strategies to reduce health disparities; (d) harnessing
advanced technologies to serve human needs; and (e) enhancing end‐of‐life experiences for patients and their families.

Conclusions: Nurse scientists around the world are increasingly integrating genomics into their programs of research. Emerging international genomic initiatives, discoveries, and resources will provide rich opportunities for nurse scientists, as members of interdisciplinary teams, to address important biological, behavioral, social, and ethical questions. This evolving genomic nursing science will be necessary in practice, education, and policy in a time when rapid genomic discoveries are occurring.
Nurses' Reported Thinking During Medication Administration
Authors: Eisenhauer Laurel A. , Hurley Ann C. , Dolan Nancy
Published: February 2007

Purpose: To document nurses' reported thinking processes during medication administration before and after implementation of point‐of‐care technology.

Design and Methods: Semistructured interviews and real‐time tape recordings were used to document the thinking processes of 40 nurses practicing in inpatient care units in a large tertiary care teaching hospital in the northeastern US.

Findings: Content analysis resulted in identification of 10 descriptive categories of nurses' thinking: communication, dose‐time, checking, assessment, evaluation, teaching, side effects, work arounds, anticipating problem solving, and drug administration. Situations requiring judgment in dosage, timing, or selection of specific medications (e.g., pain management, titration of antihypertensives) provided the most explicit data about nurses' use of critical thinking and clinical judgment. A key element was nurses' constant professional vigilance to ensure that patients received their appropriate medications.

Conclusions: Nurses' thinking processes extended beyond rules and procedures and were based on patient data and interdisciplinary professional knowledge to provide safe and effective care. Identification of thinking processes can help nurses to explain the professional expertise inherent in medication administration beyond the technical application of the “5 rights.”
Using a Citizen Consensus Conference to Revise the Code of Ethics for Nurses in Taiwan
Authors: Lin Chiou‐Fen , Lu Meei‐Shiow , Chiang Hsien‐Hsien , Chung Chun‐Chih , Lin Tze‐Luen , Yin Teresa J.C. , Yang Che‐Ming
Published: February 2007

Purpose: To revise the code of ethics for nurses in Taiwan.

Design: Citizen consensus conference, Delphi‐technique, and questionnaire survey were used in the revising process.

Methods: Citizen representatives were recruited for a 5‐day citizen consensus conference to develop a first draft of the revised code. Further modification resulted from three rounds of communication with Delphi technique among experts. Three conferences for nursing professionals were conducted where questionnaire surveys were administered. The final draft was approved by the general assembly of Taiwan National Union of Nurses Associations.

Findings: A revised code of ethics for nurses in Taiwan was proposed in six parts and 27 articles including: the fundamental responsibilities of nurses (1), nurses and clients (12), nurses and professional services (4), nurses and social interactions (4), nurses and teamwork (3), and nurses and professional growth (3).

Conclusions: The citizen consensus conference was helpful in identifying the general public's expectation of nurses in the revision process. The revised Taiwanese code of ethics for nurses has new elements, including environmental protection, personal safety, lifetime learning, and self‐care.
Valuing the Health Benefits of a Novel Functional Food
Authors: Malla Stavroula , Hobbs Jill E. , Perger Orsolya
Published: February 2007

Awareness of the link between diet and health has led to an interest from consumers, the food industry, and policymakers in the health properties of foods. Food industry innovations are emerging that enhance the health attributes of foods. Recent scientific evidence has linked the consumption of foods high in trans fatty acids with elevated cholesterol levels and a higher incidence of coronary heart disease. Foods that reduce the risk of chronic diseases have potential social welfare benefits. This article values the potential health benefits of a healthy food: a trans fat‐free canola oil. Using a range of assumptions about the extent to which a trans fat‐free canola oil will substitute for existing oils, the paper shows how two alternative methods of computing reductions in the cost of illness reveal nontrivial benefits to society. Policy implications and suggestions for further research are discussed.

La sensibilisation au lien qui existe entre l'alimentation et la santé a suscité chez les consommateurs, l'industrie alimentaire et les décideurs un intérêt pour les propriétés des aliments pour la santé. L'industrie alimentaire ne cesse d'innover afin d'accroître les attributs des aliments pour la santé. Des preuves scientifiques récentes ont établi un lien entre la consommation d'aliments riches en gras trans, des taux de cholestérol élevés et une incidence accrue de coronaropathie. Les aliments qui diminuent les risques de maladies chroniques ont des bienfaits potentiels sur le bien‐être social. Le présent article porte sur l'évaluation des bienfaits potentiels d'un aliment sain, soit une huile de canola sans gras trans. À l'aide de diverses hypothèses quant au degré de remplacement des huiles existantes par l'huile de canola, le présent article montre de quelle fa¸on deux méthodes de calcul des diminutions du coût de la maladie révèlent des avantages non négligeables pour la société. Nous discutons des incidences politiques et présentons des suggestions de recherche ultérieure.
Widespread Neonatal Brain Damage following Calcium Channel Blockade
Authors: Turner C.P. , Miller R. , Smith C. , Brown L. , Blackstone K. , Dunham S.R. , Strehlow R. , Manfredi M. , Slocum P. , Iverson K. , West M. , Ringler S.L. , Berry Z.C.
Published: February 2007

An abundance of evidence exists that shows calcium channel blockade promotes injury in cultured neurons. However, few studies have addressed the in vivo toxicity of such agents. We now show that the L-type calcium channel antagonist nimodipine promotes widespread and robust injury throughout the neonatal rat brain, in an age-dependent manner. Using both isolated neuronal as well as brain slice approaches, we address mechanisms behind such injury. These expanded studies show a consistent pattern of injury using a variety of agents that lower intracellular calcium. Collectively, these observations indicate that postnatal brain development represents a transitional period for still developing neurons, from being highly sensitive to reductions in intracellular calcium to being less vulnerable to such changes. These observations directly relate to current therapeutic strategies targeting neonatal brain injury.
Expression of the Transcriptional Coactivator CITED1 in the Adult and Developing Murine Brain
Authors: Gerstner Jason R. , Landry Charles F.
Published: February 2007

The transcription coactivator CITED1 is an important mediator of transcriptional events regulated by estrogen or TGF-β. We used in situ hybridization to delineate the distribution of CITED1 mRNA in the adult and developing murine brain and found robust CITED1 expression in ventral hypothalamus and midbrain raphe. The distribution of CITED1 in these regions overlapped the reported expression of estrogen receptors α and β. Less intense expression of CITED1 was also evident in medial preoptic area, subfornical organ, thalamus and cerebral cortex. CITED1 mRNA in the arcuate nucleus (an area of active transcriptional modulation by TGF-β) was evident in postmigratory neurons as early as embryonic day 16. Expression of CITED1 in arcuate continued throughout postnatal development. CITED1 in developing cerebellum was first evident in external granule cells and was transiently expressed in the Purkinje cell/granule cell layer in a temporal pattern similar to estrogen receptor-β. The spatial and temporal distribution of CITED1 mRNA reported here is consistent with a role for CITED1 in the modulation of transcriptional events mediated by steroid hormone and cytokine signaling pathways.
Maturational Changes in the Subunit Composition of AMPA Receptors and the Functional Consequences of Their Activation in Chicken Forebrain
Authors: Migues Paola V. , Cammarota Martin , Kavanagh Jacinta , Atkinson Rebbekah , Powis David A. , Rostas John A.P.
Published: February 2007

AMPA receptors play a critical role in synaptic plasticity and brain development. Here we show that Ca2+ uptake in response to AMPA receptor activation decreases dramatically during maturation in chicken brain microslices without a change in tissue AMPA receptor content. We found that during maturation the relative concentration of GluR2 subunits increased, the concentration of the AMPA receptor-associated scaffold proteins SAP97 and GRIP decreased and that depolarization increased GluR1 phosphorylation at Ser831 in subcellular fractions enriched in postsynaptic densities at 2 weeks but not at 10 weeks. These changes are all consistent with a decreased Ca2+ entry through AMPA receptor channels in response to receptor activation and may account for the changes in the functional properties of the receptor, which are thought to underlie, at least in part, the physiological changes that occur with maturation.
Lumbar Disc Herniation in Adolescence
Authors: Ozgen Serdar , Konya Deniz , Toktas O. Zafer , Dagcinar Adnan , Ozek M. Memet
Published: February 2007

Lumbar disc herniation very rarely occurs in adolescence. The aim of this study was to assess the radiological, clinical and surgical features and case outcomes for adolescents with lumbar disc herniation, and to compare with adult cases. The cases of 17 adolescents (7 girls and 10 boys, age range 13–17 years) who were surgically treated for lumbar disc herniation in our clinic between 1998 and 2003 were retrospectively reviewed. The mean follow-up time for these cases was 60 months. The collected histories revealed that 14 (82%) of the 17 cases involved trauma or intense sports activity. Low back pain was the most common complaint (15 cases, 88%). None of the 17 patients had major symptoms during follow-up, and most were engaged in intense sports or heavy work-related activities during this period. The main features of lumbar disc herniation in adolescents are different from those seen in adults. Careful assessment is vital to avoid misdiagnosis and prevent undesirable results from inappropriate surgery. When surgery is indicated and patients are carefully selected, the results of lumbar discectomy in adolescence can be satisfactory.
Management of Hydrocephalus in Children with Posterior Fossa Tumors: Role of Tumor Surgery
Authors: Due-Tønnessen Bernt Johan , Helseth Eirik
Published: February 2007

Objective: The majority of children with posterior fossa tumors have hydrocephalus (HC) at the time of presentation. There is no consensus regarding the management of HC in these children. Here, we report the rate of cure of HC with tumor surgery alone. Patients and Methods: This is a retrospective study of 87 children with posterior fossa tumors in which 35 patients had medulloblastoma, 38 had astrocytoma and 14 had ependymoma. The mean age at presentation was 7.3 years (range: 0.2–19.7 years). All patients underwent tumor resection and were followed with close clinical and image surveillance to detect persistent HC. HC was treated with endoscopic third ventriculostomy (ETV) or shunt. We have focused on patients who needed permanent cerebrospinal fluid diversion (ETV or shunt) within 30 days of tumor resection. HC presenting after this time period is, in the majority of cases, due to tumor recurrence or progression. In this series, 24/87 (28%) patients had a suboccipital craniectomy and 63/87 (72%) had a craniotomy. Results: At the time of presentation, 69/87 (79%) patients had symptomatic HC. In 41/69 (59%) patients presenting with HC, the HC was cured by tumor resection alone. The HC cure rate for patients with astrocytoma was 83%, whereas it was 47% for patients with medulloblastoma and 54% for patients with ependymoma. The cure rate was equal in the craniectomy and craniotomy groups. Conclusions: An 87% cure rate of HC by tumor resection alone in children with posterior fossa astrocytoma warrants no change in treatment strategy. However, the low cure rate of HC by tumor resection alone in patients with medulloblastoma and ependymoma raises the issue of whether these patients would benefit from preresection ETV.
Selective Dorsal Rhizotomy and Postoperative Pain Management
Authors: Hesselgard K. , Reinstrup P. , Stromblad L.G. , Undén J. , Romner B.
Published: February 2007

Background: Selective dorsal rhizotomy (SDR) is an operation method that decreases the degree of spasticity with long-lasting beneficial effects for children with spastic diplegia. Children undergoing SDR are postoperatively in severe pain, a pain related to both the extensive surgical exposure with multilevel laminectomy and the nerve root manipulation. Various pain management strategies for children undergoing SDR have been published. The postoperative pain treatment is a vital part of the management. The aim of this study was to estimate the number of centers performing SDR, the frequency of SDR surgery and to investigate pain management of the different centers. Methods: A questionnaire comprising 7 questions was sent by mail and/or e-mail to a total of 59 potential centers performing SDR, centers that have published material concerning SDR or centers that have been recommended. Forty-seven (80%) centers responded to the questionnaire; 11 of them do not presently perform SDR surgery, and the remaining 36 centers constitute the material of the present study. Results: 23 of the 36 centers use Peacock’s operation technique and 8 centers use Park’s technique. Continuous intravenous infusion of opioids for postoperative pain treatment is used by 17 (47%) of the centers. Seven (19%) centers use the epidural (ED) approach for treating postoperative pain and 6 (17%) centers use intrathecal (IT) pain treatment. The duration of intravenous ED or IT pain relief ranged from 24 h up to 7 days. To evaluate pain relief, 25 (70%) centers used some form of pain scale. Conclusion: The most common operation techniques in use today are described by Peacock or by Park, with an estimated number of procedures of more than 487/year in 36 centers. The majority of the centers seem to have a satisfactory pain management strategy. These centers administer continuous infusions of opioids, with an intravenous, ED or IT approach, and incorporate the use of a pain assessment tool to evaluate pain relief.
Spontaneous Spinal Epidural Hematoma in an 11-Month-Old Girl
Authors: Poonai N. , Rieder M.J. , Ranger A.
Published: February 2007

An 11-month-old girl was admitted for a 2-month history of regression of motor milestones and lateralizing neurologic findings. Tests for hypercoagulability were all within normal limits except for a moderately elevated fibrinogen level. Urine and blood cultures were negative for growth. Complete MRI of the spine revealed a well-defined extradural inhomogeneous signal intensity extending from C4 to T3 suggestive of a subacute hematoma with evidence of evolving hemorrhagic change. There was no evidence of underlying arterial venous fistula or malformation. She underwent a cervicothoracic laminoplasty and evacuation of the hematoma. The clot was confirmed to be a hematoma on pathologic investigation. She made an uneventful recovery with gradual return of neurologic function. This case represents the longest known duration between initial symptoms and definitive management of spontaneous spinal epidural hematoma.
Refractory Occipital Lobe Epilepsy Treated by Surgery in a Child with Chronic Encephalitis
Authors: Rougier Alain , Vital Anne , Michel Véronique , Chateil Jean François , Husson Marie , Pedespan Jean-Michel
Published: February 2007

An 11-year-old boy developed catastrophic occipital lobe epilepsy with progressive neurocognitive decline which led to surgical treatment. Pathological examination of the resected epileptic area showed chronic inflammatory changes. Surgery was followed by a subacute and regressive encephalopathy although the patient did not suffer further seizures. We suggest that this occipital lobe epilepsy was related to chronic nonprogressive encephalitis consistent with a variant of Rasmussen’s syndrome, and that the immune and/or inflammatory process was reactivated by surgery. This case indicates that there is no direct link between the epileptic and the encephalitic processes.
Extreme Lateral Approach in a Case of Acute-Onset Quadriplegia due to High Cervical Neurenteric Cyst
Authors: Abhishek Agrawal , Anushree Agrawal , Patir Rana , Sehgal A.D.
Published: February 2007

Spinal neurenteric cysts are very rare intradural developmental lesions, predominantly localized anterior to the cervical cord and arising from misplaced endodermal cells in the 3rd week of embryonic life. An acute onset of symptoms can occur due to hemorrhage, but has not as yet been reported in relation to infection in the cyst. We report an 18-year-old male who presented with a rapid onset of respiratory distress and quadriplegia over a period of 6 h requiring intubation and ventilatory support. There was no respiratory effort with a dense sensory level from the neck. MRI of the cervical spine revealed an intradural extramedullary ventrally located cystic lesion at the C2–3 level. There was no evidence of systemic infection elsewhere in the body. The lesion was radically excised using an extreme lateral approach as it provided excellent visualization of the cyst, thus permitting safe dissection without retraction of the cord. The cyst was tense and the contents turbid, thick, creamy and mucinous without any evidence of fresh or altered blood. Histopathological examination confirmed the cyst to be a neurenteric cyst. The cystic fluid, which was sent for culture, grew coagulase-negative Staphylococcus aureus. This is the first documented case of rapid neurological deterioration due to infection in a neurenteric cyst. In spite of an early effective surgical management, outcome was poor due to the rapid and profound neurological deficit.
Gyriform Differentiation in Medulloblastoma – A Radiological Predictor of Histology
Authors: Agrawal Deepak , Singhal Ashutosh , Hendson Glenda , Durity Felix A.
Published: February 2007

Medulloblastoma with extensive nodularity (MBEN) is a variant with an apparently favorable outcome. The authors describe a 2-month-old child with MBEN who had a characteristic gyriform morphology on MR imaging preoperatively and was found to have local metastasis into the adjoining cerebellum on histopathological examination. This case illustrates that histological subtyping may be possible based on the imaging morphology in selected tumors, which may have a bearing on the management of these tumors.
Low-Grade Astrocytoma Causing Calvarial Scalloping
Authors: Khan M. Akram , Hashmi Saeed
Published: February 2007

Gliomas are tumors of the white matter. They are usually located deep within the skull and extend into the basal ganglia, though some are found near the surface of the brain. Calvarial erosion is known to occur with some superficially located tumors, mostly oligodendrogliomas. Only 1 case of low-grade astrocytoma causing calvarial erosion has been reported in the literature of the CT era. We report the first case of a low-grade astrocytoma causing calvarial erosion in an adolescent.
Cat Scratch Disease with Epidural Extension while on Antimicrobial Treatment
Authors: Hussain Sabiha , Rathore Mobeen H.
Published: February 2007

We report the first case of a child with an epidural abscess caused by Bartonella henselae. This case is unique in that the diagnosis was confirmed by polymerase chain reaction (PCR) of the abscess fluid. A 3-year-old male was admitted with a 1-week history of fever and lower back pain. Magnetic resonance imaging (MRI) of the lumbar spine revealed a paraspinal soft tissue abnormality extending from the T12 to the L4 level, and a computed tomography (CT) scan of the lumbar spine showed osteomyelitis at the T12 level with soft tissue changes. B. henselae serology showed an IgG titer of 1:256 and IgM of <1:16.
Maturational Changes in Skin Color of Japanese Newborn Infants
Authors: Watanabe M. , Ohki Y. , Yoshizawa Y. , Inoue Y. , Tokuyama K. , Morikawa A.
Published: February 2007

Background/Objective: The skin color of newborn infants is subjectively observed to change, depending upon their gestational age. We evaluated the relationship between neonatal skin color and gestational age by employing an objective method. Methods: Using a tristimulus photocolorimeter, L*, a*, and b* were examined as the parameters of skin color in Japanese newborn infants (Commission Internationale de l’Eclairage L*a*b* color space). The following items were examined: (1) the reproducibility of the measurements; (2) the time course of the values during the first 24 h after birth, and (3) the relationship with the gestational age. The gestational age of these infants had been determined by measuring their crown-rump length during fetal periods. Results: Reliability and validity of the measurements were satisfactory for all parameters. However, a* and b* fluctuated widely during the first 24 h. By contrast, L* was stable between 3 and 24 h after birth. L* measured during these periods directly correlated with the gestational age (r = 0.843, p < 0.0001). Conclusions: Because L* represents lightness or darkness, our results suggest that the skin color changes from black to white with maturation. L* may be a helpful parameter for the evaluation of the gestational age of newborn infants.
A New Model of Neonatal Stress Which Produces Lasting Neurobehavioral Effects in Adult Rats
Authors: McPherson Ronald J. , Gleason Christine , Mascher-Denen Marcella , Chan Michelle , Kellert Brian , Juul Sandra E.
Published: February 2007

Background: During critical care in neonatal intensive care units (NICU), infants experience stressors and treatments that may produce lasting effects on adult health. An animal model simulating the NICU experience is needed to understand the impact of specific neonatal stressors. Objective: We combined approaches to develop a neonatal rat model simulating NICU stressors in order to examine the hypothesis that early stress and morphine sulfate (MS) exposure would affect development and alter adult behavior. Methods: Rat pups were exposed to stressors and given twice daily MS injections (2 mg/kg s.c.) for 5 days (postnatal days 3–7). Stress included daily maternal separation (from 08.00 to 16.00 h), hand feedings, a daily hypoxia/hyperoxia episode (100% N2 for 8 min, then 100% O2 for 4 min), and cold exposure (4°C for 20 min/day). Five treatment groups were formed: (1) ‘control control’ (dam reared and untreated); (2) control vehicle; (3) stress vehicle; (4) control morphine, and (5) stress morphine. Early growth and developmental indices were measured. Adult neurobehavioral tests were paw flick, passive avoidance, and forced swimming. Neonatal MS pharmacokinetics, neonatal and adult corticosterone levels, and adult hematocrit and blood pressure values were measured. Results: Neonatal stress significantly increased the mortality. Neonatal stress and MS treatment slowed early growth. Neonatal MS impaired passive avoidance learning and increased frequency, duration, and distance of forced swimming. There were no differences in corticosterone, hematocrit, or blood pressure values. Conclusions: This model simulates NICU stressors and enables measurement of acute physiological and long-term neurobehavioral indices. Neonatal MS treatment impaired the adult cognitive functioning.
The Contribution of Intermittent Hypoxemia to Late Neurological Handicap in Mice with Hyperoxia-Induced Lung Injury
Authors: Ratner Veniamin , Kishkurno Sergey V. , Slinko Siarhei K. , Sosunov Sergey A. , Sosunov Alexander A. , Polin Richard A. , Ten Vadim S.
Published: February 2007

Bronchopulmonary dysplasia (BPD) is considered by many to be an independent risk factor for poor neurodevelopment in premature infants. However, infants with BPD experience intermittent hypoxic episodes. This study was undertaken to determine whether intermittent hypoxic stress associated with BPD contributes to the development of neurological deficit. The model of BPD was produced in neonatal mice by exposure to hyperoxia (65% O2) for 4 weeks. Arterial blood gases, pulmonary mechanics, and histopathology were used to define the degree of lung injury. The mice were subjected to brief (10 min/day) and intermittent (10 days) hypoxic stress (8% O2) at different stages of the development of hyperoxia-induced lung injury. At 8 weeks of life, the neurofunction was assessed by water maze and rota-rod tests followed by cerebral morphological analysis using Nissl, bromodeoxyuridine, and caspase-3 immunostaining. Data were compared to naïve normoxic littermates and those mice that were exposed only to hyperoxia or intermittent hypoxia alone. Mice with BPD subjected to brief/intermittent hypoxia demonstrated a significantly poorer navigational memory performance as compared with normoxic mice and mice with BPD that were not subjected to intermittent hypoxia. The neurofunctional handicap in these mice was associated with significantly decreased brain weight and increased cerebral expression of caspase-3. Our results suggest that intermittent hypoxia associated with hyperoxia-induced lung injury, but not lung injury itself, results in significant neurological handicap in neonatal mice with BPD.
Breast Milk: A Source of Bifidobacteria for Infant Gut Development and Maturation?
Authors: Gueimonde Miguel , Laitinen Kirsi , Salminen Seppo , Isolauri Erika
Published: February 2007

Background: The establishment of gut microbiota is a stepwise process contributing to gut development and maturation of the immune system. Aberrant gut microbiota at an early age may predispose to disease later in life. Breast-fed infants harbor a characteristic intestinal microbiota dominated by bifidobacteria. Objectives: To assess, using molecular techniques (PCR), whether human milk contains bifidobacteria and to determine the bifidobacterial species present. Methods: The presence of bifidobacteria in breast milk samples (n = 20) was qualitatively and quantitatively determined by using PCR and real-time PCR, respectively. Results: Breast milk samples contained bifidobacteria. Bifidobacterium longum was the most widely found species followed by Bifidobacterium animalis, Bifidobacterium bifidum and Bifidobacterium catenulatum. Conclusion: Breast milk contains bifidobacteria and specific Bifidobacterium species that may promote healthy microbiota development.
Rationale, Design and Baseline Data of a Randomized, Double-Blind, Controlled Trial Comparing Two Antithrombotic Regimens (a Fixed-Dose Combination of Extended-Release Dipyridamole plus ASA with Clopidogrel) and Telmisartan versus Placebo in Patients with Strokes: The Prevention Regimen for Effectively Avoiding Second Strokes Trial (PRoFESS)
Authors: Diener Hans-Christoph , Sacco Ralph , Yusuf Salim
Published: February 2007

Background: Individuals with transient ischemic attack and ischemic stroke have a high risk of recurrent stroke and death. While acetylsalicylic acid (ASA, aspirin) is proven and accepted as standard therapy in these patients, recent trials demonstrate that a combination of ASA and dipyridamole (DP) or clopidogrel may be superior to ASA. Blocking the renin-angiotensin system with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may also reduce recurrent stroke. The ongoing PRoFESS (Prevention Regimen for Effectively Avoiding Second Strokes) trial is designed to evaluate whether ASA + extended-release DP compared to clopidogrel, and whether telmisartan in addition to usual care in individuals after a stroke, will reduce the risk of further strokes. Methods: PRoFESS is a multicenter, randomized, double-blind trial involving 695 sites from 35 countries or regions. Patients ≧50 years presenting with an ischemic stroke <120 days who were stable were randomized. The primary outcome for the trial is recurrent stroke, using a time-to-event analysis. The most important secondary outcome is the composite of stroke, myocardial infarction or vascular death. Other secondary outcomes include this composite + congestive heart failure, new-onset diabetes, other designated occlusive vascular events (pulmonary embolism, deep-vein thrombosis, peripheral arterial occlusion, transient ischemic attack, cerebral venous thrombosis or retinal vascular accident not classified as stroke), any death, stroke subtype by TOAST criteria and Mini Mental State Examination score. Safety is evaluated by assessing the risk of major hemorrhagic events. The comparison between ASA + DP and clopidogrel is based on an initial assessment of noninferiority, followed by evaluation of superiority, while for telmisartan, we will assess its superiority over placebo. Results: With over 20,000 patients randomized, and utilizing a 2 × 2 factorial design, PRoFESS is the largest stroke trial to investigate the prevention of recurrent stroke. The mean age was 66.1 ± 8.6 years, and 36.0% of the patients were females. The median time from qualifying event to randomization was 15 days with 39.9% of patients randomized within 10 days. According to the TOAST criteria, 28.5% of the strokes were due to large-vessel disease, 52.1% to small-vessel disease, 1.8% to cardioembolism, and 2.0% to other determined etiologies and 15.5% were of undetermined etiology. Conclusions: PRoFESS is the largest secondary stroke prevention trial to date and will directly compare two antiplatelet regimens as well as the benefit of telmisartan versus placebo.
Recombinant
Desmodus rotundus
Salivary Plasminogen Activator Crosses the Blood–Brain Barrier Through a Low-Density Lipoprotein Receptor-Related Protein-Dependent Mechanism Without Exerting Neurotoxic Effects
Authors: López-Atalaya José P. , Roussel Benoit D. , Ali Carine , Maubert Eric , Petersen Karl-Uwe , Berezowski Vincent , Cecchelli Roméo , Orset Cyrille , Vivien Denis
Published: February 2007

Background and Purpose—

Desmoteplase, a recombinant form of the plasminogen activator DSPAα1 from
Desmodus rotundus
, may offer improved clinical benefits for acute ischemic stroke treatment over the current therapy, recombinant tissue plasminogen activator (rtPA). Accumulating evidence suggests that clinical use of rtPA could be limited by unfavorable properties, including its ability to cross the blood–brain barrier (BBB), thus potentially adding to the pro-excitotoxic effect of endogenous tPA in cerebral parenchyma. Here, to investigate whether desmoteplase may display a safer profile than the structurally-related tPA, both agents were compared for their ability to cross the BBB and promote neurotoxicity.

Methods—

First, the passage of vascular DSPA and rtPA was investigated in vitro in a model of BBB, subjected or not to oxygen and glucose deprivation. Second, we studied DSPA- and rtPA-mediated effects in an in vivo paradigm of excitotoxic necrosis.

Results—

The rtPA and desmoteplase cross the intact BBB by LRP-mediated transcytosis. Under conditions of oxygen and glucose deprivation, translocation rates of both compounds increased; however, unlike rtPA, desmoteplase transport remained LRP-dependent. Additionally, neither intracerebral nor intravenous desmoteplase administration enhanced NMDA-induced excitotoxic striatal damage in vivo. Interestingly, intravenous but not intrastriatal coadministration of desmoteplase and rtPA reduced the pro-excitotoxic effect of rtPA.

Conclusions—

We show that desmoteplase crosses the BBB but does not promote neuronal death. Moreover, intravenous administration of desmoteplase antagonizes the neurotoxicity induced by vascular rtPA. This action may be caused by competition of desmoteplase with rtPA for LRP binding at the BBB, thus effectively blocking rtPA access to the brain parenchyma.
Challenging Definitions: Human Agency, Diverse Religious Practices and the Problems of Boundaries
Authors: Ramey Steven
Published: February 2007

Much contemporary scholarship in Religious Studies emphasizes communities who contest the standard definitions of their religion. However, religious labels and terms such as syncretism often implicitly validate the dominant definitions that identify these diverse practices as peripheral. This essay explores the challenges that the dominant definitions present to such communities and suggests an emphasis on agency and the contestation surrounding any definition of a religion to avoid privileging one definition of a religion and, thereby, to facilitate a more balanced analysis. The example of Sindhi Hindus illustrates the value of this emphasis on agency. Sindhi Hindu communities and individuals construct and defend their own definitions of religions in environments where non-Sindhis challenge Sindhi practices, which do not necessarily correspond exactly to the definitions that the Sindhis construct for themselves. Adding Bell's conception of ritual inscription to this discussion of agency further highlights how participation in practices commonly associated with different religions can foster internal tensions. Therefore, an emphasis on agency with its complexity and limitations enables scholars to recognize the internal pressures that exist in some constructions of religious practices without contributing to the external challenge from dominant definitions. This approach also enables a more nuanced analysis of processes of syncretism that are more complex than traditional applications of that term allow.
The Turkish Contribution to the History of Religions
Authors: Güngör Ali İsra
Published: February 2007

This article has as its subject researches in the field of history of religions in Turkey and describes a tradition that started in 1912 and has undergone a developmental process of its own up until today. This study evaluates, based on scholarly theses, published articles and books, an academic mentality which was initiated by Annemarie Schimmel and was further developed by Hikmet Tanyu and his students. It also classifies the studies in the field conducted in Turkey with examples and draws attention to the difficulties concerning the method employed. This article, moreover, provides information about the scholarly activities of the Turkish Association for the History of Religions, which was founded in 1994 with the purpose of improving the communication between Turkish historians of religions and establishing a closer dialogue with their Western colleagues.
Practical Methods for Extracting Explicit Design Rules Grounded in the Experience of Organizational Managers
Authors: Plsek Paul , Bibby Joanna , Whitby Elaine
Published: February 2007

The concept of design rules, an element of design science, helps convert the tacit knowledge of organizational change agents into explicit, actionable knowledge. Design rules are heuristic statements in the form: If you want to achieve outcome Y in situation S, something like X might help. Research suggests that experts tend to think using such heuristic rules, and the authors propose that this is also true for organizational managers leading successful change programs. Although design science approaches aim to build a body of design rules applicable in a variety of settings, little has been done to explore how design rules are elaborated from particular change efforts. The authors describe experience in testing four methods for extracting explicit design rules from existing programs of organizational change. They found this to be both a promising field of research and a potentially valuable methodology for practicing managers and change leaders in organizations.
Using a Design Approach to Assist Large-Scale Organizational Change
Authors: Bevan Helen , Robert Glenn , Bate Paul , Maher Lynne , Wells Julie
Published: February 2007

A team of practitioners, university researchers, and health care policy makers has been working to develop and apply “design sciences” thinking within the challenging context of a national system aiming to bring about a “revolution in health care.” As members of that team, the authors share that thinking and early findings with those interested in the concept, theory, and practice of design as an approach to large-scale organizational change. The article builds on what to date has been a somewhat abstract debate around the design sciences, its aim being to forge stronger links between the concept and the practice of design. Using empirical data from the English National Health Service as a case study, the article seeks to demonstrate how design sciences may first, expand our thinking around organizational theory and practice and second, offer organization development some new methods, approaches, and processes around the “doing” of large-scale change.
Design Science and Organization Development Interventions
Authors: van Aken Joan Ernst
Published: February 2007

This article discusses a design science approach to organizational development (OD) resulting in some new perspectives about how OD interventions might support more effective organizational change. These relate to the way in which the formal organization is redesigned, the way this design is translated by the members of the organization into their own roles and routines, and the way in which subsequent organizational learning produces the intended performance improvement. The background, nature, and characteristics of design science and design science research are discussed, and using a design science perspective, a process model of planned change projects is presented. Drawing on a case in planned change, it is argued that a design science perspective can provide a powerful combination of the original strengths of OD in human behavior and planned change based on humanistic values on one hand and design competencies involving both humanistic and business values on the other.
Having Relevance and Impact
Authors: Mohrman Susan Albers
Published: February 2007

This introductory article argues building intentional design capabilities is a primary approach to bridging theory and practice. To address the complexity and challenges of today’s organizational environments, the organizational development (OD) profession’s focus on humanistic development should be complemented by equally strong attention to bringing expertise to help design solutions to thorny problems. This requires attention to management as design and development of a design science to provide content and methodological knowledge to guide the design process. Treatments of organizational design science, just as other design sciences such as architecture, must juxtapose development of the guiding knowledge of the field with the descriptions of designing processes that bring to bear the perspectives, aspirations, and experiences of varied participants. The combination of the perspectives of organizational development and organization design science is critical to provide a knowledge foundation to build organizations that are sustainable and meet the needs of their stakeholders.
Phonetic Variation in the Traditional English Dialects
Authors: Shackleton Robert G.
Published: February 2007

This article illustrates the utility of a variety of quantitative techniques by applying them to phonetic data from the traditional English dialects. The techniques yield measures of variation in phonetic usage among English localities, identify dialect regions as clusters of localities with relatively similar patterns of usage, distinguish regions of relative uniformity from transitional zones with substantially greater variation, and identify regionally coherent groups of features that can be used to distinguish some dialect regions. Complementing each other, the techniques provide a reasonably objective method for classifying at least some traditional English dialect regions on the basis of characteristic features. The results largely corroborate standard presentations in the literature but differ in the placement of regional boundaries and identification of regional features, as well as in placing those systemic elements in a broader context of largely continuous and often random variation.
Making Decisions in the Dark: Disconnects Between Retention Research and Middle-Level Practice
Authors: Larsen Donald E. , Akmal Tariq T.
Published: February 2007

This study of grade-level advancement/retention policies and procedures in 10 school districts shows how retention policy and procedure are disconnected from retention research. Administrators and teachers experience ethical dilemmas when district policy and prescribed practice collide with realities that underlie student failure. However, acts of discretionary insubordination offer compromises. As the study demonstrates, when policy and research align and when educators acknowledge that neither retention nor social promotion is acceptable, viable alternatives and intervention programs can be explored.
Genre Studies in the San Diego City Schools: Accelerating or Tracking?
Authors: Powers Jeanne M. , Chapman Paula L.
Published: February 2007

This article contains an analysis of a component of a large-scale reform effort in an urban school district that entailed placing high school students identified as underperforming in literacy in separate classes aimed at accelerating their learning. The relationship between students’ academic performance and social backgrounds, school characteristics, and placement in these classes was analyzed for two cohorts of ninth graders. Although most students were placed according to their academic needs, there was evidence that race/ethnicity, language, and school socioeconomic status also influenced student placements. The findings suggest that the structural innovations of large-scale reforms must be accompanied by attention to the cultural dimensions of education reform.
The Alternate Route Teachers’ Transition to the Classroom: Preparation, Support, and Retention
Authors: Nagy Christopher J. , Wang Ning
Published: February 2007

The U.S. Department of Education predicts that more than 2.2 million teaching positions in kindergarten through 12th grade will need to be filled over the next 10 years. Given the demand for classroom teachers, 48 states and the District of Columbia have created alternate route (AR) teaching certification programs to recruit individuals who have earned college degrees and worked in their chosen fields but had no prior teaching experience. The major purpose of this study is to identify issues related to the AR teachers’ transition process in three phases: (a) preparation before entering the classroom, (b) support provided by schools/districts during the process, and (c) retention in the teaching profession. By surveying high school principals and their AR teachers in New Jersey, this study attempted to provide suggestions that support AR teachers’ positive and effective transition to the classroom and their continuous development and positive experience in the teaching profession.
Windows of opportunity for unpaid work?
Authors: Johnson Phil , Ingram Bill
Published: February 2007

This article considers the implications of the Visible Unpaid Work Strategy for the unpaid work element of a community order. It argues that such a strategy is incompatible with the requirement for skills development in the current delivery of unpaid work. It uses data collated from research into public perceptions of the sanction and consequently disputes the viability of community engagement in relation to the choice of work for offenders.
Working with sex offenders in context: Which way forward?
Authors: McCulloch Trish , Kelly Lynn
Published: February 2007

This article explores the context and content of behaviour change interventions with sex offenders, giving attention to the contemporary climate, evolving theoretical frameworks and practice realities. Recognizing the highly charged nature of policy and practice in this area, and the potential therein for conformist and collusive practices, the article argues for the adoption of a more candid and critical approach to the development and delivery of policy and practice in this area.
A study of probation revocations for technical violations in Hays County, Texas, USA
Authors: Stickels John W.
Published: February 2007

Probation revocations were examined for six months in Hays County, Texas, USA, to determine whether probationers were revoked and sentenced to jail or provided with an alternative sanction. The results indicate that 55 per cent of the revocations result in prison or jail without an intermediate sanction. This outcome is compared to the state-wide revocation percentage and discussed in terms of the goal of Texas Department of Criminal Justice – Community Justice Assistance Division (TDCJ–CJAD) of sanctioning probationers who violate the terms of probation, in lieu of sentencing them to prison. The impact of revocations on criminal justice policy is discussed.
View from a business school
Authors: Marcella Rita
Published: February 2007

Interview with the dean of a business school who is also a qualified information professional. Seeks views on the current state of access to information for business, considering issues such as Freedom of Information and the role of public libraries. Discusses how the willingness of information professionals to get involved in the businesses they serve affects the profile of their service, and emphasizes the need for proactive marketing activity within the profession. Considers the quality of current entrants into business information, looking not only at skills but also at whether the profession presents itself effectively. Touches on its gender bias. Suggests that, in the future, the information, records and knowledge management professions need to be brought together in order to ensure greater critical influence in the workplace. Expresses concern about the risk of outsourced or offshored services being insufficiently well briefed to provide a satisfactory service. Calls on the academic community to develop stronger clusters of strength in business information.
Did Boulton Sell Silver Plate to the Middle Class? A Quantitative Study of Luxury Marketing in Late Eighteenth-Century Britain
Authors: Quickenden Kenneth , Kover Arthur J.
Published: February 2007

This article analyzes sales of silver plate to different social classes by Matthew Boulton (1728-1809), an English entrepreneur and manufacturer. He claimed that efficient techniques used in his manufactory would decrease prices so that less affluent people could afford silver plate. Data from this research show that the vast majority of his orders came from the upper classes. Obviously, there was a disjunction between Boulton’s claim and his actions. We believe that this is the first quantitative study of the social-class composition of customers for a luxury product from a single factory. It marks a step (however tentative) in the measurement of luxury marketing in the late eighteenth century to consumers other than the rich.