bluuebunny/crossref_metadata_2025 huggingface dataset:
Marketing Practices Used by the Emerging American Public Library System from Inception to 1930
Authors: Kleindl Brad
Published: February 2007

This study explores the marketing practices used by the emerging American public library system from its inception in 1876 to 1930. This period fits the Era of Institutional Development, when most modern marketing practices were believed to have appeared. The results show that libraries adopted contemporary business practices and developed marketing strategies to identify and target specific market segments through the development of unique products. This can be seen as an example of the “complex flux” model, in which change in marketing practice is linked to past phenomena. Libraries developed complex marketing and promotional strategies using a mix of media to reach their targeted market segments.
Robust Fault Detection of a Robotic Manipulator
Authors: Halder Bibhrajit , Sarkar Nilanjan
Published: February 2007

In this paper, a new robust fault detection technique for robotic manipulators is developed. The new approach, called robust nonlinear analytic redundancy (RNLAR) technique, detects both sensor and actuator faults in a robotic manipulator The proposed RNLAR technique can compensate for the effects of model-plan-mismatch (MPM) and process disturbance. A nonlinear primary residual vectors (PRV) design method to detect faults is proposed where the PRVs are highly sensitive to faults and less sensitive to MPM and process disturbance. Experimental results on a PUMA 560 are presented to justify the effectiveness of the RNLAR scheme.
When the Chick Hits the Fan
Authors: Downer John
Published: February 2007

Before a new turbojet engine design is approved, the Federal Aviation Administration (FAA) must assure themselves that, among many other things, the engine can safely ingest birds. They do this by mandating a series of well-defined - if somewhat Pythonesque - ‘birdstrike tests’ through which the manufacturers can demonstrate the integrity of their engines. In principle, the tests are straightforward: engineers run an engine at high speed, launch birds into it, and watch to see if it explodes. In practice, the tests rest on a complex and contentious logic. In this paper I explore the debate that surrounds these tests, using it to illustrate the now-familiar idea that technological tests - like scientific experiments - unavoidably contain irreducible ambiguities that require judgments to bridge, and to show that these judgments can have real consequences. Having established this, I then explore how the FAA reconciles the unavoidable ambiguities with its need to determine, with a high degree of certainty, that the engines will be as safe as Congress requires. I argue that this reconciliation requires a careful balance between the opposing virtues of reproducibility and representativeness - and that this balance differs significantly from that in most scientific experiments, and from the common perception of what it ought to be.
Situation Normal? Repairing a Risky Ecology
Authors: Henke Christopher R.
Published: February 2007

The river goes through New Orleans like an elevated highway. Jackson Square, in the French Quarter, is on high ground with respect to the rest of New Orleans, but even from the benches of Jackson Square one looks up across the levee at the hulls of the passing ships. Their keels are higher than the Astro Turf in the Superdome, and if somehow the ships could turn and move at river level into the city and into the stadium they would hover above the playing field like blimps.
Searching for Circles of Meaning and Using Spiritual Experiences to Help Parents of Infants With Life-Threatening Illness Cope
Authors: Raingruber Bonnie , Milstein Jay
Published: February 2007

One of the major challenges parents can face is learning that their child has a life-threatening illness. A phenomenological study was completed to identify which interactions with health care providers were and were not helpful. Parents discussed what it was like to have an infant with a life-threatening illness and what helped them to cope. Parents indicated that they benefited from identifying “circles of meaning,” or ways in which their infant touched another life. Parents appreciated hearing from health care providers that they felt close to their infant. This sense of connection allowed parents to reconstruct a semblance of meaning in the midst of a life-altering event. Parents were also influenced by intuitive and spiritual experiences associated with their infant’s illness. Parents should be encouraged to reflect on spiritual moments and to identify how their critically ill infant influenced the lives of other family members, friends, and health care professionals.
Children's Life Paths Through Preschool and School
Authors: Torstenson-Ed Tullie
Published: February 2007

This article is based upon two studies applying a life history approach, letting 15-to 16-year-olds reconstruct their own childhood in preschool and school, to see what meaning and importance children's experiences have in forming their self-concepts and philosophy of life. A combination of methods was used: written life stories, round tours in the educational settings and interviews. The round tour, a new method, helps the youths to remember and to work inductively, using later experiences, here called post-understanding, to analyse their childhood memories. The results show that relations both with people and content characterized by dialogue and reciprocity are crucial for development and learning; the project of learning and knowledge cannot be separated from the social interpersonal project. Meetings, good or bad, could become existential questions and lead to new choices and values in life. Memory plays an important part both methodologically and in forming the young people's self-concepts, values and philosophy of life.
Images of Childhood in Mothers' Accounts of Contemporary Childrearing
Authors: Murphy Elizabeth
Published: February 2007

This article examines how a sample of first-time mothers in the UK constitute childhood in general, and their own children in particular, in and through their talk about the mundane practices of childcare. The data analysed are drawn from a longitudinal qualitative interview study that followed a sample of mothers from late pregnancy until their babies were 2 years old. The analysis explores links between mothers' representations of childhood and the actualities of their childrearing practices. The extent to which both the representations of childhood and the practices of individual mothers are consistent or contradictory, and change or remain constant over time, is also examined.
Applying Complexity Theory to Risk in Child Protection Practice
Authors: Stevens Irene , Hassett Peter
Published: February 2007

This article looks at the application of complexity theory to risk assessment in child protection practice, and how it may help to give a better understanding of risk in relation to protecting vulnerable children. Within the last 20 years increasing use has been made of the term complexity within the natural sciences. In recent times, some of the key concepts in complexity theory have started to filter through to the social sciences. The article offers an explanation of some of the key concepts in complexity theory and discusses the development of a model of assessing risk in child protection cases.
Technological research challenges of flight simulation and flight instructor assessments of perceived fidelity
Authors: Robinson Andrew , Mania Katerina
Published: February 2007

This article postulates that perceptual fidelity is not necessarily communicated by exact physics-based simulation. Fidelity ranges widely among simulators; some re-create an environment or system so that it is difficult to distinguish between the simulator and the real system, whereas others re-create a small part of a system or present the whole system in a more compact and stylized fashion. This article aims to explore technological and perceptual fidelity metrics for flight simulators based on human judgments and technological characteristics resulting in research challenges in either facet of a system. Examples include psychophysical experiments assessing perceptual sensitivity to system faults such as latency. Focusing on commercial flight and flight systems simulation, this article presents the results of an experimental study acquiring user assessments of fidelity, involving expert users with experience of the real, operational environment and the simulated equivalent. Acquiring judgments of fidelity from flight instructors, technological development could relate to respective naturalness of a simulator toward positive transfer of training.
Pharmacists' and mentors' views on the introduction of pharmacist supplementary prescribing: a qualitative evaluation of views and context
Authors: Lloyd Fran , Hughes Carmel M
Published: February 2007

Objective Supplementary prescribing has been a major policy initiative in the UK, which has seen pharmacists and nurses assume greater responsibility for prescribing in collaboration with doctors. This study explored the views and professional context of pharmacists and physicians (who acted as their training mentors), prior to the start of supplementary prescribing training.

Setting Primary and secondary healthcare settings in Northern Ireland.

Method All pharmacists (n = 63) from the first four cohorts enrolled for supplementary prescribing training in Northern Ireland were invited to participate in a series of focus groups, while mentors (n = 54) were asked to participate in face-to-face semi-structured interviews; the research took place between September 2003 and April 2005. All discussions/interviews were audiotaped and transcribed, and analysed using constant comparison.

Key findings Nine pharmacist focus groups were convened (number per group ranging from 4 to 8; total n = 47) and 35 semi-structured interviews with mentors were conducted. The four main themes that emerged were internal drivers, benefits and concerns, relationships, and beyond the current professional comfort zone. Supplementary prescribing was broadly welcomed by both professional groups and was anticipated to produce improvements in patient care and interprofessional relationships, but there were some concerns about loss of diversity, deskilling of junior doctors, safety and professional encroachment. Caution was expressed with regard to a further extension of prescribing rights, particularly in relation to the role of pharmacists in diagnosis and independent prescribing decision making.

Conclusion Although supplementary prescribing was viewed positively, these findings should be considered in the light of more recent developments in prescribing rights for other health professionals, including pharmacists.
A randomised controlled trial of the effects of note-based medication review by community pharmacists on prescribing of cardiovascular drugs in general practice
Authors: Bond Christine M , Fish Alison , Porteous Terry H , Reid John P , Scott Anthony , Antonazzo Emanuela
Published: February 2007

Objective Recent trends in primary care have seen closer working relationships between community pharmacists and general practitioners (GPs) in an attempt to improve the effectiveness and efficiency of prescribing. Community pharmacists are appropriate for a role in the management of prescribed medicines because of their detailed training in pharmacology, therapeutics and pharmaceutics. The aim of this project was to quantify the benefit of a general practice-based, community pharmacist-led, note-based medication review of patients with hypertension or angina.

Method Trained community pharmacists (20), attached to Grampian general practices (43), reviewed repeat prescriptions of a random sample of patients taking cardiovascular drugs for the treatment of angina or hypertension, and made recommendations to the GP for changes, where appropriate. The effect of the pharmaceutical intervention was measured in terms of prescribing indicators, patient outcomes (quality of life, symptom control), and physiological and biochemical markers at baseline, 6 and 12 months. A control group was treated following standard practice. An economic evaluation of the interventions was also conducted.

Key findings The baseline standard of treatment as measured against guidelines was good. At 12 months, there was a small improvement in prescribing of antiplatelet drugs, but overall changes were minimal. Average overall cost per patient was higher in the intervention group. The quality of life measures showed no change between the groups.

Conclusions Improvements in the intervention group were small and less than in other reported studies of pharmacist interventions. The National Health Service (NHS) costs of the intervention group were higher than those of the controls. Note-based medication review by community pharmacists was found to be associated with minimal changes in prescribing.
Initiation of a pharmacovigilance programme at a tertiary care hospital in South India
Authors: Narayanaswamy Nandakumar , Mallayasamy Surulivel Rajan , Manoharan Anand R , Rajendiran SD
Published: February 2007

Objective India is a country with the availability of a large number of pharmaceutical preparations as branded generics. At the time of this study there was no established pharmacovigilance system at the national level except a co-ordinating centre at the national capital. The study site was a tertiary care teaching hospital with a bed capacity of 500 and with an average of 200 outpatient visits and 50 inpatient admissions per day. The hospital did not have any system of monitoring and documenting adverse drug reactions. The objective of the study was to introduce an adverse drug reaction (ADR) monitoring programme at a tertiary care teaching hospital and assess ADR-related issues in both inpatient and outpatient departments.

Method All departments willing to report ADRs were included in the study, which was carried out for one year. Physicians and nurses filled in the notification forms when they encountered suspected ADR cases. These cases were then assessed by a panel of four judges. According to Naranjo's algorithm, the ADRs were assessed and classified based on World Health Organization (WHO) classification.

Key findings A total of 288 suspected cases were reported and 264 ADRs were confirmed by the panel. According to Naranjo's probability scale, 83 cases were categorized as ‘probable’, 181 cases were classified as ‘possible’, and none were classified as ‘unlikely’ or ‘definite’. The most common classes of drugs involved were antibiotics (25%), psychotropics (20%), analgesic and cardiovascular agents (14% each). Generalised itch and rash, tremors, urticarial drug reaction, oral ulcer, gastritis and akathesia and extrapyramidal symptoms were found to be the most common ADRs observed; 2.1% of the patients in the studied departments had ADRs.

Conclusion The ADR reporting system was initiated at the hospital and was well received by the physicians. Appreciable participation of physicians was noted during the study in reporting ADRs. The study also gave an insight into the awareness of physicians about ADR-related issues. The number of ADRs reported was reasonably comparable with the findings of other authors from India.
Audit of medication management of acute behavioural disturbance: exploring the impact of a clinical practice guideline
Authors: Wheeler Amanda J , Sheridan Janie , Chan Grace , Cu Eunice , Lee Sue Jan , Lo Rebekah KC , Williams Harriet , Wong Lan Yee
Published: February 2007

Objective This paper describes an evaluation of the impact of a concise, portable guideline for the medication management of acute behavioural disturbance in adult psychiatric inpatient units.

Setting Waitemata District Health Board provides inpatient psychiatric care for an adult catchment population of about 800 000 at two units located in west and north Auckland, New Zealand with a total of 68 beds.

Method A retrospective clinical audit of the first 72 hours' medication management for patients admitted in acute crisis was completed before and after formal guideline implementation.

Key findings Benzodiazepines were the medication of choice. Total daily doses for both benzodiazepines and antipsychotics were within recommended ranges. Areas of practice that appeared to improve after guideline implementation included reduced use of antipsychotic and short-acting injectable medications and use of lorazepam as sole treatment, but differences were not statistically significant.

Conclusion Pharmacological management was found to be consistent with best clinical practice before and after guideline implementation.
A New Open-structured Titanophosphate with Intersecting 12-Ring Channels
Authors: Zhao Yongnan , Yang Yang , Yang Xiaoqin , Guo Wenjun
Published: February 2007

A novel mixed valent titanophosphate open-structure was hydrothermally synthesized; the connections of TiO6 and PO4 groups generate a porous architecture with two types of 12-MR channels.
Synthesis and Properties of Partially Overlapped [3.n](3,9)Carbazolophanes
Authors: Tani Keita , Yamamoto Shinya , Kubono Koji , Hori Kazushige , Tohda Yasuo , Takemura Hiroyuki , Nakamura Yosuke , Nishimura Jun , Benten Hiroaki , Ohkita Hideo , Ito Shinzaburo , Yamamoto Masahide
Published: February 2007

Cyanamide- and oxa-bridged [3.n](3,9)carbazolophanes 1n and 2n (n = 4 and 5) were synthesized. X-ray analysis of 14 and 25 revealed that carbazole rings are taken to be partially overlapped geometry. Electronic spectra of 1n and 2n (n = 4 and 5) showed the existence of transannular π–π electronic interaction between two carbazole rings, whereas fluorescence of these carbazolophanes indicated monomer-like emission.
Preparation of ZnO-core/Nanoporous Silica-shell Particle and the Conversion to Hollow Nanoporous Silica Particle
Authors: Ogawa Makoto , Naito Daisuke , Shimura Naoki
Published: February 2007

ZnO particle was coated with thin nanoporous silica layers, and hollow nanoporous silica particles were obtained by removing ZnO (core).
Preparation of Eu(OH)3 and Eu2O3 Nanorods through a Simple Method
Authors: Yang Xuefeng , Ning Guiling , Lin Yuan
Published: February 2007

Eu(OH)3 and Eu2O3 nanorods were prepared by a facile hydrothermal procedure. The obtained hexagonal phase Eu(OH)3 nanorods have diameter of about 50 nm and lengths ranging from 100 to 800 nm. Eu2O3 nanorods were obtained from Eu(OH)3 by calcination. The Eu2O3 nanorods show a pure cubic phase and exhibit characteristic luminescence of Eu3+ ions at 616 nm.
Asymmetric 1,4-Addition Reaction of Arylboronic Acid to Eneone Catalyzed by Palladium with Ferrocene-based Phosphine Ligand
Authors: Suzuma Yoshinori , Yamamoto Tetsuya , Ohta Tetsuo , Ito Yoshihiko
Published: February 2007

Asymmetric 1,4-addition reaction of arylboronic acid to cyclic enone was carried out in the presence of a chiral ferrocene-based phosphine ligand–palladium catalyst. The reaction of 2-cyclohexen-1-one by palladium complex with (S,Rp)-[1-(2-bromoferrocenyl)ethyl]diphenylphosphine afford a optically active β-arylcyclohexanone in good yield up to 71% ee.
Oxidative Cleavage of Nitroalkenes with Hydrogen Peroxide in Environmentally Acceptable Solvents
Authors: Bortolini Olga , Nino Antonio De , Fogagnolo Marco , Fantin Giancarlo , Mariuolo Loredana , Tocci Amedeo
Published: February 2007

Hydrogen peroxide serves as an efficient oxidant for the nitroalkene C=C bond cleavage to aldehydes in ionic liquids.
Stereoselective Synthesis of Medium-sized Cyclic Compounds through the Intramolecular Michael-type Reaction Utilizing Alkyne–Hexacarbonyldicobalt Complex Formation
Authors: Inaba Kennichi , Takaya Jun , Iwasawa Nobuharu
Published: February 2007

Alkyne–hexacarbonyldicobalt complexes having silyl enol ether and electron-deficient alkene moieties on opposite ends were treated with MeAlCl2 in the presence of 2,6-di-t-butylpyridine in CH2Cl2 to give synthetically useful medium-sized cyclic products as a single stereoisomer in good yield.
Synthesis of β-Amino Acid Derivatives by Nickel(0)-mediated Sequential Addition of Carbon Dioxide and Dibenzoyldiazene onto Unsaturated Hydrocarbons
Authors: Murakami Masahiro , Ishida Naoki , Miura Tomoya
Published: February 2007

A stoichiometric amount of nickel(0) complex mediated the aminative carboxylation of unsaturated hydrocarbons through oxidative cyclization with carbon dioxide followed by insertion of dibenzoyldiazene into the carbon–nickel bond, giving β-amino acid derivatives.
Hybrid Metaheuristics to Aid Runway Scheduling at London Heathrow Airport
Authors: Atkin Jason A. D. , Burke Edmund K. , Greenwood John S. , Reeson Dale
Published: February 2007

Although London Heathrow is one of the busiest airports in the world, it has only one runway for use by departing aircraft at any time. Separations are required between each pair of aircraft at take-off—depending on their routes, weights, and speeds—to ensure safety. Efficient scheduling of the aircraft for take-off can reduce the total separations and increase throughput. A runway controller is responsible for take-off scheduling. This is a very intensive job with responsibility for all communication with aircraft and continuous monitoring to assure safety. The high workload limits the number of aircraft that the controller can take account of when scheduling. The geometry of the runway holding points adds physical constraints to the reordering of aircraft that are usually ignored in the academic literature. We present models for evaluating a schedule and determining the effects of the physical constraints. We propose a hybrid metaheuristic system that takes account of more aircraft than a human controller can handle, and so can aid the runway controller by recommending schedules that anticipate some future problems. We present results to show the effectiveness of this system, and we evaluate those results against real-world schedules.
A Model of the Dynamic Process of Time Allocation to Discretionary Activities
Authors: Meloni Italo , Spissu Erika , Bez Massimiliano
Published: February 2007

This paper proposes an activity-based methodology for representing the allocation of time to discretionary activities during their programming and scheduling, based on the premise that both phases are to be considered contextually and two aspects of the same decision process. The aim of this work is to extend the treatment of utility maximization associated with carrying out two activities to J activities, so as to be able to segregate the time spent traveling from the total amount of time dedicated to out-of-home activities. The global structure of the model takes the form of a nested Tobit, particularly suited for reproducing a sequence of coupled choices. The first choice concerns dividing up overall discretionary time between activities inside and outside the home, then the second choice, subordinate to the first, involves rebudgeting the time between in- and out-of-home activities and trips. Thus the proposed model enables us to analyze the effects that each explicative variable exerts on trips segregated from activities outside the home and, last, during demand forecasting, the direct consequences of allocating discretionary time to trips following changes to an individual’s time budget. A database created from a large-scale time-use survey (ISTAT 1988–1991) has been used for calibrating the model coefficients.
Performance Measurement for Inventory Routing
Authors: Song Jin-Hwa , Savelsbergh Martin
Published: February 2007

We develop technology to measure the effectiveness of distribution strategies for inventory routing. Popular, practical performance measures, such as volume delivered per mile, are effective in measuring relative performance but inadequate in measuring absolute performance. We develop a methodology that allows the computation of tight lower bounds on the total mileage required to satisfy customer demand over time. As a result, companies will be able to gain insight into the effectiveness of their distribution strategy.
Integrated Routing and Scheduling of Hazmat Trucks with Stops En Route
Authors: Erkut Erhan , Alp Osman
Published: February 2007

We consider an integrated routing and scheduling problem in hazardous materials transportation where accident rates, population exposure, and link durations on the network vary with time of day. We minimize risk (accident probability multiplied by exposure) subject to a constraint on the total duration of the trip. We allow for stopping at the nodes of the network. We consider four versions of this problem with increasingly more realistic constraints on driving and waiting periods, and propose pseudopolynomial dynamic programming algorithms for each version. We use a realistic example network to experiment with our algorithms and provide examples of the solutions they generate. The computational effort required for the algorithms is reasonable, making them good candidates for implementation in a decision-support system. Many of the routes generated by our models do not exhibit the circuitous behavior common in risk-minimizing routes. The en route stops allow us to take full advantage of the time-varying nature of accident probabilities and exposure and result in the generation of routes that are associated with much lower levels of risk than those where no waiting is allowed.
A Review of Current Practices in Breast Conservation Surgery in the UK
Authors: Young OE , Valassiadou K , Dixon M
Published: February 2007

INTRODUCTION

The aim of this study was to assess whether surgeons in the UK were practising wide excision consistent with current guidelines and current evidence.

PATIENTS AND METHODS

Questionnaires were sent to 200 breast surgeons throughout the UK to determine current practices in breast conserving surgery.

RESULTS

When performing a wide excision for invasive cancer, 61% of respondents always remove full thickness of breast tissue and 37% usually do. Of surgeons, 60% rarely use specimen X-ray for palpable lesions. However, 91% always take specimen X-rays in impalpable lesions, but 9% do not always take specimen X-rays for impalpable lesions. In 93% of units, the pathologist always reports the distance to the nearest margin. For both invasive and in situ cancer, there is a wide variation in what is considered an adequate radial margin. There is wide variation in the practice of re-excision. Of surgeons, 50% indicated that they wish wider margins in the presence of an extensive in situ component and 39% wish wider margins in younger women.

CONCLUSIONS

The results show a large variation in practice with many surgeons not treating patients in accordance with current guidelines and evidence.
Wound Oozing After Total Hip Arthroplasty
Authors: Wood James J , Bevis Paul M , Bannister Gordon C
Published: February 2007

INTRODUCTION

Total hip arthroplasty is a commonly performed operation and yet little information exists about the duration of wound oozing, the factors associated with this and the implications. The aim of this work was to identify factors influencing wound oozing by establishing their effect on the time taken for wounds to cease oozing after total hip arthroplasty.

PATIENTS AND METHODS

Sixty-two consecutive patients undergoing total hip arthroplasty were included. Wounds were examined for wound oozing on a daily basis by the same observer and were then re-dressed. The time taken for each wound to become dry was recorded. Data were analysed to determine if the time-to-dryness was influenced by wound length, body mass index, estimated volume of blood in the dissected tissues, duration of surgery and ASA grade.

RESULTS

Time to dryness was associated with wound length (P = 0.01), body mass index (BMI, P = 0.05), estimated volume of blood in dissected tissues (P = 0.05) and length of hospital stay (P = 0.02). No association was found with duration of surgery or ASA grade.

CONCLUSIONS

A small-incision, meticulous haemostasis at surgery and a reduction in pre-operative obesity reduce the time taken for hip arthroplasty wounds to become dry. Prolonged wound oozing delays hospital discharge.
Current Attitudes and Practices Towards Diathermy Smoke
Authors: Spearman John , Tsavellas George , Nichols Paul
Published: February 2007

INTRODUCTION

The hazards of surgical smoke are well documented and electrosurgical units (ESUs) are an integral part of surgical practice. The aim of this study was to gauge the opinions of general surgical consultants, specialist registrars and senior theatre nurses in the Wessex Region towards the hazards of ESU smoke.

MATERIALS AND METHODS

A literature search was carried out using Ovid Medline. A questionnaire was sent to 169 consultants, SpRs and nurses in the 14 hospitals across the Wessex Region, exploring current practices, perceived hazards and whether adequate precautions were currently in use.

RESULTS

Only 3 of 98 surgeons used dedicated smoke extractors, despite the fact the majority (72%) felt that, currently, inadequate precautions were taken to protect staff and patients from surgical smoke. There was also uncertainty about the hazards amongst the respondents.

CONCLUSIONS

The use of smoke extraction equipment is very limited. Greater awareness of the hazards and available technology to extract fumes from the theatre environment might lead to greater uptake.
Learning Curves in Orthopaedic Surgery: A Case for Super-Specialisation?
Authors: Jain NPM , Jowett AJL , Clarke NMP
Published: February 2007

INTRODUCTION

The objective of this study was to assess if there is a significant learning curve in the treatment of developmental dysplasia of the hip.

PATIENTS AND METHODS

We followed up cases of developmental dysplasia of the hip treated by a single surgeon over a 12-year period. There were 96 cases, 56 treated by open reduction and 40 treated by closed reduction. Assessment was made of the incidence and degree of avascular necrosis in the treated hips, as a radiological outcome measure.

RESULTS

Plotting the cumulative percentage of satisfactory outcomes demonstrated an increasingly high percentage of satisfactory results with increasing number of procedures performed, i.e. as the surgeon progressed up the ‘learning curve’.

CONCLUSIONS

This study demonstrates a learning curve in the treatment of developmental dysplasia of the hip. It may be possible to draw parallels to other treatments, and also support for the growing trend to specialisation.
The Role of Percutaneous Endopyelotomy for Ureteropelvic Junction Obstruction
Authors: Rukin NJ , Ashdown DA , Patel P , Liu S
Published: February 2007

INTRODUCTION

Over the last 20 years, the surgical management of ureteropelvic junction obstruction (UPJO) has been revolutionised by the development of endourological instrumentation and several minimally invasive procedures including: antegrade or retrograde endopyelotomy, retrograde balloon dilatation, and laparoscopic pyeloplasty. Currently, in our department, we offer percutaneous antegrade endopyelotomy (PAE) as primary treatment of UPJO in adults, believing it offers less morbidity, better cosmetic results, and quicker operating time compared with open pyeloplasty.

PATIENTS AND METHODS

We performed a retrospective audit of our results for the 14 patients who underwent percutaneous antegrade endopyelotomy between January 2000 and May 2004.

RESULTS

Mean operative time was 53 min (range, 30–80 min), mean in-patient stay was 3.8 days (range, 2–7 days), and there were no major postoperative complications for this series with mean follow-up of 31.8 months (range, 12–52 months). Eleven out of the 14 patients (79%) showed radiological improvement on their 3-month MAG 3 (mercaptoacetyl-triglycyl) renogram, and 13 out of the 14 (93%) patients reported significant reduction or resolution of pain, compared with their preoperative state.

CONCLUSIONS

The majority of urologists still offer open pyeloplasty as primary treatment for UPJO with laparoscopic pyeloplasty currently an evolving procedure in the UK. Our series reports comparable success rates for PAE compared to other series. Despite these results, we feel that the future role of percutaneous endopyelotomy will be as a salvage procedure following failed open or laparoscopic surgery. However, in patients with concurrent stone disease or requiring antegrade ureteric access, percutaneous endopyelotomy would be suitable as a primary treatment option.
Perfidious Gallbladders – A Diagnostic Dilemma with Xanthogranulomatous Cholecystitis
Authors: Srinivas Gandrapu NS , Sinha Surajit , Ryley Nick , Houghton Paul WJ
Published: February 2007

INTRODUCTION

Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis characterised by marked thickening of the gallbladder wall and dense local adhesions. Pre-operative and intra-operative diagnosis is difficult and it often mimics a gallbladder carcinoma (GBC). Laparoscopic cholecystectomy (LC) is frequently unsuccessful with a high conversion rate. A series of patients with this condition led us to review our experience with XGC and to try to develop a care pathway for its management.

PATIENTS AND METHODS

A retrospective review of the medical records of 1296 consecutive patients who had undergone cholecystectomy between January 2000 and April 2005 at our hospital was performed. Twenty-nine cases of XGC were identified among these cholecystectomies. The clinical, radiological and operative details of these patients have been analysed.

RESULTS

The incidence of XGC was 2.2% in our study. The mean age at presentation was 60.3 years with a female:male ratio of 1.4:1. Twenty-three patients (79%) required an emergency surgical admission at first presentation. In three patients, a GBC was suspected both radiologically and at operation (10.3%), but was later disproved on histology. Seventeen patients (59%) had obstructive jaundice at first presentation and required an endoscopic retrograde cholangiopancreatography (ERCP) before LC. Of these, five had common bile duct stones. Abdominal ultrasound scan showed marked thickening of the gallbladder wall in 16 cases (55%). LC was attempted in 24 patients, but required conversion to an open procedure in 11 patients (46% conversion rate). A total cholecystectomy was possible in 18 patients and a partial cholecystectomy was the choice in 11 (38%). The average operative time was 96 min. Three patients developed a postoperative bile leak, one of whom required ERCP and placement of a biliary stent. The average length of stay in the hospital was 6.3 days.

CONCLUSIONS

Severe xanthogranulomatous cholecystitis often mimics a gallbladder carcinoma. Currently, a correct pre-operative diagnosis is rarely made. With increased awareness and a high index of suspicion, radiological diagnosis is possible. Preoperative counselling of these patients should include possible intra-operative difficulties and the differential diagnosis of gallbladder cancer. Laparoscopic cholecystectomy is frequently unsuccessful and a partial cholecystectomy is often the procedure of choice.
Anatomy in a Modern Medical Curriculum
Authors: Turney BW
Published: February 2007

Anatomy in undergraduate education has been in decline for many years. Some suggest that it has fallen below a safe level. Balances between detail and safety, and assimilation and application of anatomy have yet to be established as the methods of teaching undergo another metamorphosis. For doctors, the human body is the focus of investigation and intervention on a daily basis; for this reason, the study of anatomy in some form will continue to be essential to safe medical practice. It is necessary for core knowledge of anatomy to be assimilated by all doctors in order to practice and communicate safely. It may be true that most doctors do not need to dissect a cadaver or study a prosection in order to practice, but if it can improve their understanding of what they do and why they do it, this surely has to be of benefit both for the safety of the patient and satisfaction of the doctor as a professional. Integration of newer teaching modalities and modern technology will encourage interest and retention of anatomical knowledge and its clinical relevance. Anatomy has a promising future in postgraduate specialist and surgical training. Detailed knowledge should be integrated into specialist training when it is clinically relevant allowing specialists of the future to practice safely and accurately and also to provide a strong base for future clinical developments.
Cement Burn of the Skin During Hip Replacement
Authors: Burston Ben , Yates Piers , Bannister Gordon
Published: February 2007

We present the first reported case of a partial thickness burn to the skin from discarded bone cement during a routine total hip replacement (THR). The patient required plastic surgical attention for 5 months before the skin was healed. We summarise the reported incidents of cement burns to various other structures and the circumstances in which these injuries can potentially occur.
A dynamic extraversion model. The brain's response to a single dose of a stimulant drug
Authors: Amigó Salvador , Caselles Antonio , Micó Joan C.
Published: February 2007

The aim of this paper is to present a mathematical dynamic modelling of the effect a stimulant drug has on different people which, at the same time, can be a useful tool for future brain studies. To this end, a dynamic model of the evolution of extraversion (considering its tonic and phasic aspects) has been constructed taking into account the unique personality trait theory and the general modelling methodology. This model consists of a delayed differential equation which, on one hand, considers that the active stimulus, a consequence of a single intake, is not constant; on the other hand, it contemplates that the state variable representing the phasic extraversion also represents the brain activation. The derivative of this state variable is calculated as the sum of the homeostatic control flow, the excitatory effect flow and the inhibitor effect flow. The solutions of this equation relate the tonic activation of an individual (that characterizes his or her personality) with his or her phasic activation level, whose evolution over time describes the organism's response to a single drug intake. These solutions quantitatively reproduce the predictions of current personality theories and anticipate vulnerability to drug misuse and addiction development.
V. Regnier. Design for Assisted Living: Guidelines for Housing the Physically and Mentally Frail. New York: John Wiley, 2002.
Authors: Chaudhury Habib
Published: February 2007

Ce livre apporte un excellent complément à la diversité des ressources portant sur la planification et la conception d'aide à la vie autonome. Il comporte quatre parties: statistiques générales sur l'aménagement du cadre de vie et les services, recherche esthétique et fonctionnelle, études de cas se rapportant à l'Europe et aux États-Unis, et orientation future. La recherche esthétique et fonctionnelle est un vaste domaine qui offre des lignes directrices portant sur le site, l'aménagement paysager, la conception des unités, le mode de dotation en personnel et l'aménagement des lieux pour les gens atteints de démence. Chacun des éléments de ce volet est présenté avec un exemple visuel et une brève description de ses aspects les plus marquants. Les quinze études de cas présentées sont particulièrement utiles parce qu'elles illustrent plusieurs des évaluations esthétiques et fonctionnelles présentées dans le livre. La formule des études de cas donne une bonne idée des caractéristiques les plus marquantes du projet et permet une comparaison des caractéristiques des bâtiments et des résidents dans le cadre des études de cas. Le livre est destiné à un vaste ensemble de lecteurs allant des professionnels du design aux administrateurs de logements, suggérant des idées de conception et de décisions en matière de gestion.
Educational reversals and first-birth timing in sub-Saharan Africa: A dynamic multilevel approach
Authors: Derose Laurie F. , Kravdal Øystein
Published: February 2007

In many areas throughout sub-Saharan Africa, young adult cohorts are less educated than their predecessors because of declines in school enrollments during the 1980s and 1990s. Because a woman with little education typically becomes a mother earlier and has more children than one with better education, and because of a similar well-established relationship between current education and current fertility at the societal level, one might expect such education reversals to raise fertility. However, if there is an additional negative effect of low educational level among currently young women compared with that in the past, which would accord with ideas about the impact of relative deprivation, the total effect of an education reversal may run in either direction. This possibility has not been explored in earlier studies, which have taken a more static approach. We focus on the initiation of childbearing. Using Demographic and Health Survey data from 16 sub-Saharan African countries with multiple surveys, we estimate a fixed-effects multilevel model for first births that includes the woman’s own education, community education, and community education relative to the past. There are negative effects of individual and community education, but no effect of relative education. Thus we conclude that education reversals do seem to speed up entry into parenthood.
FMR1 CGG Repeat Distribution and Linked Microsatellite-SNP Haplotypes in Normal Mexican Mestizo and Indigenous Populations
Authors: Felix-López Xóchitl Adriana , Argüello-García Raúl , Cerda-Flores Ricardo M , Peñaloza-Espinoza Rosenda I , Buentello-Malo Leonor , Estrada-Mena Francisco Javier , Ramos-Kuri Manuel , Gómez Fabio Salamanca , Arenas-Aranda Diego
Published: February 2007

The (CGG)n repeat size distribution in the FMR1 gene was studied in healthy individuals: 80 X chromosomes of Mexican Mestizos from Mexico City and 33 X chromosomes of Mexican Amerindians from three indigenous communities (Purepechas, Nahuas, and Tzeltales), along with alleles and haplotypes defined by two microsatellite polymorphic markers (DXS548 and FRAXAC1) and two single nucleotide polymorphisms (FMRA and FMRB). Genetic frequencies of Mestizo and Amerindian subpopulations were statistically similar in almost all cases and thus were considered one population for comparisons with other populations. Sixteen (CGG)n alleles in the 17â38 size range were observed, and the most common were the 25 (38.0%), 26 (28.3%), and 24 (12.3%) repeat alleles. This pattern differs from most other populations reported, but a closer relation to Amerindian, European, and African populations was found, as expected from the historical admixture that gave rise to Mexican Mestizos. The results of the CA repeats analysis at DXS548-FRAXAC1 were restricted to nine haplotypes, of which haplotypes 7-4 (52.2%), 8-4 (23.8%), and 7-3 (11.5%) were predominant. The modal haplotype 7-4, instead of the nearly universal haplotype 7-3, had been reported exclusively in Eastern Asian populations. Likewise, only seven different FRAXAC1-FMRA-FMRB haplotypes were observed, including five novel haplotypes (3TA, 4TA, 3-A, 4-A, and 5-A), compared with Caucasians. Of these, haplotypes -A (78.7%) and 3-A (13.2%) were the most common in the Mexican population. These data suggest a singular but relatively low genetic diversity at FMR1 in the studied Mexican populations that may be related to the recent origin of Mestizos and the low admixture rate of Amerindians.
Time Series Analysis of the Epidemiological Transition in Minorca, 1634-1997
Authors: Muñoz-Tudurí M , García-Moro Clara , Walker P. L
Published: February 2007

Autoregressive integrated moving average (ARIMA) models provide a powerful tool for detecting seasonal patterns in mortality statistics. The strength of ARIMA models lies in their ability to reveal complex structures of temporal interdependence in time series. Moreover, changes in model parameters provide an empirical basis for detecting secular trends and death seasonality patterns. This approach is illustrated by our analysis of changes in the mortality patterns of the population of the town of Es Mercadal on the island of Minorca between 1634 and 1997. These data reveal a transition from an early mortality pattern requiring a complex ARIMA model that accounts for a strong seasonal death pattern and periodic epidemic-related mortality crises to a much simpler 20th-century pattern that can be described by a simple single-parameter ARIMA model. These same data were also analyzed using standard seasonality tests. The results show that the reduction in the number of parameters required to fit the Es Mercadal mortality data coincides with the epidemiological transition in which the predominant causes of morbidly and mortality shift from infectious to degenerative causes.
Commerce and Cadiz in Spenser's Prothalamion
Authors: Owens Judith
Published: February 2007

This paper contends that in Prothalamion commercial and heroic ethoi remain for Spenser fundamentally incompatible. Close attention to the London setting of the poem, especially to those commercial aspects that the poem seems deliberately to suppress, suggests that Spenser is deeply reluctant to embrace London's commercial ethos as something conducive to heroic values and achievements. Against what he feels to be the compromises of commerce, Spenser proffers poetic vision, while in the measured praise of the Earl of Essex that forms much of the poem's interest, Spenser distinguishes heroic imperatives from the mercenary and commercial concerns that accumulated around Cadiz.
Skeltonic Anxiety and Rumination in The Shepheardes Calender
Authors: Segall Kreg
Published: February 2007

Colin Clout, the central figure in Edmund Spenser's The Shepheardes Calender, is both poet and poetic subject at different points in the poem, and the anxiety of that disjunction becomes a central focus of the poem itself. The Shepheardes Calender is fascinated with and tense about the boundaries between author, character, and work. In examining these ambiguities, Spenser aligns himself closely with John Skelton who also struggles with the relationship between poetic body and physical body.
The Rise and Secularization of Viticulture in Mendoza: The Godoy Family Contribution, 1700–1831
Authors: Lacoste Pablo
Published: February 2007

The Mendoza wine industry, currently the largest in Latin America and fifth largest in the world, is the inheritor of an almost 500 year-long process of evolution in the cultivation of grape vines and the development of wine making. The most studied period of its history corresponds to the construction of British railroads and the tremendous wave of Italian, Spanish and French immigration that began in the 1880s. Prior to the modern period, however, there was a traditional period in the Argentine wine industry, characterized by artisan production and ecclesiastical control. In the mid-nineteenth century, members of the clergy and religious groups controlled nearly 80 percent of the wine industry in Mendoza. This article examines the origins of viticulture in Mendoza, with particular reference to the influence of the clergy, and the subsequent secularization of the wine industry. At the same time, it discusses the role that the Godoy family played in the rise and consolidation of the wine making and its separation from ecclesiastical control.