bluuebunny/crossref_metadata_2025 huggingface dataset:
“I Try Not to Depend on Anyone but Me”: Welfare‐Reliant Women's Perspectives on Self‐Sufficiency, Work, and Marriage*
Authors: Scott Ellen K. , London Andrew S. , Gross Glenda
Published: October 2007

Welfare reformers sought to reduce “dependency,” or reliance on state‐supported cash benefits and deployed a discourse of “self‐sufficiency” to promote the legitimacy of efforts to remove welfare recipients from publicly funded cash assistance through either wage labor or marriage. We use longitudinal, qualitative interview data collected from 38 initially welfare‐reliant women to examine what self‐sufficiency means to them and their perspectives on how work and marriage affect their ability to be self‐sufficient. Grounded theory analysis revealed that for these women, self‐sufficiency means formal independence from both the state (i.e., Temporary Assistance to Needy Families [TANF]) and men (i.e., marriage). Although they value marriage as an institution and would ideally marry, they do not consider marriage to be a likely route to self‐sufficiency given the pool of men available to them. Rather, they embrace their own market‐based wage labor as the means by which they can attain some measure of independence. Taking our lead from the women in this study, we challenge the emphasis on marriage in current welfare policy. We argue that employment training that results in better jobs for women and men and work supports that make low‐wage work pay are clearly the appropriate direction for policy aimed at the welfare‐reliant and working poor.
Discordant Hemodynamic and Fibrinolytic Adaptations Following a 6‐Week Cardiac Rehabilitation Program
Authors: Nagelkirk Paul R. , Franklin Barry A. , Coughlin Adam M. , Hassouna Houria I. , Fink Gregory D. , Pivarnik James M. , Womack Christopher J.
Published: October 2007

The present study evaluated changes in hemodynamics and fibrinolysis during 6 weeks of participation in an exercise‐based cardiac rehabilitation program. Fourteen patients trained for 3 days per week for 6 weeks using American College of Sports Medicine guidelines for intensity and duration. Blood samples were taken at baseline and after 3 and 6 weeks of participation and analyzed for tissue plasminogen activator (t‐PA) activity and antigen, plasminogen activator inhibitor‐1 (PAI‐1) activity and antigen, and relative quantification of t‐PA and PAI‐1 RNA. Data were analyzed using repeated measures analysis of variance. Training elicited significant decreases in submaximal exercise heart rate and systolic blood pressure and resting systolic blood pressure (p<.05). There were no significant changes in plasma concentrations of t‐PA or PAI‐1, and no change was observed in t‐PA or PAI‐1 gene expression. The present findings suggest that favorable hemodynamic adaptations may occur after only 6 weeks of exercise‐based cardiac rehabilitation, but longer training periods may be needed to elicit positive hemostatic adaptations.
Distribution and Predictors of Carotid Intima‐Media Thickness in Young Adults
Authors: Tzou Wendy S. , Douglas Pamela S. , Srinivasan Sathanur R. , Bond M. Gene , Tang Rong , Li Shengxu , Chen Wei , Berenson Gerald S. , Stein James H.
Published: October 2007

The authors' aim was to determine reference values and predictors for carotid intima‐media thickness (CIMT) in the Bogalusa Heart Study. Carotid ultrasound images from 1203 young adults (mean age 36 years; 30% black, 43% male) were reviewed. Age‐, sex‐, and race‐specific CIMT percentiles were estimated using multivariable regression. Nomograms of CIMT quartiles for persons aged 25 to 40 years are provided in 5‐year increments. CIMT was thickest in the carotid bulb and increased linearly with age, most rapidly in the bulb. With age, composite CIMT increased most slowly in white women and more rapidly in white men and black women. Systolic blood pressure (P<.001) was the strongest predictor of composite CIMT. Male sex, total to high‐density lipoprotein cholesterol ratio, and age independently predicted CIMT in all segments. This report may be used to help plan epidemiologic investigations and clinical trials investigating atherosclerosis and its changes with interventions.
Cardiovascular Disease Knowledge, Medication Adherence, and Barriers to Preventive Action in a Minority Population
Authors: Mochari Heidi , Ferris Anjanette , Adigopula Santhi , Henry Glendon , Mosca Lori
Published: October 2007

Lack of knowledge and awareness of cardiovascular disease may contribute to disproportionately higher risk in minorities. The authors studied minorities in Harlem, New York (N=214), to evaluate knowledge and preventive behaviors. More than half of the participants did not know optimal blood pressure (BP) (52%) and cholesterol (60%) goals. Lack of health insurance (odds ratio, 2.1; 95% confidence interval, 1.0–4.5) and less than a high school education (odds ratio, 2.0;95% confidence interval, 1.02–3.87) were associated with not knowing optimal BP. Among those with BP ≥140/90 mm Hg, 34% were unaware that they had high BP, and age younger than 55 years was predictive of lack of awareness that they had high BP (odds ratio, 8.5; 95% confidence interval, 2.6–28.1). Predictors of medication nonadherence included age younger than 45 years vs age 45 years or older (P=.004) and no health insurance vs health insurance (P=.01). Younger, less educated, uninsured patients should be targeted for educational interventions regarding cardiovascular disease prevention goals, personal risk, and the importance of medication adherence.
Diffusion‐based magnetic resonance imaging and tractography in epilepsy
Authors: Yogarajah Mahinda , Duncan John S.
Published: October 2007

Summary

Diffusion‐based imaging is an advanced MRI technique that is sensitive to the movement of water molecules, providing additional information on the micro‐structural arrangement of tissue. Qualitative and quantitative analysis of peri, post and interictal diffusion images can aid the localization of seizure foci. Diffusion tensor tractography is an extension of diffusion‐based imaging, and can provide additional information about white matter pathways. Both techniques are able to increase understanding of the effects of epilepsy on the structural organization of the brain, and can be used to optimize presurgical planning of patients with epilepsy. This review focuses on the basis, applications, limitations, and future directions of diffusion imaging in epilepsy.

Literature search strategy: We searched Pubmed using the terms “diffusion MRI or diffusion tensor MRI or tractography and epilepsy.”
Calorie‐restricted ketogenic diet increases thresholds to all patterns of pentylenetetrazol‐induced seizures: Critical importance of electroclinical assessment
Authors: Raffo Emmanuel , François Jennifer , Ferrandon Arielle , Koning Estelle , Nehlig Astrid
Published: October 2007

Summary

Purpose:Thresholds to pentylenetetrazol (PTZ) seizures were usually based only on clinical symptoms. Our purpose was to use electroclinical patterns to assess the efficacy of a ketogenic and/or calorie‐restricted diet on PTZ‐induced seizures.

Methods:Forty 50‐day‐old rats were divided in four weight‐matched groups and fed controlled diets: normocalorie carbohydrate (NC), hypocalorie carbohydrate (HC), normocalorie ketogenic (NK), and hypocalorie ketogenic (HK). After 21 days, blood glucose and β‐hydroxybutyrate levels were determined and seizures were induced by continuous infusion of PTZ. The clinical and EEG thresholds to each seizure pattern were compared between the different groups.

Results:The electroclinical course of PTZ‐induced seizures was similar in all groups. The HK group exhibited higher thresholds than the other ones for most clinical features: absence (p = 0.003), first overt myoclonia (p = 0.028), clonic seizure (p = 0.006), and for EEG features: first spike (p = 0.036), first spike‐and‐wave discharge (p = 0.014), subcontinuous spike‐and‐wave discharges (p = 0.005). NK, HC, and NC groups were not significantly different from each other. Blood glucose and β‐hydroxybutyrate levels were not correlated with electroclinical seizure thresholds. After the clonic seizure, despite stopping PTZ infusion, a tonic seizure occurred in some animals, without significant difference regarding the diet.

Conclusion:This approach permitted a precise study of the electroclinical course of PTZ‐induced seizures. In addition to the usually studied first overt myoclonia, we clearly demonstrated the efficiency of a calorie restricted KD in elevating thresholds to most electroclinical seizure patterns. We confirmed the lack of efficiency of the KD to reduce seizure severity once the seizure has started.
EEG source localization in focal epilepsy: Where are we now?
Authors: Plummer Chris , Harvey A. Simon , Cook Mark
Published: October 2007

Summary

Electroencephalographic source localization (ESL) by noninvasive means is an area of renewed interest in clinical epileptology. This has been driven by innovations in the computer‐assisted modeling of dipolar and distributed sources for the investigation of focal epilepsy; a process fueled by the ever‐increasing computational power available to researchers for the analysis of scalp EEG recordings. However, demonstration of the validity and clinical utility of these mathematically derived source modeling techniques has struggled to keep pace. This review evaluates the current clinical “fitness’ of ESL as applied to the focal epilepsies by examining some of the key studies performed in the field, with emphasis given to clinical work published in the last five years. In doing so, we discuss why ESL techniques have not made an impact on routine epilepsy practice, underlining some of the current problems and controversies in the field. We conclude by examining where ESL currently sits alongside magnetoencephalography and combined EEG‐functional magnetic resonance imaging in the investigation of focal epilepsy.
Strategies for surgical treatment of epilepsies in developing countries
Authors: Asadi‐Pooya Ali A. , Sperling Michael R.
Published: October 2007

Summary

Epilepsy surgery has been proved to be efficacious, safe and cost‐effective in developing countries. However, the success of epilepsy surgery depends on selecting suitable candidates based on the available resources and technologies. Some of the challenges to provide appropriate surgical treatment for epilepsy patients in developing countries include providing human and technological resources and developing realistic presurgical protocols. Detection of ideal candidates for epilepsy surgery is possible for well‐trained epileptologists with the help of basic investigative technologies, for example, magnetic resonance imaging (MRI) and electroencephalography (EEG). Patients with potentially epileptogenic, well‐circumscribed lesions on MRI and patients with mesial temporal lobe epilepsy (MTLE) are reasonable candidates for surgery. Palliative epilepsy surgeries include corpus callosotomy and other disconnections. These operations are feasible in developing countries with a knowledgeable team consisting of an epileptologist, neurosurgeon and technicians and with using MRI and EEG as basic investigative technologies.
A combination of ketamine and diazepam synergistically controls refractory status epilepticus induced by cholinergic stimulation
Authors: Martin Brandon S. , Kapur Jaideep
Published: October 2007

Summary

Purpose: New treatments are needed for status epilepticus (SE) that is refractory to drugs modulating GABAA receptors, and NMDA receptor antagonists are candidate drugs.

Methods: Clinically available NMDA receptor antagonist ketamine was tested for effectiveness in terminating prolonged SE induced by a combination of lithium and pilocarpine. Animals were treated 10 min after first grade 5 behavioral seizure (Racine scoring scale) by intraperitoneal administration of ketamine, diazepam, or saline. Seizure termination was determined by electroencephalogram (EEG) recordings from the hippocampus and the cortex.

Results: Animals treated with normal saline or either 20 mg/kg diazepam, or 50 mg/kg ketamine continued in SE for the next 300 min. However, combined treatment with diazepam and ketamine rapidly terminated prolonged cholinergic stimulation‐induced SE. Detailed study of dose response relationships demonstrated that diazepam enhanced efficacy and potency of ketamine in terminating SE.

Discussion: This study demonstrated synergistic action of diazepam and ketamine in terminating SE. It suggests that a ketamine–diazepam combination might be a clinically useful therapeutic option for the treatment of refractory SE.
Glutamate and dopamine receptors contribute to the lateral spread of epileptiform discharges in rat neocortical slices
Authors: Goda Michael , Kovac Stjepana , Speckmann Erwin‐Josef , Gorji Ali
Published: October 2007

Summary

Purpose: The effects of AMPA‐type glutamate receptor as well as dopamine D1 and D2 receptors on the lateral propagation of epileptiform field potentials (EFP) were studied across adjacent areas of rat neocortical tissues.

Methods: Epileptiform burst discharges were induced by superfusion of Mg2+‐free artificial cerebrospinal fluid. Simultaneous field potential recordings of EFP were obtained from four microelectrodes placed 2–3 mm apart across coronal slices in the third layer of the neocortex. The effects of AMPA receptor antagonist 6‐cyano‐7‐nitroquinoxaline‐2,3‐dione (CNQX), dopamine D1 receptor agonist SKF 81297, and dopamine D2 receptor agonist quinpirole on lateral propagation of burst discharges were investigated.

Results: CNQX, applied focally between recording sites, blocked rapid propagation across treated areas and resulted in the emergence of spatially separate, independent pacemakers. Focal application of SKF 81297 between recording sites increased the repetition rate of EFP, but reduced the amplitude as well as the duration of epileptic discharges. However, addition of SKF 81297 to the bath medium abolished EFP. Both local and systemic applications of quinpirole irreversibly enhanced repetition rate of epileptiform burst discharges.

Conclusions: The results indicate the prerequisite of AMPA synaptic transmission for synchronized lateral propagation of Mg2+‐free ACSF‐induced epileptic activity and the modulatory effects of dopamine D1 and D2 receptors on both EFP initiation and propagation in epileptic tissues.
Differential effects of temporal pole resection with amygdalohippocampectomy versus selective amygdalohippocampectomy on material‐specific memory in patients with mesial temporal lobe epilepsy
Authors: Helmstaedter Christoph , Richter Sabine , Röske Sandra , Oltmanns Frank , Schramm Johannes , Lehmann Thomas‐Nicolas
Published: October 2007

Summary

Purpose: In the surgical treatment of mesial temporal lobe epilepsy, there is converging evidence that individually tailored or selective approaches have a favorable cognitive outcome compared to standard resections. There is, however, also evidence that due to collateral damage, selective surgery can be less selective than suggested. As part of a prospective transregional research project the present study evaluated the outcome in memory and nonmemory functions, following two selective approaches: a combined temporal pole resection with amygdalohippocampectomy (TPR+) and transsylvian selective amygdalohippocampectomy (SAH).

Methods: One year after surgery, cognitive outcomes of postoperatively seizure‐free patients with mesial TLE and hippocampal sclerosis, who underwent either TPR+ (N = 35) or SAH (N = 62) in two German epilepsy centers (Bonn/Berlin), were compared.

Results: Repeated measurement MANOVA and separate post hoc testing indicated a double dissociation of verbal/figural memory outcome as dependent on side and type of surgery. Verbal memory outcome was worse after left‐sided operation, but especially for SAH, whereas figural memory outcome was worse after right‐sided operation, preferentially for TPR+. Attention improved independent of side or type of surgery, and language functions showed some improvement after right‐sided surgeries.

Discussion: The results indicate a differential effect of left/right SAH versus TPR+ on material‐specific memory insofar as transsylvian SAH appears to be favorable in right and TPR+ in left MTLE. The different outcomes are discussed in terms of a different surgical affection of the temporal pole and stem, and different roles of these structures for verbal and figural memory.
Topiramate Moderately Reduces the Motivation to Consume Alcohol and Has a Marked Antidepressant Effect in Rats
Authors: Hargreaves Garth A. , McGregor Iain S.
Published: October 2007

Background: In recent human studies, the anticonvulsant drug topiramate (TPM) has shown efficacy in treating alcohol craving and mood disorders. However, preclinical evidence supporting such effects is surprisingly sparse. Three experiments were conducted here to assess possible anticraving and antidepressant effects of TPM using animal models.

Methods: In Experiment 1, rats were given 23 weeks ad libitum access to food, water, and either beer (4.44% ethanol v/v) or “near‐beer” (a calorie‐matched nonalcoholic beer, 0.44% ethanol) in their home cages. They were then restricted to daily 1 hour operant sessions in which they licked for water and either beer or near‐beer under a progressive ratio schedule of reinforcement in a lickometer apparatus. The acute effects of TPM on the motivation to consume beer or near‐beer were then assessed. The effects of naloxone were also assessed (as a positive control) after TPM testing. In Experiment 2, rats were given 11 weeks of ad libitum home‐cage access to food, water, and beer. They then received repeated daily injections of TPM and effects on beer consumption under ad libitum home cage access conditions were monitored. In Experiment 3, the effects of TPM were assessed in the modified Porsolt forced swim test, emergence test, and elevated plus‐maze (EPM) using alcohol naïve rats.

Results: Topiramate (10, 20, and 40 mg/kg) significantly reduced the motivation to lick for beer, although the maximal effect was moderate in comparison with naloxone (10 mg/kg). However, naloxone, unlike TPM, also reduced responding for near‐beer suggesting an alcohol‐specific effect of TPM. In Experiment 2, TPM (40 and 80 mg/kg) tended to transiently reduce alcohol consumption in the home cage under ad libitum access but this effect disappeared with repeated administration of the drug. TPM (10 to 80 mg/kg, given twice over 4 hours before test) produced a robust dose‐dependent decrease in immobility and increase in active coping strategies in the forced swim test similar to that seen with desipramine (2 × 20 mg/kg). There were modest anxiolytic effects of TPM on the EPM and emergence tests.

Conclusions: With acute administration, TPM is moderately effective and relatively selective in reducing the drive to consume alcohol in Wistar rats. This anti‐alcohol effect is modest in comparison with naloxone and appears to dissipate under conditions of chronic treatment and ad libitum alcohol access. A marked antidepressant‐like effect in the forced swim test and partial anxiolytic effects in other animal models suggests that TPM may be a beneficial treatment for affective disorders. These preliminary results suggest further research is warranted to resolve the mechanisms involved in TPM modulation of both mood and alcohol consumption.
Population‐Level Relationships Between Alcohol Consumption Measures and Ischemic Heart Disease Mortality in U.S. Time‐Series
Authors: Kerr William C. , Ye Yu
Published: October 2007

Background:  Individual‐level studies indicate the possibility of both protective and harmful effects of alcohol consumption on Ischemic Heart Disease (IHD) mortality depending on the pattern of consumption. Population‐level relationships could be in either direction and previous studies have found mixed results.

Methods:  Population‐level relationships between IHD mortality rates and per capita consumption of alcoholic beverages, cirrhosis mortality rates, cigarettes, and sugar sweetened soda for the period from 1950 to 2002 are modeled using autoregressive integrated moving average (ARIMA) and vector error correction methods.

Results:  In multivariate ARIMA models controlling for accumulated heavy drinking as represented by cirrhosis mortality, a protective effect of 4%/l was found for total alcohol consumption while cirrhosis mortality rates had significant positive effects on IHD rates. Beverage‐specific models found no effect for wine, positive risks for spirits, and significant protective effects for beer. The protective effects for both total alcohol and beer were also found in vector error correction models. Significant positive effects of cigarette sales on IHD rates were also found in both types of models.

Conclusions:  The complexity of alcohol’s relationship with IHD is highlighted. Aspects of pattern represented by beverage‐specific consumption and cirrhosis mortality indicate potential protective effects from moderate drinking and harmful effects from heavy drinking in accord with individual‐level findings.
The Biphasic Effects of Alcohol: Comparisons of Subjective and Objective Measures of Stimulation, Sedation, and Physical Activity
Authors: Addicott Merideth A. , Marsh‐Richard Dawn M. , Mathias Charles W. , Dougherty Donald M.
Published: October 2007

Background:  Alcohol produces biphasic effects of both stimulation and sedation. Sensitivity to these effects may increase the risk for the development of alcoholism. Alcohol‐induced changes in stimulation and sedation are commonly assessed with self‐report questionnaires in human research and with physical activity monitoring in animal research. However, little is known about the effects of alcohol on physical activity or the relationship between physical activity and subjective self‐report measures of stimulation and sedation following alcohol consumption in humans.

Methods:  Thirty healthy men and women (n = 15 each) from 21 to 38 years old completed daily measurements of physical activity and self‐reports of stimulation and sedation following alcohol or placebo consumption. Across each of the four experimental days, all participants consumed a placebo, 0.4, 0.6, or 0.8 g/kg dose of 95% alcohol in a counterbalanced order. Breath alcohol concentrations, physical activity levels, and self‐reported stimulation and sedation were measured at baseline and on the ascending and descending limbs of the breath alcohol concentration (BrAC) curve.

Results:  All alcohol doses increased physical activity, but these increases were time‐ and dose‐dependent. Increases in physical activity lasted across both ascending and descending limbs of the BrAC curve. Following the 0.6 g/kg dose, both physical activity and self‐reported stimulation increased during the ascending BrAC. Separate analyses of self‐reported sedation scores indicated that alcohol consumption also increased sedation for the 0.6 and 0.8 g/kg doses. Physical activity was not significantly correlated with either self‐reported stimulation or sedation at any time point.

Conclusions:  These findings suggest that assessments of subjectively measured stimulation and sedation and objectively measured physical activity each assess unique aspects of the effects of alcohol. Used simultaneously, these measures may be useful for examining underlying mechanisms of the effects of alcohol on behavior.
The Effect of Ambient Bright Light Therapy on Depressive Symptoms in Persons with Dementia
Authors: Hickman Susan E. , Barrick Ann Louise , Williams Christianna S. , Zimmerman Sheryl , Connell Bettye Rose , Preisser John S. , Madeline Mitchell C. , Sloane Philip D.
Published: October 2007

OBJECTIVES: To assess the effect of ambient bright light therapy on depressive symptoms in persons with dementia.

DESIGN: A cluster‐unit crossover intervention trial involving four lighting conditions: morning bright light, evening bright light, all‐day bright light, and standard light.

SETTING: The common areas of two geriatric units in a state‐operated psychiatric hospital in North Carolina and in a dementia‐specific residential care facility in Oregon.

PARTICIPANTS: Sixty‐six older adults with dementia.

INTERVENTION: Ambient bright light therapy was delivered through a high‐intensity, low‐glare lighting system installed in the public areas of study units at both sites. Each lighting condition was provided for multiple 3‐week periods in a predetermined sequence.

MEASUREMENTS: Staff caregivers completed the Cornell Scale for Depression in Dementia (CSDD) in the last week of each 3‐week period to provide information about participants' moods.

RESULTS: Analysis indicated a sex‐by‐treatment interaction (P=.008). Significant sex differences were found in CSDD scores in response to evening light (P=.003), all‐day light (P=.001), and standard light (P≤.001). Depressive symptoms were lowest for women and highest for men during morning light.

CONCLUSION: Findings do not support the use of ambient bright light therapy as a treatment for depressive symptoms in persons with dementia, although a subpopulation of persons with dementia may benefit from this intervention. It is likely that individual rather than unit‐level interventions are a more effective strategy for delivering bright light therapy for this population.
Sleep Problems in Elderly Women Caregivers Depend on the Level of Depressive Symptoms: Results of the Caregiver–Study of Osteoporotic Fractures
Authors: Kochar Jinesh , Fredman Lisa , Stone Katie L. , Cauley Jane A. ,   for the Study of Osteoporotic Fractures
Published: October 2007

OBJECTIVES: To determine whether depressive symptoms modify the association between caregiving and sleep problems in elderly women.

DESIGN: Cross‐sectional study conducted in four communities in 1999 to 2001.

SETTING: Home‐based interviewer‐administered questionnaires.

PARTICIPANTS: Three hundred seventy‐five caregiver and 694 noncaregiver participants from the Study of Osteoporotic Fractures.

MEASUREMENTS: Self‐reported frequency of three sleep problems in the previous month: trouble falling asleep, trouble staying asleep, and waking early and having trouble falling back asleep. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES‐D), excluding the sleep disturbance item.

RESULTS: In adjusted analyses, caregivers did not report more sleep problems than noncaregivers, although respondents with high depressive symptoms (CES‐D≥16) were twice as likely to report each sleep problem. When depressive symptoms and caregiving were considered together, caregivers with high depressive symptoms were most likely to report sleep problems (adjusted odds ratios ranging from 2.5, 95% confidence interval (CI)=1.2–5.2 for trouble falling asleep to 4.0, 95% CI=2.0–7.8 for waking early, compared with nondepressed noncaregivers). By contrast, there was no difference in sleep problems between caregivers and noncaregivers who were not depressed. The combination of high depressive symptoms and high‐stress caregiving situations (e.g., caring for a spouse or a person with dementia, or living with the care recipient) also increased the likelihood of sleep problems.

CONCLUSION: Caregivers with high levels of depressive symptoms reported sleep problems more than nondepressed noncaregivers. These results underscore the importance of screening elderly female caregivers for depressive symptoms and sleep problems.
Dietary Supplementation and Quality of Life of Older Patients: A Randomized, Double‐Blind, Placebo‐Controlled Trial
Authors: Gariballa Salah , Forster Sarah
Published: October 2007

OBJECTIVES: To test the effect of nutritional support on older patient's quality of life.

DESIGN: Double‐blind, randomized, placebo‐controlled trial conducted from March 2001 to January 2004.

SETTING: United Kingdom.

PARTICIPANTS: Two hundred twenty‐five hospitalized acutely ill older patients.

INTERVENTION: Normal hospital diet plus 400‐mL oral nutritional supplements daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal for energy and 100% of the Reference Nutrient Intakes for a healthy older person for vitamins and minerals.

MEASUREMENTS: Baseline, 6‐week, and 6‐month nutritional status and quality of life.

RESULTS: Randomization to the supplement group led to significantly better quality‐of‐life scores than in the placebo group at 6 months but not at 6 weeks, after adjustment for baseline quality of life, age, and sex. The effect of supplementation was seen in higher physical function, role physical, and social function scores. Corresponding treatment effects were 7.0 (95% confidence interval (CI)=0.5–13.6, P=.04), 10.2 (95% CI=0.1–20.2, P=.047), and 7.8 (95% CI=0.0–15.5, P=.05), respectively. There was no evidence of difference in Barthel scores at 6 months.

CONCLUSION: Oral nutritional supplementation of acutely ill hospitalized older patients led to a statistically significant benefit in quality of life.
Screening of Older Community‐Dwelling People at Risk for Death and Hospitalization: The Assistenza Socio‐Sanitaria in Italia Project
Authors: Mazzaglia Giampiero , Roti Lorenzo , Corsini Giacomo , Colombini Angela , Maciocco Gavino , Marchionni Niccolò , Buiatti Eva , Ferrucci Luigi , Bari Mauro Di
Published: October 2007

OBJECTIVES: To develop and validate mortality and hospitalization prognostic tools based upon information readily available to primary care physicians (PCPs).

DESIGN: Population‐based cohort study. Baseline predictors were patient demographics, a seven‐item questionnaire on functional status and general health, use of five or more drugs, and previous hospitalization.

SETTING: Community‐based study.

PARTICIPANTS: Prognostic indexes were developed in 2,470 subjects and validated in 2,926 subjects, all community‐dwelling, aged 65 and older, and randomly sampled from the rosters of 98 PCPs in Florence, Italy.

MEASUREMENTS: Fifteen‐month mortality and hospitalization.

RESULTS: Two scores were derived from logistic regression models and used to stratify participants into four groups. With Model 1, based upon the seven‐item questionnaire, mortality rate ranged from 0.8% in the lowest‐risk group (0–1 point) to 9.4% in the highest risk group (≥3 points), and hospitalization rate ranged from 12.4% to 29.3%; area under the receiver operating characteristic curves (AUC) was 0.75 and 0.60, respectively. With Model 2, considering also drug use and previous hospitalization, mortality and hospitalization rates ranged from 0.3% to 8.2% and from 8.1% to 29.7%, for the lowest‐risk to the highest‐risk group; the AUC increased significantly only for hospitalization (0.67).

CONCLUSION: Prediction of death and hospitalization in older community‐dwelling people can be easily obtained with two indexes using information promptly available to PCPs. These tools might be useful for guiding clinical care and targeting interventions to reduce the need for hospital care in older persons.
Effectiveness of Multidimensional Exercises for the Treatment of Stress Urinary Incontinence in Elderly Community‐Dwelling Japanese Women: A Randomized, Controlled, Crossover Trial
Authors: Kim Hunkyung , Suzuki Takao , Yoshida Yuko , Yoshida Hideyo
Published: October 2007

OBJECTIVES: To evaluate the effectiveness of pelvic floor muscle (PFM) and fitness exercises in reducing urine leakage in elderly women with stress urinary incontinence (UI).

DESIGN: Randomized, crossover, follow‐up trial.

SETTING: Urban community in Japan.

PARTICIPANTS: Seventy women aged 70 and older who reported urine leakage one or more times per month; 35 were randomly assigned to intervention and the other 35 to control.

INTERVENTION: The intervention group attended an exercise class aimed at enhancing PFMs and fitness. Duration of the exercise was 60 minutes per session twice a week for 3 months. After 3 months of exercise, the intervention group was followed for 1 year.

MEASUREMENTS: Body mass index (BMI), urine leakage, walking speed, and muscle strength were measured at baseline, after the intervention, and at follow‐up.

RESULTS: In the intervention group, maximum walking speed and adductor muscle strength increased significantly after the intervention; there were no significant changes in the control group. After 3 months of exercise, 54.5% of the intervention group and 9.4% of the control group reported being continent. Within the cured group of UI, a significantly higher proportion had decreased their BMI at 3 months (P=.03) and increased walking speed at 3 (P=.04) and 12 (P=.047) months.

CONCLUSION: Decrease in BMI and increase in walking speed may contribute to the treatment of UI, although the data do not support a positive correlation between strengthening of adductor muscle and improvement of UI, which needs more research.
A Pilot Study of Banxia Houpu Tang, a Traditional Chinese Medicine, for Reducing Pneumonia Risk in Older Adults with Dementia
Authors: Iwasaki Koh , Kato Shiro , Monma Yasutake , Niu Kaijun , Ohrui Takashi , Okitsu Reina , Higuchi Satoshi , Ozaki Shiro , Kaneko Noboru , Seki Takashi , Nakayama Katsutoshi , Furukawa Katsutoshi , Fujii Masahiko , Arai Hiroyuki
Published: October 2007

OBJECTIVES: To evaluate whether the traditional Chinese herbal medicine Banxia Houpu Tang (BHT, formula magnolia et pinelliae) prevents aspiration pneumonia and pneumonia‐related mortality in elderly people.

DESIGN: A prospective, observer‐blinded, randomized, controlled trial.

SETTING: Two long‐term care hospitals for handicapped elderly patients in Japan from March 2005 to February 2006.

PARTICIPANTS: One hundred four elderly patients (31 men and 73 women; mean age±standard deviation 83.5±7.8) with dementia and cerebrovascular disease, Alzheimer's disease, or Parkinson's disease.

INTERVENTION: Ninety‐five participants (mean age 84.0, M:F=28:67) were randomly assigned to the BHT treatment group (n=47) or the control group (n=48) and took BHT or placebo for 12 months.

MEASUREMENTS: The occurrence of pneumonia, mortality due to pneumonia, and the daily amount of self‐feeding.

RESULTS: Complete data were available for analysis on 92 of the 95 subjects randomized. Four patients in the BHT group developed pneumonia, and one of them died as a result. Fourteen patients in the control group developed pneumonia, and six of them died as a result. There was a significant difference between the two groups in pneumonia onset (P=.008), and a tendency toward significance in pneumonia‐related mortality (P=.05). The relative risk of pneumonia in the BHT group compared with the control group was 0.51 (95% confidence interval (CI)=0.27–0.84, P=.008) and that of death from pneumonia was 0.41 (95% CI=0.10–1.03, P=.06) according to the Cox proportional hazards model. No adverse events were observed from treatment with BHT. The BHT group was able to maintain self‐feeding better than the control group (P=.006).

CONCLUSION: Treatment with BHT reduced the risk of pneumonia and pneumonia‐related mortality in elderly patients with dementia.
My Life, My Times, and My Research: An Autobiographical Sketch
Authors: Ohrenstein Roman A.
Published: October 2007

Abstract.  The following is a biographical sketch of my life's journey—an epic of transmigrations from Lucifer's Kingdom of horror to a miraculous survival. It is a saga of trials and tribulations, tragedy and triumph, academic success and scholarly achievement.
The Talmudic Doctrine of “The Benefit of a Pleasure”: Psychological Well‐Being in Talmudic Literature
Authors: Ohrenstein Roman A.
Published: October 2007

Abstract.  In this article, we attempt to analyze the Talmudic notion of well‐being in the light of modern hedonic psychology. First, we examine the thoughts of Hebrew “wisdom” and Greek “sophia” concerning the phenomenon of happiness. We then discuss the Talmudic doctrine of “optimality,” a concept similar to that of the Pareto improvement. This is followed by a discourse deemed to be of extraordinary significance—the idea of “mutual benefit,” which may be described as “super optimum.” Thereafter, the doctrine of the “Benefit of a Pleasure” is demonstrated to be a “pleasure‐measure” of reciprocal and nonreciprocal happiness. Finally, it is argued, that although Plato, according to Professor Lowry, detailed precise “trade‐offs” between degrees of pleasure, pain, and time, it was applied to “moral values” only, whereas the Talmudists posited the existence of a “psychoeconomic” category, in which pleasure itself is equated with money.
The Pelagian Controversy: An Economic Analysis
Authors: Beck John H.
Published: October 2007

Abstract. In recent years economic theory has been used to analyze the introduction of new religious doctrines as innovations that further the objectives of religious organizations and their leaders. The present study analyzes the decision of church authorities in the early fifth century to reject the doctrine advanced by Pelagius in favor of the position taken by Augustine. Accounts of the controversy reveal two self‐interested motives for the church hierarchy to reject the Pelagian doctrine: (1) the Pelagian view would have undermined the authority of the church hierarchy; and (2) by making greater demands for moral conduct, it would have raised the “cost” of being a Christian and thereby discouraged growth in church membership, particularly among the Roman upper class.
The Agency Relationship in Churches: An Empirical Analysis
Authors: Zech Charles
Published: October 2007

Abstract. The agency relationship has been observed in a variety of settings. Churches, like other organizations, are plagued with the typical agency problems of moral hazard, observability, goal displacement, and risk aversion. How do churches cope with these issues in dealing with their most critical resource, clergy? This study analyzes the agency relationship between churches and their clergy.

Using data from nine denominations, this study finds strong evidence that pastor compensation is not tied directly to performance, but rather indirectly through promotion tournaments. Successful pastors are rewarded by being called to larger, presumably wealthier and more prestigious, congregations. Since it is so difficult to observe and measure a pastor's performance in specific activities, churches differentiate good pastors from mediocre ones by considering their total performance, rather than any specific activities.
Religious Market Competition and Clergy Salary: Evidence from SBC Congregations in the South
Authors: Trawick Michelle W. , Lile Stephen E.
Published: October 2007

Abstract. We utilize a rich and unique data source covering 13,825 Southern Baptist Convention churches in seven Southern states to test the impact of religious market competition, or pluralism, on clergy salary. We link county‐level religious market and socioeconomic data to the county in which each church is located. Two measures of religious output market are used. One is a narrow output market definition calculated using only SBC churches. The other is a more broadly defined measure calculated using 132 Judeo‐Christian denominations. Using regression analysis, we conclude that greater concentration among Southern Baptist Churches' members within a given county area has a positive, and statistically significant, impact on Southern Baptist clergy salaries, while greater concentration among other denominations has no impact on Southern Baptist clergy salaries. Most importantly, we show that Southern Baptist Churches exhibit predictable economic behavior despite the ethereal nature of the product they provide.
Religion and International Trade: Does the Sharing of a Religious Culture Facilitate the Formation of Trade Networks?
Authors: Lewer Joshua J. , Van den Berg Hendrik
Published: October 2007

Abstract.  Despite interest in the influence of religion on economic activity by early economists like Adam Smith, modern economists have done little research on the subject. In light of the apparent religious fervor in many parts of the global economy, economists' seeming lack of interest in studying how religious cultures enhance or retard the globalization of economic activity is especially surprising. This article makes a contribution toward filling this void by examining how religion affects international trade. Specifically, we examine whether the sharing of religious cultures enables the formation of exchange networks that can overcome the failure or nonexistence of other social and economic institutions necessary for completing complex international transactions. We apply an expanded gravity model of international trade to control for a variety of factors that determine trade, and we use two recently developed regression methods, scaled OLS and nonlinear least squares, to exploit the model to its fullest. We find that the sharing of Buddhist, Confucian, Hindu, Eastern Orthodox Catholic, and Protestant cultures by people in different countries has a significantly positive influence on bilateral trade, all other things equal. The sharing of Roman Catholic culture has a significantly negative influence on bilateral trade, and the sharing of Islamic and Judaic cultures neither promotes nor discourages international exchange. These results suggest that some religious cultures are more conducive than others for forming international trade networks.
Document: Qiao Shi on China's Long March to the Rule of Law
Authors: SHI QIAO
Published: October 2007

As it prepares to host the 2008 Olympics, China's authoritarian development model, which has sustained high growth for two decades, is entering a fragile new stage. Tainted toys and other products have made the American consumers on whom China relies wary even as the debt‐and‐deficit ridden American economy relies on China's massive foreign reserves to keep going. In the meantime, China's aggressive search for raw materials in Africa is causing a backlash while its cyberspying probes into Western defense systems are reviving Cold War‐like tensions. The US treasury secretary, a top China expert and former intelligence officials offer their views.
Chinese Hacking Signals Age of Info Warfare
Authors: INMAN BOBBY RAY
Published: October 2007

As it prepares to host the 2008 Olympics, China's authoritarian development model, which has sustained high growth for two decades, is entering a fragile new stage. Tainted toys and other products have made the American consumers on whom China relies wary even as the debt‐and‐deficit ridden American economy relies on China's massive foreign reserves to keep going. In the meantime, China's aggressive search for raw materials in Africa is causing a backlash while its cyberspying probes into Western defense systems are reviving Cold War‐like tensions. The US treasury secretary, a top China expert and former intelligence officials offer their views.
Experimental Efficacy of Pericardial Instillation of Anti‐inflammatory Agents during Percutaneous Epicardial Catheter Ablation to Prevent Postprocedure Pericarditis
Authors: D'AVILA ANDRE , NEUZIL PETR , THIAGALINGAM ARAVINDA , GUTIERREZ PAULO , ALEONG RYAN , RUSKIN JEREMY N. , REDDY VIVEK Y.
Published: October 2007

Introduction: Pericarditis is a potential complication of catheter‐based percutaneous epicardial mapping and ablation. This study evaluates the efficacy and safety of intrapericardial instillation of anti‐inflammatory agents after pericardial mapping and ablation in a porcine model of postprocedural pericarditis.

Methods and Results: Twenty‐five healthy swine underwent epicardial mapping and ablation after transthoracic subxyphoid puncture. After 60 minutes of continuous catheter manipulation in the pericardial space, radiofrequency energy was delivered in a linear fashion to the epicardial surfaces of both atria. The animals were randomly divided to receive the anti‐inflammatory agents, Hyaluronic Acid and Triamcinolone, or control. Fourteen days after ablation, the hearts were excised and the degree of pericardial reaction/adhesions scored. The severity was uniformly graded 4 (intense) in all control animals and was characterized by intense adhesion between the parietal and the visceral pericardium obscuring tissue planes and epicardial anatomy. Hyaluronic Acid provided a mild benefit (score 3.0 ± 0.9), but 2 mg/kg of Triamcinolone significantly attenuated the inflammatory effect (all animals uniformly scored 1.0).

Conclusion: In a porcine model of ablation‐related pericarditis, intrapericardial instillation of 2 mg/kg of intermediate‐acting corticosteroids effectively prevents post‐procedure inflammatory adhesion formation.
A Hybrid Surgical Transcatheter Strategy for Treating Severe Para‐Right Atrioventricular Valvular Regurgitation in a Patient with Left Atrial Isomerism
Authors: KALANTRE ATUL , VETTUKATTIL JOSEPH , HAW MARCUS , VELDTMAN GRUSCHEN R.
Published: October 2007

Paravalvular leaks are a recognized complication of valve replacement surgery. We report a 47‐year‐old man with left atrial isomerism, interrupted left sided inferior caval vein with unilateral left sided superior caval vein, a common atrium, and anomalous pulmonary venous connection to the coronary sinus, who had recurrent severe para‐right atrioventricular (AV) regurgitation with gross right heart failure following tricuspid valve (TCV) replacement. He underwent a hybrid surgery–transcatheter treatment strategy in the cardiac catheterization laboratory, which led to significant improvement in hemodynamics and symptoms. This to our knowledge is the first reported case of a minimally invasive approach to para‐right sided AV valve regurgitation.
EU Regulation of Medical Devices and Pharmaceuticals in Comparative Perspective
Authors: Altenstetter Christa , Permanand Govin
Published: October 2007

This paper provides a comparison of European Union regulatory policy for pharmaceuticals and medical devices. The discussion highlights key similarities and differences in regulatory approach for the two sectors. More importantly, it explores the balance that has been struck between public health, health care, and industrial policy as “competing” objectives within the respective regulatory regimes. It is argued that, despite both sectors being affected by the same institutional rules and constraints at the EU level, and both being central to the delivery of high‐quality health care in Europe, there are a surprising number of differences between the regulatory frameworks. That this stems in part from their different “launch” times, hence different institutional conditions of regulation, and commensurate political climates, as well as reflecting different aims and goals among member‐state and EU‐level policy makers, are among the paper's main conclusions.
Discerning Immunity for Governmental Entities: Analyzing Legislative Choices
Authors: Centner Terence J.
Published: October 2007

In 2006, three disagreements about the scope of immunity for governmental entities were considered by the U.S. Supreme Court. Governmental entities were seeking to avoid liability for their actions, claiming the defense of sovereign immunity. Other lawsuits involving governmental immunity under state constitutional and statutory provisions disclose controversies concerning the responsibilities of governments to injured persons. The complicated jurisprudence governing immunity for governmental entities shows two alternatives for legislatures. They have the ability to increase liability by waiving immunity or to add defenses that defeat liability. The trend seems to be to waive immunity for governmental entities while adding statutory defenses that are available to both the private sector and governmental entities.
Emission of Pollutants from Glycine–Nitrate Combustion Synthesis Processes
Authors: Pine Thomas , Lu Xinyu , Mumm Daniel R. , Samuelsen G. Scott , Brouwer Jacob
Published: October 2007

Four ceramic powders were produced using the glycine–nitrate process: lanthanum‐doped barium cobaltite, ceria, magnesia, and strontium‐doped lanthanum chromite (LSC). Glycine‐to‐nitrate ratios from 0.25 to 1 were investigated. During the combustion synthesis process, careful collection of process off‐gas was followed by detailed gas analyses to determine product gas composition. All of the synthesis processes produced pure phase ceramic powders, but also produced criteria pollutant emissions levels that were significant enough (up to 4500 ppm of NOx and 9000 ppm of carbon monoxide) to warrant consideration. Equilibrium and chemical kinetic computations are used to determine the implications of the current findings.