bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing Family-Centered Rounds: Pediatric Residents’ Perceptions
Authors: Rappaport David I. , Cellucci Michael F. , Leffler Maureen G.
Published: February 2010

Purpose. Many hospitals are adopting family-centered rounds (FCRs). Limited studies suggest that FCRs improve family and staff satisfaction. No study has investigated residents’ opinions about FCRs. We sought to elicit house staff opinions regarding structure, teaching, and patient care with FCRs. Method. In fall 2006, FCRs were implemented at Alfred I duPont Hospital for Children, a freestanding children’s hospital. Between March and June 2008, a cross-sectional study was mailed to pediatrics and medicine-pediatric residents. Results. Nearly all (89%) respondents supported FCRs somewhat (50%) or strongly (39%). House staff cited improved relationships with other providers, increased parent/family satisfaction, decreased need for plan clarification, and improved, “nondidactic” teaching. Concerns persisted about didactic teaching and efficiency. The most important factor associated with resident satisfaction was the attending physician. Conclusions. Residents support the use of FCRs.Training for inpatient attending physicians should include facilitation of FCRs. Concerns about efficiency and didactic teaching should be considered when implementing FCRs.
Fever of Unknown Origin: A Diagnostic Approach to This Vexing Problem
Authors: Tolan Robert W.
Published: February 2010

Fever is a common complaint leading families to seek medical attention. Its routine management is the bread and butter of pediatric practice. When fever is seen as prolonged beyond the expected time course (eg, 10 days for a presumed viral respiratory tract infection or 3 weeks for mononucleosis), concern for fever of unknown origin (FUO) may ensue. This diagnosis is among the most challenging for health care providers to approach and often involves referral to subspecialists. Generally, the pace of the evaluation should be guided by the severity of the disease, rather than the anxiety of the family or of the health care providers. It is useful to recognize that uncommon manifestations of common diseases are more likely than are rare diseases. Furthermore, clues to the diagnosis are frequently present in the history and physical examination but are not elicited or unappreciated (perhaps due to time constraints). Therefore, thoroughness and repetition are vitally important. Although the differential diagnosis of FUO is vast, a thoughtful, focused approach based on information gleaned from a thorough history and physical examination (together with any laboratory or other study results) is preferable to a “shotgun” or “running the list” one. Finally, FUO in special populations, including children in the hospital, those with HIV infection or other immunocompromise, and those in the developing world, require special consideration. Most children do well, compared to adults with FUO, but true FUO is not always a benign condition, necessitating the best care a health care provider can offer.
Reliability of Parent-Measured Axillary Temperatures
Authors: Klein Melissa , DeWitt Thomas G.
Published: February 2010

Background. Fever is a common symptom in children. Assessment of accuracy of parental temperature measurement is integral in determining proper medical management. Methods . The authors recruited 25 afebrile and 13 febrile children from outpatient sites. Participants had rectal temperatures measured by a trained study staff, followed by axillary temperature measurements by trained study staff and parent. Analysis of variance was used to compare the afebrile and febrile groups; the paired t test was used to compare parent and study personnel’s axillary temperature measurements. Analysis included the statistical significance of Pearson’s correlation coefficients for the various comparisons. Results. In both febrile and afebrile groups, the rectal temperatures were greater than axillary temperature measurements, but the difference was not consistent. There was a very high correlation (correlation coefficient range = .86-.96) between axillary temperature measurements performed by trained study staff and parents. Conclusions. Parental report of axillary temperature measurement can be considered reliable.
A Qualitative Study On the Needs of Caregivers of Inpatients With Schizophrenia in India
Authors: Jagannathan A. , Thirthalli J. , Hamza A. , Hariprasad V.R. , Nagendra H.R. , Gangadhar B.N.
Published: February 2010

Aim: To explore the needs of caregivers of inpatients with schizophrenia in India.

Material: Thirty caregivers of inpatients with schizophrenia participated in five focus group discussions (FGD), where the needs of the caregivers were discussed. The FGDs were recorded, transcribed and similar needs were grouped and ranked according to their order of importance.

Discussion: The main needs that emerged were regarding: managing the behaviour of patients; managing social-vocational problems of patients; health issues of caregivers; education about schizophrenia; rehabilitation; and managing sexual and marital problems of patients.

Conclusion: This study has identified additional needs of caregivers from those found in other studies.
The Culture and Identity Schedule a Measure of Cultural Affiliation: Acculturation, Marginalization and Schizophrenia
Authors: Bhugra Dinesh , Leff Julian , Mallett Rosemarie , Morgan Craig , Zhao Jing-Hua
Published: February 2010

Background: Previous epidemiological studies have shown a high incidence of schizophrenia in African-Caribbeans in the UK, but not in Asians.

Aims: We investigated the hypothesis that cultural adherence might protect the Asians against the stress of living in a majority white culture.

Methods: The Culture and Identity Schedule (CANDID) was given to patients with a diagnosis of schizophrenia making their first contact with psychiatric services, and to a matched group of controls randomly selected from the general population.

Results: While the Asian patients displayed no drift away from the traditional values as espoused by their controls, the African-Caribbean patients were less traditional than their controls.

Conclusions: The fact that a movement away from their traditional culture distinguishes African-Caribbean patients with a severe psychiatric illness, schizophrenia, from their mentally healthy controls strongly favours marginalization over biculturalism as an interpretation of this shift.
Apatite Reduces Amelogenin Proteolysis by MMP-20 and KLK4 in vitro
Authors: Sun Z. , Carpiaux W. , Fan D. , Fan Y. , Lakshminarayanan R. , Moradian-Oldak J.
Published: February 2010

Two enamel proteases, matrix metalloproteinase-20 (MMP-20) and kallikrein 4 (KLK4), are known to cleave amelogenin and are necessary for proper enamel formation. However, the effect of hydroxyapatite (HAP) on the proteolytic activity of these enzymes remains unclear. To investigate whether apatite affects normal amelogenin proteolysis, we used 2 different isoforms of amelogenin combined with the appropriate enzymes to analyze proteolytic processing rates in the presence or absence of synthetic hydroxyapatite (HAP) crystals (N = 3). We found a distinct dose-dependent relationship between the amount of HAP present in the proteolysis mixture and the rate of rP172 degradation by rpMMP-20, whereas the effect of HAP on proteolysis of either rP172 or rP148 by rhKLK4 was less prominent.
The Hindenburg Line of the Strauss Wars
Authors: Altman William H.F.
Published: February 2010

Bringing continental sensibilities and skill to his project, David Janssens has abandoned the line of defense heretofore used by North American intellectuals to shield Leo Strauss from criticism: Janssens wastes no time trying to prove Strauss was a liberal democrat, frankly admits his atheism, and emphasizes the continuity and European origins of his thought. Nevertheless committed to defending Strauss even at his most vulnerable points, Janssens is compelled to anchor his new defensive position on a misreading of what he calls “an inconspicuous footnote” in Philosophie und Gesetz (1935).
Operating Characteristics of a Partial‐Block Randomized Crossover Bioequivalence Study for Dutasteride, a Drug with a Long Half‐Life: Investigation Through Simulation and Comparison with Final Results
Authors: Cai Gengqian , Thiessen Jake J. , Baidoo Charlotte A. , Fossler Michael J.
Published: February 2010

Studies to establish bioequivalence (BE) of a drug are important elements in support of drug applications. A typical BE study is conducted as a single dose, randomized, 2‐period crossover design. For drugs with long half lives (≥ 48 hours) and evaluation of multiple BE objectives in 1 trial, this design may not be adequate. A parallel design may then be a more appropriate choice. However, parallel designs require increased sample size, which can become substantial.

One option that is a compromise between the complete randomized block design and the parallel design is a partial‐block crossover design. This approach came about during the development of a combination of dutasteride and tamsulosin. Previous experience with performing single‐dose dutasteride studies suggested that 28 days of washout is needed between treatments because of its half‐life of 7–9 days.

Simulations were performed to assess the operating characteristics of this design using a previously developed PK model. Four scenarios were developed, and each scenario was simulated 500 times. The results showed that this design demonstrated acceptable consumer and producer risk. Partial‐block crossover designs should be considered for studies when the half‐life of the drug is long and there are more than 2 periods.
Impact of Target‐Mediated Drug Disposition on Linagliptin Pharmacokinetics and DPP‐4 Inhibition in Type 2 Diabetic Patients
Authors: Retlich Silke , Duval Vincent , Graefe‐Mody Ulrike , Jaehde Ulrich , Staab Alexander
Published: February 2010

The pharmacokinetics of the novel dipeptidyl‐peptidase 4 (DPP‐4) inhibitor linagliptin is nonlinear. Based on in vitro experiments, concentration‐dependent binding to DPP‐4 is the most likely cause for the nonlinearity. Population pharmacokinetic/pharmacodynamic modeling was performed using linagliptin plasma concentrations and plasma DPP‐4 activities from 2 phase 2a studies. In these studies, type 2 diabetic patients received either 1, 2.5, 5, or 10 mg of linagliptin once daily over 12 days (study 1) or 2.5, 5, or 10 mg of linagliptin once daily over 28 days (study 2). The modeling results supported the hypothesis that linagliptin exhibits target‐mediated drug disposition. The linagliptin plasma concentrations were best described by a 2‐compartment model including concentration‐dependent protein binding in the central and peripheral compartment. The plasma DPP‐4 activity was included in the model in a semi‐mechanistic way by relating it to the model‐calculated plasma DPP‐4 occupancy with linagliptin. The target binding has a major impact on linagliptin pharmacokinetics. Although unbound linagliptin is cleared efficiently (CL/F220 L/h), the concentration‐dependent binding is responsible for the long terminal half‐life (∼120 hours) of linagliptin and its nonlinear pharmacokinetics. The model allowed a comprehensive understanding of the impact of target‐mediated drug disposition and provides a useful tool to support clinical development.
Women’s Contributions to the Household Economy in Pre-1949 China: Evidence from the Lower Yangzi Region
Authors: Kung James Kai-sing , Lee Daniel Yiu-fai
Published: February 2010

The economic role of women in pre-1949 China has been the subject of an ongoing debate. Farm surveys conducted in the highly commercialized region of the Lower Yangzi in the early to mid-twentieth century show that the value of women’s overall economic contribution was very similar to men’s. In particular, while a gendered division of labor existed, it was likely more notable within sericulture rather than between sericulture (in which women were supposed to specialize) and farming (predominantly a man’s job). Moreover, although men were overrepresented in local wage employment both on and off the farm, the comparatively low economic returns to these activities suggest that economic considerations rather than cultural preferences were the primary reason behind this gendered specialization. Equally important, although outnumbered by men, women were able to migrate and, conditional on employment in this better remunerated sector, they contributed equally to remittance income.
Effects of Coaching Patients With Lung Cancer to Report Cancer Pain
Authors: Wilkie Diana , Berry Donna , Cain Kevin , Huang Hsiu-Ying , Mekwa Julia , Lewis Frances , Gallucci Betty , Lin Yu-Chuan , Chen Angela Chia-Chen , Ko Nai-Ying
Published: February 2010

The authors have examined the effects of coaching sensory self-monitoring and reporting on pain-related variables in patients with lung cancer. Randomly assigned to coached or not-coached groups, 215 patients have their interactions with their providers audiotaped and complete study measures pre- and postintervention. Of the 151 patients who complete the 4-week study, those coached are more likely than those not coached to give their providers unsolicited sensory pain information and to mention it before their providers ask for it. The mean number of pain parameters discussed during the audiotaped clinic visit is statistically larger at study end for the coached group. Scores for analgesic adequacy, all pain indices except one, anxiety, depression, and catastrophizing coping are not significantly different. Although coaching increases the amount of pain data communicated to providers by patients with lung cancer, the magnitude is small and does not lead to improved adequacy of analgesics prescribed for each patient’s pain level.
Pitch error analysis of young piano students’ music reading performances
Authors: Rut Gudmundsdottir Helga
Published: February 2010

This study analyzed the music reading performances of 6—13-year-old piano students ( N = 35) in their second year of piano study. The stimuli consisted of three piano pieces, systematically constructed to vary in terms of left-hand complexity and input simultaneity. The music reading performances were recorded digitally and a code of error analysis was constructed from the data. The effect of age on the types of errors made was investigated. The age differences found were in terms of error frequency, performance continuity, contour preservation, and stimulus complexity. The study sheds light on what may be typical music reading errors of piano students in their second year of study and suggests some trends of age-related development in music reading among piano students.
Early stages of musical development: Relationships between sensory integration dysfunction, parental influence, and musical disposition of a three-year-old ‘maestro’
Authors: Hendricks Karin S. , McPherson Gary E.
Published: February 2010

Current literature offers only scant information on very young children who display high attention and engagement in music, but who are not drawn from normal populations. This study of three-year-old Danny, who possesses the neurological disorder Sensory Integration Dysfunction, provides a case study of the types of parent—child interactions that facilitated a high level of involvement with music from a young age. Parent journals, emails, interviews, and observations of the child at his home were analyzed to map out this young child’s musical development from age 2.5 until 3.5 years. Results document the high level of attention and support Danny received from his parents, and suggest an elongation of the period of ‘communicative musicality’ which typifies mother—child bonding in infancy.
Simple surface sulfonation retards plasticiser migration and impacts upon blood/material contact activation processes
Authors: Gourlay Terence , Shedden Laurie , Horne David , Stefanou Demetrios M.
Published: February 2010

Background. The use of Di-2-ethylhexyl phthalate (DEHP) plasticised polyvinyl chloride (DEHPPPVC) in medical devices persists despite evidence suggesting that DEHP migration can be harmful. Researchers have shown that a simple surface sulfonation process can retard the migration of DEHP, which may reduce the associated inflammatory response. The present study is designed to investigate the effects of surface sulfonation on DEHP migration and blood contact activation using in vitro and rodent models.

Methods. The study was carried out in two phases: phase 1, in which the migration rate of DEHP from DEHPPPVC and sulfonated DEHP plasticised PVC (SDEHPPPVC) was measured; phase 2 of the study, in which the materials were incorporated into a rat recirculation biomaterial test model and blood samples taken to assess CD11b expression on neutrophils, IL-6 and Factor XIIa.

Results. The initial DEHP concentration washed from the surface after storage was 37.19 ± 1.17 mg/l in the PPVC group and 5.89 ± 0.81 mg/l in the SPPVC group (p<0.0001). The post-wash migration rate was 3.07 ± 0.32 mg/l/hour in the PPVC group compared to 0.46 ± 0.038 mg/l/hour in the SPPVC group (p<0.0001). In phase 2 of the study, CD11b expression increased by 228.9% ± 37% over the test period in the PPVC group compared to 118.3% ± 46% in the SPPVC group (p<0.01). IL-6 levels rose from 3.1 ± 1.4 pg/ml to 263 ± 26 pg/ml in the PPVC group and 2.2 ± 1.6 pg/ml to 161 ± 29 pg/ml in the SPPVC group (p<0.01). Factor XIIa levels rose from 0.22 ± 0.13 g/ml to 3.7 ± 0.32 µg/ml and 0.28 ± 0.09 to 2.71 ± 0.21 µg/ml in the PPVC and SPPVC groups, respectively (p<0.05 at 90 minutes).

Conclusions. The simple sulfonation process significantly retards the migration of DEHP and is associated with the moderation of contact activation processes.
“Science Discovers, Genius Invents, Industry Applies, and Man Adapts Himself . . .”: Some Thoughts on Human Autonomy, Law, and Technology
Authors: Chandler Jennifer
Published: February 2010

This short note considers the relationships between human autonomy, both individual and collective, and technology. At the collective level, numerous writers have observed the profound effects on society of technological discoveries — leading to the suggestion that societal mechanisms through which we might seek to make deliberate choices about technologies are ineffective. One such mechanism is the law, and I suggest through various examples that legal doctrines and judicial processes may indeed be limited in their ability to regulate technology. At the individual level, technologies have profound effects on human autonomy, both making certain choices possible but also changing the material and cultural environment in ways that make the adoption of technologies inescapable in a way that appears to erode human autonomy.
Exploring Technological Frontiers: Autonomy in Legal Scholarship
Authors: Moses Lyria Bennett
Published: February 2010

In 1999, Barton Beebe critiqued a “golden age” of space law in the 1950s and 1960s in which obscure legal issues concerning space exploration and aliens were addressed. This article describes a more recent “golden age” in legal scholarship, namely that relating to virtual worlds such as World of Warcraft and Second Life. The author examines the motivations of legal scholars who write about legal issues at this new technological frontier. She concludes that although new technology is often a site of new legal problems, a focus on technological aspects of particular issues cannot always be justified.
Evaluating the Effectiveness of the Trumbull Advocacy and Protective Network: A Formative Evaluation
Authors: Slivinske Lee R. , Slivinske Johanna D. , Causey Linda A. , Wyant Karla A.
Published: February 2010

The Trumbull Advocacy and Protective Network (TAPN) in Ohio is a county network of agencies in social services, government, medicine, law enforcement, and housing that coordinates and integrates services and programs for seniors with extraordinary needs. The purpose of this study was to assess the strengths and weaknesses of TAPN and make recommendations for improving its effectiveness. Seventeen TAPN member agencies participated in this formative evaluation in Phase 1, whereas 19 participated in Phase 2. The fact that mean scale scores for the TAPN Accomplishment Scale increased significantly over time was revealed by t tests. The most important changes were in addressing the special needs of older adults being served by more than one agency, advocating for the efficient and effective allocation of resources, enabling agencies to better serve their clients, and offering a “single focus location” for advocacy. Important future activities and functions of TAPN were identified, and the lessons learned were described.
Removing the Frontal Lobes
Authors: Filoteo J. Vincent , Lauritzen Scott , Maddox W. Todd
Published: February 2010

The present study examined the impact of engaging frontal-mediated working memory processes on implicit and explicit category learning. Two stimulus dimensions were relevant to categorization, but in some conditions, a third, irrelevant dimension was also presented. Results indicated that in both implicit and explicit conditions, the inclusion of the irrelevant dimension impaired performance by increasing the reliance on suboptimal unidimensional strategies. With three-dimensional stimuli, a striking dissociation was observed between implicit and explicit category learning when participants performed a sequential working memory task. With explicit category learning, performance was impaired further, and there was an increased use of suboptimal unidimensional strategies. However, with implicit category learning, the performance impairment decreased, and there was an increased use of optimal strategies. These findings demonstrate the paradoxical situation in which learning can be improved under sequential-task conditions and have important implications for training, decision making, and understanding interactive memory systems.
Valid Facial Cues to Cooperation and Trust
Authors: Stirrat M. , Perrett D.I.
Published: February 2010

Decisions about whom to trust are biased by stable facial traits such as attractiveness, similarity to kin, and perceived trustworthiness. Research addressing the validity of facial trustworthiness or its basis in facial features is scarce, and the results have been inconsistent. We measured male trustworthiness operationally in trust games in which participants had options to collaborate for mutual financial gain or to exploit for greater personal gain. We also measured facial (bizygomatic) width (scaled for face height) because this is a sexually dimorphic, testosterone-linked trait predictive of male aggression. We found that men with greater facial width were more likely to exploit the trust of others and that other players were less likely to trust male counterparts with wide rather than narrow faces (independent of their attractiveness). Moreover, manipulating this facial-width ratio with computer graphics controlled attributions of trustworthiness, particularly for subordinate female evaluators.
A Khmer Veteran Remembers
Authors: Chapman Jean
Published: February 2010

The argument made in this article is that while the Cold War rhetoric has retained a stranglehold on Kampuchea and her people, methodology driven by feminism and gender–sensitive methods gives an alternate reading of Khmer history. The detritus of war that includes landmines has played a significant role for over half a century. Fieldwork was conducted in a minefield in northwestern Kampuchea in 2005 and 2007. It was early in the research project that it became evident that the respondents in the study area had another story to tell. Based on ethnographic material that was gathered and analysed through the prism of gender relations, this article challenges the stereotypical images portrayed of Khmer war and its aftermath. One story in particular, herstory, reflects gender relations during a hot war conducted during the Cold War, disparagingly referred to as a ‘sideshow’ to the Vietnam War.
Women and Land in Timor-Leste
Authors: Narciso Vanda , Henriques Pedro
Published: February 2010

Gender and development being fundamental issues, it is important to emphasise the role of women in rural development, gender–specific approaches to development and women’s status in the national and international legal systems. The main aim of this article is to analyse the position of women in Timor-Leste by examining social aspects, with an emphasis on gender roles, the family and the community, access to natural resources and women’s status within the legal system and traditional legal structures, with special attention to land and women’s land rights. This study is based on documentary sources and studies made by the authors about Timor-Leste. The contribution of the women of Timor-Leste to development is heavily constrained by the degree of gender inequality present in traditional/customary law and social practices, and in-equality of access to natural resources, especially land. In overall terms, we would argue that the Human Rights Based Approach (HRBA) is one of the best approaches to guarantee gender equality, and that this approach should be considered in the formulation of rural policies and the creation and implementation of rural development programmes and projects in Timor-Leste.
Differentials in Health Care Access in India
Authors: Kundu Soma
Published: February 2010

Gender disparity in various socioeconomic and cultural spheres, a common phenomenon in India, has a cumulative effect upon the health status of women. Poor rural women are disadvantaged by both types of disparity—rural–urban disparity and male–female disparity. This article tries to explore the disparity in access to health care services between rural and urban women and the implications of this disparity upon their children’s health status.
An Econometric Analysis of Investment Spending of a Sub-national Government in India
Authors: Mohanty Bimal K.
Published: February 2010

Investment spending of a sub-national government in India is equated with its capital expenditure. This article analyses spending by the state government of Orissa. Inadequate provision of physical infrastructure has been a primary cause of poverty and unemployment in the state. Government investment expenditure is unavoidable for the creation of physical infrastructure in a state like Orissa and thereby it works as a feeder for increasing gross state domestic product and employment in private sector of the state economy. For a substantive empirical attestation of the proposition, an econometric exercise has been accomplished. Several tools from time-series econometrics have been used starting with causality and finally vector auto-regression (VAR) modelling. The econometric tools that have been used in this article conform rather than conflict with the conclusion reached at each stage. Such agreement is suggestive of the efficacy of the final results derived from the study.
Factor Mobility, Net Migration, Growth and the Lot of the Poorest Quintile in Developing Countries
Authors: Dao Minh Quang
Published: February 2010

This article examines the impact of factor mobility and migration on per capita gross domestic product (GDP) growth and the welfare of the poorest quintile in developing countries. Based on data from the World Bank and using a sample of 46 developing economies, we found that the per capita GDP growth is linearly dependent upon net migration, infrastructure investment, the level of educational attainment, the percentage of rural and urban population with sanitation and water services, the possible effect of improved health and investment. The regression results also show that the share of the poorest quintile in national consumption or income is a linear function of the level of urbanisation, the level of educational attainment, infrastructure investment and investment. These results could assist policy makers in developing countries identify areas in which budgets need to be reallocated to stimulate economic growth.
Violent Crime (and Suicide) in Imperial Germany, 1883—1902: Quantitative Analyses and a Durkheimian Interpretation
Authors: Thome Helmut
Published: February 2010

The article seeks to bridge the gap between the history and the sociology of violent crime and to contribute to the ongoing debate on the relationship between modernization and (criminal) violence. In particular, it demonstrates the usefulness of a theoretical perspective derived from Durkheim’s work. Durkheim’s thesis that the erosion of (traditional) collectivism leads to a significant reduction in violent crime is being tested and confirmed in an empirical analysis of crime data that originally were collected for some 1,000 counties and cities of the German Reich in late 19th century. The distinction between developmental and structural effects is crucial to the argument. Supportive evidence is provided by an additional analysis of suicide data. It is argued that Durkheim’s perspective also helps explain the more recent increase in violent crime during the second half of the 20th century. For this purpose, the distinction between collectivism and individualism needs to be supplemented by a modified version of Durkheim’s additional distinction of moral (cooperative) versus egoistic (disintegrative) individualism.
World System, Anthropogenic, and Ecological Threats to Bird and Mammal Species: A Structural Equation Analysis of Biodiversity Loss
Authors: McKinney Laura A. , Kick Edward L. , Fulkerson Gregory M.
Published: February 2010

Biodiversity is essential for human well-being, the functioning of ecosystems, and the sustained flow of benefits from ecosystems to individuals and societies. An important component of biodiversity is “species richness,” the number of species in an ecological unit. Loss of species richness contributes to worsening health, lower food security, and the increasing vulnerability of human and animal populations. This article examines the effects of relevant global, anthropogenic (human caused), and ecological factors on nations’ relative shares of the global total of threatened bird and mammal species for 139 countries. Using structural equation models, the authors tested hypothesized predictions from human ecology, ecological modernization, and global political-economic approaches. The findings indicate that the structure of the global system directly affects local anthropogenic factors (modernization, population), which, in concert with ecological characteristics, are direct and indirect predictors of the loss of species. This research emphasizes the importance of informed sociological analyses that account for both the direct and indirect effects of global forces and the conjoint importance of anthropogenic and ecological processes that contribute to a key form of environmental degradation.
Reinventing vs. Restoring Sustainability in the Maine Woods: Narratives of Progress and Decline
Authors: Welcomer Stephanie A.
Published: February 2010

In Maine, narratives of sustainability have emerged in response to a proposed national park to be located on forestland traditionally owned and managed by private forest products companies. These responses are evident in this case study of texts from 1994 to 2005, in which competing sustainability narratives are analyzed. The narratives detail how the past, present, and future of the state’s forests have been constructed as depicting the forest as either (a) a reinvented sustainable landscape or (b) an unsustainable landscape with potential to be restored. Although sustainability is a concept and practice germane to both those proposing a new use for the land and those fighting such a change, sustainability narratives take different shapes—of progress or decline—depending on how humans are depicted in relation to the forest. Thus, competing narratives portray progress as a reinvented forest and decline as a yet-to-be restored forest. This study contributes to understanding environmental issues as contested sustainability and offers an empirical longitudinal study of the forms and content of competing sustainability narratives. In 2005, the focus of this conflict shifted away from the park proposal and toward an application by Plum Creek Timber to develop portions of 426,000 acres, some of which are located in the park’s proposed region. A revised and approved version of Plum Creek’s development plan is currently under appeal.
Powerful or Just Plain Power-Full? A Power Analysis of Impact and Benefit Agreements in Canada’s North
Authors: Caine Ken J. , Krogman Naomi
Published: February 2010

Impact and benefit agreements (IBAs) between natural resource developers and Aboriginal communities are increasingly portrayed as viable approaches to assure Aboriginal people will reap economic benefits of resource extraction in their traditional territories. Drawing from existing literature about the social context of IBA negotiations, especially in Northern Canada, the authors’ analysis contributes to the study of negotiated agreements by using Lukes’s three dimensions of power to examine how IBAs confer particular advantages and disadvantages to Aboriginal people and proponents of development, thereby distributing power inequitably. The authors argue that, under some conditions, IBAs may provide more direct engagement with industry and a sharing of benefits from resource development than heretofore has been provided in Northern Canada. Depending on the before-, during- and after processes and outcomes, IBAs can also stifle Aboriginal people from sharing information about benefits negotiated by other groups, prevent deeper understanding of long-term social impacts of development, thwart subsequent objections to the development and its impacts, and reduce visioning about the type and pace of development that is desirable.
Review: Taking care of yourself in later life: A qualitative study into the use of non-prescription medicines by people aged 60+
Authors: Leontowitsch Miranda , Higgs Paul , Stevenson Fiona , Rees Jones Ian
Published: February 2010

The last 40 years have witnessed substantial changes to the experience of later life. Health and life expectancy have improved and the emergence of a putative third age has allowed post-working life to move beyond being a residual social category to become an arena in which later life lifestyles can be constructed. Greater emphasis is now placed on expectations of self-agency and choice. Allied to this is the growing role of consumerism as a way of organizing key aspects of social life. Not only do these changes place increased emphasis on individual responsibility for health, but they also engage individuals in various forms of health consumerism.This study draws on these aspects of contemporary society to provide an explanatory framework for understanding older people’s engagement with, and consumption of non-prescription medicines. We present a qualitative study in which we interviewed 22 men and women aged 60 plus who were purchasing or interested in purchasing non-prescription medicines, including complementary and alternative medicines. Our findings suggest that the use of non-prescription medicines is both pluralistic and makeshift. Moreover, while this pluralism led to tensions with conventional bio-medicine, conventional bio-medicine still maintained the legitimacy of its knowledge base. Self-care using non-prescription medicines appeared more governed by hope than by evidence or knowledge of the treatments concerned.We conclude that such pluralism of approach reflects the growing consumerism in health and self-care and that older people may in fact be similar to other age groups in terms of their approach to such commodification.
Disrupted lives and threats to identity: The experiences of people with colorectal cancer within the first year following diagnosis
Authors: Hubbard Gill , Kidd Lisa , Kearney Nora
Published: February 2010

In this article we focus on the experiences of 18 people with colorectal cancer, involved in a large longitudinal qualitative study to explore people’s experiences of cancer within the first year following diagnosis. Three depth interviews over the course of the year were carried out. During analysis, we drew on biographically informed approaches of understanding chronic illness, particularly the work of Bury and Charmaz, to explore the extent to which people within the first year following diagnosis experience cancer as biographically disruptive. We explore the biographical work that individuals carry out in the context of an assault on their identity and discuss the relevance of the concept biographical disruption for people who experience cancer as an acute, chronic and/or life-threatening condition. We also discuss the concept’s relevance for people who have lived a hard life and, hence, may anticipate these types of disruptions in their lives and experience their impact differently. We conclude that universal application of the concept biographical disruption to the experience of cancer within the first year of diagnosis is not appropriate. This study has implications for cancer services, in particular, the findings call for the development of interventions to support those people who experience cancer as an assault on their identity.
Reaching the parts that other theories and methods can’t reach: How and why a policy-as-discourse approach can inform health-related policy
Authors: Shaw Sara E.
Published: February 2010

This article illustrates how conceptualizing policy-as-discourse offers opportunities for those with a vested interest in policy to ‘reach the parts that other theories and methods can’t reach’. First, it explores the dialogical relationship between theory and method in the context of policy analysis, summarizing contemporary writing on conceptualizing and analysing policy and drawing on the work of Bacchi to describe the theoretical underpinnings of three different policy representations along with methodological corollaries, research practices and disclosures about the world that flow from each. This involves reflecting on three different answers to the question ‘what is policy?’: considering how policy might be conceptualized and analysed under each and narrating the kind of research stories that emerge. Second, the article focuses on one of Bacchi’s representations — policy-as-discourse — to provide readers with a case study of this dialogical relationship and drawing on published research exploring the development of primary care research policy to illustrate what elements of discursive policy analysis might look like. Last, the article concludes by reflecting on the ways in which such an approach may (and may not) prove valuable in analysing health-related policy.
Revisiting biographical disruption: Exploring individual embodied illness experience in people with terminal cancer
Authors: Reeve Joanne , Lloyd-Williams Mari , Payne Sheila , Dowrick Christopher
Published: February 2010

Biographical accounts of illness offer useful insights into the social and adaptive processes of living with chronic illness. Yet there are concerns that the underlying theoretical assumptions of a reflexive self seeking to maintain meaning may not reflect the lived experience of individuals. A narrative emphasis may neglect the importance of emotional/felt experiences; while an analytical focus on disruptive processes may not adequately reflect the totality of actual events. In this study, we explored how well biographical theory supports understanding of individual lived experience. Narratives from 19 individuals identified from General Practice lists with a terminal diagnosis of cancer were analysed using the holistic-form approach described by Lieblich. Participants described an ongoing process of living their life, ‘managing’ disruptive events and maintaining an overall sense of well-being (narrative form = biographical flow). For a minority, continuity was lost when people’s capacity to continue living their everyday lives was overwhelmed (narrative form = fracture). The identified emphasis was on individual creative capacity in the face of terminal illness, highlighting the importance of embodied experience in understanding outcome and need. Maintaining continuity was draining: exhaustion precipitated fracture and thus need for external help to restore continuity. By focusing on feelings associated with overall narrative form, rather than individual disruptive events, we highlight the context in which disruptive events are experienced, and individual perceptions of their relative importance. We conclude that combining narrative and emotion offers new insights into the value of understanding of biographical accounts of illness in the context of individual creative capacity. We discuss the possibilities for new approaches to clinical assessment and management of need.
The Use of Focus Groups to Compare Tobacco Attitudes and Behaviors Between Youth in Urban and Rural Settings
Authors: Rothwell Erin , Lamarque Johnelle
Published: February 2010

This exploratory study uses focus groups to examine the attitudes and behaviors of male adolescent tobacco users from urban and rural settings. Five focus groups, three urban and two rural, were conducted ( n = 28). Results indicate that this is an interesting topic that generated interactions and discussion among participants. Themes that have emerged from the data include the sociability of tobacco initiation and access; tobacco preferences linked to image; social norms against secondhand smoke exposure, especially around children; ambivalence toward daily use as a habit versus an addiction; and avoidance of discussing cessation. The data from this study can help health departments distinguish and target prevention and intervention programs for youth in urban and rural settings.
The Primary Care Nutrition Training Program
Authors: Levy Joslyn , Harris Jeff , Darby Pamella , Sacks Rachel , Dumanovsky Tamara , Silver Lynn
Published: February 2010

The New York City Department of Health has designed a Primary Care Nutrition Training program for implementation in high-need neighborhoods that face growing diet-related epidemics of diabetes and obesity and a heavy burden of cardiovascular disease. Seven hundred fifty-six primary care team members complete pretest surveys and 665 complete posttest surveys at 45 training sessions between January and July 2007. Skills-building sessions center on the innovative application of visual aids and manipulatives and the provision of specific language for addressing nutritional issues with patients in busy primary care settings. Program evaluation data indicate that the training was well received by participants of all education levels, including medical assistants, physicians, nurses, and others, with 91% noting that the training content was pitched at about the right comprehension level for them. The Primary Care Nutrition Training Program offers a practical approach to continuing education for health professionals that may help to address the dearth of nutrition services currently in urban primary care.
An Applied Simulation Model for Estimating the Supply of and Requirements for Registered Nurses Based on Population Health Needs
Authors: Tomblin Murphy Gail , MacKenzie Adrian , Alder Robert , Birch Stephen , Kephart George , O'Brien-Pallas Linda
Published: February 2010

Aging populations, limited budgets, changing public expectations, new technologies, and the emergence of new diseases create challenges for health care systems as ways to meet needs and protect, promote, and restore health are considered. Traditional planning methods for the professionals required to provide these services have given little consideration to changes in the needs of the populations they serve or to changes in the amount/types of services offered and the way they are delivered. In the absence of dynamic planning models that simulate alternative policies and test policy mixes for their relative effectiveness, planners have tended to rely on projecting prevailing or arbitrarily determined target provider—population ratios. A simulation model has been developed that addresses each of these shortcomings by simultaneously estimating the supply of and requirements for registered nurses based on the identification and interaction of the determinants. The model’s use is illustrated using data for Nova Scotia, Canada.
Immune Response to Resistance Exercise
Authors: Koch Alexander J.
Published: February 2010

Resistance exercise produces transient perturbations in immunity, including alterations in circulating leukocyte numbers, cytokine concentration, and some measures of cell function. These changes are typically interpreted as being transiently detrimental to host defense. The mechanisms responsible for these immune fluctuations appear to be neuroendocrine-mediated alterations in cell trafficking and function and microtrauma-mediated alterations in cytokine release. Alterations in immunity following resistance exercise appear to be similar in pattern but smaller in magnitude than those typically seen after long, vigorous endurance exercise and are resolved within a few hours. However, resistance exercise—induced changes in immunity may become clinically relevant after repeated exercise bouts with insufficient recovery. Regular training appears to attenuate the immune response to resistance exercise. Care should be taken to ensure that resistance training is planned, with adequate variation in intensity and volume over time, to ensure recovery between sessions and to avoid chronic systemic inflammation.
Predicting MHC class I epitopes in large datasets
Authors: Roomp Kirsten , Antes Iris , Lengauer Thomas
Published: February 2010

Background

Experimental screening of large sets of peptides with respect to their MHC binding capabilities is still very demanding due to the large number of possible peptide sequences and the extensive polymorphism of the MHC proteins. Therefore, there is significant interest in the development of computational methods for predicting the binding capability of peptides to MHC molecules, as a first step towards selecting peptides for actual screening.

Results

We have examined the performance of four diverse MHC Class I prediction methods on comparatively large HLA-A and HLA-B allele peptide binding datasets extracted from the Immune Epitope Database and Analysis resource (IEDB). The chosen methods span a representative cross-section of available methodology for MHC binding predictions. Until the development of IEDB, such an analysis was not possible, as the available peptide sequence datasets were small and spread out over many separate efforts. We tested three datasets which differ in the IC50 cutoff criteria used to select the binders and non-binders. The best performance was achieved when predictions were performed on the dataset consisting only of strong binders (IC50 less than 10 nM) and clear non-binders (IC50 greater than 10,000 nM). In addition, robustness of the predictions was only achieved for alleles that were represented with a sufficiently large (greater than 200), balanced set of binders and non-binders.

Conclusions

All four methods show good to excellent performance on the comprehensive datasets, with the artificial neural networks based method outperforming the other methods. However, all methods show pronounced difficulties in correctly categorizing intermediate binders.