bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryptococcosis after living donor liver transplantation: report of three cases
Authors: Akamatsu N. , Sugawara Y. , Nakajima J. , Kishi Y. , Kaneko J. , Makuuchi M.
Published: June 2005

Abstract:Cryptococcosis is the third most common invasive fungal infection in solid organ transplantation, which usually occurs more than 6 months after the primary operation. In our series of 180 consecutive adult living‐donor liver transplantation recipients, three (1.5%) had cryptococcosis and one of these patients died. The serum cryptococcal antigen examination was positive in all three patients who suffered from cryptococcosis. The serum cryptococcal antigen test might contribute to the early detection and treatment of cryptococcosis.
Human herpesvirus‐8‐related Kaposi's sarcoma after liver transplantation successfully treated with cidofovir and liposomal daunorubicin
Authors: Verucchi G. , Calza L. , Trevisani F. , Zambruni A. , Tadolini M. , Giuliani R. , Manfredi R. , Andreone P. , Chiodo F. , Bernardi M.
Published: June 2005

Abstract: The iatrogenic form of Kaposi's sarcoma (KS) is typically observed among transplant recipients, and the most appropriate therapeutic approach (usually including reduction of immunosuppression, specific chemotherapy, and/or administration of antiviral agents against human herpes virus‐8) is still controversial. Available experiences on the effect of the anti‐herpes viruses drug cidofovir provide conflicting results. Herein, we report the clinical, histological, and virological features of a liver transplant recipient successfully treated with a combined therapy of cidofovir and liposomal daunorubicin, associated with a reduction of the immunosuppressive regimen, for an advanced cutaneous and visceral KS.
Severe hypogammaglobulinemia associated with hepatic vein stenosis causes cytomegalovirus infection after living‐related liver transplantation
Authors: Komatsu H. , Inui A. , Sogo T. , Fujisawa T. , Egawa H. , Tanaka K.
Published: June 2005

Abstract:Hepatic vein stenosis is a vascular complication that can lead to graft loss after liver transplantation. Although ascites frequently occurs as a symptom of hepatic vein stenosis, the development of severe hypogammaglobulinemia associated with hepatic vein stenosis has not been reported in the literature. An 8‐year‐old boy underwent living‐related liver transplantation (LRLT) because of Wilson disease with chronic hepatic failure. Becausede novoautoimmune hepatitis was diagnosed 1 year after LRLT, azathioprine, and prednisolone were added to the baseline immunosuppression of tacrolimus. The patient developed ascites with severe hypogammaglobulinemia (immunoglobulin G [IgG], 288 mg/dL) 2 years after LRLT. Ultrasonography and angiography disclosed stenosis of the hepatic vein. The ascites completely resolved after percutaneous balloon angioplasty. Despite serum IgG trough levels of >500 mg/dL maintained by the addition of immunoglobulin, cytomegalovirus reactivation and sepsis occurred. Serum IgG levels should be monitored to prevent opportunistic infections when hepatic vein stenosis is diagnosed after LRLT.
Seeking comfort through prayer
Authors: Hawley Georgina , Irurita Vera
Published: June 2005

Hawley G, Irurita V. International Journal of Nursing Practice 1998; 4: 9–18

Seeking comfort through prayer

The aim of the research was to discover the experience and meaning of prayer of patients in hospital when undergoing coronary artery bypass graft surgery. Ethnographic‐type post discharge interviews with 13 participants formed the major data source. Using the grounded theory method, the basic social psychological process was labeled seeking comfort through prayer. This was the process of engaging in prayer with God. The participants believed that God listened to their prayers and answered them when they were seeking comfort. It was this reassurance that gave them the strength to face uncertainty and possible death, and also gave them comfort in their psychophysiological condition at the time. Seeking comfort had three stages (maintaining or re‐establishing a relationship with God; making peace with God; and asking God to be with them during the hospitalisation). This last stage involved five levels of prayer (acquiescence, instinctive prayer, survival, confiding and honouring).
Treating skin tears in nursing home residents: A pilot study comparing four types of dressings
Authors: Edwards Helen , Gaskill Deanne , Nash Robyn
Published: June 2005

Edwards H, Gaskill D & Nash R. International Journal of Nursing Practice 1998; 4: 25–32

Treating skin tears in nursing home residents: A pilot study comparing four types of dressings

A pilot study was conducted to compare four types of dressings used to treat skin tears in nursing home residents. Wounds treated with a non‐occlusive dressing healed more quickly than those dressed with occlusive dressings. The results suggest that ease of use and product wastage are important considerations when treating skin tears. The pilot study also highlights the need for further research into skin tear management and the need for ongoing education for nurses regarding skin integrity risk assessment and product information.
Elderly Finnish people's experiences with coping at home
Authors: Pietilä Anna‐Maija , Tervo Aila
Published: June 2005

Pietilä A‐M, Tervo A. International Journal of Nursing Practice 1998; 4: 19–24

Elderly Finnish people's experiences with coping at home

The aim of this study was to describe the experiences of elderly Finnish people with coping at home. Twenty elderly inhabitants of the city of Oulu in Finland, over 75 years of age, who live at home were interviewed. Content analysis was used as the method. According to the analysis, elderly people's coping at home consisted of social contacts, daily events as the substance of life, and previous life experiences. Social contacts consisted of family, public health services, and neighbours. Daily events as the substance of life included taking part in activities of daily living. The contents of previous life experiences consisted of thinking back to organize one's life experiences and their influence on one's own life. The factors that promoted coping at home were maintenance of health, the experience of well‐being, and security.

The findings of this study indicate that by supporting elderly people to cope at home, it is possible to influence their sense of safety and well‐being and hence their quality of life.
Distal ureteral atresia: Recovery of renal function after relief of obstruction at ten months old
Authors: ASHIMINE SATOSHI , MIYAZATO MINORU , HAYASHI EIRI , MOROZUMI MAKOTO , SUGAYA KIMIO , OGAWA YOSHIHIDE
Published: June 2005

Abstract  A large cystic mass that occupied more than half of the abdomen was identified by ultrasound in a 10‐month‐old boy. Intravenous pyelography failed to visualize the right kidney, so we created a loop ureterocutaneostomy followed by temporary nephrostomy to improve renal function. Exploratory surgery revealed complete atresia of the distal right ureter. A ureteral stricture developed after ureteroneocystostomy and undiversion of the loop, so a second reconstruction procedure was required (pelvi‐ureteroplasty and reimplantation of the right ureter with a psoas hitch) to free the patient from dependence on catheters. Despite the occurrence of giant hydronephrosis secondary to complete ureteral obstruction at the age of 10 months, the function of the right kidney could be preserved. Accordingly, aggressive attempts to promote functional recovery may be justified even when patients have advanced hydronephrosis.
Primary testicular leiomyosarcoma
Authors: TAKIZAWA AKITOSHI , MIURA TAKESHI , FUJINAMI KIYOSHI , KAWAKAMI SATOSHI , OSADA YUTAKA , KAMEDA YOICHI
Published: June 2005

Abstract  We report a case of primary testicular leiomyosarcoma. A 76‐year‐old man, who complained of left scrotal swelling for 6 months, underwent radical orchiectomy. Microscopic examination revealed intratesticular leiomyosarcoma. The patient received no adjuvant therapy and at 12 months after surgery, there had been no recurrence. Primary leiomyosarcoma of the testis is extremely rare; this is the 9th case recorded worldwide.
Quality Assessment Of Digital Surface Models Generated From IKONOS Imagery
Authors: Poon Joanne , Fraser Clive S. , Chunsun Zhang , Li Zhang , Gruen Armin
Published: June 2005

The growing applications of digital surface models (DSMs) for object detection, segmentation and representation of terrestrial landscapes have provided impetus for further automation of 3D spatial information extraction processes. While new technologies such as lidar are available for almost instant DSM generation, the use of stereoscopic high‐resolution satellite imagery (HRSI), coupled with image matching, affords cost‐effective measurement of surface topography over large coverage areas. This investigation explores the potential of IKONOS Geo stereo imagery for producing DSMs using an alternative sensor orientation model, namely bias‐corrected rational polynomial coefficients (RPCs), and a hybrid image‐matching algorithm. To serve both as a reference surface and a basis for comparison, a lidar DSM was employed in the Hobart testfield, a region of differing terrain types and slope. In order to take topographic variation within the modelled surface into account, the lidar strip was divided into separate sub‐areas representing differing land cover types. It is shown that over topographically diverse areas, heighting accuracy to better than 3 pixels can be readily achieved. Results improve markedly in feature‐rich open and relatively flat terrain, with sub‐pixel accuracy being achieved at check points surveyed using the global positioning system (GPS). This assessment demonstrates that the outlook for DSM generation from HRSI is very promising.
Combined Digital Photogrammetry and Time‐of‐Flight Laser Scanning for Monitoring Cliff Evolution
Authors: Lim Michael , Petley David N. , Rosser Nicholas J. , Allison Robert J. , Long Antony J. , Pybus David
Published: June 2005

Although cliffs form approximately 75% of the world's coastline, the understanding of the processes through which they evolve remains limited because of a lack of quantitative data on the morphological changes they undergo. In this paper the combination of terrestrial time‐of‐flight laser scanning with high‐resolution digital photogrammetry is examined to generate high‐quality data‐sets pertaining to the geomorphic processes governing cliff development. The study was undertaken on a section of hard rock cliffs in North Yorkshire, UK, which has been monitored over a 12‐month period. High‐density, laser‐scanned point clouds have been used to produce an accurate representation of these complex surfaces, free from the optical variations that degrade photographic data. These data‐sets have been combined with high‐resolution photographic monitoring, resampled with the fixed accuracies of the terrestrial laser survey, to generate a new approach to recording the volumetric changes in complex coastal cliffs. This has led to significant improvements in the understanding of the activity patterns of coastal cliffs.
Cytokines in the oviparity/viviparity transition: evidence of the interleukin‐1 system in a species with reproductive bimodality, the lizard Lacerta vivipara
Authors: Paulesu Luana , Bigliardi Elisa , Paccagnini Eugenio , Ietta Francesca , Cateni Chiara , Guillaume Claude Pierre , Heulin Benoit
Published: June 2005

Summary
Placental viviparity is a reproductive strategy usually attributed to mammals. However, it is also present in other vertebrate species, e.g. in Squamate reptiles. Although the immunological mechanisms that allow the survival of the semi‐allogenic embryo in maternal tissues are still largely unknown, cytokines seem to play an important role in mammalian reproduction. Previous studies in our laboratory showed that interleukin‐1 (IL‐1), a cytokine associated with implantation in mice, is also expressed at the materno‐fetal interface of placental viviparous Squamates. In this study, we used the model of Lacerta vivipara, which exhibits reproductive bimodality, that is, the coexistence of oviparous and viviparous populations. By means of immunohistochemistry and anti‐human antibodies, we showed that uterine tissues of L. vivipara (seven oviparous and six viviparous animals) expressed the two IL‐1 isoforms, IL‐1α and IL‐1β, and the type I IL‐1 receptor (IL‐1R tI) both at the pre‐ovulatory stage and during gestation, with no significant difference between oviparous and viviparous females. In L. vivipara, as in most oviparous Squamates, an important phase of embryonic development takes place in the mother's oviduct, before egg‐laying. Moreover, although thinner than in oviparous females, an eggshell membrane persists throughout gestation in viviparous females also, which develop a very simple type of placenta. The data suggest that immunological mechanisms that allow the survival of the semi‐allogenic embryo in maternal tissues are independent of the timing or intimacy of contact between maternal and fetal tissues.
Evolutionary redeployment of a biosynthetic module: expression of eye pigment genes vermilion, cinnabar, and white in butterfly wing development
Authors: Reed Robert D. , Nagy Lisa M.
Published: June 2005

Summary Ommochromes are common among insects as visual pigments; however, in some insect lineages ommochromes have evolved novel functions such as integument coloration and tryptophan secretion. One role of ommochromes, as butterfly wing pigments, can apparently be traced to a single origin in the family Nymphalidae. The synthesis and storage of ommochrome pigments is a complex process that requires the concerted activity of multiple enzyme and transporter molecules. To help understand how this subcellular process appeared in a novel context during evolution, we explored aspects of ommochrome pigment development in the wings of the nymphalid butterfly Vanessa cardui. Using chromatography and radiolabeled precursor incorporation studies we identified the ommochrome xanthommatin as a V. cardui wing pigment. We cloned fragments of two ommochrome enzyme genes, vermilion and cinnabar, and an ommochrome precursor transporter gene, white, and found that these genes were transcribed in wing tissue at relatively high levels during wing scale development. Unexpectedly, however, the spatial patterns of transcription were not associated in a simple way with adult pigment patterns. Although our results suggest that the evolution of ommochrome synthesis in butterfly wings likely arose in part through novel regulation of vermilion, cinnabar, and white transcription, they also point to a complex relationship between transcriptional prepatterns and pigment synthesis in V. cardui.
Growth patterns during segmentation in the two polychaete annelids, Capitella sp. I and Hydroides elegans: comparisons at distinct life history stages
Authors: Seaver Elaine C. , Thamm Katrin , Hill Susan D.
Published: June 2005

Summary Many animals generate new body segments sequentially from a posterior growth zone, and this is generally thought to be the case for the annelids. Most annelids, including polychaetes, have an indirect life cycle and generate their earliest segments during larval life. We have characterized the nature of the growth zone in two polychaetes, Hydroides elegans and Capitella sp. I, during both larval and juvenile stages of segment formation by examining cell division patterns with 5‐bromo‐2′‐deoxyuridine incorporation. Cell division patterns show commonalities between the two species, even though they have distinct body plans and life history characteristics. In both polychaetes, larval segments arise from a field of dividing cells located in lateral regions of the body, rather than from a localized posterior growth zone. Circumferential expansion of the forming segmental tissue is particularly pronounced in Capitella sp. I. Post‐metamorphic segments, in contrast, originate from a classical posterior growth zone, with the exception of four posterior thoracic segments of H. elegans, which appear to arise from an area in the middle of the body, indicating plasticity of segment‐generating mechanisms present in different annelid life histories. The distinct nature of larval versus juvenile growth zones in H. elegans and Capitella sp. I raises the question of the mechanistic relationship between these two growth zones. The results of this study increase our understanding of the cellular origins of segments in annelids, and serve as a basis for interpretation of molecular expression patterns associated with segment formation in polychaetes.
Molting polychaete jaws—ecdysozoans are not the only molting animals
Authors: Paxton Hannelore
Published: June 2005

Summary Jaw shedding and replacement of Diopatra aciculata (Onuphidae, Eunicida), by the same process as arthropod molting, involving apolysis and ecdysis, is described here. These observations suggest that molting has either evolved convergently in eunicidan polychaetes and ecdysozoans or it was present in the last ecdysozoan/lophotrochozoan common ancestor and thus may not represent a synapomorphy of the ecdysozoans.
Plasma Cytokine Levels in Migraineurs and Controls
Authors: Perini Francesco , D'Andrea Giovanni , Galloni Elisabetta , Pignatelli Francesco , Billo Giuseppe , Alba Sabrina , Bussone Gennaro , Toso Vito
Published: June 2005

Background.—The vasoactive peptide, calcitonin gene‐related peptide (CGRP), is released from primary afferent neurons in the trigemino‐vascular circulation during migraine headache. CGRP at physiological concentrations and possibly via stimulation of its selective receptors on T‐cells, triggers the secretion of cytokines. Cytokines play an important role in several physiological and pathological settings such as immunology, inflammation, and pain.

Objective.—To investigate plasma levels of pro‐ and anti‐inflammatory cytokines in migraineurs and healthy controls.

Methods.—We studied 25 migraine patients, during and outside attacks, and 18 healthy control subjects measuring plasma levels of IL‐6, IL‐10, tumor necrosis factor alpha (TNFα), IL‐4, IL‐1β, and IL‐2 using ELISA.

Results.—Circulating levels of IL‐10, TNFα, and IL‐1β during attacks were significantly higher in comparison to their levels outside attacks (P= .0003, P= .03, and P= .05, respectively). IL‐10 and TNF serum levels were higher in patients studied soon after headache onset and lower over time (P= .004 and P= .05).

Conclusion.—Our results suggest that TNFα, IL‐1β, and IL‐10 may be involved in the pathogenesis of migraine attacks.
Headache in Medical Education: Medical Schools, Neurology and Family Practice Residencies
Authors: Gallagher R. Michael , Alam Rolande , Shah Shiwan , Mueller Loretta , Rogers James J.
Published: June 2005

Objective.—To explore the extent of headache education received by medical students and residents.

Background.—Headache is a common, often severe, and sometimes disabling problem. However, 49% of sufferers do not seek professional treatment—of those who do, only 28% are very satisfied. One possible reason is limited education of physicians about headache.

Methods.—Surveys were sent to all allopathic and osteopathic medical schools, 200 family medicine residencies, and all 126 neurology residencies. Information requested included the amount and perceived adequacy of headache education and any plans to increase headache education.

Results.—Response rates were 35% to 40%. Medical school lecture hours ranged from 0 (4%) to >5 (24%) with 92% having no plans for an increase in headache education. Family Medicine residency lecture hours ranged from 1–3 (30%) to >5 (34%) and case presentations from 1–5 (23%) to >5 (41%), with 88% of program directors having no plans for increase. Neurology residency lecture hours ranged from 1–3 (11%) to >5 (64%) and case presentations from 1–5 (23%) to >10 (57%), with 80% having no plans for increase.

Conclusion.—Undergraduate medical education in headache is limited. Despite medical schools perceiving their training as adequate, both neurology and family practice residency program directors believe entering residents are inadequately prepared in headache upon entering the program.
Efficacy and Tolerability of Intravenous Valproic Acid in Acute Adolescent Migraine
Authors: Reiter Pamela D. , Nickisch Jason , Merritt Glenn
Published: June 2005

Objective.—To describe the efficacy and tolerability of rapid intravenous valproic acid (VPA) infusions in children with severe migraine headache.

Background.—Intravenous VPA is an emerging treatment option for acute migraine headache. Adult data suggests both efficacy and tolerability of rapid VPA infusions as abortive therapy, but little data exist in children.

Methods.—We conducted a retrospective chart review of all children who received intravenous VPA at The Children's Hospital Headache Clinic during an 18‐month study period. Baseline intensity of headache pain, time at which maximum relief was attained, pain reduction following therapy, dose and duration of VPA infusion(s), patient's pulse, blood pressure, respiratory rate, and pulse oximetry were collected. Adverse events were also recorded.

Results.—Thirty‐one children (age = 15 ± 2 years; 81% female) requiring 58 clinic visits and 71 VPA infusions were included. Most visits (n = 45; 78%) resulted in only one dose of VPA (976 ± 85 mg infused over 12 ± 4 minutes) for desired pain relief. Percent pain reduction in those children was 39.8%, with time to maximum relief of 63 ± 31 minutes. Some children required a second dose of 500 mg (n = 13 visits; 22%), that was infused over 14 ± 6 minutes and produced a 57% reduction in pain intensity from baseline. VPA infusions were well tolerated. Adverse events described included cold sensation (1), dizziness (3), nausea (1), possible absence seizure (1), paraesthesia (2), and tachycardia (2).

Conclusions.—Rapid infusion of intravenous VPA is generally well tolerated and may play a role in the management of children with acute migraine headache. Prospective, controlled trials to further investigate this treatment in children are warranted.
Law, Policymaking, and the Policy Process: Closing the Gaps
Authors: Barclay Scott , Birkland Thomas
Published: June 2005

Public policy scholars and public Law scholars often study the same substantive issues and have similar theoretical interests Yet students of the public policy process rarely consider the courts as policymakers in the same manner as do their public law counterpart We seek to explain this difference in approaches between the two Subfield on the question of the courts as policymakers, and we ask. how models of the public policy process should incorporate the judiciary.
Hazardous Liaisons: Risk, Power, and Politics in the Liberal State
Authors: Hiskes Richard P.
Published: June 2005

This article presents a new approach to interpreting and analyzing technological risks and evaluating their impact on policymaking in liberal societies. I argue that risks must be seen first as emergent phenomena that resist reduction for either explanatory or policy purposes to the individual persons, events, or decisions that constitute them. Second, risks are intrinsically political things, involving aspects of power and interest in ways that also make policy decisions difficult. As emergent and political phenomena, then, modern technological risks pose unique policy difficulties for societies steeped in the epistemological and political individualism of classical liberalism.
Restructuring British Public Sector Industrial Relations: State Policies and Trade Union Responses
Authors: Howell Chris
Published: June 2005

This article examines how Conservative governments restructured public sector in day trial relations in Britain between 1979 and 1997, and identifies the main components of trade union strategic response to change. It argues that Conservative policy is important for its impact upon trade union strategy and practice, and that public sector unions constitute the leading edge of trade union strategic modernization in Britain.
When Businesses Collide: Producer Interest Groups and the Politics of Regulation
Authors: Campbell Heather E.
Published: June 2005

Much interest‐group analysis assumes that producer‐group pressures are especially influential. Sometimes business interests conflict; in that case, which producer groups will be most influential? Using data from 54 state telephone rate cases, this paper explores the relative influence of several different intervener types. Estimates indicate that influencing outcomes depends on credible information rather than other resources, and also that business interest groups cannot all be considered homogenous. Some implications for the Telecommunications Act of 1996 are drawn.
Comparing Three Lenses of Policy Choice
Authors: Zahariadis Nikolaos
Published: June 2005

This paper compares three lenses that explain policy choice. They include rational choice, advocacy coalitions, and multiple streams. The argument is that the three lenses generate complementary rather than competing explanations of the same event. Complementary lenses are those that are not applicable under the same conditions. Applicability of each lens is established by examining actor goals and environmental structure and by exploring predictive capability and descriptive accuracy. Finally, the paper charts a research agenda designed to make the lenses more directly competing.
Rational Choice Theory and the Evaluation of Public Policy
Authors: Neimun Max , Stambough Stephen J.
Published: June 2005

The dominance of rational choice‐inspired models of policy development, implementation, and evaluation has grown dramatically over the years as a challenge to traditional, pluralist politics. In this article, we analyze the theoretical foundations of the rational choice perspective and its criticism of pluralist politics. We explore the values inherent in the rational choice perspective and suggest that they feed into growing public cynicism about government and lead to a conservative policy agenda of less government. We then develop an unusual argument that the very tools of rational choice analysis and its values actually produce far more government involvement than expected. by examining school voucher programs. We conclude by making a case for pluralist politics as a more appropriate means for addressing the concerns of classical liberals and others about excessive government intrusion.
Community as a Policy Instrument: A Comparative Analysis
Authors: Rochefort David A. , Rosenberg Michael , White Deena
Published: June 2005

Over recent decades. “community” has been a powerful theme in social policy development not only in the United States but elsewhere in North America and Europe as well. Existing analyses of the concept, however, tended to approach it more from philosophical and sociological perspectives than from the standpoint of policy analysis. This article examines the uses of community as a policy instrument, considering its diverse applications us policy objective, policy means, and policy rhetoric. A cross‐section of major community‐oriented policies in the United States and Quebec is analyzed, providing a basis file policy‐level, regime‐level, and political culture comparison. Identifying the key components that community policies may incorporate, we propose a schema for systematically describing deferent types of interventions. Finally. we review the difficulties encountered in implementing policies with a community orientation and the need to avoid simplistic judgments of success and failure.
Beyond Empiricism: Policy Inquiry in Post positivist Perspective
Authors: Fischer Frank
Published: June 2005

This essay contributes to the growing critique of poky science's dominant neopositivist methodologies. Not only is neopositivist policy science seen to have failed in its effort to develop a usable body of predictive generalizations, it has been unable to supply effective solutions to social problems. An important part of this failure is traced to outmoded epistemological assumptions. Drawing on developments in both science and the sociology of science, in particular the recognition that the “hard” sciences themselves no longer rest on traditional concepts of objectivity and proof, the discussion outlines a post positivist conception of policy science designed to address the multidimensional complexity of social reality. As a discursive orientation grounded in practical reason, the post positivist approach situates empirical inquiry in a broader interpretive framework. More then just an epistemological alternative, the approach is offered as a better description of what social science actually do in practice the essay closes with a brief discussion of the implications of u post positivist approach for both a socially relevant policy curriculum and a democratic practice of policy inquiry.
Bridging Positivist and Interpretivist Approaches to Qualitative Methods
Authors: Lin Ann Chih
Published: June 2005

The usual juxtaposition of qualitative research against quantitative research makes it easy to miss the fact that qualitative research itself encompasses at least two traditions: positivist and interpretivist. Positivist work seeks to identify qualitative data with propositions that can then be tested or identified in other cases, while interpretive work seeks to combine those data into systems of belief whose manifestations are specific to a case. In this paper, I argue that discovering causal relationships is the province of positivist research, while discovering causal mechanisms is the province of interpretivists. I explain why absolutist claims for one or the other approach are mistaken, and argue that the combination of both makes more sense. Finally, I offer suggestions for combinations of positivist and interpretive work, both at the level of thought experiment and in actual data collection and analysis. Throughout, I draw my examples from recent studies of poverty, a field in which a small but distinguished tradition of qualitative studies of the poor has been joined by a growing body of both positivist and interpretive work.
A Wish List for 21st Century Environmental Policy: Decentralization, Integration, Cooperation, Flexibility, and Enhanced Participation by Citizens and Loc Governments
Authors: Weber Edward P.
Published: June 2005

Jeanne W. Clarke and Daniel McCool,Staking Out the Terrain: Power and Performance Among Natural Resource Agencies (2nd 4.).

Larry S. Luton,The Politics of Garbage: A Community Perspective on Solid Waste Policy Making.

Peter J. May, Raymond J. Burby, Neil J. Ericksen, John W. Handmer, Jennifer E. Dixon, Sarah Michaels, and D. IngleSmith, Environmental Management and Governance: Intergovernmental Approaches to Hazards and Sustainability.
Viruses in periodontal disease – a review
Authors: Cappuyns I , Gugerli P , Mombelli A
Published: June 2005

The purpose of this review was to evaluate the evidence supporting the hypothesis that viral infection plays a role in the development of periodontitis. An involvement in periodontal diseases has been suspected specifically for human immunodeficiency virus (HIV) and herpes viruses. An association has been demonstrated between HIV infection and some distinct forms of periodontal infection, i.e. necrotizing lesions. Furthermore, reports of increased prevalence and severity of chronic periodontitis in HIV‐positive subjects suggests that HIV infection predispose to chronic periodontitis. Several studies, most of them from the same research group, have demonstrated an association of herpesviruses with periodontal disease. Viral DNA have been detected in gingival tissue, gingival cervicular fluid (GCF) and subgingival plaque from periodontaly diseased sites. In addition markers of herpesviral activation have been demonstrated in the GCF from periodontal lesions. Active human cytomegalovirus (HCMV) replication in periodontal sites may suggest that HCMV re‐activation triggers periodontal disease activity. Concerns regarding sampling, methods and interpretation cast doubts on the role of viruses as causes of periodontal disease.
Early growth and adult health outcomes – lessons learned from the Helsinki Birth Cohort Study
Authors: Eriksson Johan G.
Published: June 2005

Slow growth during fetal life and infancy is often followed by accelerated weight gain in childhood. These patterns of growth seem to precede the development of coronary heart disease (CHD) and type 2 diabetes in adult life. Patterns of growth associated with CHD and type 2 diabetes in adult life are described based upon findings from the Helsinki Birth Cohort Study. We are beginning to understand that adult degenerative diseases are associated with different patterns of early growth. Yet it is not clear what optimal growth is and how it can be achieved. Most data suggest that the development of many non‐communicable diseases involve a number of interactions including genetic ones. Therefore these diseases can best be focused upon from a life cycle perspective.
The developmental origins of adult disease
Authors: Gluckman Peter D. , Hanson Mark A. , Pinal Catherine
Published: June 2005

Epidemiological and clinical observations have led to the hypothesis that the risk of developing some chronic diseases in adulthood is influenced not only by genetic and adult lifestyle factors, but also by environmental factors acting in early life. These factors act through the processes of developmental plasticity and possibly epigenetic modification, and can be distinguished from developmental disruption. The concept of predictive adaptation has been developed to explain the relationship between early life events and the risk of later disease. At its base, the model suggests that a mismatch between fetal expectation of its postnatal environment and actual postnatal environment contribute to later adult disease risk. This mismatch is exacerbated, in part, by the phenomenon of ‘maternal constraint’ on fetal growth, which implicitly provides an upper limit of postnatal nutritional environment that humans have adapted for and is now frequently exceeded. These experimental, clinical and conceptual considerations have important implications for prevention and intervention in the current epidemic of childhood obesity and adult metabolic and cardiovascular disorders.
The policy challenge of coexisting undernutrition and nutrition‐related chronic diseases
Authors: James W. Philip T.
Published: June 2005

The original focus on energy and protein needs for combating malnutrition gave way to UNICEF promoted concerns for maternal care and complementary feeding in association with longer‐term breast feeding. Nevertheless the World Food Summit's drive to halve malnutrition rates by 2015 was not accelerating the fall in malnutrition prevalences. The UN's Standing Committee on Nutrition's commission highlighted the crucial role of maternal nutrition and low birthweights, the need for a life cycle approach to prevention and the current global effects of maternal/fetal and childhood malnutrition in amplifying the impact of the new epidemic of obesity and chronic diseases. The emphasis on poverty reduction and free market solutions is too crude and national interventions geared to protecting the vulnerable, promoting equity with major community involvement in integrated multifaceted programmes are needed. The same principles apply to overnutrition and specifically to the avoidance of the current pandemic of the metabolic syndrome. An intergenerational amplification of diabesity is now emerging as overweight but poorly fed micronutrient deficient girls enter pregnancy and produce ever more susceptible children. So new strategies are now needed as recognized by economists but not by doctors and nutritionists! Economy, agriculture, food processing and marketing policy changes are crucial in determining patterns of food consumption because the costs of foods and their availability, rather than policies centred on individual responsibility for consumer choice, are the keys to making coherent public health advances.
Association between chronic undernutrition and hypertension
Authors: Sawaya Ana L. , Sesso Ricardo , Florêncio Telma M. de Menezes Toledo , Fernandes Maria T.B. , Martins Paula A.
Published: June 2005

In developing countries nutritional deficit during prenatal and continuing in post‐natal life is very common. This condition leads to stunting and important metabolic changes. Over 30% of children in the world are stunted. The metabolic resultants of nutritional deficit during growth are classically known to aim at energy conservation. This review summarizes data from Brazil, a developing country undergoing the double burden of obesity and undernutrition, especially among the poor, and suggests that stunting or chronic undernutrition increases the risk of obesity and hypertension later in life. Around 60 million people are under the poverty line in Brazil. In São Paulo, the richest city of the country, 20% of the population live in slums and in Maceió, the capital of one of the poorest states, this percentage reaches 50%. Undernutrition in this population is around 20% among children, with high frequency of infections, anemia, and parasitic infestations, associated with poor sanitation. Among stunted adolescents, we found a high prevalence of hypertension (21%) that is a considerably higher estimate compared to non‐stunted adolescents (less than 10%). The prevalence of hypertension in undernourished pre‐school children, or in those who recovered from undernutrition, was higher than that in controls (29%, 20% and 2%, respectively, P < 0.001). Among stunted adults eating no more than 66% of the requirements (adjusted for stature), overweight/obesity was 35% in women and 25% in men. The prevalence of hypertension was 44% among stunted women and 18% among stunted men. Fifty per cent of stunted and obese women had hypertension. These data reinforce the important association between undernutrition and hypertension from childhood through adulthood. Health policies for preventing and combating childhood undernutrition should have an impact on the morbidity and mortality related to hypertension during adulthood.
The coexistence of child undernutrition and maternal overweight: prevalence, hypotheses, and programme and policy implications
Authors: Garrett James , Ruel Marie T.
Published: June 2005

The purpose of this paper is to document the prevalence of the phenomenon of the coexistence of a stunted child and an overweight mother (SCOWT) in the same household in low‐ and middle‐income countries. We also explore whether this phenomenon is associated with a country's level of economic development and urbanization and highlight policy directions for public nutrition. Data from 36 Demographic and Health Surveys (DHS) were used (23 in Africa, 8 in Latin America, and 5 in Asia). Stunting was defined as height‐for‐age < −2 SD of the reference population and maternal overweight as a body mass index (BMI) of > 25 kg m−2. World Bank and United Nations figures were used for gross national product per capita (an indicator of economic development) and for level of urbanization respectively. Descriptive statistics were derived, and multivariate linear regression analysis was used to model the association between economic development, urbanization and the prevalence of SCOWT. The prevalence of SCOWT is generally below 10%, except in four countries, of which three are in Latin America. Among our sample of countries, SCOWT is generally more prevalent in Latin America than in Africa, and is near or below 5% in all five countries of Asia. Contrary to our expectations, SCOWT is not necessarily more prevalent in urban than rural areas. We also find that when economic development is controlled for, SCOWT is associated with urbanization only in Latin America. In Africa and Asia, SCOWT is associated with economic development, but not urbanization. The concrete recognition of the SCOWT phenomenon is an important step to delineating more effective and integrated strategies to address problems of over‐ and undernutrition and dietary quality within countries, regions and households. This gives special importance to designing programmes and policies that will address the food and nutrition needs of each individual, rather than assuming that those needs are addressed by targeting programmes or policies to the household as a whole.
The Literacy and Social Inclusion Project: a new model for building parental skills
Authors: Bird Viv
Published: June 2005

This article describes the Literacy and Social Inclusion Project, a partnership between the National Literacy Trust and the Basic Skills Agency, which looked specifically at home and community approaches to literacy teaching. It presents a model for building parental skills and considers the policy implications of this initiative.
How we started: the family literacy programme in Slovenia
Authors: Knaflic Livija
Published: June 2005

Different research on literacy demonstrates that the family has an important impact on literacy in general and it seems that there may be an inter‐generational transfer of literacy level and reading habits within families. In order to compensate for lack of encouragement of reading at home, different initiatives have been developed involving work with children and adults, because of their stronger influence on the whole family. The more effective methods are those that include members of the same family, especially parents and children. The Slovenian Institute for Adult Education has developed a family literacy programme for parents and their children called ‘Read and Write Together’. This is aimed at parents with a low standard of education who have children in the initial years of elementary school. At that time, parents are very motivated to help their children to succeed at school, but their own basic skills need some refreshment before they are able to help their children. The school programme involves two teachers, 50 hours of organised schoolwork and 25 hours of planned homework.
‘A place of their own’: creating a classroom ‘third space’ to support a continuum of text construction between home and school
Authors: Cook Margaret
Published: June 2005

This paper uses aspects of ‘third space’ theory to support the use of site‐based classroom role play as a means of ensuring continuity of text construction between home and school. A hypothetical continuum of text construction between home and school is described, and it is suggested that schools wishing to support this continuum might consider incorporating some home‐type contexts and pedagogies into classroom practice. A model of site‐based role play is described that aims to do this by setting up an actual third space in primary classrooms, together with some of the educational outcomes of the model's implementation. Implications for schools and family learning programmes are briefly discussed. In conclusion, the paper argues that if we want curriculum continuity between home and school, we need to create ‘third spaces’ in schools that bring together the experiences and pedagogies of both.
Cost‐effective faster wound healing with a sustained silver‐releasing foam dressing in delayed healing leg ulcers – a health‐economic analysis
Authors: Scanlon Elizabeth , Karlsmark Tonny , Leaper David J , Carter Kate , Poulsen Peter B , Hart‐Hansen Kristian , Hahn Tina W
Published: June 2005

The aim of this analysis was to examine the cost‐effectiveness of Contreet Foam (A) in comparison with three other commonly used venous leg ulcer treatment protocols: Aquacel Ag (B), Actisorb Silver (C) and Iodoflex (D). A health‐economic analysis reflecting the UK treatment practice and cost structure was performed. The analysis was set up to assess the cost of relative wound area reduction over a 4‐week treatment period. The model was validated by a UK expert panel consisting of four wound care specialists. To assure that the 4‐week model had a realistic link to cost‐effectiveness of complete wound healing, a Markov analysis was also performed. Sensitivity analyses were carried out to ensure validity. Protocol A and C proved to be the most effective treatments. The mean relative reduction in wound area after 4 weeks of treatment was 50·2% (protocol A), 23·9% (protocol B), 44·6% (protocol C) and 36·0% (protocol D). Cost‐effectiveness ratios showed that protocol A proved to be the most cost‐effective treatment, and protocol B the least. The cost per percentage reduction in wound area was £9·50 for protocol A, compared to £16·50–17·60 for the other treatment options. The cost‐effectiveness of complete healing (Markov analysis) and sensitivity analyses confirmed these results. Using Contreet Foam instead of the other dressing alternatives may imply savings of £2·2–4·4 million per year to the National Health Service.
Dystrophic calcification as a cause for non healing leg ulcers
Authors: Enoch Stuart , Kupitz Susanne , Miller David R , Harding Keith G
Published: June 2005

Despite advances in molecular biology and a repertoire of other therapeutic options, chronic venous leg ulcers remain a significant problem within our society. There are various reasons, both local and systemic, which contribute to the non healing nature of such wounds. Among them, dystrophic calcification (DC) or calcified deposits within the ulcer bed, although rare, is an overlooked and a seldom reported cause. In the presence of DC, wound healing cannot proceed through a timely and orderly manner resulting in a non healing ulcer. In this article, we discuss the aetiology, pathophysiology and the management options of this rarely reported condition. We also report their clinical prognosis using a series of patients with venous ulcers complicated by DC leading to difficulties in healing.
Wound healing university diplomas in France: an impact measurement after 6 years
Authors: Meaume Sylvie , Téot Luc , Dereure O
Published: June 2005

An educational programme in wound healing was developed in France in 1998. The course lasts for 1 year and consists of 100 hours of interactive education including wound‐healing principles, management of pressure ulcers, leg ulcers, diabetic foot ulcers, burns and trauma. The programme mixes theoretical and practical issues and results in the award of a diploma that identifies students as having a level of expertise in wound healing. A large component of each student's evaluation is based on a thesis that has been developed by the student during the year. After 6 years of continual development and modification, this educational approach was analysed to evaluate its impact on wound healing in France. More than 500 individuals have been trained by this educational programme, including nurses, physicians, pharmacists, physiotherapists and employees of commercial concerns. In order to evaluate the impact of such a training programme on changing practice in France, a questionnaire was developed and a telephone survey carried out. The results of this survey are reported here and they show that education and training provided undertaking a university diploma has played an important role in the development of wound healing and the subsequent change in practice in France.
Silver‐containing alginate fibres and dressings
Authors: Qin Yimin
Published: June 2005

Silver is a broad‐spectrum antimicrobial agent that is gaining more and more importance in the wound‐management industry. By incorporating silver ions into alginate fibres, highly absorbent alginate wound dressings with antimicrobial properties can be made. Laboratory studies have shown that by incorporating fine particles of silver sodium hydrogen zirconium phosphate, the silver‐containing alginate fibres can maintain the white physical appearances while providing a sustained release of silver ions when in contact with wound exudates. Test results have proven that these fibres are highly effective against bacteria.