bluuebunny/crossref_metadata_2025 huggingface dataset:
The reactions of 40 patients unexpectedly admitted to hospital
Authors: BOWMAN GERALD S. , WEBSTER ROSEMARY A. , THOMPSON DAVID R.
Published: November 2007

Forty patients (21 men and 19 women) unexpectedly informed that they were to be admitted to hospital were interviewed about their reactions from the time they knew of the imminent admission up until the admission itself. The interviews were carried out shortly after admission to a medical ward.

Patients' reactions were numerous and diverse. The most common reaction was relief at being admitted. Other reactions were related to anticipating the hospital experience, feelings about their predicament, and concern about life beyond their stay in hospital.

Men and women expressed a similar number of reactions, but those who had previously been in hospital expressed fewer reactions than those who had not.

The findings are discussed and the implications for practice are considered.
Post‐operative pain in children: a review of the literature
Authors: GILLIES MARJORIE L.
Published: November 2007

Summary

Post‐operative pain has been increasingly reported over the last 40 years.

Literature reporting pain in children is increasing.

Although methods of assessing pain in children have been developed over the last 15 years, difficulties still exist.

The long‐standing problems of managing pain persist because practice is often based on misconceptions rather than research.

This failure to base practice on research is caused, in part, by the fact that neither medical nor nurse training recognizes pain as a specific subject area in its own right.

Until training changes and practice improves, post‐operative pain in children is likely to remain poorly recognized and undertreated.
Valuing the midwife's role in the midwife/client relationship
Authors: McCREA HALLY
Published: November 2007

Summary

The unique role of the midwife is to care for childbearing women through help and assistance. This study set out to identify those factors which influence the midwife/client relationship.

A qualitative approach using in‐depth interviews with 16 mid wives was adopted for the study to generate explanations of midwives' understanding of the factors which affected the midwife/client relationship.

Dilemma analysis of the interview data identified two key factors which affected how the midwives related to clients and which centred on different aspects of the midwife's role. They include:

the nature and value of the midwife's role,

the recognition of authority/autonomy in practising this role.

The findings are discussed and a number of recommendations made for changes relating to midwifery education, practice and organizational issues.

It is concluded that these changes are crucial if the midwife/client relationship is to be of therapeutic value to clients.
Special Hospital seclusion and its clinical variations
Authors: MASON TOM
Published: November 2007

Summary

The terminology used in the published literature to indicate that a patient is being denied, or is denying themself, the company of other people is wide and varied.

With ever growing concerns of the rights, both civil and legal, of patients receiving treatment, either solicited or unsolicited, there is a need to identify the patterns of practice in any given organization and to establish their relationship to the terminological semantic.

The Special Hospitals, who cater for those patients requiring a high degree of security, have been assumed to use seclusion to a greater degree than any other form of personal‐space facility, either forced by the staff or elected by the patient. However, this has largely been based on hearsay and speculation.

Seclusion may be perceived as a clinical psychiatric intervention to prevent the serious deterioration of a person's mental state or as a method of containment of a dangerous situation when all else fails.

This study was based on a survey of all seclusion facilities within the Special Hospital system and discussions with over 100 nursing staff about the differing types and methods of providing patient withdrawal from the ward community for whatever reason.

The results highlighted a clear uniformity of practice throughout the system despite the differing terminologies used.
Do health visitors promote client participation? An analysis of the health visitor—client interaction
Authors: KENDALL SALLY
Published: November 2007

Summary

This paper presents one aspect of a larger study the aim of which was to explore and describe the extent to which clients participate in family health‐promotion encounters with health visitors.

The health visitor–client interaction during a home visit was seen to be the most appropriate setting in which to carry out the study.

Analysis of 62 tape‐recorded interactions and 75 paired interviews revealed that client participation is rarely initiated by the client or elicited by the health visitor.

This has implications for the future education and practice of health visitors when they are being asked to take a more empowering approach to health promotion.
Catheter‐associated urinary tract infection: a review
Authors: ROE BRENDA
Published: November 2007

Summary

Catheter‐associated urinary tract infection is still one of the most challenging aspects pf clinical practice, not only for professionals who work in the area of infection control, but for all who care for patients.

Urethral catheters may be used to promote post‐operative repair, relieve anatomical or physiological obstruction and provide an accurate measure of urinary output.

Catheters also have a part to play in the management of intractable urinary incontinence, but admittedly less so than 10 years ago, as we now have alternative techniques and appliances, such as intermittent self catheterization (ISC), penile sheaths and an extensive range of incontinence pads.

This paper reviews recent developments in catheterization and catheter care intended to prevent or alleviate urinary tract infections and associated problems.
Changing power relationships between nurses: a case‐study of early changes towards patient‐centred nursing
Authors: TITCHEN ANGIE , BINNIE ALISON
Published: November 2007

Summary

This case‐study provides a description and interpretation of the traditional power relationship between a sister and staff nurses, in an acute general medical ward.

The ways in which the nurses changed that power relationship, with the introduction of team nursing are explored.

The paper describes, from the sister's and nurses' perspectives, the difficulties associated with the devolution of authority, from sister to team leaders, and the resulting confusion about the new relationship between them.

Three themes emerged in the changing power relationships and these are presented and examined.
A study of the provision of health checks and health‐promotion clinics in 18 general practices
Authors: OCHERA JENNIFER , HILTON SEAN , BLAND J. MARTIN , DOWELL ANTHONY C. , JONES DAVID R.
Published: November 2007

Summary

The objective of this study was to describe the variation in provision of health checks and health‐promotion clinics operating under the regulations of the 1990 Contract for general practice in the UK.

Eighteen group practices in three Family Health Service Authority (FHSA) areas of England (two in the South West Thames region and one in the Yorkshire region) were selected for the study. The nurses, largely responsible for the implementation of the health checks at these practices, were interviewed using semi‐structured interview schedules. They were asked about age‐groups targeted, means of recruiting patients for clinics, duration of clinic appointments, and procedures carried out in clinics.

All practices offered health checks, and 55% had started doing so before introduction of the 1990 Contract. Recruitment for health checks took place in a number of ways: self‐referral (83% of practices); opportunistically in those with coronary heart disease risk factors (78%); opportunistically during attendance for cervical smears (62%); screening in at least one patient group (78%). Blood pressure, height, weight, urinalysis and life‐style advice were included by all practices. Stress management and quit smoking strategies were offered only by a minority of practices. Duration of first health‐check appointment ranged between 15 and 30 minutes.

The basic content of health checks, and life‐style advice given appeared consistent between the widely varying practices. However, the resources available for intervention and follow up showed more variation.
Complementary roles of nurse and health‐care assistant
Authors: AHMED LAILA BANA , KITSON ALISON
Published: November 2007

Summary

In community hospitals, and units for people with learning disabilities, the theoretical framework of Oxfordshire nursing services was used to examine the complementary roles of nurse and support worker.

This framework proposes that the mix in nursing teams should be determined by the needs of patients/clients.

The sample consisted of directors of nursing services, senior nurses/managers, nurses, support workers and patients/clients. Data were collected by utilizing a multimethod approach.

Findings showed that in the deployment of grade‐mix the needs of clients/patients were overlooked.

In the community hospitals the primary nurses were the main caregivers regardless of whether the patients needed the qualified input. Conversely, in the units for people with learning disabilities, the main involvement of direct‐care staff disregarded the fact that needs of many clients could only be met with a nurse's input.

In their present supervisory role the primary nurses were posed with the problem of losing client contact.
On becoming effective in taking ethical action*
Authors: JOHNS CHRISTOPHER
Published: November 2007

Summary

As nursing strives to embrace the ideology of humanism in practice, learnt ways of dealing with the ethical dimensions of practice become increasingly problematic as a framework for guiding ethical action.

This paper shares how effective ethical actions can be learnt through guided reflection, using the shared experiences of a primary nurse as an illustration.

These experiences are part of an ongoing research study that involves the author working with practitioners to enable them to become effective in defined work.
Post‐operative pain management: a literature review
Authors: KITSON ALISON
Published: November 2007

The appropriateness of any set of criteria generated to measure the quality of a particular intervention is dependent upon a thorough, up‐to‐date assessment of the current state‐of‐the‐art. Few areas in nursing have received as much research attention as that of pain control, particularly post‐operative pain control.

The following review of the literature* on this subject complements earlier reviews undertaken by Seers (1988) by organizing the information according to four distinct categories, namely environmental issues, nursing actions, patient outcomes and a review of a number of pain measures. This particular format was selected in order to help in the development of structure, process and outcome criteria on the topic of post‐operative pain management.

The section on measurement is to inform practitioners about pain‐assessment charts and provide ideas about auditing this area.
The use of complementary and alternative therapies in health care: a selective review of the literature and discussion of the implications for nurse practitioners and health‐care managers
Authors: GATES BOB
Published: November 2007

Much has been written concerning the use of complementary and alternative therapies in health care. It is the author's belief that much of the current debate exists within a context of little knowledge of the research concerning these therapies. Because of this lack of knowledge, nursing practice may not be informed and/or directed by research.

Despite guidance from the UKCC (1992) nurses need to ensure that their position regarding these therapies is based upon a judicious review of the literature and carefully crafted and reasoned actions.
Cognitive therapy as a tool for caring for the elderly confused person
Authors: HITCH SALLY
Published: November 2007

With the increase in the numbers of elderly people, methods to improve the quality of life for this population has never been more relevant. As the primary carers for this group of people, nurses are likely to be faced with this task.

Cognitive therapies such as reality orientation, validation, reminiscence and life review, can help to maintain or improve aspects of cognitive or behavioural functioning for the elderly confused.

If this in turn can increase life satisfaction for those elderly suffering from dementia then cognitive therapies must be addressed as means to improve individual quality of life.

Existing research otters contradictory evidence as to the practical application and usefulness of such therapies. More substantial research must be undertaken in the area, addressing nursing perspectives with regards to the implementation of cognitive therapies.

The author maintains that the cognitive therapies discussed in this paper have great potential for use within care of the elderly and despite controversial research results, can help to maintain or improve the quality of life for the elderly confused.
The assessment and management of post‐operative pain in children by registered sick children's nurses: an exploratory study
Authors: NETHERCOTT SALLY G.
Published: November 2007

In a small exploratory study, convenience samples of registered sick children's nurses (RSCNs), parents and children were interviewed to establish their perceptions of post‐operative pain assessment and management.

Many of the findings of previous researchers were confirmed.

Nurses and parents made judgements of pain using behavioural cues.

The administration of analgesia depended on the nurse's personal interpretation of the prescription.

The efficacy of analgesia was influenced by the organization of nursing care.
When a vulnerable patient absconds
Authors: ASPINALL PHILLIP
Published: November 2007

This case‐study examines the nurse's role when a patient at risk absconds.

It highlights possible weaknesses in the system for dealing with absconding patients who are so cognitively and emotionally impaired, that they may present a danger to themselves.

The issues of patient identification and stigmatization are raised along with the possible conflict this may cause in psychiatric nurses.

Recommendations for care at ward level are made, including asking the vulnerable patient to wear an identity bracelet and the instigation of a prepared action plan which involves engaging the help of outside agencies should a patient abscond.
The management and development of continence services within the framework of the NHS and Community Care Act (1990)
Authors: SWAFFIELD JEAN
Published: November 2007

The current context of community health care is described and the main issues concerning the development of continuity of care for the handicapped and elderly raised. Changes in philosophical and governmental approaches have coincided at a time of demographic changes that is resulting in increased numbers of elderly.

Continence services are used as a vehicle in order to demonstrate the need for protocols, systems and evaluation measures across community care team boundaries. Current government decisions and reports are interwoven within the text with professional considerations and other requirements for decision making.

The proactive approach offered in this paper for continence services, is also seen as important to other specialist services, such as stoma and diabetes care so that standards of patient care arc improved‐these being evaluated by approved quality care tools.
Community psychiatric nurses for the elderly: well tolerated, few side‐effects and effective in the treatment of depression
Authors: WATERREUS ANNA , BLANCHARD MARTIN , MANN ANTHONY
Published: November 2007

Depression in elderly people is a common yet treatable psychiatric problem.

The Gospel Oak depression study researched this much overlooked group and has shown that a community psychiatric nurse (CPN) was able significantly to improve the mental state of depressed elderly people.

A multifaceted package of care was co‐ordinated and delivered by one CPN over a study period of 3 months.

A detailed account is given of those interventions implemented, highlighting those which were of most benefit for the patient.

Outcome was assessed independently and it was found that those patients allocated to CPN care improved significantly compared to the non‐intervention control group.

Ways in which nurses can enhance care given to patients in the community are discussed.
The distribution of Quercus suber chloroplast haplotypes matches the palaeogeographical history of the western Mediterranean
Authors: MAGRI D. , FINESCHI S. , BELLAROSA R. , BUONAMICI A. , SEBASTIANI F. , SCHIRONE B. , SIMEONE M. C. , VENDRAMIN G. G.
Published: November 2007

Combining molecular analyses with geological and palaeontological data may reveal timing and modes for the divergence of lineages within species. The Mediterranean Basin is particularly appropriate for this kind of multidisciplinary studies, because of its complex geological history and biological diversity. Here, we investigated chloroplast DNA of Quercus suber populations in order to detect possible relationships between their geographical distribution and the palaeogeographical history of the western Mediterranean domain. We analysed 110 cork oak populations, covering the whole distribution range of the species, by 14 chloroplast microsatellite markers, among which eight displayed variation among populations. We identified five haplotypes whose distribution is clearly geographically structured. Results demonstrated that cork oak populations have undergone a genetic drift geographically consistent with the Oligocene and Miocene break‐up events of the European–Iberian continental margin and suggested that they have persisted in a number of separate microplates, currently found in Tunisia, Sardinia, Corsica, and Provence, without detectable chloroplast DNA modifications for a time span of over 15 million years. A similar distribution pattern of mitochondrial DNA of Pinus pinaster supports the hypothesis of such long‐term persistence, in spite of Quaternary climate oscillations and of isolation due to insularity, and suggests that part of the modern geographical structure of Mediterranean populations may be traced back to the Tertiary history of taxa.
Trust Your Compatriots, but Count Your Change: The Roles of Trust, Mistrust and Distrust in Democracy
Authors: Lenard Patti Tamara
Published: November 2007

Although trust is clearly central to human relations of all kinds, it is less clear whether there is a role for trust in democratic politics. In this article, I argue that trust is central to democratic institutions as well as to democratic political participation, and that arguments which make distrust the central element of democracy fail. First, I argue for the centrality of trust to the democratic process. The voluntary compliance that is central to democracies relies on trust, along two dimensions: citizens must trust their legislators to have the national interest in mind and citizens must trust each other to abide by democratically established laws. Second, I refute arguments that place distrust at the centre of democratic institutions. I argue, instead, that citizens must be vigilant with respect to their legislators and fellow citizens; that is, they must be willing to ensure that the institutions are working fairly and that people continue to abide by shared regulations. This vigilance – which is reflected both in a set of institutions as well as an active citizenry – is motivated by an attitude termed ‘mistrust’. Mistrust is a cautious attitude that propels citizens to maintain a watchful eye on the political and social happenings within their communities. Moreover, mistrust depends on trust: we trust fellow citizens to monitor for abuses of our own rights and privileges just as we monitor for abuses of their rights and privileges. Finally, I argue that distrust is inimical to democracy. We are, consequently, right to worry about widespread reports of trust's decline. Just as distrust is harmful to human relations of all kinds, and just as trust is central to positive human relations of all kinds, so is distrust inimical to democracy and trust central to its flourishing.
Private borrowing during the financial revolution: Hoare's Bank and its customers, 1702–241
Authors: TEMIN PETER , VOTH HANS‐JOACHIM
Published: November 2007

The financial revolution improved the British government's ability to borrow, and thus its ability to wage war. North and Weingast argued that it also permitted private parties to borrow more cheaply and widely. We test these inferences with evidence from a London bank. We confirm that private bank credit was cheap in the early eighteenth century, but we argue that it was not available widely. Importantly, the government reduced the usury rate in 1714, sharply reducing the circle of private clients that could be served profitably.
Transatlantic Catholicism: Rethinking the Nature of the Catholic Tradition in the Early Modern Period
Authors: Armstrong Megan
Published: November 2007

Recent scholarship makes a case for examining the Atlantic world as a Catholic space throughout the Early Modern period. The Catholic Church was the most expansive and broadly flung of the different religious institutions in the West throughout the Early Modern period. For better or worse, the Catholic spiritual tradition was also a critical force in shaping cultures on both sides of the ocean, and it was also itself informed by the many cultures it encountered. While historians on both sides of the Atlantic remain region‐centric in their focus, this article will suggest that a comparative examination of the Catholic tradition in a broader cultural context will best shed light on the resiliency of this tradition in an age of spiritual upheaval.
Elder Abuse and Neglect in Latino Families: An Ecological and Culturally Relevant Theoretical Framework for Clinical Practice
Authors: CARDONA JOSÉ RUBÉN PARRA , MEYER EMILY , SCHIAMBERG LAWRENCE , POST LORI
Published: November 2007

There is a scarcity of theoretical frameworks capable of describing precursors and dynamics associated with elder abuse and neglect in Latino families. The present manuscript seeks to address this gap in the literature by presenting an integrative theoretical framework that fosters an ecological and cultural understanding of elder abuse and neglect among Latinos. The proposed model rests on the premise that Latino families caring for elder adults have the ability to adapt to the demands of aging only if they are supported by nurturing environments. The usefulness of the model is threefold. First, the proposed model describes elder abuse and neglect as multifactorial phenomena and identifies specific risk factors associated with the etiology and maintenance of elder abuse and neglect in Latino families. Second, the model provides clinical applications, including reflections about the therapists' need to extend their scope of practice beyond traditional family therapy interventions. A brief case study is presented that illustrates the clinical application of the model with a Latino family. Implications for future research are discussed.
Links Between Parental Psychological Violence, Other Family Disturbances, and Children's Adjustment
Authors: GAGNÉ MARIE‐HÉLÈNE , DRAPEAU SYLVIE , MELANÇON CLAUDIANE , SAINT‐JACQUES MARIE‐CHRISTINE , LÉPINE RACHEL
Published: November 2007

In a sample of 143 parent‐child dyads from two‐parent and separated families, this investigation documented the links between parental psychological violence and separation or divorce, severity of parental conflict, triangulation of the child in this conflict, and polarized parent‐child alliances. The unique and combined contributions of all these variables to children's behavior problems were also assessed. Participants were parents, mostly mothers, and their 10–12‐year‐old child. They were recruited through schools, community organizations, and newspapers. Questionnaires were administered at home. Findings suggest that separated families undergo more relational disturbances than two‐parent families (more severe conflicts, more triangulation, stronger parent‐child alliances), but the amount of parental psychological violence was similar in both groups. Psychological violence was associated with the severity of parental conflict, especially in two‐parent families. Triangulation of the child in parental conflict was another correlate of psychological violence. Once all variables were controlled for, psychological violence remained the only significant correlate of children's externalized behavior problems. These findings raise the importance of preventing psychological violence toward children, especially in families plagued with severe parental conflicts.
Conflict Frequency and Relationship Quality Across the Transition to Parenthood
Authors: Kluwer Esther S. , Johnson Matthew D
Published: November 2007

Longitudinal data from 293 Dutch couples were used to examine the association between conflict frequency and relationship quality across the transition to parenthood, which is known as one of the most challenging events in the early stages of marriage. More frequent conflict during pregnancy was related to lower levels of relationship quality across the transition to parenthood, and lower levels of relationship quality during pregnancy were associated with more frequent conflict across the transition to parenthood. A comparison of two models showed that frequent conflict is more likely to be a determinant than a consequence of lower relationship quality. The results suggest a complicated but identifiable association between conflict frequency and relationship quality that may inform the development and modification of primary interventions targeting new parents.
Managing Children’s Friendships Through Interparental Relationships: Roles of Ethnicity and Friendship Context
Authors: Fletcher Anne C. , Bridges Tracey H. , Hunter Andrea G.
Published: November 2007

Twenty African American and European American mothers of fourth‐grade students reflected on strategies for managing children’s friendships maintained across a variety of contexts. Ethnicity differentially located families within specific social contexts that yielded children’s friendships, then informed social processes as they unfolded within these contexts. Maternal knowledge concerning children’s friendships developed as a function of the types of relationships formed among parents encountered within different settings. Findings suggest that interparental relationships represent a key source of information about children’s friendships. Yet, maternal opportunities to establish such relationships differ on the basis of both ethnicity and the nature of contexts in which children’s friendships are maintained.
Cohabitation in the Philippines: Attitudes and Behaviors Among Young Women and Men
Authors: Williams Lindy , Kabamalan Midea , Ogena Nimfa
Published: November 2007

We examine data from a national survey of 15 – 27 year olds in the Philippines to assess attitudes toward marriage and cohabitation, and we analyze the marital and nonmarital union experiences of 25 – 27 year olds. We find that attitudes toward cohabitation remain quite conservative among young Filipinos, although men view cohabitation more favorably than do women. We also find that men’s socioeconomic status affects their ability to enter unions, particularly marriage, whereas women’s union formation patterns are influenced by the family in which they grew up, their participation in religious services, and to some degree by their place of residence. Both men and women who hold more liberal attitudes on a range of issues are more likely to have cohabited than are individuals who do not share those views. For now, however, we do not expect cohabitation to become a widespread substitute for marriage in the Philippines.
Support Between Siblings and Between Friends: Two Worlds Apart?
Authors: Voorpostel Marieke , Van Der Lippe Tanja
Published: November 2007

This research examines whether siblings and friends resemble each other in supportive behavior. Using a Dutch national sample of 6,289 individuals containing 12,578 relationships with siblings and friends, we investigated the relative importance of gender composition, geographical proximity, relationship quality, and contact frequency for support exchange with siblings and friends. Results show that, controlling for other influences, siblings exchange more practical and less emotional support. High relationship quality and contact frequency are positively related to exchange of emotional support with siblings more than with friends, as is—unexpectedly—living further away. Fewer differences exist in practical support exchange. In conclusion, siblings and friends are similar with regard to practical support but different when it comes to emotional support.
Children’s Time Use: Labor Divisions and Schooling in Indonesia
Authors: Hsin Amy
Published: November 2007

Data from the Worker and Iron Status Evaluation are used to examine gendered patterns in children’s time in market and nonmarket work, schooling, and leisure in Indonesia (N= 2,929). Boys spend more time in market work; girls spend more time in nonmarket work. Work responsibilities increase with age as well as gender differentials in children’s time use. By age 18, girls spend nearly 1 more hour per day working and enjoy significantly less leisure time, but the gender gap in schooling is not significant, suggesting that parents and children are committed to both work and schooling. Additionally, Tobit regression results suggest that parents’ education, household income, and rural residency are important predictors of children’s labor and schooling time.
Financial Structure of the Family Business: Evidence From a Group of Small Spanish Firms
Authors: López-Gracia José , Sánchez-Andújar Sonia
Published: November 2007

This article presents empirical evidence on the determinants of the financial behavior of small family businesses and their differences from nonfamily small businesses. Taking into account two consolidated financial approaches, (1) the trade-off theory and (2) the pecking order theory, several hypotheses on the financial behavior of both groups of firms have been tested. By estimating these models through panel data methodology, using a sample of Spanish family businesses together with another control group of nonfamily businesses, we have obtained results confirming that a business's family nature does lead it to employ financial policy different from the rest of businesses. Furthermore, results indicate that growth opportunities, financial distress costs, and internal resources appear to be the main factors that differentiate the financial behavior of family firms from their nonfamily counterparts.
Minority Family Business in Emerging Markets: Organization Forms and Competitive Advantage
Authors: Carney Michael
Published: November 2007

The prevalence of minority family businesses in emerging markets has several theoretical and practical implications. First, a practical consequence of institutional weakness suggests that family businesses perform both wealth-creation and wealth-preservation tasks in an emerging market. Legal protection for property rights and financial institutions specializing in wealth reallocation and preservation are often ineffective in emerging markets. Lacking such security, the family business unit necessarily becomes something more than a value-creation device; it may also serve as a wealth-protection and intergenerational and/or geographical transmission device used to preserve and transfer wealth through various informal and often nontransparent means. Consequently, the financial goals of the family firm are subject to frequent trade-offs between entrepreneurial activities that generate new wealth and more defensive activities that preserve, hide, or allow for the geographic or intergenerational transmission of wealth.
The Bulleye: A Systems Approach to Modeling Family Firms
Authors: Pieper Torsten M. , Klein Sabine B.
Published: November 2007

The purpose of this article is to develop a model of family business that accounts for the unique characteristics and diversity of family businesses and addresses the dynamics among family business subsystems. An open-systems approach serves as the conceptual foundation of the model. The distinctive features of the proposed model are the multiple levels of analysis and the dynamics and interdependencies among the subsystems, allowing the integration of mainstream theories. The model can serve to discover and explore a relevant research question in the context of family business, which may help researchers advance theory building on family business. Furthermore, the model may help family business practitioners better understand the particularities of family firms.
An Exploration of the Generational Differences in Levels of Control Held Among Family Businesses Approaching Succession
Authors: Brun de Pontet Stéphanie , Wrosch Carsten , Gagne Marylene
Published: November 2007

This research examines levels of objective and perceived control held by incumbents and successors in 100 Canadian family businesses approaching succession. Although results suggest that control remains largely with incumbents, indicators of succession readiness were more reliably correlated with the successors' levels of control. Generational differences in the association between succession indicators and actual levels of control are highlighted. Implications of these generational differences and the association between succession readiness indicators and control outcomes are discussed.
Membrane Apheresis Technology: Historical Perspective and New Trends toward Bioincompatible Systems
Authors: Nosé Yukihiko , Yamaji Ken , Sueoka Akinori , Yamane Shingo
Published: November 2007

Abstract: During the past 25 years, membrane apheresis technology has been well developed through the use of biocompatible devices and immunomodulation. Now, however, we must move into a new era reconsidering the concepts of apheresis technology and considering the urgent need to develop a bioincompatible apheresis system. In the past, our aim in this field was to develop the best blood compatible system possible. With these systems, best efforts were made to reduce procedurally induced immunomodulation effects. However, it is these authors' opinion that procedurally induced immunomodulation effects should be augmented rather than reduced by incorporating such a bioincompatible apheresis system. Augmented immunoactivation and immunosuppression introduced by such systems should add therapeutic effects to the apheresis procedures. Therefore, we anticipate that the current marginally effective diseases may benefit from this strategic change in apheresis procedures.
Plasmapheresis Followed by Intravenous Immunoglobulin in Presensitized Patients Awaiting Thoracic Organ Transplantation
Authors: Robinson John A. , Radvany Ruta M. , Mullen Martin G. , Garrity Edward R.
Published: November 2007

Abstract: Four highly sensitized patients awaiting thoracic organ transplantation were treated immediately preceding transplantation with 1 plasmapheresis and infusion of high dose intravenous immunoglobulin (IVIG). All 4 underwent successful surgery and have had minor to no rejection episodes over a range from 5 1/2 to 12 months. All panel reactive antibodies (PRA) were dithiotheitol (DTT) resistant, and 1 patient had IgG specific alloantibodies to a donor alloantigen. All 4 patients had positive donor cross matches prior to transplantation, and 3 of the 4 patients remained PRA negative for up to 9 months after allografting. Possible mechanisms of this therapy include inhibition of proliferating alloreactive B cells or suppression by antiidiotypic antibodies. Further study is warranted.—
Plasmapheresis in Treatment of Adrenoleukodystrophy
Authors: Bambauer R. , Schiel R. , Cordes H. , Latza R. , Klinkmann J. , Schneidewind J.M.
Published: November 2007

Abstract: Adrenoleukodystrophy (ALD) is an X‐linked disorder of metabolism of very long chain fatty acids (VLCFAs) with a frequency of up to 1:20,000 in males. VLCFAs C24:0 and C26:0 accumulate in the cholesterol ester and ganglio‐side fraction in plasma and red cells. Symptoms of ALD are ataxia, loss of visual and auditory functions, and cerebral convulsions. Up to the present, no sure therapeutic approaches have been established. Efforts were reported by dietary regimens with VLCFA restriction and glyceroltrioleate and glyceroltrierucate intake. In the present trial, we report a 55‐year‐old Caucasian male suffering from progressive ALD with spastic paraparesis. He has had a positive family history since the eighteenth century. In this patient treated with maximum dietary therapy over a period of 60 months, no normalization of C24:0 and C26:0 was reached, and neurological disorders were progressive. As a result, plasmapheresis was applied during the period 1990–1994 and since then for more selective adsorption of VLCFAs, dextran sulfate adsorption (Liposorber, Kaneka, Japan). During this period (64 months), C24:0 and C26:0 levels were reduced by 54.5% and 51.8%, respectively (p = 0.0001). The patient experienced a significant improvement in performance and general well‐being. There has been no further progression of neuronal disorders to document.—
Plasmapheresis Combined with Somatostatin is a Successful Treatment of Porphyrias
Authors: Medenica R. , Lazovic G. , Long P. , Corbitt W. , Powell D.
Published: November 2007

Abstract: During acute attacks of hepatic porphyria, levels of polypeptides, vasoactive intestinal peptides, neurotensin, substance P, pancreatic polypeptide, gastrin releasing polypeptide, gastrin, and motilin increased in the circulation while the clinical symptoms were evident. However, somatostatin decrease was not detected. Somatostatin belongs to a group of regulatory peptides that antagonize the action of endogenous steroid hormones, and decreasing their bioavailability decreases the rate of synthesis of δ‐aminolevulinate synthase, α‐aminolevunilic acid (ALA), and polypeptides. Plasma exchange was conducted in courses for 2 consecutive days every 28 days (total of 6 courses), removing more than 100% of the patient plasma each time. Between the 2 courses of plasmapheresis, subcutaneous injections of somatostatin (100–500 mcg) were administered. A lasting disappearance of pain and complete remission were obtained in all 7 patients treated. Plasmapheresis combined with somatostatin may be considered as a treatment of porphyria exacerbation.—
Treatment of Experimental Allergic Encephalomyelitis by Selective Removal of CD4+ T Cells
Authors: Matsuo Hidenori , Ichinose Katsuhiro , Ohtsuru Izumi , Fujishit Satoshi , Onodera Hirokazu , Suematsu Junsuke , Yoshida Makoto , Yamawaki Naokuni , Shibuya Noritoshi
Published: November 2007

Abstract: Experimental allergic encephalomyelitis (EAE) is a major animal model of human multiple sclerosis (MS). The pathogenesis of both MS and EAE directly involves CD4+ helper T cells. To remove CD4+ T cells selectively from the circulation, we designed a new column in which anti‐CD4 monoclonal antibody was immobilized on the activated substance. Most of the CD4+ T cells, including pathogenic T cells, were selectively adsorbed from whole blood with a direct perfusion through the column in vitro, resulting in depletion of the antigen‐specific T cell responses. A preliminary trial of ex vivo treatment with the column in EAE rats lowered the percentages of CD4+ populations but failed to alter the course of the disease, suggesting repeated treatment would be necessary to suppress the development of the disease. We conclude that this new column is potentially useful, and repeated treatment would be beneficial in MS and other CD4+ T cell dependent autoimmune diseases.—
Automated Plateletpheresis Does Not Cause an Increase in Platelet Activation in Volunteer Donors
Authors: Karadoǧan Ìhsan , Undar Levent
Published: November 2007

Abstract: Activation of platelets during collection and storage has been implicated as a major cause of the platelet storage lesion. In this study, we investigated the effect of an automated plateletpheresis procedure on the in vivo platelet activation in 20 volunteer donors. Peripheral blood samples were collected immediately before and after plateletpheresis on the Haemonetics V50 Blood Cell Separator. Activation of platelets was determined by quantitating the amount of platelet P‐selectin (CD62) expression using a whole blood method on flow cytometry. Adenosine diphosphate (ADP), collagen, and ristocetin induced platelet aggregations were also measured on a whole blood impedance aggregometer. Plateletpheresis caused a significant decrease in the CD62‐positive platelet percentage and aggregation responses to 3 agonists. We concluded that the plateletpheresis procedure did not cause an increase in platelet activation in donors. Further studies are required to elucidate whether activated platelets are collected during the procedure or removed from the circulation of the donor and replaced by resting platelets, activated platelets bind to leukocytes or endothelial cells, and the plateletpheresis procedure is a powerful stimulus for platelet activation.—
Theoretic Opinion and Future Treatment of Amyloidosis
Authors: Jákó János , Domján Gyula , Vályi‐Nagy István
Published: November 2007

Abstract: Amyloidosis is still enigmatic. The etiology and mechanism of storage and organ impairment are still unknown. Not all amyloidogen molecules are definitely pathogenic; some precursors of tissue amyloid are structurally analogous to normal substances produced in the organism. This paper reviews the currently accepted categories, aspects of etiology and pathogenesis, and therapeutic trends of amyloidosis with a special emphasis on plasmapheresis.—
Comparison of the Adsorption Ability Between Tryptophan and Modified Tryptophan Columns
Authors: Odaka Masaaki , Yuki Nobuhiro , Hirata Koichi
Published: November 2007

Abstract: Immunoadsorption therapy (IAT) using the tryptophan column (TR:TR‐350, Asahi Medical Co., Tokyo, Japan) is used for patients with Guillain‐Barré syndrome or Fisher's syndrome. Recently, a modified tryptophan column (modified TR:TR‐350S, Asahi) was developed to reduce adsorption of fibrinogens. However, it is not clear whether the new column can effectively adsorb the antiganglioside antibodies. We treated 2 patients with Guillain‐Barré syndrome, 1 patient with Fisher's syndrome, and 1 patient with Bickerstaff s brainstem encephalitis by IAT using the TR and the modified TR. Samples were taken from the inlet and outlet of the affinity column. We compared the adsorption ability of antiganglioside antibodies between the TR and modified TR. The modified TR adsorbed antiganglioside antibodies less effectively than the TR. No significant bleeding was observed in the patients during each session. Furthermore, results of the clinical study were confirmed by batchwise adsorption test. We propose that the modified TR should not be used for treating patients with Guillain‐Barré syndrome and related disorders.—
The Mechanism of the Efficiency of Leukocytapheresis on Rheumatoid Arthritis
Authors: Hidaka Toshihiko , Suzuki Kimihiro
Published: November 2007

Abstract: This study was designed to determine the efficacy of filtration leukocytapheresis (LCAP) in the treatment of rheumatoid arthritis (RA) and the mechanism of its efficacy. Three filtration LCAP procedures in 22 RA patients were performed. Heparinized samples were collected from peripheral blood and synovial fluid. The surface markers of T cells were measured by flow cytometry before the first and third procedures. Proportions of activated and memory T cells in the peripheral blood were paradoxically higher after the third procedure than they were prior to the first treatment. Inversely, the activated T‐cell counts in the synovial fluid decreased after the third procedure. In RA patients, higher proportions of activated T lymphocytes are present in RA affected joints than in the peripheral blood. If LCAP induced the redistribution of activated T cells from the affected joints into the circulating blood, the effectiveness of LCAP in the treatment of RA might be explained by the mechanism.
Efficacy and Limitation of Apheresis Therapy in Critical Care
Authors: Hirasawa Hiroyuki , Sugai Takao , Oda Shigeto , Shiga Hidetoshi , Matsuda Kenichi , Ueno Hirokazu , Sadahiro Tomohito
Published: November 2007

Abstract: Apheresis therapy such as plasma exchange and plasma adsorption has become therapeutic tools in critical care. The indications for apheresis therapy in ICU patients include fulminant hepatic failure, thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS), autoimmune disease, and sepsis. During the past 11 years, 150 patients with various kinds of critical illnesses were treated with apheresis therapy in our ICU, and the overall survival rate was 50%. Apheresis therapy is especially useful in the treatment of a patient with fulminant hepatic failure because liver transplantation is seldom performed in Japan; therefore, the patient should be treated with artificial liver support. When plasma exchange is performed on the critically ill, continuous hemodiafiltration should be performed simultaneously to overcome the adverse effects of plasma exchange such as hypernatremia. metabolic alkalosis. and abrupt changes in colloid osmotic pressure and to enhance the removal rate of the causative middle molecular weight substances of hepatic failure or hepatic coma.
Apheresis Technology for Prevention and Regression of Atherosclerosis: An Overview
Authors: Yamamoto Akira , Kawaguchi Akito , Harada‐Shiba Mariko , Tsushima Motoo , Kojima Shun‐ichi
Published: November 2007

Abstract: Low density lipoprotein (LDL) apheresis is at present one method of treatment in homozygous cases of familial hypercholesterolemia (FH). It is also effective in the prevention of the development of coronary atherosclerosis in patients with heterozygous FH and other types of mild hypercholesterolemia, leading to the regression of the stenosing lesions. In this paper, an overview is presented on the development of the devices for LDL apheresis and its short‐and long‐term effects on FH mainly based upon experience with the Liposorber system. LDL apheresis has served to protect the lives of patients from life threatening diseases like myocardial infarction although observations for more than 10 years in some laboratories have shown that the progression of atherosclerosis has taken place in many patients, and more importantly, the involvement of the aortic valve with calcification has developed. especially in patients who had homozygous FH, making this the most obstinate complication of FH. Therefore, more aggressive treatment or the combination of LDL apheresis with other therapies is required in the future. LDL apheresis has also been approved for the treatment of glomerulosclerosis and arteriosclerosis obliterans.