bluuebunny/crossref_metadata_2025 huggingface dataset:
Building a Better Theory of Well-Being
Authors: Easterlin Richard A.
Published: February 2006

Finding a better theory of well-being compared to prevailing theories on psychology and economics is one the main challenges for studies on happiness and economics. This chapter demonstrates that empirical results are at variance with both strands, and proposes new enquiries on the interplay of personality and life-events in shaping well-being as a solution to the problem.
Happiness and Political Philosophy: The Case of Nancy Mitford versus Evelyn Waugh
Authors: Matravers Matt
Published: February 2006

This chapter argues that appeals to subjective welfare are essential in the construction of justice offered by theorists. The role of happiness has been significant in both the utilitarian and virtue ethical traditions, although virtue ethicists often prefer to invoke the idea of eudaimonia. Why this is so, and the implications of the theoretical point are discussed based on an exchange between Mitford and Waugh in 1948.
Towards a Theory of Self-Segregation as a Response to Relative Deprivation: Steady-State Outcomes and Social Welfare
Authors: Stark Oded , Wang You Qiang
Published: February 2006

This chapter discuss a theoretical case of self-segregation when a distaste for deprivation is prominent. The analysis suggests a new operational measure for social welfare, and paves the way to interesting experimental cases.
Happiness in Hardship
Authors: Veenhoven Ruut
Published: February 2006

Associating happiness with trouble-free living would make happiness studies truly illusionary. The theory has to cope with the evidence that people can be quite happy in spite of considerable problems in society and in their private lives. This is shown not to be a paradox. The illusion of a paradox is based on overestimating hardship and in false theories on happiness.
Happiness and Individualism: A Very Difficult Union
Authors: Zamagni Stefano
Published: February 2006

The basis of the reductionism affecting the economic discourse is not so much to be found in the assumption of self-interested behaviour. The real limit of economic thinking, especially today, lies in the artificially restrictive image of human nature and human motivation that is implied in the individualistic anthropology underpinning the notion of homo oeconomicus. This chapter offers a plea for personalism and relationality, and presents a theory of reciprocity.
The Performance of Democracies
Authors: Roller Edeltraud
Published: February 2006

This book offers a description and explanation of the performance of western democracies. It addresses two main questions: Is the performance of western democracies in decline? Do institutions matter for political performance? It aims at a comprehensive stock-taking for twenty-one OECD countries by systematically examining all major domestic policy areas — domestic security policy, economic policy, social policy, and environmental policy — from 1974 to 1995. The quality of democracy is assessed at the level of the four policy areas, and at a general level encompassing all areas. The question of trade-offs between policy areas is studied in an unprecedented way. The empirical findings confront widely-held beliefs about the performance of democracies: Western democracies as a whole did not converge at a lower level of performance, and trade-offs between different policy areas did not increase. The question ‘do institutions matter?’ can only partially be answered in the affirmative. Political institutions do matter, but formal and informal institutions cause different effects; both matter only sometimes and only to a limited degree.
Introduction
Authors: Roller Edeltraud
Published: February 2006

This introductory chapter defines the questions and goals of the study, and provides a brief overview on the state of research regarding the performance of democracies. It seeks to answer two questions: Is the effectiveness of western democracies in decline and do institutions matter for political effectiveness? The continuous decline in the effectiveness of democratic systems was a prominent theme in various crisis theories (ungovernability, legitimation crisis) since the 1970s. Since the early 1990s, it has been taken up by globalization theories. The assertion that institutions matter for political performance reaches back to the emergence of the —new institutionalism— in the early 1980s. The most relevant precursor for this study of the performance of democracies is Arend Lijphart’s Patterns of Democracy (1999). His book along with other contributions from the fields of comparative public policy and comparative sociology on the quality of life is used to clarify the contribution of this study on the institutional basis of political performance, and to elaborate to what extent it goes beyond the current state of research.
4 Level, Development, and Structure of the Effectiveness of Western Democracies
Authors: Roller Edeltraud
Published: February 2006

This chapter presents an empirical analysis of the level, development, and structure of political effectiveness in twenty-one OECD countries between 1974 and 1995. There are three main results. First, regarding the level of effectiveness, the USA is, with the exception of economic policy, always among those countries with the worst performance record. Second, in terms of the development of political effectiveness, the general hypothesis that western democracies have been converging at a lower level of performance can not be confirmed. Third, the thesis of increasing incompatibility or increased tension between different policy goals finds no empirical confirmation.
The Influence of Political Institutions on the Effectiveness of Western Democracies
Authors: Roller Edeltraud
Published: February 2006

This chapter examines the hypotheses about the impact of formal and informal institutions on the level, stability, and the structure of political effectiveness of western democracies. It presents a re-analysis of Arend Lijphart's Pattern of Democracy (1999) and investigates the validity of various veto player indices. It is shown that political institutions do matter, but formal and informal institutions cause different effects; both matter only sometimes and only to a limited degree.
Restructuring Europe
Authors: Bartolini Stefano
Published: February 2006

This study focuses on the historical configuration of territorial borders and functional boundaries of the European nation states, and interprets integration as a process of transcendence, redefinition, and shift of those same boundaries that alters the nature of the nation states’ domestic political structures. The core of the argument concerns the relationship between the institutional design of the new Brussels centre, the boundary redefinitions that result from its political production, and the consequences of both these processes on the established national and emerging European political structures. The EU is interpreted through three key conceptual tools: ‘centre formation’, ‘system building’, and ‘political structuring’. The ‘centre formation’ — with limited administrative and fiscal capabilities and strong regulatory and judicial capabilities — is not accompanied by ‘system building’ in the field of cultural integration, social sharing institutions, and participation rights, that is, by institutions forcing its components to stay within it beyond the mere instrumental calculations. Given that for any new centre a balance must exist between its system building capacity and the scope and reach of its political production, the argument is that the ambitious political production of the EU is clearly out of balance with its weak system building capacity. As far as the ‘political structuring’ is concerned, this work argues that the institutional design of the Union and its weak system building militate to date against any stable form of political structuring for its representative actors, while its growing political production tends to undermine national mechanisms of political representation and legitimation. Under these conditions, any institutional democratization without political structuring may turn into facade electioneering, at best, or dangerous experiments, at worst. In the view of classical sociology — that takes the existence of a certain overlap between social identities, political boundaries, and social practices as a precondition for establishing political agency and a ‘rational’ political order — the EU is both a source of problems but also a possible solution to them. It can be seen as a project for regaining some degree of coherence between extended social practices, social identities, solidarity ties, and rules of deliberation at the European level. Most of the ideas expressed in this book show how problematic this project is believed to be.
3 Centre Formation in the European Union
Authors: Bartolini Stefano
Published: February 2006

This chapter devotes attention to the specific features of the new centre at the European level, and focuses on the peculiarities of its institutional design. The typical centre-building features of territorial expansion, legal centralization, integration of the national and supra-national techno-bureaucratic infrastructure, and competence accretion have developed together with a persisting weak territoriality, an unclear competence attribution in vertical and horizontal senses, a partial constitutional empowerment of the subjects qua economic agents, and uncertain legitimacy sources. This configuration points to an ‘elite consolidation’, resulting from an alliance between national rulers (the national governments, the MPs) and the supra-national techno-bureaucratic centre builders (in the Commission, the Court, the European Central Bank). It is argued that any attempt to separate the powers, distribute the competencies, and strengthen direct forms of legitimacy would upset the inter-elite form of control on which this consolidation has rested to date.
5 Political Structuring in Loosely Bounded Territories: Territorial and Corporate Structures
Authors: Bartolini Stefano
Published: February 2006

Any configuration of boundaries is relevant for the level and type of confinement of actors and resources within the new system. Chapters Five and Six analyse the implications of the EU boundary redrawing for the different types of actors and resources active in the territorial, corporate and political-electoral channels of representation. The chapters also discuss the consequences for established national political structures and the prospects for the development of new, European-wide political structures. In the territorial channel, the European integration is likely to foster processes of sub-state territorial differentiation, generate accrued sub-state territorial competition and a renewed awareness of it, and contribute towards a rebirth of (sub-state) territorially-based politics in Europe. In the corporate channel, it is suggested that the existing interest groups experience declining interest compatibility or declining solidarity ties. This is likely to generate further pluralization and fragmentation, declining cohesion of national groups, and a destructuring of national patterns of interest intermediation associated with a predominant lobbyist incorporation into the European techno-bureaucratic decision-making processes.
7 Restructuring Europe
Authors: Bartolini Stefano
Published: February 2006

This chapter discusses the implications of the model of centre formation, system building, and political structuring prevalent at the EU level to date. It interprets European integration from a long-term historical perspective in relation to the early stages of the development of the European system of states. It then discusses the macro and micro consequences of the boundary-redrawing activities for different types of actors, following the framework presented in Chapter One. Finally, the institutional and boundary configuration of the new EU centre is related to the main structures of representation at the national and EU level. This chapter also underlines the perspective of this work as based on the interactions between ‘options’ and ‘roots’, ‘exits’ and ‘locking in’, ‘collective burdens’ and ‘individual free-riding’, ‘opportunities’ and ‘costs’ involved in the process of functional and territorial boundary redefinition in Europe.
4 Research Questions for Comparative Investigation
Authors: McDonald Michael D. , Budge Ian
Published: February 2006

This chapter describes the data and the way thse are deployed operationally in the subsequent analysis. The data falls into three main categories: aggregate voting results for post-war national elections over 21 democracies with the resulting distribution of seats in parliaments and places in cabinets; policy preferences stated by all significant parties in each election in their published policy programme (their manifesto or platform); party policy preferences can also be weighted if they are in government by their share of cabinet seats. The research questions asked with these data are how far policy outputs compare with preferences on an election-to-election and government-to-government basis. More importantly, how policy relationships evolve over time canbe examined, and equilibria both for policy and preferences can be established and compared.
6 Mandates Without Obvious Majorities?
Authors: McDonald Michael D. , Budge Ian
Published: February 2006

The government mandate in its full form fails descriptively because few spontaneous majorities form in support of one party, and there is no guarantee that the plurality party is not actually opposed by most electors. A minimal version might still apply however in terms of retrospective voting — a majority might still vote against a government. This idea has been particularly prominent in the economic voting literature, This chapter examines the evidence for ‘economic’ voting. It confirms previous comparative research by showing there is only limited evidence of consistent effects from growth, unemployment and inflation on voting. This is explained in terms of electoral reactions to any set of economic conditions never being undifferentiated or unproblematic. As there is always some rational argument for voting against incumbents some electors will always do so, accounting for a general fall of incumbent votes towards their long term norm. Median voter positions are not predictable from the state of the economy, but they do match government positions over the long term and indeed provide the equilibrium towards which government policy tends.
11 Fluctuating Political Forces
Authors: McDonald Michael D. , Budge Ian
Published: February 2006

Political variables (median voter and median parliamentary, government and ministry positions) change more radically and more quickly than policy outputs. This accounts for the lack of relationships previous studies have failed to find as we did, too, in chapters 8 and 9, between political changes and policy. However, political forces oscillate round stable equilibrium positions, which show a strong relationship to the policy regimes’ equilibria previously uncovered. In the long term, the responsiveness of the median parliamentary position to the median voter position is high, as is government position to MPP, and ministries to government position.
The influences of hyperprolactinemia and obesity on cardiovascular risk markers: effects of cabergoline therapy
Authors: Serri Omar , Li Ling , Mamputu Jean‐Claude , Beauchamp Marie‐Claude , Maingrette Fritz , Renier Geneviève
Published: February 2006

Objective  In view of the association of hyperprolactinaemia with insulin resistance, we hypothesized that patients with hyperprolactinaemia may present increased cardiovascular risk markers.

Design  Descriptive clinical trial.

Methods  Serum glucose, insulin, insulin resistance, lipids, high sensitivity C‐reactive protein (hsCRP), interleukin (IL)‐6, tumour necrosis factor (TNF)‐α and soluble E‐selectin (sELAM‐1) serum levels were determined in 15 patients with hyperprolactinaemia at baseline (compared with 20 healthy subjects) and after 12 weeks of cabergoline therapy (0·5–1 mg twice per week). We also measured mononuclear cell NF‐κB activation and TNF‐α production in a subset of subjects.

Results  Serum levels of prolactin (PRL), insulin, insulin resistance (HOMA‐IR) index and hsCRP were significantly higher in patients than in control subjects. Markers of mononuclear cell activation did not differ between the groups. Hyperprolactinaemia, BMI and age were predictors of hsCRP. BMI was the only predictor of HOMA‐IR. Cabergoline therapy significantly reduced serum PRL, insulin, hsCRP and sELAM‐1 levels.

Conclusions  These data suggest that hyperprolactinaemia is associated with insulin resistance related to increased BMI and low‐grade inflammation independently of BMI. Short‐term cabergoline therapy can reduce the inflammatory markers.
Pulsed tissue Doppler identifies subclinical myocardial biventricular dysfunction in active acromegaly
Authors: Galderisi Maurizio , Vitale Giovanni , Bianco Antonio , Pivonello Rosario , Lombardi Gaetano , Divitiis Oreste de , Colao Annamaria
Published: February 2006

Objective  The aim of this study was to assess the role of pulsed tissue Doppler (TD) to identify left (LV) and right ventricular (RV) myocardial regional involvement in acromegaly.

Patients and measurements  Thirty active acromegaly patients, free of diabetes mellitus, thyroid dysfunction, valvular and coronary heart disease, clinically overt heart failure, and 30 sex‐ and age‐matched healthy controls underwent standard Doppler echocardiography and pulsed TD, by placing the sample volume at the level of basal posterior septum, LV lateral mitral annulus and RV lateral tricuspid annulus. Myocardial systolic (Sm) and diastolic velocities (Em/Am ratio) and time‐intervals of relaxation (RTm), precontraction (PCTm) and contraction (CTm) and the PCTm/CTm ratio were measured at each level.

Results  The two groups had similar heart rate, whereas acromegaly patients had higher body mass index, systolic and diastolic blood pressure, LV mass and impaired Doppler indexes of LV and RV diastolic function, without any difference in the global systolic function. At TD, acromegaly patients showed significantly delayed RTm and PCTm, reduced Em/Am, Sm and increased PCTm/CTm of posterior septum, mitral annulus and tricuspid annulus in comparison with controls. By separate multilinear regression analyses, after adjusting for body mass index, heart rate, diastolic blood pressure and LV mass index, age was the main independent determinant of tissue Doppler diastolic but not of systolic indexes.

Conclusions  In active acromegaly, pulsed TD confirms LV and RV diastolic abnormalities detectable by standard Doppler, additionally identifying subclinical biventricular impairment of systolic function.
Uterine vein and maternal urinary levels of activin A and inhibin A in pre‐eclampsia patients
Authors: Muttukrishna S. , Hyett J. , Paine M. , Moodley J. , Groome N. , Rodeck C.
Published: February 2006

Objectives  The aims of this study were to investigate if (i) urinary concentrations of activin A and inhibin A are altered in pre‐eclampsia (PE) and (ii) to study the relationship between uterine vein and peripheral vein concentrations of these hormones in PE patients.

Design and method  In a retrospective study, maternal peripheral vein and uterine vein serum and maternal urine samples collected at the time of delivery were analysed. There were three groups of patients; (i) group 1: term normal pregnancies (n = 19) (ii) group 2: patients who developed PE ≤ 37 weeks (n = 17) and (iii) group 3: patients who developed PE 37–40 weeks (n = 8). Serum and urinary activin A, follistatin, inhibin A and pro alpha C and urinary creatinine levels were measured using enzyme immunoassays in the laboratory.

Results  Normal pregnant urine samples had very low levels of activin A and inhibin A. Both groups 2 and 3 PE patients had significantly higher levels of inhibin A (P < 0·001) and activin A (P < 0·001) compared to the controls. Pro‐alpha C was not altered and follistatin was below the detection limit of the assay in the urine. Maternal peripheral serum activin A and inhibin A were significantly higher in groups 2 (P < 0·001) and 3 (P < 0·05) patients compared to the controls. Pro‐alpha C‐containing inhibins were higher in group 2 patients (P < 0·05) compared to the controls in the peripheral circulation. Uterine vein serum activin A and inhibin A levels were also significantly higher in groups 2 (P < 0·001) and 3 (P < 0·05) patients compared to the controls. There was a highly significant positive correlation between peripheral and uterine vein serum concentrations of activin A, follistatin, inhibin A and pro alpha C, suggesting the same source for these proteins in PE.

Conclusion  Urinary activin A and inhibin A are raised in groups 2 and 3 PE patients. The magnitude of rise (> 25‐fold) suggests these proteins may rise in patients before the onset of the clinical symptoms of PE. Uterine vein levels of these proteins are also raised in PE.
Effects of growth reduction therapy using high‐dose 17β‐estradiol in 26 constitutionally tall girls
Authors: Radivojevic U. , Thibaud E. , Samara‐Boustani D. , Duflos C. , Polak M.
Published: February 2006

Objective  The efficacy and safety of height‐limiting therapy with high‐dose 17β‐oestradiol in girls with constitutionally tall stature (CTS) are controversial. We evaluated the effectiveness of high‐dose 17β‐oestradiol in premenarchal girls with CTS treated until their bone age reached 14 years.

Design  We retrospectively reviewed the medical records of the girls managed between 1989 and 2000 with high‐dose 17β‐estradiol for CTS with a predicted final height greater than +3SDs.

Patients  Twenty‐six girls met our inclusion criteria. At baseline, mean chronological age was 12·06 ± 1·51 years and mean height was 171·1 ± 6·5 cm with a height standard deviation score of 4·5 ± 0·24, and mean predicted final height was 183·0 ± 4·2 cm. Treatment was stopped when bone age reached 14 years; mean treatment duration was 1·62 ± 0·76 years.

Measurements  The following were obtained at 6‐month intervals: height, body weight, Tanner stage, bone age, plasma cholesterol and triglycerides, plasma glucose and side effects. A mailed questionnaire on final height and satisfaction was sent 2 years after treatment discontinuation (response rate, 24/26).

Results  Final height was significantly (P < 0·001) reduced, by 2·4 ± 3·2 cm, as compared to predictions. High‐dose 17β‐estradiol therapy decreased growth velocity and significantly increased skeletal maturation (P < 0·001). Linear growth after treatment discontinuation was 3·3 ± 1·9 cm. No serious side effects were recorded. Most of the patients were satisfied with the treatment.

Conclusion  High‐dose 17β‐estradiol was moderately effective in reducing final height and should probably be reserved for selected patients, particularly as knowledge on potential long‐term side effects is lacking.
A bioluminescence assay for thyrotropin receptor antibodies predicts serum thyroid hormone levels in patients with de novo Graves’ disease
Authors: Hovens G. C. J. , Buiting A. M. J. , Karperien M. , Ballieux B. E. P. B. , van Der Pluijm G. , Pereira A. M. , Romijn J. A. , Smit J. W. A.
Published: February 2006

Background  TSH receptor antibodies (TBII) in Graves’ disease (GD) may be TSH receptor stimulating (TSAb) and blocking (TBAb) antibodies. In commercially available assays however, only total TBII titres can be measured, without discriminating between TSAb and TBAb.

Objective  To design a TBII bioassay to detect of TSAb and to correlate TSAb activity with severity of hyperthyroidism in de novo GD patients.

Patients  Thirty‐five patients with de novo GD and 27 controls.

Methods  The JP‐26–26 cell line, which constitutively expresses the TSH receptor (TSHR), was stably transfected with a cyclic adenosine monophosphate responsive element – luciferase construct. The clone B1 exhibited a near linear increase in luminescence from 0·2 mU/l to 50 mU/l bovine TSH and was used as a TBII bioassay. TBII, free T4 and TSH were measured in the sera of all patients and controls.

Results  In the sera of 35 GD patients, TBII titres did not correlate with serum free T4 concentrations. In contrast, a strong and highly significant correlation was found between TSHR stimulating activity (luminescence) as measured with the TBII bioassay and serum free T4 levels (R = 0·80, P < 0·001).

Interestingly, the luminescence/TBII ratio had a wide range at low TBII titres, whereas high TBII titres were associated with a low degree of TSHR activation. The TBII bioassay also detected TBAb in GD patients who spontaneously developed hypothyroidism.

Conclusions  The B1‐TBII‐bioassay as developed in our laboratory has a high sensitivity for the detection of TSAb in GD and predicts the severity of hyperthyroidism in untreated GD patients. In addition, we found that high TBII titres are associated with weak TSHR activation.
Quality of life of cancer patients receiving inpatient and home‐based palliative care
Authors: Peters Louise , Sellick Ken
Published: February 2006

Aims.  This paper reports a comparative study of the symptom experience, physical and psychological health, perceived control of the effects of cancer and quality of life of terminally ill cancer patients receiving inpatient and home‐based palliative care, and the factors that predict quality of life.

Background.  Quality of life is a major goal in the care of patients with terminal cancer. In addition to symptom management, psychological care and provision of support, being cared for at home is considered an important determinant of patient well‐being. A more comprehensive understanding of the impact of cancer on patients and their families will inform the delivery of palliative care services.

Methods.  Fifty‐eight patients with terminal cancer (32 inpatients, 26 home‐based) were recruited from major palliative care centres in Australia in 1999. A structured questionnaire designed to obtain sociodemographic information, medical details and standard measures of symptoms, physical and psychological health, personal control and quality of life was administered by personal interview.

Results.  The two groups were similar on most demographic measures, although more home‐care patients were married, of Australian descent and had private health insurance cover. The most prevalent symptoms reported were weakness, fatigue, sleeping during the day and pain. Patients receiving home‐based services had statistically significantly less symptom severity and distress, lower depression scores, and better physical health and quality of life than those receiving inpatient care. Home‐care patients also reported statistically significantly more control over the effects of their illness, medical care and treatment received, and the course of the disease. Multiple regression analyses showed that better global physical health, greater control over the effects of cancer and lower depression scores were statistically significant predictors of higher quality of life.

Conclusions.  The main issues arising from the findings for nurses are the early detection and management of both physical and psychological symptoms, particularly fatigue, pain, anxiety and depression, and the need to use strategies that will empower patients to have a greater sense of control over their illness and treatment. Research is needed to identify other factors that may impact on quality of life, and to establish the extent to which inpatient and home‐based care meets the needs of both the patient with terminal cancer and their family.
Assessing children's emotional responses to surgery: a multidimensional approach
Authors: Li Ho Cheung William , Lopez Violeta
Published: February 2006

Aim.  This paper reports a study to assess the interrelationships between physiological measures of children's heart rates and blood pressure, subjective measures of children's level of anxiety, and direct behavioural observations in children's emotional responses to surgery.

Background.  Psychological upset has been described as a multidimensional phenomenon which includes behavioural, subjective, and physiological components. However, a majority of previous studies have employed only one or two measures of psychological upset. Most importantly, the interrelationships among these three components of psychological upset have seldom been explored.

Methods.  A cross‐sectional design was employed, and 106 Chinese children admitted for day surgery during the summer of 2004 were invited to participate in the study. They were asked to respond to the Chinese version of the State Anxiety Scale for Children. Their mean arterial blood pressure and heart rates were recorded in the operating theatre after being transferred to the operating table but before anaesthesia induction. A research nurse used the Children's Emotional Manifestation Scale to document the children's emotional behaviours during anaesthesia induction. The data were collected in 2004.

Results.  Children with high preoperative anxiety levels manifested more negative emotional behaviour during anaesthesia induction. Those with more negative emotional behaviour or high levels of state anxiety also had faster heart rates and higher mean arterial blood pressure.

Conclusion.  A child's response to stressful medical procedures can be varied. The emotional responses of children to surgery need to be understood as a multidimensional phenomenon. To gain a more comprehensive understanding of the effects of surgery on children, it is recommended that assessment strategies used should reflect the multidimensional phenomenon of the emotional upset.
Long‐term mechanical ventilation in a critical care unit: existing in an uneveryday world
Authors: Johnson Patricia , St John Winsome , Moyle Wendy
Published: February 2006

Aim.  This paper reports a study to describe and interpret the meaning of being on long‐term mechanical ventilation.

Background.  Patients who require mechanical ventilation in a critical care unit for prolonged periods of time are typically sicker than those who are ventilated for shorter periods. Despite advances in treatment modalities for critically ill patients, many still require long‐term mechanical ventilation for 7 days or more. Therefore, caring for a long‐term ventilated patient is often an everyday occurrence for critical care nurses; however, there is insufficient evidence of the meaning of this experience from a patient perspective.

Method.  We used an ontological phenomenological approach informed by the ideas of Heidegger. Data were collected using unstructured audio‐taped interviews with nine former patients from critical care units unit in Queensland, Australia. The data were collected between January 2000 and December 2001 and analysed thematically using the method developed by van Manen.

Findings.  Thematic analysis revealed four themes. This paper presents the findings from the theme titled ‘existing in an uneveryday world’, which revealed what it meant for participants to exist, live through and survive the many physiological and psychological effects arising from their critical illness episode. For the most part, this was an unpleasant and frightening experience that involved bizarre nightmares and inability to distinguish time, place and the familiar body; disagreeable effects from the technology used and patient care activities; and reliance on external agents for survival. In addition, participants reported how they questioned their chances of surviving the critical illness ordeal.

Conclusion.  There is a need for further research in the areas of sedative and analgesic management in critically ill patients, methods of communicating with intubated and mechanically ventilated patients, and debriefing and follow‐up support services for survivors.
Searching for meaning in negative events: concept analysis
Authors: Skaggs Brenda G. , Barron Cecilia R.
Published: February 2006

Aim. The aim of this paper was to synthesize the literature related to meaning and present a conceptual analysis of searching for meaning in unexpected, significant, negative events.

Background. Events or situations that are perceived as unexpected and negative (e.g. chronic and/or life‐threatening illness) can disrupt life plans and lead to emotional distress. Nurses are in a key position to aid in the coping process by assisting individuals to integrate the meaning of an unexpected, negative event into the life experience.

Methods. In May 2004, a comprehensive literature search using the terms meaning, search for meaning, meaning‐making, making meaning, life change events, adaptation‐psychological, stress, and coping was carried out. Of 339 possible references, 86 were included in the analysis.

Findings. Global meaning refers to an individual's beliefs, values, and purpose/goals. Situational meaning refers to the meaning the individual attaches to a situation. When the meaning attached to the situation is not congruent with global meaning, meaning is considered shattered and a search for meaning ensues. In the search for meaning, people may attempt to change the meaning of the event (through reattributions or creating illusions) or change global meaning (through positive reappraisal, problem‐solving coping, or revaluing ordinary events).

Conclusion. Nurses are in a key position to assist people through negative events. The process of searching for meaning provides a solid foundation for the development of nursing interventions to assist individuals through difficult times. Research is needed to develop nursing interventions based on the process of the search for meaning, as well as measures reflective of the search for meaning.
Specific association of small heat shock proteins with the pathological hallmarks of Alzheimer's disease brains
Authors: Wilhelmus M. M. M. , Otte‐Höller I. , Wesseling P. , De Waal R. M. W. , Boelens W. C. , Verbeek M. M.
Published: February 2006

The small heat shock protein family (sHsp) comprises molecular chaperones able to interact with incorrectly folded proteins. Alzheimer's disease (AD) is characterized by pathological lesions such as senile plaques (SPs), cerebral amyloid angiopathy (CAA) and neurofibrillary tangles (NFTs), predominantly consisting of the incorrectly folded proteins amyloid‐β (Aβ) and tau respectively. The aim of this study was to investigate the association of the chaperones Hsp20, HspB2, αB‐crystallin and Hsp27 with the pathological lesions of AD brains. For this purpose, a panel of well‐characterized antibodies directed against these sHsps was used in immunohistochemistry and immunoblotting. We observed extracellular expression of Hsp20, Hsp27 and HspB2 in classic SPs, and Hsp20 expression in diffuse SPs. In addition, extracellular expression of HspB2 was observed in CAA. Both Hsp27 and αB‐crystallin were also observed in astrocytes associated with both SPs and CAA. Furthermore, none of the sHsps were observed in NFTs in AD brains. We conclude that specific sHsp species may be involved in the pathogenesis of either SPs or CAA in AD.
Knockdown of annexin 2 decreases migration of human glioma cells in vitro
Authors: Tatenhorst L. , Rescher U. , Gerke V. , Paulus W.
Published: February 2006

Diffuse invasion of brain tissue is a major reason for the poor prognosis of patients with glioblastoma. Annexin 2, a member of the large annexin family of Ca2+ and membrane‐binding proteins, is expressed at high protein levels in human gliomas and has been proposed as a marker of glioma malignancy, while its functional role in these tumours is unknown so far. The ability of annexin 2 to interact with the actin cytoskeleton, as well as its potential to bind invasion‐associated proteases, suggests that it could participate in invasion‐associated processes in human gliomas. Therefore, we analysed here functional consequences of RNA interference‐mediated silencing of annexin 2 in U87MG and U373MG human glioma cell lines. While no impact of annexin 2 downregulation on proliferation and adhesion was observed, our analyses revealed that migration of U87MG and U373MG cells was significantly inhibited following annexin 2 depletion. This effect was not related to a compensatory increase of the related annexins 1 or 6. Our findings identify annexin 2 as a potential candidate involved in glioma invasion and support the potential of RNA interference as powerful tool in the decryption of glioma invasion mechanisms.
Immunohistochemical profile and chromosomal imbalances in papillary tumours of the pineal region
Authors: Hasselblatt M. , Blümcke I. , Jeibmann A. , Rickert C. H. , Jouvet A. , Van De Nes J. A. P. , Kuchelmeister K. , Brunn A. , Fevre‐Montange M. , Paulus W.
Published: February 2006

The histopathology of papillary tumours of the pineal region (PTPR) closely resembles that of ependymomas and choroid plexus tumours. Therefore, immunohistochemical staining profiles were investigated in a series of 15 PTPR. In addition to cytokeratin, synaptophysin and glial fibrillary acidic protein expression, PTPR were examined for the presence of dot‐ or ring‐like epithelial membrane antigen (EMA) immunoreactivity typically encountered in ependymoma, staining for inwardly rectifying potassium channel Kir7.1 and stanniocalcin‐1 (specifically expressed in choroid plexus tumours) as well as microtubule‐associated protein‐2 (MAP‐2). Furthermore, comparative genomic hybridization was performed in five PTPR. Cytokeratin was expressed in all PTPR examined, whereas glial fibrillary acidic protein and synaptophysin staining were absent. Dot‐ or ring‐like EMA immunoreactivity was only observed in 1 out of 15 PTPR. Membranous Kir7.1 and cytoplasmic stanniocalcin‐1 staining were present in the minority of PTPR (3/15 and 4/15, respectively). In contrast, MAP‐2 immunoreactivity was encountered in 13 out of 15 PTPR, but was significantly less frequently observed in a series of choroid plexus tumours (7/37). PTPR mainly presented with chromosomal losses affecting chromosomes 10 (4/5 cases) and 22q (3/5 cases) as well as gains on chromosomes 4 (4/5 cases), 8 (3/5 cases), 9 (3/5 cases) and 12 (3/5 cases). To conclude, the majority of PTPR can be distinguished from ependymomas and choroid plexus tumours by absent staining for epithelial membrane antigen, Kir7.1 and staniocalcin‐1 as well as the presence of distinct MAP‐2 immunoreactivity. Antibodies directed against these antigens are thus expected to be valuable markers in the diagnosis of papillary tumours located in the vicinity of the third ventricle.
Mosquito midguts and malaria: cell biology, compartmentalization and immunology
Authors: WHITTEN M. M. A. , SHIAO S. H. , LEVASHINA E. A.
Published: February 2006

The malaria parasite Plasmodium has an absolute requirement for both a vertebrate and a mosquito host in order to complete its life cycle, and its interactions with the latter provide the focus for this review. The mosquito midgut represents one of the most challenging environments for the survival and development of Plasmodium, and is thus also one of the most attractive sites for novel targeted malaria control strategies. During their attempts to cross the midgut epithelium en route to the salivary glands, motile ookinetes are swiftly detected and labelled by mosquito recognition factors and targeted for destruction by a variety of immune responses that recruit killing factors both from the midgut and from other tissues in the surrounding body cavity. The exact interplay between these factors and the parasite is highly species‐ and strain‐specific, as are the timing and the route of parasite invasion. These features are paramount to determining the success of the infection and the vector competence of the mosquito. Here we discuss recent advances in genomic analyses, coupled with detailed microscopical investigations, which are helping to unravel the identity and roles of the major players of these complex systems.
The immunomodulatory factors of arthropod saliva and the potential for these factors to serve as vaccine targets to prevent pathogen transmission
Authors: TITUS R. G. , BISHOP J. V. , MEJIA J. S.
Published: February 2006

In general, attempts to develop vaccines for pathogens transmitted by arthropods have met with little or no success. It has been widely observed that the saliva of arthropods that transmit disease enhances the infectivity of pathogens the arthropod transmits to the vertebrate host. Indeed, it has been observed that vaccinating against components of the saliva of arthropods or against antigens expressed in the gut of arthropods can protect the host from infection and decrease the viability of the arthropod. These results suggest that multi‐subunit vaccines that target the pathogen itself as well as arthropod salivary gland components and arthropod gut antigens may be the most effective at controlling arthropod‐borne pathogens as these vaccines would target several facets of the lifecycle of the pathogen. This review covers known immunomodulators in arthropod salivary glands, instances when arthropod saliva has been shown to enhance infection and a limited number of examples of antiarthropod vaccines, with emphasis on three arthropods: sandflies, mosquitoes and hard ticks.
Elimination of deleterious mutations in plastid genomes by gene conversion
Authors: Khakhlova Olga , Bock Ralph
Published: February 2006

Asexual reproduction is believed to be detrimental, mainly because of the accumulation of deleterious mutations over time, a hypothesis known as Muller's ratchet. In seed plants, most asexually reproducing genetic systems are polyploid, with apomictic species (plants forming seeds without fertilization) as well as plastids and mitochondria providing prominent examples. Whether or not polyploidy helps asexual genetic systems to escape Muller's ratchet is unknown. Gene conversion, particularly when slightly biased, represents a potential mechanism that could allow asexual genetic systems to reduce their mutation load in a genome copy number‐dependent manner. However, direct experimental evidence for the operation of gene conversion between genome molecules to correct mutations is largely lacking. Here we describe an experimental system based on transgenic tobacco chloroplasts that allows us to analyze gene conversion events in higher plant plastid genomes. We provide evidence for gene conversion acting as a highly efficient mechanism by which the polyploid plastid genetic system can correct deleterious mutations and make one good genome out of two bad ones. Our finding that gene conversion can be biased may provide a molecular link between asexual reproduction, high genome copy numbers and low mutation rates.
A routine liver transplantation in a patient with situs inversus: a case report and an overview of the literature
Authors: Wente Moritz N. , Thorn Matthias , Radeleff Boris , Dei‐Anane Genevieve , Mehrabi Arianeb , Sauer Peter , Büchler Markus W. , Schmidt Jan , Kraus Thomas W. , Schemmer Peter
Published: February 2006

Abstract:Liver transplantation (LT) in an adult with situs inversus (SI) is extremely rare and requires precise pre‐operative management. A 48‐yr‐old male with SI suffering from alcoholic liver cirrhosis underwent LT at our institution in March 2003. Pre‐operatively, liver anatomy was determined by CT scan, three‐dimensional liver reconstruction and angiography. LT was performed using the Belghiti technique with side‐to‐side cavo‐caval anastomosis, transplanting a graft from a donor with normal anatomy. Post‐operatively, the patient recovered without major complications, except an epileptic event because of a central pontine myelinolysis, and he was discharged on the 25th post‐operative day. Three months after surgery, the T‐drain placed intra‐operatively into the donor bile duct was removed; transplant perfusion and function were stable with an actual follow‐up period of 24 months. LT in patients with SI is feasible. Pre‐operative imaging with three‐dimensional reconstruction is a beneficial tool for operation planning in patients with rare anatomic variations.
Heparin‐induced thrombocytopenia following pancreatectomy and islet auto‐transplantation
Authors: Rastellini Cristiana , Brown Melissa L. , Cicalese Luca
Published: February 2006

Abstract: We report the case of a female with chronic pancreatitis who underwent multiple surgical procedures leading to total resection of the pancreas with successful islet auto‐transplantation. Postoperatively, she developed heparin‐induced thrombocytopenia. Heparinization prior to islet infusion is currently recommended to prevent portal vein thrombosis. Antibodies against heparin are not standard pre‐operative testing for islet transplantation. Timely screening for heparin‐dependent anti‐platelet antibody should be kept in consideration for elective surgical cases (especially following previous surgeries) including pancreatic islet allo‐ and auto‐transplantation.
Comparison of two different techniques of reperfusion in adult orthotopic liver transplantation
Authors: Gruttadauria Salvatore , Cintorino Davide , Musumeci Alfredo , Arcadipane Antonio , Burgio Gaetano , Clarizia Sergio , Piazza Tommaso , Spada Marco , Verzaro Roberto , Marsh James W. , Marcos Amadeo , Gridelli Bruno
Published: February 2006

Abstract: The aim of this study was to determine the impact of two reperfusion techniques on the peri‐operative hemodynamic changes and early post‐operative graft function of adult patients undergoing orthotopic liver transplantation.

Material and methods: From June 2003 to May 2004, 50 consecutive liver transplants were performed and divided into two groups: group A, 25 patients, portal vein flush with 500 cm3 of Ringer's lactate without vena caval venting. Group B, 25 patients, vena caval venting with no portal vein flush. Donor and recipient characteristics were similar in both groups. Sixty‐four different parameters were analyzed, and Pearson's χ2 test and t‐test were used for statistical analysis, p0.05.

Results: One patient (4%) in group B experienced a post‐reperfusion syndrome (PRS). Pearson's χ2 test found a significant relationship between the analyzed parameters and the two different reperfusion techniques for 10 parameters (t‐test analysis showed a significant difference between the two groups in favor of group A).

Conclusions: In our transplant center, portal vein flush without vena caval venting provided a lower incidence of hemodynamic changes in the peri‐operative period after liver transplantation and earlier recovery of the graft function.