bluuebunny/crossref_metadata_2025 huggingface dataset:
Review : Grand Rounds from International lupus centres Severe reversible cardiomyopathy associated with systemic vasculitis in primary Sjögren's syndrome
Authors: Golan TD , Keren D. , Elias N. , Naschitz JE , Toubi E. , Misselevich I. , Yeshurun D.
Published: November 2007

A 40y old woman with primary Sjögren's syndrome developed elevated purpura, peripheral neuropathy, muscular tenderness, abdominal pain, heart failure, and convulsive spells. The hallmarks of this disease were high titers of anti-Ro antibodies and low complement levels in the serum, leukocytoclastic small vessel vasculitis in the cutaneous biopsy specimen, and a life threatening clinical course. Echocardiography revealed left ventricular hypokinesis with low ejection fraction, which is unlike the more common features of cardiomyopathy complicating Sjögren's syndrome. The rapidly deteriorating heart failure and other systemic complications remitted on pulse corticosteroid and cyclophosphamide therapy. The pathogeneis of heart failure, which appeared concurrently with vasculitis and was reversed on immunosuppressive therapy, is explained in the context of the systemic disease. Leukocytoclastic vasculitis might be at the origin of this rare variant of acute, severe but reversible cardiomyopathy in pSS.
Occasional Series—Lupus Around the World Systemic lupus erythematosus in India
Authors: Malaviya AN , Chandrasekaran AN , Kumar A. , Shamar PN
Published: November 2007

The first case of systemic lupus erythematosus (SLE) was reported from India in 1955 followed by two more case reports and further, a series of eight cases, till 1969. Since the establishment of a clinical immunology laboratory at a major teaching institution in New Delhi in 1968, SLE was extensively studied and reported from that centre. From mid-1980 onwards several other centres in different regions in India including Chennai (old name Madras), Mumbai (old name Bombay), Calcutta and Hydrabad, also published their regional experience on SLE. Based on these data, the present report describes the clinical and laboratory characteristics of 1366 SLE patients seen in different regions of India. Arthritis, rash, photosensitivity, seizures and psychosis were seen in comparable proportions to other racial groups. Similarly, ANA and anti-DNA antibody positivity was also within the range seen in other racial groups. When compared with other series, however, alopecia, renal lupus, oral ulcers and neurological involvement was seen in higher proportions, reaching statistically significant figures in comparison to some racial groups. In contrast, haematological manifestations were seen in significantly less proportions in comparison to some of the racial groups. Serositis and discoid lesions were also seen in lower proportions than in most of other races. The proportion of those with anti-Sm antibodies was in between two extremes of highest among Africans and Israelis and lowest among Chinese and Europeans. Other manifestations were comparable to most other racial groups. Compared to North American and European reports, significantly low 5 and 10 year survival was observed among patients from India. This could be related to the general public health situation in the country including less than optimal management facilities in hospitals, delay in diagnosis due to lack of awareness of the disease, referral bias where only serious patients reach major city hospitals, or a truly severe disease among Indians, or a combination of these genetic, environmental and/or sociocultural factors. The Main causes of death were irreversible renal damage, infections and neurological involvement. Despite a comparable prevalence of anticardiolipin antibodies (aCL) and lupus anticoagulants (LAC), clinical antiphospholipid syndrome was significantly less common. Genetic studies showed appreciable increase of HLA DR4 (37.5%) among patients compared with controls (18%). Additionally the haplotype B8-DR3 was encountered frequently in the patient group.
Pulmonary haemorrhage in Oriental patients with systemic lupus erythematosus
Authors: Koh W-H. , Thumboo J. , Boey M-L.
Published: November 2007

We reviewed the case records of 10 Oriental patients with systemic lupus erythematosus (SLE) who developed pulmonary haemorrhage (PH) between 1987 and 1996 to determine their clinical presentation and outcome. All the patients had clinical evidence of PH including a sudden onset of dyspnoea, tachycardia, fall in haemoglobin (at least 1.5 gm%) and bilateral diffuse alveolar infiltrates on chest radiographs. At the time of PH, nine patients had a disease duration of 2 years or less and all the patients had clinical and/or laboratory evidence of active lupus disease. Fever and lung crepitations were present in 90% of patients while haemoptysis and chest pain occurred in only three and two patients, respectively. All the patients were treated with high dose intravenous corticosteroids and in addition seven had a combination of pulse methylprednisolone and cyclophosphamide, and four had received plasmapheresis. Four patients died as a result of PH. One patient died of pneumonia three years after recovering from PH while the remaining five had no recurrence of PH after a median follow-up of 22 months. Our study suggests that PH in Oriental lupus patients often occurs early in the disease, rarely presents with haemoptysis and has a high mortality despite aggressive immunosuppresive therapy.
Systemic lupus during pregnancy with refractory alveolar haemorrhage: recovery following termination of pregnancy
Authors: Keane MP , Van De Ven Cjm , Lynch JP , McCune WJ
Published: November 2007

A case of refractory pulmonary hemorrhage in a pregnant 22-year-old with systemic lupus is presented. The clinical difficulty of management of pulmonary haemorrhage and lupus flare during pregnancy are discussed.
Out On a Limb: a Qualitative Study of Patient Advocacy in Institutional Nursing
Authors: Sellin Sandra C.
Published: November 2007

This study explored the nature of patient advocacy among 40 institutionally employed registered nurses, nurse managers, clinical nurse specialists and nursing administrators. Participants were asked to define patient advocacy, to discuss their experiences with advocacy in institutions and their perceptions of risk associated with advocacy in institutional settings, and to identify one concept central to patient advocacy. The results delineated conceptual definitions of advocacy and numerous factors that influence nurses' decisions about acting as patient advocates in institutions. Additionally, they showed striking similarities between conceptual terms used to define advocacy and terms used to define caring.

Cet article est basé sur une enquête auprés de quarante infirmiers/ères, directeurs/ directrices, infirmiers/ères spécialisé(e)s et administrateurs employés dans des institu tions. On a demandé aux participants de définir la défense des malades, de discuter de leurs expériences concernant cette activité dans les institutions, de leurs perceptions des risques courus au cours de la défense et d'identifier un principe central à la défense des malades. Les résultats de l'enquête présentaient des définitions conceptuels de la défense ainsi que de nombreux éléments qui influencent les décisions prises par les infirmiers/ères qui assument la défence des malades dans les institutions. En plus, les résultats montraient de grandes ressemblances entre les expressions conceptuelles utilisées pour définir cette défense et les expressions utilisées pour définir les soins.

In dieser Studie wird untersucht, was vierzig in Insitutionen angestellte Pflegende, Man ager, und andere Pflegeexperten unter Fürsprache verstehen, wie sie sie definieren, und was ihre Erfahrung mit Fürsprache am Arbeitsort ist. Die Beteiligten wurden gefragt, wie sie die Risiken der Fürsprache in Institutionen einschätzen, und sie wurden aufgefordert, ein allgemein gültiges Konzept für Patientenfürsprache zu identifizieren. Das Resultat zeigt begriffliche Definitionen der Fürsprache sowei verschiedene Faktoren, die die Entscheidungen des Pflegepersonals beeinflussen, wenn sie als Fürsprecher der Patienten handeln. Zugleich zeigte diese Studie auch grosse Aehnlichkeiten zwischen Begriffen der Fürsprache und der Pflege.
The Influence of Gender, Education and Experience On Moral Sensitivity in Psychiatric Nursing: a Pilot Study
Authors: Lützén Kim , Nordin Conny
Published: November 2007

The purpose of this study was to investigate some factors which may influence moral decision-making in psychiatric nursing practice. The Moral Sensitivity Questionnaire, a 30-item, seven-point Likert scale, measures six dimensions that are assumed to be related to moral sensitivity. In scoring, the test is divided into six categories: interpersonal orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing conflict, and reliance on medical authority. Seventy-nine nurses, employed in the same psychiatric district, were included in the sample. Significant differences were found for some items in five of the six categories regarding gender, post-basic nursing education, experience as a mental care worker and type of clinical setting.

Le but de cette étude était d'investiguer quelques éléments qui pourraient influencer les décisions morales dans la pratique infirmière psychiatrique. Le Questionnaire de Sensibilité Morale de 30 questions, sept points échelle Likert, mesure six dimensions qu'on assume d'être lié à la sensibilité morale. En marquant les points, le test est divisé entre les six catégories: orientation interpersonnelle, structurant un sens moral, l'expression de bénévolence, la modification de l'autonomie, l'expérience de conflit et dépendance de l'autorité médicale. Soixante-dix neuf infirmiers/ères, employé(e)s dans le même rayon de psychiatrie, ont participé dans l'étude. On a trouvé des différences considérables pour quelques questions dans cinq des six catégories en ce qui concerne le genre, l'éducation avancée, l'expérience d'infirmier/ère psychiatrique et type de cadre clinique.

Das Ziel dieser Studie war die Untersuchung einiger Faktoren, die Einfluss haben auf die moralische Entscheidungsfindung in der psychiatrischen Krankenpflege. Der Fragebogen zur 'Moralischen Einfühlsamkeit' ist eine sieben-Punk Likert Skala für 30 Sachaspekte und misst sechs Dimensionen, von denen man annimmt, daß sie zur moralischer Einfühlsamkeit gehören. Für die Auswertung ist der Test in sechs Kategorien eingeteilt: Orientierung zu andem Personen, das Strukturieren moralischer Bedeutungselemente, Wohlwollen ausdrücken, Modifizierung von Selbstbestimmung,
Comprehensive Patient-Family Care: Fact or Fiction?
Authors: Wagner Nurith
Published: November 2007

The ICN 1973 Code for nurses states that 'Nurses render health services to the individual, the family and the community...'. It goes on to say that, 'The nurse's primary respon sibility is to those people who require nursing care.' Thus, our primary responsibility to provide comprehensive care to patients and their families is a concept we teach and preach, but can it be achieved?

In this paper, I would like to present the ethical dilemmas expressed by nurses as inherent in the care of patients and their families, address the difficulties in treating patients and their families in the light of these dilemmas and propose a different approach to dealing with the problem.
Nurses' Sensitivity To the Ethical Aspects of Clinical Practice
Authors: Oddi Lorys F , Cassidy Virginia R , Fisher Cheryl
Published: November 2007

The purpose of this study was to describe the extent to which nurses perceive the ethical dimensions of clinical practice situations involving patients, families and health care professionals. Using the composite theory of basic moral principles and the professional standard of care established by legal custom as a framework, situations involving ethical dilemmas were gleaned from the nursing literature. They were reviewed for content validity, clarity and representativeness in a two-stage process by expert panels. The situations were presented in a written format to a convenience sample of nurses (n = 125), who were primarily staff nurses (65.6%). Respondents' judgements about whether the main issue of each situation concerned ethics ranged from a low of 0.8% to a high of 40%. From analyses of the categories into which the majority of subjects placed each situation, it was concluded that these nurses generally perceived ethics as the main issue in situations that directly involve patients' autonomy. Analysis yielded unanticipated findings about the themes in ethical situations to which nurses in practice may respond.
Gender Differences in Moral Reasoning Among Physicians, Registered Nurses and Enrolled Nurses Engaged in Geriatric and Surgical Care
Authors: Norberg A. , Udén G.
Published: November 2007

Physicians, registered nurses (RNs) and enrolled nurses (ENs) engaged in geriatric (n = 49) and surgical (n = 59) care at a large hospital in Sweden gave 180 accounts of morally difficult care episodes. In total, the ENs (n = 40) gave 78, the RNs (n = 38) 55 and the physicians (n = 30) 47 accounts; there were 83 from geriatric care and 97 from surgical care. Forty-nine participants were male, and 59 were female; there were no differences in gender in the form and content of the moral reasoning disclosed in either morally difficult care episodes or in the complete interviews when coded as mainly narrative or propositional, or as showing a care or a justice orientation. The ENs showed a care orientation, while RNs and physicians, to an equal degree, showed both a justice and a care orientation. The ENs also used narrative reasoning more often than RNs and physicians. No differences were seen between the two health care specialties.
Letters to the Editor
Authors: Sellman Derek , Skidmore David
Published: November 2007

The following two letters were received in response to David Skidmore's article, 'Can nursing survive? A view through the keyhole', which was published in the December 1994 issue of Nursing Ethics.

David Skidmore has been asked to reply; his comments follow. Both his and Janet Duberley's letters have been shortened with their consent.
Aristotle, Nursing and Health Care Ethics
Authors: Scott P. Anne
Published: November 2007

Even a brief consideration of the nature of nursing will indicate that an ethical dimension underlies much, if not all, of nursing practice. It is therefore important that students and practitioners are facilitated in developing an ethical awareness and sensitivity from early in their professional development.

This paper argues that Aristotelian virtue theory provides a practice-based focus for health care ethics for a number of reasons. Also, because of his emphasis on the character of the moral agent, and on the importance of perception and emotion in moral decision-making, Aristotelian virtue theory provides a useful supplement to the traditional duty-based approaches to health care ethics analysis, which are increasingly being identified in the literature as having limits to their application within the health care context.
Psychiatric Nursing and Electroconvulsive Therapy
Authors: Clarke Liam
Published: November 2007

Sufficient doubt surrounds electroconvulsive therapy (ECT) to warrant nurses opting out of its administration and/or advising patients that it may be only one of a range of treatments open to them. In the latter respect, this discussion touches on aspects of the concept of advocacy. Relationships with the medical profession are also considered, as is the indefatigable attention given to issues of 'professional status' by nurses; this preoccupation facilitates an avoidance of therapeutic/advocacy issues.
The Ethics of the Health Care Market
Authors: Cooke Mary
Published: November 2007

The free market theory has as its basis the assumption of equity. This equity is ascribed to both purchasers and providers in a perfectly balanced system so that there are seen to be no 'winners' or 'losers' in the market-place. The health system that is developing in the UK is structured as a managed market, but agency relationships between GPs and health authorities buffer the costing process of goods and therefore may be described as distorting the price. This could also be distorting the ability of the users, who are the real purchasers, from exercising their economic freedom. They may also lose the autonomy to choose goods that suit their particular needs, and equally not to choose those services that they do not want or wish to pay for vicariously (i.e. that the common good is respected by both providers and purchasers).

This assumes that users of the service know the level of choice that they have and that not only are providers protected at present by the practices of the purchasers but also entry into the market for new providers is severely curtailed.

The exercise of true freedom of the market in economic terms is one of moral obliga tion to provide services that not only have a market value that is affordable and a require ment of the 'common good' but also are historically acceptable for social requirements (i.e. that the services are valued as fundamental tenets of the rights of individuals in soci ety). The expression of this need will therefore be utilitarian (i.e. the users of the services should benefit from them rather than the providers).
Educating Nurses for Their Future Role in Bioethics
Authors: Leavitt Frank J.
Published: November 2007

The emerging new multidisciplinary and crosscultural field of bioethics will require sen sitive, open-minded professionals to take the lead in hospital ethics, in genetic coun selling, and in the teaching of bioethics to students in nursing, medicine and the basic sciences. Nurses with ward experience who return to university to gain an MA or PhD in bioethics are eminently suited for this leadership role, for they may be more likely than physicians to study for a liberal education to supplement their professional know ledge ; their first-hand experience in nursing is an antidote to the pointless subtleties into which philosophical ethics so often degenerates.

When teaching ethics to nurses one must remember that, while some will simply use this knowledge in their own clinical work, others will go on to be teachers and researchers in bioethics. Their training must therefore be broad and interdisciplinary, including real substantive philosophy (as opposed to philosophical ethics), as well as mystical bioethics, religious law, ethics of genetic counselling, clinical approaches to ethical pseudo prob lems, research skills, etc.
Giving Information to Sick Children
Authors: Rozsos Elizabeth
Published: November 2007

This article describes a study carried out among 14-18-year-old nursing students in Hungary. The students were asked to consider an ethical problem. The parents of a sick child ask that she should not be told of a forthcoming operation. Are the nurses to agree to this demand or not? The author concluded from this study that nurses need more training in ethical decision-making, that they need to know about the rights of children in hospital, and that nursing training should start when students are older.
Community Nurses and Health Promotion: Ethical and Political Perspectives
Authors: Thomas Jane , Wainwright Paul
Published: November 2007

This paper brings together ideas from two perspectives on ethics and health promotion. A discussion of the ethical dimension of the health promotion practice of community nurses is set in the wider context of health policy, with particular reference to health gain and individual responsibility.

It is widely held that nurses have a key role to play in health promotion and that this is particularly the case for nurses working in primary health care. This assumption is reinforced by policy documents from the World Health Organization, the Department of Health and statutory bodies such as the United Kingdom Central Council for Nursing, Midwifery and Health Visiting.

The approach of many nurses to health promotion has tended on the one hand to be somewhat naive and on the other to be authoritarian and didactic; there has been little discussion in the nursing literature of the ethical aspects of health promotion. However, recent developments in nurse education, such as Project 2000 and the consequent changes to preregistration programmes, have resulted in increased attention to both ethics and health promotion within the curriculum.
To Kill or Not to Kill: a Question of Wartime Ethics
Authors: Williams P.T.
Published: November 2007

In this article, the author describes ethical decision-making in unique circumstances. A dichotomy exists between the dual roles of nurse and disaster manager in a wartime set ting. The circumstances of the situation had never been faced before and no precedents existed for the type of decisions being made. Clearly, professional codes of conduct existed along with international conventions with reference to war.

The circumstances required the author to challenge the concepts of teleology and deon tology in a search for the most fitting answers to a unique problem. His aim was to try to create the greatest good out of an impossible situation.

The author reflects on his actions in the light of ethical thinking and considers whether his decisions were right.
Climatic Extremes, Recurrent Crises and Witch Hunts: Strategies of European Societies in Coping with Exogenous Shocks in the Late Sixteenth and Early Seventeenth Centuries
Authors: Pfister Christian
Published: November 2007

In the late sixteenth and early seventeenth centuries, continental Europe north of the Alps was afflicted by a 13-year cycle of frequent cold and rainy summers which was the result of a series of volcanic explosions in the tropics. The inclement weather led to recurrent subsistence crises and to multiple floods in the Alps following from extensive glacier advances. This article discusses the relationship between ‘climate’ and ‘history’ from the example of this unique period. The vulnerability of food production in Europe to climatic hazard is assessed from an impact model. The result shows that the period 1560 to 1630 is most prominently marked by a high level of climatic stress. Likewise, this study demonstrates how authorities in Val Aosta (Italy) responded to annually recurrent floods in the 1590s triggered by the advancing Ruitor glacier. Finally, by confirming the thesis advanced by Wolfgang Behringer relating extensive witch hunts during that period to climatic change and recurrent subsistence crises, this article makes a plea for bridging the gap separating studies of climate from those of culture.
Towards a History of Natural Disasters in China: The Case of Lin fen County
Authors: Janku Andrea
Published: November 2007

Hitherto two discourses have dominated our thinking about natural disasters in China. The first is linked to the ancient theory of the Heavenly Mandate, interpreting natural phenomena in terms of people's behaviour and especially the government's performance. The second discourse describes China as a country especially prone to natural disasters, due to its particular geographical conditions and general backwardness. This view has gained prominence in the course of intensifying interactions with the Western world since the second half of the nineteenth century. This article is an attempt to get beyond the surface of these dominating discourses by looking at the local level experience in the pre-modern period. The history of disasters of Linfen county in the south of Shanxi province is reconstructed on the basis of local sources, such as records of portents, stele inscriptions, literati writings and popular legends. It shows how the experience of disasters is inscribed in local culture in ways very different from what the dominating discourses would suggest.
‘Mind the Next Flood!’ Memories of Natural Disasters in Northern Germany from the Sixteenth Century to the Present
Authors: Kempe Michael
Published: November 2007

Floods and storm-tides have been—and continue to be—a regular feature of the daily life of small rural communities on the coasts of the North Sea in Northern Germany and the Low Countries. This article examines the cultural strategies evolved within these communities as part of their response to catastrophe and ever-present danger. Practices of communication and memorialising are one important way of coping—for they transport a specific memoria of disaster experiences, that has a stabilising function. The article takes a longue durée perspective, extending from the sixteenth to the beginning of the twenty-first century, in order to grasp the dynamics by which collective memories crystallise into a ‘culture of disaster’. It examines the strategies of different media in the creation of a cultural memory unique to ‘amphibian societies’ in North Germany.
Fire and Quake in the Construction of Old Manila
Authors: Bankoff Greg
Published: November 2007

Manila, was one of the grandest early modern European cities in Asia, yet it was destroyed by fire and earthquake on numerous occasions. Over successive reconstructions, it evolved a style of architecture and urban planning that reconciled alien notions about space and place to local environmental realities. The city that materialised over the ensuing centuries was neither wholly European nor Asian, but a rich fusion of the two whose form and substance was ultimately determined by the twin threats of conflagration and seismic activity.
Exchange Rates, Stabilisation Policy and Redistribution of Income
Authors: Aysan Ahmet Faruk
Published: November 2007

This paper shows that exchange rate alignments are also used for redistribution of income among different groups. The heterogeneous impacts of stabilisation policies lead to formation of various coalitions throughout the evolution of stabilisation programmes. These coalitions can produce unsustainable economic policies at the expense of other groups. The model categorises these various groups with respect to their shares in total production of tradables and non-tradables. An increase in the relative prices of non-tradables benefits the poor more than the rich and middle classes. In addition to the poor, the rich benefit from unsustainable macroeconomic polices by lending to the government and eventually escaping the cost of stabilisation in the long run.
Giving Students New Eyes
Authors: Tyler Catherine L. , Anderson Marc H. , Tyler J. Michael
Published: November 2007

An extensive literature in management education addresses the pedagogical technique of showing video clips from feature films, animated films, and television shows. The bulk of this literature either asserts the benefits of using video clips or identifies specific clips and discusses how those clips can be effectively used to teach various management and organizational behavior topics. The assumption in all of this work is that the instructor will locate the video clips to be used. The authors present an alternative approach that has students locate video clips in groups, and discuss the numerous advantages of this approach for both instructors and students. In addition to describing the general approach, the authors elaborate on a number of possible variations and reflect on the lessons learned from implementing this approach in two independent courses at two different universities.
Methods for Modal Model Quality Improvement — Measurement Data Pre-processing for Model Identification Process (part I)
Authors: Iwaniec Joanna , Uhl Tadeusz
Published: November 2007

The paper concerns techniques of modal model quality improvement at the stage of data pre-processing for the purposes of identification process. Basic concepts of problem formulation (matrix conditioning) improvement by the use of the Tikhonov regularization method are presented as well as examples of method application to solution estimation of the Fredholm integral equation of the first kind and to transfer function matrix noise reduction. In the second part of the paper the authors proposed the method for transfer function estimation on the basis of data measured by the use of impulse test on big industrial systems for which classical methods fail for the reason of low coherence between exciting force and system response. Two examples of method application are presented.
Investing in the Political Beyond
Authors: Lockford Lesa
Published: November 2007

In this article, the author employs performative writing to explore the complications and contradictions that inhere in the experience of audiencing our nation's investment in the war in the Middle East. The question of how we can know the truth given the prevalence of rhetorical spin from politicians and pundits coupled with the brute fact of the loss of so many American lives is considered.
Chemotherapy induced diarrhea
Authors: Richardson Gillian , Dobish Roxanne
Published: November 2007

Purpose: To provide a current review of the literature related to chemotherapy induced diarrhea (CID), including clinical assessment, recommended management guidelines and investigational pharmacological approaches for the prevention and treatment of CID.

Data sources: A search of MEDLINE, PubMed, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, and Web of Science (1996—2006) databases was conducted using terms such as: chemotherapy, diarrhea, diarrhoea, and irinotecan. Appropriate references from selected articles were also used. The search engine, Google, provided further access to information.

Data extraction: The retrieved literature was reviewed to include all articles pertaining to the pathophysiology, assessment and management of CID.

Data synthesis: Diarrhea is a debilitating and potentially life-threatening side effect associated with many chemotherapeutic agents. Despite the high incidence and severity of CID, it is often under recognized and poorly managed. A multidisciplinary panel recently updated recommended practice guidelines for the assessment and management of CID. Prompt and aggressive intervention is important in order to minimize the negative consequences of CID, such as dehydration, which may cause interruptions in optimal clinical outcomes or may lead to life-threatening sequelae. Further investigation into the pathophysiology of CID may allow for more directed approaches in the prophylaxis and treatment of CID. J Oncol Pharm Practice (2007) 13: 181—198.
Molecularly Imprinted Solid Phase Extraction in a Syringe Needle Packed with Polypyrrole-encapsulated Carbon Nanotubes for Determination of Ochratoxin A in Red Wine
Authors: Wei Yun , Qiu Longhui , Yu Jorn C. C. , Lai Edward P. C.
Published: November 2007

A novel micro-solid phase preconcentration (μSPP) device is developed by electrochemically depositing molecularly imprinted polypyrrole (MIPPy) over carbon nanotubes (CNTs) packed inside a 22-gauge syringe needle. The ochratoxin A (OTA) template is removed with 1% triethylamine (TEA) in 20:80 v/v acetonitrile—ammonia buffer (20 mM NH4Cl/NH3, pH 9.2). This syringe needle is used to extract trace OTA in a red wine sample, and the preconcentrated OTA is eluted with 1% (v/v) TEA in 20:80 v/v acetonitrile—ammonia buffer (20 mM NH4Cl/NH3, pH 9.2). The eluate is analyzed by high performance liquid chromatography (HPLC) with fluorescence detection (FD). The results demonstrated a significantly selective enrichment of OTA at sub-ppb levels in the presence of red wine matrix components. Using a sample volume of 0.5mL red wine for preconcentration, it is possible to determine OTA down to a detection limit of 0.04 ng/mL (at 3σB) or a quantification limit of 0.10 ng/mL (at 10σB). The total MIPPy/CNTs-μSPP-HPLC-FD analysis took only 40min, including a μSPP time of 30min, elution time of 20 s, and HPLC analysis time of 10 min. This needle can be reused and hence readily adapted in an autosampler for the processing of multiple samples in series.
Effect of Thickening Agent and Fat in Custard Microstructure Upon in vitro Enzymatic Digestion
Authors: Sanz T. , Handschin S. , Nuessli J. , Conde-Petit B.
Published: November 2007

Custards desserts with and without fat were prepared using either tapioca modified starch or carboxymethylcellulose (CMC) as thickening agents and the changes in their microstructure upon in vitro simulation of mouth, stomach, and small intestine conditions were evaluated by light microscopy. A completely different pattern of behavior was found between starch and CMC custards. After mouth incubation, the partially gelatinized tapioca granules were completely disintegrated by the action of saliva, while the CMC custard is practically unaffected. Fat incorporation did not influence the breakdown of gelatinized starch. Coagulation of the milk protein is observed after stomach incubation. In the starch custards, the fat globules do aggregate with the milk protein, while in the CMC custard they are still embedded in the unaltered network. Intestine incubation completely digests the remaining structures after stomach incubation, although in the CMC custard particles of undigested hydrocolloid are observed. In the presence of fat, micelles are visualized in both custards, which favor the bioaccessibility of lipophilic compounds. The higher digestive resistance of the CMC custards implied the existence of a higher barrier against the release of active compounds from the custard matrix and therefore a higher barrier against bioaccessibility.
Alternate reality gaming and convergence culture
Authors: Örnebring Henrik
Published: November 2007

Alternate Reality Games (ARGs) are a form of internet-based mystery game in which participants are immersed in a fictional world and engage in collective problem-solving. This article studies three ARGs connected to the TV series Alias (ABC, 2001—6), two of them launched by the network ABC as part of the marketing of the TV series, the third produced by fans. Previous research on ARGs has not sufficiently problematized the fact that many ARGs are marketing tools. While ARGs can be analysed as part of a wider context of convergence culture and fan culture, such an analysis must take into account the underlying commercial logic of popular culture production. Despite the differences found between industry-produced and fan-produced ARGs, they still share a framework of consumption that conforms to corporate goals of marketing and brand-building as well as fan audiences' goals of pleasurable interaction with fictional worlds. •
Diary of a working boy
Authors: Schoneboom Abigail
Published: November 2007

A B S T R A C T ■ Anonymous workbloggers — employees who write online diaries about their work — are often simultaneously productive workers and savage critics of the organizational cultures in which they toil. This research focuses on a small group of white-collar workers from the Greater Manchester and Lancashire area, who risk their jobs by writing publicly about their office experiences under assumed identities. Countering the notion that resistance to corporate culture leads to `confusion and emptiness' (Willmott, 1993: 538), this study contributes to the recent revival of interest in worker misbehavior and recalcitrance. By focusing on workers as authors, it addresses a shortcoming in the existing critical literature, which treats informal employee resistance as an intellectually and artistically unsophisticated phenomenon. Drawing parallels with the lives and work of authors such as Franz Kafka and T.S. Eliot, it evaluates whether embedded writers, in spite of their ambivalence about the alternative, can constitute an effective counter-hegemonic force.
Muck and magic
Authors: Hamilton Lindsay
Published: November 2007

While the presence of muck, dirt and animal detritus is a quotidian and generally unremarkable feature of everyday working life for farm vets, it has special relevance to social scientists seeking to understand how they assemble their professional identities. But the cultural significance of muck and mess as a material condition of working life for vets — and other professionals more generally — has been largely under-theorized by researchers and demands further ethnographic analysis. Drawing on Bourdieu's concepts of symbolic and cultural capital, as well as anthropological insights informed by the sociology of science, this article explores the meanings that one group of farm vets ascribe to muck. The ethnographic account that follows seeks to reveal the ways in which the presence of muck, mess and disorder functions as a cultural artefact bestowing power and prestige that both structures and regulates the vets' social and professional relations.
Nonstationary Vibration Signal Analysis of a Hydroturbine Based on Adaptive Chirplet Decomposition
Authors: Feng Zhipeng , Chu Fulei
Published: November 2007

During transient processes, such as start-up and shut-down, vibration responses of hydroturbine rotors are typically frequency modulated signals. In this study, Gaussian chirplet is shown to be complete enough to match the characteristics of transient rotor vibration signals during speed varying processes. In order to avoid the amplitude distortion found in adaptive chirplet spectrograms, the Wigner—Ville distribution of normalized optimal chirplets is employed as a time—frequency window to filter the time—frequency distribution. The improved adaptive chirplet spectrogram possesses the best time—frequency resolution, and is free of cross term interference and amplitude distortion. Using this decomposition, the characteristic frequency components and their time evolution of main shaft vibration signals during the shut-down process of a hydroturbine are identified successfully. The vibration response from the upper part of the hydroturbine, which is the generator, is found to be closely related to rotor rotation, as expected. The signal is dominated by the rotational frequency of the rotor, and the frequency modulation phenomenon is the characteristic of a speed varying process. On the other hand, the vibration response from the lower part of the hydroturbine, which is the water turbine, is found to be closely related to hydraulic pressure fluctuation, and is directly influenced by the guide vane opening.
Structural Damage Location with Fiber Bragg Grating Rosettes and Lamb Waves
Authors: Betz Daniel C. , Thursby Graham , Culshaw Brian , Staszewski Wieslaw J.
Published: November 2007

The aim of this study is to present the results of testing a damage detection and damage localization system based on fiber Bragg grating sensors. The objective of the system is to detect and locate damage in structures such as those found in aerospace applications. The damage identification system involves Bragg gratings for sensing ultrasound by detecting the linear strain component produced by Lamb waves. A tuneable laser is used for the interrogation of the Bragg gratings to achieve high sensitivity detection of ultrasound. The interaction of Lamb waves with damage, e.g., the reflection of the waves at defects, allows the detection of damage in structures by monitoring the Lamb wave propagation characteristics. As the reflected waves produce additional components within the original signal, most of the information about the damage can be found in the differential signal of the reference and the damage signal. Making use of the directional properties of the Bragg grating the direction of the reflected acoustic waves can be determined by mounting three of the gratings in a rosette configuration. Two suitably spaced rosettes are used to locate the source of the reflection, i.e., the damage, by taking the intersection of the directions given by each rosette. A genetic algorithm (GA) can be used to calculate that intersection and to account for any ambiguities from the Lamb wave measurements. The performance of the GA has been studied and optimized with respect to the localization task. Initial experiments are carried out on an aluminum structure, where holes were drilled to simulate the presence of damage. The results show very good agreement between the calculated and actual positions of the damage.
Higher Order Spectra for Crack and Misalignment Identification in the Shaft of a Rotating Machine
Authors: Sinha Jyoti K.
Published: November 2007

Higher order spectra (HOS) are the tools in signal processing for the identification of the presence of higher harmonics in a signal which is a typical case of a non-linear dynamic behavior in mechanical systems. The breathing of a crack during shaft rotation also exhibits a non-linear behavior. The crack is known to generate 2X (twice the machine RPM) and higher harmonics in addition to 1X component in the shaft response during its rotation. Misaligned shaft also shows such feature as a crack in a shaft. The HOS have now been applied on a small rotating rig to observe its features. Results are found to be encouraging to distinguish these two faults based on a few experiments conducted on a small rig, which are presented here. The presented results though limited suggest the potential of the use of the HOS in the condition monitoring of rotating machinery.
Monitoring rare serious adverse events from a new treatment and testing for a difference from historical controls
Authors: Fay Michael P. , Huang Chiung-Yu , Twum-Danso Nana A. Y.
Published: November 2007

Background We detail the design of a study to monitor the safety of including albendazole to an existing treatment regimen to eliminate lymphatic filariasis. We wish to show that this new regimen does not increase the rate of a rare serious adverse event (SAE) compared to the old regimen. Controlled but small clinical trials have not detected any increase in the SAE using albendazole, and it is known to have added benefits; therefore, it is unethical to randomize patients to the old regimen.

Purpose A sample size for the new regimen is needed to test that the new rate of SAE is noninferior to the historic rate. If the new regimen does have an inferior rate of SAE then we wish to stop the study early. This setup is different from traditional early stopping for efficacy and futility. In that traditional case, the two stopping decisions are relative to the same null hypothesis of equality, while in our setup, we have two different null hypotheses: the noninferiority null and the equality null. When testing the former, we need not stop early if the new regimen appears better because no subjects are receiving the old regimen anymore anyway. When testing the equality of SAE rates, however, we want to stop early if the new regimen has a significantly higher rate of SAE.

Methods We create a design that uses an exact difference in proportions test for testing noninferiority, but calculates maximal sample size based on conditional power which treats the historical rates as true rates. The design allows for early stopping if the new treatment appears inferior with respect to SAE rate but makes no corrections for multiple testing. We explore the properties of this naive design without assuming the historical rates are known.

Results For our example, we show that our naive design strategy bounds the type I error of the noninferiority hypothesis in all cases and bounds it for the equality hypothesis at 0.05, as long as the true SAE rate is <0.00015. The same design has unconditional power for the noninferiority hypothesis greater than the nominal 80% as long as the true SAE rate for both regimens are <0.00025.

Limitations The type I and power results above hold only for our historical sample size of 17 877. We expect similar type I and power properties to hold with studies with SAE rates similar or less (i.e., < 0.00015) and historical sample sizes similar or smaller.

Conclusions Our design for comparing very rare historical SAE rates to SAE rates of a new treatment has large power to conclude noninferiority of the new treatment SAE rate when both rates are equal, but allows early stopping if the new SAE rates are worse. Clinical Trials 2007; 4: 598—610. http://ctj.sagepub.com
Design of the PEDS-C trial: pegylated interferon +/- ribavirin for children with chronic hepatitis C viral infection
Authors: Murray Karen F. , Rodrigue James R. , González-Peralta Regino P. , Shepherd John , Barton Bruce A. , Robuck Patricia R. , Schwarz Kathleen B. ,   for the PEDS-C Clinical Research Network
Published: November 2007

Background PEDS-C is the first multicenter placebo-controlled trial for the treatment of chronic hepatitis C (HCV) in childhood that has ever been conducted in the United States (USA). Establishment of the research team, protocol, administrative infrastructure, and ancillary contributors for the pediatric trial took years of planning.

Purpose To study the safety and efficacy of pegylated-interferon alpha (PEG-2a) plus ribavirin (RV) with PEG-2a monotherapy in children aged 5 years through 18 years. To assess the health-related quality of life and growth and body composition in children with chronic hepatitis C infection, before, during, and after treatment. Methods Eleven centers of pediatric hepatobiliary clinical research were united in a National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) funded grant with financial support from the Food and Drug Administration (FDA) and a corporate sponsor to conduct the treatment trial.

Limitations The most important initial limitation in the design of this complex study was securing the financial support and infrastructural organization, a process that took several years. Challenges faced by the study group included identifying the optimal study design given the limited study population, and determining what ancillary studies could be incorporated into the treatment trial.

Conclusions In this article the process taken to design the study and administrative infrastructure, the lessons learned, and the controversial issues deliberated during the planning process are discussed. The evolution of the study and the considerations taken in the development of the protocol are valuable tools which can be applied to pediatric clinical trials in general. Clinical Trials 2007; 4: 661—673. http://ctj.sagepub.com
`Having cancer changed my life, and changed my life forever': survival, illness legacy and service provision following cancer in childhood
Authors: Drew Sarah
Published: November 2007

Objectives: To explore how having cancer in childhood influences social and personal wellbeing in young adulthood.

Methods: Questionnaires (55) eliciting lengthy written responses and in-depth interviews (32) were used with male and female survivors of cancer in childhood (aged between 18 and 28 years). Analysis drew on a combination of grounded-theory techniques and narrative analysis.

Results: Three key areas are outlined relating to the characterization of survivorship by participants. These include highlighting survival as not necessarily a simple end to a cancer story, issues relating to post-cancer bodily self-concept and its gendering, and, efforts at managing uncertainties through medical interactions and information gathering.

Discussion: Participant stories in this study illustrate that even in long-term survival, cancer is present as a web of ongoing influences from the original disease and treatment, as well as the social and personal aftershocks that can occur well after malignant cells have been controlled. Findings highlight the necessity for complex redevelopment of healthcare services and social support provisions for this growing population.