bluuebunny/crossref_metadata_2025 huggingface dataset:
Parent physical punishment and child aggression in a Singapore Chinese preschool sample
Authors: Ngee Sim Tick , Ping Ong Lue
Published: January 2005

We examine how parental physical punishment (caning and slapping) and child aggression are related, and possible moderation by authoritative control and rejection. A sample of 286 Singapore Chinese preschoolers ages 4–6 reported on rejection; their parents reported on control, caning, and slapping; and their teachers rated child aggression. Results show that father caning is related to aggression, regardless of child gender, whereas mother caning is related to child aggression only at low rejection. Mother slapping is related to sons’ aggression, whereas father slapping is related to daughters’ aggression only at low rejection. Control does not moderate any of the punishment‐aggression links. The punishment‐aggression link is thus a complex one, dependent on the dyad, the punitive act, and the parent's behavior.
Parental involvement and young women's contraceptive use
Authors: Frisco Michelle L.
Published: January 2005

Young adult women in the United States tend to delay family formation, pursue higher education and professional jobs, and become sexually active before marriage. Using effective contraception is the best way to ensure that nonmarital parenthood does not disrupt educational and career plans. Because parental involvement in education shapes teenagers’ attitudes about school and work by encouraging achievement and by providing a home environment that values education, this study assesses whether it may also influence contraceptive choices during early adulthood. Analysis of data from 3,828 young women who participated in the National Education Longitudinal Study indicates that parental involvement not only increases the odds that young adult women use contraception, but it is also tied to the likelihood of using specific birth control methods.
The contribution of social support to the material well‐being of low‐income families
Authors: Henly Julia R. , Danziger Sandra K. , Offer Shira
Published: January 2005

We hypothesize that the social support available from low‐income networks serves primarily a coping function, rather than a leverage function. Social support and its relationship to material well‐being is assessed in a sample of 632 former and current welfare recipients. Respondents report higher levels of perceived emotional, instrumental, and informational support than perceived financial support, and received financial aid is particularly uncommon. Multivariate findings demonstrate that perceived support is unrelated to employment quality, but it reduces the likelihood of living in poverty and is associated with three different measures of coping. These findings generally support the contention that informal aid is important for the everyday survival of low‐income families, but is less able to assist with economic mobility.
Economic hardship in the family of origin and children's psychological well‐Being in adulthood
Authors: Sobolewski Juliana M. , Amato Paul R.
Published: January 2005

Past research consistently indicates that poverty and economic hardship have negative consequences for children. Few studies, however, have examined whether these consequences persist into adulthood. This study addresses this gap by assessing whether economic resources in the family of origin have long‐term effects on psychological well‐being in adulthood. Specifically, we test two processes—one involving interpersonal processes in the family of origin, and the other involving children's socioeconomic attainment—that may help to explain the link between early economic factors and later well‐being. Using 17‐year longitudinal data from two generations (N= 589), we find evidence that economic hardship in the family of origin predicts later adult well‐being through the parents’ marital relationship, the parent‐teen relationship, children's educational attainment, and children's earned income. Supplementary analyses suggest that economic hardship is particularly problematic when it is of long duration or when it occurs during adolescence.
Sharing roles, sharing custody? Couples’ characteristics and children's living arrangements at separation
Authors: Juby Heather , Le Bourdais Céline , Marcil‐Gratton Nicole
Published: January 2005

This article examines children's living arrangements when parents separate, during a period of rapid increase in shared physical custody in the 1990s. With prospective data from the National Longitudinal Survey of Children and Youth (N= 758 families) and a sample of families experiencing parental separation between successive survey cycles, we use multinomial logistic regression techniques to explore how characteristics of parents in intact families (mother's employment, income, and so on) influence physical custody outcomes at separation. Findings indicate that although the way couples share roles while living together has a strong influence on how they divide responsibilities when they separate, other factors also have important roles to play.
Equal access to income and union dissolution among mainland Puerto Ricans
Authors: Oropesa R. S. , Landale Nancy S.
Published: January 2005

This study investigates the implications for union stability of different methods for providing access to income in cohabiting and marital unions among mainland Puerto Ricans. Using the Puerto Rican Maternal and Infant Health Study (N = 836), we show that union dissolution is associated with both union type and type of method. The relatively high rate of union dissolution among cohabiters is explained partially by their lower likelihood of organizing access to income under an equality principle through income pooling. Cohabiting unions that follow the equality principle, however, are as stable as marital unions that follow the equality principle. These patterns are interpreted in terms of the role of economic equality in solidifying socioemotional bonds.
The psychological consequences of midlife men's social comparisons with their young adult sons
Authors: Carr Deborah
Published: January 2005

I examine how midlife men (N= 542) compare their work and family lives with those of their young adult sons, and how these comparisons affect the fathers’ self‐evaluations. Analyses are based on quantitative and qualitative data from the Wisconsin Longitudinal Study. Fathers who rate their work lives as more successful than their sons’ have elevated self‐esteem only when they also report beingvery closewith their children. Open‐ended interviews reveal that men derive pride from financially supporting their families, yet normative and economic constraints of the “good provider” role prevented them from pursuing their own career aspirations and from maintaining close parent‐child ties. Intergenerational social comparisons highlight the distinctive work and family constraints felt by the midlife fathers.
Interleukin‐4 and Dexamethasone Counterregulate Extracellular Matrix Remodelling and Phagocytosis in Type‐2 Macrophages
Authors: Gratchev A. , Kzhyshkowska J. , Utikal J. , Goerdt S.
Published: January 2005

Alternatively activated macrophages (Mφ2) are induced by Th2 cytokines and by glucocorticoids (GC), and can be distinguished from classically activated effector macrophages (Mφ1) on the basis of their anti‐inflammatory properties. In addition, Mφ2 are involved in Th2/Th1 skewing, enhance antigen uptake and processing and support tissue remodelling and healing. In order to elucidate the heterogeneity of Mφ2 population systematically, we analysed a number of genes involved in extracellular matrix (ECM) remodelling, inflammation and phagocytosis in Mφ2 populations generated with interleukin‐4 (IL‐4) or GC. Using real‐time polymerase chain reaction, we demonstrated that the ECM component, tenascin‐C, is stimulated by IL‐4, whereas it is suppressed by dexamethasone. The ECM remodelling enzymes – MMP‐1 and MMP‐12 – and tissue transglutaminase (TG) showed a similar regulation pattern. FXIIIa, another putative Mφ2‐associated TG, was synergistically regulated by IL‐4 and GC. Enzyme‐linked immunosorbent assay analysis revealed that the production of Mφ2‐associated chemokines, AMAC‐1, MCP‐4 or TARC, was induced by IL‐4 and was modulated by GC. Phagocytosis of opsonized and non‐opsonized particles was stimulated by GC, whereas IL‐4 had only a modulatory effect, what may be partially explained by the expression pattern of hMARCO, a scavenger receptor for non‐opsonized particles, that was strongly and selectively induced by GC. In conclusion, stimulation of Mφ with IL‐4 and GC regulate antagonistically the expression of ECM remodelling‐related molecules and phagocytosis of opsonized and non‐opsonized particles.
Cytokine Gene Polymorphisms and Genetic Association with Coeliac Disease in the Finnish Population
Authors: Woolley N. , Mustalahti K. , Mäki M. , Partanen J.
Published: January 2005

Coeliac disease (CD) is an intestinal disorder caused by intolerance to dietary gluten in susceptible individuals. The HLA‐DQ genes are major risk factors for CD, but other genes also play an important role in the disease susceptibility. Immune‐mediated mechanisms are known to underlie the pathogenesis of CD. We studied single‐nucleotide polymorphisms in transforming growth factor (TGF)‐β1, interleukin (IL)‐10, IL‐6, interferon (IFN)‐γ and tumour necrosis factor (TNF)‐α genes in the Finnish population using family‐based association approach. In addition, we genotyped a trinucleotide repeat polymorphism in the major histocompatibility complex (MHC) class I chain‐related protein A (MICA) gene, located in the human leucocyte antigen (HLA) region in the vicinity of TNF‐α. To control the effect of linkage disequilibrium between HLA‐DQ genes and MICA and TNF‐α, an HLA‐stratified association analysis was performed. We did not find evidence of association between TGF‐β1, IL‐10, IL‐6 and IFN‐γ polymorphisms and CD susceptibility. No association was found for any of the MICA alleles independently of DQ genes, whereas TNF‐α−308 A allele was slightly overrepresented on chromosomes carried by CD patients compared with control chromosomes, indicating that either TNF‐α, or another gene in linkage disequilibrium with it, could confer increased susceptibility to CD. This result supports the earlier findings that the HLA region harbours a novel susceptibility factor in addition to HLA‐DQ.
Clinical Isolates of Staphylococcus aureus Vary in Ability to Stimulate Cytokine Expression in Human Endothelial Cells
Authors: Strindhall J. , Lindgren P.‐E. , Löfgren S. , Kihlström E.
Published: January 2005

Human umbilical vein endothelial cells (HUVEC) were infected for 24 h with 18 well‐characterized Staphylococcus aureus isolates, and the supernatants from infected HUVEC were analysed for interleukin (IL)‐1β, tumour necrosis factor‐alpha, IL‐6, IL‐8, IL‐10, IL‐12p70, growth‐related oncogene (GRO)‐α, granulocyte macrophage colony‐stimulating factor (GM‐CSF) and regulated upon activation, normal T cell expressed and secreted (RANTES) by immunoassay. All staphylococcal isolates induced the expression of IL‐6, IL‐8, GRO‐α, GM‐CSF and RANTES. The magnitude of cytokine expression varied between isolates. Staphylococcus aureus inducing high expression of one of these cytokines also showed simultaneous high expression of the other four, indicating a common mechanism for the ability of individual S. aureus to induce expression of these cytokines. No direct correlation between cytokine expression and adhesion of S. aureus to HUVEC was observed, indicating that bacterial properties besides adhesion contribute to the activation of HUVEC.
Accumulation of Catalytically Active Proteases in Lacrimal Gland Acinar Cell Endosomes During Chronic Ex Vivo Muscarinic Receptor Stimulation
Authors: Rose C. M. , Qian L. , Hakim L. , Wang Y. , Jerdeva G. Y. , Marchelletta R. , Nakamura T. , Hamm‐Alvarez S. F. , Mircheff A. K.
Published: January 2005

Chronic muscarinic stimulation induces functional quiescence (Scand J Immunol 2003;58:550–65) and alters the traffic of immature cathepsin B (Exp Eye Res 2004;79:665–75) in lacrimal acinar cells. To test whether active proteases aberrantly accumulate in the endosomes, cell samples were cultured 20 h with and without 10‐µm carbachol (CCh), incubated with [125I]‐bovine serum albumin and then lysed and analysed by subcellular fractionation. CCh decreased total cysteine protease and cathepsin S activities in the isolated lysosome, redistributing them to early endocytic and biosynthetic compartments. CCh decreased [125I] accumulation in all compartments of cells loaded in the absence of protease inhibitors; the cysteine protease inhibitor, leupeptin, prevented the endosomal decrease but not the lysosomal decrease. Sodium dodecyl sulphate‐polyacrylamide gel electrophoresis and autoradiography demonstrated [125I]‐labelled proteolytic products in endomembrane compartments of both control and CCh‐stimulated cells, even in the presence of leupeptin, but analysis indicated that CCh increased the amount in endosomes. Two‐dimensional fractionation analyses suggest that the CCh‐induced redistributions result from blocks in traffic to the late endosome from both the early endosome and the trans‐Golgi network. Therefore, we conjecture that chronic muscarinic acetylcholine receptor stimulation leads to aberrant proteolytic processing of autoantigens in endosomes, from whence previously cryptic epitopes may be secreted to the underlying interstitial space.
Reconstitution of the Ig Heavy Chain CDR3 Repertoire after Allogeneic Haematopoietic Stem Cell Transplantation with Myeloablative or Reduced‐Intensity Conditioning Regimens
Authors: Omazic B. , Hentschke P. , Näsman‐Björk I. , Mattsson J. , Oxelius V.‐A. , Ringdén O. , Barkholt L. , Permert J. , Lundkvist I.
Published: January 2005

The objective of this study was to investigate B‐lymphocyte reconstitution in patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) after myeloablative conditioning (MAC) or reduced‐intensity conditioning (RIC) regimens. B‐lymphocyte reconstitution was studied by monitoring the CDR3 repertoire with spectratyping. We demonstrate a delay in the recovery of the B‐lymphocyte repertoire, measured by variation in size distribution of the immunoglobulin H CDR3 in patients conditioned with RIC compared to MAC. We found no general explanation for this finding, but when clinical data for each patient were studied in detail, we could identify a cause for the oligoclonality of the B‐lymphocyte repertoire after HSCT with RIC for each of the patients. Older patients and donors, low cell dose at transplantation, relapse, graft‐versus‐host disease (GVHD) and its treatment as well as cytomegalovirus infection and its treatment are all possible causes for the restriction of the B‐lymphocyte repertoire observed in this study. Taken together, reconstitution of the B‐lymphocyte repertoire after HSCT is a process dependent on multiple factors and differs between patients. The conditioning regimen may be of importance, but data from this study suggest that individual factors and the various complications occurring after HSCT are more likely to determine the development of the B‐lymphocyte repertoire.
Interleukin (IL)‐4, IL‐10, IL‐18 and IFN‐γ Cytokines Pattern in Patients with Combined Hepatitis C Virus and Schistosoma mansoni Infections‡
Authors: M. El‐Kady I. , Lotfy M. , Badra G. , El‐Masry S. , Waked I.
Published: January 2005

Schistosoma mansoni infection is characterized by a strong T‐helper type 2 (Th2) cell‐associated immune response, but in the case of viral infection, it is associated with interferon‐gamma (IFN‐γ) increase and induction of Th1 immune response. Few data are available about the immune response of cases infected with combined hepatitis C virus (HCV) and schistosomiasis. Thus, the investigation of the cytokine pattern in patients coinfected with both HCV and Schistosoma mansoni was our rationale. This study included four patient groups: Group 1 included 20 patients infected with chronic HCV, Group 2 included 15 patients infected with schistosomiasis alone, Group 3 included 20 patients with chronic HCV and schistosomiasis and Group 4 included 15 healthy control individuals with matched age and sex. Serum levels of IFN‐γ, interleukin (IL)‐4, IL‐10 and IL‐18 were measured in all groups by enzyme‐linked immunosorbent assay. The results showed that the patients infected with HCV had significantly higher serum levels of IFN‐γ and IL‐18 compared with the controls and with the patients with schistosomiasis and coinfection (P < 0.001). On the other hand, serum levels of IL‐4 and IL‐10 were significantly higher in patients with schistosomiasis and coinfection compared with the control group (P < 0.001 and 0.0001, respectively) and with the HCV patients (P < 0.05 and P < 0.001, respectively). A significant increase in serum levels of IL‐4 and IL‐10 was also found in HCV patients compared with the control (P < 0.05). Schistosomiasis appears to induce a Th2 cytokine profile, with increase in serum levels of IL‐4 and IL‐10, even in the presence of HCV coinfection. In conclusion, schistosomiasis may downregulate the stimulatory effect of HCV on Th1 cytokines and this may lead to the chronicity of HCV infection in coinfected patients.
Dietary Antigen‐Specific T‐Cell Responses: Switch from an Interleukin‐10‐Dominated Response in Normal Mice to a T‐Helper 1 Cytokine Profile in Gαi2‐Deficient Mice prior to Colitis
Authors: Bjursten M. , Hultgren Hörnquist E.
Published: January 2005

We investigated dietary antigen‐specific T‐cell responses in mesenteric lymph nodes (MLN) and Peyer's patches (PP) in noncolitic control mice as well as in colitis‐prone mice prior to onset of histological active colitis. T cells were restimulated in vitro with constituents isolated from the mouse diet. Interestingly, MLN T cells of littermate Gαi2+/– control mice responded to soya with high production of interleukin (IL)‐10, but did not produce proinflammatory T‐helper 1 (Th1) cytokines. Recall dietary antigen stimulation of Gαi2+/– PP T cells did not result in increased IL‐10 production above the spontaneous production in the absence of antigenic stimulation. In strong contrast, MLN T cells from precolitic Gαi2–/– mice produced high levels of interferon‐gamma (IFN‐γ) upon restimulation with soya, which could be abolished using a major histocompatibility complex class II‐blocking antibody. In conclusion, the present study demonstrates that MLN T lymphocytes in normal healthy mice respond with a significantly increased production of the regulatory cytokine IL‐10 on re‐encounter with dietary proteins in vitro. In marked contrast precolitic Gαi2–/– mice respond to dietary antigens with a Th1‐dominated cytokine response in the mucosa, prior to onset of colitis, with excessive IFN‐γ production. These results suggest that aberrant immune responses to dietary antigens could contribute as a potential pathogenic mechanism in the onset of colitis in Gαi2‐deficient mice.
A Novel Model of Fibroblast‐Mediated Cartilage Destruction
Authors: Sack U. , Hirth A. , Funke B. , Wiedemeyer K. , Lange F. , Tröltzsch M. , Tannapfel A. , Gebhardt R. , Emmrich F. , Lehmann J.
Published: January 2005

In rheumatoid arthritis (RA), fibroblasts have been shown to be crucial for disease progression as well as joint destruction. In the model of human/murine SCID arthritis, synovial explants as well as fibroblasts from human rheumatoid synovial membrane induce destructive arthritis in immunodeficient mice. Hereby, the underlying cartilage destruction is accomplished by murine fibroblasts. Therefore, murine destructive fibroblasts represent a promising tool to investigate destruction of articular cartilage and bone. In this context, a novel destructive murine fibroblast line (LS48) was examined for morphological, ultrastructural, immunological and functional cellular parameters. These cells were injected into knees of SCID mice. Subsequently, the animals were monitored for joint swelling and serological parameters of arthritis by radiological methods. Finally, cartilage destruction was assessed morphologically. Cultured LS48 cells exhibit characteristic features that resemble those of activated synovial fibroblasts in human RA. Expression levels of inducible nitric oxide synthase, interleukin‐6, tumour necrosis factor‐α and matrix metalloproteinases were comparable to those detected in invasive human fibroblasts. The instillation of 5 × 105 LS48 cells into the knee joints of SCID mice initiated a rapid progressive process, that caused cartilage destruction within 10 days, and morphological examinations revealed that articular cartilage was infiltrated by the fibroblasts injected previously. In summary, the intra‐articular application of LS48 cells represents a rapid and highly reproducible model to investigate the initiation and progression of cartilage destruction in connection with RA therapy and represents an easy‐to‐handle animal model.
Increased Frequency of Antral CD4+ T and CD19+ B Cells in Patients with Helicobacter pylori‐Related Peptic Ulcer Disease
Authors: Goll R. , Husebekk A. , Isaksen V. , Kauric G. , Hansen T. , Florholmen J.
Published: January 2005

Only a fraction of Helicobacter pylori (HP)‐infected individuals develop clinical disease. Recent research indicates that immunological mechanisms may be important for understanding the pathophysiology of HP infection. Differences in the individual cellular immune response may reflect the clinical diversity. The aim of the present study was to investigate the cellular immune response against HP in three clinically well‐defined patient groups: HP‐positive peptic ulcer, HP‐positive and HP‐negative gastritis. Biopsies from gastric mucosa were processed for analysis by flow cytometry and histology. The number of T lymphocytes (CD3+) was significantly higher in HP‐positive peptic ulcer (13.8%) than in HP‐positive nonulcer gastritis (6.3%). A nonsignificant increase for B lymphocytes (CD19+) was noted as well. Furthermore, a significant difference was seen in mucosal CD4/CD8 ratio between HP ulcer (2.4) and nonulcer HP gastritis (1.0) patients. Thus, B cells (CD19+) and T‐helper cells (CD4+) were dominant in gastric mucosa from peptic ulcer patients, and cytotoxic T cells (CD8+) were relatively dominant in gastric mucosa from nonulcer patients. In conclusion, distinct differences in the T‐cell subset distribution of mucosal lymphocytes were detected in patients with HP infection, strongly correlated with the presence or absence of peptic ulcer.
Immunohistochemistry of the B‐Cell Component in Lower Lip Salivary Glands of Sjögren's Syndrome and Healthy Subjects
Authors: Larsson Å. , Bredberg A. , Henriksson G. , Manthorpe R. , Sallmyr A.
Published: January 2005

Serial sections of lower lip salivary gland (LSG) biopsies were examined by immunohistochemistry, using a battery of B‐ and partly T‐related antibodies (CD5, CD20, CD21, CD27, CD38, CD45RO, CD79a, Bcl‐2 and Bcl‐6) in different groups of subjects: healthy controls and clinically verified smoking or nonsmoking cases of primary Sjögren's syndrome (SS). The purpose was to characterize the B‐cell pattern of the lymphocytic foci and of the tiny perivascular infiltrates preceding the development of foci. Hyperplastic tonsil was used as stain control. In normal LSG, widely dispersed CD38+ and CD79a+ as well as some CD5+ cells are a normal constituent, with lack of staining with the other antibodies. In SS/LSG, the lymphocytic foci showed staining with all the antibodies, with variable degrees of overlapping or nonoverlapping. In SS/LSG of nonsmokers, CD20+ B cells make up a prominent part of the fully developed periductal lymphocytic foci, not overlapping with CD45RO. Also, CD20+ B cells did not overlap in the infiltrates with colocalized CD27+/CD38+ cells. CD20+ B cells and CD45RO+ T cells also occur as minute infiltrates perivascularly in areas of no foci in SS/LSG as well as in SS smokers lacking the typical foci. Smokers lack foci, but tiny infiltrates express CD20 as well CD45R0. Our findings suggest that CD20+ B cells and CD45RO+ T cells are early immigrants in the LSG of SS of smokers as well as nonsmokers and that another subgroup of CD27+/CD38+ B cells gradually mix with the first two to form the characteristic foci in SS/LSG. The simultaneous demonstration of CD20+ and CD27+ B cells in SS/LSG may constitute a significant diagnostic tool. Further, the findings suggest that the early immigrating lymphocytes may have been primed at a site remote from the glands before arriving via the blood to the gland tissue.
STOCHASTIC HYPERBOLIC DYNAMICS FOR INFINITE‐DIMENSIONAL FORWARD RATES AND OPTION PRICING
Authors: Aihara Shin Ichi , Bagchi Arunabha
Published: January 2005

We model the term‐structure modeling of interest rates by considering the forward rate as the solution of a stochastic hyperbolic partial differential equation. First, we study the arbitrage‐free model of the term structure and explore the completeness of the market. We then derive results for the pricing of general contingent claims. Finally we obtain an explicit formula for a forward rate cap in the Gaussian framework from the general results.
EXISTENCE OF AN EQUILIBRIUM WITH DISCONTINUOUS PRICES, ASYMMETRIC INFORMATION, AND NONTRIVIAL INITIAL σ‐FIELDS
Authors: Hillairet Caroline
Published: January 2005

In this paper, we solve the problems of optimization and equilibrium on a continuous‐time financial market with discontinuous prices, in which agents have different random endowments and different information on the structure and future behavior of the prices. Our purpose is to go over and to extend the work of Pikovsky and Karatzas (1996) by using the theory developed by Amendinger (2000) about martingale representation theorems for initially enlarged filtrations, and to generalize the results in the case of discontinuous prices.
A QUANTIZATION TREE METHOD FOR PRICING AND HEDGING MULTIDIMENSIONAL AMERICAN OPTIONS
Authors: Bally Vlad , Pagès Gilles , Printems Jacques
Published: January 2005

We present here the quantization method which is well‐adapted for the pricing and hedging of American options on a basket of assets. Its purpose is to compute a large number of conditional expectations by projection of the diffusion on optimal grids designed to minimize the (square mean) projection error (Graf and Luschgy 2000). An algorithm to compute such grids is described. We provide results concerning the orders of the approximation with respect to the regularity of the payoff function and the global size of the grids. Numerical tests are performed in dimensions 2, 4, 5, 6, 10 with American style exchange options. They show that theoretical orders are probably pessimistic.
A NOTE ON NONAFFINE SOLUTIONS OF TERM STRUCTURE EQUATIONS WITH APPLICATIONS TO POWER EXCHANGES
Authors: Teichmann Josef
Published: January 2005

A method based on transformations of well‐known solutions of term structure equations is presented in order to incorporate Martin Barlow's spot price model for electricity into a model for future prices on electricity. The setting for the evolution of term structures is chosen in the spirit of Da Prato and Zabczyk.
Cognitive Mapping as an Emergency Management Training Exercise
Authors: Alexander David E.
Published: January 2005

This paper describes a scenario‐based, table‐top exercise which was given to a variety of postgraduate university classes in emergency preparedness and to some groups of trainee disaster managers. Participants in the exercise were asked to draw maps of a developing crisis situation and suggest a set of tactics for managing it. The results were analysed using theories of cognitive mapping. They showed that seven distinct kinds of map emerged from the sample of 67 collected. These were labelled well‐defined, systematic, emblematic, ill‐defined (cryptic), compressed, diagrammatic (ideographic) and mirror image. About 60 per cent of the maps depicted the majority of the elements, while the remaining 40 per cent were lacking in detail to varying degrees. The cognitive maps therefore introduced distortions into the representation of elements, and these were negatively correlated with the abilities, experience, knowledge and training of their authors, as manifested by their other work in the classroom. The extraordinary variety of perceptions of space and place during emergencies has considerable implications for how such events are managed during the crisis phase.
Respecting the Margins of Agency: Alzheimer's Patients and the Capacity to Value
Authors: JAWORSKA AGNIESZKA
Published: January 2005

[A] man does not consist of memory alone. He has feeling, will, sensibilities, moral being…. And it is here … that you may find ways to touch him.

—A. R. Luria1
Rifabutin‐ and furazolidone‐based Helicobacter pylori eradication therapies after failure of standard first‐ and second‐line eradication attempts in dyspepsia patients
Authors: Qasim Asghar , Sebastian Shaji , Thornton Orla , Dobson Mark , McLoughlin Ramona , Buckley Martin , O'Connor Humphrey , O'Morain Colm
Published: January 2005

Background : Optimal management approach is not well defined for subjects who fail initial first‐ and second‐line Helicobacter pylori eradication attempts and are dealt on a case‐by‐case basis by the specialists.

Aim:  To evaluate the efficacy and safety of standard and ‘rescue’ eradication therapies at primary and secondary care levels.

Methods : H. pylori infected dyspepsia patients referred to our C13 urea breath testing laboratory between January 1999 to February 2002 were included. Eradication failure at secondary care level was treated using strategies including antibiotic sensitivity testing and the use of rifabutin‐ and furazolidone‐based therapies.

Results : 3280 patients received standard first‐line eradication therapy, which was successful in 2530 (77%) patients. Second‐line therapy (bismuth‐based ‘quadruple’) or triple therapy (altering constituent antibiotics) was successful in 56% of 270 treated patients. Subsequent eradication attempts using rifabutin‐based (n = 34) and furazolidone‐based (n = 10) regimens were successful in 38% and 60% patients respectively. H. pylori eradication rates were significantly different for guidelines compliant (94.8%) and non‐compliant (82%) groups (P = 0.0001). H. pylori eradication rates for non‐ulcer dyspepsia (40%) and peptic ulcer disease (36%) were not significantly different.

Conclusions : Available H. pylori eradication therapies remain very effective and compliance to guidelines achieves high success rates. Furazolidone‐based ‘rescue’ regimen achieved high eradication rates after failure of the standard first‐line, second‐line and rifabutin‐based therapies.
Standard treatment for Helicobacter pylori infection is suboptimal in non‐ulcer dyspepsia compared with duodenal ulcer in Chinese
Authors: Wong W. M. , Xiao S. D. , Hu P. J. , Wang W. H. , Gu Q. , Huang J. Q. , Xia H. H.‐X. , Wu S. M. , Li C. J. , Chen M. H. , Cui Y. , Lai K. C. , Hu W. H. C. , Chan C. K. , Lam S. K. , Wong B. C.‐Y.
Published: January 2005

Background : Recent studies suggest that the Helicobacter pylori eradication rate in patients with non‐ulcer dyspepsia is lower when compared to patients with peptic ulcer diseases.

Aim : The aim of this study was to study the efficacy of triple therapy for H. pylori infection in patients with duodenal ulcer vs. patients with non‐ulcer dyspepsia.

Methods : A total of 582 Chinese patients with proven H. pylori infection were recruited to receive: omeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg all given twice daily for 7 days (OCA regime). Endoscopy with rapid urease test, histology and culture were performed before treatment. Post‐treatment H. pylori status was determined by 13C‐urea breath test. Metronidazole, clarithromycin and amoxicillin resistance was defined as minimum inhibitory concentration (MIC) of >8 μg/mL, >1 μg/mL and >1 μg/mL, respectively.

Results : A significantly higher (intention‐to‐treat/per‐protocol) eradication rate was found in patients with duodenal ulcer than those with non‐ulcer dyspepsia (91/94% vs. 84/88% respectively, P = 0.011 and P = 0.016). Clarithromycin resistance rate was higher in patients with non‐ulcer dyspepsia than those with duodenal ulcer (14% vs. 6%, P = 0.015). Clarithromycin resistance (40% vs. 5%, P < 0.001, OR 12, 95% CI: 5.7–24.3) and the diagnosis of non‐ulcer dyspepsia (91% vs. 84%, P = 0.011, OR 2.0, 95% CI: 1.2–3.3) significantly affected the success of H. pylori eradication.

Conclusion : Clarithromycin resistance accounts for the significantly lower and suboptimal H. pylori eradication rate of OCA regimen in Chinese patients with non‐ulcer dyspepsia compared to those with duodenal ulcer.
Increased use of low anterior resection for veterans with rectal cancer
Authors: Abraham N. S. , Davila J. A. , Rabeneck L. , Berger D. H. , El‐Serag H. B.
Published: January 2005

Background : Two surgical procedures with curative intent are available to patients with rectal cancer: lower anterior resection and abdominoperineal resection; however, lower anterior resection may improve quality of life and functional status.

Aim : To examine temporal changes in after lower anterior resection and abdominoperineal resection between 1989 and 2000. Potential factors associated with the use of lower anterior resection were evaluated.

Methods : Using national administrative data, we identified patients who received lower anterior resection or abdominoperineal resection. Logistic regression models examined the association between use of lower anterior resection and time period of surgical resection.

Results : A total of 5201 rectal cancer patients underwent resection. The use of lower anterior resection increased from 40.0% (1989–91) to 50.1% (1998–2000) paralleled by a corresponding decline in abdominoperineal resection (60.1 to 49.9%; P < 0.001). Patients who received surgery during 1992–94, 1995–97 and 1998–2000 were 6, 7 and 28% more likely to receive lower anterior resection, when compared with 1989–1991 after adjusting for demographic characteristics, co‐morbidity and hospital surgical volume. Older age, lower co‐morbidity score and lower hospital surgical volume were predictive of lower anterior resection.

Conclusions : An increase in the use of lower anterior resection for rectal cancer was observed over time. This observed increase in use is not confined to high‐volume hospitals.
Clinical trends in ulcer diagnosis in a population with high prevalence of Helicobacter pylori infection
Authors: Pérez‐Aisa M. A. , Del Pino D. , Siles M. , Lanas A.
Published: January 2005

Background : It is unknown whether the incidence of peptic ulcer changes in areas with a high prevalence of Helicobacter pylori infection.

Aim : To determine trends in peptic ulcer complications in a community with a high prevalence of H. pylori infection.

Methods : New endoscopic diagnoses of peptic ulcers and their complications from 1985 to 2000 were obtained. H. pylori infection in the adult population, the number of prescriptions for anti‐secretory drugs and non‐steroidal anti‐inflammatory drugs were also evaluated.

Results : Although the global prevalence of H. pylori infection remains high in this population (>60%), a 41.4 to 25.4% decrease in the incidence of peptic ulcers and ulcer complications was observed. This was associated with a decrease in the prevalence of H. pylori infection in people under 65 years of age, a 3.5‐fold increase in the number of prescriptions of proton‐pump inhibitors and an increase in the number of prescriptions of non‐steroidal anti‐inflammatory drugs, especially coxibs.

Conclusions : In an area with a high prevalence of H. pylori infection, the incidence of peptic ulcer and associated complications is declining rapidly. This was associated with a reduction of the prevalence of H. pylori infection in the young and a widespread use of proton‐pump inhibitors. The increase in the use of non‐steroidal anti‐inflammatory drugs, especially coxibs, has not changed the tendency.
An evaluation of the antireflux properties of sodium alginate by means of combined multichannel intraluminal impedance and pH‐metry
Authors: Zentilin P. , Dulbecco P. , Savarino E. , Parodi A. , Iiritano E. , Bilardi C. , Reglioni S. , Vigneri S. , Savarino V.
Published: January 2005

Background : Alginate‐based preparations act as mechanical antireflux barrier, which can reduce both acid and non‐acid reflux events and limit the proximal migration of oesophageal refluxate.

Aim : To evaluate all the above features with a novel technique, multichannel electrical impedance and pH‐metry.

Methods : Ten reflux patients underwent stationary impedancemetry and pH‐metry after eating a refluxogenic meal. They were studied 1 h in basal conditions and 1 h after taking 10 mL of Gaviscon Advance. In both sessions, measurements were obtained in right lateral and supine decubitus.

Results : Alginate preparation was able to decrease significantly (P < 0.05) the number of acid reflux events and the percentage time pH < 4.0 compared with baseline. There was no effect of the drug on non‐acid refluxes. Gaviscon Advance was also significantly effective (P < 0.05) in reducing the height of proximal migration of reflux events compared with baseline in both decubitus positions.

Conclusions : Our findings explain how Gaviscon Advance controls acid reflux episodes, limits the proximal migration of refluxed material and thereby decreases symptoms in clinical practice.
The value of a general therapeutic approach in subjects with irritable bowel syndrome
Authors: Monsbakken K. W. , Vandvik P. O. , Farup P. G.
Published: January 2005

Background : The general therapeutic approach is the cornerstone in the management of irritable bowel syndrome, but the effect is poorly documented.

Aim : To evaluate the effect of the general therapeutic approach for irritable bowel syndrome.

Methods : Subjects with irritable bowel syndrome identified in a public screening were included. Scores for abdominal symptom (range 0–12), musculoskeletal pain and mood disorders were calculated. After exclusion of other disorders, a doctor presented irritable bowel syndrome as a positive diagnosis, gave information, reassurance and lifestyle advice, but no pharmacotherapy. A dietician gave dietary advice. There was a follow‐up after 6 months.

Results : Sixty‐five persons (females/males: 44/21) with mean age 49 years (range 31–76) were included, 31 (48%) were recommended dietary changes. Twenty subjects (31%) had satisfactory relief of symptoms after 6 months. The scores for abdominal symptom was reduced from 3.1 to 2.2 (P = 0.007), the reduction was 2.2 in the diarrhoea‐predominant group given advice compared with 0.4 in the other subjects (P = 0.035). Previous consultations for the complaints, visits for psychiatric disorders, and presence of mood disorders were predictors of persistent complaints.

Conclusions : There was a significant relief of symptoms after 6 months, those with psychological co‐morbidity responded less well. The effect of dietary advice was only seen in those with diarrhoea‐predominant irritable bowel syndrome.
Impact on postoperative pain of long‐lasting pre‐emptive epidural analgesia before total hip replacement: a prospective, randomised, double‐blind study
Authors: Klasen J. , Haas M. , Graf S. , Harbach H. , Quinzio L. , Jürgensen I. , Hempelmann G.
Published: January 2005

Clinical studies on pre‐emptive analgesia have produced inconsistent results. We conducted a clinical study investigating the effect of long‐lasting pre‐emptive epidural analgesia on consumption of analgesics and acute pain. Forty‐two patients scheduled for elective hip replacement for osteo‐arthritis were randomly assigned to receive, on the day before operation, either 5 ml.h−1 ropivacaine 0.2% (study group, n = 21) or 5 ml.h−1 saline (control group, n = 21). Postoperative analgesia was achieved in both groups by patient‐controlled epidural analgesia (PCEA) with ropivacaine 0.2%. The main outcome measure was consumption of local anaesthetics. Additional parameters included visual analogue pain scale (VAS) scores, consumption of rescue analgesics, requests for PCEA boluses, and side‐effects. The pre‐operative parameters and pain scores were similar in the two groups. Epidural blocks provided sufficient operative analgesia in all patients. Pre‐emptive analgesia was continued for 11–20 h and led to significantly decreased pain scores before surgery. The consumption of local anaesthetics was decreased postoperatively in the study group (194 mg vs. 284 mg in the postoperative period). Furthermore, bolus requests occurred more frequently in the control group. VAS scores did not differ significantly between groups. Long‐lasting ‘pre‐emptive’ epidural analgesia decreases postoperative pain with improved pain control.
Coronary artery angioplasty for treatment of peri‐operative myocardial ischaemia
Authors: Obal D. , Kindgen‐Milles D. , Schoebel F. , Schlack W.
Published: January 2005

Increasing numbers of elderly patients with severe co‐existing medical diseases undergo major surgery. With these patients there is also an accompanying risk of age‐related cardiovascular complications such as life‐threatening myocardial ischaemia. We present a patient who suffered a myocardial infarction after a hemicolectomy and suffered a cardiac arrest in the recovery room. The therapeutic options available (e.g. coronary artery bypass grafting, acute percutaneous coronary angioplasty and peri‐operative thrombolysis) are discussed and the successful management of the case by coronary angioplasty and stent implantation is described.
Nefopam or clonidine in the pharmacologic prevention of shivering in patients undergoing conscious sedation for interventional neuroradiology
Authors: Bilotta F. , Ferri F. , Giovannini F. , Pinto G. , Rosa G.
Published: January 2005

The aim of this randomised, double‐blind study was to investigate the usefulness of intravenous nefopam, clonidine or placebo in preventing shivering in patients undergoing conscious sedation for interventional neuroradiological procedures. A total of 101 patients were prospectively enrolled and assigned to one of three groups to receive nefopam, clonidine or placebo. The overall incidence of intra‐operative shivering was significantly lower in patients treated with nefopam than in those treated with clonidine or placebo (2/32 (6%) vs. 11/38 (29%), p < 0.02; 2/32 (6%) vs. 24/31 (77%), p < 0.0001, respectively). The number of patients who required ephedrine infusions to maintain a mean arterial pressure of 100 mm Hg was higher in the clonidine group than in the nefopam and placebo groups (18/38 (47%) vs. 5/32 (17%), p < 0.05; 18/38 (47%) vs. 6/31 (19%), p < 0.05, respectively). We found that both nefopam and clonidine significantly lowered the rate and severity of shivering during interventional neuroradiological procedures. Fewer patients in the nefopam group than in the other two groups required vasoactive drugs.
Doppler estimation of zero flow pressure during changes in downstream pressure in a bench model of a circulation using pulsatile flow*
Authors: Athanassiou L. , Hancock S. M. , Mahajan R. P.
Published: January 2005

Zero flow pressure is the arterial pressure at which blood flow ceases in the cerebral circulation and may represent the effective downstream pressure of this system. We used a bench model of pulsatile fluid flow to determine whether simulated changes in downstream pressure may be detected by estimation of zero flow pressure. A Doppler probe was used to record flow velocity and a pressure transducer was used to measure driving pressure. Eight different configurations of the circuit were produced, and at each configuration the external pressure around a collapsible segment of the circuit was changed in order to simulate intracranial pressure. Perfusion pressure and zero flow pressure were estimated for each configuration and each level of external pressure. The sensitivity of the model in predicting the change in external pressure from the change in zero flow pressure was 94%. This indicates that estimation of zero flow pressure by this method is a sensitive way of monitoring trends in changes in downstream pressure.
Interaction of arousal states and low dose halothane on the acute hypercapnic ventilatory response in humans
Authors: Pandit J. J. , Moreau B.
Published: January 2005

The purpose of this study was to examine the effect of low dose halothane on the acute ventilatory response to hypercapnia, and to assess whether arousal (due to audiovisual (AV) stimulation or pain) modulates the response to halothane. Single step increases in end‐tidal Pco2 using dynamic end‐tidal forcing were performed from eucapnia (end‐tidal Pco2 held 1 mmHg (0.13 kPa) above ambient) to hypercapnia (end‐tidal Pco2 6 mmHg (0.79 kPa) above ambient) in eight healthy volunteers, with end‐tidal PO2 held at 100 mmHg (13.2 kPa), in six protocols: 1) control conditions (darkened, quiet room, eyes closed) without halothane; 2) control conditions with 0.1 MAC halothane; 3) AV stimulation (bright room, loud television) without halothane; 4) AV stimulation with 0.1 MAC halothane; 5) pain (electrical stimulation of skin over tibia to produce visual analogue pain score 5–6/10) without halothane; 6) pain with 0.1 MAC halothane. Both AV stimulation (p = 0.014) and pain (p = 0.0003) significantly increased the baseline eucapnic minute ventilation modestly (by ∼ 1.5–4 l.min−1). Halothane did not influence the baseline minute ventilation in any arousal state (p = 0.572), nor did it affect the hypercapnic ventilatory response in any arousal state (p = 0.208). Arousal (either AV stimulation or pain) did not affect the ventilatory response to CO2, regardless of the presence or absence of halothane (p = 0.585). We conclude that halothane affects neither baseline minute ventilation nor the response to CO2. Arousal can increase baseline ventilation but has no influence on the ventilatory response to CO2.
Evaluation of ease of intubation with the GlideScope® or Macintosh laryngoscope by anaesthetists in simulated easy and difficult laryngoscopy*
Authors: Lim T. J. , Lim Y. , Liu E. H. C.
Published: January 2005

The GlideScope® is a new video laryngoscope developed for management of the difficult airway. We compared the GlideScope with the Macintosh laryngoscope in simulated easy and difficult laryngoscopy. Twenty anaesthetists were allowed three attempts to intubate in each of four laryngoscopy scenarios in a high fidelity simulator. In the simulated easy laryngoscopy scenarios, the anaesthetists took longer to intubate using the GlideScope than the Macintosh laryngoscope (mean (SD) 19.0 (9.7) s vs. 12.7 (5.9) s, respectively; p = 0.006). There was no difference in the number of successful intubations, ease of intubation or choice of intubating device. In the simulated difficult laryngoscopy scenarios, the anaesthetists took less time to intubate using the GlideScope (23.5 (12.7) s vs. 70.5 (101.2) s, respectively; p = 0.001). The slightly higher success rate with the GlideScope was not statistically significant (20/20 vs. 18/20, respectively; p = 0.5). However, the anaesthetists found it easier to intubate using the GlideScope (median (interquartile range [range]) 1 (1–2 [1–2]) vs. 2 (2–3 [1–3]), respectively; p < 0.0001).
Neuroanaesthetists' experience of workload‐related issues and long‐duration cases
Authors: Willoughby L. , Morgan R.
Published: January 2005

A survey of the members of the Neuroanaesthesia Society of Great Britain and Ireland was conducted to examine issues arising from the management of long cases. Replies were received from 47% of neuroanaesthetists. The survey highlights that consultants are working for prolonged periods without adequate rest. This may compromise patient safety, job satisfaction and recruitment to the specialty. These pressures are likely to increase as the European Working Time Directive reduces the availability of trainees, and because of expansion in neurosurgery and neuroradiology. Similar concerns are likely to extend into other anaesthetic specialties with long‐duration cases and may apply to our surgical colleagues.