bluuebunny/crossref_metadata_2025 huggingface dataset:
Microwave Blanching Of Vegetables For Frozen Storage
Authors: Glasscock S.J. , Axelson J.M. , Palmer J.K. , Phillips J.A. , Taper L.J.
Published: March 2007

The quality of five vegetables, blanched using either microwave or hot water methods currently recommended to the American consumer, was examined after one, two, four, and six months of frozen storage. The vegetables were analyzed for residual peroxidase activity immediately after blanching. Storage stability of cooked and uncooked vegeta bles was determined by examining various quality factors after each period of frozen storage. Quality factors included color, texture, flavor, and overall acceptability of the vegetables as measured using objective methodology and sensory evaluation. Broccoli and zucchini retained high levels of peroxidase activity after microwave blanching. Broccoli and green beans blanched with microwave energy retained less chlorophyll (p 0.05), had higher shear force values (p 0.05), and received lower sensory eval uation scores than the water blanched vegetables (p 0.05) for quality factors common ly used by consumers. The texture of zucchini blanched with microwave energy was limp as measured by shear force and by sensory evaluation. No significant differences (p 0.05) were found in the quality of carrots or cauliflower blanched by the two meth ods. Instructions currently available for microwave blanching of vegetables for home freezing do not result in a quality product for all vegetables.
Fish Protein Concentrate As A Protein Supplement In Four Baked Products
Authors: Kvitka Elaine F. , Chen Tung‐Shan
Published: March 2007

Fish Protein Concentrate (FPC) is a stable, wholesome protein powder which can be used as a low cost food supplement. At present there is little information available to the consumer for home use of FPC. This article reports the findings of a study on the use of FPC in home baked products. Four baked products supplemented with FPC were for mulated in order to study the feasibility of using home baked products supplemented with FPC as a low cost means to improve protein nutrition. The four products were whole wheat bread, whole wheat muffins, peanut butter cookies, and date nut bars. The quality and acceptability of the baked products were evaluated by both subjective and objective methods. The results showed that home baked products can be supplemented with up to five percent FPC as a replacement for flour and result in standard quality as well as consumer acceptability. Higher amounts of supplementation with FPC are pos sible depending on the type of product.
Nutrition Knowledge, Attitude, Dietary Behavior, and Commitment to Nutrition Education of Nutrition Educators
Authors: Byrd‐Bredbenner Carol , Shear Twyla
Published: March 2007

The nutrition knowledge, food/nutrition attitude, dietary behavior, and commitment to nutrition education of nutrition educators were assessed. Nutrition educators were de fined as those individuals, by virtue of baccalaureate level training, who are often responsible for, or expected to take part in, teaching nutrition. The population was comprised of six groups of individuals who earned baccalaureate degrees in nutrition, home economics, nursing, elementary education, health and physical education, and/or individuals in any other field of study. Data were collected by means of a mailed questionnaire. Results indicate that nutrition knowledge is positively correlated with both food/nutrition attitude and commitment to nutrition education. Also, food/nutrition attitude is positively correlated with dietary behavior and commitment to nutrition education. In addition, enrollment in home economics courses at the secondary level of school correlated positively with food/nutrition attitude, knowledge, and commitment. Knowledge was not significantly correlated with commitment. These data suggest that interrelationships among nutrition knowledge, food/nutrition attitude, dietary behavior, and commitment to nutrition education for nutrition educators as well as the general population warrant further study because this may aid in the improvement of nutrition education efforts.
Lifestyle Alternatives: Development and Evaluation Of An Attitude Scale
Authors: Pestle Ruth E. , Cornille Thomas A. , Solomon Karol
Published: March 2007

Home economics teachers need a valid and reliable attitude scale with which to deter mine changes in students' beliefs as they learn how to live a voluntarily simpler lifestyle. Such behaviors as recycling, home production of goods, conservation of nature, and sharing of skills are part of this lifestyle. One hundred and twenty Likert items con cerning Voluntary Simplicity were built. Factor analysis of 236 students' replies resulted in a seven factor instrument. When answers of known groups who were living and not living the lifestyle were analyzed, reliabilities (coefficient alpha) were found from 0.3 to 0.9 for each of the factors. Significant Mann‐Whitney U's (p ≤ 0.01) were found between groups for six of the seven factors, with differences in the expected direction. Discriminant analysis was also performed in order to assess the predictive validity of the instrument.
Alienation in Rural Women: A Longitudinal Cross‐Lagged Analysis of its Association with Community and Family Involvement, Socioeconomic Status, and Education
Authors: Poresky Robert H. , Atilano Raymond B.
Published: March 2007

Rural women's alienation was studied longitudinally to determine its interrelationship with community activities, family involvement, income, and maternal education. Fifty‐eight rural women were interviewed when their children were three, six, or nine years old and again two years later. Significant longitudinal cross‐lagged panel correla tions were obtained between gross socioeconomic status (SES), maternal education, and community involvement with anomie two years later. Maternal alienation appears to be primarily affected by gross SES, community involvement and maternal education. Ma ternal alienation appears to affect future net income. The validity of anomia as a social psychological measure of rural women and its implications for applied programs are dis cussed.
Clinical life: expectation and the double edge of medical promise
Authors: Shim Janet K. , Russ Ann J. , Kaufman Sharon R.
Published: March 2007

This article introduces the concept of clinical life to capture a form of life produced in the pursuit and wake of medically achieved longevity. Relying on the retrospective accounts of 28 individuals over age 70 who have undergone cardiac bypass surgery, angioplasty or a stent procedure, as well as interviews with their families and with clinicians, we examine three features of clinical life. First, patients do not distinguish between clinical possibility and clinical promise, and thus assume that life can and will be improved by medical intervention in late life. Rather than anticipating a range of potential treatment outcomes, patients therefore expect the best-case scenario: that medical procedures will reverse aging, disease and the march of time. Second, patients then assess the value of their post-procedure lives in accordance with that expectation. Norms regarding what life ‘should be like’ at particular ages are continually recalibrated to the horizon of what is clinically possible. And third, the price of living longer entails a double-edged relationship with the clinic – it generates opportunities for bodily restoration and increased self-worth but also creates ambivalence about the value of life. This latter feature of clinical life is rarely publicly acknowledged in an environment that emphasizes medical promise.
Optical design and development of fibre coupled compact solar collectors
Authors: Sansoni P , Fontani D , Francini F , Jafrancesco D , Longobardi G
Published: March 2007

The paper describes the design and realization of optical systems for concentrating solar light onto an optical fibre. Three different classes of optical system, with increasing surface complexity, were studied. These were collectors with spherical surfaces only, parabolic concentrators and collectors containing aspherical surfaces. This research led to two designs of solar collecting systems for application to the illumination of internal spaces. The first is an original catadioptric configuration made of a single block of quartz coupled to small silica fibres. The second consists of a polymethyl methacrylate aspherical lens and a larger fibre bundle made of plastic.
Driver decision making in response to peripheral moving targets under mesopic light levels
Authors: Akashi Yukio , Rea M S , Bullough J D
Published: March 2007

A field study was conducted to extend fundamental findings about visual performance at mesopic light levels to a driving context. Subjects participating in this field study drove a vehicle along a lighted street while performing a high-order decision-making task. Subjects identified the direction of an off-axis target, toward or away from the street, and braked or accelerated, accordingly. Two sets of light sources were compared: a set of ceramic metal halide light sources and a set of high-pressure sodium light sources. The same study was also performed during the day-time. The results demonstrated that both braking and acceleration response times decreased monotonically as unified luminance increased, suggesting that unified luminance is a suitable rectifying variable for characterizing light levels for different light sources with respect to a complex visual task.
Identifying with the nation
Authors: Dhoest Alexander
Published: March 2007

This article investigates viewer memories of former Flemish television fiction in order to research how its representation of Flanders has influenced national identification. Viewer memories show strong patterns, as the same serials are positively remembered by most respondents. The strength and fondness of these memories suggests that these serials became part of collective memory. The importance of `Flemishness' also becomes apparent through the emphasis on realism and recognition. All the respondents said that they preferred domestic drama to imported serials, portraying `typical' situations of the past using Flemish dialects. They strongly identified with this image, and by sharing fond memories, they form a national 'mnemonic' community.
Writing gendered memories of repression in Northern Ireland
Authors: Warren Kay
Published: March 2007

This article explores Begoña Aretxaga's research on women, nationalism and political subjectivity in Northern Ireland during `the troubles' by considering her writings as a field worker as they bear on her work as an ethnographer and theoretical innovator. My goal is to illustrate the knowledge production and representational strategies integral to Aretxaga's analysis of violence, state power, and politicized ethnic minorities in European democracies. The article centers on correspondence between Aretxaga and a republican woman prisoner that evolved into a dialogue about coming of age in situations of state repression and counternationalist resistance. This analysis also considers the ways that women built their own cultural and social worlds in prison as a counterpoint to the changing techniques of prison control from 1971 through the early 1990s.
Make-believe papers, legal forms and the counterfeit
Authors: Navaro-Yashin Yael
Published: March 2007

This article studies the affects retained, carried, and effected by documents, as they are produced, exchanged, transformed, and transacted among their users. I study the interactions which Turkish-Cypriots (in Britain and on either side of the border in Cyprus) forge with documents, especially those used for identity verification and travel. For those who juggle documents manufactured by several complexes of law and statecraft (including the `illegal' Turkish Republic of Northern Cyprus), documents generate differential and politically charged affectivities. Bringing anthropological literature on law, policy, and bureaucracy, as well as Actor Network Theory, into dialogue with psychoanalytic work on affect, this article charts a new terrain for the study of affect (in the domain of documents as objects) and explores emotive dimensions previously unattended by scholars of bureaucracy.
Decolonizing family literacy in a culture circle: Reinventing the family literacy educator's role
Authors: Reyes Loui V. , Torres Myriam N.
Published: March 2007

There is a growing ideological divide in the field of family literacy between programs that are striving to colonize families with middle-class European-American literacy practices, and those based on Freire's philosophy which works toward affirming diverse family literacy practices. The Freirean alternative includes ‘culture circles’ for the growth of critically conscious participants and family educators, who work toward ‘reading the word and the world’ while working to transform that world into a better place for all. Organizing various culture circles has enabled the authors to examine critically and coreconstruct a reflective narrative on the role of the culture circle's ‘cocoordinator’ or ‘leader’, as well as to reinvent themselves as ‘decolonizing family literacy educators’. This article is a step in this reinvention.
An Evaluation of the Value of Group Education in Recently Diagnosed Diabetes Mellitus
Authors: Ooi G. S. , Rodrigo C. , Cheong W. K. , Mehta R. L. , Bowen G. , Shearman C. P.
Published: March 2007

Diabetic patients have a 12% to 25% lifetime risk of developing foot complications leading to significant morbidity and mortality. The objective of this study was to assess the effectiveness of group education in improving patient awareness of foot care. The authors evaluated the effect of group size and areas in which knowledge seemed to be most affected. Patients attending a 2-hour teaching session between November 2005 and March 2006 were recruited. Patients filled in an 18-part questionnaire before and after the teaching session to assess knowledge. Fifty-nine patients recently diagnosed with diabetes mellitus or foot complications were recruited for 7 sessions. Analysis of the data showed a statistically significant improvement in foot care knowledge after the teaching session compared with before (69% to 85%,P < .001). Patients in the smaller group (n< 10) had significantly higher scores compared with the bigger groups (n> 10;P < .025). These data show the benefit of group education about foot care for patients with diabetes. Smaller groups benefited more than larger ones did, which could be attributed to the sizes allowing for better interaction between the tutor and patient. As patient knowledge is variable from individual to individual, smaller teaching sessions may allow patients to address specific concerns.
TAMEE: data management and analysis for tissue microarrays
Authors: Thallinger Gerhard G , Baumgartner Kerstin , Pirklbauer Martin , Uray Martina , Pauritsch Elke , Mehes Gabor , Buck Charles R , Zatloukal Kurt , Trajanoski Zlatko
Published: March 2007

Background

With the introduction of tissue microarrays (TMAs) researchers can investigate gene and protein expression in tissues on a high-throughput scale. TMAs generate a wealth of data calling for extended, high level data management. Enhanced data analysis and systematic data management are required for traceability and reproducibility of experiments and provision of results in a timely and reliable fashion. Robust and scalable applications have to be utilized, which allow secure data access, manipulation and evaluation for researchers from different laboratories.

Results

TAMEE (Tissue Array Management and Evaluation Environment) is a web-based database application for the management and analysis of data resulting from the production and application of TMAs. It facilitates storage of production and experimental parameters, of images generated throughout the TMA workflow, and of results from core evaluation. Database content consistency is achieved using structured classifications of parameters. This allows the extraction of high quality results for subsequent biologically-relevant data analyses. Tissue cores in the images of stained tissue sections are automatically located and extracted and can be evaluated using a set of predefined analysis algorithms. Additional evaluation algorithms can be easily integrated into the application via a plug-in interface. Downstream analysis of results is facilitated via a flexible query generator.

Conclusion

We have developed an integrated system tailored to the specific needs of research projects using high density TMAs. It covers the complete workflow of TMA production, experimental use and subsequent analysis. The system is freely available for academic and non-profit institutions from http://genome.tugraz.at/Software/TAMEE.
Expression of a synapsin IIb site 1 phosphorylation mutant in 3T3-L1 adipocytes inhibits basal intracellular retention of Glut4
Authors: Muretta Joseph M. , Romenskaia Irina , Cassiday Patrick A. , Mastick Cynthia Corley
Published: March 2007

Glut4 exocytosis in adipocytes uses protein machinery that is shared with other regulated secretory processes. Synapsins are phosphoproteins that regulate a `reserve pool' of vesicles clustered behind the active zone in neurons. We found that adipocytes (primary cells and the 3T3-L1 cell line) express synapsin IIb mRNA and protein. Synapsin IIb co-localizes with Glut4 in perinuclear vesicle clusters. To test whether synapsin plays a role in Glut4 traffic, a site 1 phosphorylation mutant (S10A synapsin) was expressed in 3T3-L1 adipocytes. Interestingly, expression of S10A synapsin increased basal cell surface Glut4 almost fourfold (50% maximal insulin effect). Insulin caused a further twofold translocation of Glut4 in these cells. Expression of the N-terminus of S10A synapsin (amino acids 1-118) was sufficient to inhibit basal Glut4 retention. Neither wild-type nor S10D synapsin redistributed Glut4. S10A synapsin did not elevate surface levels of the transferrin receptor in adipocytes or Glut4 in fibroblasts. Therefore, S10A synapsin is inhibiting the specialized process of basal intracellular retention of Glut4 in adipocytes, without affecting general endocytic cycling. While mutant forms of many proteins inhibit Glut4 exocytosis in response to insulin, S10A synapsin is one of only a few that specifically inhibits Glut4 retention in basal adipocytes. These data indicate that the synapsins are important regulators of membrane traffic in many cell types.
Communication skills for mobile remote presence technology in clinical interactions
Authors: Nestel Debra , Sains Parvinder , Wetzel Cordula M , Nolan Carmel , Tay Ann , Kneebone Roger L , Darzi Ara W
Published: March 2007

The use of mobile robotic units for teleconsultation means that the clinician's cognitive and attention skills are divided between tele-operation of the robotic unit and the consultation with the patient. We developed a communication guide based on evidence-based patient-centred interviewing and telephone conferencing skills. The communication guide was tested by five trainee surgeons in a pre- and post-test design. Each surgeon completed three simulated patient consultations. After reading the communication guide, trainees completed three further consultations. The trainees rated authenticity, degree of difficulty, familiarity of clinical presentation and confidence in using telepresence to manage the consultations. Their mean scores were 3.0–4.6, 2.2–4.0, 4.4–4.8 and 3.2–4.2 respectively (maximum possible score 5). The simulated patients rated their satisfaction with communication. Their ratings suggested that there were areas for communication skills development with mean scores ranging from 8.2 to 11.4 (maximum possible score = 15). Although we do not yet know enough about communicating with real patients using mobile robotic units, the communication guide appeared to be useful in our simulated interactions.
Feasibility of telerobotic microsurgical repair of corneal lacerations in an animal eye model
Authors: Mines Michael J , Bower Kraig S , Nelson Brett , Ward Thomas P , Belyea David A , Kramer Kenyon , Thach Allen B
Published: March 2007

We evaluated the feasibility of telerobotic microsurgical repair of corneal lacerations. The telerobotic microsurgical device consisted of a Robotic Slave Micromanipulator Unit (RSMU) coupled to a Telepresence Surgical System (TeSS). Five mm central full-thickness corneal wounds were fashioned in five enucleated rabbit eyes and repaired remotely using the telerobotic system. Five additional eyes were also repaired by hand using a standard technique. The primary outcome measure was creation of a watertight seal. All eyes in both groups maintained an intraocular pressure (IOP) of 25 mm Hg without leak. The mean repair time was 80 min (range 50–130) with telerobotic surgery compared to 8 min (range 7–9) by hand. Histological evaluation showed that suture placement was similar in robotically assisted repair and manual repair. Subjectively, the telerobotic system provided adequate three-dimensional visualization of the surgical field. The study showed that a surgeon could close standardized corneal wounds using the telerobotic system. The potential benefits of remote eye surgery include improved access, surgical teleconsultation and telementoring.
Home telecare for COPD/CHF patients: outcomes and perceptions
Authors: Whitten Pamela , Mickus Maureen
Published: March 2007

We evaluated the use of home telehealth for patients with chronic obstructive pulmonary disease (COPD) and/or congestive heart failure (CHF). Patients diagnosed with COPD and/or CHF who were prescribed home health-care services were randomly assigned to an experimental group where they received home health care through a combination of traditional face-to-face and telemedicine visits ( n = 83), and a control group where only conventional home care was employed ( n = 78). Data were collected via the Short Form 36 (SF-36), Outcome and Assessment Information Set (OASIS) and patient charts. In the experimental group, patient perceptions of the home telecare services were collected via telephone interviews. Overall, the addition of telehealth to COPD/CHF patient care was not a significant predictor of health and wellbeing, either positively or negatively. Although those receiving telehealth had worse ratings on the SF-36 general health subscale after the intervention, this measure was only significant when controlling for a number of key variables in the model. In regard to patient perceptions of home telecare, patients were satisfied with the technology and the way that care was delivered via this modality.
Lercanidipine in the Treatment of Hypertension
Authors: Beckey Cherylyn , Lundy Amber , Lutfi Nahla
Published: March 2007

Objective:

To review the literature regarding the efficacy, tolerability, and utility of lercanidipine in the treatment of hypertension.

Data Sources:

A search of the literature was performed using MEDLINE (1966'September 2006), EMBASE Drugs and Pharmacology (1980'September 2006), and Current Contents/Clinical Medicine (week 24, 2005'week 30, 2006). Package inserts from lercanidipine, nifedipine, felodipine, and amlodipine were also reviewed for comparison of adverse effects.

Study Selection And Data Extraction:

Articles were limited to clinical trials, abstracts, and review articles published in English.

Data Synthesis:

Lercanidipine is a novel dihydropyridine (DHP) calcium-channel blocker indicated for the treatment of mild-to-moderate hypertension. Although it is not yet available in the US, lercanidipine has been utilized extensively in other countries. In 2 randomized controlled trials of approximately 400 patients with mild-to-moderate hypertension, lercanidipine showed efficacy similar to that of 2 other DHPs, felodipine and slow-release nifedipine, in significantly reducing systolic blood pressure and diastolic blood pressure (DBP) after 4 weeks. In a longer trial (12 mo), lercanidipine 10 mg/day led to normalized blood pressure in 49% of patients after 4 weeks. A postmarketing trial of 9050 patients corroborated the results observed in previous clinical trials, with 64% of patients achieving a DBP of less than 90 mm Hg and 32% attaining blood pressure control (<140/90 mm Hg). in elderly patients, lercanidipine was found comparable with lacidipine and nifedipine, showing similar decreases in DBP when compared with nifedipine ('18.3 vs '17.7 mm Hg, respectively). What distinguishes lercanidipine from other members of the DHP class is its lower incidence of adverse effects, particularly edema. One study showed that fewer patients withdrew secondary to adverse drug reactions in the lercanidipine (0.9%) and nifedipine (3.8%) group compared with the felodipine (4.5%) group. Lercanidipine has also shown efficacy similar to that of other antihypertensives, including atenolol, captopril, and losartan.

Conclusions:

Lercanidipine may be an option in the treatment of hypertension, as current literature suggests comparable antihypertensive efficacy and better tolerability. Further randomized, double-blind clinical trials must be conducted in order to clarify its position among other antihypertensive medications.
Olmesartan Medoxomil–Induced Angioedema
Authors: Nykamp Diane , Winter Erin E
Published: March 2007

Objective:

To report a case of olmesartan medoxomil-induced angioedema in an angiotensin-converting enzyme (ACE) inhibitor–naïve patient.

Case Summary:

A 61-year-old white woman with hypertension experienced significant swelling of her face, neck, and lips 10 days after initiation of olmesartan medoxomil 20 mg/day. After discontinuation of the drug, symptoms resolved within 10 days. Use of the Naranjo probability scale indicated a probable association between angioedema and olmesartan medoxomil.

Discussion:

An angiotensin receptor blocker (ARB) is, in many cases, considered a safe alternative to an ACE inhibitor since serum bradykinin is thought not to be affected. However, angioedema has been reported with the use of ARBs, suggesting alternative pathways or mechanisms that result in this adverse reaction. Although not proven in humans, one explanation is that a secondary stimulation of angiotensin II AT2 receptors produces an increase in tissue bradykinin, resulting in angioedema.

Conclusions:

As of February 26, 2007, this is the first published reported case of olmesartan medoxomil–induced angioedema. Practitioners should be aware of this rare but potentially serious adverse event.
Preparing Future Teachers and Doctoral-Level Leaders in Deaf Education: Meeting the Challenge
Authors: Andrews Jean F , Covell John Andrew
Published: March 2007

The deaf education profession faces a critical juncture. First, the 2006 leadership crisis that swept deaf education's flagship institution—Gallaudet University—will propel professionals to think deeply about promoting diversity, equity, and access in deaf education teacher and leadership preparation programs. Second, personnel shortages require attention: Teacher and leadership voids in university and Kâ12 programs loom if training efforts are not increased. Teaching and leadership needs center on three challenges: (a) understanding the changing demographic composition of the student, teacher, and leadership populations; (b) developing an evolving curriculum founded on research-based practices; (c) continuing to enlarge the knowledge base through applied research in the social sciences. Two case studies examine teacher training and leadership programs at universities that address these challenges. The importance of workplace deaf-hearing bicultural teams is examined. Implications for the preparation of teacher and leadership personnel in deaf education are discussed.
Hospitalized Younger: A Comparison of a National Sample of Homeless and Housed Inpatient Veterans
Authors: Adams Jennifer , Rosenheck Robert , Gee Lauren , Seibyl Catherine L , Kushel Margot
Published: March 2007

Background. Homelessness is associated with high rates of hospitalizations and age-adjusted mortality. Few studies have examined whether homeless people are admitted to the hospital at an earlier age than the general population or for different diagnoses. Methods. We compared the age at admission and the primary discharge diagnoses in a national sample of 43,868 hospitalized veterans. Results. The difference in median age between homeless and housed inpatients ranged from 10–18 years for medical-surgical diagnoses and 3–4 years for psychiatric and substance abuse diagnoses (p#.005 for all diagnoses). Homeless veterans were more likely to have been admitted for psychiatric and substance abuse diagnoses (79.9%), compared with housed veterans (29.1%). Conclusions. Substance abuse and psychiatric illness account for the majority of admissions among homeless veterans. Among all diagnostic groups, homeless people were admitted at younger ages. Our findings suggest that homeless people have either a more rapid disease course, leading to earlier morbidity, or lower admission threshholds sufficient to generate hospital admission.
Factors that Influence the Acceptability of Collecting In-Home Finger Stick Blood Samples in an Urban, Low-Income Population
Authors: Borders Ann E. Bryant , Grobman William A , Amsden Laura B , Collins Emily T , Holl Jane L
Published: March 2007

Objectives. To examine the acceptability of non-medical, community-based interviewers obtaining blood samples during in-home interviews from low-income study participants. Methods. Two separate focus groups were conducted, one with ten non-medical community-based interviewers and the other with eight research participants from a low-income population. (Both the interviewers and the research participants had previously taken part in a research project over the course of five years.) Results. Participants and interviewers were comfortable with finger stick blood samples performed in the home. The interviewers felt that adequate training was critical. Participants identified key issues: blood would not be used for other purposes and that the interviewers would be trained to handle blood safely. Both groups felt that it was crucial to communicate the study purpose and results. Recommendations from the focus groups were implemented and the acceptance rate for blood sampling was 99.5% (205/206). Conclusion. Proper training of interviewers, organization of supplies, and communication with participants can be combined to maximize acceptance of in-home, finger stick blood sample collection by community-based interviewers among a low-income population.
Evaluation of Breast Cancer Care under Puerto Rico's Health Care Reform
Authors: Chirikos Thomas N , López-Garcia Josefina , Cintrón Vargas Cristóbal , Gonzalez Omayra L , Pérez-Grau Maria P , Baez-Diaz Luis
Published: March 2007

Puerto Rico has implemented Health Care Reform legislation that shifted medically indigent and underserved persons from direct care by public sector institutions to managed care arrangements through the private sector. Our aim is to assess how previously underserved women with breast cancer have fared during the first three years of the Reform. Medical claims data were obtained on breast cancer cases in San Juan who were either enrolled in the capitated Reform plan or in a commercial policy offered by the same insurer. A set of indicators reflecting initial therapy, use of key services, and cumulative utilization rates of various medical procedures were constructed. Statistical tests were conducted to assess whether these indicators differed between Reform- and commercially-insured patients. Failure to reject null hypotheses of indicator differences were then used to judge Reform progress. We found some differences, but they were neither pervasive nor unidirectional. On balance, we conclude that previously underserved women are being treated for breast cancer roughly on par with other patients. This conclusion, however, is preliminary and subject to important qualifications.
Prevalence of Major Depressive Episodes in Rural Women Using Primary Care
Authors: Hauenstein Emily J , Peddada Shyamal Das
Published: March 2007

Women carry a disproportionate burden of depression in part because situational and other factors enhance their risk. Rural women may be at particular risk because of poverty and lack of treatment opportunities. For this study we investigated the rate of current major depressive episodes (MDE) in impoverished rural women seeking care in a community health center (CHC) in the rural South. We screened 982 women for MDE during a routine primary care visit: about half were positive for depressive symptoms. Of women positive at screening, 194 were then assessed for psychiatric disorder. A current MDE was observed in 14.3% of women screened for depression and 72.2% of women assessed for psychiatric disorder. Recognizing that neither of these percentages reflects the likely rate of MDE among the larger population of rural impoverished women, we used probability theory and binary logistic regression to estimate a depression rate that could be applied as one factor associated with unmet need in this population of women. We estimate that 44.3% of the population of women using the CHC had MDE. These findings underscore the need for mental health services in rural primary care, especially in facilities serving impoverished women.
Community Characteristics and Violence Against Homeless Women in Los Angeles County
Authors: Heslin Kevin C , Robinson Paul Langham , Baker Richard S , Gelberg Lillian
Published: March 2007

Research on violence against homeless women has focused mainly on individual rather than community-level risk factors. Using an ecological conceptual framework, we estimated the independent association of community characteristics with sexual and physical assault in a probability sample of 974 homeless women. Participants were interviewed at 66 assistance programs in Los Angeles County, California in 1997. Individual responses were linked to community-level data from land use files and the U.S. Census by the facility ZIP codes. Multivariate logistic regression analysis showed that women using service providers in closer proximity to Skid Row had higher odds of physical assault (OR=1.48; 95% CI=1.03, 2.14). A number of individual characteristics were also associated with violent victimization. To reduce violence against homeless women, ensuring the safety of locations for shelters and other assistance programs should be a planning priority for local housing authorities.
Knowledge, Attitudes, and Behaviors of Hepatitis B Screening and Vaccination and Liver Cancer Risks Among Vietnamese Americans
Authors: Ma Grace Xueqin , Shive Steven E , Fang Carolyn Y , Feng Ziding , Parameswaran Lalitha , Pham Anny , Khanh Che
Published: March 2007

Hepatitis B Virus (HBV) infection is a serious health problem among Asian Americans. Vietnamese Americans are disproportionately affected by liver cancer compared with other racial and ethnic groups. Vietnamese males have the highest incidence of liver cancer of any racial group; incidence of liver cancer among Vietnamese males is 11 times higher than among White males. Nearly 80% of liver cancer is attributed to HBV. This study measured knowledge, attitudes, and behaviors related to HBV screening and vaccination. The study was conducted among 256 Vietnamese Americans in the greater Philadelphia and New Jersey area, with a large number of underserved, recent immigrants with low socioeconomic status and limited English proficiency. Participants were recruited from Vietnamese community-based organizations. Overall, 46.3% of the sample had heard of HBV or knew about the availability of screening (32.6%) or vaccination (35.5%) while 7.5% were ever screened and 6.3% had been vaccinated. Community-based, culturally appropriate interventions for Vietnamese Americans and health care providers should increase screening and vaccination rates.
African American Veterans' Experiences with Mobile Geriatric Care
Authors: Rodriguez Keri L , Appelt Cathleen J , Young Amanda J , Fox Andrea R
Published: March 2007

To explore perspectives concerning use of a mobile geriatrics unit (MGU) by underserved populations in low-income urban neighborhoods, we recruited 18 elderly African American patients and engaged them in in-depth semistructured interviews. Using grounded theory techniques of constant comparative analysis, we found that most patients learned about the MGU from community members and initially visited it to determine whether it would be worth using in the future. In describing their MGU experiences, patients tended to focus on three main factors: quality of care, accessibility of services, and ambience of the care setting. They reported that the MGU allowed them to have their health conditions and medications monitored regularly and functioned as a central link to the larger Veterans Affairs health care system. The findings suggest that using MGUs is an acceptable and effective way to help medically underserved populations receive primary medical care and referrals to specialty care.
Oral Health is the Measure of a Just Society
Authors: Treadwell Henrie M , Northridge Mary E
Published: March 2007

Former Surgeon General David Satcher's report, Oral Health in America, documents the higher burden of oral diseases and conditions borne by those with relatively low social standing at each stage of life. When an entire community suffers from a health concern, that concern becomes a social justice issue. Racial and ethnic minorities, prisoners, and seniors suffer disproportionately from oral diseases and conditions due to societal prejudices that place them at risk over and above any risk associated with their economic means. Community-based delivery models that involve the community in planning and implementation, build upon the existing health safety net to link oral health services with primary care, and change public or institutional policy to support the financing and delivery of oral health care have proven successful. Here we champion the need for a national health plan that includes oral health care to promote social justice and oral health for all.
The Costs of Non-Insurance in Maryland
Authors: Waters Hugh , Steinhardt Laura , Oliver Thomas R , Burton Alice , Milner Susan
Published: March 2007

This study calculates expenditures and costs related to a lack of health insurance coverage in the State of Maryland. Research methods. The study is based on detailed primary and secondary data collection on the following sources of payment and care related to non-insurance: (1) uncompensated hospital care; (2) other public subsidies; (3) ambulatory services; (4) philanthropic spending; and (5) uninsured individuals' costs. Results. Expenditures by and for the uninsured in Maryland total $1.47 billion dollars. On a per-capita basis, this is equivalent to $2,371 per full-year uninsured person in the state. Twenty-seven percent of this total, or $633 per uninsured person, is paid directly by the uninsured themselves in out-of-pocket medical expenditures. The state and local governments spent $497 per uninsured person (21% of the total), and the federal government spent an additional $401 (17%). Private payers (including insurance, physicians, and philanthropy) accounted for $460 (19%). Conclusions. The sources and flows of spending on the uninsured are complex, and these expenditure levels should not be interpreted as savings that would directly result from an expansion of insurance coverage. Our results are consistent with earlier studies completed at the national level, and add considerable detail.
Social History and World History: From Daily Life to Patterns of Change
Authors: Pomeranz Kenneth
Published: March 2007

This article asks how questions from social history can be more closely integrated into world history and vice versa. It highlights cases in which this has already happened and suggests avenues for further development. It divides social history into three different types: history of daily life, history of social organization, and history of social movements and deliberate attempts to induce social change, whether from the top down or from the bottom up. The last kind of social history is particularly difficult to frame as world history, partly because we lack terms for collective agents that are agreed to be useful across cultural lines. But developing such a vocabulary remains necessary. The last section of the article examines how social histories of empire offer some approaches that are promising for this purpose.
World History and the History of Women, Gender, and Sexuality
Authors: Wiesner Merry E.
Published: March 2007

Women's history had its origins in the women's movement and in the new social history, and like other areas of social history, it has seen relatively few interchanges with world history as both have developed over the past twenty years. This article suggests some of the reasons for this lack of intersection; assesses recent scholarship that brings world history and the history of women, gender, and sexuality together; and suggests future directions.
Maternal Care Modulates the Relationship between Prenatal Risk and Hippocampal Volume in Women But Not in Men
Authors: Buss Claudia , Lord Catherine , Wadiwalla Mehereen , Hellhammer Dirk H. , Lupien Sonia J. , Meaney Michael J. , Pruessner Jens C.
Published: March 2007

Smaller hippocampal volume is associated with psychiatric disorders. Variations in hippocampal volume are discussed as both a consequence of the neurotoxic effects of stress and as a pre-existing condition leading to increased vulnerability for cognitive and emotional impairments. To investigate whether early experience can account for variability in hippocampal volume in adulthood (vulnerability hypothesis), we assessed the relationship between birth weight and hippocampal volume in 44 subjects. The reported quality of maternal care in early childhood, as evaluated by the Parental Bonding Inventory, was used as index of the quality of the postnatal environment. Hippocampal volume was assessed from magnetic resonance images using a manual segmentation protocol. We show that birth weight significantly predicts hippocampal volume in adulthood only in female subjects reporting low maternal care. The results suggest that the postnatal environment modulates the neurodevelopmental consequences of prenatal risk and that this effect is sex-specific.
Sirtuin 2, a Mammalian Homolog of Yeast Silent Information Regulator-2 Longevity Regulator, Is an Oligodendroglial Protein That Decelerates Cell Differentiation through Deacetylating α-Tubulin
Authors: Li Wenbo , Zhang Bin , Tang Junhong , Cao Qiong , Wu Yajun , Wu Chun , Guo Jing , Ling Eng-Ang , Liang Fengyi
Published: March 2007

Silent information regulator-2 (SIR2) proteins regulate lifespan of diverse organisms, but their distribution and roles in the CNS remain unclear. Here, we show that sirtuin 2 (SIRT2), a mammalian SIR2 homolog, is an oligodendroglial cytoplasmic protein and localized to the outer and juxtanodal loops in the myelin sheath. Among cytoplasmic proteins of OLN-93 oligodendrocytes, α-tubulin was the main substrate of SIRT2 deacetylase. In cultured primary oligodendrocyte precursors (OLPs), SIRT2 emergence accompanied elevated α-tubulin acetylation and OLP differentiation into the prematurity stage. Small interfering RNA knockdown of SIRT2 increased the α-tubulin acetylation, myelin basic protein expression, and cell arbor complexity of OLPs. SIRT2 overexpression had the opposite effects, and counteracted the cell arborization-promoting effect of overexpressed juxtanodin. SIRT2 mutation concomitantly reduced its deacetylase activity and its impeding effect on OLP arborization. These results demonstrated a counterbalancing role of SIRT2 against a facilitatory effect of tubulin acetylation on oligodendroglial differentiation. Selective SIRT2 availability to oligodendroglia may have important implications for myelinogenesis, myelin–axon interaction, and brain aging.
Acquisition, Extinction, and Reacquisition of a Cerebellar Cortical Memory Trace
Authors: Jirenhed Dan-Anders , Bengtsson Fredrik , Hesslow Germund
Published: March 2007

Associative learning in the cerebellum underlies motor memories and probably also cognitive associations. Pavlovian eyeblink conditioning, a widely used experimental model of such learning, depends on the cerebellum, but the memory locus within the cerebellum as well as the underlying mechanisms have remained controversial. To date, crucial information on how cerebellar Purkinje cells change their activity during learning has been ambiguous and contradictory, and there is no information at all about how they behave during extinction and reacquisition. We have now tracked the activity of single Purkinje cells with microelectrodes for up to 16 h in decerebrate ferrets during learning, extinction, and relearning. We demonstrate that paired peripheral forelimb and periocular stimulation, as well as paired direct stimulation of cerebellar afferent pathways (mossy and climbing fibers) consistently causes a gradual acquisition of an inhibitory response in Purkinje cell simple spike firing. This conditioned cell response has several properties that matches known features of the behavioral conditioned response. The response latency varies with the interstimulus interval, and the response maximum is adaptively timed to precede the unconditioned stimulus. Across training trials, it matches behavioral extinction to unpaired stimulation and also the substantial savings that occur when paired stimulation is reinstated. These data suggest that many of the basic behavioral phenomena in eyeblink conditioning can be explained at the level of the single Purkinje cell.
Sensitization of Calcitonin Gene-Related Peptide Receptors by Receptor Activity-Modifying Protein-1 in the Trigeminal Ganglion
Authors: Zhang Zhongming , Winborn Christina S. , Marquez de Prado Blanca , Russo Andrew F.
Published: March 2007

The neuropeptide calcitonin gene-related peptide (CGRP) from the trigeminal ganglion has been established as a key player in the pathogenesis of migraine. In this study, we provide evidence that the responsiveness of neuronal CGRP receptors is strongly enhancedin vitroandin vivoby expression of human receptor activity-modifying protein-1 (hRAMP1), an obligatory subunit of the CGRP receptor. We first demonstrated that activation of CGRP receptors on cultured trigeminal ganglion neurons increased endogenous CGRP mRNA levels and promoter activity. The promoter activation was cAMP dependent and blocked by the antagonist BIBN4096BS [1-piperidinecarboxamide,N-[2-[[5-amino-l-[[4-(4-pyridinyl)-l-piperazinyl]carbonyl]pentyl]amino]-1-[(3,5-dibromo-4-hydroxyphenyl)methyl]-2-oxoethyl]-4-(1,4-dihydro-2-oxo-3(2H)-quinazolinyl)], a new antimigraine drug. Gene transfer using an adenoviral hRAMP1 expression vector increased the maximal production of cAMP by 1.8 ± 0.2-fold and decreased the EC50to 2.3 ± 0.8 nmfrom 9.0 ± 5.9 nmand 15.6 ± 5.2 nmin uninfected and control-infected cultures, respectively. To establish whether RAMP1 is limitingin vivoas indicated from the culture studies, a transgenic mouse expressing hRAMP1 in the nervous system was generated. After CGRP injection into the whiskerpad, the hRAMP1 transgenic mice displayed 2.2 ± 0.2-fold greater plasma extravasation, which is a measure of neurogenic inflammation. These results demonstrate that RAMP1 is functionally rate limiting for CGRP receptor activity in the trigeminal ganglion, which raises the possibility that elevated RAMP1 might sensitize some individuals to CGRP actions in migraine.