bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term hair repigmentation following a hair transplant for frontal scarring alopecia
Authors: Dinh Hope V , Sinclair Rodney , Martinick Jennifer
Published: October 2007

A 57‐year‐old woman developed repigmentation of white donor hairs 9 months after undergoing hair transplantation for an area of frontal scarring alopecia present since childhood. The hairs have remained repigmented more than 2 years post transplant. We discuss possible mechanisms underlying long‐term follicular repigmentation of white hairs.
Annular erythema with eosinophilia: A subset of Wells' syndrome
Authors: Howes R. , Kossard S.
Published: October 2007

We present a 52‐year‐old lady with a 5‐year history of a persistent, widespread, annular erythema associated with lethargy, arthralgias, and an inflammatory synovitis. Skin biopsies have shown mild lichenoid change at the dermoepidermal junction; and oedema, mucin, and a diffuse lymphocytic and eosinophilic infiltrate without flame figures in the dermis. A full blood count including an eosinophil count; liver, renal and thyroid function; rheumatoid factor, ANA, ENA, dsDNA, complement studies, immunoglobulins, and serum protein elecrophoresis and immunoelectrophoresis; flow cytometry of peripheral blood for lymphocyte markers; stool examination for ova, cysts and parasites; and a CT scan of the chest and abdomen have shown no significant abnormality. Hydroxychloroquine has stabilised but not cleared her condition.

Cases presenting clinically with annular erythema and histologically with eosinophilic cellulitis are difficult to classify. We discuss the classification of this case in the context of the literature.
Unmet need in inadequately controlled asthma
Authors: BEASLEY Richard
Published: October 2007

Abstract:  Over the last 20 years in Australia, outcomes have improved for patients with asthma. With the advent of inhaled corticosteroids and long‐acting beta agonists, and improvements in management including implementation of the guided self‐management plan system of care, the mortality rate for asthma has fallen by almost half. However, despite huge improvements, there remains a small but significant cohort of patients with inadequately controlled severe persistent asthma. This group of patients consumes a substantial proportion of public health resources. Patients who have poorly controlled asthma, despite receiving ‘optimal’ treatment, are the ones most likely to benefit from new therapies such as those that target IgE. This presentation provides an overview of severe asthma in terms of prevalence and morbidity, mortality, economic costs and then considers a way forward in terms of identifying patients in greatest need of novel treatment such as omalizumab.
A systematic stapling defect – a potential cause of ‘anastomotic’ leak after restorative proctocolectomy
Authors: Byrne C. M. , Uraiqat A. A. , Phillips R. K. S.
Published: October 2007

Objective  When constructing ileal‐anal pouches with staples, a novel potential cause of anastomotic leak was recently identified at the apex of the pouch. This study was performed to assess this stapling defect.

Method  Careful inspection of the ileal pouch staple lines was made in eight consecutive pouch constructions. Pouch construction was further evaluated using pig small bowel.

Results  When constructing ileal‐anal pouches with staples, a novel potential cause of anastomotic leak was recently identified at the apex of the pouch. This defect was present in seven of eight consecutive ileo‐anal J‐pouches. It was repaired by direct suturing and no clinical or radiological leaks were identified in these patients. In the pig model, the same defect was found in five of five stapled constructions. It was avoiding in five of five cases by limiting the amount of bowel placed into the stapler on the initial firing.

Conclusion  This defect may be related to stapler design. It can be avoided by using less than the full staple line on the initial firing of the stapler or by using an alternative device. Surgeons creating ileal pouches using staplers, or indeed any use of this particular stapler, need to be aware of this potential for a defect in the staple line and should take steps to avoid the defect or repair it depending on the circumstances.
Evidence for a Neuroendocrinological Foundation of Human Affiliation
Authors: Feldman Ruth , Weller Aron , Zagoory-Sharon Orna , Levine Ari
Published: October 2007

Although research on the neurobiological foundation of social affiliation has implicated the neuropeptide oxytocin in processes of maternal bonding in mammals, there is little evidence to support such links in humans. Plasma oxytocin and cortisol of 62 pregnant women were sampled during the first trimester, last trimester, and first postpartum month. Oxytocin was assayed using enzyme immunoassay, and free cortisol was calculated. After the infants were born, their interactions with their mothers were observed, and the mothers were interviewed regarding their infant-related thoughts and behaviors. Oxytocin was stable across time, and oxytocin levels at early pregnancy and the postpartum period were related to a clearly defined set of maternal bonding behaviors, including gaze, vocalizations, positive affect, and affectionate touch; to attachment-related thoughts; and to frequent checking of the infant. Across pregnancy and the postpartum period, oxytocin may play a role in the emergence of behaviors and mental representations typical of bonding in the human mother.
Inferring Design
Authors: Lombrozo Tania , Kelemen Deborah , Zaitchik Deborah
Published: October 2007

Unlike educated adults, young children demonstrate a “promiscuous” tendency to explain objects and phenomena by reference to functions, endorsing what are called teleological explanations. This tendency becomes more selective as children acquire increasingly coherent beliefs about causal mechanisms, but it is unknown whether a widespread preference for teleology is ever truly outgrown. The study reported here investigated this question by examining explanatory judgments in patients with Alzheimer's disease (AD), whose dementia affects the rich causal beliefs adults typically consult in evaluating explanations. The results indicate that unlike healthy adults, AD patients systematically and promiscuously prefer teleological explanations, suggesting that an underlying tendency to construe the world in terms of functions persists throughout life. This finding has broad relevance not only to understanding conceptual impairments in AD, but also to theories of development, learning, and conceptual change. Moreover, this finding sheds light on the intuitive appeal of creationism.
A Theoretical Reexamination of Privatization: Assessing its Welfare Impacts
Authors: Ang Alvin , Yamada Masatoshi
Published: October 2007

Privatization has been one of the significant public policies adopted in the last two decades. Previous studies have focussed on efficacy gains at the firm and industry levels. This paper intends to reconsider the distributive impacts of privatization on the economy as a whole from a theoretical perspective. Specifically, it supposes an economy with two goods, two producers and two consumers, in which it is assumed that one of the consumers is not able to obtain one good that is regarded as a necessity. Since one basis of government intervention is to provide necessity to people who would not otherwise be able to obtain it, government intervention into production is assumed to satisfy this purpose. Using comparative statics, the paper analyzes how the welfare of two consumers is affected by this intervention, and shows that intervention can increase the welfare of some consumers and social welfare in general.
Factor Price Equality and Biased Technical Change in a Two‐Cone Trade Model
Authors: Becker Daniel , Gundlach Erich
Published: October 2007

We reconsider the effects of long‐run economic growth on relative factor prices across cones of specialization. We model economic growth as exogenous technical change. Allowing for capital biased technical change with a sector bias and for endogenous commodity prices, we find that economic growth may increase or decrease factor price differences across cones. For a neutral demand side and capital biased growth in the most capital intensive sector, we find that economic growth encourages less factor price diversity across cones.
Partial Free Trade Agreements and Economic Welfare: Reconsidering GATT Article 24
Authors: Ohyama Michihiro
Published: October 2007

This paper generalizes the Kemp–Wan theorem on the customs union to cover partial and incomplete free trade agreements emerging all over the world and elucidates the conditions which ensure that they are potentially conducive to the economic welfare of member countries without harming the rest of the world. In the light of this generalization, it also reconsiders two well‐known conditions stipulated in Article 24 of the GATT required for the formation of FTAs.
Trade Policies as Signals of Private Political Pressure
Authors: Sawaki Hisashi
Published: October 2007

The situation of a home government facing political pressure from an exporting industry within its jurisdiction is considered. If a foreign government cannot directly observe such pressure, the home government has an incentive to understate it to induce foreign tariff reductions. In equilibrium, the home government will distort its first‐period trade policy in a direction that the industry does not prefer (i.e. raising the export tax or reducing the export subsidy) in order to reveal the true pressure, as compared with a policy selected under complete information.
Trade Gains and Public Goods
Authors: Shimomura Koji
Published: October 2007

This paper proves that in a multicountry general‐equilibrium model of international trade with local public goods, free trade is beneficial if the governments in the trading world behave strategically with respect to the provision of public goods.
Current Account Adjustment and Capital Flows*
Authors: Debelle Guy , Galati Gabriele
Published: October 2007

We examine episodes of current account adjustment in industrial countries over the past 30 years. We find that they were typically associated with a sizable growth slowdown and a large exchange rate depreciation. There was no discernible change in the nature of capital flows just prior to an adjustment. Hence, adjustments may be responding to the resolution of domestic imbalances rather than being an exogenous event. We show that global developments triggered the adjustment, possibly by triggering the unwinding of the domestic imbalances. Most of the ex post adjustment of the financial account was in private sector flows, primarily by foreign investors.
Neoclassical Growth, Manufacturing Agglomeration, and Terms of Trade
Authors: Urban Dieter M.
Published: October 2007

This study reverses the prediction of geography and growth models that trade integration may cause income divergence. Moreover, a new dynamic welfare gain of trade openness is identified. These results are obtained from embedding a new economic geography model into a neoclassical growth model. Starting from symmetric countries, a country that accumulates more capital than the other increases its home market size, improves its terms of trade, and lowers its relative consumption price index, because trade costs drive a wedge in between relative producer and consumption price indices. Both effects in turn tend to increase its marginal revenue product of capital relative to the other country (divergence forces), while factor substitution diminishes its marginal revenue product of capital (convergence force). Reducing trade costs decreases the wedge and weakens the divergence forces, while the convergence force is unaffected. Hence, divergence is more likely with higher rather than lower trade costs.
Do Workplace Gender Transitions Make Gender Trouble?
Authors: Schilt Kristen , Connell Catherine
Published: October 2007

This article examines what happens when an employee makes the transition from one recognized gender category to another and remains in the same job. Drawing on in‐depth interviews with transmen and transwomen in Texas and California, we illustrate how a new social gender identity is interactionally achieved in these open workplace transitions. While transgender people often are represented as purposefully adopting hyper‐feminine or masculine gender identities post‐transition, we find that our respondents strive to craft alternative femininities and masculinities. However, regardless of their personal gender ideologies, their men and women co‐workers often enlist their transitioning colleague into gender rituals designed to repatriate them into a rigid gender binary. This enlistment limits the political possibilities of making gender trouble in the workplace, as transgender people have little leeway for resistance if they wish to maintain job security and friendly workplace relationships.
The Codex, the Codicil and the Codpiece: Some Thoughts on Diminution and Elaboration in Identity Formation
Authors: Höpfl Heather
Published: October 2007

This article is about the way in which the processes of diminution and elaboration can be detected in gendered accounts of identity formation. Firstly, it considers the ways in which power is denied to women through a series of reductions, restrictions and controls, and looks at the ways in which men, in contrast, elaborate their identities via a range of enlargements and extensions. The codex of the title refers to the role of the ‘Law’, in Kristeva's sense of the term, in authorizing such arrangements. The codpiece offers a metaphor for elaboration and extension: a male form of extension and elaboration. The codicil, an appendage to a last will and testament, is intended to convey the position of women as appendages, afterthoughts, marginal notes. The article is an example of what Pullen and Rhodes have called ‘dirty writing’, that is to say, it is written with the purpose of allowing the intrusion of the author into the text: with a deliberate confusion of the authorial standpoint and the content. Dirty writing contaminates. This article is written with the intention of contaminating the regulatory mechanisms of the production of the codex, to reveal the enormity of the codpiece and to permit the codicil to assume a role within the codex rather than simply occupying the position of appendage to it. The article is not auto‐ethnographic, although it has elements of autobiography. Rather this article seeks to ‘undo’ gender by fragmenting the coherence of the codex. More tentatively, it seeks to lay bare the male erection which is concealed by the codpiece and to expose it for what it is: an elaborate construction — an elaborate creation masking a less adequate membership. And so this piece of writing attempts to undermine the extravagance of masculine forms of writing; of writing to produce the codpiece, writing as conceit; writing which is antagonistic to fragmented experience. It will not satisfy some, it will irritate others. The article is unbalanced, unresolved: like life itself. It is about stories, illustrations, asides, observations. It is also, with all its attempts to subvert, (with all its attempts to make it ‘dirty’), a piece of male writing.
Role of angiotensin receptor blockers in the prevention and management of ischaemic stroke
Authors: Mathur G. , Cleland J. G. F. , Rodrigues E. , Davis G. K.
Published: October 2007

Angiotensin receptor blockers (ARB's) are an important class of antihypertensive agents and appear to have a role in the prevention and management of ischaemic stroke. We present a discussion of the data on ARB's in this important condition.
Effectiveness of a community‐based 3‐year advisory program after acquired brain injury
Authors: Grill E. , Ewert T. , Lipp B. , Mansmann U. , Stucki G.
Published: October 2007

Objective of this study was to examine the effectiveness of a coordinated, community based 3‐year advisory program in 1534 patients with acquired brain injury. Patients and caregivers were offered a coordinated advisory program after discharge from rehabilitation. Patients in the historical control group received standard aftercare. The main outcomes were functional status [Functional Independence Measure (FIM)], and days spent in the acute hospital. The secondary outcome was survival. Patients were comparable for sex (intervention: 41.3% female, control: 38.0%), and younger in the control group (mean age intervention: 55.3, control: 49.6). Functional status at discharge was lower in the intervention group (mean FIM intervention: 66.2, control: 80.3). Patients in the intervention group experienced a moderate gain in FIM. Rate of days in hospital was 15.4 per 1000 person days (intervention) and 15.5 per 1000 person days (control). Patients of the intervention group had an increased rate of days in hospital. A total of 16.0% of patients in the intervention group and 19.3% in the control group died during follow‐up. Patients in the intervention had a significant lower mortality risk depending on follow‐up period and discharge FIM. The advisory program may be effective for all patients with acquired brain injury.
Low RLS prevalence and awareness in central Greece: an epidemiological survey
Authors: Hadjigeorgiou G. M. , Stefanidis I. , Dardiotis E. , Aggellakis K. , Sakkas G. K. , Xiromerisiou G. , Konitsiotis S. , Paterakis K. , Poultsidi A. , Tsimourtou V. , Ralli S. , Gourgoulianis K. , Zintzaras E.
Published: October 2007

Restless legs syndrome (RLS) is a sensorimotor disorder with a general population prevalence of 3–10%. A single, previous epidemiological study performed in south‐east Europe reported the lowest prevalence rate amongst European countries. We conducted a population‐based survey of RLS in central Greece. A total of 4200 subjects were randomly recruited. We used the international RLS study group criteria for diagnosis and the severity scale for severity assessment in subjects with RLS. We also included questions to assess the level of awareness of RLS in our region. A total of 3033 subjects were screened. The overall lifetime prevalence was 3.9% with a female‐to‐male ratio of 2.6:1. Nearly half of RLS patients reported moderate to severe intensity of symptoms. After adjustment for multiple comparisons we found no association of RLS with education level, smoking, alcohol intake, caffeine consumption, shift work, professional pesticide use or comorbid illness. Our study revealed a low level of awareness amongst the population and physicians in our region and sub‐optimal management. We provide further evidence for low prevalence of RLS in south‐east Europe and a low level of awareness of RLS in our region.
An Exploration of Issues around Menstruation for Women with Down Syndrome and their Carers
Authors: Mason Linda , Cunningham Cliff
Published: October 2007

Background  There is little research on issues related to menstruation for women with Down syndrome, yet they may experience menstruation in a qualitatively different way from normal women, which impacts on their quality of life and that of their families and carers. The aim of this qualitative study was to explore issues with the women and/or their carers.

Method  Face‐to‐face or telephonic interviews were carried out with six women with Down syndrome, and 53 mothers of women with Down syndrome.

Results  The range in age and pattern of menses was similar to that of the general population. Around two‐thirds of the women were coping with the self‐care aspects with limited help. Heavy periods were an issue for around one‐third. Use of tampons was rare, yet several women had problems with pads. Some mothers were unaware how much their daughter knew about the menstrual cycle; others deliberately withheld information.

Conclusions  Lack of information and preparation, heavier periods for some and reluctance to use tampons, all indicated specific issues for these women. Establishing routines was helpful and could have been applied to more of the women. Further research is suggested into heavy periods and other possible interventions.
Needs of Persons with Severe Intellectual Disabilities: a Q‐Methodological Study of Clients with Severe Behavioural Disorders and Severe Intellectual Disabilities
Authors: Kreuger Linda , Van Exel Job , Nieboer Anna
Published: October 2007

Background  A demand‐oriented approach is becoming increasingly important in care provision. The purpose of this study was to identify the primary needs of clients with Severe Behavioural Disorders and Severe Intellectual Disabilities.

Materials and Methods  We used the theory of Social Production Function and Maslow’s hierarchy of needs to operationalize different types of needs of clients with Severe Behavioural Disorders and Severe Intellectual Disabilities. A Q‐methodological study enabled us to distinguish the needs of 23 clients.

Results  Two needs prioritizations were found. Physical well‐being ultimately weighs most heavily for all clients, but in one of the two groups affection and behavioural confirmation (i.e. social needs) were also found to be important. There were no significant differences in needs between clients whose main behavioural difficulty was aggression and clients whose main behavioural difficulty was self‐harm.

Conclusions  A demand‐oriented policy for clients with Severe Behavioural Disorders and Severe Intellectual Disabilities should be targeted at groups with different needs prioritizations, rather than groups with different behavioural problems. That does not mean that the same needs of different clients can be met in exactly the same way. It takes creativity and a person‐centred approach to find ways to enable clients to realize their social and physical needs.
Moral Imagination, Disability and Embodiment
Authors: MACKENZIE CATRIONA , SCULLY JACKIE LEACH
Published: October 2007

abstract  In this paper we question the basis on which judgements are made about the ‘quality’ of the lives of people whose embodied experience is anomalous, specifically in cases of impairments. In moral and political philosophy it is often assumed that, suitably informed, we can overcome epistemic gaps through the exercise of moral imagination: ‘putting ourselves in the place of others’, we can share their points of view. Drawing on phenomenology and theories of embodied cognition, and on empirical studies, we suggest that there are barriers to imagining oneself differently situated, or imagining being another person, arising in part from the way imagination is constrained by embodied experience. We argue that the role of imagination in moral engagement with others is to expand the scope of our sympathies rather than to enable us to put ourselves in the other's place. We argue for explicit acknowledgement that our assessments of others’ QOL are likely to be shaped by the specifics of our own embodiment, and by the assumptions we make as a consequence about what is necessary for a good quality of life.
Vegetarians and their Children
Authors: SHERRATT ANNA
Published: October 2007

abstract There are estimated to be five million vegetarians in the United Kingdom and another four million in the United States. There are numerous vegetarians elsewhere in the world: around fifteen million, for instance, in India. Some of these vegetarians are parents. And some of the vegetarian parents will bring up their children to be vegetarian, too. Is this a permissible course of action? Or should vegetarian parents raise omnivorous offspring? In this article, I consider three arguments that aim to show that a parent should not raise a child on a vegetarian diet. None of these arguments are convincing and I know of no better ones — so I conclude that it is permissible for a parent to raise her child as a vegetarian.
Variation of coat color in house mice throughout Asia
Authors: Lai Y. ‐C. , Shiroishi T. , Moriwaki K. , Motokawa M. , Yu H. ‐T.
Published: October 2007

Coat color variation due to melanin pigment synthesis in house miceMus musculusin Asia is described and found to be consistent with Gloger's rule, which states that individuals of endothermic animals are darker in humid habitats than those in drier habitats. Three properties of coat color (hue, value and chroma) were measured, and a lightness variable was derived from a principal components analysis using 428 skin specimens representing three subspecies from 85 localities. Dorsal coat color ranged from yellow through brown to black, whereas ventral coat color ranged from white to black. Dorsal coat color varied less than the ventral color. In our samples, the variation in coat color in natural populations was far less than that observed in the laboratory. We found a significant correlation between the lightness variable of dorsal coat color and precipitation. Dark coat color was observed in more humid and closed habitats (darker background color), and pale coat color in drier, more open habitats (lighter background color). This result might imply the role of concealment as a selective force affecting dorsal coat color that was observed in house mice. We also discussed other selective forces that could affect the coat color variation in house mice, such as resistance to bacterial degradation and thermoregulation. In addition, the color spectra of the dorsal pelage among the three subspecies were different, the major distinction being the environmental background color of the habitats in which they are distributed.
c‐Jun N‐terminal kinase regulates mitochondrial bioenergetics by modulating pyruvate dehydrogenase activity in primary cortical neurons
Authors: Zhou Qiongqiong , Lam Philip Y. , Han Derick , Cadenas Enrique
Published: October 2007

This study examines the role of c‐jun N‐terminal kinase (JNK) in mitochondrial signaling and bioenergetics in primary cortical neurons and isolated rat brain mitochondria. Exposure of neurons to either anisomycin (an activator of JNK/p38 mitogen‐activated protein kinases) or H2O2 resulted in activation (phosphorylation) of JNK (mostly p46JNK1) and its translocation to mitochondria. Experiments with mitochondria isolated from either rat brain or primary cortical neurons and incubated with proteinase K revealed that phosphorylated JNK was associated with the outer mitochondrial membrane; this association resulted in the phosphorylation of the E1α subunit of pyruvate dehydrogenase, a key enzyme that catalyzes the oxidative decarboxylation of pyruvate and that links two major metabolic pathways: glycolysis and the tricarboxylic acid cycle. JNK‐mediated phosphorylation of pyruvate dehydrogenase was not observed in experiments carried out with mitoplasts, thus suggesting the requirement of intact, functional mitochondria for this effect. JNK‐mediated phosphorylation of pyruvate dehydrogenase was associated with a decline in its activity and, consequently, a shift to anaerobic pyruvate metabolism: the latter was confirmed by increased accumulation of lactic acid and decreased overall energy production (ATP levels). Pyruvate dehydrogenase appears to be a specific phosphorylation target for JNK, for other kinases, such as protein kinase A and protein kinase C did not elicit pyruvate dehydrogenase phosphorylation and did not decrease the activity of the complex. These results suggest that JNK mediates a signaling pathway that regulates metabolic functions in mitochondria as part of a network that coordinates cytosolic and mitochondrial processes relevant for cell function.
Duane’s retraction syndrome: its sensory features
Authors: Tomaç Suhan , Mutlu Fatih Mehmet , Altınsoy Halil İbrahim
Published: October 2007

Purpose:  To investigate binocularity in Duane’s retraction syndrome (DRS) and to evaluate whether or not there is a relationship between the sensory and clinical features of the syndrome.

Methods:  Clinical and sensory findings of 29 patients with DRS were recorded. Binocularity was tested with the Bagolini glasses (BG), Worth four‐dot (W4D), TNO and the stereo‐fly plate of the Titmus test.

Results:  Twenty‐four (83%) patients showed fusion with the BG at near and 23 (79%) had fusion at distance. With the W4D, 23 (79%) patients had fusion at near and 19 (65%) had fusion at distance. Seven (24%) patients demonstrated normal stereoacuity, 15 (52%) had reduced stereoacuity and the remaining seven (24%) patients had no measurable stereoacuity. In patients without stereoacuity, amblyopia (p < 0.001), type 2 and 3 DRS (p = 0.031) and exotropia (p = 0.003) in primary position were more common than in those with reduced or with normal stereoacuity. Restriction of ocular ductions was also more severe in patients without stereoacuity than in those with reduced or normal stereoacuity (p = 0.019, p = 0.016). Patients with type 2 and 3 DRS were significantly more likely to have amblyopia (p = 0.037), large‐angle heterotropia (p = 0.005) in primary position, upshoot or downshoot (p = 0.010) than those with type 1 DRS.

Conclusions:  Although approximately 75% of DRS patients had fusion and measurable stereoacuity, only 25% demonstrated normal binocularity. This report provides new data on the relationship of sensory features to most of the clinical findings of this syndrome. Sensory features, as well as most clinical features of the syndrome, are better in patients with type 1 DRS.
The changing visual profile of children attending a regional specialist school for the visually impaired in Northern Ireland
Authors: McClelland Julie , Saunders Kathryn J. , Hill Nan , Magee Anne , Shannon Myrtle , Jackson A. Jonathan
Published: October 2007

Aim:  To investigate the changing profile of children attending a special school for visually impaired children over a 30‐year period.

Methods:  Between 1975 and 2004, 266 children were identified as having been students in the introductory years to secondary education at Jordanstown School. School records and records from the Regional Paediatric Low Vision Clinic at the Royal Victoria Hospital, Belfast were examined to obtain data regarding age, primary ophthalmic diagnosis, visual acuity and any additional impairment.

Results:  There was no statistically significant change in mean visual acuity of the children entering the secondary school over this period (p > 0.1). Albinism was the most common single condition (20.3%). Notable also was the reduction in incidence of visual impairment following congenital glaucoma and cataract and the corresponding increase in cortical visual impairment (CVI) during this period.

Conclusion:ensp; During the last 30 years medical/surgical treatment has reduced the impact of treatable conditions (e.g. cataract) on visual impairment to the extent that their prevalence within this school has decreased. Consequently, children with non‐treatable conditions (e.g. albinism) constitute a larger proportion of the school population. An increase in the proportion of children with CVI and learning disability in the school was noted.
The Dundee University Scottish Keratoconus Study II: a prospective study of optical and surgical correction
Authors: Weed K. H. , MacEwen C. J. , McGhee C. N. J.
Published: October 2007

Aim:  To investigate and correlate optical correction, and progression to penetrating keratoplasty (PKP), with the corneal, refractive, topographic and familial characteristics of subjects with keratoconus, within the Tayside region of Scotland.

Method:  Prospective, observational, longitudinal study design. Two hundred subjects with keratoconus were enrolled into the Dundee University Scottish Keratoconus Study (DUSKS) and were assessed during a 4‐year period using standardised clinical assessment, computerised corneal topography and questionnaires.

Results:  Keratoconic subjects in this study wore rigid contact lenses (90.6%) for longer than 12 hours per day (81%), 7 days a week (91%) and achieved a very good level of Snellen visual acuity (97%, ≥6/9). Corneal staining was observed in the majority of corneas (71%), although only a small percentage of subjects reported major problems of: discomfort (18%), hyperaemia (16%), or the lens falling out (4%). Poor visual acuity was the main reason (79%) for undergoing PKP usually in the latter part of the third decade of life, approximately a decade after diagnosis. During the study period 4% of eyes progressed to PKP. Only a small percentage of eyes (9.5%) required no visual correction postoperatively.

Conclusion:  The main mode of visual rehabilitation for keratoconus was rigid contact lenses, which were mostly worn successfully with good visual acuity. During the study period a small minority of keratoconics progressed to corneal graft surgery. It is advisable to emphasise that postoperatively refractive correction will be required in the majority of these cases.
Coping with Prescription Drug Cost Sharing: Knowledge, Adherence, and Financial Burden
Authors: Reed Mary , Brand Richard , Newhouse Joseph P. , Selby Joe V. , Hsu John
Published: October 2007

Objective. Assess patient knowledge of and response to drug cost sharing.

Study Setting. Adult members of a large prepaid, integrated delivery system.

Study Design/Data Collection. Telephone interviews with 932 participants (72 percent response rate) who reported knowledge of the structures and amounts of their prescription drug cost sharing. Participants reported cost‐related changes in their drug adherence, any financial burden, and other cost‐coping behaviors. Actual cost sharing amounts came from administrative databases.

Principal Findings. Overall, 27 percent of patients knew all of their drug cost sharing structures and amounts. After adjustment for individual characteristics, additional patient cost sharing structures (tiers and caps), and higher copayment amounts were associated with reporting decreased adherence, financial burden, or other cost‐coping behaviors.

Conclusions. Patient knowledge of their drug benefits is limited, especially for more complex cost sharing structures. Patients also report a range of responses to greater cost sharing, including decreasing adherence.
Has the Medicare Prospective Payment System Led to Increased Nursing Home Efficiency?
Authors: Zhang Ning Jackie , Unruh Lynn , Wan Thomas T. H.
Published: October 2007

Research Objective. To assess the impact of recent Medicare prospective payment system (PPS) changes on efficiency in skilled nursing homes.

Data Source/Study Setting. Medicare Cost Reports (MCR), On‐line Survey Certification and Reporting System (OSCAR), Area Resource Files (ARF), a Centers for Medicare and Medicaid Services (CMS) hospital wage index website, a Consumer Price Index (CPI) database, and a survey of state Medicaid reimbursement rates. The sample was 8,361 nursing homes in the Medicare Cost Report databases from the years 1997 to 2003.

Study Design. Data‐envelopment analyses (DEA) calculated efficiency scores for three separate DEA models: unadjusted, acuity‐adjusted, and acuity‐and‐quality‐adjusted efficiency. The efficiency scores from these models were regressed on the Medicare PPS changes (the Balanced Budget Act [BBA], the Balanced Budget Refinement Act [BBRA] and the Benefits Improvement and Protection Act) and other organizational and market explanatory variables using a panel‐data truncated regression.

Principal Findings. Mean values for all efficiency measures decreased over time, the acuity‐quality‐adjusted efficiency measures decreasing the most. All policy variables were significantly negatively related to all efficiency measures. Higher nurse staffing was negatively related to efficiency in all but the acuity‐quality‐adjusted model. Other explanatory variables varied in their relationships to the efficiency variables.

Conclusions. The results suggest that the reimbursement policy changes had a significantly negative impact on efficiency. Higher nurse staffing contributed to lower efficiency only when efficiency was not adjusted for quality. Various organizational and market factors also played significant roles in all efficiency models.
Role of Stress in Acquisition of Alcohol‐Conditioned Place Preference in Adolescent and Adult Mice
Authors: Song Mei , Wang Xue‐Yi , Zhao Mei , Wang Xiao‐Yi , Zhai Hai‐Feng , Lu Lin
Published: October 2007

Background:  Both clinical evidence and findings from animal models demonstrate that there are differences between adolescents and adults in alcohol dependence. As stress plays a critical role in processes of alcohol addiction, we tested whether stress is involved in alcohol vulnerability differently during adolescence and adulthood in mice.

Methods:  To determine whether age differences exist in the acquisition of alcohol‐conditioned place preference (CPP) in mice, adolescent and adult mice were trained for CPP with different doses of alcohol (0, 0.5, 1, and 2 g/kg, i.p.). To explore the effects of stress (footshock) on acquisition of alcohol CPP in mice of different ages, adolescent and adult mice underwent acute (1 day) or chronic (1 week) stress before CPP training. Acquisition of CPP was examined after the CPP training.

Results:  Under nonstress conditions, adult mice acquired alcohol CPP when trained with 2 g/kg alcohol, while adolescent mice did not acquire alcohol CPP. After chronic but not acute stress exposure, adolescent mice acquired significant CPP trained with 2 g/kg alcohol that did not produce CPP under nonstress conditions. However, stress did not have significant effect on acquisition of CPP in adult mice trained CPP with 1 g/kg alcohol.

Conclusions:  These results indicate that there is an age difference in acquiring alcohol CPP and adolescent mice are more sensitive than adults to stress.
Persistent Impairment of Hippocampal Neurogenesis in Young Adult Rats Following Early Postnatal Alcohol Exposure
Authors: Klintsova Anna Y. , Helfer Jennifer L. , Calizo Lyngine H. , Dong Willie K. , Goodlett Charles R. , Greenough William T.
Published: October 2007

Background:  Prenatal alcohol exposure can cause damage to the developing fetus with outcomes including growth deficiency, facial dysmorphology, brain damage, and cognitive and behavioral deficits. Smaller brains in children with FASD have been linked both with reduced cell proliferation in the developing CNS and with apoptotic cell loss of postmitotic neurons. Prenatal alcohol exposure in rodents during the period of brain development comparable to that of the first and second trimesters of human pregnancy persistently alters adult neurogenesis. Long‐term effects of alcohol exposure during the third trimester equivalent, which occurs postnatally in the rat, on adult neurogenesis have not been previously reported. The goal of this study was to examine the effect of postnatal binge‐like alcohol exposure on cell proliferation and neurogenesis in hippocampal dentate gyrus during adolescence and young adulthood.

Methods:  Male Long‐Evans rat pups were assigned to 3 groups: alcohol‐exposed (AE), sham‐intubated (SI) or suckle control (SC). AE pups received ethanol in a milk formula in a binge manner (2 feedings, 2 hours apart, total dose 5.25 g/kg/day) on postnatal days (PD) 4–9. BrdU was injected every other day on PD30–50. Animals were perfused either on PD50 to examine cytogenesis and neurogenesis in hippocampal dentate gyrus at the end of BrdU injections or on PD80 to evaluate new cell survival. Dorsal hippocampal sections were immunostained for BrdU, a marker for proliferating cells, Ki67, endogenous marker of proliferation, and NeuN, a marker for mature neurons.

Results:  Binge‐like alcohol exposure on PD4–9 significantly reduced the number of mature neurons in adult hippocampal dentate gyrus (DG) both on PD50 and PD80, without altering cumulative cytogenesis on PD50. In addition, the number of new neurons, that were generated between PD30 and 50, was further reduced after 30 days of survival in all 3 groups (SC, SI, and AE).

Conclusions:  These observations suggest that early postnatal binge alcohol exposure results in long‐term deficits of adult hippocampal neurogenesis, providing a potential basis for the deficits of hippocampus‐dependent behaviors reported for this model.
Acetaldehyde Increases Endogenous Adiponectin and Fibrogenesis in Hepatic Stellate Cells But Exogenous Adiponectin Inhibits Fibrogenesis
Authors: Potter James J. , Mezey Esteban
Published: October 2007

Background:  Adiponectin has antifibrogenic properties. Acetaldehyde, the principal metabolite of ethanol, is known to stimulate the expression of type I collagen genes and the production of type I collagen by wild‐type (wt) but not by obese gene (ob/ob) stellate cells. The aim of this study was to determine the expression of adiponectin in activated stellate cells obtained from wt and ob/ob mice and to determine the effects of acetaldehyde on adiponectin in relation to the expression of type I collagen.

Methods:  Stellate cells were isolated from wt and ob/ob mice by perfusion of the portal vein and cultured. Cell adiponectin was visualized by immunohistochemistry and confocal microscopy and determined by radioimmunoassay and by western blot. Adiponectin mRNA and α1(I) collagen mRNA were determined by quantitative real time polymerase chain reaction.

Results:  Adiponectin levels were similar in wt and ob/ob stellate cells. Adiponectin receptor 2 mRNA (AdipoR2 mRNA) and AdipoR2 immunoprotein were higher in ob/ob than in wt stellate cells (p < 0.01). Acetaldehyde (200 μM) increased adiponectin both in wt and in ob/ob stellate cells (p < 0.05), but increased AdipoR2 immunoprotein only in ob/ob stellate cells (p < 0.01). However, in the presence of leptin, acetaldehyde decreased adiponectin in ob/ob stellate cells (p < 0.01). Acetaldehyde enhanced α1(I) collagen mRNA in wt (p < 0.05), but decreased it in ob/ob stellate cells (p < 0.01). Leptin abrogated the effect of acetaldehyde in decreasing α1(I) collagen mRNA in ob/ob stellate cells (p < 0.01). Adiponectin inhibited α1(I) collagen mRNA in the basal state in wt stellate cells or when enhanced by acetaldehyde.

Conclusions:  Adiponectin and adiponectin receptor are present in activated stellate cells. Adiponectin has a negative regulatory role on the enhancing effect of acetaldehyde on fibrogenesis in alcoholic liver disease.
Promising Practices for Providing Alternative Media to Postsecondary Students with Print Disabilities
Authors: Wolfe Gerri L. , Lee Christopher
Published: October 2007

For postsecondary students with disabilities influencing reading performance, printed class materials pose a substantial barrier and have a negative impact on academic achievement. Digital technologies offer alternative ways of accessing print materials for students with print‐related disabilities.Alternative mediais a broad term that encompasses a variety of formats into which printed text is converted. Alternative media, together with assistive computer technologies designed to read aloud the text, provide a means to access textual information and bypass the difficult reading process. The purpose of this article is to provide an overview of model programs and pertinent research on the use of alternative media by postsecondary students with print disabilities; we will identify promising practices for students whose disabilities negatively influence reading performance.
Environmentally Benign Production of Chemicals and Energy Using a Carbon‐Based Strong Solid Acid
Authors: Nakajima Kiyotaka , Hara Michikazu , Hayashi Shigenobu
Published: October 2007

This paper reviews amorphous carbon bearing sulfonic acid groups as an efficient solid acid catalyst for the production of various chemicals. The material is produced by the sulfonation of incompletely carbonized organic carbon to yield an insoluble, stable, and inexpensive catalyst with acid catalytic activity comparable to that of sulfuric acid (H2SO4). The carbon material can also be readily separated from liquid products by decantation or filtration, and can be repeatedly reused without any decrease in activity. As a replacement for H2SO4 in industrial chemical production, a carbon‐based solid acid catalyst thus has the potential to substantially reduce energy consumption and waste generation. The carbon catalyst also converts crude vegetable oils into biodiesel in a one‐step process, demonstrating the potential utility of this material in a wide range of catalytic processes. The remarkable catalytic activity of this material is attributable to the incorporation of reactants into the bulk structure and the high density of strongly acidic SO3H sites.
Healthy and Safe School Environment, Part I: Results From the School Health Policies and Programs Study 2006
Authors: Jones Sherry Everett , Fisher Carolyn J. , Greene Brenda Z. , Hertz Marci F. , Pritzl Jane
Published: October 2007

Background:  Policies set at the state, district, and school levels can support and enhance a healthy and safe school environment.

Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 461). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1025).

Results:  Most districts had adopted a policy on the inspection and maintenance of school facilities and equipment, and most schools had inspected and provided appropriate maintenance for each type of school facility and equipment during the 12 months preceding the study. Nearly all districts and schools had a comprehensive crisis preparedness, response, and recovery plan. Nearly all districts and schools prohibited tobacco, alcohol, and illegal drug use; fighting; weapons use; and weapon possession; but when students broke rules related to those behaviors, punitive measures were taken more often than provision of supportive services. Most schools did not reschedule outdoor activities to avoid times when the sun was at peak intensity, nor did they encourage the use of sunscreen before going outside.

Conclusions:  To provide students with a truly healthy and safe school environment in which learning can take place, more schools need to promote a positive school climate and reduce violence, injuries, and the use of tobacco, alcohol, and other substances. States and districts need to continue to provide policy and technical assistance in support of school efforts.
Faculty and Staff Health Promotion: Results From the School Health Policies and Programs Study 2006
Authors: Eaton Danice K. , Marx Eva , Bowie Sara E.
Published: October 2007

Background:  US schools employ an estimated 6.7 million workers and are thus an ideal setting for employee wellness programs. This article describes the characteristics of school employee wellness programs in the United States, including state‐, district‐, and school‐level policies and programs.

Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in 49 states plus the District of Columbia and among a nationally representative sample of school districts (n = 445). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 873).

Results:  During the 2 years preceding the study, 67.3% of states provided assistance to districts or schools on how to develop or implement faculty and staff health promotion activities or services. Although nearly all schools offered at least 1 health promotion service or activity, few schools offered coordinated activities and services within a comprehensive employee wellness program. During the 12 months preceding the study, none of the health screenings were offered by more than one third of schools; only a few of the health promotion activities and services were offered by more than one third of schools; about one third of schools offered physical activity programs, employee assistance programs, and subsidies or discounts for off‐site health promotion activities; and only 1 in 10 schools provided health‐risk appraisals for faculty and staff.

Conclusions:  More schools should implement comprehensive employee wellness programs to improve faculty and staff health behaviors and health status.