bluuebunny/crossref_metadata_2025 huggingface dataset:
A Formative Evaluation to Develop a School Health Nursing Early Intervention Model for Adolescent Substance Use
Authors: Pirskanen Marjatta , Laukkanen Eila , Pietilä Anna‐Maija
Published: May 2007

ABSTRACT
Objective: To improve an early intervention (EI) triggered by the Adolescents' Substance Use Measurement (ADSUME) as a method to prevent substance abuse among adolescents. We assessed how ADSUME and EI work in practice and how EI could be improved.

Design and sample: School health nurses (n=10) tested ADSUME and EI on 14‐ to 18‐year‐old adolescents (n=228). Six months later, these nurses and their professional partners were invited to assess EI in focus group interviews.

Methods: Four focus group interviews involving a total of 24 nurses and partners were implemented. Interview data were analyzed with qualitative content analysis.

Results: ADSUME concretized assessment, activated profound dialogue, and proved to be an important part of EI. It was important to assess the adolescent's resources in addition to the ADSUME score. EI worked well in confidential dialogues after the adolescent and the PHN reached a consensus on the level of concern about the adolescent's substance use. The recommended EI enabled individual brief intervention in all four stages of substance use, from abstinence or experimental use to hazardous use.

Conclusions: EI was improved practically, and the contents of the intervention were reformulated. It is important to integrate EI with the preventive efforts of the school.
Using a Community‐Based Outreach Program to Improve Breast Health Awareness Among Women in Hong Kong
Authors: Chan Sophia S. C. , Chow Denise M. K. , Loh Edith K. Y. , Wong David C. N. , Cheng Karis K. F. , Fung Wendy Y. C. , Cheung Polly S. Y.
Published: May 2007

ABSTRACT
Objective: To evaluate the effectiveness of a community‐based health education program via a mobile van to promote the awareness of breast cancer and breast self‐examination (BSE) practice among women in Hong Kong.

Design: One group pretest/posttest design.

Sample and measurements: Seven hundred and seventy‐seven women in Hong Kong completed a self‐administered questionnaire before and after a breast health education program from May 2002 to March 2003.

Results: About half were aware of breast health and breast diseases (53.7%) and breast screening methods (48.6%) before the intervention. It was found that women who had received instruction on BSE practice, and those who were aware of breast screening methods, breast health, and breast diseases were more likely to have had prior BSE practice. Most indicated their willingness to practice BSE regularly (93.3%) and to pass on the BSE knowledge to their relatives and friends (92%) in the posttest.

Conclusions: The outreach health education program has successfully reached women living in the 18 districts in Hong Kong. It appears to be useful in raising the awareness of breast health and BSE practice among the women, but longer term follow‐up is required to ascertain its sustainability.
Study of the Reliability and Validity of the Community Health Intensity Rating Scale (CHIRS) in the Turkish Community
Authors: Çelebioğlu Aysun , Özsoy Süheyla Altuğ , Peters Donna
Published: May 2007

ABSTRACT
The purpose of this study was to examine the reliability and validity of the Community Health Intensity Rating Scale (CHIRS) that was translated into the Turkish language and applied in the Turkish community. The CHIRS is a tool that assesses the intensity of need for care of persons/families in the community. The original version of the tool was translated into Turkish, examined for face validity and language appropriateness by the Turkish experts, and then applied to 372 families living in Odemis, Turkey. Significant correlations were found between total scale score (TSS) and total number of household members, and between the TSS and the total number of visits to any health institution within the previous month. In addition, the self‐health care needs evaluation scores supported predictive validity. For reliability, min–max values, standard errors and deviations, skewness, and kurtosis coefficients of parameter scores, domain scores, and TSS were examined. The mean TSS was 26.7 (± 5.32) and the mean age of the participants was 35.0 years. For internal consistency, Cronbach's α (.525) and Guttman split‐half coefficient (.629) values were established for the TSS. In conclusion, the reliability and validity of the Turkish version of CHIRS have been established.
Impairment in Color Perception in Migraine With and Without Aura
Authors: De Marinis Milena , Rinalduzzi Steno , Accornero Neri
Published: May 2007

Objective.—To assess visual perception in 40 patients suffering from migraine with aura (MA), 40 patients suffering from migraine without aura (MO), and 40 controls.

Background.—Visual perception abnormalities are a common feature in both MA and MO.

Methods.—We performed luminance and color central perimetry. Black and white pattern reversal visual‐evoked potentials were also assessed.

Results.—Luminance perimetry was similar in patients and controls. Color perimetry instead revealed an impairment in the perception of red (“quantitative perception index”) in migraine patients; this impairment was more pronounced in patients with MA (P < .001) than in those with MO (P < .05) and was related to the degree of photophobia recorded before testing. A subgroup of MO patients who had a migraine attack shortly after being tested also displayed a marked impairment in the perception of blue. This subgroup of patients had a statistically significant (P < .001) lower perception of blue than the rest of the MO patients, who had a migraine attack later; they also had a high degree of unpleasant perceptions after testing. Black and white visual evoked potentials were similar in patients and controls.

Conclusion.— The impairment in visual perception of red, which was more marked in MA than in MO patients, may be related to the degree of photophobia recorded before testing. The reduced perception of blue, which only occurred in a subgroup of MO patients in the premonitory phase of the migraine attack, probably occurs through mechanisms that involve dopaminergic function. We cannot exclude the possibility that the visual stimulations induced the migraine attack in this subgroup of MO patients shortly after they were tested.
ED Treatment of Migraine Headache: Factors Influencing Pharmacotherapeutic Choices
Authors: Hurtado Timothy R. , Vinson David R. , Vandenberg J. Toby
Published: May 2007

Study Objective.—To evaluate the factors that influence clinicians' choices of parenteral medications in the emergency department (ED) management of migraine headache.

Background.—Migraine headache is a common problem in the United States. Many migraineurs require periodic ED management. Though a large variety of parenteral medications are used by ED clinicians in the treatment of migraine, little research has been directed to the reasons why providers use the medications they do.

Methods.—This study used a self‐administered questionnaire for providers from 3 geographically distinct EDs to evaluate their pharmacotherapeutic preferences in the treatment of uncomplicated migraine based on a fictitious scenario. Factors influencing medication choices were rated on a 5‐point Likert scale and analyzed descriptively. Hypothetical practice patterns from the questionnaires were compared with actual practice patterns from a prior study from the same institutions.

Results.—Eighty‐three percent of surveys were returned, the majority from attending physicians (71%), as their initial drugs‐of‐choice providers preferred dopaminergic antiemetics (93%) and parenteral NSAIDs (22%). If initial therapy failed, opioids (40%) with nonspecific antiemetics (24%) were preferred as second‐line agents. Choice of therapy was influenced (in descending order) by medication availability and its antimigraine properties, the providers' training, current departmental practice patterns, and national practice guideline recommendations. Opioid use was influenced by patients' failure to respond to ED and outpatient alternatives and the presence of contraindications/intolerances to non‐opioids. When these results were compared to a prior study of actual practice patterns, a range of discordance was observed, which varied significantly by institution.

Conclusion.—Emergency clinicians report that a variety of factors influence their parenteral pharmacotherapy in the management of patients with migraine headache. The comparison of hypothetical practice patterns with actual practice patterns reveals a range of institution‐specific discordance. There is discordance between providers' responses to a fictitious scenario and their previously recorded practice patterns with regional variation.
Emergency Department Management of Acute Migraine in Children in Canada: A Practice Variation Study
Authors: Richer Lawrence , Graham Lee , Klassen Terry , Rowe Brian
Published: May 2007

Objectives.—Evidence‐based guidelines for the treatment of children with migraine are limited given the paucity of randomized controlled trials, especially in the emergency department (ED). Our objectives were to: (1) characterize the treatment of children with migraine in the ED; (2) determine whether treatment varies in pediatric versus mixed (pediatric and adult) EDs.

Methods.—Children aged 5 to 17 years presenting to 4 regional emergency departments in Edmonton, Alberta, Canada during the 2003/2004 fiscal year with a diagnostic code of headache or migraine were selected. A standardized retrospective chart abstraction was performed and migraine or probable migraine cases were classified based on the International Classification of Headache Disorders II.

Results.—Three hundred and eighty‐two cases were identified of which 48.7% (n = 186/382) met sufficient criteria for migraine. No treatment was given in 44.2% (n = 169/382). Simple oral analgesics (23.3%; n = 89/182) and dopamine antagonists (metoclopramide and prochlorperazine; 20.7%; n = 79/182) were prescribed first‐line most commonly. Opiate medications (5.5%), ketorolac (4.7%), dihydroergotamine (1%) were prescribed first‐line infrequently. There was a significant difference in the management choices between pediatric and mixed adult/pediatric EDs (χ2= 19.695; df = 5; P= .001). The pediatric ED was more likely to prescribe a dopamine antagonist (12.9 vs 6.8%; P= .044) while the mixed adult/pediatric EDs were more likely to prescribe an opiate (28.1% vs 18.4%; P= .031). Children with migraine in all EDs were significantly more likely to receive drug therapy (68.3% vs 42.9%; P < .001) or a dopamine antagonist (32.3% vs 9.7%; P < .001). Polypharmacy (31.2%; n = 119/382) and neuroimaging (29.1%; n = 111/382) were common. Outcome was poorly documented overall. No adverse events were recorded.

Conclusions.—Significant variation in practice in the management of acute headaches in children was observed between mixed population and pediatric‐only emergency physicians in the same city. Most children do not receive any drug therapy. Children presenting to the pediatric ED were significantly more likely to receive a dopamine antagonist while opiates were prescribed more commonly in the mixed ED. More clinical trials are required in children to clarify areas of clinical uncertainty on which evidence‐based practice guidelines can be formed.
Central Overexpression of Angiotensin AT1A Receptors Prevents Dopamine D2 Receptor Regulation of Alcohol Consumption in Mice
Authors: Moore Rosanna , Krstew Elena V. , Kirchhoff Jeppe , Davisson Robin L. , Lawrence Andrew J.
Published: May 2007

Background: While angiotensin receptors are found on the soma and terminals of dopaminergic neurons, controversy surrounds the potential role of angiotensin in alcohol consumption.

Methods: Using a transgenic mouse with a brain‐specific overexpression of angiotensin AT1A receptors (NSE‐AT1A mice), we have examined the role of angiotensin in alcohol consumption and alcohol‐induced regulation of the dopaminergic system.

Results: The functional relevance of the overexpressed AT1A receptors was confirmed by an exaggerated rehydration response following 24‐hour dehydration. NSE‐AT1A mice showed a high preference for alcohol (similar to wild‐type mice); yet, raclopride treatment had no effect on alcohol consumption in NSE‐AT1A mice, while significantly reducing consumption in wild‐type mice. In contrast, NSE‐AT1A mice showed enhanced sensitivity to raclopride compared with wild types in terms of D2 receptor up‐regulation within the ventral mesencephalon. In addition, striatal D2 receptors in NSE‐AT1A mice were sensitive to up‐regulation by chronic alcohol consumption.

Conclusions: Collectively, these data imply that while expression of angiotensin AT1A receptors on striatal neurons has no impact upon basal alcohol consumption or preference, AT1A receptors do modulate the sensitivity of dopamine D2 receptors to regulation by alcohol and the ability of a D2 receptor antagonist to reduce consumption.
AUDIT‐C as a Brief Screen for Alcohol Misuse in Primary Care
Authors: Bradley Katharine A. , DeBenedetti Anna F. , Volk Robert J. , Williams Emily C. , Frank Danielle , Kivlahan Daniel R.
Published: May 2007

Background: The Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) questions have been previously validated as a 3‐item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT‐C's validity and optimal screening threshold(s) in other clinical populations are unknown.

Methods: This cross‐sectional validation study compared screening questionnaires with standardized interviews in 392 male and 927 female adult outpatients at an academic family practice clinic from 1993 to 1994. The AUDIT‐C, full AUDIT, self‐reported risky drinking, AUDIT question #3, and an augmented CAGE questionnaire were compared with an interview primary reference standard of alcohol misuse, defined as a Diagnostic and Statistical Manual, 4th ed. alcohol use disorder and/or drinking above recommended limits in the past year.

Results: Based on interviews with 92% of eligible patients, 128 (33%) men and 177 (19%) women met the criteria for alcohol misuse. Areas under the receiver operating characteristic curves (AUROCs) for the AUDIT‐C were 0.94 (0.91, 0.96) and 0.90 (0.87, 0.93) in men and women, respectively (p=0.04). Based on AUROC curves, the AUDIT‐C performed as well as the full AUDIT and significantly better than self‐reported risky drinking, AUDIT question #3, or the augmented CAGE questionnaire (p‐values <0.001). The AUDIT‐C screening thresholds that simultaneously maximized sensitivity and specificity were ≥4 in men (sensitivity 0.86, specificity 0.89) and ≥3 in women (sensitivity 0.73, specificity 0.91).

Conclusions: The AUDIT‐C was an effective screening test for alcohol misuse in this primary care sample. Optimal screening thresholds for alcohol misuse among men (≥4) and women (≥3) were the same as in previously published VA studies.
Coexisting Cerebral Infarction in Alzheimer's Disease Is Associated with Fast Dementia Progression: Applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer's Disease with Concomitant Cerebral Infarction
Authors: Sheng Bun , Cheng Lik Fai , Law Chun Bon , Li Ho Lun , Yeung Kwan Mo , Lau Kwok Kwong
Published: May 2007

OBJECTIVES: To determine whether patients with Alzheimer's disease (AD) and coexisting cerebral infarction (CI) that satisfy the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS‐AIREN) neuroimaging criteria for vascular dementia (VaD) progress faster than those who do not satisfy the neuroimaging criteria.

DESIGN: Retrospective cohort study.

SETTING: Multidisciplinary memory clinic in a tertiary hospital.

PARTICIPANTS: One hundred thirty consecutive patients with AD, with or without CI, followed up regularly for more than 1 year.

MEASUREMENTS: The patients were classified according to the distribution and severity of CI as defined according to the NINDS‐AIREN neuroimaging criteria into those with AD and no CI (AD‐N), those with AD and CI not fulfilling neuroimaging criteria (AD‐I), and those with AD and CI fulfilling neuroimaging criteria (AD‐V), and their differences in dementia progression were tested. The loss of independence, indicated by institution admission or a clinical dementia rating (CDR) score of 3, was defined as the endpoint for a poor outcome.

RESULTS: The mean age was 75.8, and 68.5% were women. The initial Mini‐Mental State Examination (MMSE) score was 15.3±0.4, and the average duration of follow up was 30.4 months. Fifty‐four patients had reached study endpoint at the time of analysis. AD‐V (hazard ratio (HR)=3.1, 95% confidence interval (CI)=1.2–8.2), use of psychotropic drugs (HR=2.7, 95% CI=1.1–6.4), and initial MMSE score (HR=0.9, 95% CI=0.8–1.0) were independent predictors of poor outcome in the Cox regression model.

CONCLUSION: In AD, co‐occurrence of CI with distribution and severity as defined in the NINDS‐AIREN neuroimaging criteria for VaD is associated with faster dementia progression.
The Effect of Age on Short‐Term Outcomes After Abdominal Surgery for Pelvic Organ Prolapse
Authors: Richter Holly E. , Goode Patricia S. , Kenton Kim , Brown Morton B. , Burgio Kathryn L. , Kreder Karl , Moalli Pamela , Wright E. James , Weber Anne M. ,   for the Pelvic Floor Disorders Network
Published: May 2007

OBJECTIVES: To compare perioperative morbidity and 1‐year outcomes of older and younger women undergoing surgery for pelvic organ prolapse (POP).

DESIGN: Prospective ancillary analysis.

SETTING: Academic medical centers in National Institutes of Health, National Institute of Child Health and Human Development Colpopexy and Urinary Reduction Study.

PARTICIPANTS: Women with POP and no symptoms of stress incontinence.

INTERVENTION: Abdominal sacrocolpopexy with randomization to receive Burch colposuspension for treatment of possible occult incontinence or not.

MEASUREMENTS: Perioperative complications and Pelvic Organ Prolapse Quantification and quality‐of‐life (QOL) questionnaires (Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Medical Outcomes Study Short‐Form Health Survey (SF‐36) preoperatively, immediately postoperatively, and 6 weeks and 3 and 12 months postoperatively).

RESULTS: Three hundred twenty‐two women aged 31 to 82 (21% aged ≥70), 93% white. Older women had higher baseline comorbidity (P<.001) and more severe POP (P=.003). Controlling for prolapse stage and whether Burch was performed, there were no age differences in complication rates. Older women had longer hospital stays (3.1±1.0 vs 2.7±1.5 days, P=.02) and higher prevalence of incontinence at 6 weeks (54.7% vs 37.2%, P=.005). At 3 and 12 months, there were no differences in self‐reported incontinence, stress testing for incontinence, or prolapse stage. Improvements from baseline were significant on all QOL measures but with no age differences.

CONCLUSION: Outcomes of prolapse surgery were comparable between older and younger women except that older women had slightly longer hospital stays.
The Input Relationship Between Co‐Authors in Economics: A Production Function Approach
Authors: Medoff Marshall H.
Published: May 2007

Abstract.  This study addresses the question of what the relative input relationship is between co‐authors in economics. Using the direct addilog production function, the partial elasticities of substitution between co‐authors are estimated. The empirical results suggest that co‐authors in economics are equivalent substitutes in production. The empirical results are robust whether the direct addilog production is estimated using each co‐author's research capital stock, depreciated research capital stock, impact‐adjusted research capital stock, or depreciated impact‐adjusted research capital stock.
Learning from Postproject Reviews: A Cross‐Case Analysis*
Authors: Koners Ursula , Goffin Keith
Published: May 2007

Every new product development (NPD) project should not only deliver a successful new product but also should generate learning for the organization. Postproject reviews (PPRs) are recognized by both practitioners and academics as an appropriate mechanism to stimulate and capture learning in NPD teams. However, relatively few companies use PPRs, and those that do use them often fail to do so effectively. Although they are widely perceived to be a useful tool, empirical research on how PPRs are typically organized and the learning that results is limited. The present article addresses this gap in the extant knowledge and describes five in‐depth case studies, which were conducted at leading companies in Germany. A detailed investigation was made of how PPRs are conducted and of the type of learning that can result. Three main sources of data were used for each case: company documentation, in‐depth interviews with managers responsible for NPD, and observation of an actual PPR. The different data sources enabled extensive triangulation of data to be conducted and a high degree of reliability and validity to be achieved. The analysis enabled a number of key characteristics of the way PPRs are managed to be identified. Various characteristics of PPRs influence their utility, such as the time at which they take place and the way discussions are moderated. In addition, the data show that participants in the discussions at PPRs often use metaphors and stories, which indicates that PPRs have the potential to generate tacit knowledge. Interestingly, the data also show that there are various different ways in which metaphors and stories appear to stimulate discussions on NPD projects. Based on the cross‐case analysis, a wide range of implications are identified. Researchers need to investigate PPRs further to identify how they can generate tacit and explicit knowledge and support project‐to‐project learning. The generation of tacit knowledge in NPD is a topic that particularly needs further investigation. The research also led to a range of recommendations for practitioners. Companies need to strongly communicate the purpose and value of PPRs, to run them effectively to stimulate the maximum possible learning, and to disseminate the findings widely. PPRs have the potential to create and transfer knowledge amongst NPD professionals, but, as they are seldom currently used, many companies are missing an important opportunity.
Underperformance in Affluence: The Remarkable Relative Decline in U.S. Heights in the Second Half of the 20th Century*
Authors: Komlos John , Lauderdale Benjamin E.
Published: May 2007

Objective. We use the complete set of NHES and NHANES data collected between 1959 and 2004 in order to construct trends for the physical stature of the non‐Hispanic white and black U.S. adult population and compare them to those of western and northern Europeans.

Method. Regression analysis is used to estimate the trend in U.S. heights stratified by gender and ethnicity, holding income and educational attainment constant.

Results. U.S. heights stabilized at mid‐century and a two‐decade period of stagnation set in with the birth cohorts 1955–1974, concurrent with continual rapid increases in heights in western and northern Europe. Americans had been the tallest in the world for (more than) two centuries until World War II, but by the end of the 20th century fell behind many European populations. Only since the most recent birth cohorts 1975–1983 is some gain apparent among whites but not among blacks. The relationship between height and income and between height and educational attainment has not changed appreciably over time for either men or women.

Conclusion. We conjecture that the U.S. health‐care system, as well as the relatively weak welfare safety net, might be why human growth in the United States has not performed as well in relative terms as one would expect on the basis of income alone. The comparative pattern bears some similarly to that of life expectancy insofar as the United States is also lagging behind in that respect.
Effects of a Poverty Intervention Policy Demonstration on Parenting and Child Behavior: A Test of the Direction of Effects*
Authors: Epps Sylvia R. , Huston Aletha C.
Published: May 2007

Objectives. This study compares two explanations for the effects of an employment‐based anti‐poverty intervention, the New Hope project, on parenting and child behavior. (1) Did the New Hope intervention directly affect child behavior and, if it did, is this the result of New Hope effects on earlier parenting practices? (2) Did the New Hope intervention directly affect parenting practices and, if it did, is this the result of New Hope effects on earlier child behavior?

Methods. Assessments were collected two and five years after parents were randomly assigned to participate in New Hope or in a control group. The two models were tested using Baron and Kenny's (1986) recommendations for regression to test mediation.

Results. The results support the second research question, but only for boys; neither model was supported for girls. New Hope led to increased positive behavior and reduced behavior problems for boys after two years; children's behavior accounted for experimental effects on parents' reports of their parenting behaviors after five years.

Conclusions. Employment‐based interventions designed for low‐income parents can affect children directly; expanding such programs may help improve children's life chances.
Whose Risk in Philadelphia? Proximity to Unequally Hazardous Industrial Facilities*
Authors: Sicotte Diane , Swanson Samantha
Published: May 2007

Objective. Few researchers have investigated who lives near the worst polluting facilities. In this study, we test for disparate impact from hazardous industrial and infrastructure facilities on racial/ethnic minorities, the disadvantaged, the working class, and manufacturing workers in the nine‐county Philadelphia MSA.

Methods. Hazard Scores for Philadelphia‐area facilities in EPA's Risk‐Screening Environmental Indicators (RSEI) database were calculated and facilities mapped onto Census block group maps. One‐kilometer buffer zones around facilities were created and intersected with Census data on population inside and outside buffers. After correcting for spatial autocorrelation, we tested for relationships between Hazard Scores and characteristics of people near facilities using multivariate regression.

Results. Hazard Scores rose along with percents black, Hispanic, disadvantaged, and employed in manufacturing in some (but not all) counties.

Conclusions. Among those living near polluting facilities, minorities, the poor, and manufacturing workers lived near the most hazardous, constituting a disparate impact on these groups.
TRI to Communicate: Public Knowledge of the Federal Toxics Release Inventory*
Authors: Atlas Mark
Published: May 2007

Objective. Investigate public knowledge and use of information from the U.S. Toxics Release Inventory (TRI), the most internationally prominent and well‐regarded environmental information program, providing industrial facility chemical release and transfer data since 1989.

Method. Three‐phase survey panel of 1,292 people in two counties.

Results. Only very small percentages recalled, without prompting, TRI or recognized it when it was mentioned. Only minuscule percentages recalled TRI facility names when asked for local facilities using hazardous chemicals. Respondents did not recognize most local TRI facilities or know if they used hazardous chemicals. Very few who were aware of TRI information obtained it from the sources Congress intended. Finally, when provided with TRI information, many respondents did not review it and virtually no one took any action.

Conclusions. These results raise concerns about the TRI program's effectiveness in enhancing public knowledge of nearby industrial facilities using hazardous chemicals.
Does Relationship Lending Still Matter in the Consumer Banking Sector? Evidence from the Automobile Loan Market*
Authors: Holmes Jessica , Isham Jonathan , Petersen Ryan , Sommers Paul M.
Published: May 2007

Objective. This article examines the role of relationship lending in the automobile loan market at a community development credit union (CDCU) and at a traditional community bank.

Method. Data collected from actual car loan applications are used in a probit analysis to estimate the importance of selected demographic, financial, and loan‐specific variables on the probability of loan approval at the two types of financial institutions.

Results. We first show that the community bank relies on credit scoring, not relationship lending. Relationship lending is, however, a critical factor in the loan decision at the CDCU. Low‐income households with strong ties to the CDCU are likely to receive loans, despite poor credit histories.

Conclusions. If consolidation, deregulation, and technology move mainstream financial institutions away from relationship lending and toward credit scoring, CDCUs will occupy an increasingly critical niche for low‐income households.
Focal Atrial Tachycardia Originating from the Left Atrial Appendage: Electrocardiographic and Electrophysiologic Characterization and Long‐Term Outcomes of Radiofrequency Ablation
Authors: YUN‐LONG WANG , XUE‐BIN LI , XIN QUAN , JIN‐XIN MA , PING ZHANG , YUAN XU , HAI‐CHENG ZHANG , JI‐HONG GUO
Published: May 2007

Introduction: This study sought to investigate electrophysiologic characteristics and radiofrequency ablation (RFA) in patients with focal atrial tachycardia (AT) arising from the left atrial appendage (LAA).

Methods: This study included seven patients undergoing RFA with focal AT. Activation mapping was performed during tachycardia to identify an earlier activation in the left atria and the LAA. The atrial appendage angiography was performed to identify the origin in the LAA before and after RFA.

Results: AT occurred spontaneously or was induced by isoproterenol infusion rather than programmed extrastimulation and burst atrial pacing in any patient. The tachycardia demonstrated a characteristic P‐wave morphology and endocardial activation pattern. The P wave was highly positive in inferior leads in all patients. Lead V1 showed upright or biphasic (±) component in all patients. Lead V2–V6 showed an isoelectric component in five patients or an upright component with low amplitude (<0.1 mV) in two patients. Earliest endocardial activity occurred at the distal coronary sinus (CS) ahead of P wave in all seven patients. Mean tachycardia cycle length was 381 ± 34 msec and the earliest endocardial activation at the successful RFA site occurred 42.3 ± 9.6 msec before the onset of P wave. RFA was acutely successful in all seven patients. Long‐term success was achieved in seven of the seven over a mean follow‐up of 24 ± 5 months.

Conclusions: The LAA is an uncommon site of origin for focal AT (3%). There were consistent P‐wave morphology and endocardial activation associated with this type of AT. The LAA focal ablation is safe and effective. Long‐term success was achieved with focal ablation in all patients.
Electrical Conductivity and Thermal Expansion of Spinels at Elevated Temperatures
Authors: Petric Anthony , Ling Hang
Published: May 2007

Binary oxide spinels composed of Mg, Al, Cr, Mn, Fe, Co, Ni, Cu, and Zn were synthesized. Electrical conductivity was measured in air at 500°–800°C. Thermal expansion was measured from room temperature to 1000°C. Ferrite spinels have thermal expansion coefficients of 11–12 ppm/K, compared with 7–9 ppm/K for other spinels except Cu–Mn and Co–Mn which show anomalous behavior. The highest electrical conductivity among transition metal spinels was found for MnCo2O4 (60 S/cm at 800°C) and Cu1.3Mn1.7O4 (225 S/cm at 750°C).
Zirconium Carbide–Tungsten Cermets Prepared by In Situ Reaction Sintering
Authors: Zhang S. C. , Hilmas G. E. , Fahrenholtz W. G.
Published: May 2007

Zirconium carbide–tungsten (ZrC–W) cermets were prepared by a novel in situ reaction sintering process. Compacted stoichiometric zirconium oxide (ZrO2) and tungsten carbide (WC) powders were heated to 2100°C, which produced cermets with 35 vol% ZrC and 65 vol% W consisting of an interpenetrating‐type microstructure with a relative density of ∼95%. The cermets had an elastic modulus of 274 GPa, a fracture toughness of 8.3 MPa·m1/2, and a flexural strength of 402 MPa. The ZrC content could be increased by adding excess ZrC or ZrO2 and carbon to the precursors, which increased the density to >98%. The solid‐state reaction between WC and ZrO2 and W–ZrC solid solution were also studied thermodynamically and experimentally.
Appearance of Chemical Burns Resulting from the Washing of a Deceased Body with Bleach
Authors: Adair Thomas W. , Dobersen Michael J. , Lear‐Kaul Kelly
Published: May 2007

ABSTRACT: The authors report on a case of postmortem washing of a body with bleach. An adult female victim was found nude in an alleyway with both hands removed in the City of Westminster, CO. Cause of death was attributed to severe blunt force trauma to the head. The victim had been dumped in the alleyway within 7 h of discovery. Evidence discovered at the crime scene and autopsy indicated that the murder and subsequent washing of the body with bleach occurred at a secondary location(s). The victim was wet to the touch, presenting a strong odor of bleach. Several “ribbon”‐like burn patterns were observed on the victim's back and upper thighs. These burn marks were replicated by dowsing a deceased pig with an over‐the‐counter concentration of bleach.
Review of Pathologic Findings in Remnant Hearts Following Valve Donation
Authors: Mackey‐Bojack Shannon , Roe Susan , Titus Jack L.
Published: May 2007

ABSTRACT:The failure of medical examiners/coroners (ME/C) to allow heart valve donation is a major problem encountered by tissue agencies. Even though many ME/C favor tissue donation they remain responsible for determination of cause and manner of death. In 2001, the Jesse E. Edwards Registry of Cardiovascular Disease was approached by one of the nation's largest tissue procurement agencies (The American Red Cross—ARC) for the purpose of performing cardiovascular pathologic examinations following valve donation. The affiliation existed from October 2001 to January 2005. This study was undertaken to review all 593 postvalve recovery heart remnants received during that time period to tabulate the abnormalities identified and to determine whether donation interfered with the determination of cause of death. For each case, a preliminary cause of death was provided by the ARC. The decedent's body height and weight were also provided. Using the preliminary cause of death, the 593 cases were divided into natural and nonnatural manner of death groups. This division of the cases resulted in 106 cases placed in the natural manner of death group and 487 cases in the nonnatural manner of death group. For each case, all cardiac findings including significant conditions, additional findings, incidental findings, and congenital abnormalities were tabulated. Within the natural manner of death group, 15 cases had a noncardiac cause of death and 91 cases had a cause of death suspected to be cardiac related. In the 91 cases, a total of 132 significant cardiac findings were identified and there were six structurally normal hearts including two infants. In the nonnatural manner of death group, 214 significant cardiac findings were identified and 222 cases had a structurally normal heart. In both natural and nonnatural groups, the most common cardiac abnormality was atherosclerotic coronary artery disease. Other frequently encountered conditions were also identified including 11 cases with acute angle of origin of a coronary artery (five cases natural group; six cases nonnatural group). An important feature of this review was the recognition of potentially inheritable conditions that were diagnosed in both natural and nonnatural manner of death groups. There were three cases of hypertrophic cardiomyopathy (one natural; two nonnatural), three cases of arrhythmogenic right ventricular cardiomyopathy (one natural; two nonnatural), and one case of mitral valve prolapse (natural). In reviewing these cases, we did not feel that valve donation severely impaired cardiac pathologic examination. The benefits of cardiovascular pathologic examination by a cardiac pathologist include the identification of significant and incidental findings and recognition of potentially inheritable conditions.
Percentage of Body Recovered and Its Effect on Identification Rates and Cause and Manner of Death Determination*
Authors: Komar Debra A. , Potter Wendy E.
Published: May 2007

ABSTRACT: Anthropologists frequently encounter cases in which only partial human remains are recovered. This study reports how the percentage of the body recovered affects identification (ID) rates and cause and manner of death determination. A total of 773 cases involving anthropology consults were drawn from the New Mexico medical examiner's office (1974–2006). Results indicate a significant correlation between body percent recovered and ID rates, which ranged from 89% for complete bodies to 56% when less than half the body was present. Similar patterns were evident in cause/manner determination, which were the highest (83% and 79%, respectively) in complete bodies but declined to 40% when less than half the body was found. The absence of a skull also negatively impacted ID and ruling rates. Findings are compared with general autopsy ID rates (94–96%) and cause/manner determination rates (96–99%) as well as prior published rates for individual casework and mass death events.
Prediction of Stature Based on Radiographic Measurements of Cadaver Long Bones: A Study of the Croatian Population*
Authors: Petrovečki Vedrana , Mayer Davor , Šlaus Mario , Strinović Davor , Škavić Josip
Published: May 2007

ABSTRACT: We tested a new approach to the stature prediction that could be used in the identification process of human skeletal remains of unknown identity. The stature of 19 female and 21 male adult cadavers was measured within 24 h after death and considered to be equal to the living stature. The antero‐posterior radiographs of all limbs were taken, and the maximum length of the six long bones was measured from radiographs. There was a significant difference in the stature and maximum length of long bones between female and male cadavers (p<0.001 for all). The correlation between the stature and long bone length was the best for the humerus in females (r=0.792) and the tibia in males (r=0.891). Regression equations specific to the Croatian population were computed separately for each long bone in males and females and proven to be reliable in predicting the living stature of the individual.
Accidental Boric Acid Poisoning Following the Ingestion of Household Pesticide
Authors: Hamilton Rebecca A. , Wolf Barbara C.
Published: May 2007

ABSTRACT: Borate‐containing compounds were formerly used as topical antiseptics and were components of many medicinal preparations including skin powders and ointments used for the treatment of burns and diaper rash. These compounds were also used as irrigants for body cavities, including the pleural, vaginal, and rectal cavities. These applications were subsequently discontinued by the medical community when the toxicity and potential lethality of borates were recognized. Although documented cases of borate poisoning are now rare, the chemical is still an active component commonly used in high concentrations in household disinfectants/cleaners, pesticides, and wood preservatives. While the majority of documented borate‐related deaths have occurred in infants, the toddler population is currently at risk due to possible exposure to these household products. We present the case of an 18‐month‐old child who died following the accidental ingestion of a boric acid‐containing, commercially available roach pesticide product.
Comparison of Motor Oils Using High‐Temperature Gas Chromatography‐Mass Spectrometry
Authors: Reardon Michelle R. , Allen Lance , Bender Edward C. , Boyle Katherine M.
Published: May 2007

ABSTRACT:The analysis of motor oils has wide applications in the forensic science field from comparing lubricants transferred between an automobile and a victim or crime scene to differentiating the compositions of plastic explosives. In this study, 40 unused motor oils were analyzed and compared by high‐temperature gas chromatography‐mass spectrometry to determine the potential for oil individualization. Oil samples were also collected from the crankcase dipsticks of 30 cars. Twenty‐six of these oils could be differentiated from each other based on visual comparisons of the unresolved envelope (baseline rise due to incomplete separation) and the resolved hydrocarbons in the raw total ion chromatograms (TICs) and smoothed TIC data. Four of these oils were analyzed as unknowns and were correctly related to the corresponding vehicle. The use of extracted ion profiles (EIPs) was explored as a means to further discriminate between the indistinct samples based on the polycyclic aromatic hydrocarbon (PAH) content. The research discussed in this paper demonstrated that differentiation of motor oils was possible by examining the TIC, smoothed TIC, and EIP data.
Evaluation of Purkait's Triangle Method for Determining Sexual Dimorphism*
Authors: Brown Robert P. , Ubelaker Douglas H. , Schanfield Moses S.
Published: May 2007

ABSTRACT:The identification of sex from the skeleton is an important demographic assessment in medicolegal investigations. Rama Purkait developed a method for estimating sex using measurements from a triangle defined by three points on the proximal end of the femur using skeletal material from Bhopal, India. This method was tested with measurements on 200 Indo‐European and African American adult femora from the Terry collection using discriminant function analysis to determine if Purkait's method was valuable for determining sex in Americans. A side‐by‐side analysis was conducted of Purkait's “triangle method” and the maximum diameter of the femoral head to determine their relative value in assessing sexual dimorphism. In the study sample a single variable from Purkait's method provided 85.5% prediction accuracy, similar to 87% for the head diameter. Combining threshold values for a single variable from Purkait's method and the femoral head diameter raised the predictability to greater than 90% for both sexes.
Importance of Electromyography and the Electrophysiological Severity Scale in Forensic Reports
Authors: Bilgin Nursel Gamsιz , Özge Aynur , Mert Ertan , Yalçιnkaya Deniz E. , Kar Hakan
Published: May 2007

ABSTRACT: Forensic reports on traumatic peripheral nerve injuries include dysfunction degrees of extremities, which are arranged according to the Turkish Penalty Code. The aim of this study is to discuss the role and importance of electromyography while preparing forensic reports in the cases of traumatic peripheral nerve injuries and the usefulness of scoring systems. A modified global scale, recommended by Mondelli et al., was used to assess the electrophysiological impairment of each peripheral nerve. Forensic reports of 106 patients, reported between 2002 and 2004, were evaluated. Thirty‐four percent of the cases were reported as “total loss of function,” 41.5% were reported as “functional disability,” and there were no dysfunctions in the other cases in forensic reports that were prepared based on Council of Social Insurance Regulations of Health Processes and Guide prepared by the Council of Forensic Medicine and profession associations of forensic medicine. When we rearranged these forensic reports based on the electrophysiological severity scale (ESS), it was clearly found that all of the score 2 cases and 86.7% of the score 3 cases corresponded to “functional disability” and 91.4% of the score 4 cases correspond to “total loss of function.” We found a significant correlation between the ESS and functional evaluation in peripheral nerve injury cases. Evaluation of functional disabilities in peripheral nerve injuries with the ESS represents a standardized and objective method used for forensic reports.
Identification of Organic Pigments in Automotive Coatings Using Laser Desorption Mass Spectrometry*
Authors: Stachura Sylwia , Desiderio Vincent J. , Allison John
Published: May 2007

ABSTRACT:When one looks at an automotive coating, one sees color due to pigments. Modern organic pigments, with high molar absorptivities, may be only minor components of the mixture. Laser desorption mass spectrometry (LDMS) has been shown to be a useful tool for the analysis of colorants such as pen ink dyes. Here, LDMS is used to determine its utility for the identification of pigments, in simple media and in more complex paints. Small paint chips can be introduced into the LDMS instrument, and when an ultraviolet laser is focused on a portion of a chip, ions representative of the pigment(s) are selectively formed. Some pigments such as quinacridones and copper phthalocyanine are very stable and are desorbed and ionized intact. In contrast, benzimidazolones, which contain some single‐skeletal bonds, form fragment ions. This method proves to be sensitive and convenient, as no sample preparation is required. The presence of inorganic pigments in addition to modern organic pigments can be determined, and pigments can be directly identified in actual automotive paint chip samples.
Detection of Malingered PTSD: An Overview of Clinical, Psychometric, and Physiological Assessment: Where Do We Stand?
Authors: Hall Ryan C. W. , Hall Richard C. W.
Published: May 2007

ABSTRACT: Posttraumatic stress disorder (PTSD) is a condition that can be easily malingered for secondary gain. For this reason, it is important for physicians to understand the phenomenology of true PTSD and indicators that suggest an individual is malingering. This paper reviews the prevalence of PTSD for both the general population and for specific events, such as rape and terrorism, to familiarize evaluators with the frequency of its occurrence. The diagnostic criteria for PTSD, as well as potential ambiguities in the criteria, such as what constitutes an exposure to a traumatic event, are reviewed. Identified risk factors are reviewed as a potential way to help differentiate true cases of PTSD from malingered cases. The question of symptom overreporting as a feature of the disease versus a sign of malingering is discussed. We then examine how the clinician can use the clinical interview (e.g., SIRS, CAPS), psychometric testing, and the patient's physiological responses to detect malingering. Particular attention is paid to research on the MMPI and the subscales of infrequency (F), infrequency‐psychopathology (Fp), and infrequency‐posttraumatic stress disorder (Fptsd). Research and questions regarding the accuracy of self‐report questionnaires, specifically the Mississippi Scale (MSS) and the Personality Assessment Inventory (PAI), are examined. Validity, usability, and cutoff values for other psychometric tests, checklists, and physiological tests are discussed. The review includes a case, which shows how an individual used symptom checklist information to malinger PTSD and the inconsistencies in his story that the evaluator detected. We conclude with a discussion regarding future diagnostic criteria and suggestions for research, including a systematic multifaceted approach to identify malingering.
Genetic Polymorphism of Two Novel STR Loci AY639920 and AY639923 in a Chinese Population
Authors: Yan Jing , Zhang Weiiuan , Wu Jin , Li Yingbi , Zhang Ji , Hou Yi ping
Published: May 2007

POPULATION: Chinese.