bluuebunny/crossref_metadata_2025 huggingface dataset:
Economics of Nursing
Authors: Aiken Linda H.
Published: May 2008

Pay-for-performance initiatives have renewed interest in payment reform as a vehicle for improving nurse staffing and working conditions in hospitals because of research linking investments in nursing and better patient outcomes. This article addresses the economics of nursing from a broad perspective that considers how both national policies such as hospital prospective payment and managerial decisions within institutions impact the outcomes of nurses and patients. Cost offsets are considered from the perspective of savings in patient-care resources that accrue from investments in nursing. Cost offsets are also considered from the perspective of the interactions among different strategies for investing in nursing, including the impact of staffing levels on patient outcomes with varying educational levels of nurses and varying quality of practice environments.
Laparoscopic Gastric Ischemic Conditioning Prior to Esophagogastrectomy: Technique and Review
Authors: Varela Esteban , Reavis Kevin M. , Hinojosa Marcelo W. , Nguyen Ninh
Published: May 2008

Esophagectomy can be associated with significant peri-operative morbidity such as leaks and strictures. Gastric ischemia as a result of gastric devascularization is one of the several contributing factors that may play a role in development of these complications. In an attempt to improve gastric tissue perfusion, a technique of gastric ischemic conditioning was proposed. For patients with esophageal cancer and at the time of laparoscopic staging, partial gastric devascularization is achieved by division of the left gastric vessels. Esophagectomy is subsequently performed several days after the gastric ischemic conditioning procedure. Our experience showed that preoperative ligation of left gastric vessels prior to esophagogastrectomy is technically feasible and safe and may decrease ischemic complications such as leaks and strictures.
Initial Laparoscopic Access Using an Optical Trocar Without Pneumoperitoneum Is Safe and Effective in the Morbidly Obese
Authors: Rabl Charlotte , Palazzo Francesco , Aoki Hisae , Campos Guilherme M.
Published: May 2008

Obtaining access to the peritoneal cavity in laparoscopic surgery is more difficult in morbidly obese people. The aim of this study was to examine the safety and efficacy of accessing the peritoneal cavity using an optical, bladeless trocar without previous pneumoperitoneum in morbidly obese patients. The patients' characteristics and outcomes with consecutive and preferential use of an optical, bladeless, first trocar insertion without previous pneumoperitoneum in morbidly obese patients (body mass index > 35 kg/m2) was reviewed. A total of 208 morbidly obese patients were included. The trocar insertion technique was used in 196 patients. No bowel or major abdominal vessel injuries occurred. Ninety-eight patients (50%) had previous abdominal operations. Trocar-related injuries occurred in 3 patients: a superficial mesenteric laceration in 2 and a laceration of a greater omentum vessel in 1. The direct first trocar insertion technique provides safe entry into the peritoneal cavity in morbidly obese patients.
Regulation of D6 chemokine scavenging activity by ligand- and Rab11-dependent surface up-regulation
Authors: Bonecchi Raffaella , Borroni Elena M. , Anselmo Achille , Doni Andrea , Savino Benedetta , Mirolo Massimiliano , Fabbri Monica , Jala Venkatakrishna R. , Haribabu Bodduluri , Mantovani Alberto , Locati Massimo
Published: May 2008

The decoy receptor D6 plays a nonredundant role in the control of inflammatory processes through scavenging of inflammatory chemokines. However it remains unclear how it is regulated. Here we show that D6 scavenging activity relies on unique trafficking properties. Under resting conditions, D6 constitutively recycled through both a rapid wortmannin (WM)–sensitive and a slower brefeldin A (BFA)–sensitive pathway, maintaining low levels of surface expression that required both Rab4 and Rab11 activities. In contrast to “conventional” chemokine receptors that are down-regulated by cognate ligands, chemokine engagement induced a dose-dependent BFA-sensitive Rab11-dependent D6 re-distribution to the cell membrane and a corresponding increase in chemokine degradation rate. Thus, the energy-expensive constitutive D6 cycling through Rab11 vesicles allows a rapid, ligand concentration–dependent increase of chemokine scavenging activity by receptor redistribution to the plasma membrane. D6 is not regulated at a transcriptional level in a variety of cellular contexts, thus ligand-dependent optimization of its scavenger performance represents a rapid and unique mechanism allowing D6 to control inflammation.
The role of NPM, p14arf and MDM2 in precursors of bronchial squamous cell carcinoma
Authors: Mascaux C. , Bex F. , Martin B. , Burny A. , Haller A. , Paesmans M. , Willard-Gallo K. , Ninane V. , Sculier J-P.
Published: May 2008

Murine double minute clone 2 (MDM2), p14 alternate reading frame (p14arf), and nucleophosmin (NPM) regulate p53 activity.

A total of 200 biopsies, including normal bronchial, pre-invasive and invasive tissues, were examined for changes in NPM, p14arf, MDM2 and p53 expression patterns by immunohistochemistry and immunofluorescence with confocal microscopy.

NPM and p14arf displayed a diffuse nuclear staining in most normal bronchial tissue. The fraction of biopsies displaying an increased MDM2 staining or a nucleolar relocalisation of NPM increased at mild and moderate dysplasia, respectively. Two different modifications occurred in p14arf expression,i.e.its loss or its nucleolar relocalisation, both increasing at severe dysplasia and both being associated with high MDM2 expression. In addition, the nucleolar relocalisation of p14arf was associated with that of NPM. Immunofluorescence staining indicated that NPM and p14arf either co-localised in the nucleoplasm or in the nucleoli, before and as a result of severe dysplasia, respectively. MDM2 was not detected in the nucleoli.

Thus, changes occur in murine double minute clone 2, p14 alternate reading frame and nucleophosmin level of expression and/or cellular distribution during early steps of lung carcinogenesis. Their relative localisation as determined by immunofluorescence, supports the hypothesis that p14 alternate reading frame nucleolar relocalisation impairs p14 alternate reading frame–murine double minute clone 2 complex formation and that nucleophosmin might sequester p14 alternate reading frame. The demonstration of this hypothesis requires further functional studies.
Wheezing in childhood: incidence, longitudinal patterns and factors predicting persistence
Authors: Matricardi P. M. , Illi S. , Grüber C. , Keil T. , Nickel R. , Wahn U. , Lau S.
Published: May 2008

Childhood asthma is frequently perceived as a disease with uniform clinical pathways. This perception might be an oversimplification. The aim of the present study was to investigate the incidence and natural course of wheeze over the first 13 yrs of life and analyse the risk factors predicting wheeze at 11–13 yrs of age.

The Multicentre Allergy Study, a German birth cohort, recruited 1,314 children in 1990. Physical examinations, interviews on atopic diseases, immunoglobulin (Ig)E and lung function tests were performed up to 13 yrs of age.

Complete data on the course of wheeze were available for 441 children. It was found that incidence of wheezing declined with age. The first wheezing episode was reported by 29, 9 and 9% of participants at ≤3 (early wheezers), 3–6 (late wheezers), and >6 yrs (very late wheezers) of age, respectively. Wheezing at the age of 13 yrs was associated with parental atopy, and with IgE sensitisation to common allergens, elevated total IgE and exposure to high levels of indoor allergens in early life. All these associations were remarkably stronger among early wheezers than among early nonwheezers.

In conclusion, the relevance of an early expression of atopy as a predictor of wheezing at age 13 yrs declines with increasing age of wheezing onset.
Muscarinic receptors mediate stimulation of collagen synthesis in human lung fibroblasts
Authors: Haag S. , Matthiesen S. , Juergens U. R. , Racké K.
Published: May 2008

Clinical observations indicate that in chronic obstructive pulmonary disease patients, the long-acting muscarinic antagonist tiotropium delays decline in airway function, suggesting that cholinergic mechanisms contribute to long-term structural changes. Human lung fibroblasts express muscarinic receptors and the present study aimed to explore their role in controlling collagen synthesis.

MRC-5, HEL-299 and primary human lung fibroblasts (phLFb) were cultured. Incorporation of [3H]-proline into cellular proteins was determined as measure of collagen synthesis.

In MRC-5 cells, the muscarinic agonist carbachol enhanced [3H]-proline incorporation in a concentration-dependent manner (effective concentration of 50%: 220 nM, increase at 10 µM by 40–55%, in a different series of experiments). Likewise, 10 µM oxotremorine caused an increase of ∼65%. For comparison, transforming growth factor-β1 (5 ng·mL−1) caused an increase of ∼80%. Effects of carbachol on total [3H]-proline incorporation and collagenase-sensitive [3H]-proline fraction were similar. The effect of 10 µM carbachol was inhibited by tiotropium (inhibitory concentration of 50%: 110 pM), prevented by pertussis toxin and the mitogen-activated protein kinase inhibitor, PD 98059. Muscarinic agonists also enhanced [3H]-proline incorporation in a tiotropium-sensitive manner in HEL-299 cells and phLFb.

In human lung fibroblasts, muscarinic receptors exert stimulatory effects on collagen synthesis. Prolonged blockade of muscarinic-induced collagen synthesis may contribute to reported beneficial long-term effects of anticholinergics in chronic obstructive pulmonary disease.
Pseudomonas aeruginosa, cyanide accumulation and lung function in CF and non-CF bronchiectasis patients
Authors: Ryall B. , Davies J. C. , Wilson R. , Shoemark A. , Williams H. D.
Published: May 2008

In patients with cystic fibrosis (CF) and non-CF bronchiectasis,Pseudomonas aeruginosais the most important respiratory pathogen. It is able to synthesise hydrogen cyanide, a potent inhibitor of cellular respiration.

The present study investigated whether cyanide is present in the sputum of CF and non-CF bronchiectasis patients infected withP. aeruginosa, and whether the detection of cyanide affected lung function. Cyanide was measured in sputum using a cyanide ion selective electrode.

Cyanide was detected in sputum from 15 out of 25 CF and non-CF bronchiectasis patients with currentP. aeruginosainfection; however, it was not detected in any of the 10 patients without this organism. Maximum levels were 130 µM (mean±se72±6.6 µM). Concurrent lung function data were available on all 21P. aeruginosa-infected CF patients; the group with measurable sputum cyanide (n = 11) was not different from those without (n = 10) on the basis of age or sex. However, those with detectable cyanide had significantly poorer lung function than those without (forced expiratory volume in one second (% predicted) 26.8±3.8versus46.0±6.7%; forced vital capacity (% pred) 44.4±4.9versus60.1±7.7%).

Cyanide is detectable in sputum from cystic fibrosis and non-cystic fibrosis bronchiectasis patients infected withPseudomonas aeruginosa, and is also associated with impaired lung function.
Characterization of two heparan sulphate-binding sites in the mycobacterial adhesin Hlp
Authors: Portugal Michelle I , Todeschini Adriane R , de Lima Cristiana S , Silva Carlos AM , Mohana-Borges Ronaldo , Ottenhoff Tom HM , Mendonça-Previato Lucia , Previato Jose O , Pessolani Maria CV
Published: May 2008

Background

The histone-like Hlp protein is emerging as a key component in mycobacterial pathogenesis, being involved in the initial events of host colonization by interacting with laminin and glycosaminoglycans (GAGs). In the present study, nuclear magnetic resonance (NMR) was used to map the binding site(s) of Hlp to heparan sulfate and identify the nature of the amino acid residues directly involved in this interaction.

Results

The capacity of a panel of 30 mer synthetic peptides covering the full length of Hlp to bind to heparin/heparan sulfate was analyzed by solid phase assays, NMR, and affinity chromatography. An additional active region between the residues Gly46 and Ala60 was defined at the N-terminal domain of Hlp, expanding the previously defined heparin-binding site between Thr31 and Phe50. Additionally, the C-terminus, rich in Lys residues, was confirmed as another heparan sulfate binding region. The amino acids in Hlp identified as mediators in the interaction with heparan sulfate were Arg, Val, Ile, Lys, Phe, and Thr.

Conclusion

Our data indicate that Hlp interacts with heparan sulfate through two distinct regions of the protein. Both heparan sulfate-binding regions here defined are preserved in all mycobacterial Hlp homologues that have been sequenced, suggesting important but possibly divergent roles for this surface-exposed protein in both pathogenic and saprophic species.
Isolation and characterization of novel microsatellite markers and their application for diversity assessment in cultivated groundnut (Arachis hypogaea)
Authors: Cuc Luu M , Mace Emma S , Crouch Jonathan H , Quang Vu D , Long Tran D , Varshney Rajeev K
Published: May 2008

Background

Cultivated peanut or groundnut (Arachis hypogaeaL.) is the fourth most important oilseed crop in the world, grown mainly in tropical, subtropical and warm temperate climates. Due to its origin through a single and recent polyploidization event, followed by successive selection during breeding efforts, cultivated groundnut has a limited genetic background. In such species, microsatellite or simple sequence repeat (SSR) markers are very informative and useful for breeding applications. The low level of polymorphism in cultivated germplasm, however, warrants a need of larger number of polymorphic microsatellite markers for cultivated groundnut.

Results

A microsatellite-enriched library was constructed from the genotype TMV2. Sequencing of 720 putative SSR-positive clones from a total of 3,072 provided 490 SSRs. 71.2% of these SSRs were perfect type, 13.1% were imperfect and 15.7% were compound. Among these SSRs, the GT/CA repeat motifs were the most common (37.6%) followed by GA/CT repeat motifs (25.9%). The primer pairs could be designed for a total of 170 SSRs and were optimized initially on two genotypes. 104 (61.2%) primer pairs yielded scorable amplicon and 46 (44.2%) primers showed polymorphism among 32 cultivated groundnut genotypes. The polymorphic SSR markers detected 2 to 5 alleles with an average of 2.44 per locus. The polymorphic information content (PIC) value for these markers varied from 0.12 to 0.75 with an average of 0.46. Based on 112 alleles obtained by 46 markers, a phenogram was constructed to understand the relationships among the 32 genotypes. Majority of the genotypes representing subspecieshypogaeawere grouped together in one cluster, while the genotypes belonging to subspeciesfastigiatawere grouped mainly under two clusters.

Conclusion

Newly developed set of 104 markers extends the repertoire of SSR markers for cultivated groundnut. These markers showed a good level of PIC value in cultivated germplasm and therefore would be very useful for germplasm analysis, linkage mapping, diversity studies and phylogenetic relationships in cultivated groundnut as well as relatedArachisspecies.
Flying lemurs – The 'flying tree shrews'? Molecular cytogenetic evidence for a Scandentia-Dermoptera sister clade
Authors: Nie Wenhui , Fu Beiyuan , O'Brien Patricia CM , Wang Jinhuan , Su Weiting , Tanomtong Alongkoad , Volobouev Vitaly , Ferguson-Smith Malcolm A , Yang Fengtang
Published: May 2008

Background

Flying lemurs or Colugos (order Dermoptera) represent an ancient mammalian lineage that contains only two extant species. Although molecular evidence strongly supports that the orders Dermoptera, Scandentia, Lagomorpha, Rodentia and Primates form a superordinal clade called Supraprimates (or Euarchontoglires), the phylogenetic placement of Dermoptera within Supraprimates remains ambiguous.

Results

To search for cytogenetic signatures that could help to clarify the evolutionary affinities within this superordinal group, we have established a genome-wide comparative map between human and the Malayan flying lemur (Galeopterus variegatus) by reciprocal chromosome painting using both human and G. variegatus chromosome-specific probes. The 22 human autosomal paints and the X chromosome paint defined 44 homologous segments in the G. variegatus genome. A putative inversion on GVA 11 was revealed by the hybridization patterns of human chromosome probes 16 and 19. Fifteen associations of human chromosome segments (HSA) were detected in the G. variegatus genome: HSA1/3, 1/10, 2/21, 3/21, 4/8, 4/18, 7/15, 7/16, 7/19, 10/16, 12/22 (twice), 14/15, 16/19 (twice). Reverse painting of G. variegatus chromosome-specific paints onto human chromosomes confirmed the above results, and defined the origin of the homologous human chromosomal segments in these associations. In total, G. variegatus paints revealed 49 homologous chromosomal segments in the HSA genome.

Conclusion

Comparative analysis of our map with published maps from representative species of other placental orders, including Scandentia, Primates, Lagomorpha and Rodentia, suggests a signature rearrangement (HSA2q/21 association) that links Scandentia and Dermoptera to one sister clade. Our results thus provide new evidence for the hypothesis that Scandentia and Dermoptera have a closer phylogenetic relationship to each other than either of them has to Primates.
U12 intron positions are more strongly conserved between animals and plants than U2 intron positions
Authors: Basu Malay Kumar , Makalowski Wojciech , Rogozin Igor B , Koonin Eugene V
Published: May 2008

We report that the positions of minor, U12 introns are conserved in orthologous genes from human and Arabidopsis to an even greater extent than the positions of the major, U2 introns. The U12 introns, especially, conserved ones are concentrated in 5'-portions of plant and animal genes, where the U12 to U2 conversions occurs preferentially in the 3'-portions of genes. These results are compatible with the hypothesis that the high level of conservation of U12 intron positions and their persistence in genomes despite the unidirectional U12 to U2 conversion are explained by the role of the slowly excised U12 introns in down-regulation of gene expression.

Reviewers

This article was reviewed by John Logsdon and Manyuan Long. For the full reviews, please go to the Reviewers' Reports section.
Loss of genes implicated in gastric function during platypus evolution
Authors: Ordoñez Gonzalo R , Hillier LaDeana W , Warren Wesley C , Grützner Frank , López-Otín Carlos , Puente Xose S
Published: May 2008

Background

The duck-billed platypus (Ornithorhynchus anatinus) belongs to the mammalian subclass Prototheria, which diverged from the Theria line early in mammalian evolution. The platypus genome sequence provides a unique opportunity to illuminate some aspects of the biology and evolution of these animals.

Results

We show that several genes implicated in food digestion in the stomach have been deleted or inactivated in platypus. Comparison with other vertebrate genomes revealed that the main genes implicated in the formation and activity of gastric juice have been lost in platypus. These include the aspartyl proteases pepsinogen A and pepsinogens B/C, the hydrochloric acid secretion stimulatory hormone gastrin, and the α subunit of the gastric H+/K+-ATPase. Other genes implicated in gastric functions, such as the β subunit of the H+/K+-ATPase and the aspartyl protease cathepsin E, have been inactivated because of the acquisition of loss-of-function mutations. All of these genes are highly conserved in vertebrates, reflecting a unique pattern of evolution in the platypus genome not previously seen in other mammalian genomes.

Conclusion

The observed loss of genes involved in gastric functions might be responsible for the anatomical and physiological differences in gastrointestinal tract between monotremes and other vertebrates, including small size, lack of glands, and high pH of the monotreme stomach. This study contributes to a better understanding of the mechanisms that underlie the evolution of the platypus genome, might extend the less-is-more evolutionary model to monotremes, and provides novel insights into the importance of gene loss events during mammalian evolution.
Effect of the mean strength on the endurance limit or threshold value of the crack growth curve and two-dimensional joint probability distribution
Authors: Xiong J-J , Shenoi R A , Zhang Y
Published: May 2008

Two new phenomenological expressions for generalized constant-life curves are developed on the basis of a traditional fatigue constant-life curve. Parameter estimation formulae of the generalized constant-life curve are obtained from the standard procedure for regression analysis. From the generalized constant-life curves proposed, two-dimensional joint probability distributions of generalized strength are derived. Finally, the methods developed are used to analyse three sets of experimental data pertaining to the two-dimensional up-and-down tests for LY11 aluminium alloy and fracture threshold tests for aluminium alloy and alloyed steel in order to verify the practicability and validity of the new approaches. These matters have an important role in fatigue and fracture reliability analysis in ultra-long-life regions and need to be resolved.
Single-stage nosing of thin-walled tubes into hollow spheres using a die
Authors: Alves L M , Martins P A F
Published: May 2008

In recent work, the present authors reported a thorough analysis of the mechanics of nosing thin-walled tubes into hollow spheres using a die and proposed enhancement of the formability limits of the process by means of preforming stages and preliminary tube-end preparation schemes.

In an effort to improve the surface quality and dimensional accuracy and to extend further the formability of thin-walled hollow spheres, the present authors now report a new single-stage process based on the utilization of an innovative tool design consisting of two sharp-edge dies and a floating ring. The overall performance of the new proposed process is evaluated by means of numerical simulations based on the finite element method and experimentation on industrial aluminium alloy 6060 tubes under laboratory-controlled conditions.
Contouring control of biaxial feed drive systems with non-linear friction compensation
Authors: Uchiyama N
Published: May 2008

Contouring control that employs tracking error components normal to desired contour curves as feedback signals is an effective method of improving contouring accuracy in machine tool control. In this paper, a contouring control method for biaxial feed drive systems is presented, which transforms tracking errors in each feed drive axis into errors that are reference to a moving frame around the desired position. The method is extended to include a referenced adjustment function for reducing inherent contour errors in the moving frame approach. Because friction is a major disturbance in motion control of feed drive systems, a friction compensation method for the contouring control systems is proposed. Since properties of friction cannot be predicted accurately, an estimation method of the friction model parameters is developed, and a robust controller for the estimation errors is designed. The effectiveness of the proposed method is demonstrated by experimental results with circular contour curves.
Dynamic Allocation of Airline Check-In Counters: A Queueing Optimization Approach
Authors: Parlar Mahmut , Sharafali Moosa
Published: May 2008

This paper was motivated by an observation in an international airport with regard to allocation of resources for check-in counters. In an exclusive check-in counter system, each flight has a dedicated number of counters that will be open until at least a half-hour before the scheduled departure of that flight. Currently, in many of the airports around the world, the decision to open or close check-in counters is done on an ad hoc basis by human schedulers. In doing so, the schedulers are almost always forced to perform a balancing act in meeting the quality of service stipulated by the airport authority vis-à-vis the optimal allocation of the resources to the counters. There appear to be very few academic and application papers in counter management, and most of those that have looked into this problem have resorted to simulation to study the queue characteristics. Ours is the first paper to show that for a specific flight, this complicated problem is amenable to analytical treatment. We first propose a multicounter queueing model with a special type of arrival process reflecting reality from the population of passengers booked for the flight. Most importantly, we derive the time-dependent operating characteristics to the queueing process under a specified time-window constraint. Then a stochastic dynamic programming model is formulated to determine the optimal numbers of counters to open over the time window specified. A numerical example is provided to illustrate the model solution and gain managerial insights.
Estimation and representation of head size (people overestimate the size of their head – evidence starting from the 15th century)
Authors: Bianchi Ivana , Savardi Ugo , Bertamini Marco
Published: May 2008

The head is a special part of our body since we do not see it directly. Four experiments were conducted to verify what healthy people know about the size of their head. As a control, we used the accuracy in estimating other people's heads (in all the experiments) and the estimation of the size of another part of the body, the hand (in Experiment 4). Results showed that people overestimate their own head size compared to its actual size when visual information is not provided (Experiments 1–4). They also overestimate their head size compared to the heads of others whether viewed directly (Experiment 1) or from memory (Experiment 2). Overestimation with respect to the actual size is reduced when visual information is provided (Experiments 1 and 4) and when proprioception is (presumably) increased by wearing a headband (Experiment 3). Overestimation with respect to actual size is not found for hands (Experiment 4). In the final study evidence emerged of head size overestimation in self‐portraits as compared to portraits of others.
National, Regional, and Global: New Waves of Latin American Cinema
Authors: Alvaray Luisela
Published: May 2008

Since the 1990s, the phenomenon of media globalization has contributed to transforming the status of local and regional cinemas. This article offers a documented economic perspective and a critical approach to reassess the current situation of the major Latin American film industries.
“The More You Look, the Less You Really Know”: The Redemption of White Masculinity in Contemporary American and French Cinema
Authors: Franco Judith
Published: May 2008

Through a reading of contemporary American and French films that privilege homosocial and father–son relations, this essay explores the ways in which narrative structures and formal strategies are employed to articulate white masculinity in crisis.
Becoming Clifton Webb: A Queer Star in Mid-Century Hollywood
Authors: Leff Leonard
Published: May 2008

Attentive to a wide range of signs that mark queerness, “Becoming Clifton Webb” not only shows that Webb was perceived as queer in the mid-twentieth century but argues that, coincident with Sexual Behavior and the Human Male (1948), he helped introduce moviegoers to the “new” homosexual of the postwar era.
Race, Difference, and Anthropology in Kant’s Cosmopolitanism
Authors: Hedrick Todd
Published: May 2008

This paper explores the connections between Kant’s theory of hierarchical racial difference, on the one hand, and his cosmopolitanism and conceptions of moral and political progress, on the other. I argue that Kant’s racial biology plays an essential role in maintaining national-cultural differences, which he views as essential for the establishment of the cosmopolitan union. Unfortunately, not only are these views racist, they also complicate Kant’s ability to consistently think through the prospect of the human species’ moral progress. Thus, while in the abstract, Kant’s attempts to understand the prospects for moral and political progress as rooted in historical reality, and his insistence that such progress is necessarily connected to the persistence of cultural difference, is appealing, his own way of carrying this out is decidedly not, being so intimately connected to racial hierarchy as a basic source of difference.
Romantic Cosmopolitanism: Novalis’s “Christianity or Europe”
Authors: Kleingeld Pauline
Published: May 2008

German Romanticism is commonly associated with nationalism rather than cosmopolitanism. Against this standard picture, I argue that the early German romantic author, Novalis (Georg Philipp Friedrich von Hardenberg, 1772–1801) holds a decidedly cosmopolitan view. Novalis’s essay “Christianity or Europe” has been the subject of much dispute and puzzlement ever since he presented it to the Jena romantic circle in the fall of 1799. On the basis of an account of the philosophical background of Novalis’s romanticism, I show that the image of the Middle Ages sketched in “Christianity or Europe” plays a symbolic role and should not be taken as a literal description of the historical past or as a blueprint for the future. Rather, the romantic picture of medieval Europe serves to evoke poetically the ideal of a cosmopolitan re-unification of humanity.
No Man Is an Island: Nature and Neo-Platonic Ethics in Ḥayy Ibn Yaqẓān
Authors: Kukkonen Taneli
Published: May 2008

Ibn Ṭufayl’s story of the solitary philosopher Ḥayy who, aided only by the power of his natural reason, comes to his own on an uninhabited equatorial island, attractively portrays the neo-Platonic worldview of the Muslim falāsifah . At the same time it forces to the foreground the most trenchant problem in any intellectualist ethics. If the highest virtue consists in the unmixed contemplative life, what good can a thinker do any longer, in any more mundane context? In this article, a reading is proposed that integrates Ḥayy’s cosmological explorations with his relations towards nature and his fellow human beings.
Religion in Hutcheson’s Moral Philosophy
Authors: Harris James A.
Published: May 2008

It is shown that belief in providence and a future state are key components of Hutcheson’s account of moral virtue. Though Hutcheson holds that human beings are naturally virtuous, religion is necessary to give virtuous dispositions support and stability. The aspects of Hutcheson’s moral psychology which lead him to this conclusion are spelled out in detail. It is argued that religion and virtue are connected in this way in both the Dublin writings (the Inquiry and the Essay ) and the later pedagogical texts, and that, therefore, there are reasons to question claims made by James Moore to the effect that Hutcheson had two distinct philosophical “systems.”
Does Being an Immigrant Make a Difference in Seeking Physician Services?
Authors: Xu Ke Tom , Borders Tyrone F.
Published: May 2008

The current study investigated the effects of immigration status, acculturation, and health beliefs on the use of preventive and non-preventive visits, through use of a nationally representative sample of U.S.-born and foreign-born adults. U.S.-born adults were found to have significantly more preventive and non-preventive visits than immigrants. The effects on predicting preventive visits of education, having a usual source of care, and having other public insurance were stronger among immigrants than among the U.S.-born. Health confidence and believing in the need for health insurance significantly predicted the numbers of both preventive and non-preventive visits among the U.S.-born but correlated little with either type of visit among immigrants. Among immigrant adults, acculturation affected only the number of preventive visits. The lower utilization of both preventive and non-preventive care among immigrants may be associated with a combination of better health and more limited enabling resources.
Adaptations to Health Care Barriers as Reported by Rural and Urban Providers
Authors: Chipp Cody L. , Johnson Mark E. , Brems Christiane , Warner Teddy D. , Roberts Laura W.
Published: May 2008

Barriers to ethical and effective health care in rural communities have been well-documented; however, less is known about strategies rural providers use to overcome such barriers. This study compared adaptations by rural and urban health care providers. Physical and behavioral health care providers were randomly selected from licensure lists for eight groups to complete a survey; 1,546 (52%) responded. Replies indicated that health care providers from small rural and rural communities were more likely to integrate community resources, individualize treatment recommendations, safeguard client confidentiality, seek out additional expertise, and adjust treatment styles than were providers from small urban and urban communities. Behavioral health care providers were more likely than physical health care providers to integrate community resources, individualize treatment recommendations, safeguard client confidentiality, and adjust their treatment styles; physical health care providers were more likely than behavioral health care providers to make attempts or have options to seek out additional expertise.
Predictors of Influenza Vaccination in an Urban Community during a National Shortage
Authors: Phillips-Caesar Erica , Coady Micaela H. , Blaney Shannon , Ompad Danielle C. , Sisco Sarah , Glidden Kathryn , Vlahov David , Galea Sandro
Published: May 2008

Little is known about the impact of vaccine shortages on vaccination rates among disadvantaged populations in the United States. We compared factors associated with influenza vaccination rates during a vaccine shortage (2004–2005) and a non-shortage (2003–2004) year among adults in predominantly minority New York City neighborhoods. Thirty-one percent of participants received influenza vaccine during the non-shortage year compared with 18% during the shortage. While fewer people received the influenza vaccine during the shortage, a higher proportion of the vaccinated were in a high-risk group (68% vs. 52%, respectively). People were less likely to have been vaccinated during the shortage if they were Black. This study suggests that vaccination rates were lower during the shortage period among Blacks and those who are not explicitly a focus of national vaccination outreach campaigns. Such groups are less likely to be vaccinated when vaccines are scarce.
Access to Hospital Interpreter Services for Limited English Proficient Patients in New Jersey: A Statewide Evaluation
Authors: Flores Glenn , Torres Sylvia , Holmes Linda J. , Salas-Lopez Debbie , Youdelman Mara K. , Tomany-Korman Sandra C.
Published: May 2008

Context/Objectives . We surveyed New Jersey (NJ) hospitals to assess current language services and identify policy recommendations on meeting limited English proficiency (LEP) patients' needs. Methods . Survey with 37 questions regarding hospital/patient features, interpreter services, and resources/policies needed to provide quality interpreter services. Results . Sixty-seven hospitals responded (55% response rate). Most NJ hospitals have no interpreter services department, 80% provide no staff training on working with interpreters, 31% lack multilingual signs, and 19% offer no written translation services. Only 3% of hospitals have full-time interpreters, a ratio of 1 interpreter:240,748 LEP NJ residents. Most hospitals stated third-party reimbursement for interpreters would be beneficial, by reducing costs, adding interpreters, meeting population growth, and improving communication. Conclusions . Most NJ hospitals have no full-time interpreters, interpreter services department, or staff training on working with interpreters, and deficiencies exist in hospital signage and translation services. Most NJ hospitals stated third-party reimbursement for interpreter services would be beneficial.
Child and Parental Poor Health Among Families at Risk for Hunger Attending a Community Health Center
Authors: Miller Elizabeth , Wieneke Kristin M. , Murphy J. Michael , Desmond Sheila , Schiff Andrew , Canenguez Katia M. , Kleinman Ronald E.
Published: May 2008

Background . Hunger is prevalent in low-income families. Community clinics offer an opportunity to identify families who experience hunger and to address hunger-related health problems. Methods . Parents of pediatric patients seen in an urban clinic completed a single question hunger screen. A subsample of parents participated in an interview. Patient and parental medical and mental health diagnoses were collected from medical records. Results . Children from families reporting hunger were more likely than those from families not reporting hunger to be obese and to have more documented medical diagnoses. Parents reporting hunger were also more likely to have mental health problems noted and to describe poor health status. Conclusion . Hunger is associated with specific health problems among children and parents in a low-income community clinic. A simple screen to identify hungry families in clinics may assist in recognition of hunger's contribution to child and parental poor health and development of targeted interventions.
Diabetes Management: Utilizing Community Health Workers in a Hawaiian/Samoan Population
Authors: Beckham Sheila , Bradley Stephen , Washburn Anuenue , Taumua Tusi
Published: May 2008

Background . Although not widely utilized, community health workers (CHWs) have been shown to enhance diabetes education and management efforts among racial/ethnic minority populations. Objective . To examine the effectiveness of CHWs on diabetes management among a population with primarily Native Hawaiian and Samoan ethnic minority participants with HbA1c greater than 10%. Design . Descriptive study comparing HbA1c readings of participants with diabetes with and without CHW intervention. Participants . Of 116 eligible participants, 74% were either Native Hawaiian or Samoan. Results . The mean baseline HbA1c for all eligible participants was 10.9 ± 0.8%. The 80 participants who completed CHW intervention had a 2.2 ± 1.8% (p.< 01, compared with baseline) mean reduction in HbA1c, compared with a 0.2 ± 1.5% reduction for those without CHW intervention. Conclusion . Community health workers had a positive impact on diabetes management defined in terms of improved HbA1c amongst this predominantly Native Hawaiian and Samoan population.
Do Public Health Clinics Reduce Rehospitalizations?: The Urban Diabetes Study
Authors: Robbins Jessica M. , Valdmanis Vivian G. , Webb David A.
Published: May 2008

Safety-net health clinics have been shown to reduce hospitalizations for ambulatory care-sensitive conditions. Their impact on rehospitalization after hospital discharge is unknown. We hypothesized that use of publicly-funded safety-net health clinics would reduce rates of rehospitalization among patients with diabetes. We expected this effect to be most evident among the most vulnerable patients. Linking data from the Philadelphia Health Care Centers (HCCs) with statewide hospital discharge data for 1994-2001 for patients with diabetes, we found that patients enrolled in the HCCs prior to hospitalization were rehospitalized 22% of the time, the same rate as other Philadelphians. Among those at higher risk of rehospitalization because pre-existing diabetes was not noted in hospital records, odds of rehospitalization were reduced by 24% for HCC patients. Given that patients in the HCCs are overwhelmingly poor and uninsured or underinsured, these findings suggest that access to primary care through the HCCs may have a protective effect against the poor health outcomes typically associated with lower socioeconomic status. Enrollment in publicly-funded safety-net health clinics may have prevented rehospitalizations for some vulnerable patients with diabetes.
The Contribution of International Medical Graduates to Diversity in the U.S. Physician Workforce: Graduate Medical Education
Authors: Norcini John J. , van Zanten Marta , Boulet John R.
Published: May 2008

Purpose . To describe the ethnicity/race and gender distribution of the international medical graduates (IMGs) qualified to enter graduate medical education (GME) and those who are actually in GME. Methods . The Educational Commission for Foreign Medical Graduates (ECFMG) database and the American Medical Association's Masterfile provided ethnicity/race and gender data for the pool of IMGs qualified to enter GME (ECFMG certificants from 2000–2005) and those in GME in 2005. Data for U.S. medical graduates come from Association of American Medical Colleges' publications. Results . Compared with USMGs, both the pool of available IMGs and those in graduate training have a larger percentage of Asians and Hispanics, a lower percentage of Blacks and American Indian/Pacific Islanders, and a much lower percentage of Whites. The groups had comparable percentages of women. Conclusions . International medical graduates provide much-needed diversity in GME. Since most IMGs remain in the U.S. after training, this diversity can lead to a richer training environment, increased access to health care, and better health care outcomes.
Social Support and Dental Utilization among Children of Latina Immigrants
Authors: Nahouraii Helen , Wasserman Melanie , Bender Deborah E. , Rozier R. Gary
Published: May 2008

Latino children use fewer professional dental services and experience more dental decay than non-Hispanic White and non-Hispanic Black children. This study tested the association between four types of social support (information, influence, material aid, emotional aid) and dental use among children of Latina immigrants in North Carolina. Latina mothers age 15–44 years (N=174) were sampled from four counties using a multistage church-based sampling design. Each mother reported dental care use for her oldest child younger than 11 years of age. Instrumental aid (information) alone was not associated with dental care use, but receiving any of the other types of social support was associated with dental care use at the bivariate level (p<.01) and at the multivariate level (OR = 3.13; 95% CI = 1.67–5.87). Over half of the women (65.2%) received at least one of these forms of social support. Interventions expanding dental-related social support could help Latina immigrant mothers overcome barriers to dental care for their children.
Health Selection vs. Causation in the Income Gradient: What Can We Learn from Graphical Trends?
Authors: Muennig Peter
Published: May 2008

Income produces health, and sickness negatively affects earnings. These two factors likely explain the income gradient in health, but each has very different policy implications. In this paper, I examine graphical trends in mortality risk between low-income and higher-income people by age and gender. These trends suggest that forward causality (income affecting health) is more important than reverse causality (health affecting income) in the income-health gradient. However, there is some evidence to suggest that reverse causality plays an important role for younger men.
Language Interpreter Utilization in the Emergency Department Setting: A Clinical Review
Authors: Ramirez Dorian , Engel Kirsten G. , Tang Tricia S.
Published: May 2008

The emergency department (ED) serves as the entry point into the U.S. health care system for many patients with limited English proficiency (LEP). This paper reviews the literature on language interpreter utilization in the ED setting. We focused on three clinical issues related to professional language interpretation: (1) patient satisfaction, (2) health care delivery, and (3) current interpreter utilization practices. Compared with-English speaking patients, LEP patients report less satisfaction with medical encounters, have different rates of diagnostic testing, and receive less explanation and follow-up. Although professional interpretation has been associated with improvements in patient satisfaction, communication, and health care access, these services are largely under-utilized in ED settings. Reliance on untrained ad hoc interpreters, perceived time and labor associated with obtaining and working with an interpreter, and costs of implementing professional interpreter services serve as barriers to implementation and utilization.
Constraints to Caring: Service to Medically Indigent Patients by Allopathic and Osteopathic Physicians
Authors: Chirayath Heidi T. , Wentworth Ashley L.
Published: May 2008

Most U.S. physicians limit their care of medically indigent populations, rendering millions of patients underserved. Using survey data from a national sample of 669 allopathic and osteopathic physicians, this paper explores the professional, demographic, and attitudinal correlates of care of medically indigent (Medicaid and uninsured) patients. Separate bivariate and multivariate data analyses for allopathic and osteopathic physicians generate path models of the influences of physician characteristics on care of indigent patients. For both physician groups, professional characteristics such as practice type, location, medical specialty, and perceptions of the medical system shape care of indigent patients. Differential patterns of association emerge, with care provided by osteopathic physicians most significantly influenced by private practice, while medical specialty and employment in community clinics shapes indigent care provided by allopathic physicians. Results highlight the utility of comparative analyses in discerning the mechanisms through which professional characteristics influence indigent care by diverse health providers.
Seroprevalence of HCV Infection in Homeless Baltimore Families
Authors: Schwarz Kathleen B. , Garrett Beth , Alter Miriam J , Thompson Douglas , Strathdee Steffanie A
Published: May 2008

Our objective was to investigate hepatitis C virus (HCV) seroprevalence in homeless caregivers and their children 2-18 years of age living in a family. During a 30-month period from October 2001 through April 2004 in Baltimore, 170 caregivers enrolled and 168 of these accepted testing for antibody to HCV (anti-HCV), as did all 336 children and adolescents enrolled. Main results . None of the children younger than 18 years old were HCV seropositive; in striking contrast, however, 32 (19%) caregivers were seropositive. Most (59%) were previously unaware of their HCV serostatus. History of ever injecting drugs was the strongest predictor of HCV seropositive status in the caregivers, reported by 14% overall, and by 71% of HCV positives. Conclusion . The homeless families were very receptive to our HCV seroprevalence study and are likely also to be receptive to shelter-based HCV prevention programs for young children and adolescents as well as for adults.