bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescence Lost/Childhood Regained: on Early Intervention and the Emergence of the Techno-Subject
Authors: Luke Allan , Luke Carmen
Published: October 2003

This article is a materialist philosophical and historical analysis of the current policy focus on early intervention programmes for print literacy. It documents the direct impact of economic and cultural globalization and new technologies on the material conditions for adolescence and youth. We argue that educational systems and government policies are struggling with the consequences of these changes: new forms of identity, technological competence and practice, and new life pathways for children and adolescents. The case is made that the current enthusiasm for early intervention programs is a ‘rhetorical displacement’ that attempts to solve the problems of unruly adolescence and the emergence of the ‘techno-subject’ through an ‘inoculation’ model dedicated to the restoration and preservation of print-based early childhood.
An Analysis of Primary Literacy Policy in England using Barthes’ Notion of ‘Readerly’ and ‘Writerly’ Texts
Authors: Hall Kathy
Published: October 2003

This article seeks to describe and explain the nature of current literacy policy in England, especially the National Literacy Strategy (NLS). It applies Barthes’ concept of ‘readerly’ and ‘writerly’ texts to literacy policy documents. The article is not so much about the merits or demerits of the various conceptions of literacy underpinning the documents, but about who gets to define what counts as literacy and the most appropriate way to develop it. A key question to be addressed is: where does authority lie in the English policy texts on primary literacy? The article refers to three primary policy contexts, in order to understand the origin and format of the current policy: ‘the context of influence’; ‘the context of policy text production’; and ‘the context of practice’. The first section of the article outlines the theoretical framework, it offers a rationale for the focus and approach, it explains the notion of policy contexts, and it then describes Barthes’ account of literary texts. The second, and longer section, examines current policy documents in the light of this framework. It is argued that state control over literacy policy increased considerably with the advent of the NLS and this occurred at the cost of teacher power and teacher autonomy.
Parental Pedagogies: An Analysis of British ‘Edutainment’ Magazines for Young Children
Authors: Buckingham David , Scanlon Margaret
Published: October 2003

As the UK government places a growing emphasis on the importance of learning in the home, commercial companies are increasingly targeting the educational aspirations of parents.This article offers a critical analysis of a range of ‘edutainment’ magazines aimed at pre-school children, most of which are based on children’s television programmes and characters. It describes the expansion of this market in the context of the broader commercialization of children’s media culture and the growth in cross-media merchandising. It then provides an analysis of the educational rhetoric of the magazines, as embodied in their sales pitches and pedagogic advice to parents. Finally, the pedagogic strategies of the magazines are analysed through an account of their mode of address and their positioning of the child reader.The article suggests that many of the magazines are informed by a reductive and disciplinary conception of learning, combined with an apparently contradictory emphasis on entertainment and ‘fun’–a combination which, it suggests, may be symptomatic of contemporary changes in the forms and sites of learning.
Click on Me! An Example of How a Toddler Used Technology in Play
Authors: Smith Cynthia R.
Published: October 2003

This article explores the ways a young child’s play revealed his understanding of technology in contextual and decontextualized ways.The child, James, spent a year (age 21/2 to 31/2) learning how to share CD-ROM storybooks with his mother, who was also the researcher. James’s experience with the hypertext of CD-ROM storybooks is described and the relationship between technology, play, and literacy is explored. James’s experience with CD-ROM storybooks resulted in play behaviors in which he revealed his understandings of the technological concepts related to this new medium of storybook. Consequently, this article brings to the forefront questions concerning a re-conceptualization of literacy in view of new technologies and what internalization of technological concepts will mean to the next generation of emergent literacy learners.
Parents’ Construction of Their Children as Gendered, Literate Subjects: a Critical Discourse Analysis
Authors: Nichols Sue
Published: October 2003

Semi-structured interviews with 56 middle-class Australian parents, both mothers and fathers, were analysed using critical discourse analysis.The effects of three discourses of childhood are traced through parents’ accounts of their children’s literacy development: the discourse of individualism, the discourse of childcentredness and the discourse of developmentalism.The study finds that alignments between these discourses and discourses of gender produce certain ideal kinds of gendered literate girls and gendered literate boys even when parents explicitly subscribe to the notion of gender equality or gender neutrality.The association of literacy with femininity or with particular personality types which are associated with femininity; the notion of girls being developmentally advanced in key literacy-related areas such as speech; the absence of a taboo on directing girls’ early learning; all of these elements have the potential to form a tight cluster constituting girls’ literacy learning as natural and unproblematic. In contrast, the opposition between masculinity and literacy, or particular literacies; the expectation of developmental delay and the attribution of agency to boys in deciding (or not deciding) when they are ready to learn; these elements form another tight cluster constituting boys’ literacy learning as problematic.
Interactions between Teachers, Children and Texts in Three Primary Classrooms in England
Authors: Dombey Henrietta
Published: October 2003

Although not legally mandatory, England’s National Literacy Strategy (NLS) has been introduced into almost every primary school in England. Interactive pedagogy and a broad conception of the reading process are claimed to permeate the various parts of the Strategy. This article examines the interactions between teachers, children and text during a Literacy Hour shared book session in three different Year 1 classrooms with five- and six-year-old children. The first transcript is taken from early demonstration video material produced by the NLS; the other two are of teachers implementing the strategy. A close examination of these transcript extracts shows very different patterns of interaction and implicit conceptions of the reading process. Paradoxically, the teacher chosen to demonstrate the Literacy Hour in action presents the most limited kind of interaction and the narrowest view of the process of reading. It is the teachers taking a more independent line who establish and support the interactive style and focus on meaning claimed by the NLS. These teachers encourage their children to develop relationships of both engagement and detachment with the texts that are the focus of attention, and thus, it is suggested, lay an important foundation for the development of complex acts of comprehension.
‘Use Your Words’
Authors: de Haan Dorian , Singer Elly
Published: October 2003

In resolving peer conflicts among young children, a sociocultural approach stresses the importance of creating a Zone of Proximal Development through the teacher’s use of dialogic tools. This approach is questioned and modified following a review of studies of toddlers’ peer conflictsand of language acquisition. In the early years, the non-symbolic, social function of speech predominates. Only gradually do toddlers learn to understand the decontextualized, symbolic function of language that teachers tend to use when they try to discuss feelings, intentions or causes of a peer conflict. Teachers are easily deceived by toddlers’ formulaic phrases. Teachers are advised to respect young children’s (non-verbal) logic-in-action and to use interactive strategies that foster togetherness. Young children have to experience dialogic tools as meaningful moves in conflict resolution that can be integrated into the (non-verbal) strategies they already have developed.
Family–School–Community Partnerships in Rural PreK At-Risk Programs
Authors: McBride Brent A. , Bae Ji-Hi , Blatchford Kristina
Published: October 2003

The purpose of this study was to explorepotential antecedents andbarriers to effective family–school–community partnerships in pre-kindergarten (PreK) programs serving children in rural settings who havebeen identified as being at-risk for later school failure. A total of 180 individuals participated in 27 focus groups conducted in nine targeted ruralcommunities. Focus group participants were comprised of parent groups, school personnel groups, and community stakeholder groups. Data from the focus group meetings identified several potential barriers to effective partnerships in these rural PreK programs, as well as discrepancies among the perceptions of parents, school personnel, and community stakeholders of the purpose and functions of such programs. Results are discussed in terms of implications for initiatives designed to increase family–school– community partnerships in rural (PreK) programs.
Chinese Early Childhood Educators’ Perspectives
Authors: Hsueh Yeh , Tobin Joseph
Published: October 2003

To study changing beliefs about early childhood education, educators in Beijing were asked to discuss a 20-minute video of a typical day in a Beijing preschool. This paper focuses on reactions to a segment in the video where a teacher, Ms Chang, speaks harshly to a four-year-old girl who cries throughout breakfast. The preservice educators who commented on the videotapeon the whole were unsurprised by and supportive of Ms Chang’s approach to dealing with a crying child. In contrast, the inservice teachers expressed surprise and indignation. The experts (professors and graduate students in early childhood education) were also generally critical, but they saw Ms Chang’s approach as symptomatic of an emphasis on control that remains common even in an era that emphasizes respect for children, creativityand freedom. These disparate reactions expose the tensions and contradictions facing Chinese early childhood educators as they struggle to maintain cultural values while preparing children to compete in the global capitalist economy.
Dynamic Characterisation of Industrial Textiles Using an Environmental Scanning Electron Microscope
Authors: Wei Q. F. , Wang X. Q.
Published: October 2003

The fundamental understanding of individual fibers and fiber assemblies has driven innovations in industrial textiles. The use of new tools is of importance in this innovation process. The use of Environmental Scanning Electron Microscope (ESEM) for characterization of industrial textiles under dynamic conditions has been explored in this study. We have developed different techniques for examining and imaging industrial textiles under varying conditions. The dynamic experiments of wetting, absorption, loading deformation, and thermal bonding of industrial textiles were performed in the Philips XL 30 FEG-ESEM. ESEM provides new approaches to dynamic studies of industrial textiles. The relative humidity in the ESEM chamber was raised up to 100% by controlling the specimen's temperature and the chamber pressure to produce the condition for dynamic wetting and absorption tests. The tensile testing was carried out on a tensile stage that was placed in the ESEM chamber. The thermal bonding process was imaged on a hot stage in the ESEM. Studies under dynamic conditions have given new insight into the kinetics of structure formation, rearrangement, and breakdown that are important for processing and product development of industrial textiles.
A Principal-Agent Analysis of U.S. Courts of Appeals Responses to Boerne V. Flores
Authors: Brent James
Published: November 2003

Using principal-agent theory, Brent found that support for claimants before the U.S. Courts of Appeals in religious free exercise cases declined following the Supreme Court's decision in Employment Division, Department of Human Resources v. Smith and rose again following congressional passage of the Religious Freedom Restoration Act (RFRA). The present study attempts to determine how the Courts of Appeals responded to the Supreme Court's decision in Boerne v. Flores that RFRA was unconstitutional. A multivariate analysis controlling on political and case-fact variables reveals that support for free exercise claimants did decline again following the Boerne decision. The Supreme Court apparently succeeded in reestablishing itself as the relevant principal in free exercise cases.
Limited to Follow
Authors: Rottinghaus Brandon
Published: November 2003

This article adds to the recent literature on the development and institutionalization of the public opinion apparatus in the White House by exploring the internal process for gauging public opinion during the administration of Herbert Hoover. Although descriptions of the public opinion polling apparatus, which developed in the White House under President Franklin D. Roosevelt, are rich, there are few analytical descriptions of the early public opinion apparatus. This article explains the process of gauging public opinion during the Hoover Administration through the systematic collection, synthesis, and analysis of White House opinion data from newspaper editorials. In addition, this article describes the use of these data during three major events in the Hoover White House: the stock market crash in 1929, the outcome of the 1930 congressional elections, and the Soldiers' Bonus Bill in 1931. In each case, institutional procedures primarily allowed President Hoover to follow, rather than manipulate, public opinion.
The Impact of Public Finance Laws on Fundraising in State Legislative Elections
Authors: Francia Peter L. , Herrnson Paul S.
Published: November 2003

Campaign finance reform has become a hotly debated issue at both the federal and state levels. Maine and Arizona became the first states to implement a fully subsidized public finance system for legislative candidates during the 2000 election. Minnesota, Wisconsin, and Hawaii have provided partial public funding to legislative candidates for several elections. The experiences of these states provide an opportunity to evaluate public funding programs. This study addresses the question: Does public funding reduce the time that candidates devote to fundraising? Using data comprising a representative nationwide sample, we demonstrate that candidates who accepted full public funding spent less time raising money than other candidates, including those who accepted partial public funding. We conclude that full public funding has the potential to redirect modern campaign efforts away from the “money chase,” freeing time for other campaign activities.
What do chronic obstructive pulmonary disease patients die from? Amultiple cause coding analysis
Authors: Hansell A.L. , Walk J.A. , Soriano J.B.
Published: October 2003

Information on obstructive lung disease (OLD) deaths is generally derived from the underlying cause of death on the death certificate. This neglects information on other conditions mentioned and may underestimate the burden of disease.

Descriptive analyses of all conditions mentioned on the death certificate for all decedents where OLD (chronic obstructive pulmonary disease or asthma) was mentioned as a contributing cause of death were conducted for England and Wales for 1993–1999.

OLD was mentioned in 312,664 or 8.0% of all deaths. OLD comprised the underlying cause of death in 59.8% of deaths with any mention of OLD. Where OLD was not the underlying cause of death, the leading causes by the International Classification of Disease version 9 chapter were diseases of the circulatory system, neoplasms, and non-OLD diseases of the respiratory system. The top single causes were acute myocardial infarction, other ischaemic heart disease, and lung cancer.

The current analysis confirms that using the underlying cause of death underestimates the contribution of obstructive lung disease to mortality in England and Wales, in contrast to myocardial infarction where underlying cause of death captures most (94%) mentions on the death certificate.
CARD15 gene mutations in sarcoidosis
Authors: Schürmann M. , Valentonyte R. , Hampe J. , Müller-Quernheim J. , Schwinger E. , Schreiber S.
Published: October 2003

Sarcoidosis, Blau syndrome and Crohn's disease are complex disorders, characterised by granulomatous inflammation affecting a variety of organs. Mutations of the CARD15 gene, on chromosome 16, have been shown to contribute significantly to Crohn's disease and to cause Blau syndrome. These factors prompted the current authors to study CARD15 mutations in sarcoidosis.

A total of 138 families were genotyped, including 302 patients with sarcoidosis and 127 patients without a family history of sarcoidosis (together with their parents), for four main coding CARD15 polymorphisms associated with increased risk of Crohn's disease. Furthermore, the gene segment that harbours Blau syndrome mutations was sequenced in 39 selected patients from 39 families with affected siblings identical for one or two parental chromosomes 16s and in eight patients from multi-case families.

None of the reported Blau syndrome mutations and no new sequence alterations were found. There was an increased frequency of transmission of the rare allele of the polymorphic sites 802C>T (SNP5) and 2722G>C (SNP12) in at least one of the two study groups.

In conclusion, CARD15 mutations, which are important in Crohn's disease and Blau syndrome, play no major role in sarcoidosis in this study population. However, these mutations could be of limited importance, especially in patients without a family history of sarcoidosis.
Natural evolution of sleep apnoea syndrome: a five year longitudinal study
Authors: Sforza E , Addati G , Cirignotta F , Lugaresi E
Published: October 2003

We wanted to investigate the natural evolution of Obstructive Sleep Apnoea Syndrome (OSAS). We therefore followed 58 patients who refused any treatment at the time of diagnosis. Of the eligible patients 32 subjects enrolled in instrumental follow-up. The effects on daytime somnolence, daytime lung function and nocturnal respiratory disturbances were retrospectively evaluated by repeating Multiple Sleep Latency Test (MSLT), spirometry and polysomnography after a follow-up period of at least 5 years (5.7 +/- 0.2 SEM yrs). In the patient group as a whole the mean Apnoea+Hypopnoea Index (AHI), the mean low arterial oxygen saturation (Sao2) and the mean Body Mass Index (BMI) did not change over time. The only significant differences were the increase in mean duration of apnoeas (21.0 vs 23.5 s) and hypopneas (13.5 vs 16.3 s) and the decrease in AHI < 80% (13.3 vs 7.9). No correlations were found between the changes in AHI or mean low Sao2 and age, BMI, AHI, mean low Sao2, pulmonary function tests or arterial blood gases at baseline. No significant changes were observed in systemic blood pressure, pulmonary function tests, blood gases analysis or MSLT. "Improved" (n = 6) and "worsened" (n = 7) groups were defined by a reduction or increase in AHI over 35% of baseline value. At baseline the "worsened" group tended to have lower AHI and higher mean low Sao2 compared with the "improved" group. In the "worsened" group the BMI rose significantly from 26.0 to 29.2, AHI rose significantly from 14.1 to 51.3 and mean low Sao2 decreased from 92 to 90 (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Comparison of cervical magnetic stimulation and bilateral percutaneous electrical stimulation of the phrenic nerves in normal subjects
Authors: Wragg S , Aquilina R , Moran J , Ridding M , Hamnegard C , Fearn T , Green M , Moxham J
Published: October 2003

Cervical magnetic stimulation is a new technique for stimulating the phrenic nerves, and may offer an alternative to percutaneous electrical stimulation for assessing diaphragmatic strength in normal subjects and patients in whom electrical stimulation is technically difficult or poorly tolerated. We compared cervical magnetic stimulation with conventional supramaximal bilateral percutaneous electrical stimulation in nine normal subjects. We measured oesophageal pressure (Poes), gastric pressure (Pgas) and transdiaphragmatic pressure (Pdi). The maximal relaxation rate (MRR) was also measured. The mean magnetic twitch Pdi was 36.5 cmH2O (range 27-48 cmH2O), significantly larger than electrical twitch Pdi, mean 29.7 cmH2O (range 22-40 cmH2O). The difference in twitch Pdi was explained entirely by twitch Poes, and it is possible that the magnetic technique stimulates some of the nerves to the upper chest wall muscles as well as the phrenic nerves. We compared bilateral, rectified, integrated, diaphragm surface electromyographic (EMG) responses in three subjects and found results within 10% in each subject, indicating similar diaphragmatic activation. The within occasion coefficient of variation, i.e. same subject/same session, was 6.7% both for magnetic and electrical twitch Pdi. The between occasion coefficient of variation, i.e. same subject/different days, was 6.6% for magnetic stimulation and 8.8% for electrical. There was no difference between relaxation rates measured with either technique. We conclude that magnetic stimulation is a reproducible and acceptable technique for stimulating the phrenic nerves, and that it provides a potentially useful alternative to conventional electrical stimulation as a nonvolitional test of diaphragm strength.
Bronchoalveolar lavage immunoglobulin A and G and antiproteases correlate with changes in diffusion indices during the natural course of pulmonary sarcoidosis
Authors: Vandenplas O , Depelchin S , Delaunois L , Delwiche JP , Sibille Y
Published: October 2003

We wanted to determine whether cell populations and soluble components in bronchoalveolar lavage (BAL) could be useful in predicting the outcome of lung function and chest radiography in patients with untreated pulmonary sarcoidosis. Analysis of soluble proteins in BAL fluid, included the levels of immunoglobulins and the two major antiproteases, alpha 2-macroglobulin (alpha 2-M) and alpha 1-protease inhibitor (alpha 1-PI), expressed as a relative coefficient of excretion (RCE). Thirty one nonsmoking patients with biopsy proven sarcoidosis, who remained untreated, had reassessment of lung function tests after 6-54 months (median 21 months). No correlation was observed between initial BAL data and changes in lung volumes and radiographic opacities. By contrast, the initial BAL immunoglobulin A and G (IgA and IgG) RCE correlated inversely with the change in transfer factor for carbon monoxide (TLCO) in the whole group and in patients with sarcoidosis of recent origin (estimated disease duration < 6 months). In the whole group and in patients with longstanding disease (estimated disease duration > 24 months, or radiographic Stage 4), the change in carbon monoxide transfer coefficient (KCO) correlated negatively with the initial alpha 1-PI RCE and positively with the initial helper to suppressor T-cell (T4/T8) ratio. By contrast, no significant difference in BAL cellular and protein data was found between patients with recent and longstanding sarcoidosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Trichomonas in pleural effusion
Authors: Radosavljevic-Asic G , Jovanovic D , Radovanovic D , Tucakovic M
Published: October 2003

Numerous living trichomonads were seen in a parapneumonic pleural effusion, in a patient who was at risk of aspiration pneumonia because of acute alcoholism. Of all the drugs administered, metronidazole had the most favourable therapeutic effect. However, decortication was necessary for the successful outcome.
Recruiting and retaining psychiatrists
Authors: Pidd Sally A.
Published: November 2003

Recruitment and retention of psychiatrists is a major concern in commissioning and providing mental health services. With consultant vacancies overall in the UK running at over 12% for many years, current services are stretched and in some areas only locum provision enables them to be maintained. This means that plans to reshape services with new teams, strengthening community-based work, could founder. Most professions within mental health share similar difficulties. The different stages of the career pathway of aspiring psychiatrists, from interested teenagers through to post-retirement consultants, are described. Difficulties at each stage in attracting and retaining the most appropriate people are discussed, and solutions at each point of the career cycle that could add up to a permanently better staffed service and a happier workforce are offered.
Social systems intervention and crisis resolution. Part 2: Intervention
Authors: Bridgett Christopher , Polak Paul
Published: November 2003

Home treatment as an alternative to acute adult in-patient care is part of the National Health Service's Plan for mental health services in the UK. As a form of crisis intervention, it benefits from an understanding of, and ways of working with, the social systems relevant to the patient in crisis. This article describes the social systems intervention process as an alternative to admission and also considers its application in achieving early in-patient discharge.
Globalisation and psychiatry
Authors: Kelly Brendan D.
Published: November 2003

Globalisation means crossing borders. It is a complex, large-scale social phenomenon that presents to mental health services both challenges and opportunities. These relate to the increased cultural diversity of service users and service providers; the effects of migration on mental health; and the implementation of international protocols in relation to training, policy and education. In the aftermath of 11 September 2001 in the USA, the relationship between large-scale social change and mental health has also focused attention on the concepts of anomie and social capital. An explicit return to the principles of biopsychosocial psychiatry and a positive engagement with globalisation will advance the development of effective, evidence-based models of care appropriate to the changing needs of patients.
Rate of convergence for the generalized Pareto approximation of the excesses
Authors: Raoult J.-P. , Worms R.
Published: October 2003

Let F be a distribution function in the domain of attraction of an extreme-value distribution Hγ. If Fu is the distribution function of the excesses over u and Gγ the distribution function of the generalized Pareto distribution, then it is well known that Fu(x) converges to Gγ(x/σ(u)) as u tends to the end point of F, where σ is an appropriate normalizing function. We study the rate of (uniform) convergence to 0 of F̅u(x)-G̅γ((x+u-α(u))/σ(u)), where α and σ are two appropriate normalizing functions.
Functionals of clusters of extremes
Authors: Segers Johan
Published: October 2003

For arbitrary stationary sequences of random variables satisfying a mild mixing condition, distributional approximations are established for functionals of clusters of exceedances over a high threshold. The approximations are in terms of the distribution of the process conditionally on the event that the first variable exceeds the threshold. This conditional distribution is shown to converge to a nontrivial limit if the finite-dimensional distributions of the process are in the domain of attraction of a multivariate extreme-value distribution. In this case, therefore, limit distributions are obtained for functionals of clusters of extremes, thereby generalizing results for higher-order stationary Markov chains by Yun (2000).
An alternating motion with stops and the related planar, cyclic motion with four directions
Authors: Leorato S. , Orsingher E. , Scavino M.
Published: October 2003

In this paper we study a planar random motion (X(t), Y(t)), t>0, with orthogonal directions taken cyclically at Poisson paced times. The process is split into one-dimensional motions with alternating displacements interrupted by exponentially distributed stops. The distributions of X
= X(t) (conditional and nonconditional) are obtained by means of order statistics and the connection with the telegrapher's process is derived and discussed. We are able to prove that the distributions involved in our analysis are solutions of a certain differential system and of the related fourth-order hyperbolic equation.
Brownian excursions and Parisian barrier options: a note
Authors: Schröder Michael
Published: October 2003

This paper addresses Paris barrier options, as introduced by G. Kentwell and J. Cornwall at Bankers Trust Australia in the mid-1990s, and their valuation, as developed by Chesnay, Jeanblanc-Picqué and Yor using the Laplace-transform approach. The notion of Paris barrier options is extended so that their valuation becomes possible at any point during their lifespan, and the pertinent Laplace transforms of Chesnay, Jeanblanc-Picqué and Yor are modified when necessary.
Geometric bounds on certain sublinear functionals of geometric Brownian motion
Authors: Hörfelt Per
Published: October 2003

Suppose that {Xs, 0 ≤s≤T} is anm-dimensional geometric Brownian motion with drift,μis a bounded positive Borel measure on [0,T], andϕ: ℝm→ [0,∞) is a (weighted)lq(ℝm)-norm, 1 ≤q≤ ∞. The purpose of this paper is to study the distribution and the moments of the random variableYgiven by theLp(μ)-norm, 1 ≤p≤ ∞, of the functions↦ϕ(Xs), 0 ≤s≤T. By using various geometric inequalities in Wiener space, this paper gives upper and lower bounds for the distribution function ofYand proves that the distribution function is log-concave and absolutely continuous on every open subset of the distribution's support. Moreover, the paper derives tail probabilities, presents sharp moment inequalities, and shows thatYis indetermined by its moments. The paper will also discuss the so-called moment-matching method for the pricing of Asian-styled basket options.
Optimal reward on a sparse tree with random edge weights
Authors: Khoshnevisan Davar , Lewis Thomas M.
Published: October 2003

It is well known that the maximal displacement of a random walk indexed by an m-ary tree with bounded independent and identically distributed edge weights can reliably yield much larger asymptotics than a classical random walk whose summands are drawn from the same distribution. We show that, if the edge weights are mean-zero, then nonclassical asymptotics arise even when the tree grows much more slowly than exponentially. Our conditions are stated in terms of a Minkowski-type logarithmic dimension of the boundary of the tree.
On the geometric growth in controlled branching processes with random control function
Authors: González M. , Molina M. , del Puerto I.
Published: October 2003

The limit behaviour of a controlled branching process with random control function is investigated. A necessary condition and a sufficient condition for the geometric growth of such a process are established by considering the L1-convergence. Finally, taking into account the classical X log+X criterion in branching processes, a necessary and sufficient condition is provided.
Imperfect repair models with preventive maintenance
Authors: Li Haijun , Shaked Moshe
Published: October 2003

Brown and Proschan (1983) introduced the imperfect repair model, in which an item, upon failure, is replaced with a new one with probability α, and is minimally repaired with probability 1 − α. In this paper we equip the imperfect repair model with preventive maintenance, and we obtain stochastic maintenance comparisons for the numbers of failures under different policies via a point-process approach. We also obtain some results involving stochastic monotonicity properties of these models with respect to the unplanned complete repair probability α.
A lower bound using Hamilton-type circuits and its applications
Authors: Chen John T.
Published: October 2003

This paper presents a degree-two probability lower bound for the union of an arbitrary set of events in an arbitrary probability space. The bound is designed in terms of the first-degree Bonferroni summation and pairwise joint probabilities of events, which are represented as weights of edges in a Hamilton-type circuit in a connected graph. The proposed lower bound strengthens the Dawson–Sankoff lower bound in the same way that Hunter and Worsley's degree-two upper bound improves the degree-two Bonferroni-type optimal upper bound. It can be applied to statistical inference in time series and outlier diagnoses as well as the study of dose response curves.
Appropriateness of test use in pathology: a new era or reinventing the wheel?
Authors: Smellie WSA
Published: October 2003

Pathology has struggled to define and implement changes to improve requesting practices, yet, with the increasing transfer of care from secondary to primary care, our workloads are increasing out of proportion to health care activity. Conversely, some tests appear to be considerably under-used by some general practitioners. Aspects of service reconfiguration such as rationalization of low-volume testing and joint equipment and reagent procurement may release some savings, although any such financial benefits are likely to be quickly nullified by the continued rise in activity and do not contribute to quality of test use. With very large differences between general practices in their use of pathology tests, this review looks at methods for changing pathology requesting activity and calls for involvement from professional organizations to support such initiatives.
Benchtop mass spectrometry in clinical biochemistry
Authors: Honour John W
Published: October 2003

Mass spectrometry has for many years enabled us to rapidly identify and quantify many different compounds in biological samples. The equipment is currently available in specialist centres investigating metabolic disorders and in toxicology laboratories. Improvements in sample introduction and refinements in the mass spectrometry hardware now allow higher sample throughput without extensive sample purification. Many mass spectrometers are compact and operated by computers that also assist data handling.

Mass spectrometry has the potential to change hospital laboratory operations generally. Consideration of the practical and financial aspects of its application may reveal cost-effective means of improving the specificity of analyte assay. Considerable advantages are expected in the analysis of metabolites and drugs and in proteomics.
Low but detectable serum thyroid-stimulating hormone concentrations in ambulant subjects not receiving thyroxine
Authors: Chatterjee S , O'Malley BP , Price DE , Fielding AM , Aitken R
Published: October 2003

Background: In laboratories employing 'front-line' sensitive thyroid-stimulating hormone (TSH) measurement, it is generally accepted that a fully suppressed serum TSH concentration (third-generation assay) alongside normal serum concentrations of free thyroid hormones indicates subclinical hyperthyroidism. However, other explanations are often provided for low but detectable serum TSH concentrations, such as drug effects or non-thyroidal illness.

Methods: We investigated 25 consecutive ambulant individuals, identified over an 18-month period as having low but not fully suppressed TSH concentrations (third-generation assay; sensitivity 0.003 mIU/L) with additional free thyroxine (T4), free tri-iodothyronine (T3) and thyroid microsomal antibody estimations and thyroid isotope scanning (technetium).

Results: Concentrations of serum hormones (median, inter-quartile range) were: TSH, 0.23, 0.17-0.26 mIU/L (reference range 0.34-5.6 mIU/L); free T4, 14.6, 10.6- 17.6 pmol/L (reference range 10-25 pmol/L); free T3, 6.1, 5.7-6.6 pmol/L (reference range 4.5-7.5 pmol/L). Thyroid antibodies were negative in all but one individual. On isotope scanning, nine individuals had hot nodules and ten individuals had multinodular goitres (MNG). Of the six with normal scans, ultrasound scanning showed a definite MNG ( n = 1) and early MNG ( n = 2).

Conclusions: A low but detectable serum TSH concentration, obtained using a third-generation assay, found in an ambulant individual, is frequently a pointer to underlying thyroid disease.
The place of capillary electrophoresis techniques in screening for haemoglobinopathies
Authors: Gulbis Béatrice , Fontaine Bernard , Vertongen Françoise , Cotton Frédéric
Published: October 2003

Background: Capillary zone electrophoresis (CZE) methods are new laboratory diagnostic tools. The screening of haemoglobin (Hb) variants by a battery of two automated CZE methods at alkaline and acid pH, followed by micellar electrokinetic capillary chromatography (MECC), has been evaluated.

Methods: Three hundred and ninety-two patients' samples with an abnormal haemoglobin fraction, detected either by isoeletric focusing (IEF) or by automated cation-exchange exchange high-performance liquid chromatography (automated HPLC), were tested by both CZE methods. Their performances were compared with IEF and automated HPLC techniques. The place of MECC has been evaluated.

Results: Using both CZE methods, the clinically relevant variants (HbS, HbC, etc.) as well as 15 of 20 clinically silent variants tested were separated from HbA. Using the alkaline CZE method, a presumptive identification of Hb Bart's, HbH and Hb Constant Spring was obtained. Complementary testing by MECC has demonstrated it to be an aid in distinguishing the globin chain mutations before confirmation by DNA or protein structure analysis.

Conclusion: Using only one device, alkaline CZE, acid CZE and MECC methods offer high resolution, automated sampling and rapid analysis. They are good tools for screening of haemoglobinopathies and can replace conventional techniques.
A study of haptoglobin phenotypes in patients with chronic renal failure
Authors: Awadallah Samir , Hamad Mawieh
Published: October 2003

Background: This study has investigated the association between haptoglobin (Hp) polymorphism and the occurrence of chronic renal failure (CRF) in Jordanians.

Methods: Blood specimens were collected from 159 patients with CRF resulting from various predisposing conditions and from 200 healthy unrelated controls. Hp phenotyping was conducted using polyacrylamide gel electrophoresis.

Results: The Hp 2-2 phenotype was over-represented in CRF patients in general (0.547), patients with hypertension (0.622) and patients with diabetes mellitus (0.633). The Hp 2-1 phenotype was over-represented in patients with chronic glomerulonephritis (0.549) and patients with reflux nephropathy (0.445). In patients with polycystic kidney disease (PKD), only Hp 2-1 and Hp 2-2 were detected, occurring at a frequency of 0.214 and 0.786, respectively. The frequency of Hp 2 allele in PKD patients was 0.893 compared with 0.706 in the control group. Hp-type distribution was in agreement with the expectations of a population in Hardy-Weinberg equilibrium in all groups except for the hypertensive patients.

Conclusions: Haptoglobin homozygosity seems to represent a possible risk factor for CRF in hypertensive, diabetic and PKD patients; Hp heterozygosity may lead to chronic glomerulonephritis.
Subclinical hypothyroidism: an audit of management
Authors: Prakash PK , Bolusani H , Hameed A , Premawardhana LDKE
Published: October 2003

Background: Subclinical hypothyroidism (SH) is a marker for overt hypothyroidism and vascular disease. Treatment guidelines are not universally followed. Thyroxine is recommended if serum thyroid-stimulating hormone (TSH) concentration is 10 mU/L or more, or if serum TSH is 5-9.9 mU/L (mild SH) with other risk factors, such as thyroid peroxidase antibodies (TPOAb).

Methods: We examined the management of mild SH in a retrospective case note audit of 150 consecutive subjects. Twenty-seven subjects with a serum TSH concentration above 10 mU/L were excluded from analysis. Of the group with mild SH, 27 were also excluded because of previous thyroid disease or amiodarone therapy.

Results: The prevalence of previous thyroid disease was similar in subjects with TSH 10 mU/L or more, compared to those with mild SH. Overall, both TPOAb and goitre status were determined in only 39% of subjects with mild SH, but in more by endocrinologists compared with general physicians (63% versus 22% for TPOAb; 47% versus 17% for goitre) ( P = 0.001). Endocrinologists treated a greater number of subjects with mild SH who were eligible for thyroxine therapy compared to nonendocrine colleagues (96% versus 67%) ( P = 0.024). Both groups treated subjects in whom TPOAb status was not determined (endocrinologists 21% versus general physicians 40%) ( P = 0.21).

Conclusion: In subjects with mild SH, evaluation is incomplete, a large percentage who were TPOAb positive were on appropriate therapy, thyroxine was prescribed when TPOAb status was unknown and, on the whole, endocrinologists performed better than general physicians.
Complementary Medicine Use by Psychiatry Patients of an Australian Hospital
Authors: Alderman Christopher P , Kiepfer Barbara
Published: October 2003

BACKGROUND:

Complementary medicine (CM) usage continues to grow in popularity and is now widespread in many cultures throughout the world. Even so, detailed research addressing the use of many of these products in specific populations has yet to be undertaken.

OBJECTIVE:

To investigate CM usage among patients treated in an Australian psychiatry unit and to assess fundamental attitudes and beliefs regarding CM in this cohort.

METHODS:

Fifty-two patients were recruited from the department of psychiatry of an Australian teaching hospital. Forty-eight subjects were men, 4 were women, and the mean ± SD age of subjects was 56.7 ± 9.1 years. Structured interviews were conducted to obtain details of the extent of CM use, usage patterns, reasons for use, and general perceptions about CM. The questionnaire also elicited information about the subjects' past medical and psychiatric history, prescribed medication, and substance use. Satisfaction with conventional drugs and CMs was measured using visual analog scales. Responses to a series of structured statements were used to assess attitudes and beliefs about complementary therapies.

RESULTS:

Eighty-five CM treatments had been used by 27 (51.9%) subjects during the preceding 6 months, and 18 subjects were current CM users (44 items). The most common products taken were vitamins and minerals (n = 18) and herbal medicines (n = 14). Use of CM products was not related to demographic or medical factors, but was significantly less frequent among patients seeing their local physician >1 time per month. Only 17 of the respondents using CMs (63.0%) informed their physician about these therapies. Daily users of CMs ranked their satisfaction level with these products significantly higher (mean satisfaction score 79.0 ± 21.9) than with conventional therapies (62.9 ± 26.8). The attitude toward CMs was positive overall, and was slightly more favorable among users than nonusers.

CONCLUSIONS:

This survey provides insight into the nature of CM usage in an Australian population of psychiatry patients. As this and other studies have revealed extensive use of CM products in various populations, healthcare providers should take this into account and include this issue in discussions with patients.
Memory Loss in a Patient Treated with Fluoxetine
Authors: Joss Jacqueline D , Burton Robert M , Keller Cecilia A
Published: October 2003

OBJECTIVE:

To report a case of severe memory loss in an elderly patient after initiation of fluoxetine.

CASE SUMMARY:

An 87-year-old white woman was started on fluoxetine for depression, and the dose was titrated to 20 mg/d. She developed progressive memory loss over the next 6 weeks for which she ultimately was hospitalized. Other potential causes for her memory loss were ruled out. After fluoxetine was discontinued, the patient's memory improved significantly over the next 2 months. An objective causality assessment indicated a possible relationship between the memory loss and fluoxetine in this patient.

DISCUSSION:

Our report documents a case of severe reversible memory deterioration after initiating fluoxetine. Fluoxetine has a favorable adverse effect profile when compared with older classes of antidepressants. Postmarketing studies and isolated case reports, however, suggest that fluoxetine may harm memory in some patients. Some selective serotonin-reuptake inhibitors (SSRIs) appear to cause memory loss more frequently than others.

CONCLUSIONS:

Clinicians should be aware of the possible effects of fluoxetine (and possibly other SSRIs) on memory.
Bortezomib Treatment for Multiple Myeloma
Authors: Stanford Brad L , Zondor Stacey D
Published: October 2003

OBJECTIVE:

To review the pharmacology, pharmacokinetics, and place of bortezomib in the therapy of multiple myeloma (MM).

DATA SOURCES:

A MEDLINE search was conducted (1985–May 2003). Meeting abstracts, bibliographies from identified articles, and the package insert were also used. Search terms were bortezomib, multiple myeloma, Velcade, PS-341, LDP-341, MLNM341, and proteasome inhibitor.

STUDY SELECTION AND DATA EXTRACTION:

All published information relevant to the clinical activity of bortezomib in MM was considered. All human clinical studies, with an emphasis on Phase II trials, were selected.

DATA SYNTHESIS:

Current therapy for MM yields significant, although temporary, responses. Bortezomib is a novel anticancer agent with significant activity in relapsed and refractory MM.

CONCLUSIONS:

Although the clinical trial data are incomplete, bortezomib offers a novel therapeutic modality for patients with MM who would otherwise have few options.
Continuous Local Anaesthesia for Post-Operative Mobilization of Injured Digits
Authors: PENG Y. P. , SEOW C. , LOW C. K. , CHEW W. Y. C. , PHO R. W. H.
Published: November 2003

We have studied the effects of sustained local anaesthesia on postoperative mobilization of the injured hand. Small epidural catheters were placed adjacent to the peripheral nerves providing sensation to the involved part of the hand under direct vision in the distal forearm. Repeated doses of 0.5% bupivacaine were then administered during mobilization therapy to relieve pain. Fourteen out of 24 digits (60%) recorded 30° or more increases in active range of motion after bupivacaine injection. The cases that failed to improve had suffered severe injuries. Complications were few and were easily managed as the catheters were distal, superficial and accessible. This is an effective, specific and safe method of providing sustained postoperative analgesia for mobilization.
The role of moving air‐water interfaces in colloid mobilization within the vadose zone
Authors: Saiers James E. , Hornberger George M. , Gower Drew B. , Herman Janet S.
Published: November 2003

The movement of colloid‐sized particles through the vadose zone has important water‐quality implications, yet the mechanisms that govern colloid mobilization are poorly understood. Results of our laboratory column experiments demonstrate that moving air‐water interfaces associated with a downward‐propagating drying front are capable of scouring kaolinite colloids from the surfaces of quartz sand. The efficiency of air‐water interfaces in capturing the immobile colloids increases with increasing drying‐front velocity and decreasing porewater ionic strength. A model that approximates the sand pack as a bundle of capillary tubes and that links pressure‐head changes during drainage to the rates of air‐water interface movement through the tubes reproduces the time‐series data on effluent‐kaolinite concentrations.