bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment Options for the Child with Allergic Rhinitis
Authors: Meltzer Eli O.
Published: June 2007

Allergic rhinitis is extremely common in pediatric populations. Its symptoms can interfere markedly with everyday life; moreover, untreated allergic rhinitis can predispose patients toward more serious respiratory diseases. Therapy focuses both on reducing the causes (avoidance, immunotherapy) and on controlling manifest symptoms (pharmacotherapy). Antihistamines, decongestants, anticholinergic agents, mast cell stabilizers, and intranasal corticosteroids constitute the pharmacotherapy arsenal. Of these, the intranasal corticosteroids most effectively control the major symptoms; many studies have found that their efficacy in persistent allergic rhinitis is greater than that of decongestants, antihistamines, and cromolyn sodium. Moreover, unlike systemic corticosteroids, they are generally free from adverse side effects. Thus, with appropriate attention to education and formulations most tolerable to children, they should be a wise choice for many pediatric patients.
The Web, Communication Trends, and Children's Health Part 4: How Children Use the Web
Authors: Izenberg Neil , Lieberman Debra A.
Published: June 2007

Children are embracing the Internet and the World Wide Web. How are they using it and what do they find? This article, the fourth in a five-part series, explores the “whys” and the “wherefores” of children's Web use. Included are online recourses geared specifically for children, including health, educational, and entertainment sites.
Randomized, Single-Blinded Comparative Study of the Efficacy of Amoxicillin (40 mg/kg/day) Versus Standard-Dose Penicillin V in the Treatment of Group a Streptococcal Pharyngitis in Children
Authors: Gopichand Ishwar , Williams Gary D. , Saracusa Carla , Medendorp Sharon V. , Sabella Camille , Lampe John B. , Garcia Richard E. , Lebrun Lisette , Goldfarb Johanna
Published: June 2007

A 10-day course of amoxicillin at a dosage of 40 mg per kilogram per day was compared with conventional (lower dosage) penicillin V therapy in the treatment of culture-proven Group A streptococcal pharyngitis in children 3 to 18 years of age in a prospective, randomized, and singleblinded study. Children had to have signs and symptoms compatible with the diagnosis of streptococcal pharyngitis and to have a throat swab positive for Group A streptococci. A second throat culture was obtained 10 to 14 days after the completion of therapy. Serotyping was performed to help differentiate carrier states from reinfections. Of 161 children enrolled, 113 were evaluable; 55 received penicillin and 58 received amoxicillin. At the completion of therapy 70.9% (39/55) of patients in the penicillin group vs 87.9% (51/58) of patients in the amoxicillin group were asymptomatic (clinical cure, P=0.025). At the completion of therapy, 54.5% (30/55) of patients in the penicillin group vs 79.3% (46/58) of patients in the amoxicillin group had negative throat cultures (bacteriologic cure, P=0.005). The carrier rate (children who were well but who were still carrying the same serotype of Group A streptococcus) also differed betweent the groups: 13 (23.6%) in the penicillin group compared with six (10.3%) in the amoxicillin group. Amoxicillin at 40 mg/kg/day was significantly more effective than lower dosages of penicillin V for clinical and bacteriologic cure in the treatment of Group A streptococcal pharyngitis in children. The current perception that penicillin is declining in effectiveness may be due to inadequate dosing.
Tetracaine-Lidocaine-Phenylephrine Topical Anesthesia Compared with Lidocaine Infiltration During Repair of Mucous Membrane Lacerations in Children
Authors: Smith Gary A. , Cohen Daniel M. , Strausbaugh Steven D. , Shields Brenda J. , Harbeck-Weber Cynthia , Powers Jean D.
Published: June 2007

This study compared the effectiveness of a new topical anesthetic, tetracaine-lidocaine phenylephrine (TetraLidoPhen), with that of lidocaine infiltration during repair of mucous membrane lacerations in children. It was conducted in the emergency department of an urban children's hospital with use of a prospective, randomized, blinded study design. Participants were 90 children 1 year of age or older with a laceration 5 cm or less in length on or near a mucous membrane that required suturing. They were randomly assigned to one of two treatment groups, with 45 patients in each group. Pain felt during suturing was scored by suture technicians, research assistants, a videotape reviewer, parents, and patients 5 years of age and older using a Visual Analogue Scale (VAS). Suture technicians, research assistants, a videotape reviewer, and parents also scored pain using a seven-point Likert scale. In addition, suture technicians completed an Anesthesia Effectiveness scale and a Wound Blanching scale. The laceration was located near the eyes in 71 patients (79%), and on or near the lips in 19 (21%). Lidocaine infiltration performed significantly better than topical TetraLidoPhen in comparisons of Likert scores of suture technicians ( P=0.007), research assistants ( P=0.005), the videotape reviewer ( P=0.003), and parents ( P=0.03); Anesthetic Effectiveness scale scores of suture technicians ( P=0.00002; relative risk (RR)=1.83, 95% confidence interval 1.36<RR<2.46); and VAS scores of suture technicians ( P=0.002), research assistants ( P=0.001), and the videotape reviewer ( P=0.005). No significant difference in performance was detected between lidocaine and TetraLidoPhen in comparing VAS scores of parents and patients. There was a 4.4% wound complication rate, including two (2.2%) wound infections. The authors conclude that TetraLidoPhen is a new topical anesthetic that appears to be safe when applied on or near mucous membranes. Its performance among study participants was statistically inferior to that of lidocaine infiltration; however, the differences in pain scores were small and may not be clinically significant. Also, comparisons of pain scores in this study did not take into account the pain associated with the initial injection of lidocaine. Therefore, study findings may underestimate the comparative performance of TetraLidoPhen. Further investigation of this new topical anesthetic is warranted.
Developmental Implications of Head Growth Following Intracranial Hemorrhage
Authors: Bendersky Margaret , Koons Anne , Lewis Michael , Hegyi Thomas
Published: June 2007

This study examined the association between head size at birth, discharge, and 1 year and developmental outcome at 1 year in preterm infants, with and without intracranial hemorrhages (ICH) or associated periventricular echodensities (PVE). The data indicated that most sick preterm infants with small heads at discharge achieved appropriate head sizes at 1 year. Analyses of the 1-year mental and motor performances of 125 subjects revealed that for subjects who did not develop ICH, appropriate head sizes at birth and discharge were associated with good developmental outcome, whereas infants with small heads (< two standard deviations below the mean for age) before hospital discharge were more likely to show poorer developmental outcome at 1 year. For subjects with ICH, birth and discharge head circumference were not predictive of 1-year developmental status; however, normal head size at 1 year was associated with better outcome. This was true for children with transient PVE as well. However, persistent periventricular echodensities were associated with both mental and motor deficits at 1 year, regardless of head growth.
Pneumococcal Bacteremia and Focal Infection in Young Children
Authors: Teach Stephen J. , Dryja Diane M. , Tristram Debra
Published: June 2007

We reviewed a consecutive case series of 178 immunocompetent children aged 3-36 months without central venous lines who had blood cultures positive for Streptococcus pneumoniae by either of paired broth and quantitative culture methods. The incidence of accompanying focal infection was significantly greater in patients with >10 colony-forming units (cfu)/mL than in patients with <10 cfu/mL (30.4% vs 12.9% respectively, p=0.04). No significant relationships existed between the magnitude of bacteremia and the age, gender, presenting temperature, interval until the blood culture turned positive, total peripheral blood white cell count, absolute neutrophil count, or absolute band count. Overall, the quantitative method detected 59/178 (33.1%) of the isolates, including five isolates (2.8%) that the broth method failed to detect.
Ocular Medications in Children
Authors: Wallace David K. , Steinkuller Paul G.
Published: June 2007

Many ocular medications are used by pediatricians or ophthalmologists caring for pediatric patients. Topical antibiotics are commonly prescribed for bacterial conjunctivitis, nasolacrimal duct obstructions, and ophthalmia neonatorum. Many new antiallergy eye drops are now available for the treatment of seasonal (hay fever) conjunctivitis. Dilating eye drops and antiglaucoma medications are generally used or prescribed by ophthalmologists, but pediatricians must be aware of their potentially serious systemic side effects. Before initiating treatment, physicians should evaluate the risks and benefits of ophthalmic medications, establish minimum dosages necessary to achieve a therapeutic benefit, and monitor children for local and systemic side effects.
A Computerized School-Based Health Assessment with Rapid Feedback to Improve Adolescent Health
Authors: Bracken Ann C. , Hersh Adam L. , Johnson Deborah J.
Published: June 2007

Adolescent health problems are often undetected in physicians' offices. The Dartmouth Primary Care Cooperative Information Project has developed a validated and reliable approach to identify adolescent health problems and initiate education in a school setting. A self-administered, anonymous, 26-item questionnaire was given to 204 students in a rural high school. Responses were scanned into PC-based software. Within one working day students were given individualized letters identifying their problem health issues as detected by the questionnaire and recommendations for education. Ninety-nine percent of students participated. Six weeks later 49% of a sample of 41 students reported reading the information and 50% planned to change behavior. This standardized, validated strategy of adolescent health assessment, feedback, and education was feasible for use in schools. The school responded to the data by employing a psychologist to address mental health needs.
Infective Endocarditis in the Premature Neonate
Authors: Pearlman Stephen A. , Higgins Stephen , Eppes Stephen , Bhat A. Mageed , Klein Joel D.
Published: June 2007

We describe a series of 11 high-risk neonates with infective endocarditis (IE) in this retrospective review. Previously IE has rarely been diagnosed in newborns and is usually fatal. The frequency was 4.3 cases per 100 patients. Five patients survived. Microorganisms included gram positives such as S. aureus and coagulase-negative Staphylococcus, gram negatives such as Klebsiella pneumoniae, Enterobacter cloacae, Enterococcusfaecalis, Serratia marcescens, and Acinetobacter calcoaceticus. Echocardiographic location of the lesions showed four left sided, five right sided, and two bilateral. We conclude that IE may be more common than previously described. Prompt diagnosis and treatment led to survival in 45% of our patients. Prospective studies are needed to identify patients at risk and to establish the true incidence of IE in high-risk neonates.
Zeliweger Syndrome in Saudi Arabia and Its Distinct Features
Authors: Al-Essa M. , Dhaunsi Gursev S. , Rashed M. , Ozand Pinar T. , Rahbeeni Z.
Published: June 2007

Clinical and laboratory findings of Zellweger syndrome (ZS) patients diagnosed at King Faisal Specialist Hospital and Research Center (KFSH & RC), Riyadh, Saudi Arabia over a period of 10 years are presented in this report. Eleven patients (nine females and two males) from 2 to 4 months old were referred to KFSH & RC for evaluation of hypotonia, seizures, and dysmorphic features. The common clinical findings included high forehead, large fontanelle, shallow orbit ridges, micrognathia, upslanting palebral fissures, epicanthal folds, severe hypotonia, hyporeflexia, pigmentary retinopathy, optic nerve atrophy, complete or partial agenesis of corpus callusum, and failure to thrive. We did not observe any Brushfield spots, any renal and brain cysts, or adrenal insufficiency. Some unique clinical findings were the presence of gallstones, club feet, or bilateral knee or hip dislocation in some patients. All patients had markedly elevated plasma levels of very long chain fatty acids (VLCFA). Electron microscopy performed on liver biopsies of two patients revealed absence of peroxisomes. Biochemical studies of dermal fibroblasts from three patients showed deficient 13-oxidation of lignoceric acid and dihydroxyacetone phosphate acyltransferase (DHAPATase) activity. The tribal living in Saudi Arabia and our observation that 10 of the 11 parents in this study were first-degree relatives and, except for families 1 and 3, each family had at least another baby who died of the same disease. This suggests that the incidence of ZS in Saudi Arabia may actually be higher than our experience at KFSH & RC.
Anxiety in Parents of Young Febrile Children in a Pediatric Emergency Department: Why is it Elevated?
Authors: Parkinson Gregory W. , Gordon Kevin E. , Camfield Carol S. , Fitzpatrick Eleanor A.
Published: June 2007

This study assessed anxiety levels of parents of young febrile children who presented to a pediatric emergency department (ED) with fever. One hundred and seventy parents completed a 90-item questionnaire. Anxiety was measured by use of the State Trait Anxiety Inventory. Parents were asked what they had previously thought about and how they felt about the ED process. Mean parental anxiety was 50.1 (95% CI 48.1, 52.2), significantly elevated from adult standards (p<0.0001). A multivariate model comprising: (1) feeling “not at all” well rested, (2) having no other children, (3) having thought about a blood test, and (4) feeling worried about trusting the physician was associated with elevated anxiety. In conclusion, parents of febrile young children in the ED are very anxious.
A Critical Review of Cranial Ultrasounds: Is There a Closer Association Between Intraventricular Blood, White Matter Abnormalities or Cysts, and Cerebral Palsy?
Authors: Weiss Hali E. , Goldstein Ruth B. , Piecuch Robert E.
Published: June 2007

In an attempt to determine cranial ultrasonographic features of preterm infants with intraventricular hemorrhage (IVHI) and/or periventricular white matter abnormalities (PVWMA) that could serve as more specific predictors of cerebral palsy (CP), we reviewed the cranial sonograms of 34 infants with IVH and/or PVWMA. Fourteen of the 34 infants studied (41%) developed CP. One of five infants with grade III LVH alone developed CP. Eleven infants with PVWMA did not develop cysts and only two (18%) developed CP (p=0.04). Of the 18 infants who went on to develop cysts, four had a small, discrete solitary cyst and 14 had large cystic areas. Three of the four with small cysts were neurologically normal, whereas only three of the 14 with large cysts were neurologically normal (p=0.04). Preterm infants with grade III IVH in the absence of any parenchymal lesion had a more favorable neurologic outcome than those with IVH and concomitant PVWMA. Infants with PVWMA in the presence or absence of IVH had much poorer neurologic prognoses. In infants with PVWM abnormalities, both the presence and extent of cystic lesions, though not their location, are the strongest predictors of long-term neurologic outcome.
Effects of Skin-to-Skin Holding on General Movements of Preterm Infants
Authors: Constantinou Janet C. , Adamson-Macedo Elvidina N. , Stevenson David K. , Mirmiran Majid , Fleisher Barry E.
Published: June 2007

The study objective was to test the hypothesis that the effect of skin-to-skin (STS) holding increases the ratio of rest to activity in low birth weight preterm infants. Ten infants with birthweight <2,000 grams were videotaped before and after STS holding. Video recordings were analyzed to determine the number of general movements. We found no statistically significant difference between the percentage of general movements over the two periods. We conclude that the ratio of rest-activity before and after STS holding does not change as measured by occurrence of general movements.
Growth of Newborn, Term Infants Fed Soy Formulas For 1 Year
Authors: Lasekan John B. , Ostrom Karin M. , Jacobs Joan R. , Blatter Mark M. , Ndife Louis I. , Gooch Willis M. , Cho Sechin
Published: June 2007

Few studies have measured long-term growth in infants fed soy protein-based formulas. The effect of nucleotide (NT) supplementation of soy protein-based infant formulas on growth is unknown. Growth was therefore evaluated in healthy term infants fed a soy protein-based formula (SOY; n=73), SOY with added NT (72 mg added NT/L) at human milk (HM) levels (SOYN, n=73), or mixed feeding (MF, n=67) in a randomized, masked, parallel 1-year feeding study. The MF group (a nonrandomized reference group) was fed HM exclusively from birth to 2 months of age followed by HM and/or a standard milk-based formula (Similac® with Iron with no supplemental NTs) to 1 year of age. Results indicated that growth (weight, length, and head circumference) was normal and comparable among the three groups. All three groups had similar plasma albumin (at 2 months of age) and hemoglobin levels (at 12 months of age). Thus, this study demonstrated similar growth in the first year of life among infants fed MF feeding or soy formula with or without supplemental NTs.
Frequency and Predictors of Medically Attended Injuries in HlV-nfected Children
Authors: Turner Barbara J. , Cocroft James , Hauck Walter W. , Schwarz Donald F. , Casey Rosemary
Published: June 2007

The extent to which medically attended injuries complicate the clinical course of HIVinfected (HIV+) children is unknown. In a cohort of HIV+ children delivered from 1985 to 1990 and aged less than 60 months, we determined medically attended injuries per 100 child-years, Injury Severity Scores (ISS), and predictors of medically attended injuries by using New York State Medicaid claims from 1986 to 1992 linked to birth certificates. Injury rates and ISS were compared to those of a population of black, inner city children aged less than 60 months from emergency room records. HIV+ children had slightly more injuries (19.3 vs. 16.8/100 child-years) but similar ISS (2.4 vs. 2.3). Predictors of injuries in HIV+ children included younger maternal age (24/100 child-years, p=0.008) and delivery outside of New York City (29/100 child-years, p=0.02). Illicit drug use and alcohol use were associated with greater ISS while cocaine use was associated with a higher rate of possibly intentional injuries. Medically attended injuries affected one in five HIV+ children in our cohort annually, slightly more than the comparison population. Specific maternal and birth characteristics such as substance abuse and younger age at delivery may help target at-risk children.
Lead Screening Among Low-Income Children in Galveston, Texas
Authors: Javier Felipe C. , McCormick David P. , Alcock Nancy W.
Published: June 2007

The objective of this study was to report results of a lead-screening program for low-income children living in Galveston, Texas. We obtained blood lead by graphite furnace spectrophotometry on 1,571 children aged 6 months to 8 years. Nineteen percent of children had blood lead levels >10 mcg/dL. Risk factors included African-American ethnicity, young age, and residence in old housing. Follow-up was accomplished in only 50% of children with low-level toxicity. Lead screening is an important public health measure in communities with old houses. For screening to be successful, caregivers need to devote additional effort to follow-up.
Business Interruption Insurance
Authors: Haugland Richard L.
Published: June 2007

Hotels, restaurants, and clubs encounter fires and other perils under circumstances similar to those of other business establishments. Owners lose not only physical assets and inventories but also the income from sales that would have oc curred. Further, they have continuing expenses to meet and service contracts which must be paid.

The New York Times Magazine (Sunday, June 2, 1968) reports interviews with Washington merchants and service trade operators and their difficulties in covering losses they experienced in the April riots, following the assassination of Rev. Martin Luther King. Most had inadequate insurance and few had business interruption in surance. Elsewhere after disaster, the business story has been much the same.

This article by Richard L. Haugland examines the need for business interruption insurance and explains possible coverage. Mr. Haugland, who was formerly with the Travelers Insurance Co. in Seattle, is the author of "Fire Insurance Rates and Restaurant Design," which appeared in the February 1968 (Vol. 8, No. 4) issue of this magazine. — Editor
Problems in Going International
Authors: Cornwell Richard , Greene Melvyn
Published: June 2007

Messrs. Cornwell and Greene are management consultants with headquarters in London. Before opening their own offices, both were affiliated with Horwath & Horwath. Consulting projects have taken them to Canada, Mexico, the West Indies, and to European countries in recent years. — Ed.
Food Service's Year of Decision
Authors: O'Malley Patrick L.
Published: June 2007

This article is based on addresses delivered be fore the National Restaurant Association's semi nars, "Outlooks and Decisions — 1969," held during January 1969 in Chicago and New York.
Man Power Strategy
Authors: Winter Elmer L.
Published: June 2007

This article is based on an address Mr. Winter delivered on January 8 in Chicago at the Na tional Restaurant Association's seminar, "Out looks and Decisions — 1969."
Survey of Fast Food Franchising
Authors: Vaughn Charles L.
Published: June 2007

This article is based on an address Dr. Charles L. Vaughn delivered on June 5 at the Franchis ing Seminar sponsored by the Massachusetts Association of Real Estate Boards and the Notre Dame University Club of Boston. Dr. Vaughn is director of the Boston College Center for the Study of Franchise Distribution. He is also the author of the Vaughn Report of Franchising Fast Food Restaurants, from which much of this article is adapted. The complete report may be obtained from Farnsworth Publishing Co., Lyn brook, N.Y.
Trends in Guest Room Design
Authors: Cole Warren M. , Broten Paul R.
Published: June 2007

It is difficult to define a "typical hotel guest room." Most major properties today utilize sev eral types of guest unit design within a single property. The breakdown of this "mix" of guest room designs is an area where further study is warranted. Limited work has already been started to better define and design these areas by Cornell University and several independent hotel interests.

Many sources were investigated to obtain the basic information for this study. To ascertain current practices for new structures, a question naire was sent to 68 hotel executives who are dealing with new properties. In addition, rela tive material was reviewed in trade periodicals, books, and the actual floor plans of new struc tures, those recently built, under construction, or in the planning stage. Most of these findings are summarized in the tables appearing with this article.

Appreciation is expressed to ITT-Sheraton for permission to present in this article parts of the study they originally sponsored at Cornell Uni versity. Initially, this study was undertaken by direction of Fred B. Mills, formerly president of ITT-Sheraton Design and development Cor poration and now affiliated with Alexander & Baldwin in Honolulu, Hawaii. Nat Martin, who succeeded Mr. Mills at ITT-Sheraton, continued this work and has graciously allowed us to use much of the study findings. — Paul R. Broten, Dir ector of Research and Development.
Guest Room Design
Authors: Hill Marjorie
Published: June 2007

Rooms should be furnished in relation to guest functions in using the room. These functions are related to the markets served. Some rooms are over-furnished with items not suitable to guest- occupant activities and lamps may be poorly placed.

The editor recently occupied for several days an expensively furnished room in a new hotel which had a wall-hung chest-dresser and console- vanity to facilitate vacuum cleaning. But the furniture was poorly positioned and except for for the dressing room, which was part of the bathroom, lighting was exceedingly poor.

On the wall along which the bed and a sofa bed were positioned, there were only two small wall brackets with dim bulbs. The chest-dresser

along the opposite wall had a tall lamp, but there was none next to the easy chair adjacent to the window wall. It was impossible to read in bed or on the sofa, or in the easy chair. There was no place to write except at the dressing room basin counter and neither the sofa or the easy chair could be moved into this room as a seat. Moreover, it was observed that if a family oc cupied the room, traffic conjestion in the dress ing room-bath room would be unbelievable.
What the Restaurateur Should Expect from His Accountant
Authors: Neal Geller A.
Published: June 2007

The purpose of this article is to familiarize the restaurant operator with the functions and services that are both necessary and available through professional accoun tants. Two fundamental aspects are explored. The first, a consumer view, defines the level of service the res taurateur can expect for the fees he pays. The second is a discussion of the multitude of services available when an accountant is hired. The first view is explored in the paragraph below. The second theme, forming the central issue of the article, is discussed at greater length in the subsequent sections.
Innkeeping and the Law of Antitrust
Authors: McConnell Jon P.
Published: June 2007

Writing in his column, "The Inn-Side of the Law, " Professor John E. H. Sherry of the School's faculty warned readers of the February Quarterly that federal enforcement of antitrust statutes was becoming more stringent and increasingly widespread. In the following article, Professor McConnell of Washington State University provides a brief description of the applicable antitrust laws and surveys some of the cases in which the legisla tion has been invoked against hoteliers.
Operational Budgeting in Small Hotel Companies
Authors: Kosturakis Jorge G. , Eyster James J.
Published: June 2007

In these times of continual challenge and change, effective budgeting can help reduce the uncertainties and help businesses achieve their objectives
The "Ladies' Menu"
Authors: Sherry John E. H.
Published: June 2007

A growing number of female restaurant customers are playing host to male guests. Restaurateurs with a dual-menu policy may lose the patronage of these customers—and may also lose in court
How to Develop a Positioning Strategy
Authors: MacNaughton Roy W.
Published: June 2007

The small-restaurant operator's market research and analysis lay the groundwork for a marketing plan that effectively sets the operation apart from other restaurants large and small
Revamping the Hospital Menu
Authors: Oswald Charles A.
Published: June 2007

A new hospital meal program offers patients more than nutritious food choices for every meal of every day —it also lays the groundwork for better eating habits in patients' daily lives
A New Marketing Mix for the Hospitality Industry
Authors: Renaghan Leo M.
Published: June 2007

Traditional marketing-mix concepts have little utility for the service industries, because they reflect strategies for selling products, rather than services
The Telecommunications Revolution, Part II
Authors: Teicher James S.
Published: June 2007

New information-storage and retrieval systems are creating an "information generation"— allowing consumers to select a restaurant, check hotel rates, make room reservations, write letters, pay bills, and shop, all via the video screen. This second article in a two-part series explores how the hospitality industry should adapt to this new technology, and explains how videotex systems can serve the industry's needs
Toward a Theory of Peace Agreement Implementation: The Case of Liberia
Authors: Bekoe Dorina A.
Published: June 2007

The implementation of a peace agreement following a civil war is one of the most critical and uncertain processes of any post-war period. Many argue that promises of extensive power sharing arrangements in future governments and international intervention help advance the implementation of a peace process. While not doubting the importance of these factors, this paper argues that they do not sufficiently account for the incremental process of an implementation. Through an analysis of the numerous peace agreements of Liberia’s first civil war, from 1989-1996, this paper presents the theory that the implementation of a peace agreement will advance if the level of vulnerability during the implementation period is equally balanced among the faction leaders. In other words, given that the concessions offered in a peace agreement will bring some change in military, economic, or political vulnerability among the factions, the implementation process advances when the faction leaders feel mutually vulnerable. Liberia’s nearly decade-long conflict, interspersed with periods of fragile peace, provides an opportunity to observe the effects of changes in military and political vulnerability on the implementation process.
Commentary: Oil and the Economy
Authors: Weale Martin
Published: June 2007

Between 2000 and 2003 OPEC maintained a target range for the price of oil of US$22–28 per barrel. In early September of this year the price of oil reached US$67 per barrel. Such a rapid change in the price of oil was not anticipated either by economic forecasters or by those involved in the industry. Indeed, about a year ago, with the price of oil just over US$40 per barrel, a senior oil company executive, said that the high prices were caused by short-term factors and that prices had reached their peak. As the rise of oil prices has continued, people's thoughts have inevitably turned to the two oil crises of 1973–4 and 1979–80.
Prospects for the UK Economy
Authors: Barrell Ray , Choy Amanda , Kirby Simon , Riley Rebecca
Published: June 2007

GDP growth remained below trend into the second half of this year. Early estimates of GDP show the economy expanding by 0.4 per cent in the third quarter of the year, similar to the rate we projected when constructing the forecast. The economy has now expanded at a rate below 0.6 per cent for five consecutive quarters (chart 1), and this is now affecting the annual figures. Our forecast shows GDP growth this year at 1.7 per cent. This is the weakest growth rate observed in the past decade in a single calendar year.
UK Economy Forecast
Authors: Barrell Ray , Kirby Simon , Riley Rebecca
Published: June 2007

Economic growth remained relatively subdued in the second half of last year, at around ½ per cent per quarter. However, this is faster than in the first half of 2005 (see figure 1). Over the year as a whole the economy expanded by 1.7 per cent in 2005. We expect economic growth to accelerate in 2006 and 2007 to around 2¼ and 2¾ per cent per annum respectively.
Commentary: Immigration and Its Effects
Authors: Riley Rebecca , Weale Martin
Published: June 2007

The past few months have seen a growing debate on the question of migration. There is little doubt that there has recently been a sharp inflow of migrants into the United Kingdom, raising a range of both economic and social issues. In this commentary we consider the structure of recent immigration and assess some of its economic consequences.
Migration in Europe
Authors: Barrell Ray , Guillemineau Catherine , Liadze Iana
Published: June 2007

Recent developments in the European Union have raised immigration as an issue, especially in the UK. There has been a large wave of migrants into the UK from Poland since its accession in 2004, and as Romania and Bulgaria are preparing to become members of the European Union on 1 January 2007, migration from the new member states to other EU countries has become even more a focus of attention. Concerns over potential immigration towards the old EU member states have been rising because the total population of Bulgaria and Romania is approximately 30 million, a similar size to Poland, and the standards of living in both countries are considerably lower than in the EU-15 member countries, or than in any of the current New Member States. Hence outward migration is more likely to be attractive. The scale of flows will depend upon any restrictions that might be imposed by other member states, but current estimates suggest that 2 million Romanians, for instance, are already at work in the core EU countries.
UK Economy Forecast
Authors: Barrell Ray , Kirby Simon , Riley Rebecca
Published: June 2007

GDP growth accelerated from 1.6 per cent in the year to the second quarter of 2005 to 2.6 per cent in the year to the second quarter of 2006. At the time of writing the official preliminary estimates suggest economic growth was 0.7 per cent in the third quarter of this year. This is a little stronger than implied by our forecast, which is based on monthly estimates of GDP. But, taking on board the preliminary estimate in our forecast would have only a small effect on the annual growth figure for this year. Looking further forward we expect relatively stable GDP growth at around the economy's trend rate (figure 1). Our central projection is for growth of 2.6 per cent in 2007, 2008 and over the medium term. The outlook for GDP growth is not very different from our previous forecast published in the JulyReview.
Monetary Policy and Global Imbalances
Authors: Barrell Ray , Hurst Ian
Published: June 2007

The US current account imbalance has stayed stubbornly high despite the fall in the dollar that we have seen since the beginning of 2003. The exchange rate has fallen by around 15 per cent on average, mainly between the first quarter of 2003 and the first quarter of 2005. As we can see from figure 1, the fall has come in three steps, and each time it fell we might have expected an initial worsening of the current account for a year or so as prices change in advance of quantities (the J curve effect of the first year textbook). Hence we might have expected no sustained improvement until at least a year after the last downward step towards the end of 2004. However, as we can see from figure 2, there is no noticeable improvement in the current account during 2006, suggesting that domestic absorption was rising. At the same time inflation in the US was gradually drifting up under pressure from the weakening exchange rate.
Is Form-Focused Vocabulary Instruction Worthwhile?
Authors: Mason Beniko , Krashen Stephen
Published: June 2007

Hearing stories can result in considerable incidental vocabulary development, for both first and second language acquisition (e.g. Elley 1992; Robbins and Ehri 1994; Senechal, LeFevre, Hudson and Lawson 1996). It has also been claimed, however, that direct instruction is more effective than incidental vocabulary acquisition and that combining both approaches will be more effective than incidental acquisition alone (Coady 1997). In this study, we compare vocabulary growth in English as a foreign language through hearing a story with a combination of a story and supplementary activities designed to focus students specifically on learning the new words in the story. Subjects were first-year Japanese female students at a junior college in Osaka. One class was the ‘story-only’ group and the other was the ‘story-plus study’ group. The story-only group spent only 15 minutes hearing a story. The story-plus study group spent nearly the entire class period (85 minutes) hearing the story and doing supplementary activities. Calculations of words learned per minute revealed that the story-only group learned words more efficiently. The results suggest that additional focus on form in the form of traditional vocabulary exercises is not as efficient as hearing words in the context of stories.
La Sociologie des Religions et la Condition de Minoritaire Dans le Champ Religieux
Authors: Turcotte Paul-André
Published: June 2007

The cognitive minorities that are the sect, the new religious movement and the religious order, constitute social organizations that publicly affirm the difference which is of a symbolic nature. In consequence, the organizations self-define their frontiers, and hence demonstrate the capacity for self-regulation of their internal relations and the instances of conflict resolution in society at large. Social Compass has studied the subject, above all through an analytic analysis. It went through its most intense periodfrom the 1970s to the 1990s, linked, it would seem, to the debate on secularization as a social withdrawal on the part of religious institutions. The debate has rekindled, in recent years on points of method and theory, in the tension between a sociology of implication and a distanced sociology.
Children, Childhood and Social Capital: Exploring the Links
Authors: Leonard Madeleine
Published: June 2007

This article is concerned with exploring how children develop and utilize stocks of social capital. It draws on two research projects illustrating children’s family, peer and community networks. In the burgeoning literature on social capital, children’s accounts remain under-researched. Indeed most of the literature operates with a simplistic view of adults passing social capital assets on to children without a subsequent consideration of how children perceive and make use of existing networks and create and manage additional networks. The article will examine the limited treatment of children and childhood in the conceptualization of social capital put forward by Putnam, Coleman and Bourdieu. One of the most important attributes of social capital is its supposed ability to be converted into other forms of capital. A focus on children’s networks calls into question the ease with which social capital can be transformed into other types of capital.
Clinical Use of Digitalis Materials
Authors: Levitt Barrie , Keefe Deborah L.
Published: June 2007

Digitalis is a drug widely used in modern medicine for the control of ventricular response in atrial fibrillation and the treatment of congestive heart failure (CHF). Recently, the use of digitalis for the treatment of CHF in patients in sinus rhythm has become quite controversial. The findings of several clinical studies suggest a small but definite hemodynamic or clinical improvement in patients treated with digitalis. These effects are limited by the onset of toxicity, which is at least partially mediated via the central nervous system. If the inotropic effect of the drug could be separated from the central nervous system effect, much higher doses of digitalis could be tolerated and presumably a greater therapeutic effect could be obtained.
Digitalis: Neurally Mediated Arrhythmogenic and Coronary Vasoconstrictor Properties
Authors: Somberg John Charin
Published: June 2007

Studies of digitalis have revealed an appreciable role of the autonomic nervous system in the modulation of the cardiovascular toxicity of digitalis. Neuraxis transection experiments and studies using digitalis compounds that fail to enter the central nervous system suggest that centers located in the floor of the fourth cerebral ventricle play a substantial part in the neural arrhythmogenic effects of the digitalis glycosides. Electrical stimulation of the area postrema in partially digitalized animals, not otherwise manifesting ventricular arrhythmias, elicits ventricular tachycardia. Neuraxis transection experiments and studies with a charged digitalis derivative also suggest localization of the coronary vasoconstrictive properties of digitalis to the area postrema. The results suggest that this region of the brainstem is sensitive to a neurally active substance, digitalis, causing peripheral sympathetic effects of considerable consequence.
Digitalis: Its Place in Therapy
Authors: Somberg John , Keefe Deborah , Levitt Barrie
Published: June 2007

Since the initial introduction of digitalis 200 years ago by Withering, its low therapeutic ratio has limited the use of this agent. The utility of digitalis in patients with congestive heart failure and a recent myocardial infarction has been questioned recently. Findings of rigorously controlled clinical studies suggest a small but definite hemodynamic and clinical improvement in patients administered digitalis. Congestive heart failure can be effectively treated without cardiac glycosides. However, when used judiciously, digitalis provides an additional agent in our therapeutic armamentarium. The inotropic, dormotropic, and vagomimetic properties are uniquely suited for the patient with supraventricular arrhythmias and compromised left ventricular function.
Enalapril in the Management of Hypertension Associated With Renal Artery Stenosis
Authors: Canzonello Vincent J. , Madaio Michael P. , Madias Nicolaos E.
Published: June 2007

Enalapril maleate (MK‐421) is a new non‐sulfhydryl‐containing converting‐enzyme inhibitor that has been shown to be effective and well tolerated in patients with essential hypertension. Data on its effectiveness and safety in patients with renovascular hypertension are limited and have involved predominantly short‐term observations. This is particularly true with respect to the long‐term effects of enalapril on renal function. We report our experience using the combination of enalapril and hydrochlorothiazide (HCTZ) in a group of nine patients with moderate to severe hypertension associated with renal artery stenosis. The enalapril‐HCTZ combination successfully controlled blood pressure in seven patients during a six‐week period of study. Adverse effects were not noted, and detailed renal hemodynamic studies did not reveal any significant changes of renal plasma flow and glomerular filtration rate during this time interval. Five patients were continued on this regimen for a period of six to 18 months. In this group of patients, the regimen continued to be well tolerated and to provide excellent blood pressure control: glomerular filtration rate was maintained in two patients and variable grades of decrease were noted in three. The mechanism of this delayed renal dysfunction as well as its relationship to enalapril treatment remain unclear. The long‐term impact of converting‐enzyme inhibition on renal function requires further study.
Hemodynamic and Electrophysiologic Effects of Combined Infusion of Lidocaine and Propafenone in Humans
Authors: Feld Gregory K. , Nademanee Koonlawee , Singh Bramah N. , Kirsten Edward
Published: June 2007

The hemodynamic and electrophysiologic effect of a combined intravenous infusion of lidocaine (100 mg bolus followed by 2 mg/min infusion) and propafenone (1 or 2 mg/kg) in patients with a history of ventricular arrhythmia was studied. Lidocaine infusion alone significantly increased the mean pulmonary artery (+28%) and pulmonary capillary wedge (+17%) pressure, with no effect on cardiac index. Lidocaine alone produced no consistent change in any measured electrophysiologic parameter, except slight QTc shortening (—2%,P < .05). Propafenone alone, particularly at the higher dose (2 mg/kg), produced significant increases in mean blood pressure (+14%), right atrial pressure (+78%), pulmonary artery pressure (+50%), pulmonary capillary wedge pressure (+65%), systemic vascular resistance (+29%), and pulmonary vascular resistance (+61%) and a decrease in cardiac index (‐12%). Significant prolongation of PR (+9%), AH (+29%), and HV (+23%) intervals, atrial functional refractory period (+12%), ventricular effective (+7%) and functional (+6%) refractory period, and Wenckebach cycle length (+13%) also occurred after the administration of propafenone alone. Only the effects on atrioventricular (AV) node were observed at the lower dose of propafenone (1 mg/kg). Combined infusion of lidocaine with propafenone produced a mild, statistically insignificant additional negative inotropic effect but reversed the prolongation in atrial and ventricular refractoriness produced by propafenone alone. Thus, the data show that lidocaine attenuates certain electrophysiologic effects of propafenone, which might alter its antiarrhythmic efficacy, while producing mild additive negative inotropic effects that may be of hemodynamic significance.
Unusual Absorption Profile of Phenytoin in a Massive Overdose Case
Authors: Chaikin Philip , Adir Joseph
Published: June 2007

The pharmacokinetics of phenytoin was evaluated in a nonepileptic adult man after the ingestion of an undertermined amount of the drug following an apparent suicide attempt. A serum phenytoin concentration of 45 μg/mL was observed on admission 12 hours after ingestion. Phenytoin concentrations steadily increased, reached a maximum of 114 μg/mL four days later, then fluctuated at about 100 μg/mL for a week, and slowly declined to undetectable levels within the following week. At 96.5 μg/mL, the unbound serum concentration was 2.5 times that observed in therapeutic drug concentrations. Computer fitting of the data indicated that the Michaelis—Menten constants, apparent volume of distribution, and renal clearance of phenytoin were consistent with those parameters reported after therapeutic doses. However, phenytoin absorption was best described by parallel first‐ and zero‐order rate processes, with the latter proceeding for as long as two weeks following drug ingestion. This protracted absorption appears to be a result of the presence of a large concretion of phenytoin in the gastrointestinal tract, having a slow disintegration and dissolution attributable to the limited solubility of the drug in the gastrointestinal tract and to the patient's diminished intestinal motility.
Hemopoietic Growth Factors: A Review
Authors: Rowe Jacob M. , Rapoport Aaron P.
Published: June 2007

The hemopoietic growth factors are peptide hormones that are known to be responsible for the in vitro and in vivo proliferation of bone marrow progenitor cells into mature differentiated cells. These cytokines have had a major impact on the management of patients with cytopenias and have been extensively used as an adjunct to the management of patients with hematologic malignancies, with or without prior intensive chemotherapy. Other potential uses, being rigorously studied, include the potential mobilization of stem cells as well as recruitment phase‐specific cells into the cell cycle, thus providing a more sensitive environment for targeting specific chemotherapeutic agents.
Insulin Resistance, Hyperinsulinemia, Dyslipidemia, Hypertension, and Accelerated Atherosclerosis
Authors: Sowers James R.
Published: June 2007

Hypertension is only one component of a multifaceted metabolic‐hemodynamic complex that also includes obesity, subtle and overt glucose intolerance, dyslipidemia, enhanced vascular resistance and accelerated atherosclerosis. Results of a number of studies in the past 5 years have shown that even nonobese, nondiabetic individuals with hypertension display insulin resistance, which is located in peripheral tissues (primarily skeletal muscle), is limited to nonoxidative pathways of glucose disposal, and appears to be directly correlated with the severity of hypertension. Insulin resistance and associated hyperinsulinemia in hypertensive individuals are also associated with increased plasma triglyceride levels and decreased high‐density lipoprotein concentrations, which likely contributes to enhanced atherosclerosis. Hyperinsuiinemia may directly promote atherosclerosis by enhancing LDL‐cholesterol accumulation in vessel walls, vascular smooth muscle migration, and proliferation, augmenting connective tissue synthesis in the vascular wall, and decreasing the regression of lipid plaques. The enhanced peripheral vascular resistance that characterizes insulin resistance/hyperinsu Jinemic states may be related to decreased vascular smooth muscle responses to insulin, which normally modulates (attenuates) vascular contractile responses to vasoactive agents.