bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-criteria decision aids for sustainable water management
Authors: Kain J.-H. , Kärrman E. , Söderberg H.
Published: October 2007

This article evaluates three multi-criteria decision aid (MCDA)methods—Regime, Novel Approach to Imprecise Assessment and Decision Environments (Naiade) and Strategic Advisor (Strad)—from a process facilitation perspective. This research shows that Strad has many advantages over the other tools regarding knowledge management, pluralism, functionality, transparency and participation. Concluding recommendations are as follows. (1) Agree explicit aims with stakeholder participation and if the aims change during the process, this is to be communicated. (2) Match methodology with the aims of the process since it is not always necessary to base the ranking on complex mathematical calculations. (3) Participatory processes should be conducted with care as they are resource consuming. Select cases thoughtfully and design them with a reflective attitude. The systematic structure of going through one criterion at a time is perceived as more important than software aggregation of multiple criteria at the end. It was further concluded that MCDAs have to be transparent and software must be flexible with an understandable user interface.
The CCH Consumer Outcome Scales: A Brief Instrument to Assess the Multiple Problems of Homelessness
Authors: Cook Paul F. , Farrell Ed , Perlman Jennifer
Published: October 2007

Homeless persons are underresearched; existing instruments do not adequately address this population. Clinical experts developed a brief instrument to assess housing, employment, benefits, physical health, mental health, and substance use that was tested for its psychometric properties. The instrument demonstrated content validity based on expert consensus, adequate interrater reliability (average r = .58), convergent and divergent validity with established measures, freedom from social desirability bias (average r = .00 with the Marlowe-Crowne scale), criterion-related validity for housing (85% accurate) and employment (83% accurate) items, and no floor effects. The benefits item had poorer psychometrics. The Colorado Coalition for the Homeless (CCH) Consumer Outcome Scales are recommended for assessment and service planning with homeless individuals. Further research is needed on the instrument’s sensitivity to change over time and applicability to diverse cultural groups.
Psychometric Properties of the Minnesota Nicotine Withdrawal Scale: A Korean Version
Authors: Kim Sun S. , Gulick Elsie E. , Kim Seong-Ho , Seo Hong-Gwan
Published: October 2007

Smoking is considerably more common among Korean American male individuals compared with all U.S. males, but no reliable and valid nicotine withdrawal scale has been available to measure withdrawal symptoms from the Korean American perspective, which is the aim of the present study. Translation and back-translation of the Minnesota Nicotine Withdrawal Scale (MNWS) was conducted to obtain a measure consistent with the Korean cultural understanding of smoking withdrawal symptoms. Following satisfactory interrater agreements, the Korean version (MNWS-K) was administered to 118 Korean American male smokers. Data were analyzed for internal consistency reliability and stability as well as construct validity. Internal consistency reliability was satisfactory for the total scale and factors (.88, .88, .79) and intraclass correlation coefficient (ICC) for the total score over a 1-month period was fair (r = .51). Exploratory factor analysis with orthogonal rotation yielded two factors. Together, Factor I, early-occurring disturbances in mental functioning, and Factor II, disturbances in physiological functioning and late-occurring disturbances in mental functioning, explained 66% of the variance in the scale. Theoretically related variables to the MNWS-K, number of smoking quit attempts and self-efficacy, showed modest but statistically significant correlations with the MNWS-K total and factored scales. Satisfactory internal consistency coefficients together with the validity findings suggest the MNWS-K warrants use with the Korean American population.
Longitudinal Field Comparison of the RT3 and an Activity Diary With Cardiac Patients
Authors: Hertzog Melody A. , Nieveen Janet L. , Zimmerman Lani M. , Barnason Susan A. , Schulz Paula M. , Miller Connie L. , Rasmussen Doris A.
Published: October 2007

This study investigated reliability and validity of two methods of measuring patients’ physical activity following coronary artery bypass graft (CABG) surgery. Sixty-five patients wore an RT3 accelerometer and recorded activity in a diary at 3 weeks, 6 weeks, and 3 months postsurgery. Generalizability coefficients greater than .80 required approximately 2 to 4 days of data, fewer than reported elsewhere. Energy expenditure estimates correlated .77, .72, and .57 (p < .01), with mean RT3 estimates higher, especially when overall energy expenditure was low. Changes from 3 to 6 weeks correlated only moderately (r = .37–.46) across methods. The methods produce reliable but differing estimates of physical activity in this population. Although no method bias is evident in assessing change over time, correlations support the importance of using multiple methods.
Psychometric Evaluation of the Nursing Stress Scale (NSS) Among Chinese Nurses in Taiwan
Authors: Lee Mei-Hua , Holzemer William L. , Faucett Julia
Published: October 2007

The purpose of this study was to translate the Nursing Stress Scale (NSS) into Chinese and test its reliability and validity among Chinese nurses in Taiwan. Potential participants were asked to self-administer a Chinese version of the NSS. The agreement estimation was used to determine the equivalence of the meaning between the Chinese and original English versions and was rated by five bilingual nurses as 92% accurate for the 34 items. The test-retest reliability for the NSS at 2 weeks was .71 (p = .022, n = 10). Internal consistency reliability and factor analysis were tested with 770 nurses from 65 inpatient units at a medical center in Taiwan. The internal consistency of the Chinese version of the NSS for an overall coefficient alpha is .91 for the total scale, and ranges from .67 to .79 for the subscales. The Chinese version of the NSS explains 53.77% of the variance in work stressors among Chinese nurses in Taiwan. Overall, the Chinese version of the NSS is internally consistent but may not be stable over 2 weeks. There was adequate evidence of the reliability and validity of the NSS-Chinese as an instrument appropriate to measure work stress among Chinese nurses. The translated NSS could be a useful tool for examining the frequency and major sources of stress experienced by Chinese nurses in hospital settings, and for the development of appropriate interventions for stress reduction.
The Use of EMDR in Reducing Presentation Anxiety: A Case Study
Authors: Barker Randolph T. , Barker Sandra B.
Published: October 2007

Effective presentation skills are vital for success in most organizations. Preparing students for their careers, college educators often require that students demonstrate effective presentation skills. While traditional approaches to managing presentation anxiety help some students, EMDR may offer an effective intervention for those with serious presentation anxiety. This case study involves a student with presentation anxiety referred for EMDR from an organizational communication class. The subject delivered videotaped presentations and completed the State-Trait Anxiety Inventory (STAI) prior to and after completing three EMDR sessions. The subject’s pre–post STAI scores reduced from the 98th to the 55th percentile. Blind expert ratings of the videotaped presentations indicated pronounced performance improvement. At 12-month follow-up, the subject was successfully employed in a management position, making effective presentations without intense anxiety.
A Clinical Vignette: EMDR Treatment of Choking Phobia
Authors: Schurmans Karen
Published: October 2007

A vignette is a brief case report that makes a contribution to the literature, but which has used only EMDR’s standard protocol measures. This vignette describes the treatment of a woman who developed a severe choking phobia following an allergic reaction to a herbal beverage. She was hospitalized on several occasions because of her resultant inability to consume food and liquids. She received four years of various types of treatment for this phobia, including eating disorder treatment, brief psychodynamic therapy, cognitive behavioral therapy, and psychopharmacological treatment. None were successful in eliminating the disorder. Then when Mary received a course of EMDR treatment, addressing childhood etiological events, there was complete remission of the choking phobia and elimination of all related behaviors.
EMDR, Adaptive Information Processing, and Case Conceptualization
Authors: Shapiro Francine
Published: October 2007

EMDR is an integrative, client-centered psychotherapy approach that emphasizes the brain’s information processing system and memories of disturbing experiences as the bases of those pathologies not caused by organic deficit or insult. EMDR addresses the experiences that contribute to clinical conditions and those needed to bring the client to a robust state of psychological health. Overviews of the history, development, and research that have established EMDR as an empirically supported treatment are provided. Subsequent to an explanation of the adaptive information processing model, an extended case example is used to illustrate the recommended EMDR case conceptualization and eight phases of treatment. This approach is used to process the early memories that set the foundation for the pathology and the present situations that trigger the dysfunction, while providing templates for appropriate future action that incorporate the information and behaviors needed to overcome skill and/or developmental deficits. The benefits of integrating EMDR and family systems perspectives to provide the most comprehensive therapeutic effects are described.
Treatment of Rhinitis Medicamentosa
Authors: Bende Mats
Published: October 2007

Eleven patients with rhinitis medicamentosa were treated with twice the recommended dose of a topical nasal corticosteroid for 2 months. Nasal airway resistance (NAR) was measured at rest and after a physical exercise test, before and after the treatment period. NAR at rest was reduced after the treatment because of diminished blood volume in the nasal mucosa. Treatment with topical corticosteroids for short periods may help patients with rhinitis medicamentosa to refrain from using nasal decongestants. Topical nasal decongestants are not recommended for sustained use.
Lymphoma of the Sinonasal Region
Authors: Hassab Mohammed H. , Aziz Mohammad T. , Thabet M. Hossam M. , Deeb Nadia El , Hamza Mervat A.
Published: October 2007

Despite its low incidence, non-Hodgkin lymphoma of the sinonasal region is the most frequent nonepithelial malignancy in this site. A review of a series of 10 patients with this disease is presented with discussion of the clinical and pathologic features of the disease as well as the management outlines.
Capillary Hemangioma of the Ethmoidal Sinus: A Case Report
Authors: Boedts Michael , Van Damme Boudewijn , Jorissen Mark
Published: October 2007

We describe the case of a capillary hemangioma of the ethmoidal sinus, resected under endoscopic control. The capillary hemangioma of the nose is a rare condition. It usually presents on the nasal septum; very rarely it arises from the turbinates. A capillary hemangioma arising from the ethmoid has not been previously reported.
Reversibility of Abnormal Mucociliary Clearance in Experimental Chronic Sinusitis
Authors: Czaja Judith M. , McCaffrey Thomas V.
Published: October 2007

Normal mucociliary clearance in the paranasal sinuses must be restored to reverse the effects of chronic sinusitis. This study examined effects of middle meatal antrostomy (MMA) on ciliary beat frequency (CBF), mucociliary transport (MCT) velocity, MCT patterns, and histology of sinus mucosa in rabbits with chronic sinusitis to determine whether objective measures of mucociliary function and histology could be reversed. Two groups of rabbits were compared: uninfected (Group A controls, n = 9) and infected (Group B, n = 11). Maxillary sinus ostia were occluded; 108 cfu of Streptococcus pneumoniae were inoculated into sinuses of rabbits in group B, and chronic sinusitis developed. This was confirmed by histopathology and culture 6 weeks after infection. Middle meatal antrostomies were performed in the infected group, and sinuses were studied 6 weeks later. Control animals (Group A) had mean CBF = 11.5 Hz (±.39 Hz). Animals with chronic sinusitis (Group B) had mean CBF = 8.6 Hz (±.24 Hz). This was statistically different from control (P < 0.05). Six weeks following MMA, group B had mean CBF = 12.9 Hz (±.75 Hz). This was not different from control. There were changes in MCT velocity that correlated with the CBF (r = 0.72). Examination of MCT patterns after MMA demonstrated minimal pooling and stagnation; however, small areas of misdirected flow persisted. After MMA, there were decreased numbers of inflammatory and goblet cells and increased numbers of ciliated epithelial cells. This study demonstrated that mucociliary clearance and histological changes seen in rabbits with chronic sinusitis are reversed by MMA.
Mucociliary Clearance in Experimental Chronic Sinusitis
Authors: Czaja Judith M. , McCaffrey Thomas V.
Published: October 2007

Abnormal mucociliary clearance in the paranasal sinuses is a significant factor in the pathogenesis of sinusitis. This study examined effects of chronic sinusitis on ciliary beat frequency (CBF), mucociliary transport (MCT) velocity, mucociliary transport patterns, and histology of sinus mucosa in rabbits. Two groups of rabbits were studied: uninfected (n = 9) and infected (n = 18). Maxillary sinus ostia in all animals were occluded, and sinuses in the infected group were inoculated with 108 cfu of Streptococcus pneumoniae. Chronic sinusitis developed over 6 weeks and was confirmed by histopathology and culture. Evaluation of the MCT mechanism included 1) measurement of CBF using a photometric technique, 2) direct measurement of MCT velocity, and 3) analysis of MCT patterns with inert India ink. In seven of nine (77.8%) uninfected animals, the mean CBF was 11.5 Hz (±.39 Hz) initially and 11.3 Hz (±.32 Hz) 6 weeks after occlusion (P = 0.69). MCT velocity measured 20.6 mm/min (±1.40 mm/min) initially and 16.85 mm/min (±1.96 mm/min) 6 weeks after occlusion (P = 0.16). In the infected group, there were statistically significant decreases in CBF (P < 0.05) and measured MCT velocity (P < 0.05). Examination of MCT in infected animals showed patterns of misdirected flow, pooling, and stagnation. Histopathologic changes included significant losses of ciliated epithelium and mucosal abnormalities consistent with chronic sinusitis. Chronic sinusitis secondary to long-standing bacterial infection leads to alterations in CBF, MCT velocity, and MCT patterns in the paranasal sinuses of rabbits.
Chronic Lateral Ankle Instability and Associated Conditions: A Rationale for Treatment
Authors: Strauss Joseph E. , Forsberg Jonathan Agner , Lippert Frederick G.
Published: October 2007

Background: Ankle sprains have a high incidence of associated injuries and conditions that may be unrecognized at the initial time of injury. Failure to treat these conditions at the index surgery may compromise outcomes and delay recovery. The purpose of this study was to determine the type and frequency of associated injuries and conditions in military patients with chronic lateral ankle instability. Methods: Between 1996 and 2002, 160 patients had 180 modified Broström-Gould lateral ankle ligament reconstructions for chronic ankle instability. A retrospective review of the clinical history, physical examination, radiographs, and intraoperative findings was conducted. Results: The overall incidence of associated extra-articular conditions and injuries found in this study was 64%; 115 conditions were identified in 180 ankles. Peroneal tendon injuries occurred with the highest frequency (28%), followed by os trigonum lesions (13%), lateral gutter ossicles (10%), hindfoot varus alignment (8%), anterior tibial spurs (3%), and tarsal coalitions (2%). Twenty revision lateral ankle ligament reconstructions were required for either persistent pain or recurrent instability. The most common associated conditions were undiagnosed hindfoot varus alignment abnormalities (28%) followed by untreated peroneal injuries (25%). Conclusions: This study confirms the frequency of conditions associated with lateral ankle instability and emphasizes several conditions that have received little attention in the literature. Identifying these associated conditions before surgery enables the surgeon to treat all conditions at one operation, returning the patient to full activity sooner. Guidelines are presented to assist clinicians in screening patients for these associated conditions.
Off-Loading of Hindfoot and Midfoot Neuropathic Ulcers Using a Fiberglass Cast with a Metal Stirrup
Authors: Tamir Eran , Daniels Timothy R. , Finestone Aharon , Nof Matityahu
Published: October 2007

Background: This study was designed to assess the effectiveness of a method of off-loading large neuropathic ulcers of the hindfoot and midfoot. The device used is composed of a fiberglass cast with a metal stirrup and a window around the ulcer. Methods: A retrospective study of 14 diabetic and nondiabetic patients was performed. All had chronic plantar hindfoot or midfoot neuropathic ulcers that failed to heal with conventional treatment methods. A fiberglass total contact cast with a metal stirrup was applied. A window was made over the ulcer to allow daily ulcer care. Results: The average duration of ulcer before application of the metal stirrup was 26 + 13.2 (range 7 to 52) months. The ulcer completely healed in 12 of the 14 patients treated. The mean time for healing was 10.8 weeks for midfoot ulcers and 12.3 weeks for heel ulcers. Complications developed in four patients: three developed superficial wounds and one developed a full-thickness wound. In three of these four patients, local wound care was initiated, and the stirrup cast was continued to complete healing of the primary ulcer. Conclusions: A fiberglass cast with a metal stirrup is an effective off-loading device for midfoot and hindfoot ulcers. It is not removable and does not depend on patient compliance. The window around the ulcer allows for daily wound care, drainage of the ulcer and the use of vacuum-assisted closure (VAC) treatment. The complication rate is comparable to that of total contact casting.
Immediate Effects of Silicone Insoles on Gait Pattern in Patients with Flexible Flatfoot
Authors: Kulcu Duygu Geler , Yavuzer Gunes , Sarmer Sercan , Ergin Sureyya
Published: October 2007

Background: Flatfoot in which a normal arch fails to develop is a common deformity in both children and adults. A frequently-used treatment is an over-the-counter insole to normalize foot mechanics and relieve pain. This study was designed to evaluate the effects of over-the-counter silicone insoles on the gait patterns of patients with flexible flatfoot. Methods: Thirty-four adults (24 women and nine men, average age 43.7 ± 9.7 years) with bilateral symptomatic flatfoot deformities were included in the study. Flatfoot was diagnosed by a lateral talometatarsal angle of more than 4 degrees and a talocalcaneal angle of more than 30 degrees. Three-dimensional gait analysis and video recordings were done at a single session. All patients walked at self-selected speeds over a 10-meter walkway with and without insoles. Time-distance parameters and kinematic and kinetic characteristics of gait in the sagittal plane were evaluated by a quantitative gait analysis system. Results: Mean lateral talometatarsal and talocalcaneal angles were 6.3 ± 2.5 degrees and 56.1 ± 8.6 degrees, respectively. There was no difference in gait parameters with or without the insoles. Conclusions: Over-the-counter insoles have no beneficial effect in normalizing forces acting on the foot and on the entire lower extremity in adults with flexible flatfoot.
Three-year Followup Study of Topical Glyceryl Trinitrate Treatment of Chronic Noninsertional Achilles Tendinopathy
Authors: Paoloni Justin Alan , Murrell George A.C.
Published: October 2007

Background: Topical glyceryl trinitrate treatment has demonstrated short-term efficacy in chronic noninsertional Achilles tendinopathy. No long-term followup is reported. We aimed to assess if the demonstrated efficacy of this treatment persisted 3 years after discontinuation of therapy. Methods: A followup study of 52 patients (68 tendons) treated with 6 months of glyceryl trinitrate therapy or placebo was performed 3 years after cessation of therapy. Assessment included pain scores, return to previous activity, the Victorian Institute of Sport Achilles tendon scale (VISA-A), asymptomatic patient outcomes, clinical assessment of tendon tenderness, and functional hop test. Results: Patients treated with topical glyceryl trinitrate had significantly less Achilles tendon tenderness ( p = 0.03), and improved VISA-A scores ( p = 0.04) than those in the placebo group; 88% (28 of 32 tendons) of patients were completely asymptomatic at 3 years (VISA-A score of 100) compared to 67% (24 of 36 tendons) of patients treated with rehabilitation alone (p = 0.03 with Chi square analysis). Other outcome measures showed nonsignificant trends towards improvement in the glyceryl trinitrate group (pain scores p = 0.07, functional hop test p = 0.07, and return to sport p = 0.16). The mean estimated effect size for all outcome measures was 0.21. Conclusions: Topical glyceryl trinitrate treatment has demonstrated efficacy in treating chronic noninsertional Achilles tendinopathy, and the treatment benefits continue at 3 years. Significant differences in asymptomatic patient outcomes for the glyceryl trinitrate group continue at 3 years, and this is confirmed by the effect size estimate. This suggests that the mechanism of action of topical glyceryl trinitrate on chronic tendinopathies is more than an analgesic effect.
Current Trends in Thromboprophylaxis in Surgery of the Foot and Ankle
Authors: Gadgil Aniruth , Thomas Rhys H.
Published: October 2007

Background: Few studies exist to guide the best practice in thromboprophylaxis after foot and ankle surgery. A survey of foot and ankle surgeons was performed to assess current trends in thromboprophylaxis. Methods: An email-based survey of American and British foot and ankle surgeons was conducted. Surgeons were questioned as to their use and type(s) of thromboprophylaxis as well as reasons for not using prophylaxis. Surgeons also were asked about their use of thromboprophylaxis in hip and knee arthroplasty, if they did these surgeries. Results: Nearly one-fifth (19%, 27) of surgeons routinely used thromboprophylaxis in both elective and trauma foot and ankle surgery. The most common situation for use was in a postoperative patient who was immobilized and nonweightbearing. A lack of published evidence and a low rate of thromboembolism were the most commonly cited reasons for not using thromboprophylaxis. Conclusions: This survey showed a wide variability in thromboembolic prophylaxis. It suggests that despite the literature indicating to the contrary, a significant proportion of foot and ankle surgeons routinely use thromboprophylaxis. Confusion remains regarding the appropriateness of thromboprophylaxis and what type(s)(if any) should be used. This study has identified a need for more in-depth evaluation of the importance of, and possible prophylaxis against, thromboembolic problems after foot and ankle surgery.
Biomechanical Testing of Epitenon Suture Strength in Achilles Tendon Repairs
Authors: Shepard Michelle E. , Lindsey Derek P. , Chou Loretta B.
Published: October 2007

Background: Recent evidence that early, active mobilization protocols after Achilles tendon repairs increase recovery speed and strength make operative repair strength critical to positive outcomes after Achilles tendon ruptures. While previous research has focused on core (tendon proper) repair techniques, no previous literature has reported testing of core repairs augmented with epitenon sutures, which have been shown to increase the strength of repairs of flexor tendons of the hand. Methods: Five matched pairs of fresh frozen human Achilles tendons were tested with and without the addition of an epitenon suture to the core repair suture. All specimens were repaired using a No. 2 Ethibond Krakow locking loop core suture. The epitenon suture was added to one tendon randomly chosen from each pair, using a 40 nylon suture. All specimens were mounted on an MTS testing machine (MTS Systems Corp., Eden Prairie, MN) and loaded to failure, which was defined as a 1-cm gap formation. Results: The addition of epitenon sutures significantly increased the force necessary to produce a 2-mm gap as compared to core sutures alone by 74%, and it increased the average load to failure by 119%. Also, initial tendon stiffness was 173% greater in tendons reinforced with epitenon sutures. Conclusions: This study demonstrates that greater resistance to gap formation, approximation of tissue ends, and tensile strength were achieved by the addition of an epitenon suture. Clinical relevance may improve healing by decreased gap formation at the repair site and a lower risk of adhesion formation.
Effect of Pilot-Hole Size on the Pullout Strength of Flexor Digitorum Longus Transfer Fixed with a Bioabsorbable Screw
Authors: Donley Brian G. , Jambor Clinton , Erdermier Ahmet , Sferra James , Cavanagh Peter
Published: October 2007

Background: Fixation of tendon transfers with a bioabsorbable interference-fit screw has several advantages over other fixation methods: decreased dissection, operative time, and blood loss; preservation of tendon length; no interference with radiographic studies; no need for implant removal; and no barrier to revision surgery. Whether strength of fixation is affected by the size of the pilot hole has not been established. The purpose of this study was to determine the effect of pilot hole size on the pullout strength of a flexor digitorum longus (FDL) tendon secured into a bone analog using a 5.5-mm bioabsorbable screw. Methods: Thirty FDL tendons were harvested from 15 cadaver specimens and secured into predrilled 4 times 4 × 4 cm bone cubes with a 5.5-mm Arthrex bioabsorbable screw (Arthrex, Naples, FL). The use of bone analog foam cubes ensured consistent porosity at the insertion site, eliminating the variations associated with varying bone densities of cadaver specimens. Pilot hole sizes studied were 5.0 mm, 5.5 mm, and 6.0 mm. Pullout tests were done with an servohydraulic testing frame (MTS, Eden Prairie, MN). Results: There was no significant difference ( p = 0.4) between the pullout forces and stresses among the three pilot hole sizes. All specimens failed at the interface between the FDL and the bioabsorbable screw. In the 6.0-mm pilot hole group, there was a trend for increased pullout strength with increased tendon size. Conclusions: With a bioabsorbable 5.5-mm screw used for FDL transfer, a pilot hole the same size or a half millimeter larger or smaller than the screw had no statistically significant effect on the strength of the construct, even with tendons of different sizes.
The Influence of Second Toe and Metatarsal Length on Stress Fractures at the Base of the Second Metatarsal in Classical Dancers
Authors: Davidson Gabrielle , Pizzari Tania , Mayes Susan
Published: October 2007

Background: Stress fractures at the base of the second metatarsal frequently occur in female classical dancers. There is a strong belief that a foot shape in which the first metatarsal or toe is shorter than the second metatarsal or toe increases the risk of this injury in dancers. However, there is a lack of empirical evidence to support this theory. The objective of this study was to examine the influence of the relative length difference between the first and second metatarsals and first and second toes on the frequency of stress fractures at the base of the second metatarsal in elite, female classical dancers. Methods: Both feet of 50 elite female classical dancers were measured for length differences between the first and second toes and first and second metatarsals. Retrospective analysis of dancers' medical histories revealed 17 feet with stress injury and 83 without. The mean of the difference between the metatarsal and toe length for the stress-injury group was compared to that of the control group. Results: No difference between the groups was identified for first and second toe length difference ( p = 0.865) and the relative difference between the ends of the first two metatarsals ( p = 0.815). Conclusions: Dancers who had a stress injury at the base of the second metatarsal displayed similar variances in the two independent variables as dancers who had not had such an injury.
Beyond the Demonology of Power: The Study of German Foreign Policy after the Cold War
Authors: Berger Thomas
Published: October 2007

Jeffrey Anderson, German Unification and the Union of Europe (Cambridge and New York: Cambridge University Press, 1999)

Thomas Banchoff, The German Problem Transformed: Institutions, Politics and Foreign Policy, 1945-1995 (Ann Arbor, Michigan: University of Michigan Press, 1999)
Ruth Bettina Birn Answers Goldhagen
Authors: Birn Ruth Bettina
Published: October 2007

In response to my review of his book, Hitler’s Willing Executions, Daniel Goldhagen suggests, in the Fall 1997 issue of German Politics and Society (GPS), that I was unduly critical. His failure to address my main criticisms, and his abusive language interspersed with invectives and ad hominem attacks make replying to his article quite complicated. As I consider this style entirely inappropriate in a scholarly debate, I have restricted my response to his factual criticisms.
Keeping Weimar at Bay: The German Federal Presidency since 1949
Authors: Helms Ludger
Published: October 2007

Learning from the Weimar experience, the founding fathers of the

Federal Republic eliminated the chance of a renewed institutionalized

conflict between the head of state and the federal government

through the creation of the Basic Law [Grundgesetz ]. They primarily

strengthened the power of the chancellor and his cabinet by introducing

the “constructive” vote of no confidence and abolishing the

principle of individual ministerial responsibility, while also reducing

the position of the federal president to a mere representative head of

state. With these clear-cut constitutional arrangements it is not surprising

that Germany has not been among the number of west European

democracies (such as Italy or Austria) for which issues

regarding the power of heads of state have occupied a rather prominent

position on the political agenda of the 1990s.
Dynamics of Health Care Seeking Behaviour of Elderly People in Rural Bangladesh
Authors: Biswas Priti , Nahar Kabir Zarina , Nilsson Jan , Zaman Shahaduz
Published: October 2007

Bangladesh is projected to experience a doubling of its elderly population from the current level of 7 million to 14 million by the end of the next decade. Drawing upon qualitative evidence from rural Bangladesh, this article focuses on coping strategies in cases of illness of elderly people and the contributing factors in determining the health-seeking behaviour of elderly persons. The sample for this study consisted of elderly men and women aged 60 years or older and their caregivers. Nine focus group discussions and 30 in-depth interviews were conducted. Findings indicate that old age and ill-health are perceived to be inseparable entities. Seeking health care from a formally qualified doctor is avoided due to high costs. Familiarity and accessibility of health care providers play important roles in health-seeking behaviour of elderly persons. Flexibility of health care providers in receiving payment is a crucial deciding factor of whether or not to seek treatment, and even the type of treatment sought.
Social Capital and Health in the Oldest Old
Authors: Nyqvist Fredrica , Gustavsson Janna , Gustafsson Yngve
Published: October 2007

The aim of this study was to measure social capital in the oldest old, and its association with different dimensions of health. The Umeå 85+ study is a cross-sectional study of 253 people, aged 85 years, 90 years and 95 years or older. A principal component factor analysis was performed to assess classes of information measuring the structural and the cognitive components of social capital on an individual level. In the final model, one factor consisting of attachment, social integration and social network emerged which accounted for 55 per cent of the total variance. We analysed the association between structural social capital and various dimensions of health such as depressive symptoms, functional ability and self-rated health. This study suggests that structural social capital may partially explain depressive symptoms but not functional ability or self-rated health. We conclude that social capital is a relevant resource for the oldest old, but we suggest a different approach when measuring social capital in this age group, such as conducting a longitudinal study or including retrospective questions in the study. The oldest old may have had a high level of social capital, but our study could not identify this statistically.
Population aging, genders and generations
Authors: Arber Sara , Motel-Klingebiel Andreas
Published: October 2007

Not available.
Stereotypes of Old People Persist. A Swedish “Facts on Aging Quiz” in a 23-year Comparative Perspective
Authors: Tornstam Lars
Published: October 2007

In 2005, as well as in 1982, almost 90 percent of Swedes subscribed to the stereotype that retirement pensioners suffer from loneliness and more than half of Swedes also believed that pensioners suffer from boredom and dissatisfaction with life. Little seems to have changed for the better, or even impaired with regard to the images of the psychological conditions of pensioners, at the same time as Swedes have become somewhat more knowledgeable about the physiological/material conditions associated with aging. This follows from a 2005 follow-up of a Swedish Facts on Aging Quiz, first given in 1982. The comparatively stable pattern of stereotypes over the 23-year period indicates that stereotypes – in old, well-known or permutated forms – will prevail as long as their ageist roots do. The changes observed indicate the possibility of a future pattern of stereotypes, which combines an exaggerated “positive” image of retirement pensioners’ health and wealth, with associated envy of the “greedy geezers”, and pity for their lonely and meaningless lives.
Visual Signs of Ageing: What are we Looking at?
Authors: Rexbye Helle , Povlsen Jørgen
Published: October 2007

Consumer culture has placed the ageing body in a dilemma of representation. Physical appearance has become increasingly important as a symbol of identity, and at the same time society idealizes youth. This study explores visual ageing empirically. By using photographs of older persons (70+) as starting point, it is explored how visual age is assessed and interpreted. It is shown that informants read age in a spread of stages and categories. Main age indicators are biological markers: skin, eyes, and hair colour, but supplemented by vigour, style, and grooming. Furthermore, in-depth interviews indicate that visual age is mainly interpreted into categories and moral regulations rooted in early modernity. Subsequently the question of a postmodern perspective of visual ageing is discussed in this article. The empirical findings in the study question a postmodern fluidity of visual signs – at least when the concern is signs of ageing.
Older Consumers in Malaysia
Authors: Sim Ong Fon , Phillips David R.
Published: October 2007

The main objective of this study was to understand the concerns and problems faced by older people in an industrializing middle-income country, Malaysia, in their process of acquiring products to meet their everyday needs. Respondents aged 55 and over were interviewed in eight states throughout Peninsular Malaysia providing 1356 usable questionnaires; two-thirds from urban and one-third from rural areas. Education, health status, and life satisfaction were recorded. Service patronage behaviour was examined for four main categories of commonly-sought consumer goods: groceries, health supplements, apparel, eating outlets, plus selected services (public transport, vacation packages and financial services). The findings showed that older adults in Malaysia are rather discerning consumers. Many respondents are price conscious and have developed consumer attitudes with regard to attitude of staff and assistance rendered. Many display a good ability to discriminate and to select, especially on the basis of price and durability of products and many appear to be acting as effectively as consumers in any other age group.
Exclusion in Very Old Age : The Impact of Three Critical Life Events
Authors: Cavalli Stefano , Bickel Jean-François , Lalive d´Epinay Christian J.
Published: October 2007

This paper focuses on relational exclusion (i.e. isolation and non-participation in social activities) in very old age. Based on a five-year study of an octogenarian cohort, the authors investigate the impact of three critical life events (deterioration of health, death of a close relative, entry into a nursing home) on relational life and social involvement. With advancing age, older people withdraw from some social activities, but their relationships with their family and friends remain stable. Life events have a stimulative effect on the support network (especially of family), and only the deterioration of health curbs social activity. This would seem to confirm the existence of a process of disengagement stemming more from the older people’s functional or sensory disabilities than from an individual choice.
Finite Element Methods forMaxwell Equations
Authors: Demkowicz Leszek
Published: October 2007

The article reviews fundamentals of finite element discretizations of time‐harmonic Maxwell equations. The paper includes a short introduction to Maxwell equations, derivation of the standard and regularized variational formulations, discussion of three fundamental Nedelec's elements in context of exact sequences, projection‐based interpolation, and the commuting diagram property. The presentation is biased towardhpdiscretizations andhpadaptivity.
Computability and Adaptivity inCFD
Authors: Hoffman J. , Johnson C.
Published: October 2007

We briefly recall research on adaptive computational methods for laminar compressible and incompressible flow, and then move on to present recent work on computability and adaptivity for turbulent incompressible flow, based on adaptive stabilized Galerkin finite element methods with duality‐based a posteriori error control for chosen output quantities of interest, here referred to asgeneral Galerkin G2 methods.

We show in concrete examples that outputs such as mean values in time of drag and lift of turbulent flow around a bluff body are computable on a PC with a tolerance of a few percent using a few hundred thousand mesh points in space.
Uncertainty Quantification with Stochastic Finite Elements
Authors: Matthies Hermann G.
Published: October 2007

Uncertainty estimation arises at least implicitly in any kind of modeling of the real‐world, and it is desirable to actually quantify the uncertainty in probabilistic terms. Here the emphasis is on uncertain systems, where the randomness is assumed spatial. Traditional computational approaches usually use some form of perturbation or Monte Carlo simulation. This is contrasted here with more recent methods based on stochastic Galerkin approximations. Also some approaches to an adaptive uncertainty quantification are pointed out.
Cell and Tissue Organization
Authors: Sarraf Catherine E.
Published: October 2007

The aim of this chapter is to provide an introduction that will serve the following chapters. An understanding of normal cell and tissue organization is essential to being able to conceptualize changes that occur preceding the development of malignancy. Initial tissue progression takes place after fertilization and gastrulation, and then cell phenotypes specialize as specific tissues develop. Through morphogenesis and organogenesis, tissues described here are those of the gastrointestinal tract with the pancreas, liver, and lung; the primordial germ cells and gonads; vasculature and blood progenitor cells; central nervous system; epidermis; and breast. These have been chosen as they are amongst the most common sites in which primary malignancies are found. Normal, adult parenchymal cells of these are briefly explained, followed by a concise description of stem cell niches, where cancer stem cells might reside.
RNATumour Viruses
Authors: Edwards Dustin C. , Marriott Susan J.
Published: October 2007

It is estimated that 15% of all cancer cases are aetiologically linked to viral infection. In these cancers, genomic instability and subsequent multi‐step tumourigenesis is associated with the expression of viral oncoproteins. Human T‐cell leukaemia virus type‐I (HTLV‐I), a prototypic representative of the RNA tumour viruses, is linked to the development of adult T‐cell leukaemia. The HTLV‐I oncoprotein, Tax, targets the regulators of cell cycle progression and DNA repair, leading to cellular transformation.
Genomic Instability and
DNA
Repair
Authors: Gagos Sarantis
Published: October 2007

There is growing evidence that genomic instability is both an epiphenomenon and a leading cause of cancer. Chromosomal instability in neoplasia (CIN) is the most frequent type of genomic instability in solid tumours. For more than a century, chromosomal rearrangements and aneuploidy in neoplasia have been extensively studied and a vast number of genes and pathways, directly or indirectly implicated in CIN, have been described. Chromosomal abnormalities in cancer generate huge genomic imbalances and tumour heterogeneity. This chapter addresses the role of genes, chromosome structure, and telomere dysfunction in the initiation and perpetuation of CIN. The biological consequences of large chromosomal imbalances are discussed and the long‐standing hypotheses for the generation of chromosomal anomalies in neoplasia are re‐examined under the context of telomere dysfunction and restoration.
Apoptosis
Authors: Williamson Kate E. , El Din Osama Sharaf , O'Kane Hugh F.
Published: October 2007

Apoptosis plays a key role in homeostasis and its inhibition results in diseases, including cancer. Multiple genes control apoptosis at the level of stimuli, sensitivity, and execution of the process. Apoptosis can be stimulated by diverse factors including cytotoxic immune cells, radiation, chemotherapy, absence of growth factors, and cytokine deprivation. The life/death balance in cells is controlled by the Bcl‐2 and inhibitor of apoptosis protein (IAP) families whose complex interactions seal the fate of the cell. The execution of apoptosis, the demolition of the cell, is undertaken by caspases. Advances in our understanding of the apoptotic process have led to the search for targets in the pathway that can be manipulated therapeutically to enhance response to treatment in cancer cells.
Clinical Trial Design for Anticancer Therapies
Authors: Lee J. Jack
Published: October 2007

Clinical trials, which are prospective studies to evaluate the effect of interventions in humans under pre‐specified conditions, have become a standard and integral part in the development of new cancer therapies. A properly planned and executed clinical trial is the most definitive tool for evaluating the effect and applicability of new anticancer therapies. Basic elements of clinical trial design are discussed, including study objective, population, design, randomization and blinding, primary and secondary end points, power and sample size calculation, study accrual, interim monitoring plan, and data analysis plan. The paradigm and essence of phase I, II, III, and IV trials are reviewed and illustrated with examples of commonly used designs. Novel study designs for the development of targeted agents, designs using biomarker and genomic end points, and Bayesian methods are introduced and reviewed. Finally, information on clinical trial conduct and reporting is provided and practical considerations and useful links are given.
Multidisciplinary Team Management of Upper Gastrointestinal, Hepatic, Pancreatic, and Biliary Cancers
Authors: Kristeleit Rebecca , Chua Yujo , Cunningham David
Published: October 2007

Despite recent advances in the management of gastrointestinal cancer and the development of more effective treatment paradigms there is still much scope for improvement. The multidisciplinary team is a vital part of clinical management as treatment pathways are becoming increasingly multimodal and complex and in some tumour types the expertise of the treatment team has been shown to be a major determinant of outcome. In addition to optimising the combination of surgery, radiotherapy and conventional cytotoxics in the treatment of these cancers, the role of molecular targeted therapy is also being established. These newer agents are likely to be integrated into future treatment protocols. In addition, improvements in tumour staging with imaging techniques such as PET (positron emission tomography) and the identification of new prognostic markers will enable more accurate tailoring of treatment according to disease extent and biological behaviour. This chapter summarizes the current status of multidisciplinary treatment for upper gastrointestinal, hepatic, pancreatic and biliary cancer.
Transforming Growth Factor‐β and Cancer
Authors: Zhu Beibei , Kyprianou Natasha
Published: October 2007

Members of the TGF‐β super‐family regulate differentiation, proliferation, growth arrest, and apoptosis. TGF‐β mediated signalling proceeds via binding of the ligand to membrane receptor kinases, phosphorylation of TβRII receptor to the TβRI receptor kinase, and subsequently Smad activation, resulting in gene transcription. Dysfunctional TGF‐β signalling is associated with cancer development and progression, while TGF‐β ligand secretion and activation enhances tumour aggressiveness and correlates with metastatic behaviour in human tumours. Molecular exploitation of defective signalling effectors of this pathway is of major significance in detection and therapeutic targeting of human cancers. The present chapter summarizes the current knowledge on the contribution of dysfunctional TGF‐β1 signalling in tumour development and progression and its relevance in cancer prognosis and therapy.
WntSignal Transduction
Authors: Ilyas Mohammad
Published: October 2007

Disruption of Wnt signalling is commonly found in a wide range of cancers and thus can possibly be regarded as a “generic” step in the process of carcinogenesis. Recent advances in the understanding of the Wnt signalling pathway have given insight into how inappropriate activation of this pathway may facilitate the neoplastic conversion of a normal cell. In addition, identification of the mechanisms which regulate Wnt signalling has led to the possibility of manipulating these mechanisms in order to down‐regulate Wnt signalling as a therapeutic strategy. In this chapter, the role of aberrant Wnt signalling in the mechanics of tumour development is discussed together with its implications for anti‐tumour therapy.