bluuebunny/crossref_metadata_2025 huggingface dataset:
Web Woman: The On-line Construction of Corporate and Gender Images
Authors: Gustavsson Eva , Czarniawska Barbara
Published: September 2004

One of the many interesting applications of information technology is ‘business on the net’ and, within this trend, the appearance of virtual females whose job it is to assist customers by giving advice and delivering information. These creatures raise a host of interesting questions about corporate image, but also about humanness and femininity. Who or what do they represent: the companies that produced them? their designers? society’s dreams—both open and forbidden? Although we cannot aspire to provide final answers to these questions, we do try to formulate the questions in this paper and frame them in contexts that seem to be promising.
From Moby Dick to Free Willy: Macro-Cultural Discourse and Institutional Entrepreneurship in Emerging Institutional Fields
Authors: Lawrence Thomas B. , Phillips Nelson
Published: September 2004

In this paper, we draw on a case study of the development of commercial whale-watching on Canada’s west coast to explore the role of macro-cultural discourse and local actors in the structuration of new institutional fields. We argue that the development of the commercial whale-watching industry in the area was made possible by broad macrocultural changes in the conceptualization of whales in North America. At the same time, however, the characteristics of the geographically distinct institutional fields that emerged depended on local action and the processes of structuration that those actions supported. The constitution of specific new fields required interested actors to engage in the institutional innovation and isomorphism that produced the unique networks of relationships and sets of institutions that constituted those fields.
A Breast Cancer Fear Scale: Psychometric Development
Authors: Champion Victoria L. , Skinner Celette Sugg , Menon Usha , Rawl Susan , Giesler R. Brian , Monahan Patrick , Daggy Joanne
Published: September 2004

Fear of breast cancer has been inversely associated with participation in screening. However, investigators have generally used only one item or global scales to measure fear. This report describes development of a fear scale specific to breast cancer. Data from a large study involving mammography adherence were used to test the breast cancer fear scale for validity and reliability. Construct validity was verified through factor analysis and regression analysis predicting mammography. All items loaded on a single factor and theoretical relationships were verified by linear and logistic regression. The Cronbach alpha for the scale was .91.
The Effect of Meteorological and Pollution Parameters on the Frequency of Hospital Admissions for Cardiovascular and Respiratory Problems in Athens
Authors: Bartzokas A. , Kassomenos P. , Petrakis M. , Celessides C.
Published: September 2004

This study aimed to investigate the influence of meteorological and pollution parameters on the frequency of hospital admissions for cardiovascular and respiratory diseases. The study included 1,554 patients who were hospitalised in a major hospital in Athens during an 8-year period. The meteorological and pollution database consists of daily values of 12 original parameters and 24 constructed ones. The statistical methods used to analyse it were simple linear correlation and linear stepwise regression analysis and they were applied to 10-day period data. The results showed that temperature, humidity and smoke concentrations were significantly correlated with the incidence of cardiovascular and respiratory diseases.
Bacteria Removal and Viability Attenuation by Means of an Electrostatic Barrier
Authors: Dottori Mariangiola , Fava Gabriele , Ruello Maria Letizia
Published: September 2004

This study is focused on bacterial control through the removal and attenuation of viability by means of a commercial electrostatic air cleaner inserted in the ductwork of a central heating and air-conditioning system. Adapting the system to include an electrostatic barrier resulted, on an average, in removal of 88% of the bacteria in the airflow. In addition, the ratio of viable to non-viable organisms, calculated on the basis of epifluorescence measurements, was changed appreciably by passage through the electrostatic filter. Evaluation of performance was followed by two different strategies of sampling-analysis: a plate count method and epifluorescence microscopy. The system overall was highly efficient in removing the bacteria, since those few that evaded the filter underwent attenuation of around 50% of their viability on passage through it. This work suggests a strong positive effect when an electrostatic barrier is inserted in a ventilation duct.
Accessibility: A New Concept to Evaluate Ventilation Performance in a Finite Period of Time
Authors: Li Xianting , Zhao Bin
Published: September 2004

A new concept of ‘accessibility’ is presented that considers the influence of supply air or of a contaminant inside ventilated spaces within a finite period of time. Two new indices—accessibility of supply air (ASA) and accessibility of contaminant source (ACS)—are defined to evaluate the relative effect of spread of supply air or contaminant in a given period of time. The two new indices in a two-dimensional ventilated room have been numerically analysed to demonstrate the characteristics of the new concept. It is shown that accessibility increases with the increase of time. For emergency ventilation, people usually care about accessibility in a short period of time, which is usually less than twice the nominal time constant in the ventilated room. The analysis indicates that accessibility over such a period of time is very different from that over an ‘infinite’ period, i.e. the steady state case. The ASA and ACS scale influence the supply of air or contaminant in each zone quantitatively and thus they can be used to guide ventilation strategy, especially when an emergency occurs.
The International Observatory on End of Life Care (IOELC): An Information Resource for Palliative Care
Authors: Bath Peter A. , Clark David , Wright Michael
Published: September 2004

Although millions of people die each year throughout the world, and a large proportion of these would benefit from palliative care services to provide care for dying people are underdeveloped, particularly in resource-poor regions. This article describes the development of an information resource on the World Wide Web, the International Observatory on End of Life Care (IOELC), to provide information on palliative care services in Eastern Europe and Central Asia. The article describes the development of the IOELC, the structure of the resource, and how data were collected. It concludes with a discussion of plans to evaluate the website and to expand it to include other world regions, with the aim of developing it into a global information resource for the development of palliative care services.
When the going gets tough, the tough go photoshopping: September 11 and the newslore of vengeance and victimization
Authors: Frank Russell
Published: September 2004

The terrorist attacks on the United States on September 11 2001 inspired an outpouring of electronic folklore, particularly ‘photoshops’ (humorous digitally-altered photographs). This material is of two types. One, the newslore of vengeance, consists of fantasies of annihilation or humiliation aimed at Osama bin Laden or Afghanistan. The other, the newslore of victimization, expresses bewilderment at the role of fate or chance in who lived and died on that terrible day. This article analyzes the newslore of September 11 in light of Elliott Oring’s ‘unspeakability’ hypothesis: the material expresses emotions that were too raw to be covered in the news media and thus functions as both an outlet for those emotions and a protest against the decorousness of the press.
Interpersonal communication after 9/11 via telephone and internet: A theory of channel complementarity
Authors: Dutta-Bergman Mohan J.
Published: September 2004

How did Americans respond to the crisis posed by the terrorist attacks of September 11 (‘9/11’) in their communicative choices? Proposing the theory of channel complementarity, this article argues that users of a medium who satisfy a particular functional need also use other media types to fulfill that need. Based on an analysis of the data gathered by the Pew Research Center for the People and the Press immediately after the 9/11 attacks, it demonstrates that the individuals who communicated via telephone with family and friends about the 9/11 attacks were also more likely to communicate with family and friends on the internet.
Virilio’s Screen: The Work of Metaphor in the Age of Technological Convergence
Authors: Friedberg Anne
Published: September 2004

This brief essay traces the evolving role of the screen in the writing of high-speed theorist Paul Virilio. In Virilio’s writing, the screen serves as the locus of lost dimensions of space and technological transformations of time; it modifies our relation to space, is a surface-mount for its ‘accelerated virtualization’. If Virilio does not theorize the technological differences between film, television and the computer, I argue, it is because, for him, the screen remains in a metaphoric register, a virtual surface which overrides any specificities of its media formation.
Exploring Tongan Social Work
Authors: Mafile'o Tracie
Published: September 2004

This article discusses two Tongan social work concepts - fakafekau'aki(connecting) and fakatokilalo(humility) - that have emerged out of qualitative research exploring the practice of Tongan social workers in New Zealand. It is argued that social work is socially constructed and that positive social change for indigenous and migrant groups in western countries requires the utilization of relevant cultural concepts as foundations for practice. The use of Tongan concepts such as fakafekau'akiand fakatokilaloimply Tongan-centric conceptualizations of professionalism and relationship in social work. Finally, it is noted that these concepts must be viewed holistically in relation to the lived reality of Tongans.
Talking Back to Stigmatized Identities
Authors: Juhila Kirsi
Published: September 2004

The article is based on interviews with 17 shelter residents. The culturally dominant way of categorizing both shelters and their residents is negative, producing stigmatized identities. The questions asked are: do the shelter residents make references to the stigmatized identities and, how do they talk back to these identities? The residents often refer to their `given' identities, but instead of taking them for granted, adopt a critical position towards them. The talking back consists in a negotiation in which one's own identity is compared with the identities of either the shelter or the coresidents. The interviewees stress, on the one hand, the ordinary quality of the shelter and its residents or their own ordinariness. On the other hand, it is also possible to locate in the residents' talking back an identity politics, which attempts to replace the dominant categorizations with different ways of representing the shelter and its residents, ways which are conscious of diversity.
Multi-Lingual, but not Making it in International Schools
Authors: Kusuma-Powell Ochan
Published: September 2004

International schools are increasingly identifying Functionally Multi-Lingual children in their student populations. These students, bilingual or multilingual at surface levels of conversation, have not established academic competence in any single language. In many cases, the teacher may assume that another, more robust language exists, when in fact English is the child’s most highly developed language. These children experience difficulty with verbal cognitive development and often demonstrate other issues with learning, including problems with organization and memory, and difficulties in learning to read or in the production of written expression.
International Education and IB Programmes
Authors: Drake Barry
Published: September 2004

It has been suggested that the International Baccalaureate Organization could be expected to ‘influence’ as many as 100 million people in the foreseeable future. This article focuses on some of the cultural dissonances that may be produced from attempts to ‘clone’ on to non-Eurocentric models, educational systems and methodologies designed to accommodate cultural norms in another part of the world. Cultures are dynamic entities and a certain repositioning of defining characteristics may be regarded as an acceptable, even desirable, consequence of adopting IB programmes and methodologies. This article argues that such outcomes need to be the product of intentional design and not accidental byproducts.
Joseph Conrad
Authors: Walker George
Published: September 2004

This article discusses the contribution made by Joseph Conrad’s fictional writing to our understanding of cultural awareness. Never comfortable with his adopted English culture, Conrad used his experiences in different parts of the world during his career in the merchant navy to explore in his writing aspects of cultural dissonance and cultural isolation. His contribution to our understanding of these themes, which are of central importance to the international educator, is illustrated by particular reference to three of his early short stories: ‘An Outpost of Progress’, ‘Karain: A Memory’ and ‘Amy Foster’.
Damage Detection of Reinforced Concrete Beams with Novel Distributed Crack/Strain Sensors
Authors: Chen Genda , Mu Huimin , Pommerenke David , Drewniak James L.
Published: September 2004

Coaxial cables are used as distributed sensors to detect cracks or measure strains in reinforced concrete (RC) structures with the electrical time domain reflectometry (ETDR). An emphasis was placed on the development and validation of a type of novel cable sensors. The new sensor was designed based on the change in topology of its outer conductor under strain conditions instead of the change in geometry of a conventional cable sensor. Finite difference time domain (FDTM) models of four types of cables were established to understand the inter-relationship among various design parameters. They were calibrated with a standard displacement transducer in nine tension tests and then mounted near the surface of six RC beams of 0.91-m long to validate their sensitivity and performance. The bending test results of RC beams are in general agreement with those from the calibration test of cables. Both indicate that the proposed sensors are over 15-80 times more sensitive than sensors based on commercial coaxial cables. The test results of the beams also show that the measured reflection coefficient correlates well with the measured crack width. Overall, the new cables have a sensitivity of 160-750 milli rho per unit crack width in mm and a spatial resolution of 50 mm.
Technical Note: A Condition Classification System for Reciprocating Compressors
Authors: Yang Bo-Suk , Han Tian , An Jing-Long , Kim Hee-Chul , Ahn Byung-Ha
Published: September 2004

This paper proposes a classification system for damage detection that combines the discrete wavelet transform, a statistical methodology, and neural networks. In the proposed system, vibration signals of compressors are acquired as initial system inputs. The condition features are extracted by statistical moments of wavelet coefficients before entering the networks. The proposed on-line classification system can automatically classify a normal or faulty compressor. The system has been implemented to increase product reliability and reduce downtime for a large production facility.
How Psychological Therapy may Prolong Survival in Cancer Patients: New Evidence and a Simple Theory
Authors: Cunningham Alastair J. , Watson Kimberly
Published: September 2004

This article presents new data and attempts to draw together converging lines of evidence on the mental attributes that may favor prolonged survival in the face of metastatic cancer. The authors interviewed 10 individuals with medically incurable cancers who had outlived their prognoses by from 2.2 to 12.5 years (and have all survived, a further 2 more years in most cases, between interview and publication). The authors derived, by qualitative analysis, a number of themes common to most or all of them. Three major qualities emerged: “authenticity,” or a clear understanding of what was important in one’s life; “autonomy,” the perceived freedom to shape life around what was valued; and “acceptance,” a perceived change in mental state to enhanced self-esteem, greater tolerance for and emotional closeness to others, and an affective experience described as more peaceful and joyous. Previous descriptions of “remarkable survivors” have suffered from a serious limitation: the research to date has not clarified to what extent they differed psychologically from their many peers who did not survive. The authors attempted to address this question in 2 ways. Six of the subjects were part of a protocol (the Healing Journey study) in which patients belonged to a larger group, all of whom were medically assessed prospectively, by an expert panel. A prediction of the likely duration of survival was made for each of the patients in this study, and it could be shown that those who subsequently survived were not a random sample of the whole but displayed a much higher degree of early involvement in their psychological self-help than did most of their nonsurviving peers. They also compared long survivors with 2 other groups: 6 individuals with similar diseases who had not yet received psychological help and 6 individuals from the Healing Journey study whose survival duration was at the lower end of the whole group. The patients in these comparison groups also lacked many of the most salient qualities identified among the long survivors. Many of the attributes found in the long survivors were, however, also noted in the earlier reports of remarkable survivors in the literature, which suggests that the observations may be generalizable. Putting these joint findings together with the early work of Temoshok on “type C” adaptation as a risk factor for cancer, one can see that there is a mirrored symmetry between the psychological patterns possibly promoting disease and the changed adaptations that may lead to longer survival in some cases. The authors arrive at a commonsense hypothesis: to the extent that the progression of cancer, or other chronic disease, is favored by a distorted psychological adaptation such as type C, healing may be assisted by a reversal of that adaptation—in the case of cancer, toward greater authenticity of thought and action.
Long-Term Survival and Complete Response of a Patient with Recurrent Diffuse Intrinsic Brain Stem Glioblastoma Multiforme
Authors: Burzynski Stanislaw R. , Lewy Robert I. , Weaver Robert , Janicki Tomasz , Jurida Gabor , Khan Mohammad , Larisma Chymbeelyn B. , Paszkowiak Jaroslaw , Szymkowski Barbara
Published: September 2004

Recurrent diffuse intrinsic brain stem glioblastoma multiforme carries an extremely poor prognosis and a median survival of less than 7 months. In this article, the authors report good results in a 40-year-old man diagnosed with glioblastoma multiforme who received antineoplastons. The patient’s brain tumor was diagnosed in May 1999, and he subsequently underwent subtotal tumor resection and standard radiation therapy. Magnetic resonance imaging and positron emission tomography scans documented his tumor recurrence. Approximately 2 months after completion of radiation therapy, he was admitted for administration of intravenous antineoplastons A10 and AS2-1 through a subclavian venous catheter by intermittent bolus injections 6 times per day using a portable pump. Administration of antineoplastons A10 and AS2-1 was over 655 consecutive days with the exception of a few short interruptions. The maximum dosage of A10 was 8.15 g/kg/d and AS2-1 0.35 g/kg/d. Antineoplastons A10 and AS2-1 administration was very well tolerated with only mild reversible side effects. Follow-up magnetic resonance imaging and positron emission tomography scans revealed decrease and eventually disappearance of the tumor. A complete response was documented after approximately 1 year of antineoplastons A10 and AS2-1 administration. More than 4 years later, off antineoplastons A10 and AS2-1, the patient is tumor free, able to carry on normal activities, and works full-time, and his Karnofsky Performance Status increased from 50 to 100. Extensive phase II trials with antineoplastons A10 and AS2-1 in patients with glioblastoma multiforme are nearing completion. These trials may provide more data regarding the efficacy of antineoplastons A10 and AS2-1 in the treatment of glioblastoma multiforme in untreated patients compared to the results in those patients with tumor recurrence after radiation therapy.
An Approach to Teaching Physicians about Complementary Medicine in the Treatment of Cancer
Authors: Ben-Arye Eran , Frenkel Moshe
Published: September 2004

In recent years, complementary and alternative medicine (CAM) has become popular with the general public. Many cancer patients use CAM, usually without their physicians’ knowledge. The importance of discussing CAM with cancer patients is increasingly acknowledged. Unfortunately, there is little information available about teaching and increasing physicians’ knowledge about these therapies. In a preliminary trial addressing this lack of information, a course about the role of CAM in the treatment of cancer was designed and administered to primary care physicians. The course evolved as a response to an interest that was acknowledged among practicing family physicians and residents. The course involved family physicians, patients, and CAM practitioners. The main focus of the course was to enhance physicians’ understanding and attentiveness to patients’ reasons for using CAM, as well as education about the variety of CAM practices patients are using. The course consisted of biweekly meetings in which practitioners and patients brought their experience and practice. The course outcome was evaluated with an analysis of precourse and postcourse questionnaires. After completing the course, the participants reported that they were more open and able to talk about CAM with their patients and that they felt more prepared to treat patients with cancer, in general. This introductory course appears to be a first step in bridging some of the gaps between the popularity of CAM among cancer patients and primary care physicians’ knowledge related to CAM in cancer care.
Supporting the Transformative Process: Experiences of Cancer Patients Receiving Integrative Care
Authors: Mulkins Andrea L. , Verhoef Marja J.
Published: September 2004

Purpose. The purpose of this study is to describe the essential features of the transformative experience among people living with cancer who are seeking integrative care and to identify factors supporting this process. It is hoped that after establishing the nature and meaning of this change or shift, one will better understand what is most meaningful in terms of providing appropriate care and support to patients seeking integrative care. Study Design. An interpretational, qualitative approach guided sampling, data collection, and analysis with 11 individuals. A purposeful sample was drawn from selected integrative care facilities according to sociodemographics and type of cancer. Due to the complexity of this subject, second interviews were conducted with 5 participants to enhance the richness and validity of the data. Results. The experience of transformation is a dynamic 4-stage process in which participants learned about themselves and became more aware of who they are and how they relate to the world. Participants found that 4 dimensions of integrative medicine played a fundamental role in supporting this process. These dimensions include (1) having access to a range of appropriate therapies to support individual journeys, (2) care that focuses on one’s overall well-being, (3) control over cancer management, and (4) developing healing relationships with care providers. Conclusion. Although practitioners may not be able to create transformative experiences for patients, they may be able to establish and maintain conditions that support this process.
No Soy de Aqui ni Soy de Alla
Authors: Cardona Jose Ruben Parra , Busby Dean M. , Wampler Richard S.
Published: September 2004

The transgenerational cultural identity model offers a detailed understanding of the immigration experience by challenging agendas of assimilation and by expanding on existing theories of cultural identity. Based on this model, immigration is a complex phenomenon influenced by many variables such as sociopsychological dimensions, family, oppression, and quality of reception in the new country. These factors produce different outcomes of cultural identity. Potential applications of the model for educational institutions serving Latina/o students are discussed.
Chicana College Aspirations and the Role of Parents: Developing Educational Resiliency
Authors: Ceja Miguel
Published: September 2004

Using a theory of resiliency, this study provides a Chicana student’s perspective of the role of parents in the development of college aspirations. Qualitative interviews with Chicana high school seniors shed light on the different ways these students perceive and come to understand the manner by which their parents influence and shape their educational goals and aspirations. The findings of this study point to the pertinent role of parents in the development of educational aspirations.
Analysis of the Therapeutic Course of an Eating Disorders Group
Authors: Brunori Luisa , Gibin Anna Maria , Miglioli Maristella , Bussandri Monica
Published: September 2004

This paper documents how eating disorders are treated through homogeneous slow-open groups, alternating small groups with larger groups. The work performed was tested using transference and countertransference analysis supported by the use of the MRG grid.
Guidelines for Art Group Therapy as Part of a Day Treatment Program for Patients with Personality Disorders
Authors: Johns Siri , Karterud Sigmund
Published: September 2004

Art group therapy has been rated as the most favoured therapeutic element by patients, irrespective of personality type, in a combined group therapy program. In this article we outline the guidelines for such treatment and discuss why patients favour this group.
Role of Ultrasonography and Color Doppler in Identification of the Corpus Luteum of Early Pregnancy
Authors: Gupta Rakhee , Kochhar Suman , Devi Kamla , Sehgal Alka , Malhotra Sarla
Published: September 2004

A prospective study was conducted in 49 first-trimester pregnancies—39 with live intrauterine pregnancies and 10 with missed abortions. Transvaginal sonography and color Doppler recorded size, sonographic appearance, color flow pattern, peak systolic velocity, and resistance index of each corpus luteum. Gray-scale sonographic appearances revealed thick-walled cysts, hypoechoic to isoechoic rounded structures, thin-walled cysts, and bilocular thick-walled cysts in patients with live intrauterine pregnancies. In patients with missed abortions, the most common pattern was thick-walled cysts, followed by hypoechoic areas and simple cysts. It was concluded that the corpus luteum, a well-identified structure in one of the ovaries in early pregnancy, has a wide range of sonographic morphologies. Better delineation is possible with color Doppler and color power angiography. Knowledge of the various morphological patterns on sonogram and color Doppler can help differentiate the corpus luteum from true ovarian pathologies.
The efficacy of duloxetine: A comprehensive summary of results from MMRM and LOCF_ANCOVA in eight clinical trials
Authors: Mallinckrodt Craig H , Raskin Joel , Wohlreich Madelaine M , Watkin John G , Detke Michael J
Published: September 2004

Background

A mixed-effects model repeated measures approach (MMRM) was specified as the primary analysis in the Phase III clinical trials of duloxetine for the treatment of major depressive disorder (MDD). Analysis of covariance using the last observation carried forward approach to impute missing values (LOCF_ANCOVA) was specified as a secondary analysis. Previous research has shown that MMRM and LOCF_ANCOVA yield identical endpoint results when no data are missing, while MMRM is more robust to biases from missing data and thereby provides superior control of Type I and Type II error compared with LOCF_ANCOVA. We compared results from MMRM and LOCF_ANCOVA analyses across eight clinical trials of duloxetine in order to investigate how the choice of primary analysis may influence interpretations of efficacy.

Methods

Results were obtained from the eight acute-phase clinical trials that formed the basis of duloxetine's New Drug Application for the treatment of MDD. All 202 mean change analyses from the 20 rating scale total scores and subscales specified a priori in the various protocols were included in the comparisons.

Results

In 166/202 comparisons (82.2%), MMRM and LOCF_ANCOVA agreed with regard to the statistical significance of the differences between duloxetine and placebo. In 25/202 cases (12.4%), MMRM yielded a significant difference when LOCF_ANCOVA did not, while in 11/202 cases (5.4%), LOCF_ANCOVA produced a significant difference when MMRM did not. In 110/202 comparisons (54.4%) the p-value from MMRM was lower than that from LOCF_ANCOVA, while in 69/202 comparisons (34.2%), the p-value from LOCF_ANCOVA was lower than that from MMRM. In the remaining 23 comparisons (11.4%), the p-values from LOCF_ANCOVA and MMRM were equal when rounded to the 3rd decimal place (usually as a result of both p-values being < .001). For the HAMD17 total score, the primary outcome in all studies, MMRM yielded 9/12 (75%) significant contrasts, compared with 6/12 (50%) for LOCF_ANCOVA. The expected success rate was 80%.

Conclusions

Important differences exist between MMRM and LOCF_ANCOVA. Empirical research has clearly demonstrated the theoretical advantages of MMRM over LOCF_ANCOVA. However, interpretations regarding the efficacy of duloxetine in MDD were unaffected by the choice of analytical technique.
Impairments, activity limitations and participation restrictions: Prevalence and associations among persons living with HIV/AIDS in British Columbia
Authors: Rusch Melanie , Nixon Stephanie , Schilder Arn , Braitstein Paula , Chan Keith , Hogg Robert S
Published: September 2004

Background

To measure the prevalence of and associations among impairments, activity limitations and participation restrictions in persons living with HIV in British Columbia to inform support and care programs, policy and research.

Methods

A cross-sectional population-based sample of persons living with HIV in British Columbia was obtained through an anonymous survey sent to members of the British Columbia Persons With AIDS Society. The survey addressed the experience of physical and mental impairments, and the experience and level of activity limitations and participation restrictions. Associations were measured in three ways: 1) impact of types of impairment on social restriction; 2) impact of specific limitations on social restriction; and 3) independent association of overall impairments and limitations on restriction levels. Logistic regression was used to measure associations with social restriction, while ordinal logistic regression was used to measure associations with a three-category measure of restriction level.

Results

The survey was returned by 762 (50.5%) of the BCPWA participants. Over ninety percent of the population experienced one or more impairments, with one-third reporting over ten. Prevalence of activity limitations and participation restrictions was 80.4% and 93.2%, respectively. The presence of social restrictions was most closely associated with mental function impairments (OR: 7.0 for impairment vs. no impairment; 95% CI: 4.7 – 10.4). All limitations were associated with social restriction. Among those with ≤ 200 CD4 cells/mm3, odds of being at a higher restriction level were lower among those on antiretrovirals (OR: 0.3 for antiretrovirals vs. no antiretrovirals; 95% CI: 0.1–0.9), while odds of higher restriction were increased with higher limitation (OR: 3.6 for limitation score of 1–5 vs. no limitation, 95%CI: 0.9–14.2; OR: 24.7 for limitation score > 5 vs. no limitation, 95%CI: 4.9–125.0). Among those with > 200 CD4 cells/mm3, the odds of higher restriction were increased with higher limitation (OR: 2.7 for limitation score of 1–5 vs. no limitation, 95%CI: 1.4–5.1; OR: 8.6 for limitation score > 5 vs. no limitation, 95%CI: 3.9–18.8), as well as by additional number of impairments (OR:1.2 for every additional impairment; 95% CI:1.1–1.3).

Conclusions

This population-based sample of people living with HIV has been experiencing extremely high rates of impairments, activity limitations and participation restrictions. Furthermore, the complex inter-relationships identified amongst the levels reveal lessons for programming, policy and research in terms of the factors that contribute most to a higher quality of life.
Potential cellular conformations of the CCN3(NOV) protein
Authors: Kyurkchiev Stanimir , Yeger Herman , Bleau Anne-Marie , Perbal Bernard
Published: September 2004

Aim

To study the cellular distribution of CCN3(NOV) and to determine if the carboxyterminus of CCN3 is hidden or masked due to high affinity interactions with other partners. CCN3 was detected using affinity purified antibodies (anti-K19M-AF) as well as a Protein A purified anti-K19M antibodies (anti-K19M IgG) against a C-terminal 19-aminoacid peptide (K19M) of human CCN3 protein. The antibodies were applied in indirect immunofluorescence tests and immunoenzyme assays on glial tumor cell line, G59, and its CCN3-transfected variant G59/540 and the adrenocortical cell line, NCI-H295R.

Results

Anti-K19M-AF antibodies reacted against K19M peptide in ELISA and recognized two bands of 51 kDa and 30 kDa in H295R (adrenocortical carcinoma) cell culture supernatants by immunoblotting. H295R culture supernatants which contained CCN3 as shown by immunoblotting did not react with anti-CCN3 antibodies in liquid phase. Anti-CCN3 antibodies stained the surface membranes of non-permeabilized H295R and cytoplasm in permeabilized H295R cells. Similarly, anti-CCN3 stained surface membranes of G59/540, but did not react with G59 cells. Prominent cytoplasmic staining was observed in G59/540, as well as the cell footprints of G59/540 and H295R were strongly labeled.

Conclusions

The K19M-AF antibody directed against the C-terminal 19-aminoacid peptide of CCN3 recognized the secreted protein under denaturing conditions. However, the C-terminal motif of secreted CCN3 was not accessible to K19M-AF in liquid phase. These anti-CCN3 antibodies stained CCN3 protein which was localized to cytoplasmic stores, cell membranes and extracellular matrix. This would suggest that cytoplasmic and cell membrane bound CCN3 has an exposed C-terminus while secreted CCN3 has a sequestered C-terminus which could be due to interaction with other proteins or itself (dimerization). Thus the K19M-AF antibodies revealed at least two conformational states of the native CCN3 protein.
What do evidence-based secondary journals tell us about the publication of clinically important articles in primary healthcare journals?
Authors: McKibbon Kathleen Ann , Wilczynski Nancy L , Haynes Robert Brian
Published: September 2004

Background

We conducted this analysis to determine i) which journals publish high-quality, clinically relevant studies in internal medicine, general/family practice, general practice nursing, and mental health; and ii) the proportion of clinically relevant articles in each journal.

Methods

We performed an analytic survey of a hand search of 170 general medicine, general healthcare, and specialty journals for 2000. Research staff assessed individual articles by using explicit criteria for scientific merit for healthcare application. Practitioners assessed the clinical importance of these articles. Outcome measures were the number of high-quality, clinically relevant studies published in the 170 journal titles and how many of these were published in each of four discipline-specific, secondary "evidence-based" journals (ACP Journal Club for internal medicine and its subspecialties; Evidence-Based Medicine for general/family practice; Evidence-Based Nursing for general practice nursing; and Evidence-Based Mental Health for all aspects of mental health). Original studies and review articles were classified for purpose: therapy and prevention, screening and diagnosis, prognosis, etiology and harm, economics and cost, clinical prediction guides, and qualitative studies.

Results

We evaluated 60,352 articles from 170 journal titles. The pass criteria of high-quality methods and clinically relevant material were met by 3059 original articles and 1073 review articles. For ACP Journal Club (internal medicine), four titles supplied 56.5% of the articles and 27 titles supplied the other 43.5%. For Evidence-Based Medicine (general/family practice), five titles supplied 50.7% of the articles and 40 titles supplied the remaining 49.3%. For Evidence-Based Nursing (general practice nursing), seven titles supplied 51.0% of the articles and 34 additional titles supplied 49.0%. For Evidence-Based Mental Health (mental health), nine titles supplied 53.2% of the articles and 34 additional titles supplied 46.8%. For the disciplines of internal medicine, general/family practice, and mental health (but not general practice nursing), the number of clinically important articles was correlated withScience Citation Index (SCI) Impact Factors.

Conclusions

Although many clinical journals publish high-quality, clinically relevant and important original studies and systematic reviews, the articles for each discipline studied were concentrated in a small subset of journals. This subset varied according to healthcare discipline; however, many of the important articles for all disciplines in this study were published in broad-based healthcare journals rather than subspecialty or discipline-specific journals.
Ambulatory chemotherapy: pharmaceutical care as a part of oncology service
Authors: Höckel Michael
Published: September 2004

Cancer patients and the application of pharmaceutical care: 1) Patients with chronic illnesses receive multiple benefits from pharmaceutical care. 2) The pharmaceutical care of the cancer patient must be co-ordinated with the physician. 3) The cancer care-providing pharmacist should acquire psychological competency. 4) The pharmacist sets up and maintains for the patient a drug therapy record and a drug application plan. Cancer patients require our attention and our professional knowledge in many respects.

On the one hand, there is the centralized aseptic preparation of chemotherapy drugs with respective individual requirements, on the other hand there is the monitoring of therapy, pharmacoeconomics, reducing the risk of chemotherapy errors and safe drug handling. All of these require our professional commitment. In order to provide care to cancer patients in community pharmacies, it is essential to establish a structural procedure. Individualized counselling and personal care of the patient is a part of pharmaceutical services.

Development of a constructive and relevant relationship between patient and pharmacist must be cultivated and begins with the issue of the first prescription. Possibly the patient could still frequent his regular pharmacy and use the special pharmacy only for oncology therapy. In the near future, with patient authorization, an exchange of medication-related data between hospital and community pharmacy will also be possible. We consider a possible German concept for oncology out-patients.
Rationing costly treatments: can it be fair?
Authors: de Lemos Mário L
Published: September 2004

Healthcare resources are finite and rationing is common. Fair distribution assumes that equals are treated equally and unequals are treated unequally, based on morally relevant differences such as the needs of and likely benefits to the patients. Applying these considerations in practice is complex. A case is described to illustrate the ethical issues raised by patients’ requests to pay for an expensive drug treatment.
Assimilation of Meteosat radiance data within the 4D‐Var system at ECMWF: Assimilation experiments and forecast impact
Authors: Köpken Christina , Kelly Graeme , Thépaut Jean‐Noël
Published: September 2004

The direct assimilation of water vapour (WV) clear‐sky radiances (CSRs) from geostationary satellites within the ECMWF four‐dimensional variational assimilation (4D‐Var) became operational on 9 April 2002 with the assimilation of radiances from Meteosat‐7. To extend the coverage provided by geostationary radiances, the derivation of a similar CSR product from the Geostationary Operational Environmental Satellites GOES‐W and GOES‐E was initiated and since 14 January 2003 these data have been operationally assimilated as well. This paper discusses results from the pre‐operational impact experiments using Meteosat‐7 and the subsequent operational implementation of the WV radiance assimilation. The pre‐operational data monitoring of the CSRs shows contamination of certain time slots caused by intruding solar stray light and a certain degree of cloud influence present in the CSR. Data quality control is introduced to exclude affected data. When assimilated, the Meteosat WV CSRs correct the upper‐tropospheric humidity field in areas of known model problems. While the analysis draws well to Meteosat data, the fit to other conventional observations does not degrade, and the fit to other satellite observations is noticeably improved. This is visible in statistics for the assimilated HIRS‐12 as well as for passive Advanced Microwave Sounding Unit B (AMSUB) radiances, both in the pre‐operational experiments and in the operational assimilation cycle. The impact on forecast quality is slightly positive to neutral for different areas of the globe. In some experiments a positive impact on upper‐level wind fields (around 200 hPa) is seen, especially in the tropics. A relatively large sensitivity is noted of the mean increments and also forecast scores to the bias correction. Copyright © 2004 Royal Meteorological Society
Speciation of Cr and As Leachates from CCA Treated Wood by Differential Pulse Polarography
Authors: Hingston J. A. , Moore J. , Murphy R. J. , Lester J. N. , Collins C. D.
Published: September 2004

Considerable research has been conducted to quantify the leaching rates of chromium and arsenic
from timbers treated with the traditional wood preservative, CCA. However, much of this work
has concentrated on measuring total metal concentrations. The environmental toxicity of these elements
is significantly affected by their oxidation state. Therefore, quantification of individual
metal species is considered important if the environmental effects of wood preservative leachates
are to be determined. Laboratory leaching tests were conducted to allow speciation of both
chromium and arsenic lost from CCA treated timbers exposed to artificial seawater for the first
time. Differential pulse polarography was used to measure concentrations of As(III), Cr(VI) and
Cr(III). Analysis indicated that less than 10% of the total As was leached as As(III), and that less
than 1% of the total Cr was leached as Cr(VI).
Comparative analysis of inactivated wood surfaces
Authors: Šernek M. , Kamke F. A. , Glasser W. G.
Published: September 2004

The surface inactivation of two wood species, yellow poplar (Liriodendron tulipifera) and southern pine (Pinus taeda), was studied following high temperature drying. Surface analysis involved X-ray photoelectron spectroscopy, sessile drop wettability and fracture mechanics of the adhesively-jointed surfaces. The results showed that wood drying at high temperature (i.e., >160 to 180 °C) caused modifications in surface composition. The oxygen to carbon ratio (O/C) decreased and the ratio of carbon atoms bonded to other carbon or to hydrogen atoms vis-à-vis carbons bonded to oxygen atoms (i.e., the C1/C2 ratio) increased with drying temperature. In addition, the contact angle increased with the temperature of exposure, but decreased with time. A dependence on wood species was evident: southern pine surfaces always exhibited higher contact angles than yellow poplar. Also, the rate of contact angle decline with time, dθ/dt, was found to vary with surface composition: this rate corresponded to O/C ratio-changes, especially in the case of southern pine. Southern pine was most susceptible to inactivation particularly when bonded with PF adhesive. Yellow poplar surfaces did not show significant inactivation when exposed to drying temperatures below ca. 180 °C. The results are explained by a relative enrichment of wood surfaces with non-polar substances, hydrophobic extractives and volatile organic compounds that 'become visually evident during the drying process at temperatures above ca. 160 °C. Little change was observed if drying temperatures remained below 150 °C.
Caspofungin: A Potential Cause of Reversible Severe Thrombocytopenia
Authors: Lynch Julia , Wong‐Beringer Annie
Published: September 2004

Caspofungin is an echinocandin agent approved for the treatment of invasive candidiasis and refractory aspergillosis. Compared with amphotericin B, caspofungin has an improved safety profile, but clinical experience with this agent is still accumulating. A 68‐year‐old man developed reversible severe thrombocytopenia, possibly due to caspofungin, after being successfully treated for Candida albicans endocarditis. Given the limited clinical experience with caspofungin, continued vigilance for unusual and serious adverse events associated with the drug is imperative.
Ximelagatran: Pharmacology, Pharmacokinetics, and Pharmacodynamics
Authors: Dobesh Paul P.
Published: September 2004

Thromboembolism is the largest cause of morbidity and mortality in the western world, yet oral anticoagulation is currently available only with vitamin K antagonists—most often, warfarin. Warfarin has been used for treatment of thrombotic disease for about 50 years. However, despite its widespread use, it is associated with several limitations, such as varied patient response, a narrow therapeutic window, numerous drug and food interactions, and need for frequent therapeutic monitoring. In addition, its full anticoagulant effect usually takes at least 4–5 days after the start of therapy or any dosage change, and it has a slow offset of therapy. A new oral anticoagulant, ximelagatran, has considerable advantages compared with warfarin. The agent requires no therapeutic monitoring, has a wide therapeutic window, and is not known to interact with food or drugs. The advantages ximelagatran brings to clinical practice should be a welcome addition to the options for management of thrombotic disease.
Reaction kinetics of multiphase polymer systems under flow
Authors: Feng Lian‐Fang , Hu Guo‐Hua
Published: September 2004

For given nominal molar concentrations in complementary functional groups, the common wisdom is that the reaction rate of those attached to large molecules does not exceed that of small molecule analogues. They are at best equal. The difference in reaction kinetics is more pronounced if reactive molecules are so large that they phase‐separate, which is often so for polymers. In such cases, complementary functional groups from the two phases can meet and react only at the interfaces. Thus, reaction kinetics of functional groups attached to small molecules has always been taken as the upper bound for those attached to polymers. Here we show that under sufficient mixing, reaction kinetics of two immiscible reactive polymers can be significantly higher than that of small molecule analogues. This phenomenon is attributed to the combined effects of increasing collision probability originated from mixing‐induced interfacial area generation, longer relaxation time of reactive polymer chains, and eventually interfacial slip. © 2004 American Institute of Chemical Engineers AIChE J, 50:2604–2612, 2004