bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectives on prevention: the views of General Practitioners
Authors: Williams Simon J. , Calnan Michael
Published: February 2004

Over the years there has been increasing support from a number of different sources for General Practitioners and their primary health care teams to have greater involvement in prevention. However, while attention has been paid to what leading figures and official bodies such as the Royal College of General Practitioners say there has been less emphasis upon what the rank‐and‐file of GPs themselves think and feel about prevention. Hence, this paper reports on the results of a small‐scale exploratory study of 40 GPs' perceptions of coronary heart disease (CHD) prevention. In particular it addresses three main issues: first, the value which GPs place upon prevention and their concepts of prevention; second, the extent to which they view prevention as problematic and the reasons given; finally, in the light of these issues, the manner in which they attempt to resolve these dilemmas. Whilst GPs appeared to positively endorse the principle of prevention, they nonetheless tended to view it as problematic and had limited personal involvement. In this respect five key themes emerged in GPs' accounts: i) that health promotion and prevention was tedious, dull and boring; ii) the constraints of time and the manner in which it detracted from curative medicine; iii) the uncertainties of risk factor identification and interventions; iv) ambivalence towards the effectiveness of behavioural change and the problem of patient motivation, and finally; v) a concern that it represented a moral intrusion and inflated patients anxiety levels unnecessarily. Beyond the voicing of these concerns, the main way in which GPs attempted to resolve these dilemmas was by delegating much of this work to a new and relatively low‐status member of the primary health care team: the practice nurse.
The medico‐legal production of fatal accidents
Authors: Green Judith
Published: February 2004

There has been a considerable sociological interest in suicide, but accidents have attracted little theoretical study. This paper is concerned with the ways in which some fatalities are classified as ‘accidental death’ through the processes of the Coroner's Court. Critiques of the positivist tradition in suicide research are taken as a departure to examine the role of the Coroner in the classification of some deaths as accidental. The modern English Coroner has two functions, neutral fact‐finding for the state and moral amelioration, which are in potential conflict during an inquest. There is no official definition of an ‘accidental death’: such events are produced through a moral analysis of the facts surrounding a death and through the resulting process of demarcating them from other, more culpable, deaths.
Smoking in pregnancy: smokescreen or risk factor? Towards a materialist analysis
Authors: Oakley Ann
Published: February 2004

This paper considers the topic of women's smoking in pregnancy within the general context of the current health promotion concern about smoking as a public health issue. Drawing on data from an ongoing research project which is investigating the interrelationships between‘risk’, social support and reproductive health, the paper argues that smoking in pregnancy constitutes an area of women's behaviour which is linked in systematic ways with aspects of their material and social position. Consequently, conventional individualist models of smoking behaviour both fail to explain why pregnant women smoke and are unable adequately to account for the health consequences of this behaviour. The reason for singling out smoking in this analysis inheres not in any detrimental health effect directly attributable to it, but rather to the way in which pregnancy smoking has been socially constructed as a reprehensible feature of women's life‐styles.
Prevention is better …
Authors: Roberts Helen , Smith Susan , Bryce Carol
Published: February 2004

There have been a number of important critiques of the idea of prevention from a theoretical viewpoint, but in practice the value of preventive activities has been less subject to critical appraisal, and less well substantiated by research, than the enthusiasm for them might indicate. The government White Paper The Health of the Nation published in July 1992 focusses on five health issues where preventive work is advocated. This is likely to lead to an increase in health promotion activities. One of the areas prioritised in the White Paper is accidents. This paper explores a number of current preventive efforts in this field, and illustrates prevention in action by drawing on a study of safety as a social value. Fundamental differences in approach to prevention by professionals and citizens identified in this study indicate that if the flow of work stemming from the White Paper is to be effective, citizen conceptions of need in this area will have to be more seriously addressed than has been the case in the past. One means of doing this is through the establishment of hazard or risk surveillance systems at a local level, complementing the injury surveillance systems which inevitably focus on the sequelae rather than the antecedents, of accidents.
The redefinition of the situation: the social construction of spiritual healing experiences.
Authors: Glik Deborah C.
Published: February 2004

This paper is based on interviews with 160 persons who were participants in spiritual healing groups in Baltimore between 1981 and 1983. Survey data are used to describe how participants in spiritual healing groups presented their health problems, and how and if these problems were resolved or 'healed' over a six‐month period. The majority of respondents claimed some degree of healing, associated mainly with symptom alleviation rather than cure. A process of health problem redefinition occurred among some respondents, that provided better 'fit' with outcome descriptions of healing than original problem formulations. Redefined health problems were often less serious, less medical, more chronic, and more 'emergent' than those initially defined, and respondents who redefined problems were significantly more likely to claim a healing experience. 'Psychologisation' of problems suggest that healing experiences can be conceived as socially constructed events.
Research note: Blood drawing and hepatitis B ‐‐ the case of Ethiopian Jews in Israel.
Authors: Chemtob Daniel , Kalka Iris , Fassberg Yossef
Published: February 2004

This paper describes the first stage of a prospective study created to evaluate a public health problem ‐ hepatitis B virus (HBV) infection ‐ and to design a strategy of prevention suitable for the target population, Ethiopian Jews in Israel. In the first stage of the study serological tests were conducted on 165 Ethiopian Jews, all of whom were residing in one location. This stage was designed to estimate the prevalence of HBV infection and to identify the high risk groups. The paper explores the response of Ethiopian Jews to the procedures which the research involved as well as to the researchers. It thus presents a methodological case history, demonstrating the way in which the perceptions of the subjects can affect the outcome of a research programme. It also makes evident the advantages of adding qualitative data to an epidemiological study, if these responses are to be understood. The response of the target population was connected with the position of these newcomers in the new land. It was also influenced by perceptions of blood and blood drawing, which had been changing since their arrival in Israel. The relationships of Ethiopian Jews with the religious establishment in Israel were found to be linked to perceptions of blood and blood drawing.
Service users' views of psychiatric treatments
Authors: Rogers Anne , Pilgrim David
Published: February 2004

Compared to other types of patients, the views of mental health service users have been attended to infrequently by sociologists. This paper presents quantitative and qualitative data on patients’ views of their psychiatric treatments. The data was derived from a piece of action research conducted by the authors on behalf of the mental health charity MIND. With the exception of anti‐depressants, chemotherapy is substantially criticised, as is Electro Convulsive Therapy. Hospital based interventions (whatever their type) receive the poorest endorsement from recipients. Overall, talking treatments are favoured although group therapy is disliked. The data is discussed in the context of other sociological work on the lay perspective.
Spectral Properties in Modon Stability Theory
Authors: Swaters Gordon E.
Published: February 2004

Spectral properties of an invariant functional, denoted by H, for the linear stability equation associated with the modon, or solitary drift vortex, solutions of the quasi‐geostrophic equivalent barotropic potential vorticity, or Charney–Hasegawa–Mima (CHM), equation are investigated. It is shown that H, which is the only known quadratic invariant in modon stability theory, is identical in form to the second variation of a “Benjamin‐like” variational principle for solitary vortices. However, such a principle does not exist for the modon. The discrete spectrum of the “form operator” in H contains two simple negative eigenvalues and the simple zero eigenvalue. For the leftward‐traveling solution there are only a finite number of positive eigenvalues. For the rightward‐traveling solution, there are a countable infinity of positive eigenvalues. A sharp lower bound on the spectrum, for both the rightward‐ and leftward‐traveling solutions, and a sharp upper bound for the leftward traveling solution, is determined. For the leftward‐traveling solutions, the eigenfunctions span a finite‐dimensional vector space and are orthogonal with respect to an inner product which is valid for all of L2. For the rightward‐traveling solutions, the eigenfunctions span an infinite‐dimensional Hilbert space, but are orthogonal with respect to an inner product, which is not valid for all of L2.
The Spectrum of a Linearized 2D Euler Operator
Authors: Latushkin Y. , Li Y. C. , Stanislavova M.
Published: February 2004

We study the spectral properties of the linearized Euler operator obtained by linearizing the equations of incompressible two‐dimensional fluid at a steady state with the vorticity that contains only two nonzero complex conjugate Fourier modes. We prove that the essential spectrum coincides with the imaginary axis, and give an estimate from above for the number of isolated nonimaginary eigenvalues. In addition, we prove that the spectral mapping theorem holds for the group generated by the linearized 2D Euler operator.
Generation of Secondary Solitary Waves in the Variable‐Coefficient Korteweg–de Vries Equation
Authors: Grimshaw R. H. J. , Pudjaprasetya S. R.
Published: February 2004

We consider the solitary wave solutions of a Korteweg–de Vries equation, where the coefficients in the equation vary with time over a certain region. When these coefficients vary rapidly compared with the solitary wave, then it is well known that the solitary wave may fission into two or more solitary waves. On the other hand, when these coefficients vary slowly, the solitary wave deforms adiabatically with the production of a trailing shelf. In this paper we re‐examine this latter case, and show that the trailing shelf, on a very long time‐scale, can lead to the generation of small secondary solitary waves. This result thus provides a connection between the adiabatic deformation regime and the fission regime.
The non‐fiction reading habits of young successful boy readers: forming connections between masculinity and reading
Authors: Smith Susannah
Published: February 2004

The reading experiences of six young successful boy readers were studied over a two‐year period. In this article, their non‐fiction reading is analysed and ways in which the boys make positive connections between masculinity and reading are identified. The boys' non‐fiction reading centres on typical boy interest areas and hobbies (for example, football, space, dinosaurs) and, through their reading, they have become experts on these areas. This has earned them respect from their peers, particularly other boys, and a high status, hegemonic masculine identity in the classroom. Thus, for this group of boys, unlike many other boys, masculinity and reading are compatible; in this particular version of masculinity, reading is a desirable pursuit.
Shaping identities: the reading of young bilinguals
Authors: Jones Susan
Published: February 2004

How far do bilingual readers identify with the ‘implied readers’ of the texts they read? This article explores this question through a quantitative analysis of the reading habits of a sample of 100 English secondary‐school students, mainly from southern Asian backgrounds. Particular focus is given to the way a bilingual reader may or may not be able to identify with the implied reader in the particular texts to which they are exposed, and attendant implications. It was found that reading in the mother tongue played only a small part in the lives of the majority of respondents. It is argued, therefore, that the dominance of Anglo‐American culture in the lives of these students (and, indeed in the lives of bilingual adolescents across many parts of the world) places pressure on the home language and culture of bilingual adolescents to compete with the experience offered to them, at a time when they are already striving to form an individual identity. Parallels are drawn between the experiences of young Welsh–English bilinguals and those of young Urdu/Punjabi–English bilinguals, and recommendations are made based on the current successes of the model of publishing children's fiction in Wales. The students in this study are of secondary school age, but the analysis and implications have a wider relevance.
Challenging the Bioethical Application of the Autonomy Principle within Multicultural Societies
Authors: Fagan Andrew
Published: February 2004

abstract  This article critically re‐examines the application of the principle of patient autonomy within bioethics. In complex societies such as those found in North America and Europe health care professionals are increasingly confronted by patients from diverse ethnic, cultural, and religious backgrounds. This affects the relationship between clinicians and patients to the extent that patients’ deliberations upon the proposed courses of treatment can, in various ways and to varying extents, be influenced by their ethnic, cultural, and religious commitments. The principle of patient autonomy is the main normative constraint imposed upon medical treatment. Bioethicists typically appeal to the principle of patient autonomy as a means for generally attempting to resolve conflict between patients and clinicians. In recent years a number of bioethicists have responded to the condition of multiculturalism by arguing that the autonomy principle provides the basis for a common moral discourse capable of regulating the relationship between clinicians and patients in those situations where patients’ beliefs and commitments do or may contradict the ethos of biomedicine. This article challenges that claim. I argue that the precise manner in which the autonomy principle is philosophically formulated within such accounts prohibits bioethicists’ deployment of autonomy as a core ideal for a common moral discourse within multicultural societies. The formulation of autonomy underlying such accounts cannot be extended to simply assimilate individuals’ most fundamental religious and cultural commitments and affiliations per se. I challenge the assumption that respecting prospective patients’ fundamental religious and cultural commitments is necessarily always compatible with respecting their autonomy. I argue that the character of some peoples’ relationship with their cultural or religious community acts to significantly constrain the possibilities for acting autonomously. The implication is clear. The autonomy principle may be presently invalidly applied in certain circumstances because the conditions for the exercise of autonomy have not been fully or even adequately satisfied. This is a controversial claim. The precise terms of my argument, while addressing the specific application of the autonomy principle within bioethics, will resonate beyond this sphere and raises questions for attempts to establish a common moral discourse upon the ideal of personal autonomy within multicultural societies generally.
Identity‐Neutral and Identity‐Constitutive Reasons for Preserving Nature
Authors: Musschenga Albert W.
Published: February 2004

abstract  Environmental ethicists will often say that in dealing with natural entities we need the guidance of an ethic rooted in ‘the intrinsic value of nature’. They will add that subjectivist value theories are unable to account for the normativity of intrinsic value discourse. This preoccupation with normativity explains why many environmental ethicists favour value objectivism.

As I see it, value theories must address not only the problem of normativity but also the problem of motivation. In fact, my approach to the question as to which type of value theory does most justice to our intuition regarding the value of nature is primarily in terms of the motivational perspective. I argue that neither the usual objectivist theories nor their subjectivist counterparts can accommodate and explain the fact that those who agree that nature has intrinsic value may well differ in motivation to support its preservation. I suggest that such difference in kinds of motivation is related to distinct kinds of value judgement in which belief in the intrinsic value of nature is expressed.

To clarify my view I discuss the subjectivist value theory of Gerald Gaus[1]. Gaus regards the distinction between personal and impersonal value judgements to be deeply embedded in his theory. His internalism about the relation between reason and motivation however, leads him to the mistaken conclusion that independent impersonal value judgements do not provide reasons for action. Next, I introduce the distinction between identity‐neutral and identity‐constitutive reasons. This distinction allows me to formulate more clearly the differences between the kinds of reasons provided by personal and impersonal value judgements.

The resulting theory explains how it is that people who do not (personally) value nature may still be motivated to support nature preservation. It also explains why not everyone who endorses natural values will join movements for the preservation of nature.
The Timeliness of Income Recognition by European Companies: An Analysis of Institutional and Market Complexity
Authors: Raonic Ivana , McLeay Stuart , Asimakopoulos Ioannis
Published: February 2004

This study examines international differences in the asymmetric timeliness of accounting earnings by modelling international exposure to different jurisdictions as a firm‐specific effect, using an index of regulatory complexity that relates to conditions in each of the capital markets in which the firm's equity is listed. The companies investigated are those with shares cross‐listed on European stock exchanges, some of which are also listed in New York. Variation across jurisdictions and markets with respect to earnings timeliness and conservatism can be explained in part as an interaction of market effects and regulatory effects, with some evidence of opposition between the two, and the sensitivity of earnings to stock price changes shows a common, converging trend towards greater accounting conservatism in Europe.
Are Economically Significant Stock Returns and Trading Volumes Driven by Firm‐specific News Releases?
Authors: Ryan Paul , Taffler Richard J.
Published: February 2004

This paper explores whether firm‐specific information events drive economically relevant positive and negative stock price changes and trading volume and, if so, the nature of such information. We find that no less than 65% of significant price changes and trading volume movements in our sample of FTSE 350 companies can be readily explained by public domain information contradicting the thesis that corporate news is not a primary driver, and that share price changes and trading volume activity are driven by factors unrelated to information flows per se. In addition, we find that a parsimonious set of news categories represent the key drivers. Sell‐side analyst stock recommendations and earnings forecast revisions as a class, unaccompanied by other news releases, dominate all other news categories in terms of significant market reaction. However, taking into account the relative magnitude of market response to different news releases, firms’ formal accounting disclosures dominate within this domain. As such, we conclude these are not fully anticipated by apparently more timely market disclosures, and that the existence of news services and the activities of the sell‐side analyst are not substitutes for a firm's interim and preliminary results.
Increasing Market Share as a Rationale for Corporate Acquisitions
Authors: Ghosh Aloke
Published: February 2004

This study examines the relative importance of market share in acquisitions because anecdotal evidence and economic theory suggest that merging firms benefit from larger market share. Firms might focus on market share to improve shareholder value through improved efficiency, which benefits consumers. Alternatively, higher market share could generate greater market power, which adversely affects consumers. I find that market share of merging firms increases by more than 30%, relative to the pre‐acquisition level, and the increase is even larger after I account for industry changes. Abnormal returns are positively correlated with changes in market share around acquisitions, but not with changes in industry concentration, which suggests stock market's expectation of future benefits from efficiency rather than market power. More directly, I find that merging firms’ long‐run profitability increases with market share, and the increase in profitability primarily results from better asset management.
What Role Taxes and Regulation? A Second Look at Open Market Share Buyback Activity in the UK
Authors: Oswald Dennis , Young Steven
Published: February 2004

This paper re‐examines the evidence on open market share repurchase activity reported by Rau and Vermaelen (2002) for the UK. Using data from the Securities Data Corporation (SDC), Rau and Vermaelen conclude that the level of repurchase activity is trivial. They attribute the low repurchase volume to regulatory restrictions that limit companies' ability to take advantage of an undervalued stock price and conclude that the bulk of repurchase activity that does occur is driven by the desire to generate tax credits for pension funds. Using data collected from a variety of sources, we find that the SDC substantially understates UK open market buyback activity. Based on our more comprehensive dataset we conclude that (a) pension funds' tax considerations are not the primary cause of UK share repurchases and (b) despite the prevailing regulatory environment, underpricing still represents an important determinant of repurchase activity.
Human Vulnerability, Dislocation and Resettlement: Adaptation Processes of River‐bank Erosion‐induced Displacees in Bangladesh
Authors: Mutton David , Haque C. Emdad
Published: February 2004

The purpose of this research was to identify and analyse patterns of economic and social adaptation among river‐bank erosion‐induced displacees in Bangladesh. It was hypothesised that the role of social demographic and socio‐economic variables in determining the coping ability and recovery of the river‐bank erosion‐induced displacees is quite significant. The findings of the research reveal that displacees experience substantial socio‐economic impoverishment and marginalisation as a consequence of involuntary migration. This in part is a socially constructed process, reflecting inequitable access to land and other resources. Vulnerability to disasters is further heightened by a number of identifiable social and demographic factors including gender, education and age, although extreme poverty and marginalisation create complexity to isolate the relative influence of these variables. The need to integrate hazard analysis and mitigation with the broader economic and social context is discussed. It is argued that the capacity of people to respond to environmental threats is a function of not only the physical forces which affect them, but also of underlying economic and social relationships which increase human vulnerability to risk. Hazard analysis and mitigation can be more effective when it takes into account such social and demographic and socio‐economic dimensions of disasters.
Where to Go? Strategic Modelling of Access to Emergency Shelters in Mozambique
Authors: Gall Melanie
Published: February 2004

This paper, through spatial‐analysis techniques, examines the accessibility of emergency shelters for vulnerable populations, and outlines the benefits of an extended and permanently established shelter network in central Mozambique. The raster‐based modelling approach considers data on land cover, locations of accommodation centres in 2000, settlements and infrastructure. The shelter analysis is a two‐step process determining access for vulnerable communities first, followed by a suitability analysis for additional emergency shelter sites. The results indicate the need for both retrofitting existing infrastructure (schools, health posts) to function as shelters during an emergency, and constructing new facilities — at best multi‐purpose facilities that can serve as social infrastructure and shelter. Besides assessing the current situation in terms of availability and accessibility of emergency shelters, this paper provides an example of evaluating the effectiveness of humanitarian assistance without conventional mechanisms like food tonnage and number of beneficiaries.
Moving Upstream: Becoming a Public Health Nurse, Part 2
Authors: SmithBattle Lee , Diekemper Margaret , Leander Sheila
Published: February 2004

Abstract  This article extends the argument in Part 1 that stand‐ ards, protocols, textbook knowledge, and other external guidelines, while important for beginners, must yield to the “real world” of practice. Additional narratives document how the development of practical reasoning, perceptual skills, and responsiveness to clients supplants the beginner's reliance on external guidelines and promotes a situated understanding of practice. This growth in understanding and clinical know‐how, cultivated by frontline experience with individuals and families, fosters a perceptual grasp of the “big picture” and makes it possible for the nurse to learn the community through the eyes of clients. Experiences from home visiting and community‐based activities provide critical lessons that inform and inspire nurses to act and think upstream. This interpretation provides additional evidence for legitimating clinical practice as a rich source of situated knowledge and clinical reasoning.
Integrating Research into Teaching Public Health Nursing
Authors: Ervin Naomi E. , Cowell Julia M.
Published: February 2004

Abstract  Integration of research into teaching provides an environment for students to not only learn how research is conducted but also experience how research contributes to improving practice and client outcomes. Integrating research into teaching is important because of the need to build evidence for public health nursing practice. This article describes an innovative approach by faculty to integrate research into teaching undergraduate and graduate public health nursing courses. This approach was developed using the Mexican‐American Problem Solving research study. The purpose of the Mexican‐American Problem Solving study was to develop, test, and refine a home‐ and school‐based nursing intervention to improve family functioning, children's health conceptions, self‐esteem, and mental health. Students were involved in all aspects of the study, including focus group sessions, instrument translation, data collection, intervention implementation, and dissemination of the results. The authors describe these activities and provide recommendations for successfully involving students in faculty research.
Public Health Nursing in Ireland: A Critical Overview*
Authors: Clarke Jean
Published: February 2004

Abstract  The World Health Organization have stressed the importance of nurses and midwives as a “force for health” in society's efforts to tackle the public health challenges of our time. The public health challenges are both diverse and complex. Principally, they emanate from a social model of health that takes cognizance of our behavior, our environment, and the historical, political, and cultural structures that facilitate health or militate against it. This paper provides a critical overview of public health nursing in Ireland, toward situating both our contribution to public health and some of the challenges that lie ahead of us. Specifically, it looks at nonquantifiable practice, where, through the presentation of stories, the wealth of public health nursing work is demonstrated in the ordinary voices of public health nurses. The potential risk of ignoring and minimizing the contribution of public health nursing in future developments in primary care in Ireland is discussed. Finally, it is proposed that public health nurses need to get political.
Expression of vanilloid receptor subtype 1 in cutaneous sensory nerve fibers, mast cells, and epithelial cells of appendage structures
Authors: Ständer Sonja , Moormann Corinna , Schumacher Mark , Buddenkotte Jörg , Artuc Metin , Shpacovitch Victoria , Brzoska Thomas , Lippert Undine , Henz Beate M. , Luger Thomas A. , Metze Dieter , Steinhoff Martin
Published: February 2004

Abstract:  The vanilloid receptor subtype 1 (VR1)/(TRPV1), binding capsaicin, is a non‐selective cation channel that recently has been shown in human keratinocytes in vitro and in vivo. However, a description of VR1 localization in other cutaneous compartments in particular cutaneous nerve fibers is still lacking. We therefore investigated VR1 immunoreactivity as well as mRNA and protein expression in a series (n = 26) of normal (n = 7), diseased (n = 13) [prurigo nodularis (PN) (n = 10), generalized pruritus (n = 1), and mastocytosis (n = 2)], and capsaicin‐treated human skin (n = 6). VR1 immunoreactivity could be observed in cutaneous sensory nerve fibers, mast cells, epidermal keratinocytes, dermal blood vessels, the inner root sheet and the infundibulum of hair follicles, differentiated sebocytes, sweat gland ducts, and the secretory portion of eccrine sweat glands. Upon reverse transcriptase‐polymerase chain reaction and Western blot analysis, VR1 was detected in mast cells and keratinocytes from human skin. In pruritic skin of PN, VR1 expression was highly increased in epidermal keratinocytes and nerve fibers, which was normalized after capsaicin application. During capsaicin therapy, a reduction of neuropeptides (substance P, calcitonin gene‐related peptide) was observed. After cessation of capsaicin therapy, neuropeptides re‐accumulated in skin nerves. In conclusion, VR1 is widely distributed in the skin, suggesting a major role for this receptor, e.g. in nociception and neurogenic inflammation.
‘And When did You Last See Your Father?’ Exploring the Views of Children with Learning Difficulties/Disabilities
Authors: Lewis Ann
Published: February 2004

The Gulliford Lecture 2003 was given by Professor Ann Lewis of the School of Education at the University of Birmingham. Professor Lewis's lecture, on which this article is based, focused on the process of listening to the views of children and, in particular, children with learning difficulties. Following the near‐universal ratification of the United Nations (UN) Convention on the Rights of the Child, a plethora of recent initiatives, both in the UK and internationally, has encouraged professionals to access children's views about provision (educational, health‐related, social and legal). A range of materials has been developed to support this process, often by, or in liaison with, children's charities. At the same time, research provides valuable insights into effective practice in exploring the views of children with learning difficulties. In this article, Ann Lewis reviews ten strategies for gathering the views of children and raises four challenges for the further development of policy and practice. She closes her argument with a call for greater rigour and critical evaluation in this crucial and demanding area.
Connectedness: Developing a Shared Construction of Affect and Cognition in Children with Autism
Authors: Sherratt Dave , Donald Gill
Published: February 2004

Dave Sherratt and Gill Donald teach children with autism at Mowbray School, North Yorkshire. Dave Sherratt also teaches at the University of Birmingham and is honorary research fellow at the University College of York St John. Gill Donald is also a specialist speech and language therapist for Hambleton and Richmondshire Primary Care Trust. In this article, Dave Sherratt and Gill Donald outline an approach to teaching children who are on the autistic spectrum. They describe the social construction of understanding in normally developing children and suggest ways in which this differs in children with autism. These children may have difficulties in attributing relevance to the aspects of experience that are regarded as significant by most learners. The authors suggest that this may account for the poverty in social engagement or connectedness commonly observed in children with autism. Illustrating their propositions with vivid examples from practice, Dave Sherratt and Gill Donald go on to describe ten teaching structures promoting progress from early social engagement; through a shared understanding of objects and observable processes; to a shared understanding of symbolic representation in play, ideas and language. These structures, rooted in a fascinating evocation of theory, will help practitioners striving to develop a shared understanding of self, others and the environment in children with autistic spectrum disorders.
A Social Development Curriculum: Applying Nurture Group Principles and Practices to Support Socially and Emotionally Vulnerable Children Within Mainstream Classrooms
Authors: Doyle Rebecca
Published: February 2004

Rebecca Doyle set up the first nurture group in Thetford Education Action Zone in 2000. In 2001, she published an account of her work to reintegrate pupils from the nurture group into the mainstream of their infant school in the pages of BJSE. In this article, Rebecca Doyle describes how mainstream class teachers requested further support in working with socially and emotionally vulnerable children in their classes using the principles and practices from the nurture group. A social development curriculum was written to support this interest, offering mainstream staff a planning tool to complement their existing schemes of work and to help in the drive to make the curriculum appropriate for every child, regardless of their barriers to learning. This article indicates that mainstream staff are now able to bring the increasing knowledge of nurture group working to the fore in their planning, supporting the development of whole‐school nurturing approaches. The social development curriculum has become a well‐used document alongside current planning frameworks, supporting staff in meeting the diverse needs of pupils within mainstream classrooms with minimal cost and little additional workload.

In closing her article, Rebecca Doyle argues that the social development curriculum has had a positive impact upon the pupils in her school and upon her colleagues on the staff. She is pursuing her research into nurturing approaches through her membership of the National Nurture Group Network and her studies for a higher degree at the University of East Anglia.
Living with a disability that others do not understand
Authors: Munyere Alex
Published: February 2004

Last year, Martyn Rouse organised a project focused on inclusive education for the British Council. As part of the link between the University of Cambridge, the Ministry of Education in Kenya and Kenyatta University, your editor was lucky enough to be invited to visit Kenya. Martyn and I spent much of our time running workshops and attending meetings, but we were also able to visit some schools in far‐flung rural areas. I recall walking into one village where a group of school children were walking down the street in an orderly line. When they saw us, their curiosity and excitement overtook them and they started to call out: ‘mzungu! mzungu!’, which means ‘white man’. They laughed and waved and it was an unusual, and rather pleasant, feeling for me to be regarded as something so exotic and rare. But when I met Alex Munyere, at a workshop on inclusive education in Nakuru, I came to see another side to the experience of being perceived as different. Alex has albinism, which means that he has blond hair and white skin and experiences some difficulties with his sight. He is also a member of the Maasai community, who traditionally live under the broad, tropical skies of the heartlands of Kenya. In this article, Alex Munyere recalls his childhood and his life at school. He provides a fascinating first‐hand account of the experience of living with a disability. Alex is now a respected professional who works with children with special educational needs in the assessment centre in Kajiado district in Kenya. He is a quiet and dignified man but he is passionately committed to the development of inclusion in his country. These qualities are evident in the thoughtful reflections he provides here on the relationships between specialist provision and the development of an inclusive society. I suggest that Alex's story can be instructive for us all.
The Concept of Inclusive Education: Teacher Training and Acquisition of English Language in the Hearing Impaired
Authors: Wamae Gertrude M. I. , Kang'ethe‐Kamau Rachael W.
Published: February 2004

Three languages are widely used in schools in Kenya – English, Kiswahili and Kenya Sign Language. Many pupils with hearing impairments are taught separately from the mainstream, in specialist settings. The fact that most of the formal teaching, assessment and examination processes in Kenyan schools rely upon spoken and written English compounds the separation of these pupils from the mainstream of education and, potentially, from the mainstream of society. In this article, Gertrude Wamae, graduate assistant in the Department of English and Linguistics at Kenyatta University, and Rachael Kang'ethe‐Kamau, lecturer in the Department of Special Education at Kenyatta University, discuss the relationships between language, hearing impairment and inclusion in the Kenyan context. The article suggests that the use of signed exact English would enhance opportunities for inclusion for those with hearing impairments and that programmes of teacher training need to take account of persuasive research in this area. The article closes with a plea for further research, carried out collaboratively by educationalists, linguists, teacher trainers and practitioners, to develop policies and practices suited to more inclusive futures. The article is based on a paper presented to the International Conference on Inclusive Education run by Maseno University in September 2002.
Development and testing of an instrument to assess the Quality of Life of Children with Haemophilia in Europe (Haemo‐QoL)
Authors: Von Mackensen S. , Bullinger M. ,   Haemo‐QoL Group
Published: February 2004

Summary.  In spite of an increased interest in the assessment of quality of life (QoL) in children, so far no instrument for children with haemophilia is available. Because of the low prevalence of the condition, such an instrument should also be cross‐culturally applicable. In the study presented, a (QoL) assessment instrument for children with haemophilia (the Haemo‐QoL questionnaire) was developed and tested in six countries (France, Germany, Italy, the Netherlands, Spain and the United Kingdom) for psychometric properties in 339 children with haemophilia and their parents. The Haemo‐QoL is a self‐reported questionnaire for children in the age ranges 4–7 (I: 21 items), 8–12 (II: 64 items), 13–16 years (III: 77 items) as well as for parent rating containing 9–11 subscales (depending on age‐group versions). Psychometric testing involved the examination of reliability and validity. The three age‐group versions of the Haemo‐QoL had acceptable internal consistency and retest reliability values, as well as possessing sufficient discriminant and convergent validity. However, in young children when compared to older children, these indicators were less satisfactory. The Haemo‐QoL full version is now available for children of three age groups and their parents and is ready for use in clinical research (http://www.haemoqol.org).
Health status and health‐related quality of life of children with haemophilia from six West European countries
Authors: Gringeri A. , Von Mackensen S. , Auerswald G. , Bullinger M. , Garrido R. Perez , Kellermann E. , Khair K. , Lenk H. , Vicariot M. , Villar A. , Wermes C. ,   For the Haemo‐QoL Study
Published: February 2004

Summary.  A multicentre, international, cross‐sectional study was carried out in the frame of field testing of the first haemophilia‐specific quality‐of‐life (QoL) questionnaire (Haemo‐QoL). The aim of this paper is to describe health status and health care and their impact on QoL in haemophilic children in Western Europe. Children aged 4–16 years with severe haemophilia without inhibitors were enrolled by 20 centres in France, Germany, Italy, the Netherlands, Spain and the United Kingdom. Clinical information was collected by the physicians with a medical documentation form. Health‐related QoL (HRQoL) of children was assessed with Haemo‐QoL, available for three age groups. Clinical data were available in 318 patients, 85.5% with haemophilia A. The mean age at first bleeding was 11 months, at first joint bleed 25 months. Functional joint impairments were found in 11.3%. Prophylaxis treatment was given to 66.7% of children in whom breakthrough bleeds occurred 0.4 times a month compared to 1.1 bleeds in children receiving on‐demand treatment. A significantly higher factor consumption was found only in the two younger age groups of prophylaxis patients compared to on‐demand patients. HRQoL was satisfactory in this cohort: young children were impaired mainly in the dimension ‘family’ and ‘treatment’, whereas older children had higher impairments in the so‐called ‘social’ dimensions, such as ‘perceived support’ and ‘friends’. Health care of children in Western Europe is progressively improving with a large diffusion of home treatment and prophylaxis. This provides a high level of health status and HRQoL, being better in haemophilic adolescents on prophylaxis.
Origin of the Blue Ridge escarpment along the passive margin of Eastern North America
Authors: Spotila James A. , Bank Greg C. , Reiners Peter W. , Naeser Charles W. , Naeser Nancy D. , Henika Bill S.
Published: February 2004

The Blue Ridge escarpment is a rugged landform situated within the ancient Appalachian orogen. While similar in some respects to the great escarpments along other passive margins, which have evolved by erosion following rifting, its youthful topographic expression has inspired proposals of Cenozoic tectonic rejuvenation in eastern North America. To better understand the post‐orogenic and post‐rift geomorphic evolution of passive margins, we have examined the origin of this landform using low‐temperature thermochronometry and manipulation of topographic indices. Apatite (U–Th)/He and fission‐track analyses along transects across the escarpment reveal a younging trend towards the coast. This pattern is consistent with other great escarpments and fits with an interpretation of having evolved by prolonged erosion, without the requirement of tectonic rejuvenation. Measured ages are also comparable specifically to those measured along other great escarpments that are as much as 100 Myr younger. This suggests that erosional mechanisms that maintain rugged escarpments in the early post‐rift stages may remain active on ancient passive margins for prolonged periods. The precise erosional evolution of the escarpment is less clear, however, and several end‐member models can explain the data. Our preferred model, which fits with all data, involves a significant degree of erosional escarpment retreat in the Cenozoic. Although this suggests that early onset of topographic stability is not required of passive margin evolution, more data are required to better constrain the details of the escarpment's development.
Numerical models of growth‐sediment development above an active monocline
Authors: Patton Thomas L.
Published: February 2004

The deposition, erosion and deformation of growth strata associated with an actively growing monocline are modelled using mechanically based numerical experiments. The results demonstrate that the nature of the growth‐stratal record depends on (1) the interaction between the base‐level rate of change and the rate of change of the accommodation space created due to structural relief across the limbs of the monocline; and (2) the progressive folding of the growth strata. With base‐level elevation initially coincident with the upper surface of the pre‐tectonic units, constant rates of base‐level change create three growth‐stratal preservation states. If the base level rises, a growth‐sediment wedge covers both limbs of the monocline, with thinner sediment thicknesses on the upthrown limb, forming an on‐structure wedge. If the base level falls at a rate less than the rate of accommodation space creation due to structural relief, growth‐strata pinch out onto the dipping limb of the monocline, forming an off‐structure wedge. If the base level falls at a rate greater than the rate of accommodation space generation due to structural relief, no syntectonic deposition occurs and pre‐tectonic units on both sides of the monocline are eroded. Syntectonic unconformities develop within the growth‐sediment packages when the rate of accommodation space generation changes during the course of the experiment. The bedding angularity across the unconformities is greatest in the region of the dipping limb of the monocline; off structure, the bedding across the correlative event becomes parallel, forming correlative conformities or disconformities.