bluuebunny/crossref_metadata_2025 huggingface dataset:
A Look into the Mind of the Negotiator: Mental Models in Negotiation
Authors: Van Boven Leaf , Thompson Leigh
Published: November 2003

Negotiation can be conceptualized as a problem-solving enterprise in which mental models guide behavior. We examined the association between negotiation outcomes and mental models, as measured by negotiators’ associative networks. Four hypotheses were supported. First, negotiators who reached optimal settlements had mental models that reflected greater understanding of the negotiation’s payoff structure, and of the processes of trading and exchanging information, compared to negotiators who did not reach optimal settlements. Second, negotiators who reached optimal settlements exhibited greater within-dyad mental model similarity. Third, experience-based training was more likely than instruction-based training to produce mental models similar to the mental models of negotiators who actually reached optimal settlements. Finally, negotiators who received 10 weeks of experience-based training had mental models that were similar to novice negotiators who reached optimal settlements, except that the mental models of the experienced negotiators were more abstract.
Attitude Change in Computer-Mediated Communication: Effects of Anonymity and Category Norms
Authors: Sassenberg Kai , Boos Margarete
Published: November 2003

The current research compared the effect of computer-mediated communication (CMC) and direct communication on attitude change. The social identity model of deindividuation effects (Spears & Lea, 1994) predicts that CMC results in behavior that is more in line with the salient level of self-categorization (compared to non-anonymous communication): in CMC salient social identity should lead to conformity to group norms whereas salient personal identity was expected to result in behavior that fits individual goals. Two experiments showed that when personal identity was salient and when social identity was salient and a category norm was explicitly given, CMC led to the predicted effects, whereas the lack of a social category norm led to lower attitude change in CMC compared to direct communication.
Some Implications of Pierre Bourdieu’s Works for a Theory of Social SelfOrganization
Authors: Fuchs Christian
Published: November 2003

The philosophical implications of the sciences of complexity suggest that complex systems (such as society) function according to a dialectic of chance and necessity, multidimensionality, non-linearity and circular causality. It is argued that one could employ aspects of Pierre Bourdieu’s theory in order to establish a consistent theory of social self-organization. Bourdieu describes society in epistemological terms as consisting of mutual relationships of subjectivity/objectivity, individual/society, homogeneity/diversity, freedom/necessity, externalization of internality/internalization of externality, embodiment/objectification, modus operandi/ opus operatum. The concept of the habitus is a means of explaining the re-creation/self-organization of social systems in terms of human beings as permanent creators and permanently created results of society.
Pragmatic Sociology as Cultural Sociology
Authors: Silber Ilana Friedrich
Published: November 2003

Pragmatic sociology is often read as a reaction to and an alternative to Bourdieu’s ‘critical sociology’. This article, in contrast, offers an assessment of pragmatic sociology in terms of its contribution to the theory of culture in general and its affinities with repertoire theory in particular. Whereas the tendency has been to conceive of repertoires as largely unstructured entities, pragmatic sociology has demonstrated a systematic interest in their internal contents and structure, which it has even expanded through its more recent turn to historical and macro comparative analysis. In the process, however, pragmatic sociology has also been leaning towards a form of cultural sociology that actually challenges some major aspects of repertoire theory–thus also bringing into relief the dilemmas facing any attempt at further elaboration of what is now a growing strand of cultural theory.
Taking the ‘Ism’ Out of Cosmopolitanism
Authors: Fine Robert
Published: November 2003

This article addresses the character and potential of the radical cosmopolitanism that is currently flourishing within the social sciences. I explore how cosmopolitanism is articulated in a number of disciplines–including international law, international relations, sociology and political philosophy–and how it conceives of its own age. I focus first of all on the timeconsciousness that informs the cosmopolitan representation of modernity, in particular its projection of a rupturebetween the old ‘Westphalian’ order of nation states and the advancing cosmopolitan order of the present, and, second, on the nature of cosmopolitan critiques of nationalism, socialism and ‘modernist’ social and political thought in general. Behind this focus lie a question over the extent to which cosmopolitanism replicates in its own normative proposals the defects of that which it criticizes, and another question over the means by which the critical kernel of contemporary cosmopolitanism can be separated from its doctrinal shell.
Accounting Practices as Situated Knowing: Dilemmas and Dynamics in Institutional Categorization
Authors: Mäkitalo Åsa
Published: November 2003

This article analyses the dynamics of the use of institutional categories in institutional encounters. The focus is on documenting how categories are invoked to index what is relevant to situated knowing in interactional sequences where there is a need to bridge the gap between action and expectation. This general problem has been studied in the context of interactions between job applicants and vocational guidance officers in a public employment agency. Institutional categories are inference-rich, and they work as flexible tools that allow participants to recontextualize and negotiate the issues at stake. In this sense, categories serve as constitutive tools that can be crafted to fit into a broad range of circumstances. However, in order to produce a relevant account, participants’ ways of reasoning need to fit into the institutionally specific traditions of argumentation and the practical outcomes which need to be produced. In this sense, the focus on accounting practices is illuminating when attempting to understand the situated knowing that maintains institutional practices.
Asking Questions, Making Sound-Bites: Research Reports, Interviews and Television News Stories
Authors: Nylund Mats
Published: November 2003

This article is a detailed discourse analytic study about the transformation of three social research reports into television news, above all through the reporter–source interview. The focus is on how questions are used to probe responses and explanations and how these are either omitted from or incorporated into the final news stories. By this unique research design the interactional conduct of the reporter–source interview as well as some aspects of question design applied in the interview are described. It is argued that both the interviews as well as the editing of the news stories are guided by ‘narrative relevance’, i.e. the reporter’s preliminary idea of what the emerging story should/could look like, rather than by the actual outcome of the interviews.
Is Economic Crime a Man’s Game?
Authors: Davies Pamela A.
Published: November 2003

In researching women’s involvement in economic crime, the concept of the ‘economic’ is problematic. Women’s crime for economic gain and women’s crime in economic terms are inadequately catered for. In reviewing criminologists’ uses of the notion of ‘economic crime’ I suggest that criminological understandingin relation to crime for economic gain is poor and that gender freedom/blindness/specificity variously operate. This article provides an original feminist reading of contemporary work on crime and markets and rational choicetheory and relates this to feminist economic critiques in order to achieve agendering of the economy. The broad aims of the article are to illustratethe problematics of economic classifications and definitions in criminologyand to mount an argument that suggests the whole notion of the economic within criminology demands (feminist) critique.
Feminist Technological Futures
Authors: Currier Dianne
Published: November 2003

The figure of Donna Haraway’s cyborg continues to loom large over contemporary feminist engagements with questions of technology. Across a range of analytical projects ranging from cosmetic surgery to employment practices it has come to be one of the defining figurations through which the social and discursive construction of bodies in a technological age are theorized. Indeed, it has become a widely accepted and largely unquestioned orthodoxy of postmodern feminist thinking. Not only has the cyborg offered a theoretical framework for exploring the feminist possibilities of technologies, it has provided a focus for situating questions of technology and bodies into broader feminist theoretical considerations of the structures of knowledge, particularly those of binary oppositions and the logic of identity. While a productive and influential intervention into feminist theorizing, the cyborg is not without limitations. One of these is pointed out by Kirby (1997) as a failure to break convincingly with the logic ofidentity in the way Haraway theorizes the intersection of bodies and technologies in the fabrication of the cyborg. This article examines that criticism and then explores the possibilities which Deleuze and Guattari’s concept of assemblageoffers as a mean of thinking the meetings of bodies and technologies beyond binary oppositions.
Corporate Social Responsibility, Corporate Citizenship and the Global Compact
Authors: Whitehouse Lisa
Published: November 2003

This article addresses the apparent demise of the concept of corporate social responsibility and its usurpation within academic literature, managerial practice and policy debate, by the concept of corporate citizenship. Having failed in its attempt to compel companies to behave responsibly, corporate social responsibility has been superseded by a more consensual approach that seeks to encourage companies to behaveas good corporate citizens. To view these two concepts as alternatives, however, fails to recognize the value to be gained in using them in combination. The role envisaged for corporate citizenship by this article is illustrated by an account of the United Nations Global Compact and concerns the establishment, through consensual means, of the norms necessary for an effective regime of corporate social responsibility.To this extent therefore, corporate citizenship should be viewed, not as a replacement for corporate social responsibility, but as a complement to it.
International Non-State Actors and Social Development Policy
Authors: Stubbs Paul
Published: November 2003

This article focuses on two broad groups of actors, international non-governmental organizations (INGOs) and international consultancy companies (ICCs), and situates them within wider trends in aid and development policies. In the context of a neo-liberal policy agenda, many leading INGOs reorganized so that they became closer to emerging ICCs, as consulting, outsourcing and subcontracting became key features of aid and development policy. Throughout the 1990s, in the context of declining ODA and increasing spending on emergencies, trends towards concentration and oligopolization among private development actors grew apace, fuelling short-termism, projectization, and intense competition within the aid market. The article discusses a new aid and development regime, which is focused on coordinated poverty reduction. It suggests that, notwithstanding its progressive elements, the regime will provide added impetus to existing tendencies towards concentration, oligopolization, mergers and consortia among non-state actors, given that it is being implemented within the core principles of the new public management.
Placement Learning and the Code of Practice
Authors: Fell Alan , Kuit Judith A.
Published: November 2003

This article is a report of a single-site investigation in a post-1992 university which looked at placement learning from a variety of programmes and compared it with the QAA Code of Practice on placement learning. Each of the eight precepts from the Code of Practice is listed separatelyand compared with actual practice. The greatest correlation occurs in thoseprogrammes that have a mandatory placement linked to vocational requirements. Although all the programmes studied meet some of the precepts, none meetall of the precept requirements. This was particularly evident in precepts 2–8 in which rhetoric departed from reality. The university involved in the study is probably very typical in the sector and the article discusses some of the possible reasons for this.
Teaching African conflicts
Authors: Dougherty Beth K.
Published: November 2003

Teaching African conflicts can be difficult, as an instructor confronts ideological debates, contested discourses, the historical burden of slavery and colonialism, and issues of (western) power/privilege, race and voice, all while navigating the approbation of colleagues and students alike. This article identifies four broad philosophical issues in constructing a course focusing on African conflicts: students’ lack of knowledgeabout Africa; the complexity of the material; concerns about negativity; and controversial, contested issues. The second part of the article discussesa variety of strategies for meeting these challenges, including: active learning techniques, such as role-play simulations and structured debates; theuse of documentaries, African films, and popular books/novels as teaching materials; exercises to identify stereotypes; and providing students with ‘conflict programs’ or handouts containing vital information suchas the main actors, a timeline, and a map.
Contrasting Visions of Early Childhood Education
Authors: Cleghorn Ailie , Prochner Larry
Published: November 2003

This article explores the way in which two, quite distinct, visions of early childhood (EC) education were manifested in selected rural and urban centers in India and Zimbabwe. Elements of a pediatric orientation existed along with aspects of a pedagogical model that emphasizes a western form of school preparation. The article concludes that the potential for rural early childhood programs in particular, to be effective, may be strengthened if EC teacher education included knowledge about the divergent influences of these two orientations towards children and their developmental needs.
Possibilities of Criterion Referenced Social Skills Development
Authors: Zsolnai AnikÛ , JÛzsa Kriszti·n
Published: November 2003

A prevention-oriented, two-year school-based program for seven-year-olds to facilitate the development of social competence was designed and tested. Conducted by a trained psychologist, the program focused on three groups of social skills and behaviors (interpersonal, self-related and task-related). The authors applied a new theoretical framework for the interpretation of our findings, that of ‘criterion referenced education’. The main idea of this new concept is that training will not be stopped until each and every child reaches optimal acquisition and mastery of skills and abilities. In one third of the subjects involved in the experiment the two-year development resulted in the optimal acquisition of the studied skill group. The results confirmed our hypothesis that social skills can be developed effectively in a school context and that criterion referenced education can be used for developing social skills with success.
Young Deaf Children and the Prediction of Reading and Mathematics
Authors: Tymms Peter , Brien David , Merrell Christine , Collins Judith , Jones Paul
Published: November 2003

Nearly 1000 deaf children were assessed upon entry to school, aged four and five years, using a broad baseline assessment, and then again one year later in reading and maths. Comparative data were also available for hearing children. These data were used to look at the prediction of the academic achievement of children with varying degrees of hearing loss. Despite past failures at establishing good predictors and despite the apparently very complex nature of the task, clear and simple prediction proved to be possible. The findings are discussed in terms of monitoring systems and research potential.
Sustaining the Heart of Action Research(ers)
Authors: Bradbury Hilary
Published: November 2003

In designing the new Action Researchjournal Peter Reason and I agreed to introduce influential thinkers using an interview format. Our goal is to connect journal readers with people whose work is not often cited within the action research community, but which we believe can benefit reflection and practice among action researchers. My first interview is with Joanna Macy, an eco-philosopher and experiential educator. In particular I believe that Macy’s work has much to teach us about accessing those parts that block action researchers and their research partners from embracing and realizing the changes we desire. By addressing deeper emotions that color all our so-called rational efforts, we may find ourselves more capable of doing better action research.
Transformational Potential of Focus Group Practice in Participatory Action Research
Authors: Chiu Lai Fong
Published: November 2003

In Participatory Action Research (PAR), group processes are central in facilitating change and focus groups are widely used by action researchers. However, the epistemological basis upon which focus group practice is grounded has not been closely examined and its transformational role has been taken for granted. This might impede the development of the focus group as a distinctive research practice and the realization of its transformational potential. Against the background of three participatory action research projects carried out in the National Health Service of the UK, the author shares her experience of using a variety of focus group methods for facilitating change in health promotion practice. Practical examples are used to explore the relationships between focus group practice and its epistemological grounding. It is suggested that the transformational potential of the focus group lies in the equal value placed on different ways of knowing by an extended epistemological framework and the dynamic of knowing and doing embedded in the PAR process.
Airway inflammation after removal from the causal agent in occupational asthma due to high and low molecular weight agents
Authors: Boulet LP , Boutet M , Laviolette M , Dugas M , Milot J , Leblanc C , Paquette L , Cote J , Cartier A , Malo JL
Published: November 2003

In order to determine 1) the features of airway inflammation after removal from exposure to high (HMW) and low (LMW) molecular weight agents 2) if there are any differences in the pattern of inflammation induced by these two types of agents, we studied 18 subjects with a recently confirmed diagnosis of occupational asthma (OA) due to HMW (n = 11) and LMW (n = 7) agents. The duration of asthma symptoms varied from 2 to 108 months (mean 33 months), and withdrawal from exposure to the sensitizing agent from 3 to 24 weeks (mean 10 weeks). All subjects underwent measurements of expiratory flow rates, methacholine inhalation tests, and a flexible bronchoscopy with bronchoalveolar lavage (BAL) and bronchial biopsies. Endoscopic findings were compared with a group of 10 normal subjects. At the time of the bronchoscopy, asthma symptoms were minimal in most subjects. Although 15/18 subjects had normal forced expiratory volume in one second (FEV1 > 80% pred), all subjects had increased airway responsiveness to methacholine (provocation concentration producing a 20% fall in FEV1 = 0.2-10.0 mg.ml-1). BAL analysis showed similar median percentages of the total number of cells and differentials in control subjects and those exposed to HMW and LMW agents. Bronchial biopsies showed that mean inflammatory cell count, both epithelial and sub-epithelial, was similarly raised in OA subjects exposed to either HMW or LMW agents, compared to controls, except for epithelial lymphocyte count. In contrast to the controls, bronchial biopsy of both groups with OA also showed other changes such as extensive epithelial desquamation, ciliary abnormalities of the epithelial cells, smooth muscle hyperplasia and subepithelial fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)
High dose inhaled atrial natriuretic peptide is a bronchodilator in asthmatic subjects
Authors: Hulks G , Thomson NC
Published: November 2003

Atrial natriuretic peptide (ANP) has been shown to be an effective bronchodilator when given intravenously, but its efficacy by inhalation has not been assessed. In the first part of the current study, six asthmatic subjects, mean (SEM) forced expiratory volume in one second (FEV1) 2.09 (0.30) l, received 0.1 and 1 mg atrial natriuretic peptide by inhalation, and in the second study five subjects, FEV1 1.92 (0.40) l, received 5 mg ANP by inhalation. ANP was given in a placebo-controlled, double blind, randomized manner, with measurement of FEV1 over the following 60 min. Nebulized salbutamol was given at 60 min as a measure of the maximal bronchodilator response attainable by conventional therapy. No significant bronchodilator effect was seen following the 0.1 or 1 mg inhalation, although the latter produced a minimal transient elevation in peripheral atrial natriuretic peptide plasma levels. A bronchodilator effect was seen with the 5 mg dose, which produced delta FEV1 0.42 (0.09) l compared to 0.93 (0.13) l subsequently produced by salbutamol. This effect peaked at 5 min and was no different from placebo from 10 min onwards. We conclude that atrial natriuretic peptide may produce significant bronchodilation when given by inhalation in high doses, and speculate that substances which generate cyclic guanosine monophosphate (cGMP) in airway smooth muscle warrant further investigation as potential bronchodilatory agents.
Patterns of increasing beta-agonist use and the risk of fatal or near-fatal asthma
Authors: Suissa S , Blais L , Ernst P
Published: November 2003

The association between the use of inhaled beta-agonists by metered-dose inhaler and the risk of fatal or near-fatal asthma has been demonstrated. It shows that asthmatics who use one canister of beta-agonist per month more than the number used by other similar asthmatics have twice the risk of fatal or near-fatal asthma. The present investigation assesses the magnitude of this excess risk when an asthmatic increases his/her own monthly use of inhaled beta-agonists over time. From a previous nested case-control study of 129 deaths and near-deaths from asthma (cases) and 655 controls from a cohort of 12,301 asthmatics, the subset using at least 12 inhalers during the 12 month study period was identified (97 cases and 258 controls). A profile score, ranging 0-11, was formed to quantify the patterns of beta-agonist use over time for each subject, covering the entire spectrum extending from decreasing to increasing use. The relative risk was 15.2 (95% confidence interval (CI) 2.4-96.2) per unit increase of the profile score in subjects with a pattern of increasing beta-agonist use (profile score of 6.5 or more), but this relative risk was only 1.5 (95% CI 0.8-2.6) per unit when the profile score was less than 6.5 (non-increasing use). This relative risk was independent of the risk associated with the total quantity of beta-agonist use in the 12 month period, which remained around 1.6 (95% CI 1.3-2.0) per inhaler per month.(ABSTRACT TRUNCATED AT 250 WORDS)
Beta 3-adrenoceptor agonists, BRL 37344 and SR 58611A, do not induce relaxation of human, sheep and guinea-pig airway smooth muscle in vitro
Authors: Martin CA , Naline E , Bakdach H , Advenier C
Published: November 2003

The existence of atypical- or beta 3-adrenoceptors has now been generally accepted. These receptors have been shown to be abundant in adipose tissue and in a number of gastrointestinal smooth muscle preparations. A recent study reported that beta 3-adrenoceptor stimulation mediated relaxation of isolated canine bronchial smooth muscle. The aim of the present study was to extend this observation to other species. We investigated the in vitro responses of guinea-pig, human and sheep bronchial smooth muscle to isoprenaline, salbutamol (a selective beta 2-adrenoceptor agonist), and BRL 37344 and SR 58611A (two presumably selective beta 3-adrenoceptor agonists). The preparations were precontracted to 60-70% of maximal tension with histamine 10(-6) M for guinea-pig and human bronchi, or acetylcholine 10(-6) M for sheep bronchi. In each species, SR 58611A produced a slight fall in tension of about 10% of the effects of theophylline (3 mM), but this decrease in tension was not significantly different from the spontaneous and weak relaxation observed with saline addition during the same duration of the experiment. These relaxations were not modified by either the nonselective beta-adrenoceptor antagonist propranolol or the selective beta 2-adrenoceptor antagonist ICI 118,551. In contrast, BRL 37344 induced a significant concentration-dependent fall in tension induced by both spasmogens. Its relaxant effects were inhibited both by propranolol and ICI 118,551 in human and guinea-pig airways, whereas on the isolated sheep bronchus BRL 37344-induced relaxations were only slightly, albeit significantly, reduced with either of the beta-adrenoceptor antagonists tested.(ABSTRACT TRUNCATED AT 250 WORDS)
Exogenous surfactant enhances mucociliary clearance in the anaesthetized dog
Authors: De Sanctis GT , Tomkiewicz RP , Rubin BK , Schurch S , King M
Published: November 2003

Therapy with exogenous surfactants is currently used for the treatment of respiratory distress syndrome of the newborn (RDS) and is under investigation for treatments related to adult RDS. However, the possible use of exogenous surfactant as a means of enhancing mucus clearance in other respiratory diseases has not been addressed. We therefore studied the effects of an artificial surfactant (Curosurf) on in vivo tracheal mucus velocity in intubated pentobarbital-anaesthetized dogs. Five dogs were randomly administered, on separate occasions, either vehicle (saline) or 10 mg Curosurf by means of local instillation via a catheter into the right lung. Tracheal mucus was collected by inserting a soft-bristled cytology brush to the level of the carina, and analysed for viscoelasticity by microrheometry. Mucociliary clearability in vivo, tracheal mucus velocity (TMV) in mm.min-1, was determined by bronchoscopic observation of charcoal marker particle transit times. The initial placement of charcoal was at the same level of the lower trachea that mucus was collected from. The effect of ciliary beat frequency was assessed on the frog palate assay by a videoscopic technique. In the dog, TMV was significantly increased after administration of surfactant. The values of TMV in the vehicle- and surfactant-treated dogs were 6.3 +/- 4.0 vs 25.6 +/- 6.5 mm.min-1 (SD), respectively. There were no discernible differences between prevehicle and postvehicle TMV values, and no significant differences in any mucus viscoelastic parameter, as determined by magnetic rheometry.(ABSTRACT TRUNCATED AT 250 WORDS)
A hospital outbreak of penicillin-resistant pneumococci in The Netherlands
Authors: Mandigers CM , Diepersloot RJ , Dessens M , Mol SJ , van Klingeren B
Published: November 2003

Respiratory infections with penicillin resistant pneumococci constitute an increasing health care problem. This paper describes the nosocomial spread of penicillin resistant pneumococci (PRP) on a pulmonary ward. During an eight-month period, minimal inhibitory concentrations (MICs) for penicillin and several other antibiotics were performed on all Streptococcus pneumoniae isolates that were shown to be penicillin resistant by a screening assay. The personal data and case history of all patients with penicillin resistant pneumococci were evaluated. Penicillin Resistant Pneumococci were cultured from 18 patients, 16 men (mean age 74 +/- 8 yrs) and 2 women (aged 54 and 60 yrs). Chronic obstructive pulmonary disease was diagnosed in 16 patients, 10 of which had an additional underlying disease (2 diabetes mellitus, 2 heart failure, 2 malignancy). Prior to culture of Penicillin Resistant Pneumococci, 11 out of 18 patients were treated with antibiotics, a beta-lactam in most instances. Ten out of 18 patients died during or shortly after hospitalization. The death of one patient seems to be directly related to infection with Penicillin Resistant Pneumococci. The five Penicillin Resistant Pneumococci isolates available for serotyping were all type 9. The minimal inhibitory concentrations for penicillin varied from 0.5 to 2.0 mg.l-1. High minimal inhibitory concentrations were also noted for cefixime (all over 4.0 mg.l-1) and ceftriaxone (0.5-1.0 mg.l-1). It is concluded that penicillin resistant pneumococci can spread rapidly among old and debilitated patients. Thus, patients with this infection should be barrier nursed.
Home versus hospital intravenous antibiotic therapy in the treatment of young adults with cystic fibrosis
Authors: Pond MN , Newport M , Joanes D , Conway SP
Published: November 2003

We wanted to investigate whether home intravenous antibiotic treatment of pulmonary exacerbations of cystic fibrosis is as effective as treatment in hospital. The case records of all patients attending the Leeds adult cystic fibrosis clinic were reviewed to identify those who had received home intravenous antibiotic treatment. All home treatments undertaken were included. For each home treatment, the temporally closest hospital treatment for that patient was then selected for comparison and the changes with treatment in peak expiratory flow rate (PEFR), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), C-reactive protein (CRP), plasma viscosity, total white cell count, absolute neutrophil count, total immunoglobulin G (IgG) concentration, chest X-ray score (Northern), clinical score, Shwachman-Kulczyki score and weight were analysed for differences between home treatment and hospital treatment. Fifty one paired home/hospital treatments in 25 patients were compared. The improvement in total white cell count was found to be significantly greater in the hospital group, but the difference was very small. The improvements in absolute neutrophil count, and all the other measured variables, were the same in the two groups. Treatment of exacerbations of cystic fibrosis at home or in hospital is, thus, equally effective given proper patient selection and adequate monitoring of the response to treatment.
Survival and prediction of successful ventilator weaning in COPD patients requiring mechanical ventilation for more than 21 days
Authors: Nava S , Rubini F , Zanotti E , Ambrosino N , Bruschi C , Vitacca M , Fracchia C , Rampulla C
Published: November 2003

We studied survival and failure or success of weaning from mechanical ventilation (MV) in 42 consecutive chronic obstructive pulmonary disease (COPD) patients requiring prolonged MV (more than 21 days) after an episode of acute respiratory failure requiring admission to our Intermediate Intensive Care Unit (IICU). Parameters including arterial blood gases, pulmonary function tests, respiratory muscle force, neuromuscular drive, and nutritional status were recorded during a phase of clinical stability, in order to identify the features related to survival and weaning. All the patients were submitted to a comprehensive rehabilitation programme. Successful weaning from MV was defined as complete respiratory autonomy for at least 48 h. Twenty three patients were successfully weaned from MV after an average period of 44 days (Group A), requiring no further MV during their stay in hospital, whilst the remaining 19 patients were not able to be disconnected from the ventilator (Group B). The discriminant analysis showed that weaning from MV was significantly associated with arterial carbon dioxide tension (PaCO2), neuromuscular drive (P0.1), maximal inspiratory pressure (MIP), arterial oxygen tension (PaO2), the ratio of respiratory frequency to tidal volume (f/VT) and the serum protein level. Other pulmonary function tests (forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC), anthropometric data, nutritional status, number of pulmonary exacerbations during MV and evidence of cor pulmonale, were similar in the two groups. The discriminant equation considering PaCO2 and MIP could separate the two groups with an accuracy of 84%. The overall survival at 2 yrs was 40%; in Group B it was significantly lower than in Group A (22 vs 68%). Most of the deaths occurred within the first 120 days after intubation.(ABSTRACT TRUNCATED AT 250 WORDS)
The ageing of lung function: cross-sectional and longitudinal studies of an Inuit community
Authors: Rode A , Shephard RJ
Published: November 2003

Three surveys (1969/1970, 1979/1980 and 1989/1990) have examined the impact of acculturation to a sedentary lifestyle on the pulmonary function of a circumpolar native Inuit community. The sample comprised more than 50% of those aged 20-60 yrs, most recently 119 males and 92 females. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximal mid-expiratory flow (MMEF) were measured by standard spirometric techniques, and information was obtained on smoking habits and health. Multiple regression equations showed that lung function was affected by height and age, but usually not by age squared. Cross-sectional age coefficients for FVC and FEV1 increased over the period 1969/1970 to 1989/1990. Parallel longitudinal trends were seen in FEV1 (males only). Multiple analysis of variance (MANOVA) showed age-decade*cohort effects for FVC and FEV1 (males but not females). Almost all of the population now smoke (mean +/- SD males 13 +/- 8 cigarettes.day-1; females 11 +/- 7 cigarettes.day-1). However, smoking bears little relationship to lung function perhaps due to limited variance in consumption. About a third of the community have physician-diagnosed and/or radiographically visible chest disease, but with little effect upon pulmonary function. We conclude that an apparent secular trend to a faster ageing of lung function in men is not explained by disease or domestic air pollution. Possible factors include increased lung volumes in young adults, greater pack-years of cigarette exposure, nonspecific respiratory disease, increased inspiration of cold air or altered chest mechanics due to operation of high-speed snowmobiles, and loss of physical fitness.
Descending necrotizing mediastinitis secondary to a retropharyngeal abscess
Authors: Takao M , Ido M , Hamaguchi K , Chikusa H , Namikawa S , Kusagawa M
Published: November 2003

A rare case of descending necrotizing mediastinitis (DNM) secondary to a nontraumatic retropharyngeal abscess is reported. Even in the era of antibiotics, the mortality of DNM is still around 40%. In spite of drainage of a localized neck abscess, and the administration of systemic antibiotics, the retropharyngeal abscess extended to the pericardial and pleural cavities. Several drainage procedures and thoracotomies were performed to treat the bilateral empyemas and purulent pericarditis. The patient was discharged on hospital day 52. Computed tomography was used to follow the progression of disease, and assess the efficacy of treatment. DNM is a very aggressive form of mediastinitis. The importance of proper mediastinal drainage, as well as the systemic administration of antibiotics, must be emphasized.
Home treatment for chronic respiratory insufficiency: the situation in Europe in 1992. The European Working Group on Home Treatment for Chronic Respiratory Insufficiency
Authors: Fauroux B , Howard P , Muir JF
Published: November 2003

The search for improved quality of life and a reduction in health care costs is leading to the development of home treatment. The organization of home treatment for chronic respiratory patients in 13 European countries was evaluated at the end of 1992 by means of a questionnaire. Switzerland and the Association Nationale pour le Traitement A Domicile de l'Insuffisance Respiratoire Chronique (ANTADIR) in France maintain registers for patients on oxygen therapy, mechanical ventilation and sleep disorders. Sweden and Poland have a national register for patients receiving oxygen. In other countries, some information can be obtained from the National Health Service or the commercial provider. Oxygen concentrators are used preferentially in all countries except Italy, Denmark, Spain and The Netherlands. Home ventilator treatment is generally performed by volume-cycled ventilators. National prescription rules exist in some parts of Spain, Switzerland and Belgium. In other countries, such as Germany, prescriptions rely on recommendations elaborated by specialists or international guidelines. Service and equipment are provided by national organizations, health services, commercial companies or hospitals. Home supervision of the patient is performed by a nurse and/or a doctor and equipment maintenance by a technician. Important differences exist between countries in Europe in home treatment of chronic respiratory disease. Comparative analysis should help achieve uniform standards and provide a basis for future research.
Specific CAPN10 Gene Haplotypes Influence the Clinical Profile of Polycystic Ovary Patients
Authors: Gonzalez Alejandro , Abril Eduardo , Roca Alfredo , Aragón Maria José , Figueroa Maria José , Velarde Pilar , Ruiz Rocío , Fayez Omar , Galán José Jorge , Herreros José Antonio , Real Luis Miguel , Ruiz Agustín
Published: November 2003

Recently, several research groups have evaluated CAPN10 gene in polycystic ovarian syndrome (PCOS) patients and other phenotypes, including hirsutism or intermediate phenotypes of PCOS. Molecular genetic analysis of CAPN10 gene indicates that different alleles may play a role in PCOS susceptibility and could be associated with idiopathic hirsutism. However, these observations are not exempt from controversy, because independent studies cannot replicate these preliminary findings.

We present a haplotype-phenotype correlation study of CAPN10 haplotypes in 148 women showing ecographically detected polycystic ovaries (PCO) combined with one or more of these clinical symptoms: amenorrhea or severe oligomenorrhea, hyperandrogenism, and anovulatory infertility, as well as 93 unrelated controls. We have reconstructed and analyzed 482 CAPN10 haplotypes in patients and controls. We detected the association of UCSNP-44 allele with PCO phenotype in the Spanish population (P = 0.02). In addition, we identified several CAPN10 alleles associated to phenotypic differences observed between PCO patients, such as the presence of hypercholesterolemia (haplotype 1121, P = 0.005), presence of hyperandrogenic features (P = 0.05), and familial cancer incidence (haplotype 1111, P = 0.0005). Our results confirm the association of UCSNP-44 allele with PCO phenotype in the Spanish population. Moreover, we have identified novel candidate risk alleles and genotypes, within CAPN10 gene, that could be associated with important phenotypic and prognosis differences observed in PCOS patients.
Cortical Bone Density Is Normal in Prepubertal Children with Growth Hormone (GH) Deficiency, but Initially Decreases during GH Replacement due to Early Bone Remodeling
Authors: Schweizer R. , Martin D. D. , Schwarze C. P. , Binder G. , Georgiadou A. , Ihle J. , Ranke M. B.
Published: November 2003

Dual energy x-ray absorptiometry (DEXA) has revealed that GH- deficient adults gain in bone mineral density during GH therapy. Measurements of volumetric bone density (grams per cubic centimeter vs. grams per square centimeter) and structure, however, are achieved through peripheral quantitative computed tomography (pQCT). In 45 prepubertal GH-deficient children, we studied pQCT measurements before the start and for 12 months of GH treatment. Serum alkaline phosphatase (AP), procollagen I carboxyl-terminal propeptide (PICP), and deoxypyridinoline reflected bone metabolism status. Findings at the start of GH treatment were (mean sd score): bone area, −0.44; cortical density, −0.03; cortical area, −1.32; cortical thickness, −1.41; and marrow area, +0.66. At 12 months, cortical density had fallen to −0.73 (P < 0.001), whereas cortical area and thickness, and marrow area did not change. AP, PICP, and deoxypyridinoline increased significantly within the first 3 months (increase: AP, 66.5 U/liter; PICP, 72 μg/liter; DPD, 11.4 nmol/mmol creatinine). The pQCT showed that cortical density is not reduced in GH-deficient patients. Higher bone metabolism explains the lower cortical density after GH therapy commenced. Thus, the manifestation of GH deficiency is evidently similar in children and adults, and pQCT provides important information in addition to DEXA measurements, as DEXA does not take bone structure into account.
Association of Inflammation Markers with Impaired Insulin Sensitivity and Coagulative Activation in Obese Healthy Women
Authors: Romano Mario , Guagnano Maria Teresa , Pacini Giovanni , Vigneri Sergio , Falco Angela , Marinopiccoli Marina , Manigrasso Maria Rosaria , Basili Stefania , Davì Giovanni
Published: November 2003

Insulin resistance is associated with a low chronic inflammatory state. In this study we investigated the relationship between impaired insulin sensitivity and selected markers of inflammation and thrombin generation in obese healthy women. We examined 32 healthy obese women (body mass index ≥ 28), with normal insulin sensitivity (NIS, n = 14) or impaired insulin sensitivity (n = 18), and 10 nonobese women (body mass index < 25). Impaired insulin sensitivity patients had significantly higher levels of C-reactive protein (CRP), TGF-β1, plasminogen activator inhibitor-1 (PAI-1), activated factor VII (VIIa), and prothrombin fragment 1 + 2 (F1 + 2) compared with either control subjects or NIS patients. On the other hand, NIS patients had higher CRP, TGF-β1, PAI-1, and factor VIIa, but not F1 + 2, levels than controls. Significant inverse correlations were observed between the insulin sensitivity index and TGF-β1, CRP, PAI-1, factor VIIa, and F1 + 2 levels. Moreover, significant direct correlations were noted between TGF-β1 and CRP, PAI-1, factor VIIa, and F1 + 2 concentrations. Finally, multiple regressions revealed that TGF-β1 and the insulin sensitivity index were independently related to F1 + 2. Our results are the first to document an in vivo relationship between insulin sensitivity and coagulative activation in obesity. The elevated TGF-β1 levels detected in the obese population may provide a biochemical link between insulin resistance and an increased risk for cardiovascular disease.
Endogenous Sex Hormones and Cardiovascular Disease in Men
Authors: Muller Majon , van der Schouw Yvonne T. , Thijssen Jos H. H. , Grobbee Diederick E.
Published: November 2003

Unlike women, men do not experience an abrupt reduction in endogenous sex hormone production. It has, however, become clear that an age-associated decrease in the levels of (bioactive) sex hormones does occur. Whether endogenous sex hormones have an impact on cardiovascular disease has for many years remained largely unknown, but during the last decade more attention has been drawn to the importance of testosterone, estrogens, and adrenal androgens in etiology, prevention, and treatment of male cardiovascular disease. The purpose of this article is to summarize the evidence currently available on the association between endogenous sex hormones and cardiovascular disease in males. Published studies dealing with the relationship between circulating levels of sex hormones and cardiovascular disease in males were reviewed. The studies reviewed in this article suggest that circulating endogenous sex hormones and estrogens have a neutral or beneficial effect on cardiovascular disease in men.
Effects of Growth Hormone (GH) on Ghrelin, Leptin, and Adiponectin in GH-Deficient Patients
Authors: Engström Britt Edén , Burman Pia , Holdstock Camilla , Karlsson F. Anders
Published: November 2003

Ghrelin is a recently discovered gastric peptide that increases appetite, glucose oxidation, and lipogenesis and stimulates the secretion of GH. In contrast to ghrelin, GH promotes lipolysis, glucose production, and insulin secretion. Both ghrelin and GH are suppressed by intake of nutrients, especially glucose. The role of GH in the regulation of ghrelin has not yet been established.

We investigated the effect of GH on circulating levels of ghrelin in relation to its effects on glucose, insulin, body composition, and the adipocyte-derived peptides leptin and adiponectin. Thirty-six patients with adult-onset GH deficiency received recombinant human GH for 9 months in a placebo-controlled study. Body composition and fasting serum analytes were assessed at baseline and at the end of the study. The GH treatment was accompanied by increased serum levels of IGF-I, reduced body weight (−2%) and body fat (−27%), and increased serum concentrations of glucose (+10%) and insulin (+48%). Ghrelin levels decreased in 30 of 36 subjects by a mean of −29%, and leptin decreased by a mean of −24%. Adiponectin increased in the women only. The decreases in ghrelin and leptin correlated with changes in fat mass, fat-free mass, and IGF-I. The reductions in ghrelin were predicted independently of the changes in IGF-I and fat mass.

It is likely that the reductions in ghrelin and leptin reflect the metabolic effects of GH on lipid mobilization and glucose production. Possibly, a suppression of ghrelin promotes loss of body fat in GH-deficient patients receiving treatment. The observed correlation between the changes in ghrelin and IGF-I may suggest that the GH/IGF-I axis has a negative feedback on ghrelin secretion.
Longitudinal Association between Sex Hormone Levels, Bone Loss, and Bone Turnover in Elderly Men
Authors: Gennari Luigi , Merlotti Daniela , Martini Giuseppe , Gonnelli Stefano , Franci Beatrice , Campagna Stella , Lucani Barbara , Dal Canto Norberto , Valenti Roberto , Gennari Carlo , Nuti Ranuccio
Published: November 2003

Male osteoporosis is an increasingly important health problem. It is known that sex steroid hormones play an important role in regulating bone turnover and bone mass in males as well as in females. However, the exact mechanism of bone loss in men remains unknown. In the present study, 200 elderly men (age range, 55–85 yr) were followed for 4 yr to evaluate the relationships between hormone levels, bone turnover markers, bone mineral density, and rates of bone loss. Femoral and lumbar bone mineral density, bone ultrasound parameters at the os calcis, serum testosterone (T), serum estradiol (E2), SHBG levels, and bone turnover markers (urinary crosslaps and bone alkaline phosphatase) were evaluated for each man at enrollment and 4 yr afterward. The free androgen index (FAI) and free estrogen index (FEI) as well as measures of the bioavailable sex hormones [calculated bioavailable E2 (c-bioE2) and T (c-bioT)] were calculated from total hormone levels and SHBG. In the total population, T, c-bioT, c-bioE2, FAI, and FEI, but not E2, decreased significantly with age, whereas SHBG increased significantly. Subjects with FEI, c-bioE2, and E2 levels below the median showed higher rates of bone loss at the lumbar spine and the femoral neck as well as higher speed-of-sounds decrease at the calcaneus with respect to men with FEI, c-bioE2, and E2 levels above the median. Serum bone alkaline phosphatase and urinary crosslaps were significantly higher in men with FEI, c-bioE2, and E2 in the lower quartile than in men with FEI, c-bioE2, and E2 levels in the higher quartile. No statistically significant differences were observed in relation to T, c-bioT, or FAI levels. Finally, the ratio between E2 and T, an indirect measure for aromatase activity, increased significantly with age and was higher in normal than in osteoporotic subjects. In conclusion, results from the present study indicate an important role of estrogens, and particularly of the ability to aromatize T to E2, in the regulation of bone loss and bone metabolism in elderly men.