bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-effectiveness of Early Treatment for Retinopathy of Prematurity
Authors: Kamholz Karen L. , Cole Cynthia H. , Gray James E. , Zupancic John A. F.
Published: December 2008

BACKGROUND. The Early Treatment for Retinopathy of Prematurity trial demonstrated that peripheral retinal ablation of eyes with high-risk prethreshold retinopathy of prematurity (early treatment) is associated with improved visual outcomes at 9 months' corrected gestational age compared with treatment at threshold disease (conventional management). However, early treatment increased the frequency of laser therapy, anesthesia with intubation, treatment-related systemic complications, and the need for repeat treatments.

OBJECTIVE. To determine the cost-effectiveness of an early treatment strategy for retinopathy of prematurity compared with conventional management.

DESIGN/METHODS. We developed a stochastic decision analytic model to assess the incremental cost of early treatment per eye with severe visual impairment prevented. We derived resource-use and efficacy estimates from the Early Treatment for Retinopathy of Prematurity trial's published outcome data. We used a third-party payer perspective. Our primary analysis focused on outcomes from birth through 9 months' corrected gestational age. A secondary analysis used a lifetime horizon. Parameter uncertainty was quantified by using probabilistic and deterministic sensitivity analyses.

RESULTS. The incremental cost-effectiveness of early treatment was $14200 per eye with severe visual impairment prevented. There was a 90% probability that the cost-effectiveness of early treatment would be less than $40000 per eye with severe visual impairment prevented and a 0.5% probability that early treatment would be cost-saving (less costly and more effective). Limiting early treatment to more severely affected eyes (eyes with “type 1 retinopathy of prematurity” as defined by the Early Treatment for Retinopathy of Prematurity trial) had a cost-effectiveness of $6200 per eye with severe visual impairment prevented. Analyses that considered long-term costs and outcomes found that early treatment was cost-saving.

CONCLUSIONS. Early treatment of retinopathy of prematurity is both efficacious and economically desirable. Because of the high lifetime costs of severe visual impairment, the early treatment strategy provides long-term cost savings.
Construction of a Parent-Derived Questionnaire to Measure End-of-Life Care After Withdrawal of Life-Sustaining Treatment in the Neonatal Intensive Care Unit
Authors: Williams Constance , Cairnie Janice , Fines Valerie , Patey Colleen , Schwarzer Karla , Aylward Jennifer , Lohfeld Lynne , Kirpalani Haresh ,   for the With Care team
Published: December 2008

OBJECTIVES. The objective of this study was to develop and pretest a questionnaire to assess the practice of withdrawal of life-sustaining treatment in the NICU on the basis of the experiences of bereaved parents.

METHODS. We conducted semistructured interviews with 11 parents whose infants had undergone withdrawal of life-sustaining treatment in the NICU at McMaster University Medical Centre to obtain their views on helpful practices. Interviews continued until no new items were obtained (ie, saturation point). A total of 370 items were distilled into 82 questionnaire statements on care by a multidisciplinary team and grouped for analysis into 6 domains: communication, quality of care, quality of life, shared decision-making, withdrawal of life-sustaining treatment process, and bereavement care. Respondents were asked to rank how frequently events occurred on a 7-point Likert scale anchored from 1 = never to 7 = always. A score of >5 was considered favorable. The questionnaire was distributed to a pretest sample of perinatal social workers who attended a bereavement workshop at an international conference.

RESULTS. The response rate was 48%. Respondents ranked items that pertained to the withdrawal of life-sustaining treatment process highest, indicating that items were done well. Items related to quality of care and bereavement care ranked lowest. Other domains ranked as follows: communication, shared decision-making, and quality of life. Consistency of items within domains was tested by Cronbach's α and split-half testing and were >0.6 for most domains.

CONCLUSIONS. Parents' views on important aspects of end-of-life care in the NICU were incorporated into a quality assurance questionnaire. Pretesting assessed the performance of the instrument and the perceptions of social workers on the effectiveness of end-of-life practices. Respondents identified that parents' practical needs were met during the withdrawal process but were not consistently met in regard to the quality of in-hospital and follow-up bereavement care.
Inhaled Corticosteroids and Asthma Control in Children: Assessing Impairment and Risk
Authors: Rachelefsky Gary
Published: December 2008

OBJECTIVE. To review the use of inhaled corticosteroids on asthma control in children by using the new therapeutic paradigm outlined in the Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma.

METHODS. A systematic review of the literature was performed by using the Medline and Embase databases (January 1996 to October 2007).

RESULTS. A total of 18 placebo-controlled, clinical trials in >8000 children (aged 0–17 years) with asthma met the criteria for evaluating monotherapy with inhaled corticosteroids: 13 double-blind studies of inhaled corticosteroids versus placebo and 5 controlled studies that compared inhaled corticosteroids to a nonsteroid antiinflammatory agent. The findings can be summarized as follows: (1) Compared with placebo, inhaled corticosteroid treatment was associated with reductions in both the impairment and risk domains. (2) Improvements in impairment and risk observed with inhaled corticosteroids were generally greater than those observed with nonsteroid antiinflammatory comparator medications. (3) Inhaled corticosteroids were well tolerated. (4) Small reductions in growth rates were evident when compared with placebo and/or comparator nonsteroid antiinflammatory medication use in the long-term (>1-year) studies, but when measured, the reductions diminished with time.

CONCLUSIONS. Treatment with inhaled corticosteroids improves the asthma-control domains of impairment and risk in children. Differences in study protocols make detailed comparisons difficult. Specific needs for additional trials include (1) more studies using appropriate indicators for impairment (eg, rescue-medication use; symptoms scores; asthma/episode-free days) and risk (eg, forced expiratory volume in 1 second in children who can perform spirometry; exacerbations requiring oral corticosteroids; urgent care usage) and (2) more studies evaluating adolescents; the majority of the data reported were for children up to the age of 12 years, and data for adolescents are often lost (either grouped with adults [eg, studies in patients ≥12 years old] or not included [eg, studies of school-aged children ≤12 years old]). Attention should be given to standardizing variables that will permit comparison of outcomes between trials.
How Well Can Hospital Readmission Be Predicted in a Cohort of Hospitalized Children? A Retrospective, Multicenter Study
Authors: Feudtner Chris , Levin James E. , Srivastava Rajendu , Goodman Denise M. , Slonim Anthony D. , Sharma Vidya , Shah Samir S. , Pati Susmita , Fargason Crayton , Hall Matt
Published: December 2008

BACKGROUND. Children with complex chronic conditions depend on both their families and systems of pediatric health care, social services, and financing. Investigations into the workings of this ecology of care would be advanced by more accurate methods of population-level predictions of the likelihood for future hospitalization.

METHODS. This was a retrospective cohort study. Hospital administrative data were collected from 38 children's hospitals in the United States for the years 2003–2005. Participants included patients between 2 and 18 years of age discharged from an index hospitalization during 2004. Patient characteristics documented during the index hospitalization or any previous hospitalization during the preceding 365 days were included. The main outcome measure was readmission to the hospital during the 365 days after discharge from the index admission.

RESULTS. Among the cohort composed of 186856 patients discharged from the participating hospitals during 2004, the mean age was 9.2 years, with 54.4% male and 52.9% identified as non-Hispanic white. A total of 17.4% were admitted during the previous 365 days, and among those discharged alive (0.6% died during the admission), 16.7% were readmitted during the ensuing 365 days. The final readmission model exhibited a c statistic of 0.81 across all hospitals, with a range from 0.76 to 0.84 for each hospital. Bootstrap-based assessments demonstrated the stability of the final model.

CONCLUSIONS. Accurate population-level prediction of hospital readmissions is possible, and the resulting predicted probability of hospital readmission may prove useful for health services research and planning.
Latent Tuberculosis Diagnosis in Children by Using the QuantiFERON-TB Gold In-Tube Test
Authors: Lighter Jennifer , Rigaud Mona , Eduardo Roger , Peng Chia-Hui , Pollack Henry
Published: December 2008

BACKGROUND. The QuantiFERON-TB Gold test was the first blood test to be approved for the diagnosis of latent tuberculosis infection. Although it has been shown to be sensitive and specific in adults, limited data on its performance in children are available.

METHODS. This was a prospective study of children receiving health care in New York, New York. Each child was assessed for risk factors for Mycobacterium tuberculosis infection, underwent tuberculin skin testing, and had a QuantiFERON-TB Gold In-Tube test performed. The concordance between tuberculin skin test and QuantiFERON-TB Gold In-Tube test results was calculated, and the results were analyzed according to the likelihood of exposure to M tuberculosis.

RESULTS. Data for 207 children with valid tuberculin skin test and QuantiFERON-TB Gold In-Tube test results were analyzed. There was excellent correlation between negative tuberculin skin test results and negative QuantiFERON-TB Gold In-Tube test results; however, only 23% of children with positive tuberculin skin test results had positive QuantiFERON-TB Gold In-Tube test results. Positive QuantiFERON-TB Gold In-Tube test results were associated with increased likelihood of M tuberculosis exposure, and interferon γ levels were higher in children with known recent exposure to M tuberculosis, compared with children with older exposure histories. Younger children produced lower interferon γ levels in response to the mitogen (phytohemagglutinin) control used in the QuantiFERON-TB Gold In-Tube test, but indeterminant results were low for children of all ages. Performance characteristics were similar across all age groups.

CONCLUSION. The QuantiFERON-TB Gold In-Tube test is a specific test for M tuberculosis exposure in children, with performance characteristics similar to those for adults residing in regions with low levels of endemic disease. Concerns about test sensitivity, especially for children <2 years of age, will require additional prospective long-term evaluation.
Finding the Optimal Postnatal Dexamethasone Regimen for Preterm Infants at Risk of Bronchopulmonary Dysplasia: A Systematic Review of Placebo-Controlled Trials
Authors: Onland Wes , Offringa Martin , De Jaegere Anne P. , van Kaam Anton H.
Published: December 2008

CONTEXT. Postnatal dexamethasone therapy reduces the incidence of bronchopulmonary dysplasia in preterm infants but may be associated with an increased risk for adverse neurodevelopmental outcome.

OBJECTIVE. Our goal was to determine if the effects of dexamethasone on mortality and pulmonary and neurodevelopmental sequelae in preterm infants are modified by the cumulative dose given.

METHODS. Randomized, controlled trials comparing dexamethasone with placebo in ventilated preterm infants >7 days old were identified by searching the electronic databases and the abstracts from the Pediatric Academic societies and by performing manual reference searches. Two reviewers independently assessed eligibility and quality of trials and extracted data on study design, patient characteristics, and relevant outcomes. Original trialists were asked to provide additional data.

RESULTS. Sixteen trials including 1136 patients were analyzed by using meta-analysis and metaregression. Additional data were provided by 12 original trialists. Trials with a moderately early (7- to 14-day) or delayed (>3-week) postnatal treatment onset were analyzed separately. Higher dexamethasone doses reduced the relative risk for the combined outcome, mortality or bronchopulmonary dysplasia, with the largest effect in trials that used a cumulative dose of >4 mg/kg. No effect was found of doses on the risk of neurodevelopmental sequelae in the delayed treatment studies, but in the moderately-early-treatment studies the risk of mortality or cerebral palsy decreased by 6.2%, and the risk of a Mental Developmental Index below −2 SDs decreased by 6.6% for each incremental mg/kg cumulative dexamethasone dose.

CONCLUSIONS. Higher cumulative dexamethasone doses administered after the first week of life may decrease the risk for bronchopulmonary dysplasia without increasing the risk for neurodevelopmental sequelae in ventilated preterm infants. A large randomized trial is needed to confirm or refute these findings.
Chronic Diarrhea and Juvenile Cataracts: Think Cerebrotendinous Xanthomatosis and Treat
Authors: Berginer Vladimir M. , Gross Bella , Morad Khayat , Kfir Nechama , Morkos Siman , Aaref Salameh , Falik-Zaccai Tzipora C.
Published: December 2008

Cerebrotendinous xanthomatosis is an autosomal recessive disease of bile acid synthesis caused by 27-hydroxylase deficiency. Treatment with chenodeoxycholic acid normalizes cholestanol concentrations and abrogates progression of the disease. We present 4 patients with cerebrotendinous xanthomatosis within 1 family who were treated with chenodeoxycholic acid for 14 years. Two young sisters started treatment at the preclinical stage before the appearance of major symptoms. Their 2 older uncles, who had already developed the complete phenotypic form of cerebrotendinous xanthomatosis when diagnosed, commenced treatment at the same time as the sisters, thus establishing a natural control group. After 14 years of chenodeoxycholic acid therapy, the cholestanol levels of all 4 patients decreased to normal levels (<6 μg/mL). Both sisters remained asymptomatic. Only moderate improvement in symptoms was observed in their uncles. In this long-term study, prompt preclinical administration of chenodeoxycholic acid in early childhood completely prevented the cerebrotendinous xanthomatosis phenotype in 2 sisters. Pediatricians should be aware of this diagnostic possibility of cerebrotendinous xanthomatosis in children presenting with chronic diarrhea and juvenile cataracts. Prevention is particularly significant in light of the availability of early genetic diagnosis and the devastating effects of this illness if not treated.
Obesity and Excessive Daytime Sleepiness in Prepubertal Children With Obstructive Sleep Apnea
Authors: Gozal David , Kheirandish-Gozal Leila
Published: December 2008

INTRODUCTION. The epidemic of childhood obesity has prompted remarkable changes in the relative proportions of symptomatic overweight or obese children being referred for evaluation of habitual snoring. However, it remains unclear whether obesity modifies the relative frequency of daytime symptoms such as excessive daytime sleepiness.

METHODS. Fifty consecutive, nonobese, habitually snoring, otherwise-healthy children (age range: 6–9 years) and 50 age-, gender-, and ethnicity-matched obese children (BMI z score: >1.67) underwent an overnight polysomnographic evaluation, followed by a multiple sleep latency test the following day.

RESULTS. The mean obstructive apnea/hypopnea index values for the 2 groups were similar (nonobese: 12.0 ± 1.7 episodes per hour of total sleep time; obese: 10.9 ± 1.5 episodes per hour of total sleep time). However, the mean sleep latency for obese children was significantly shorter (12.9 ± 0.9 minutes) than that for nonobese children (17.9 ± 0.7 minutes). Furthermore, 21 obese children had mean sleep latencies of ≤12.0 minutes, compared with only 5 nonobese children. Although significant associations emerged between mean sleep latency, obstructive apnea/hypopnea index, proportion of total sleep time with oxygen saturation of <95%, and respiratory arousal index for the whole cohort, the slopes and intersects of the linear correlation of mean sleep latency with any of these polygraphic measures were consistently greater in the obese cohort.

CONCLUSIONS. The likelihood of excessive daytime sleepiness for obese children is greater than that for nonobese children at any given level of obstructive sleep apnea severity and is strikingly reminiscent of excessive daytime sleepiness patterns in adults with obstructive sleep apnea.
Patient Teenagers? A Comparison of the Sexual Behavior of Virginity Pledgers and Matched Nonpledgers
Authors: Rosenbaum Janet Elise
Published: December 2008

OBJECTIVE. The US government spends more than $200 million annually on abstinence-promotion programs, including virginity pledges. This study compares the sexual activity of adolescent virginity pledgers with matched nonpledgers by using more robust methods than past research.

SUBJECTS AND METHODS. The subjects for this study were National Longitudinal Study of Adolescent Health respondents, a nationally representative sample of middle and high school students who, when surveyed in 1995, had never had sex or taken a virginity pledge and who were >15 years of age (n = 3440). Adolescents who reported taking a virginity pledge on the 1996 survey (n = 289) were matched with nonpledgers (n = 645) by using exact and nearest-neighbor matching within propensity score calipers on factors including prepledge religiosity and attitudes toward sex and birth control. Pledgers and matched nonpledgers were compared 5 years after the pledge on self-reported sexual behaviors and positive test results for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, and safe sex outside of marriage by use of birth control and condoms in the past year and at last sex.

RESULTS. Five years after the pledge, 82% of pledgers denied having ever pledged. Pledgers and matched nonpledgers did not differ in premarital sex, sexually transmitted diseases, and anal and oral sex variables. Pledgers had 0.1 fewer past-year partners but did not differ in lifetime sexual partners and age of first sex. Fewer pledgers than matched nonpledgers used birth control and condoms in the past year and birth control at last sex.

CONCLUSIONS. The sexual behavior of virginity pledgers does not differ from that of closely matched nonpledgers, and pledgers are less likely to protect themselves from pregnancy and disease before marriage. Virginity pledges may not affect sexual behavior but may decrease the likelihood of taking precautions during sex. Clinicians should provide birth control information to all adolescents, especially virginity pledgers.
Physical Fitness and Physical Activity at Age 13 Years as Predictors of Cardiovascular Disease Risk Factors at Ages 15, 25, 33, and 40 Years: Extended Follow-up of the Oslo Youth Study
Authors: Kvaavik Elisabeth , Klepp Knut-Inge , Tell Grethe S. , Meyer Haakon E. , Batty G. David
Published: December 2008

OBJECTIVE. Few studies have examined the association of childhood physical activity and physical fitness with cardiovascular disease risk factors in adulthood. Furthermore, interpretation of these findings is hampered by methodologic shortcomings. In a population-based cohort study, we explored the influence, if any, of childhood physical activity and physical fitness on later cardiovascular disease risk factors.

METHODS. Data were taken from the Oslo Youth Study, a prospective cohort study that began in 1979, when 1016 students (mean age: 13 years; range: 11–15 years) who were attending 6 schools were invited to participate in a health education intervention. Cardiovascular disease risk factor data were collected at baseline and again in 1981 (mean age: 15 years; range: 13–17 years), 1991 (mean age: 25; range: 23–27 years), 1999 (mean age: 33; range: 31–35 years), and 2006 (mean age: 40; range: 38–42 years).

RESULTS. At baseline, physical fitness was inversely related to BMI, triceps skinfold thickness, and blood pressure (systolic and diastolic; N = 716). These associations were also present in prospective analyses at ages 15 (N = 472), 25 (N = 280; except for systolic blood pressure), and 33 years (N = 410, only BMI measured)—albeit with progressively diminishing magnitude—but were lost at 40 years (N = 294). There were fewer relationships with cardiovascular disease risk factors when physical activity was the exposure of interest. Controlling for educational attainment of both the parent and the study member had little impact on these associations.

CONCLUSIONS. Although childhood physical fitness seems to reveal some inverse associations with obesity and blood pressure in early adulthood, these effects diminished markedly into middle age.
Planning for Health Care Transitions: Results From the 2005–2006 National Survey of Children With Special Health Care Needs
Authors: Lotstein Debra S. , Ghandour Reem , Cash Amanda , McGuire Elizabeth , Strickland Bonnie , Newacheck Paul
Published: December 2008

OBJECTIVES. Many youth with special health care needs have difficulties transferring to adult medical care. To address this, the Maternal and Child Health Bureau has made receipt of transition services a core performance outcome for community-based systems of care for youth with special health care needs. In this article we describe the results for the transition core outcome from the 2005–2006 National Survey of Children With Special Health Care Needs. We also describe changes in the measurement strategy for this outcome since the first National Survey of Children With Special Health Care Needs in 2001.

METHODS. In the nationally representative, cross-sectional 2005–2006 National Survey of Children With Special Health Care Needs, parent or guardian respondents of 18198 youth with special health care needs (aged 12–17) were asked if they have had discussions with their child's health care providers about (1) future adult providers, (2) future adult health care needs, (3) changes in health insurance, and (4) encouraging their child to take responsibility for his or her care. All 4 components had to be met for the youth to meet the overall transition core outcome. Those who had not had transition discussions reported if such discussions would have been helpful.

RESULTS. Overall, 41% of youth with special health care needs met the core performance outcome for transition. Forty-two percent had discussed shifting care to an adult provider, 62% discussed their child's adult health care needs, and 34% discussed upcoming changes in health insurance. Most (78%) respondents said that providers usually or always encourage their child to take responsibility for his or her health. Non-Hispanic black or Hispanic race/ethnicity, lower income level, not speaking English, and not having a medical home reduced the odds of meeting the transition core outcome.

CONCLUSIONS. Current performance on the transition core outcome leaves much room for improvement. Many parents feel that having transition-related discussions with their health care providers would be helpful. Future clinical and policy-level research should be directed at identifying barriers to, and recommending content for, health transition discussions.
Juggling Work and Breastfeeding: Effects of Maternity Leave and Occupational Characteristics
Authors: Guendelman Sylvia , Kosa Jessica Lang , Pearl Michelle , Graham Steve , Goodman Julia , Kharrazi Martin
Published: December 2008

OBJECTIVES. Juggling breastfeeding and paid work can challenge breastfeeding success. We examined the relationship between breastfeeding and maternity leave before and after delivery among working mothers in Southern California. California is 1 of only 5 states in the United States providing paid pregnancy leave that can be extended for infant bonding.

PATIENTS AND METHODS. Drawing from a case-control study of preterm birth and low birth weight, 770 full-time working mothers were compared on whether they established breastfeeding in the first month. For those who established breastfeeding, we examined duration. Eligible women participated in California's Prenatal Screening Program; delivered live births between July 2002 and December 2003; were ≥18 years old; had a singleton birth without congenital anomalies; and had a US mailing address. We assessed whether maternity leave and other occupational characteristics predicted breastfeeding cessation and used multivariate regression models weighted for probability of sampling to calculate odds ratios for breastfeeding establishment and hazards ratios for breastfeeding cessation.

RESULTS. A maternity leave of ≤6 weeks or 6 to 12 weeks after delivery was associated, respectively, with a fourfold and twofold higher odds of failure to establish breastfeeding and an increased probability of cessation after successful establishment, relative to women not returning to work, after adjusting for covariates. The impact of short postpartum leave on breastfeeding cessation was stronger among nonmanagers, women with inflexible jobs, and with high psychosocial distress. Antenatal leave in the last month of pregnancy was not associated with breastfeeding establishment or duration.

CONCLUSIONS. Postpartum maternity leave may have a positive effect on breastfeeding among full-time workers, particularly those who hold nonmanagerial positions, lack job flexibility, or experience psychosocial distress. Pediatricians should encourage patients to take maternity leave and advocate for extending paid postpartum leave and flexibility in working conditions for breastfeeding women.
Evaluation and Management of the Infant Exposed to HIV-1 in the United States
Authors: Havens Peter L. , Mofenson Lynne M. ,   and the Committee on Pediatric AIDS
Published: December 2008

The pediatrician plays a key role in the prevention of mother-to-child transmission of HIV-1 infection. For infants born to women with HIV-1 infection identified during pregnancy, the pediatrician ensures that antiretroviral prophylaxis is provided to the infant to decrease the risk of acquiring HIV-1 infection and promotes avoidance of postnatal HIV-1 transmission by advising HIV-1–infected women not to breastfeed. The pediatrician should perform HIV-1 antibody testing for infants born to women whose HIV-1 infection status was not determined during pregnancy or labor. For HIV-1–exposed infants, the pediatrician monitors the infant for early determination of HIV-1 infection status and for possible short- and long-term toxicity from antiretroviral exposures. Provision of chemoprophylaxis for Pneumocystis jiroveci pneumonia and support of families living with HIV-1 by providing counseling to parents or caregivers are also important components of care.
Concepts musicaux en pensée politique : l'analogie est-elle féconde ?
Authors: Heard Mélanie
Published: December 2008

Résumé Les analogies musicales en philosophie politique ne sont pas nécessairement intuitives pour le profane car elles s’inscrivent dans des problématiques de théorie musicale dont la richesse est souvent méconnue. L’article se propose d’explorer l’idée d’une contribution des dissonances à l’harmonie, que Montesquieu applique par analogie au champ politique. Pour être éclairante en pensée politique, cette analogie implique une compréhension riche de l’usage harmonieux des dissonances en musique, où la théorisation leibnizienne de l’usage baroque des dissonances apparaît fondamentale. La prise en compte de cet apport leibnizien permet d’identifier un enjeu essentiel de l’analogie selon Montesquieu : l’identification, dans les dissonances, d’un exercice énergique et heureux de la liberté et de l’harmonie politiques.
Musique, politique et sécularisation
Authors: Moysan Bruno
Published: December 2008

Résumé Penser la relation entre musique, politique et sécularisation conduit à questionner au préalable la nature même de la musique. Dans quelle mesure cet art du sonore, peut-il prendre en charge une signification politique et religieuse, se socialiser et s’historiciser ? Pour tenter de répondre à cette question, l’article interroge d’abord la nature de la musique en proposant une brève théorie du signe musical et de la signification en musique, pour se concentrer ensuite sur deux moments : la naissance de l’opéra au début du 17 e siècle et la révolution romantique de 1830. L’étude des trois versions du Lamento d’Ariane de Monteverdi et de deux pièces pour piano de Liszt ( Lyon et Sposalizio ) montre que la musique, pleinement acteur des débats d’idée qui l’entourent, est susceptible de produire un langage sonore agissant où le politique ne se sépare pas du poétique.
La musique « dégénérée » sous l'Allemagne nazie
Authors: Schnapper Laure
Published: December 2008

Résumé La politique musicale nazie reflète une opposition manichéenne, typique des totalitarismes, entre œuvres jugées conformes à l’idéologie du régime et celles qui ne l’étaient pas : d’un côté la musique « allemande », de l’autre la musique « dégénérée », dont l’absence de définition précise permettait d’interdire tout ce qui semblait suspect. Une œuvre était acceptée à condition que son auteur ne fût ni juif ni opposant au régime, la musique étant, en l’absence de paroles, peu dangereuse en soi. Le langage musical devait aussi répondre à un idéal de clarté et de sensibilité, et l’opéra mettre en scène les symboles archétypaux de l’idéologie nazie (puissance, courage et supériorité raciale). Si le public resta peu convaincu par ce répertoire néo-wagnérien, cette politique suscita un appauvrissement artistique durable en Europe longtemps après la guerre, de nombreux artistes ayant été anéantis physiquement ou artistiquement.
Généalogie politique de la psychologie. Une lecture du cours de Michel Foucault Du gouvernement des vivants (Collège de France, 1980)
Authors: Landry Jean-Michel
Published: December 2008

Résumé Demeuré inédit, le cours prononcé en 1980 au Collège de France correspond à un moment charnière dans l’œuvre de Michel Foucault. D’une part, il constitue le point culminant des travaux menés sur le thème du gouvernement des hommes ; d’autre part, il trace la généalogie du dispositif politique de la psychologie. En suivant l’évolution des rapports qui se sont noués entre l’aveu et l’obéissance au cours des premiers siècles de notre ère, les leçons de 1980 montrent que chercher à découvrir et formuler sa vérité cachée équivaut à se placer sous dépendance. Ce faisant, elles dévoilent l’enjeu politique de la psychologie. Réalisé à partir d’une transcription intégrale de l’année de cours, cet article retrace le cheminement qui conduira Foucault à affirmer que la formulation d’une vérité sur soi représente « une des formes premières de notre obéissance ».
La cigale lacanienne et la fourmi pharmaceutique
Authors: Pignarre Philippe
Published: December 2008

Résumé Une nouvelle psychiatrie a peu à peu sapé toute possibilité de développement de la psychanalyse. Pour comprendre comment elle s’est imposée, il est moins important de s’intéresser aux débats théoriques qu’aux pratiques et aux apprentissages qui dictent la manière dont les médecins regardent les patients. À la notion de chronicité qui a déterminé les pratiques psychiatriques jusqu’à la Seconde Guerre mondiale, a succédé une psychiatrie des comportements (gérables/ingérables) qui commence avec la psychochirurgie (les lobotomies) et se réalise pleinement avec l’essor des psychotropes, de 1952 à nos jours, de la prise en charge de la schizophrénie à celle des troubles du comportement. On a vu ainsi se développer une « petite biologie » et une « petite psychologie » dont les pouvoirs de réorganisation permanente sont considérables. L’épisode du trouble de déficit avec hyperactivité chez l’enfant et l’adolescent doit être compris dans ce contexte.
Est-il permis, du point de vue éthique, de limiter la migration économique ?
Authors: Demuijnck Geert
Published: December 2008

Résumé La question que cet article examine est de savoir s'il est moralement légitime de limiter le droit d'une personne de quitter son pays et de s'installer dans un autre dans la perspective d'améliorer sa situation économique. La thèse défendue est qu'il n'y a pas de raison éthique fondamentale de limiter ces migrations. Les seules raisons susceptibles de justifier une limitation dans le contexte actuel dépendent de l'existence de profondes inégalités économiques au niveau mondial. Dans l'hypothèse d'un monde juste, ces raisons perdent leur pertinence. Cet article critique ensuite les arguments contre l'ouverture des frontières qui ne font pas appel à l'idée de justice distributive. De nature communautarienne, ceux-ci reposent souvent sur des analogies équivoques entre les Etats et d'autres institutions comme les familles ou les clubs.
Retour sur la « communauté imaginée » d'Anderson.
Authors: Chivallon Christine
Published: December 2008

Résumé Cet article revient sur la notion de « communauté imaginée » d’Anderson dont le succès depuis près de 25 ans ne cesse de se conforter. En dépit de cette notoriété, la notion reste pourtant fragile, traversée par des contradictions théoriques qui empêchent de clarifier le couple « réel-imaginaire ». Après avoir envisagé la principale aporie de l’approche d’Anderson qui réside dans le présupposé de l’existence de communautés réelles logées dans les relations de face-à-face, le propos se consacre à l’examen des usages actuels du modèle andersonien et à la description de deux trajectoires bien typées, l’une guidée par la figure de H. Bhabha, avec la déstabilisation du thème de la nation, l’autre placée sous l’influence de A. Appadurai avec l’insistance illimitée sur l’imaginaire. C’est après avoir posé cet état des lieux critique que l’article propose une conceptualisation du réel et de l’imaginaire des communautés. L’objectif est de dépasser la dualité de ces deux termes pour monter que le « réel » est toujours un imaginaire parvenu à se matérialiser sous l’effet des luttes pour la mobilisation des outils de la représentation symbolique.
Le quartier, lieu de réinvention des relations Etat-société en Chine urbaine : l'exemple des comités de résidents à Pékin
Authors: Audin Judith
Published: December 2008

Résumé Depuis la fin des années 1990, un nouveau système émerge en Chine, issu du déclin du système de l'unité de travail (danwei) et de la pluralisation de la vie citadine en une mosaïque d'individus et de situations. Dans le contexte d'une exigence accrue de bien-être et de la nouvelle symbolique du lieu de résidence, la « communauté de quartier » (shequ) investit le quartier en vue de légitimer le pouvoir politique chinois. Les comités de résidents, situés à l'échelon le plus local des institutions de gestion urbaine, participent de cette évolution, en combinant des nouvelles formes de surveillance et d'assistance sociale.
Racisme, xénophobie et idéologies politiques dans les stades de football
Authors: Bodin Dominique , Robène Luc , Héas Stéphane
Published: December 2008

Résumé Récemment les manifestations racistes et xénophobes semblent se multiplier dans les stades au point qu'hommes politiques, dirigeants sportifs, voire le pape en personne, les dénoncent et annoncent des mesures pour éradiquer le phénomène. Mais ces problèmes sont ils si récents ? L'annonce de mesures pour éradiquer ce qui se donne à voir dans les stades de football ne répond elle pas de la logique de l'urgence médiatique face à un trouble de « l'ordre en public » ? Ces prises de position amalgament de fait des manifestations et des comportements qui n'ont bien souvent rien à voir entre eux, bien que hautement condamnables, au lieu de chercher à interpréter ce qui se donne à voir dans les stades afin d'adapter les réponses politiques et sociales et tenter de s'en prémunir. C'est à l'analyse des idéologies existantes ou émergentes dans les stades, réalisée à partir d'une recherche sur le hooliganisme commencée depuis bientôt dix ans que s'intéresse cet article, en examinant à travers différents exemples de manifestations racistes les constructions identitaires et sociales mais aussi les processus sociaux à l'œuvre dans les tribunes des stades européens.
Guerre juste et intervention armée en Irak
Authors: Maffettone Sebastiano
Published: December 2008

Résumé La théorie de la guerre juste, issue des élaborations médiévales, s'appuie sur les critères de la juste cause et de l'autorité compétente. La théorie politique moderne reformule les arguments de type moral ou religieux en termes politiques et légalistes tandis que la théorie politique contemporaine doit tenir compte du réalisme nouveau qui s'articule sur la notion de souveraineté et éventuellement le critiquer au nom d'une approche normative libérale. L'auteur analyse ici les éléments de la doctrine classique qui sont susceptibles d'être repris dans le cadre contemporain du paradigme légaliste. Examinant les situations d'intervention justifiées par des situations de violation systématique des droits humains, il énonce les conditions auxquelles une guerre est justifiable ­ juste cause, autorité légitime et intention droite ­ et, les appliquant à l'intervention américaine en Irak, peut avancer que s'il y avait de bonnes raisons de combattre Saddam Hussein, les Etats-Unis n'avaient aucun titre à s'en charger.
Nicolas Sarkozy ou la masculinité mascarade du Président
Authors: Achin Catherine , Dorlin Elsa
Published: December 2008

Résumé L'analyse de la construction de l'identité stratégique du Président de la République Nicolas Sarkozy dévoile la façon dont l'identité sexuelle travaille le rôle présidentiel, mais aussi comment elle peut être définie comme un « capital corporel identitaire » qui fonctionne à plein dans et pour le corps politique. L'investissement exacerbé, explicite et inédit du Président dans une « virilité ressource » se comprend en effet dans le contexte paritaire français et son duel avec Ségolène Royal, mais aussi par une logique compensatoire liée à la structure de ses capitaux et à sa trajectoire. Nicolas Sarkozy retourne en ressources des stigmates apparents, par la revendication d'une « rupture » dans le style présidentiel, qui passe notamment par la mise en avant d'une masculinité populaire et décomplexée. Pour la première fois au sein de la République universaliste, la virilité n'est donc plus un privilège implicite, mais apparaît comme un capital comme un autre.
La condition biomérique. Une approche socio-anthropologique des techniques d'identification biométrique
Authors: Dubey Gérard
Published: December 2008

Résumé Généralement le thème de l'identification biométrique est abordé par les sciences humaines sous l'angle de la problématique du contrôle, et en particulier du contrôle exercé par les Etats sur les individus. Or, si une filiation existe bien entre la logique de contrôle à distance mise en oeuvre par les Etats au 19e siècle et les techniques d'identification biométriques que nous connaissons aujourd'hui, une autre dimension doit être prise en compte. L'identification biométrique cristallise en même temps qu'elle révèle les tensions qui affectent nos représentations du corps et de l'identité. Ainsi le corps « par défaut » de la biométrie met-il paradoxalement à découvert d'autres figures de celui-ci qui transcendent le clivage désormais classique entre corps subjectif (ipséité) et corps objectif et laisse entrevoir d'autres modes de légitimation et d'autres rapports à l'identité. Ce sont ces micro-déplacements de sens que cet article propose d'analyser sur la base d'un travail empirique de type anthropologique.
La naissance de la biosécurité
Authors: Deziel Pierre Luc
Published: December 2008

Résumé Cet article vise à étudier et à expliquer l'émergence d'une forme de sécurité que l'on nomme la biosécurité, et tente de démontrer comment celle-ci s'est construite dans le cas particulier des Etats-Unis. La thèse principale est que la biosécurité s'est construite comme un processus de régulation continu de la menace que représente le bioterrorisme, et ce plus particulièrement depuis les attaques à l'anthrax de septembre et octobre 2001. Quatre dimensions de ce mouvement de sécurisation sont distinguées et discutées, soit la prise de conscience de la menace bioterroriste, la surveillance et la détection, la prévention et la protection des corps biologiques et la planification et la réponse en cas d'attaque.
La peur de la violence et la figure du « dernier homme »
Authors: Castillo Monique
Published: December 2008

Résumé On parle beaucoup aujourd'hui des transformations qui marquent les pratiques de la violence, eu égard aux « guerres nouvelles » et aux violences urbaines notamment. Mais en même temps, ce qui frappe les esprits, c'est le fait que ces changements dans la violence ont lieu dans un monde qui se veut de plus en plus pacifique et pacificateur, dans un monde où la sécurité tend à devenir la valeur sociétale suprême, le bien public dominant de toutes les communautés. Une curieuse cohabitation s'installe : d'un côté, une frénésie de violence auto-régénérée alimente et perpétue la peur comme facteur de déstabilisation ; d'un autre côté, l'obsession sécuritaire conduit à des politiques uniquement vouées à lutter contre la peur de la violence. Par suite, les nouvelles pratiques de la violence obligent à repenser plusieurs types de questions : A-t-on affaire à un nouvel enjeu sociétal ? Les violences nouvelles sont-elles la mise en cause de la société de consommation ? A-t-on affaire à de nouveaux enjeux de pouvoir sur le plan symbolique et culturel ? Nous testerons une dernière hypothèse de travail sur la place du ressentiment dans une démocratisation sans démocratie.
Three‐dimensional CFD model for a flat plate photocatalytic reactor: Degradation of TCE in a serpentine flow field
Authors: Jarandehei Asefeh , De Visscher Alex
Published: December 2008

Computational fluid dynamics (CFD) simulation was applied to a photocatalytic reactor with surface reaction for trichloroethylene (TCE) oxidation at various pollutant concentrations, and flow rates. First‐order and Langmuir‐Hinshelwood kinetics for TCE removal rate were considered. The results were compared with those from experiments of Demeestere et al. (Appl Catal B Environ. 2004;54:261–274) in a flat plate photocatalytic reactor with serpentine geometry. The flow regime was laminar. Through the CFD simulation, the velocity field and the concentration gradient of TCE in the reactor were studied in detail. At Reynolds numbers around 900, the laminar flow becomes unstable. Under such a condition, when flow passes the 180° sharp turns, due to formation of secondary flow and consequently vortices, there is a lot of cross‐sectional mixing in the reactor. This kind of studies can help us to model the photocatalytic reactor as accurately as possible. © 2008 American Institute of Chemical Engineers AIChE J, 2009
A heuristic design procedure for water‐using networks with multiple contaminants
Authors: Liu Zhi‐Yong , Yang Yi , Wan Lin‐Zhan , Wang Xi , Hou Kai‐Hu
Published: December 2008

On the analogy of the water‐using networks with single contaminant, we will introduce new methodology concepts: the concentration potentials of the demand streams and those of the source streams in the water‐using systems with multiple contaminants, based on the overall allocation possibility of the source streams to the demand streams. In the design procedure, the performing order of the processes is determined by the inlet concentration potentials of the processes. The processes with the lowest inlet concentration potential will be performed first. When satisfying the inlet stream of the process being performed, the source with the largest quasi‐allocation amount, which is defined in this article, will be used first. A few literature examples are investigated to show the method proposed. The results show that the method proposed in this work is very simple and the freshwater consumptions of the designs obtained are very close to the minimum freshwater targets. © 2008 American Institute of Chemical Engineers AIChE J, 2009
Identification of cellular objective for elucidating the physiological state of plasmid‐bearing Escherichia coli using genome‐scale in silico analysis
Authors: Ow Dave Siak‐Wei , Lee Dong‐Yup , Yap Miranda Gek‐Sim , Oh Steve Kah‐Weng
Published: December 2008

The presence of multiple copies of plasmids in Escherichia coli could induce a complex cascade of physiological changes known as the metabolic burden response. In this work, the physiological effect of such plasmid metabolic burden on E. coli metabolism was investigated by constraint‐based genome‐scale flux modeling. We systematically applied three cellular objectives: (a) maximizing growth rate, (b) maximizing plasmid production, and (c) maximizing maintenance energy expenditure to quantify in silico flux distributions. These simulated results were compared with experimental flux information to identify which of these cellular objectives best describes the physiological and metabolic states of plasmid‐bearing (P+) E. coli. Unlike the wild‐type E. coli cells that have directed the metabolism toward an optimum growth rate under the nutrient‐limited condition, the maximum growth rate objective could not correctly predict the metabolic state of recombinant P+ cells. Instead, flux simulations by maximizing maintenance energy expenditure showed good consistency with experimental observation, indicating that the P+ cells are energetically less efficient and could require higher maintenance energy. This study demonstrates that the cellular objective of maximizing maintenance energy expenditure provides a better description of the underlying physiological state in recombinant microorganisms relevant to biotechnological applications. © 2008 American Institute of Chemical Engineers Biotechnol. Prog., 2009
Newer concepts in the medical management of patients with congestive heart failure
Authors: Weintraub Neal L. , Chaitman Bernard R.
Published: December 2008

Congestive heart failure (CHF) remains a major cause of morbidity and mortality in the United States, especially among the elderly. Although an underlying disturbance in cardiac function can be identified in most patients, manifestations of the disease are greatly influenced by other factors, particularly neurohumoral and peripheral adaptive responses which occur secondary to impaired cardiac function. The renin‐angiotensin system (RAS) is integrally involved in the pathophysiology of CHF. Originally considered a humoral system, the RAS is now known to exist and operate within cardiac and vascular tissues. The importance of tissue‐specific renin‐angiotensin systems in CHF is presently under investigation. Most patients with symptomatic CHF benefit from the administration of an ACE inhibitor. Certain asymptomatic patients, such as those with severe left ventricular (LV) dysfunction and those who are at high risk for LV remodeling after anterior wall myocardial infarction, may also benefit from ACE inhibitor therapy. Diuretics and nitrates improve symptoms and often cardiac output in many patients with CHF. Although many new inotropic agents have been tested in CHF patients, none appear clinically superior to digitalis glycosides. The efficacy of digitalis glycosides in CHF may in part result from sympathoinhibitory properties such as the activation of baroreceptor mechanisms. Despite the fact that many CHF patients die from arrhythmias, treatment of asymptomatic ventricular arrhythmias in these patients is not recommended. Patients with symptomatic or sustained ventricular arrhythmias are best treated by a physician experienced in cardiac electrophysiology. Therapy with beta‐blocking drugs for CHF patients is controversial. Anticoagulants are recommended for selected patients with CHF. Finally, exercise therapy may improve functional capacity in some patients with CHF through its effects on peripheral blood vessels and skeletal muscle tissues.