bluuebunny/crossref_metadata_2025 huggingface dataset:
Population energy use scales positively with body size in natural aquatic microcosms
Authors: Hayward April , Khalid Maaheen , Kolasa Jurek
Published: June 2009

Aim  We test the ‘energetic equivalence rule’ (EER) – the idea that the amount of energy used by a population per unit area per unit time is independent of body mass – in meio‐invertebrate communities from a series of natural, multitrophic aquatic ‘rock pool’ microcosms. Our study represents the first rigorous test of the EER at local scales of observation in a community of naturally coexisting species.

Location  Discovery Bay, Jamaica.

Method  We estimated population energy use (PEU) for every occurrence of every species of meio‐invertebrate fauna found in each of 29 microcosms (233 observations of 31 species) using estimates of population density obtained in January 2005 in combination with published metabolism–mass relations for closely related taxa.

Results  In the rock pool system as a whole, population density decreased (ancova: b = –0.38 (–0.55 to –0.19), r2 = 0.19, P < 0.001) and PEU increased with body mass (ancova: b = 0.55 (0.36–0.73), r2 = 0.28, P < 0.001).

Main conclusions  The positive PEU–body mass relation found here suggests that larger organisms are energetically dominant and points to the importance of size‐structured competition in these systems. Our results contrast those obtained in the few other previously published tests of the EER and challenge the idea that all species use similar amounts of energy regardless of their size.
Comparative Effectiveness Research and Evidence‐Based Health Policy: Experience from Four Countries
Authors: CHALKIDOU KALIPSO , TUNIS SEAN , LOPERT RUTH , ROCHAIX LISE , SAWICKI PETER T. , NASSER MONA , XERRI BERTRAND
Published: June 2009

Context: The discussion about improving the efficiency, quality, and long‐term sustainability of the U.S. health care system is increasingly focusing on the need to provide better evidence for decision making through comparative effectiveness research (CER). In recent years, several other countries have established agencies to evaluate health technologies and broader management strategies to inform health care policy decisions. This article reviews experiences from Britain, France, Australia, and Germany.

Methods: This article draws on the experience of senior technical and administrative staff in setting up and running the CER entities studied. Besides reviewing the agencies' websites, legal framework documents, and informal interviews with key stakeholders, this analysis was informed by a workshop bringing together U.S. and international experts.

Findings: This article builds a matrix of features identified from the international models studied that offer insights into near‐term decisions about the location, design, and function of a U.S.‐based CER entity. While each country has developed a CER capacity unique to its health system, elements such as the inclusiveness of relevant stakeholders, transparency in operation, independence of the central government and other interests, and adaptability to a changing environment are prerequisites for these entities' successful operation.

Conclusions: While the CER entities evolved separately and have different responsibilities, they have adopted a set of core structural, technical, and procedural principles, including mechanisms for engaging with stakeholders, governance and oversight arrangements, and explicit methodologies for analyzing evidence, to ensure a high‐quality product that is relevant to their system.
Toward a Transdisciplinary Model of Evidence‐Based Practice
Authors: SATTERFIELD JASON M. , SPRING BONNIE , BROWNSON ROSS C. , MULLEN EDWARD J. , NEWHOUSE ROBIN P. , WALKER BARBARA B. , WHITLOCK EVELYN P.
Published: June 2009

Context:This article describes the historical context and current developments in evidence‐based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the evolution of the seminal “three circles” model of evidence‐based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines.

Methods:The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline.

Findings:Common challenges across disciplines include (1) how “evidence” should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision‐making process; (3) the definition and role of the “expert”; and (4) what other variables should be considered when selecting an evidence‐based practice, such as age, social class, community resources, and local expertise.

Conclusions:A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed.
How Do You Modernize a Health Service? A Realist Evaluation of Whole‐Scale Transformation in London
Authors: GREENHALGH TRISHA , HUMPHREY CHARLOTTE , HUGHES JANE , MACFARLANE FRASER , BUTLER CERI , PAWSON RAY
Published: June 2009

Context: Large‐scale, whole‐systems interventions in health care require imaginative approaches to evaluation that go beyond assessing progress against predefined goals and milestones. This project evaluated a major change effort in inner London, funded by a charitable donation of approximately $21 million, which spanned four large health care organizations, covered three services (stroke, kidney, and sexual health), and sought to “modernize” these services with a view to making health care more efficient, effective, and patient centered.

Methods: This organizational case study draws on the principles of realist evaluation, a largely qualitative approach that is centrally concerned with testing and refining program theories by exploring the complex and dynamic interaction among context, mechanism, and outcome. This approach used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the case and follow its fortunes over the three‐year study period. The methods included ethnographic observation, semistructured interviews, and scrutiny of documents and other contemporaneous materials. As well as providing ongoing formative feedback to the change teams in specific areas of activity, we undertook a more abstract, interpretive analysis, which explored the context‐mechanism‐outcome relationship using the guiding question “what works, for whom, under what circumstances?”

Findings: In this example of large‐scale service transformation, numerous projects and subprojects emerged, fed into one another, and evolved over time. Six broad mechanisms appeared to be driving the efforts of change agents: integrating services across providers, finding and using evidence, involving service users in the modernization effort, supporting self‐care, developing the workforce, and extending the range of services. Within each of these mechanisms, different teams chose widely differing approaches and met with differing success. The realist analysis of the fortunes of different subprojects identified aspects of context and mechanism that accounted for observed outcomes (both intended and unintended).

Conclusions: This study was one of the first applications of realist evaluation to a large‐scale change effort in health care. Even when an ambitious change program shifts from its original goals and meets unforeseen challenges (indeed, precisely because the program morphs and adapts over time), realist evaluation can draw useful lessons about how particular preconditions make particular outcomes more likely, even though it cannot produce predictive guidance or a simple recipe for success. Noting recent calls by others for the greater use of realist evaluation in health care, this article considers some of the challenges and limitations of this method in the light of this experience and suggests that its use will require some fundamental changes in the worldview of some health services researchers.
Health Consequences of Uninsurance among Adults in the United States: Recent Evidence and Implications
Authors: MICHAEL McWILLIAMS J.
Published: June 2009

Context: Uninsured adults have less access to recommended care, receive poorer quality of care, and experience worse health outcomes than insured adults do. The potential health benefits of expanding insurance coverage for these adults may provide a strong rationale for reform. However, evidence of the adverse health effects of uninsurance has been largely based on observational studies with designs that do not support causal conclusions. Although recent research using more rigorous methods may offer a better understanding of this important subject, it has not been comprehensively reviewed.

Methods: The clinical and economic literature since 2002 was systematically searched. New research contributions were reviewed and evaluated based on their methodological strength. Because the effectiveness of medical care varies considerably by clinical risk and across conditions, the consistency of study findings with clinical expectations was considered in their interpretation. Updated conclusions were formulated from the current body of research.

Findings: The quality of research has improved significantly, as investigators have employed quasi‐experimental designs with increasing frequency to address limitations of earlier research. Recent studies have found consistently positive and often significant effects of health insurance coverage on health across a range of outcomes. In particular, significant benefits of coverage have now been robustly demonstrated for adults with acute or chronic conditions for which there are effective treatments.

Conclusions: Based on the evidence to date, the health consequences of uninsurance are real, vary in magnitude in a clinically consistent manner, strengthen the argument for universal coverage in the United States, and underscore the importance of evidence‐based determinations in providing health care to a diverse population of adults.
Housing First for Homeless Persons with Active Addiction: Are We Overreaching?
Authors: KERTESZ STEFAN G. , CROUCH KIMBERLY , MILBY JESSE B. , CUSIMANO ROBERT E. , SCHUMACHER JOSEPH E.
Published: June 2009

Context: More than 350 communities in the United States have committed to ending chronic homelessness. One nationally prominent approach, Housing First, offers early access to permanent housing without requiring completion of treatment or, for clients with addiction, proof of sobriety.

Methods: This article reviews studies of Housing First and more traditional rehabilitative (e.g., “linear”) recovery interventions, focusing on the outcomes obtained by both approaches for homeless individuals with addictive disorders.

Findings: According to reviews of comparative trials and case series reports, Housing First reports document excellent housing retention, despite the limited amount of data pertaining to homeless clients with active and severe addiction. Several linear programs cite reductions in addiction severity but have shortcomings in long‐term housing success and retention.

Conclusions: This article suggests that the current research data are not sufficient to identify an optimal housing and rehabilitation approach for an important homeless subgroup. The research regarding Housing First and linear approaches can be strengthened in several ways, and policymakers should be cautious about generalizing the results of available Housing First studies to persons with active addiction when they enter housing programs.
DISENCHANTMENT, RE‐ENCHANTMENT, AND ENCHANTMENT
Authors: SHERRY PATRICK
Published: June 2009

Max Weber described the modern world as disenchanted. By contrast, some contemporary writers have said that postmodernism and other developments are re‐enchanting the world. I put Weber and these writers alongside each other, and then undercut the discussion by considering a third possibility raised by some recent writers on theological aesthetics: that the world is still enchanted in certain ways. But this third point of view depends on a wide reading of the concept of “sacrament”, and one very different from Weber's understanding.
PROMETHEUS AND KANT: NEUTRALIZING THEOLOGICAL DISCOURSE AND DOXOLOGY
Authors: SCIGLITANO ANTHONY C.
Published: June 2009

This essay argues that Kant's writings on religion recapitulate or anticipate many of the theoretical moves we find in Promethean discourses of the eighteenth and nineteenth centuries. The first portion of the article lays out fundamental elements of Promethean discourse from a theological point of view, and distinguishes between “aggressive” and “urbane” Prometheanism. I contend that both types attack divine transcendence and Christian doxology, focus almost entirely on soteriology to the detriment of creation, and advocate a movement from theo‐centric discourse to anthropocentric discourse. Yet urbane Prometheanism differs from its aggressive cousin by moving from hatred of God to a non‐dialogical mode of indifference to God as an impotent and inconsequential deity. I argue that an urbane Prometheanism is what properly characterizes Kant's philosophy of religion—from his epistemic work in the first Critique, through his way of parsing theological and philosophical discursive responsibilities, to his actual hermeneutics of Christian doctrine.
BLACK HOLES AND REVELATIONS: MICHEL HENRY AND JEAN‐LUC MARION ON THE AESTHETICS OF THE INVISIBLE
Authors: FRITZ PETER JOSEPH
Published: June 2009

This essay examines how Michel Henry's and Jean‐Luc Marion's continuation of phenomenology's turn to the invisible relates to painting, aesthetics, and theology. First, it discusses Henry and Marion's redefinition of phenomenality. Second, it explores Henry's “Kandinskian” description of abstract painting as expressing “Life.” Third, it explicates Marion's “Rothkoian” rehabilitation of the idol and renewed zeal for the icon—both phenomena exemplify “givenness.” Fourth, it unpacks my thesis: Henry's phenomenology, theologically applied, exercises an inadequate Kantian apophasis, characterized by a sublime sacrifice of the imagination; although Marion's work sometimes evidences a similar tendency, its prevailing momentum offers theology a fully catholic scope.
ECONOMY OF THE GIFT: RETHINKING THE ROLE OF LAND ENCLOSURE IN POLITICAL ECONOMY*
Authors: MEI TODD S.
Published: June 2009

The theological revivification of the concept of gift and gift exchange in the last two decades has provoked questions on how notions of divine superabundance can be translated into economics. In this article, I relate the thinking of Paul Ricoeur, John Milbank, Philip Goodchild and Albino Barrera to a specific economic reform that entails seeing land enclosure as inimical to the stability and fairness of an economy. I refer to the political economy of Henry George (1839–97) which takes land value taxation to be its centrally defining principle for a just economy.
PHENOMENOLOGY—METAPHYSICS—THEOLOGY
Authors: PEPERZAK ADRIAAN
Published: June 2009

Phenomenology—Metaphysics—Theology (a review article of Belief and Metaphysics and Transcendence and Phenomenology, edited by Conor Cunningham and Peter M. Candler, Jr. [JCM Press, London 2007]).

The forty papers collected in these books form the proceedings of two conferences organized by the University of Nottingham's Centre of Theology and Philosophy. These articles present an image of the diverse ways in which continental philosophers working in the Anglophone world approach the relation between philosophy and theology.

The reviewer highlights the most inspiring essays and summarizes others. He emphasizes and appreciates the strong influence of 20th century phenomenologists and of Aquinas, as well as the high esteem of some contributors for a certain form of metaphysics as condition of a new orthodox theology. He also draws attention, however, to the absence of dialogue among the contributors, and the paucity of properly scriptural and theological analysis—both of which failings are especially problematic in relation to the Centre's overall program.
IRRESPONSIBLE LOVE: RETHINKING INTELLECTUAL DISABILITY, HUMANITY AND THE CHURCH1
Authors: VOLPE MEDI ANN
Published: June 2009

This review essay considers three recent studies at the intersection of theology and intellectual disability. All three authors work out constructive proposals against a background of literature in which Nancy Eiesland and Stanley Hauerwas are central. Each explores the nature of intellectual disability through interdisciplinary study and draws this work into conversation with classical Christian theology. The essay welcomes these three books, and also suggests ways in which their constructive proposals might be strengthened. In particular, their use of resources within late ancient Christian tradition fails to take into account some of the doctrinal formulations most congenial to their projects.
Simplified Implementation of the Heckman Estimator of the Dynamic Probit Model and a Comparison with Alternative Estimators*
Authors: Arulampalam Wiji , Stewart Mark B.
Published: June 2009

This paper presents a convenient shortcut method for implementing the Heckman estimator of the dynamic random effects probit model and other dynamic nonlinear panel data models using standard software. It then compares the estimators proposed by Heckman, Orme and Wooldridge, based on three alternative approximations, first in an empirical model for the probability of unemployment and then in a set of simulation experiments. The results indicate that none of the three estimators dominates the other two in all cases. In most cases, all three estimators display satisfactory performance, except when the number of time periods is very small.
Transnational Corporations, Global Production Networks, and Urban and Regional Development: A Geographer's Perspective onMultinational Enterprises and the Global Economy
Authors: YEUNG HENRY WAI‐CHUNG
Published: June 2009

This paper offers an economic‐geographical interpretation of the role of transnational corporations (TNCs) in urban and regional development that is grounded inDunning and Lundan's (2008)Multinational Enterprises and the Global Economy. I argue that TNCs and their activity are indisputably one of the keys to understanding urban and regional development in today's globalizing world economy. To support this perspective, I will deploy the recently developed analytical framework of global production networks (GPNs) to unpack the complex and mutually dependent relationships between TNCs and urban and regional development. The paper first provides a critique of several recent influential theories of urban and regional growth and identifies the omitted components in such important actors as TNCs. It then offers an analysis of TNCs as key agents of urban and regional development on the basis of ideas on TNC strategies, networks, and regional institutions expressed inMultinational Enterprises. Finally, I draw upon a relational view of TNCs in GPNs to illustrate how urban and regional development is increasingly a “globalizing” phenomenon. Situated in recent work in economic geography, I elaborate on the concept of strategic coupling as an interfacing mechanism bringing together TNCs and development at the urban and regional scales.
Knowledge Networks in an Uncompetitive Region: SME Innovation and Growth
Authors: HUGGINS ROBERT , JOHNSTON ANDREW
Published: June 2009

Knowledge networks are now recognised as a crucial element underlying the economic success and competitiveness of geographic locations, in particular regions. The aim of this paper is to assess the types of knowledge networks utilised and formed by knowledge‐based small‐ and medium‐sized enterprises (SMEs) in the relatively uncompetitive regional setting of Yorkshire and Humberside in the UK. It explores the relationship between knowledge networking activity and the levels of innovation and growth achieved by these SMEs. It is found that SMEs tend to utilise and value more knowledge networks with actors outside the region. However, more innovative SMEs possess a balance of inside and outside the region knowledge networks. Knowledge networking activity is sometimes negatively associated with growth, suggesting that networks with certain actors, such as public sector support agencies, may be formed by SMEs when they are facing competitive pressures. In terms of policy implications, the paper recommends a shift from the cluster policies implemented by many regional authorities to a regional innovation systems approach, focusing equally on the regional and more global dimensions of knowledge networks. It is concluded that regional public policy makers need to renew their efforts to support SMEs in creating and sustaining their knowledge networks.
NAFTA or Nada? Trade's Impact on U.S. Border Retailers
Authors: FORD TIMOTHY C. , LOGAN BRIAN , LOGAN JENNIFER
Published: June 2009

The extensive debate over trade liberalization policies in the United States holds a general consensus that some industries will benefit while others will not. This paper explores the impact of the North American Free Trade Agreement on U.S. retailers in states located along the border with Mexico. Overall, the impact of trade on U.S. border retailers has been beneficial. However, the results demonstrate that retailers in the region are vulnerable to exchange rate fluctuations and other macroeconomic influences that change the relative price ratio between the United States and Mexico. Furthermore, retailers in metropolitan statistical areas that have a relatively high concentration of retail sector employment are more susceptible to these changes.
Changing Noise Levels and Housing Prices Near the Atlanta Airport
Authors: COHEN JEFFREY P. , COUGHLIN CLETUS C.
Published: June 2009

Using hedonic models, we analyze the effects of proximity and noise on housing prices in neighborhoods near Hartsfield‐Jackson Atlanta International Airport during 1995–2002. Proximity to the airport is related positively to housing prices. We address complications caused by changes over time in the levels and geographic distribution of noise and by the fact that noise contours are measured infrequently. A general decline in noise boosted housing prices during 1995–2002. After accounting for proximity, house characteristics, and demographic variables, houses in noisier areas sold for less than houses subjected to less noise. Also, the noise discount is larger during 2000–2002 than 1995–1999.
Discrimination against children with disability in China
Authors: Shang Xiaoyuan , Fisher Karen R. , Xie Jiawen
Published: June 2009

Shang X, Fisher KR, Xie J. Discrimination against children with disability in China

Int J Soc Welfare 2011: 20: 298–308 © 2009 The Author(s), International Journal of Social Welfare © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.

Families' experiences in connection with having a child with disability have been little researched in China. This study applies a child‐based human rights framework to analyse families' experiences of children's disability rights and their experience of discrimination. It applies the framework to families in a disadvantaged, rural case‐study community in China. It finds that children and their families experience significant discrimination in the four child disability domains of rights to care and protection, economic security, developmental support and social participation. The impact is both direct in terms of poor support for the children and their families, and indirect in terms of cumulative pressure on the family, which accentuated the poor social development of the child. The research contributes to understanding child disability rights in China and social policy responses, and raises questions for further research.
Liquidity Provision of Limit Order Trading in the Futures Market Under Bull and Bear Markets
Authors: Chiang Min‐Hsien , Lin Tsai‐Yin , Yu Chih‐Hsien Jerry
Published: June 2009

Abstract:  This study investigates how limit orders affect liquidity in a purely order‐driven futures market. Additionally, the possible asymmetric relationship between market depth and transitory volatility in bull and bear markets and the effect of institutional trading on liquidity provision behavior are examined as well. The empirical results demonstrate that subsequent market depth increases as transient volatility increases in bull markets. Market depth exhibits significantly positive relationship to subsequent transient volatility in bull markets. Additionally, although trading volume positively influences transient volatility in bull markets, no such relationship exists in bear markets. Liquidity provision decreases when institutional trading activity intensifies during bear markets. Thus, liquidity provision for limit orders differs between bull and bear markets.
Tax Motivated Income Shifting and Korean Business Groups (Chaebol)
Authors: Jung Kooyul , Kim Boyoung , Kim Byungmo
Published: June 2009

Abstract:  This paper examines tax‐induced income shifting behavior among affiliated firms in Korean business groups (chaebols). Korean corporate income tax law does not require consolidated tax returns, and business groups with a large number of affiliated member firms have incentives to shift income across member firms to reduce the overall taxes of the group. For a large number of Korean companies that are subject to external audits, we perform univariate and multivariate regression analyses on the income shifting behavior of chaebol firms compared with non‐chaebol control firms. Our evidence suggests that tax‐motivated income shifting activities exist among chaebol firms, and that the extent of income shifting is found to depend on its effect on non‐tax cost factors such as the earnings, leverage, and cash flow rights of the controlling shareholders. We also find that income shifting is more pronounced in chaebol firms where the control‐cash flow divergence is relatively large, suggesting that income shifting is affected by the controlling shareholders' opportunism. Our study provides some insights on the intra‐group income shifting activities where research is limited.
Information‐Based Trading and Price Improvement
Authors: Lee Kaun Y. , Chung Kee H.
Published: June 2009

Abstract:  In this study we test the information hypothesis of price improvement. Our results show that price improvement is negatively related to both the probability of information‐based trading and the price impact of trades. We interpret these results as evidence that liquidity providers selectively offer price improvements according to the information content of trades. We also show that liquidity providers offer greater (and more frequent) price improvements when they are at the NBBO, and for stocks with wider spreads, fewer trades, or smaller trade sizes relative to the quoted depth. Buyer‐initiated trades receive smaller (larger) price improvements than seller‐initiated trades on the NYSE (NASDAQ).
Effects of family structure and socialization on materialism: a life course study in Thailand
Authors: Nguyen Hung Vu , Moschis George P. , Shannon Randall
Published: June 2009

Consumer researchers have long been interested in understanding the development of materialistic attitudes and values in different cultural settings. The life course approach, which has developed recently as an interdisciplinary programme for studying various aspects of behaviour, was used as an overarching framework for studying the development of materialism in Thailand. Specifically, the paper first presents the general conceptual framework that serves as a blueprint for discussing theoretical perspectives. Next, hypotheses derived from life course perspectives are formulated, and a survey of young adults (ages 20 to 32) is used to test them. We found that family disruption influences materialism only among those young adults from lower social classes. Findings of this paper have implications for theory development and suggest directions for future research.
Consumer credit card ownership and usage practices: empirical evidence from Sri Lanka
Authors: Wickramasinghe Vathsala , Gurugamage Anurudh
Published: June 2009

Knowledge that has been accumulated through research efforts concerning credit card ownership and usage behaviour has been confined to Western societies. Given the importance of cross‐national application of consumer marketing concepts and propositions for academic and practical reasons, investigations are needed to test whether consumer credit card usage patterns that are assumed to exist in the West also exist in non‐Western parts of the world, especially in Asia. Therefore, objectives of this research were to explore credit card ownership and usage practices in Sri Lanka, and to explore the relationship between credit card ownership and usage practices, and demographic and socio‐economic characteristics of credit card users. The findings offer implications for researchers and practitioners.
Loosening the belt: on the effects of goal‐conflict situations on regular savings
Authors: Loibl Cäzilia
Published: June 2009

This paper examines the effect of implementation intentions on consumers' success in pursuing conflicting saving–spending goals. Surveys of participants in a community‐based savings programme were conducted to test whether the forming of implementation intentions in specific action plans facilitate the pursuit of the focal savings goal. The intervention had no effect in facilitating the savings goal, suggesting that goal conflict undermines goal commitment above and beyond the influence of commitment mechanisms. Inquiring into the reasons for not saving within the implementation intention group, we found that conflict with spending goals emerged as a partial mediator explaining subjects' failure to enact their savings intentions. Implications for community‐based savings programmes are also discussed.
Effect of eslicarbazepine acetate on the pharmacokinetics of digoxin in healthy subjects
Authors: Vaz da Silva Manuel , Costa Raquel , Soares Eva , Maia Joana , Falcão Amílcar , Almeida Luis , Soares da Silva Patrício
Published: June 2009

Eslicarbazepine acetate (ESL) is a new‐generation voltage‐gated sodium channel blocker, which has been demonstrated to be effective and well tolerated in the treatment of epilepsy. The primary objective of this study was to investigate the effect of ESL on the pharmacokinetics of digoxin. This study was a randomized, double‐blind, placebo‐controlled, two‐way crossover study of 12 healthy subjects (six men and six women). The study included two 8‐day treatment periods with a washout of ≥10 days. In each period, subjects received either ESL 1200 mg once‐daily or placebo, concomitantly with a loading oral dose of digoxin 0.5 mg on days 1 and 2, followed by a once‐daily maintenance dose of 0.25 mg on days 3–8. Maximum serum digoxin plasma concentrations (Cmax) were reached (tmax) at 0.5–2.0 h post‐dose (median = 1.0 h) and at 0.5–4.0 h post‐dose (median = 1.0 h) with Reference (digoxin plus placebo) and Test (digoxin plus ESL) treatments, respectively. The Test/Reference digoxin geometric mean ratios and 90% confidence intervals (90% CI) were 0.96 and 0.90–1.03 for the area under the plasma concentration–time curve over the dosing interval (AUC0–24) and 0.85 and 0.68–1.07 for Cmax. The 90% CI was within the bioequivalence range (0.80–1.25) for AUC0–24, thus demonstrating bioequivalence. The 90% CI was outside the 0.80–1.25 range for digoxin Cmax, but it appeared to be caused by a higher variability in digoxin Cmax following co‐administration of digoxin with placebo than with ESL. Co‐administration of ESL and digoxin was well tolerated. Concomitant administration of ESL has no clinically relevant effect in the systemic exposure to digoxin.
Ethical considerations in cardiovascular prevention
Authors: Follath F.
Published: June 2009

The fundamental values in medical ethics include the following aspects of professional conduct: (i) actions in the best interest of patients; (ii) first, do no harm; (iii) patients’ right to refuse or choose treatments; (iv) fairness and equality in the distribution of healthcare resources; and (v) truthfulness and honesty (informed consent). These values have to be considered in all diagnostic steps and therapeutic decisions. They should also form the basis for discussions of potential conflicts of interest among patients, doctors, healthcare financers and politicians. Cardiovascular (CV) diseases represent the most frequent cause of death and a major healthcare problem in most regions of the world. CV prevention is therefore an important task both in individual subjects and as a means to improve health in the general population. While the merits of treatment in patients with established CV diseases, i.e. secondary prevention, are widely accepted and regarded as necessary, primary prevention with drugs in apparently healthy individuals at an increased risk of future CV events is not free of controversies. The different types of prevention envisaged also give rise to ethical questions: Should all the growing number of classical and newly recognised CV risk markers be a reason for intervention or should they be preferably used for calculating a total risk score? What are the compelling or only relative indications for anti‐hypertensive, cholesterol‐lowering, anti‐diabetic or platelet‐inhibiting drugs? Are pre‐hypertension, pre‐diabetes and marginally elevated cholesterol levels early diseases justifying drug treatment, regardless of the possibility that some prophylactic interventions may be associated with adverse events? Discussions also often arise concerning the role of age, gender and of non‐CV co‐morbidities for decisions about long‐term prevention with drugs. How reliable and applicable are ‘evidence‐based’ guidelines derived from trials in highly selected patients and healthy subjects for the general population seen in everyday practice? Increasingly, the economic aspects of long‐term prevention and problems of a fair allocation of limited healthcare resources are also important issues giving rise to contrasting views among patients, doctors, insurance providers and politicians. What are the priorities and who should decide? Ethical considerations relating to the above questions in CV prevention are discussed in this article.
Aggressive chronic platelet inhibition with prasugrel and increased cancer risks: revising oral antiplatelet regimens?
Authors: Serebruany Victor L.
Published: June 2009

The TRITON‐TIMI 38 was a head‐to‐head trial to assess the efficacy and safety of the experimental antiplatelet agent prasugrel vs. standard care with clopidogrel on top of aspirin. Besides some ischemic protection at expense of overwhelming bleeding disadvantage, prasugrel treated patients experienced three times higher rate of colonic neoplasms then after clopidogrel, and this difference was significant. Importantly, known gastrointestinal bleeding preceded the diagnosis of colonic neoplasms only in half of the patients. Three potential mechanisms responsible for such harmful association are reviewed, namely: (i) direct hazard of the experimental drug on cancer occurrence and progression; (ii) indirect modulation of tumor growth; and (iii) enhanced metastatic dissemination due to instability of platelet‐tumor cell aggregates, or/and inability to keep the disease locally due by much more potent long‐term platelet inhibition should be considered. Significant excess of cancer after prasugrel is alarming, and can be reasonably explained, with critical clinical implications not only for prasugrel further development, but also for existing and future chronic antiplatelet strategies. If the hypothesis that oral aggressive platelet inhibition cause higher cancer risks will turn out to be true, then intensity of platelet inhibition, and especially duration of chronic antiplatelet therapy should be reconsidered. More delicate platelet inhibition, and shorter exposure to oral antiplatelet agents will prevail.
Experiential placements and scaffolding for reflection
Authors: Owen Susanne M. , Stupans Ieva
Published: June 2009

Reflection is a cognitive process for organizing ideas and building theory from observations and experiences. Learning within work‐integrated and clinical placements is increasingly required for professional accreditation approval of allied health and other university programmes. Through clinical placements students can develop the knowledge and the practical skills and personal attributes needed for entry into their professions. Relevant to communities of practice, in experiential placements learners actively build on their own life experiences within realistic work‐oriented contexts. Supervising practitioner feedback and guidance potentially accelerate the learning through a process of feedback and skilful questioning to encourage deep reflection. However, there has been little research into the role of reflection within experiential placements, particularly with respect to the preparation of students for the Australian pharmacy profession.

A 2007 Australian Learning and Teaching Council‐funded research study was conducted regarding pharmacy experiential placements. The purpose was to map Australian university programmes, analyse handbooks and also consult with about 250 stakeholders from a range of backgrounds in relation to issues and quality indicators.

This paper focuses on reflection as one aspect of the Australian pharmacy experiential placement research. It highlights the importance of more comprehensively planned approaches to learning and reflection within experiential placements. This includes university and clinical educator scaffolding and feedback at the pre‐placement, during placement and post‐placement stages.
Marine glacial and interglacial stratigraphy in Vendsyssel, northern Denmark: foraminifera and stable isotopes
Authors: KNUDSEN KAREN LUISE , KRISTENSEN PETER , LARSEN NICOLAJ KROG
Published: June 2009

The marine Quaternary of Vendsyssel has been studied in a series of new boreholes in the area, and the climatic development is discussed on the basis of foraminiferal assemblages and stable isotopes. The foraminiferal zones are correlated with previously published records from northern Denmark, and the spatial local and regional distribution is discussed in details based on the new evidence. The new data show that the marine sedimentation in Vendsyssel was not continuous from the Late Saalian to the Middle Weichselian, as previously thought. For example, there is indication of a hiatus at our key site, Åsted Vest in the central part of Vendsyssel, at the transition between regional foraminiferal zones N4 and N3, i.e. at the Late Saalian (MIS 6) – Eemian (MIS 5e) transition. The hitherto most complete Early Weichselian succession (zone N2) in Vendsyssel is presented from Åsted Vest. Deposits from the Early Weichselian sea‐level lowstands (MIS 5d and 5b) may, however, be missing in parts of the area. Two major breaks in the marine deposition during the Middle Weichselian represent glacial advances into northern Denmark. The first event occurred just after deposition of the regional foraminiferal zone N2 (late MIS 4), and the second event in the middle part of zone N1 (early MIS 3). Zone N1 is succeeded by a series of non‐marine units deposited during the sea‐level lowstand of the Weichselian maximum glaciation (late MIS 3 and MIS 2), including deeply incised tunnel valleys, which have been refilled with non‐marine sediments during the Late Weichselian. Vendsyssel was inundated by the sea again during the Late Weichselian, atc. 18 kyr BP. Subsequently, the marine conditions were gradually changed by forced regression caused by local isostatic uplift, and around the Weichselian–Holocene transition most of Vendsyssel was above sea level. A continuous deposition across the Late Weichselian–Holocene boundary only occurred at relatively deep sites such as Skagen. The environmental and climatic indications for Vendsyssel are in accordance with the global sea‐level curve, and the Quaternary record is correlated with the oxygen isotope record from the NorthGRIP ice core, as well as the marine isotope stages.
Species Listing under Canada's Species at Risk Act
Authors: FINDLAY C. SCOTT , ELGIE STEWART , GILES BRIAN , BURR LINDA
Published: June 2009

Abstract:  In a preliminary analysis of listing decisions under Canada's Species at Risk Act (SARA),

Mooers et al. (2007)

demonstrated an apparent bias against marine and northern species. As a follow‐up, we expanded the set of potential explanatory variables, including information on jurisdictional and administrative elements of the listing process, and considered an additional 16 species recommended for listing by SARA's scientific advisory committee as of 15 August 2006. Logistic model selection based on Akaike differences suggested that species were less likely to be listed if they were harvested or had commercial or subsistence harvesting as an explicitly identified threat; had Department of Fisheries and Oceans (DFO) as a responsible authority (RA); were located in Canada's north generally, and especially in Nunavut; or were found mostly or entirely within Canada. Subsequent model validation with an independent set of 50 species for which a listing decision was handed down in December 2007 showed an overall misclassification rate of <0.10, indicating reasonable predictive power. In light of these results, we recommend that RAs under SARA adopt a two‐track listing approach to address problems of delays arising from extended consultations and the inconsistent use by the RAs of socioeconomic analysis; consider revising SARA so that socioeconomic analysis occurs during decisions about protecting species and their habitats rather than at the listing stage; and maintain an integrated database with information on species’ biology, threats, and agency actions to enable future evaluation of SARA's impact.
Public Preference for Endemism over Other Conservation‐Related Species Attributes
Authors: MEUSER EMILY , HARSHAW HOWARD W. , MOOERS ARNE Ø.
Published: June 2009

Abstract: Public preferences are likely to play an important role in prioritizing species at risk for conservation. We conducted a survey of British Columbians (Canada) (n =555, r =73%) to examine how the public ranks a species’ attributes (rather than named species) with respect to conservation priority. Endemism, defined as species only or mainly occurring in British Columbia or species occurring in British Columbia and nowhere else in Canada, was considered the most important among the measured attributes. This preference was strongest among men and among respondents who had completed postsecondary education. The preference for endemism is generally consistent with science‐based federal listings of British Columbian species. This congruence between listing and public opinion is welcome if such congruence is considered important. We suggest that investigating how much the public values species’ attributes, as opposed to named species, provides a more efficient way of incorporating public opinion into policies on species at risk, especially if large numbers of species must be ranked for conservation priority.
Predicted Climate‐Driven Bird Distribution Changes and Forecasted Conservation Conflicts in a Neotropical Savanna
Authors: MARINI MIGUEL ÂNGELO , BARBET‐MASSIN MORGANE , LOPES LEONARDO ESTEVES , JIGUET FRÉDÉRIC
Published: June 2009

Abstract: Climate‐change scenarios project significant temperature changes for most of South America. We studied the potential impacts of predicted climate‐driven change on the distribution and conservation of 26 broad‐range birds from South AmericaCerradobiome (a savanna that also encompass tracts of grasslands and forests). We used 12 temperature or precipitation‐related bioclimatic variables, nine niche modeling techniques, three general circulation models, and two climate scenarios (for 2030, 2065, 2099) for each species to model distribution ranges. To reach a consensus scenario, we used an ensemble‐forecasting approach to obtain an average distribution for each species at each time interval. We estimated the range extent and shift of each species. Changes in range size varied across species and according to habitat dependency; future predicted range extent was negatively correlated with current predicted range extent in all scenarios. Evolution of range size under full or null dispersal scenarios varied among species from a 5% increase to an 80% decrease. The mean expected range shifts under null and full‐dispersal scenarios were 175 and 200 km, respectively (range 15–399 km), and the shift was usually toward southeastern Brazil. We predicted larger range contractions and longer range shifts for forest‐ and grassland‐dependent species than for savanna‐dependent birds. A negative correlation between current range extent and predicted range loss revealed that geographically restricted species may face stronger threat and become even rarer. The predicted southeasterly direction of range changes is cause for concern because ranges are predicted to shift to the most developed and populated region of Brazil. Also, southeastern Brazil is the least likely region to contain significant dispersal corridors, to allow expansion of Cerrado vegetation types, or to accommodate creation of new reserves.
Paracoccygeal Corkscrew Approach to Ganglion Impar Injections for Tailbone Pain
Authors: Foye Patrick M. , Patel Shounuck I.
Published: June 2009

A new technique for performing nerve blocks of the ganglion impar (ganglion Walther) is presented. These injections have been reported to relieve coccydynia (tailbone pain), as well as other malignant and nonmalignant pelvic pain syndromes. A variety of techniques have been previously described for blocking this sympathetic nerve ganglion, which is located in the retrorectal space just anterior to the upper coccygeal segments. Prior techniques have included approaches through the anococcygeal ligament, through the sacrococcygeal joint, and through intracoccygeal joint spaces. This article presents a new, paracoccygeal approach whereby the needle is inserted alongside the coccyx and the needle is guided through three discrete steps with a rotating or corkscrew trajectory. Compared with some of the previously published techniques, this paracoccygeal corkscrew approach has multiple potential benefits, including ease of fluoroscopic guidance using the lateral view, ability to easily use a stylet for the spinal needle, and use of a shorter, thinner needle. While no single technique works best for all patients and each technique has potential advantages and disadvantages, this new technique adds to the available options.