bluuebunny/crossref_metadata_2025 huggingface dataset:
The Rhetoric of Unity and the Quest for Political Power in Nigeria
Authors: Alumona Victor
Published: July 2006

Post colonial African countries, like Nigeria, have been contending, in one form or another, with the problems of nation building. One of these problems in the post independent era is that of forging one nation from a plethora of peoples and cultures brought together under one flag by the erstwhile colonialists. The author argues that even though the various Nigerian political elite usually give the impression that National unity is a sine qua non for the existence of Nigeria as a state and a country, and that every one who must be considered a patriot must be seen to be rooting for it, the real thing, however, is that they emphasize national unity as a leverage for political power. In other words, they see in Unity of the country a topic for generating arguments to support their drive for political power, or to justify their retention of it in spite of the means used to achieve these ends.A careful consideration of the policies of these elite while in government show that they use Unity of Nigeria expediently like the rhetoricians of ancient Greece would do, not out of principles but to serve a contingent purpose. The unity of Nigeria became a source of arguments for power ever before independence because the Northern region feared domination by the Southern region given its many advantages.
China's New Mercantilism in Central Africa
Authors: Holslag Jonathan
Published: July 2006

The objective of this article is twofold. On one hand it elucidates the goals and dynamics of China's foreign trade policy since the 1990s. On the other hand it assesses the impact of this strategy on the development of the Central African Region as a case for China's influence on other developing countries. We observe that China is pursuing a pragmatic mercantilist policy that combines a wide array of diplomatic and economic devices. As a result the People's Republic gains ground slowly but surely. However, China's ascent does not lift the Central African states to a more favourable position in the global division of labour. We conclude that China's rise confirms the current economic position of African countries: that of a commodity supplier and a modest consumer's market.
Ageing Contested: Anti-ageing Science and the Cultural Construction of Old Age
Authors: Vincent John A.
Published: July 2006

Recent developments in the fundamental science of biological ageing have raised the possibility of extending the human lifespan. This article examines contests within bio-gerontology as to the nature of ageing, identifies the methods through which old age is constructed by reference to particular kinds of knowledge and thus considers the impact of the culture of science on the contemporary meaning of old age. Definitions of ageing and death that focus on biological failure lead to a cultural construction of old age whereby diversity across the life course is devalued.
The Absent Body Project: Cosmetic Surgery as a Response to Bodily Dys-appearance
Authors: Gimlin Debra
Published: July 2006

Sociologists have conceptualized the body as a ‘project’ that is worked on and transformed as a central part of self-identity (Shilling, 2003). In contrast, Leder’s (1990) notion of the ‘absent’ body focuses on the body’s tendency to remain in the ‘corporeal background’ unless specific physiological or social experiences cause it to ‘dys-appear’, or emerge problematically into direct consciousness.This article draws upon data from interviews with women who have had cosmetic surgery to show that these seemingly contradictory approaches to the body and self-identity are not reconcilable. Specifically, the data presented suggest that while cosmetic surgery provides a resource for bringing the body into line with an existing sense of self, it is also used to alleviate the body’s dys-appearances. Thus, this article describes how elements of both the ‘absent body’ and ‘body project’ perspectives are relevant to cosmetic surgery patients’ experiences of embodiment.
Delay of Ovulation by Meloxicam in Healthy Cycling Volunteers: A Placebo‐Controlled, Double‐blind, Crossover Study
Authors: Bata M. S. , Al‐Ramahi M. , Salhab A. S. , Gharaibeh M. N. , Schwartz Jill
Published: July 2006

This study aimed to assess the effect of meloxicam on female ovulation. Twenty consented fertile females were monitored for 4 menstrual cycles: a baseline cycle, 2 treatment cycles, and a washout cycle between treatment cycles. In the first cycle visit, transvaginal ultrasound was performed, a blood sample for progesterone and meloxicam analysis was withdrawn, and volunteers were given a luteinizing hormone (LH) urine test kit and meloxicam or placebo. Volunteers started the treatment on the following day and asked to return the day the LH kit was positive to detect the dominant follicle. At subsequent visits, transvaginal ultrasound and progesterone and meloxicam levels were investigated. Compared to placebo, a 5‐day delay in follicle rupture, a 55.7% increase in the mean maximum follicle diameter, and 33.5% decrease of plasma progesterone level were observed in the meloxicam‐treated group. Such demonstrated meloxicam effects were reversed in participants who were randomized to meloxicam first and then placebo. Only minor side effects were reported by volunteers during the course of treatment. It is concluded that meloxicam resulted in a reversible delay of ovulation, an increase in follicular diameter, and a decrease in plasma progesterone level.
Pharmacokinetics and Pharmacodynamic Effects of the Oral DPP‐4 Inhibitor Sitagliptin in Middle‐Aged Obese Subjects
Authors: Herman Gary A. , Bergman Arthur , Liu Fang , Stevens Cathy , Wang Amy Q. , Zeng Wei , Chen Li , Snyder Karen , Hilliard Deborah , Tanen Michael , Tanaka Wesley , Meehan Alan G. , Lasseter Kenneth , Dilzer Stacy , Blum Robert , Wagner John A.
Published: July 2006

Sitagliptin (MK‐0431) is an oral, potent, and selective dipeptidyl peptidase‐IV (DPP‐4) inhibitor developed for the treatment of type 2 diabetes. This multicenter, randomized, double‐blind, placebo‐controlled study examined the pharmacokinetic and pharmacodynamic effects of sitagliptin in obese subjects. Middle‐aged (45–63 years), nondiabetic, obese (body mass index: 30–40 kg/m2) men and women were randomized to sitagliptin 200 mg bid (n = 24) or placebo (n = 8) for 28 days. Steady‐state plasma concentrations of sitagliptin were achieved within 2 days of starting treatment, and >90% of the dose was excreted unchanged in urine. Sitagliptin treatment led to ∼90% inhibition of plasma DPP‐4 activity, increased active glucagon‐like peptide‐1 (GLP‐1) levels by 2.7‐fold (P < .001), and decreased post—oral glucose tolerance test glucose excursion by 35% (P < .050) compared to placebo. In nondiabetic obese subjects, treatment with sitagliptin 200 mg bid was generally well tolerated without associated hypoglycemia and led to maximal inhibition of plasma DPP‐4 activity, increased active GLP‐1, and reduced glycemic excursion.
Tyramine Pressor Sensitivity During Treatment With the Selegiline Transdermal System 6 mg/24 h in Healthy Subjects
Authors: Azzaro Albert J. , VanDenBerg Chad M. , Blob Lawrence F. , Kemper Eva M. , Sharoky Melvin , Oren Dan A. , Campbell Bryan J.
Published: July 2006

The oral tyramine pressor test was administered to healthy males during treatment with a selegiline transdermal system (STS; 6 mg/24 h). The tyramine sensitivity factor (TSF) was calculated from the ratio of baseline and on‐treatment tyramine pressor doses. The tyramine sensitivity factor value following 9 days of treatment with the selegiline transdermal system was 1.85 ± 0.10. Extended treatment, 33 days, produced a small, clinically nonmeaningful increase in this value. The tyramine sensitivity factor for the selegiline transdermal system was similar to that following treatment with 10 mg/d of oral selegiline capsules but more than 20 times less than observed during tranylcypromine treatment. A larger increase in the tyramine sensitivity factor was observed following extended selegiline transdermal system treatment at a higher dose (12 mg/24 h), which was significantly decreased following coadministration of tyramine capsules with a meal. These results suggest a wide tyramine safety margin for the selegiline transdermal system and provide evidence that the 6‐mg/24‐h selegiline transdermal system can be administered safely without dietary tyramine restrictions.
FTY720: Placebo‐Controlled Study of the Effect on Cardiac Rate and Rhythm in Healthy Subjects
Authors: Schmouder Robert , Serra Denise , Wang Yibin , Kovarik John M. , DiMarco John , Hunt Thomas L. , Bastien Marie‐Claude
Published: July 2006

The purpose of this double‐blind, placebo‐controlled study was to measure the effects of FTY720, a novel immunomodulator, on heart rate and rhythm in healthy volunteers. Subjects (n = 66) were randomized to FTY720 1.25 mg or 5 mg or placebo administered once daily for 7 days. Continuous telemetry revealed an acute, dose‐dependent decrease in mean heart rate (10‐bpm decrease vs placebo) following the first dose of FTY720, with a nadir generally 4 hours postdose. Although a persistent FTY720‐related decrease in heart rate was measured from day 2 to day 7, additional doses of FTY720 after day 2 resulted in no further incremental decreases. Mean PR interval increased by approximately 8 to 10 msec in FTY720‐treated subjects on day 1. FTY720 did not increase the QRS or QT interval. These results confirm that the first dose of FTY720 has a mild to moderate negative chronotropic effect.
The Curse of the Law (Galatians 3.13): Crucifixion, Persecution, and Deuteronomy 21.22-23
Authors: O’Brien Kelli S.
Published: July 2006

It is widely accepted that Christians were persecuted for preaching a crucified messiah because, according to Deut. 21.22-23, one who is crucified is also accursed. However, the arguments in favor of that position are weak. A larger examination of Jewish texts on Deut. 21.22-23 and crucifixion per se demonstrate that attitudes toward crucifixion and its victims were generally very different. The article concludes that Deut. 21.22-23 is an unlikely basis for early Jewish rejection and persecution of Christianity and that other causes should be sought.
Relational and physical victimization by peers and romantic partners in college students
Authors: Lento Jennifer
Published: July 2006

This cross-sectional study of college students investigated prevalence and gender differences in relational and physical victimization by peers and romantic partners, as well as interrelationships among the victimization types with hostility and interpersonal sensitivity. Results indicated that relational victimization by peers and romantic partners was more prevalent than physical victimization. Males reported more relational victimization by romantic partners and more physical victimization by peers. Multiple regression analyses revealed that the influence of hostility and interpersonal sensitivity on relational and physical victimization by peers and romantic partners differed by gender and type of victimization. These results shed new light on relational and physical victimization by peers and romantic partners in college students especially as they relate to gender.
Theoretical models of narcissism, sexuality, and relationship commitment
Authors: Foster Joshua D. , Shrira Ilan , Campbell W. Keith
Published: July 2006

The present research examines the link between narcissistic personality and sexuality. Additionally, it explores how sexuality may inform the operation of narcissism within the context of close relationships. Two theoretical models, each addressing one of these issues, were evaluated empirically. Our first proposed model suggests that the agentic nature of narcissism explains why narcissism is linked to less restricted forms of sexual attitudes and behaviors (i.e., unrestricted sociosexuality). Our second proposed model suggests that a consequence of the sexual attitudes and behaviors associated with narcissism is low relationship commitment. Both of these models received empirical support. Discussion centers upon the theoretical implications and limitations of these models.
Emerging adult men and their mothers in divorced families: A typology of relationship patterns
Authors: Shulman Shmuel , Cohen Omri , Feldman Benni , Mahler Amalia
Published: July 2006

Sixty four dyads of mothers and emerging adult sons (32 divorced families) were individually interviewed about their relationships and the relationship with the father. Results show that sons' relationships with their mothers can be classified into three relational types: the Idealized, the Balanced-Realistic, and the Critical. While the majority of nondivorced families belonged to the optimal Balanced-Realistic type, two thirds of the divorced families belonged to the two less optimal types. Belonging to an Idealized type was associated with devaluation of the father and lower autonomous functioning. In contrast, belonging to the Critical type was characterized by a balanced relationship with the father and a higher level of autonomy. Vignettes are presented to demonstrate the three relationship patterns.
Exploring young adults' perspectives on communication with aunts
Authors: Ellingson Laura L. , Sotirin Patricia J.
Published: July 2006

Women are typically studied as daughters, sisters, mothers, or grandmothers. However, many, if not most, women are also aunts. In this study, we offer a preliminary exploration of the meaning of aunts as familial figures. We collected 70 nieces' and nephews' written accounts of their aunts. Thematic analysis of these accounts revealed nine themes, which were divided into two categories. The first category represented the role of the aunt as a teacher, role model, confidante, savvy peer, and second mother. The second category represented the practices of aunting: gifts/treats, maintaining family connections, encouragement, and nonengagement. Our analysis illuminates important aspects of aunts in family schema and kin keeping.
A Randomized Controlled Trial of a Decision Aid for Women at Increased Risk of Ovarian Cancer
Authors: Tiller K. , Meiser B. , Gaff C. , Kirk J. , Dudding T. , Phillips K.-A. , Friedlander M. , Tucker K.
Published: July 2006

Purpose. To carry out a randomized controlled trial of a decision aid for women at increased risk of developing ovarian cancer to facilitate decision making regarding risk management options. Methods. This randomized trial, conducted through 6 familial cancer centers, compared the efficacy of tailored decision aid to that of a general educational pamphlet in preparing women for decision making. Participants. 131 women with a family history of breast and/or ovarian cancer or of hereditary nonpolyposis colorectal cancer. Outcome measures. Decisional conflict, knowledge about ovarian cancer risk management options, and psychological adjustment were reassessed at 3 time points. Results. Compared to those who received the pamphlet (control), women who received the decision aid (intervention) were significantly more likely to report a high degree of acceptability of the educational material at both follow-up assessment time points. Findings indicate neither group experienced significant increases in psychological distress at either follow-up assessment time points relative to baseline. Two weeks postintervention, the intervention group demonstrated a significant decrease in decisional conflict compared to the control group (t = 2.4, P < 0.025) and a trend for a greater increase in knowledge about risk management options (t = 2.1, P = 0.037). No significant differences were found 6 months postintervention. Conclusion. This form of educational material is successful in increasing knowledge about risk management options and in reducing decisional conflict in the shorter term. The decision aid is an effective and acceptable strategy for patient education to facilitate an inclusive and informed decision-making process about managing ovarian cancer risk.
Process Utility in Breast Biopsy
Authors: Swan J. Shannon , Lawrence William F. , Roy Jessica
Published: July 2006

Purpose. To determine whether the waiting trade-off (WTO) is feasible for differentiating short-term biopsy preferences in an acute situation where anxiety is the symptomatic disease state. Methods. 75 women with past experience of either breast core-needle biopsy (CNB), more invasive excisional surgical biopsy (EXB), or both, had telephone WTO assessments. Patients' baseline and test-related anxiety were valued by time trade-off (TTO) used to scale the WTO. Rating scales (RS) were obtained for convergent validity assessment with WTO and TTO. Results. Data were obtained in 38 women who had both CNB and EXB (“paired”) and 20 who had CNB only and 16 who had EXB only (“unpaired”). Patients rated only the procedure(s) they experienced. Median paired and mean unpaired WTO scores indicated patients were willing to wait significantly longer to avoid EXB ( P = 0.0003, P = 0.0002, respectively). The waiting time difference between EXB and CNB was 2.1 weeks greater in unpaired data than paired data. RS scores comparing the procedures were significantly different only for paired data ( P < 0.05). Median TTO preferences for baseline (1.00) and test anxiety (0.93) obtained in 74 patients were significantly different ( P < 0.0001) and consistent with RS. Correlation was noted between WTO and RS (-0.307 to -0.453, P = 0.0205 to 0.0001). The median EXB quality-adjusted life years toll (1.5 quality-adjusted life days) calculated from pooled WTO data (paired and unpaired) from 54 patients is near a threshold in a published model. Conclusion. The WTO is feasible for discriminating preferences for short-term health states in an acute medical scenario where it might have been expected to be impracticable.
Impact of the Ottawa Decision Support Framework on the Agreement and the Difference between Patients' and Physicians' Decisional Conflict
Authors: Légaré France , O'Connor Annette M. , Graham Ian D. , Wells Georges A. , Tremblay Stéphane
Published: July 2006

Background. The Ottawa Decision Support Framework (ODSF) provides a process that facilitates shared decision making. Objective. To assess the impact of implementing the ODSF on the agreement and the difference between patients' and physicians' decisional conflict scores. Design. In total, 120 physicians and 903 patients enrolled in this before-and-after study. Implementation of the ODSF was composed of an interactive workshop, feedback, and a reminder at the point of care. The Decisional Conflict Scale (DCS) was completed by physicians and patients after a clinical encounter. Results. The intraclass correlation coefficient was–0.205 ± 0.096 (95% confidence interval [CI]= – 0.224 to –0.186) before implementing the ODSF and– 0.013 ± 0.114 (95% CI = – 0.036 to 0.009) after. At the patient level, the following factors were significantly associated with the difference between the patients' and physicians' DCS: unemployed (P = 0.023), implementing the ODSF (P = 0.008), high school degree (P = 0.04), male (P = 0.03), and unilateral role in decision making (P = 0.03). At the physician level, provincial committee (P = 0.001), national committee (P = 0.045), clinical site (P = 0.016), reluctance to share uncertainty (P = 0.023), and anxiety due to uncertainty (P = 0.017) were significantly associated with this outcome. Conclusion. After implementing the ODSF, there was less dissimilarity between patients' and physicians' DSC than expected by chance than before. Implementing the ODSF was also found to be associated with the difference between patients' and physicians' DSC. The physician level explained a significant amount of the variance in this outcome, thus emphasizing the importance of an intervention at this level.
Preference-Based EQ-5D Index Scores for Chronic Conditions in the United States
Authors: Sullivan Patrick W. , Ghushchyan Vahram
Published: July 2006

Background. The Panel on Cost-Effectiveness in Health and Medicine has called for an “off-the-shelf” catalogue of nationally representative, community-based preference scores for health states, illnesses, and conditions. A previous review of cost-effectiveness analyses found that 77% did not incorporate community-based preferences, and 33% used arbitrary expert or author judgment. These results highlight the necessity of making a wide array of appropriate, community-based estimates more accessible to cost-effectiveness researchers. Objective. To provide nationally representative EQ-5D index scores for chronic ICD-9 codes. Methods. The nationally representative Medical Expenditure Panel Survey (MEPS) was pooled (2000–2002) to create a data set of 38,678 adults. Ordinary least squares (OLS), Tobit, and censored least absolute deviations (CLAD) regression methods were used to estimate the marginal disutility of each condition, controlling for age, comorbidity, gender, race, ethnicity, income, and education. Results. Most chronic conditions, age, comorbidity, income, and education were highly statistically significant predictors of EQ-5D index scores. Homoskedasticity and normality assumptions were rejected, suggesting only CLAD estimates are theoretically unbiased. The magnitude and statistical significance of coefficients varied by analytic method. OLS and Tobit coefficients were on average 60% and 143% greater than CLAD, respectively. The marginal disutility of 95 chronic ICD-9 codes as well as unadjusted mean, median, and 25th and 75th percentiles are reported.Conclusion. This research provides nationally representative, communitybased EQ-5D index scores associated with a wide variety of chronic ICD-9 codes that can be used to estimate quality-adjusted life-years in cost-effectiveness analyses.
Being There Is Important, but Getting There Matters Too: The Role of Path in the Valuation Process
Authors: Goldberg Julie H.
Published: July 2006

Purpose. Traditional decision-analytic models presume that utilities are invariant to context. The influence of 2 types of context on patients' utility assessments was examined here the path by which one reaches a health state and personal experience with a health state. Methods. Three groups of patients were interviewed: men older than age 49 years with prostate cancer but no diabetes (CaP), diabetes but no prostate cancer (DM), and neither disease (ND). The utility of erectile dysfunction (ED) was assessed using a standard gamble (SG). Each subject completed 2 SGs: 1) a no-context version that gave no explanation for the cause of ED and 2) a contextualized version in which prostate cancer treatment, the failure to manage diabetes, or the natural course of aging was said to be the cause. Results. Patients with disease assigned higher utilities to ED in a matching context than in discrepant contexts. Regression models found that the valuation process was also sensitive to the match between disease path in the utility assessment and patients' personal experiences. Conclusions. These findings lend insight into why acontextual utility assessments typically used in decision analyses have not been able to predict patient behavior as well as expected. The valuation process appears to change systematically when context is specified, suggesting that unspecified contexts rather than random error may lead to fluctuations in the values assigned to identical health states.
A novel additive for the reduction of acid gases and NOx in municipal waste incinerator flue gas
Authors: Hall William J. , Williams Paul T.
Published: July 2006

The reduction of SO2, HCl, and NOx concentrations using calcium magnesium acetate (CMA) as a novel sorbent in a simulated municipal waste incinerator flue gas was investigated. The reduction of individual SO2, HCl, and NOx concentrations was tested at 850°C and it was found that CMA could reduce the SO2 concentration by 74%, HCl concentration by 64%, or NOx concentration by 94%. It was observed that individual SO2 or HCl capture increased with increasing initial oxygen concentration in the reacting gas or increasing sorbent input. NOx reduction decreased with increasing initial oxygen concentration in the reacting gas. The simultaneous reduction of SO2, HCl, and NOx concentrations by CMA was also investigated. It was found that CMA could simultaneously capture 60% SO2 and 61% HCl and reduce NOx concentrations by 26%, when the initial oxygen concentration in the reacting gas was 4%. During the simultaneous reduction of SO2, HCl, and NOx, it was noted that as the initial oxygen concentration in the reacting gas increased, the efficiency of SO2 capture increased too, but the efficiency of HCl capture and the efficiency of NOx destruction decreased.
Report on hazardous household waste generation in Japan
Authors: Yasuda Kenji , Tanaka Masaru
Published: July 2006

Surveys of over 2000 households in Japan were conducted to investigate the characteristics of hazardous household waste (HHW) generation. In Japan, about 2.5 to 4.3 kg of HHW are produced per tonne of the residential waste stream. The percentage of used batteries in HHW was over 50%. Every household using spray (aerosol) cans had more than seven cans on average. The generation of HHW, in terms of both quantities and type of waste produced, appeared to vary with dwelling type. Detached dwelling residents tended to store HHW such as used batteries, whereas apartment residents tended not to store waste. The amounts of discarded HHW were larger at the end of the year in comparison with other months. The data accumulated were used to estimate the quantities of HHW disposed off annually, and the quantities and type of waste that might be received by a typical depot collection programme in Japan.
Numerical modelling of multiphase flow and transport processes in landfills
Authors: Kindlein Jonatham , Dinkler Dieter , Ahrens Hermann
Published: July 2006

Waste material in municipal landfills can be described as heterogeneous porous media, where flow and transport processes of gases and liquids are combined with local material degradation. This paper deals with the basic formulation of a multiphase flow and transport model applicable to the numerical analysis of coupled transport and reaction processes inside landfills. The transport model treats landfills within the framework of continuum mechanics, where flow and transport processes are described on a macroscopic level. The composition of organic and inorganic matter in the solid phase and its degradation are modelled on a microscopic scale. The degradation model captures the different reaction schemes of various microbial activities. Subsequently, transport and reaction processes have to be coupled, since emissions at the surface and from the drainage layer depend on the flow of leachate and gas, the transport of various substances and heat, and the biodegradation of organic matter. The theoretical considerations presented here are fundamental to the development of numerical models for the simulation of multiphase flow and transport processes inside landfills coupled with biochemical reactions and heat generation. The implicit modelling of leachate and gas flows including growth and decay of micro-organisms are innovative contributions to landfill modelling
Systems analysis as support for decision making towards sustainable municipal waste management - a case study
Authors: Klang Anders , Vikman Per-Åke , Brattebø Helge
Published: July 2006

During the last decade, systems analysis has become a more frequently used tool in municipal waste management. This paper investigates how one such analysis, carried out in a Swedish county, was perceived by local municipal officers and politicians as support in the decision-making process. A questionnaire was sent to municipal officers and politicians in local government committees and municipal councils. The respondents considered the most important aspects in evaluating scenarios to be: possibilities for municipal co-operation to minimize cost and negative environmental influence; sound working conditions for refuse disposal personnel; low emissions of greenhouse gases; keeping household economy in mind; and using technologies that are known and reliable. Aspects of relatively low importance were the number of locally generated job opportunities, and minimizing work efforts for the households. The study also showed differences between male and female respondents and between politicians and municipal officers, on how scenarios were valued and on which aspects of the systems analysis were of greatest importance for this valuation. Respondents, on average, were satisfied with the systems analysis, and its usefulness as a decision-support tool. However, more work should be carried out to explain and present the results of the systems analysis to further improve its usefulness.
Approximate cost functions for solid waste treatment facilities
Authors: Tsilemou Konstantinia , Panagiotakopoulos Demetrios
Published: July 2006

Cost estimation is a basic requirement for planning municipal solid waste management systems. The variety of organizational, financial and management schemes and the continuously developing technological advancements render the economic analysis a complex task, made more complex by the scarcity of real cost data. The objectives of this paper were: (1) to explore the problems arising in getting cost estimates from scattered and limited published data; (2) to suggest a procedure for generating cost functions relating initial set-up cost and operating cost with facility size; and (3) to present such cost functions, relevant to European states, for selected types of solid waste treatment and disposal facilities. Regarding the problems of available scarce data, one needs to deal with cost figures which correspond to facilities with variations in size, technology, year of construction, working conditions, level of technological automation, environmental impacts, social acceptance, capacity utilization rate, composition of inflowing waste, waste management policies, degree of compliance with quality standards, etc. The paper addresses this issue and discusses the proper use of statistical analyses in such cases of fragmented data; moreover, it points out some usual misuses of statistics by analysts and the danger of getting erroneous results. The suggested process for generating cost functions acceptable to the decision-makers is pivoted around the question of acceptable approximation level. Finally, approximate cost curves are suggested for waste-to-energy facilities, landfilling facilities, anaerobic digestion facilities and composting facilities.
Thrombolytic Therapy for Massive Pulmonary Embolism in a Patient With a Known Intracranial Tumor
Authors: Han Steve , Chaya Craig , Hoo Guy W. Soo
Published: July 2006

The objective was to describe and review the use of thrombolytic therapy in a patient with an intracranial tumor and massive pulmonary embolism. This is the first reported case of a patient with a known glioblastoma multiforme and massive pulmonary embolism who was successfully treated with alteplase. Pulmonary embolism was demonstrated by a ventilation-perfusion scan and transthoracic echocardiogram with repeat studies demonstrating resolution of the thromboembolism and reperfusion of pulmonary vasculature. A review of the literature revealed that the incidence of intracranial hemorrhage with thrombolysis is <3% and compares favorably with the much higher mortality rate of 25% to ≥50% in patients with hemodynamically unstable pulmonary emboli. The benefit of thrombolysis may outweigh the risks of intracranial hemorrhage in these patients, and careful consideration for its use in these patients is warranted.
Quality and Safety in the Intensive Care Unit
Authors: Stockwell David C. , Slonim Anthony D.
Published: July 2006

Ensuring patient safety is becoming increasingly important for intensive care unit practitioners. The intensive care unit is particularly prone to medical errors because of the complexity of the patients, interdependence of the practitioners, and dependence on team functioning. This review provides historical perspectives, research foundations, and a practical “how to” guide to improving care in the intensive care unit. It also considers the organizational structure, the processes of care, and the occurrence of adverse outcomes in this setting. Effective intensive care unit quality and safety programs capitalize on institutional resources and have multidisciplinary input with clear leadership, input from quality improvement initiatives, a responsible yet nonpunitive culture, and data-driven assessment and monitoring to reduce medical errors. Intensive care unit practitioners need to capitalize on the benefits that patients and their families bring to the patient safety discourse. This provides opportunities for better understanding the risks of the intensive care unit and improving the consent process.
Ventilator-Associated Pneumonia: A Review
Authors: Davis Kimberly A.
Published: July 2006

Ventilator-associated pneumonia is the most frequent intensive care unit (ICU)-related infection in patients requiring mechanical ventilation. In contrast to other ICU-related infections, which have a low mortality rate, the mortality rate for ventilator-associated pneumonia ranges from 20% to 50%. These clinically significant infections prolong duration of mechanical ventilation and ICU length of stay, underscoring the financial burden these infections impose on the health care system. The causes of ventilator-associated pneumonia are varied and differ across different patient populations and different types of ICUs. This varied presentation underscores the need for the intensivist treating the patient with ventilator-associated pneumonia to have a clear knowledge of the ambient microbiologic flora in their ICU. Prevention of this disease process is of paramount importance and requires a multifaceted approach. Once a diagnosis of ventilator-associated pneumonia is suspected, early broad-spectrum antibiotic administration decreases morbidity and mortality and should be based on knowledge of the sensitivities of common infecting organisms in the ICU. De-escalation of therapy, once final culture results are available, is necessary to minimize development of resistant pathogens. Duration of therapy should be based on the patient’s clinical response, and every effort should be made to minimize duration of therapy, thus further minimizing the risk of resistance.
Decomposition Behavior of Kevlar 49 Fibers: Part II. At T values < Td
Authors: Iyer R. V. , Sudhakar A. , Vijayan Kalyani
Published: July 2006

The residual effects of thermal aging of Kevlar 49 fibers in the temperature range 150-450′C have been analyzed. Thermal aging introduces crystallographic as well as macro-structural changes. Weight losses and deterioration in tensile properties were also observed. The order in which the deterioration in crystallinity, weight and tensile strength occur has been identified. Master curves for predicting the time needed for 50% deterioration at various temperatures and the corresponding activation energy have been estimated. The role of the parameter, tcum( T), the cumulative exposure to any temperature T, on thermally induced effects has been unambiguously established. In particular, the influence of the T- tcum( T) effect on crystallographic parameters has been observed for the first time.
Bookkeeping in the sixteenth-century building yard of the Castello of Crotone: an accountancy and architectural analysis
Authors: Mussari Riccardo , Mussari Bruno
Published: July 2006

This article aims to promote interdisciplinary research between the history of accounting and that of architecture, and recognizes the different point of view that ancient accounting documentation offers to two scientific branches of study that only appear to be distant. The article analyses the surviving registries prepared during the renovation of the fortification of Crotone in Calabria (Italy) during the sixteenth century and, accordingly, it allows the reconstruction of a sufficiently broad outline of the architectural events that occur in a large building yard, connecting this intervention to an architectural history frame of reference that surpasses the limits of regional boundaries. At the same time, the specificity of the examined documentation has allowed us to identify the roles and the subjects assigned to keep accounts, within the complex system with which the disorderly Spanish administration managed its extremely vast dominion.
Ernest Adams Ltd: the demise of a family business
Authors: Robb Alan J. , Shanahan Yvonne P. , Lord Beverley R.
Published: July 2006

This article tells of the changes experienced by a family business, through restructuring under outside professional management, until being taken over by a multinational company. Evidence was collected from interviews, annual reports and media articles. As a family business, the company exploited lower agency costs and sustained its profitability. Debt levels remained low. Under external professional managers, profitability declined and debt levels rose sharply. Informal communication networks were no longer utilized, and the professional managers were subject to criticism for excessive spending, inappropriate skills and a lack of industry knowledge. The board of directors began to function less effectively. Poor performance led to restructuring under three different CEOs, yet costs continually increased, profitability declined, and a takeover bid was successful. However, all responsibility, of course, cannot be placed on the new professional managers, who inherited responsibility for some decisions made prior to their period of stewardship. Also the family did not adequately plan for successful transition to professional management.
I Am They
Authors: Hofer Sonya
Published: July 2006

The construction of multiple personae by musicians is a practice that continues to be prevalent: from Robert Schumann, through David Bowie, to recent techno artists. In this article I examine the work of one artist who may be music's most prodigious multiple and who may be deemed not one, but many different artists. Techno-chameleon Uwe Schmidt, aka Señor Coconut, aka Geeez ‘n’ Gosh, is a musician who has radically intensified the creation of multiple personae and here I situate his work as part of a contemporary technocultural moment; one where recent technologies have further enabled, destigmatized, and for some individuals, made preferable or even necessary, the idea of the performed, multiple identity. As such, by enacting certain key concepts of a postmodern and/or posthuman conception of identity, artists like Schmidt thus problematize traditional modes of artistic representation, marketing, and reception that were previously based upon notions of individual authorship.
PCTV: Consumers, Expectancy-Value and Likely Adoption
Authors: Book Constance Ledoux , Barnett Brooke
Published: July 2006

This study examines the potential of PCTV (watching television on your PC) among consumers. An intercept field study that included product demonstration with a convenience sample of US adults was conducted ( N = 309). Expectancy-value theory was used to measure respondents’ interest in PCTV. While a majority had heard of the product, expectations of what PCTV could provide remained low and as a result, value and subsequent interest was low. As terrestrial broadcasting, cable, telephone, internet companies and other programming providers explore the potential market for PCTV and promote that market, the possibility exists that value related to PCTV could be developed. In other words, PCTV remains an open field waiting for leadership to manifest its diffusion.
Focus on Media Art Histories
Authors: Huhtamo Erkki
Published: July 2006

This report reviews ‘REFRESH! The First International Conference on the Histories of Media Art, Science and Technology’ held at the Banff Centre for the Arts, Alberta, Canada, from 28 September to 1 October 2005. The event dealt with the interconnections between media art, science and technology, although its mission was not absolutely clear. As the review points out, there was some vagueness in defining the goals, partly related to its interdisciplinary nature. The review then places the event within a cultural and institutional context and discusses plans to turn it into a continuing tradition.
Parenting Programmes for Behavioural Problems: Where Do Tertiary Units Fit in a Comprehensive Service?
Authors: Beeson Marina , Davison Ingrid , Vostanis Panos , Window Suzanne
Published: July 2006

Children with behavioural problems are often referred to child mental health services without rationalization of criteria or referral routes. The aims of the present study were to establish the psychosocial characteristics of children with behavioural problems referred to a tertiary Day Resource, and to compare these with children referred for similar problems to a specialist outpatient child mental health service and a family support community service. Demographic data, the Strengths and Difficulties Questionnaire and the Health of the Nations Outcome scales for Children and Adolescents were used. Families attending the Day Resource were found to have more involvement with other agencies, and children showed higher levels of clinical severity and complexity. Most of this difference was accounted for by attentional difficulties, as well as communication and physical health problems. These findings confirmed the hypothesis that families seen at tertiary service level presented with more complex psychosocial needs and frequent child comorbidity, thereby justifying the multimodal treatment package developed at that service level. It is concluded that there is a need for this level of parenting interventions, but only for complex cases that have not responded to community interventions.
A Parent-report Gender Identity Questionnaire for Children: A Cross-national, Cross-clinic Comparative Analysis
Authors: Cohen-Kettenis Peggy T. , Wallien Madeleine , Johnson Laurel L. , Owen-Anderson Allison F.H. , Bradley Susan J. , Zucker Kenneth J.
Published: July 2006

A one-factor, 14-item parent-report Gender Identity Questionnaire for Children (GIQC) was developed in a sample of 325 clinic-referred children with gender identity problems and 504 controls from Toronto, Canada (Johnson et al., 2004). In this study, we report a cross-national, cross-clinic comparative analysis of the GIQC on gender-referred children ( N = 338) from Toronto and gender-referred children ( N = 175) from Utrecht, The Netherlands. Across clinics, the results showed both similarities and differences. Gender-referred boys from Utrecht had a significantly higher total score (indicating more cross-gender behavior) than did gender-referred boys from Toronto, but there was no significant difference for girls. In the Toronto sample, the gender-referred girls had a significantly higher total score than the gender-referred boys, but there was no significant sex difference in the Utrecht sample. Across both clinics, gender-referred children who met the complete DSM criteria for gender identity disorder (GID) had a significantly higher cross-gender score than the gender-referred children who were subthreshold for GID (Cohen's d = 1.11). The results of this study provide the first empirical evidence of relative similarity in cross-gender behavior in a sample of gender-referred children from western Europe when compared to North American children. The results also provide some support for cross-clinic consistency in clinician-based diagnosis of GID.
Family Impact of Neurodevelopmental Late Effects in Survivors of Pediatric Cancer: Review of Research, Clinical Evidence, and Future Directions
Authors: Peterson Catherine Cant , Drotar Dennis
Published: July 2006

Children and adolescents who have survived childhood cancer are vulnerable to late effects of their disease and treatment experience, including both physical and psychological sequelae. The neurodevelopmental (ND) sequelae (e.g., difficulties with attention, memory, information processing, and other executive functions) faced by children surviving central nervous system (CNS) cancers or CNS treatments can have a range of effects on their psychological adjustment and quality of life as they reintegrate into school and social settings. Survivors facing such difficulties may be influenced by their family environment, and these struggles may in turn impact the perceived burden of their parents and family system, suggesting a bidirectional framework for understanding the impact of ND late effects within the family. The current study summarizes the following: Findings of family outcomes in children with ND late effects of cancer treatment; evaluation of methodological and measurement issues; the importance of examining bidirectional family–child influences; and implications for future survivorship research and clinical care addressing the role of ND late effects from a systems perspective.
Solution-focused Brief Therapy with Families Who Have a Child with Intellectual Disabilities: A Description of the Content of Initial Sessions and the Processes
Authors: Lloyd Helen , Dallos Rudi
Published: July 2006

Solution-focused brief therapy (SFBT) is used in a range of child services but little is known about its application to families who have a child with severe or profound intellectual disabilities. This qualitative study examines SFBT with seven such families. It considers the content of sessions and the processes that occur from the practitioner's perspective. Participants' experiences are reported elsewhere (Lloyd & Dallos, submitted). A thematic analysis of seven initial sessions indicated that SFBT highlighted parents' competencies, goals and achievements. The ‘miracle question’ prompted a change in rapport, discussion about the impossibility of the child becoming ‘normal’ and a shift away from wishful thinking towards problem solving. In sessions processes emerged of empowerment, integration of the goals into the mothers' life narrative, understanding the child's abilities and clarification of the preferred future. These themes resonated with the literature on effective coping styles for these families. The cases suggest that SFBT can generate a useful parent–professional partnership. However, difficulties were encountered when a child with autism participated in the session. Consideration is given to the ‘miracle question’ and the inclusion of measures of self-efficacy, coping and the therapeutic relationship.
An Examination of Cutting and Other Methods of DSH among Children and Adolescents Presenting to an Outpatient Psychiatric Clinic in New Zealand
Authors: Fortune Sarah A.
Published: July 2006

This article explores the issue of cutting among children and adolescents presenting to an outpatient child and adolescent mental health service in New Zealand. Of interest is the extent to which children and adolescents who cut themselves also carry out other forms of deliberate self-harm (DSH). This study found that there was much cross over in the methods of DSH used and that cutters were not a distinguishable group. Therefore, those who present to mental health services with cutting need to be treated as carrying significant risk of fatality.
Intensive Mental Health Services for Children with Serious Emotional Disturbances through a School-based, Community-oriented Program
Authors: Vernberg Eric M. , Roberts Michael C. , Randall Camille J. , Biggs Bridget K. , Nyre Joseph E. , Jacobs Anne K.
Published: July 2006

Treating children with severe, early onset emotional and behavioral disturbances remains a daunting task for mental health and education systems. This article describes key principles, features, and outcomes for the school-based Intensive Mental Health Program (IMHP), a program designed specifically to provide comprehensive evidence-based, ecologically sensitive, and individualized services for this difficult-to-treat population. Although the IMHP is a relatively new model, preliminary studies of outcomes and treatment processes give initial evidence that most children improve notably in their role performance, behavior, and emotional adjustment over the course of treatment. With increasing demands for effective, affordable school-based mental health services, the IMHP offers a developing but promising prototype for services geared to meet the unique needs of children with complex disturbances of emotions and behavior.