bluuebunny/crossref_metadata_2025 huggingface dataset:
Guided interaction in pre‐school settings
Authors: Plowman L. , Stephen C.
Published: January 2007

Abstract
The aim of this study was to explore how guided interaction could create opportunities for learning with information and communication technologies (ICT) for children aged three and four. The study was grounded in the naturalistic environment of the playroom, in a context of free play and child‐initiated activity, and focused on interventions selected and implemented by practitioners. Guided interaction describes the ways in which children's interactions with computers and other forms of ICT can be actively supported in pre‐school settings. The paper presents a framework that illustrates proximal and distal guided interaction and the modes by which they are enacted. The concept of guided interaction (i) provides a tool for thinking about the different modes by which learning can be supported in pre‐school settings and (ii) helps practitioners to articulate, reflect on and legitimise changes in pedagogy, enabling them to find new approaches to working with ICT. The paper provides an account of the analysis underpinning the development of the concept, followed by a description of its characteristics and the different types of learning that can be supported. An adapted version of this analytical framework has potential both as a research tool and to support changes in practice for professionals in other sectors of education.
Characteristics of drills related to development of skills
Authors: Luik P.
Published: January 2007

Abstract
It is important for the teacher to choose effective software for students. It is also important for designers to know what features of educational software make it effective. But the results of studies dealing with the effectiveness of educational software are contradictory. One reason for such results might be the fact that meta‐analysis covers different kinds of educational software, simulations and drills for example, but it is hard to compare them. Another reason might be that the conditions (instruments, subjects, etc.) of the various studies were different. A third possibility might be that a particular type of educational software could consist of both good and bad characteristics. Therefore, research is needed on the characteristics of educational software. This type of study focuses on a particular kind of educational software, and this article is about the findings of one such study, exploring the characteristics and the effectiveness of drills in Estonian elementary schools. Sixteen characteristics of drills that had statistically significant correlation with student learning, and the influence of these characteristics are discussed as the results of this study. The results indicated that characteristics related to feedback, presentation of information and questions are the most critical evaluating quality of drills and in designing such educational software.
Variability, contingency and rapid change in recent subarctic alpine tree line dynamics
Authors: DANBY RYAN K. , HIK DAVID S.
Published: January 2007

Boundaries between forest and tundra ecosystems, tree lines, are expected to advance in altitude and latitude in response to climate warming. However, varied responses to 20th century warming suggest that in addition to temperature, tree line dynamics are mediated by species‐specific traits and environmental conditions at landscape and local scales.

We examined recent tree line dynamics at six topographically different, but climatically similar, sites in south‐west Yukon, Canada. Dendroecological techniques were used to reconstruct changes in density of the dominant tree species, white spruce (Picea glauca), and to construct static age distributions of willow (Salix spp.), one of two dominant shrub genera. Data were analysed to identify periods and rates of establishment and mortality and to relate these to past climate.

Tree line elevation and stand density increased significantly during the early to mid 20th century. However, this change was not uniform across sites. Spruce advanced rapidly on south‐facing slopes and tree line rose 65–85 m in elevation. Tree line did not advance on north‐facing slopes, but stand density increased 40–65%. Differences observed between aspects were due primarily to the differential presence of permafrost. Additional variability among sites was related to slope and vegetation type. Results were less conclusive for willow, but evidence for an advance was found at two sites.

Increases in stand density were strongly correlated with summer temperatures. The period of rapid change coincided with a 30‐year period of above average temperatures, beginning in 1920. The highest correlations were obtained using a forward average of 30–50 years, supporting the hypothesis that tree line dynamics are controlled more by conditions influencing recruitment than by establishment alone.

The changes observed at several sites are suggestive of a threshold response and challenge the notion that tree lines respond gradually to climate warming. Overall, the results provide further evidence to support the idea that the pattern and timing of change is contingent on local, landscape, and regional‐scale factors, as well as species’ biology.
A model‐based framework for the phenotypic characterization of the flowering of Medicago truncatula
Authors: MOREAU DELPHINE , SALON CHRISTOPHE , MUNIER‐JOLAIN NATHALIE
Published: January 2007

To facilitate the phenotypic characterization of Medicago truncatula, our aim was to provide a framework of analysis of flowering in response to environmental factors. The flowering of the line A17 was analysed in different conditions of temperature, duration of vernalization and photoperiod. Flowering was characterized using three descriptors at the axis level: the position of the first reproductive node (1RN), the date of beginning of flowering (DBF) and the florochron (RFa−1) corresponding to the reciprocal of the rate of progression of flowering along each axis. As for vegetative development, it was found that flowering could be analysed as a function of thermal time using a base temperature (Tb) of 5 °C. Vernalization displayed a sound impact on the flowering. For all the studied axes, increasing the duration of vernalization lowered the 1RN and hastened the DBF. By contrast, for most of the studied axes, RFa−1 was only slightly affected by vernalization. For the branch B0, RFa−1 was a genotypic constant when thermal time was used. Considering B0 as a reference axis, an ecophysiological model was developed to simulate the impact of environmental factors on the three components of flowering. Concrete practical applications of the model‐based framework presented herein are proposed for helping the genetic and genomic studies of M. truncatula.
Regulation of carbon and nitrogen metabolisms in rice roots by 2‐oxoglutarate at the level of hexokinase
Authors: Yuan Yongze , Ou Jiquan , Wang Zhiqiang , Zhang Chufu , Zhou Zhipeng , Lin Qinghua
Published: January 2007

Feeding experiments were designed, to investigate the role of 2‐oxoglutarate (2‐OG) in regulation of carbon and nitrogen metabolisms in non‐photosynthetic tissues of rice (Oryza sativa L.), and enzyme activities involved in the metabolisms as well as contents of several relating metabolites were determined in the roots. The enhancement of 2‐OG level by feeding 2‐OG or metabolizable sugars [sucrose (Suc) or glucose (Glc)], rather than by feeding non‐metabolizable carbon sources (mannose or mannitol), led to increase in enzyme activities, including hexokinase (HXK, EC 2.7.1.1), nicotinamide adenine dinucleotide phosphate (NADP)+‐dependent isocitrate dehydrogenase (NADP+‐ICDH, EC 1.1.1.42), phosphoenolpyruvate carboxylase (PEPC, EC 4.1.1.31), glutamine synthetase (GS, EC 6.3.1.2) and the reduced form of nicotinamide adenine dinucleotide (NADH)‐dependent glutamate synthase (NADH‐GOGAT, EC 1.4.1.14). In addition, the increase in ammonium uptake, glutamine and glutamate (Glu) as well as the decrease in soluble carbohydrates were observed. The effects of feeding 2‐OG or metabolizable sugars were reversed by feeding of N‐acetyl‐glucosamine (NAG; a HXK inhibitor). The decreased 2‐OG level by the feeding of NAG alone led to increase in soluble carbohydrates and decrease in the enzyme activities, ammonium uptake as well as Glu content. The effects of NAG were reversed by supply of 2‐OG, Suc and Glc. These results suggest that nitrogen uptake and assimilation as well as their related carbohydrate metabolism in rice roots were regulated in coordination by 2‐OG level, and HXK activity was involved in the regulation of 2‐OG.
Long‐term effects of a structured intensive diabetes education programme (SIDEP) in patients with Type 2 diabetes mellitus—a 4‐year follow‐up study
Authors: Ko S.‐H. , Song K.‐H. , Kim S.‐R. , Lee J.‐M. , Kim J.‐S. , Shin J.‐H. , Cho Y.‐K. , Park Y.‐M. , Jeong J.‐H. , Yoon K.‐H. , Cha B.‐Y. , Son H.‐Y. , Ahn Y.‐B.
Published: January 2007

Aims  Patient education is a very important part of diabetes care. However, until now, little data has been presented about the long‐term effectiveness of structured intensive diabetes education programmes (SIDEP) for people with Type 2 diabetes mellitus.

Methods  People with Type 2 diabetes (n = 547) hospitalized from December 1999 to December 2000 were randomly assigned to two groups. Two hundred and nineteen patients undertook an inpatient SIDEP and the remaining patients received conventional glycaemic control without intensive education. After discharge, all patients were monitored regularly. Laboratory data were obtained, and adherence to self‐care behaviour was determined on a five‐point scale by questionnaires completed annually.

Results  Of the patients who completed the SIDEP, 160 (73.1%) were followed up for more than 4 years. The mean HbA1c (7.9 ± 1.2 vs. 8.7 ± 1.6%; P < 0.05) and the frequency of hospitalization related to diabetes per patient per year (0.3 ± 0.6 vs. 0.8 ± 0.9; P < 0.05) was significantly lower in the SIDEP group than in the control group. The SIDEP group adhered more closely to self‐care behaviour than the control group over 4 years (P < 0.05). People with Type 2 diabetes mellitus of longer duration and those treated with insulin had poorer HbA1c at follow‐up.

Conclusions  A well‐designed, intensive patient education programme is necessary for people with diabetes. However, regular and sustained reinforcement with encouragement is also required to maintain optimal glycaemic control, especially in insulin‐treated patients.
Experiences of patients with insulin‐treated diabetes in conscript military service
Authors: Sane T. , Rautuoja A. , Mäkelä M. , Westerberg J. , Lehesjoki M.
Published: January 2007

Aims  To determine how young adults with insulin therapy manage daily care of diabetes during the physically demanding conditions of conscript military service, and to evaluate the effects of military service on glycaemic control and on the incidence of acute diabetic complications.

Methods  An observational study of 47 young male volunteer conscripts receiving insulin therapy was carried out at the Signal Regiment in Riihimäki from January 2001 to July 2005. Outcome measures were drop‐out rate from service, management of diabetes care, glycaemic control, and occurrence of severe hypoglycaemia or ketoacidosis during service.

Results  Forty (85%) diabetic conscripts completed service, with service time ranging from 180 to 362 days, and seven (15%) interrupted service. One‐third of conscripts reported difficulties during military training with insulin injections and blood glucose testing. The mean HbA1c during service increased by 0.6% units (P = 0.007) from baseline. Five events of severe hypoglycaemia in three conscripts (overall incidence rate 0.15 per patient‐year) and one ketoacidosis event occurred. Diabetic conscripts were chosen for leadership training more often than non‐diabetic conscripts.

Conclusions  Our data suggest that selected and motivated adolescents on insulin therapy can manage the daily care of diabetes and maintain appropriate glycaemic control during service, although the risk of severe hypoglycaemia exists.
Insulin detemir compared with NPH insulin in children and adolescents with Type 1 diabetes
Authors: Robertson K. J. , Schoenle E. , Gucev Z. , Mordhorst L. , Gall M.‐A. , Ludvigsson J.
Published: January 2007

Aims  This study compared the effect of insulin detemir on glycaemic control (HbA1c, fasting plasma glucose and variability thereof) with that of Neutral Protamine Hagedorn human isophane (NPH) insulin, both combined with insulin aspart, in children with Type 1 diabetes mellitus, and compared the safety of these treatments.

Methods  In this 26‐week, open‐label, randomized (2 : 1), parallel‐group study, 347 (140 prepubertal and 207 pubertal) children with Type 1 diabetes, aged 6–17 years, received insulin detemir (n = 232) or NPH insulin (n = 115) once or twice daily, according to the prestudy regimen, plus premeal insulin aspart.

Results  The mean HbA1c decreased by ∼0.8% with both treatments. After 26 weeks, the mean difference in HbA1c was 0.1% (95% confidence interval −0.1, 0.3) (insulin detemir 8.0%, NPH insulin 7.9%). Within‐subject variation in self‐measured fasting plasma glucose was significantly lower with insulin detemir than with NPH insulin (SD 3.3 vs. 4.3, P < 0.001), as was mean fasting plasma glucose (8.4 vs. 9.6 mmol/l, P = 0.022). The risk of nocturnal hypoglycaemia (22.00–07.00 h) was 26% lower with insulin detemir (P = 0.041) and the risk of 24‐h hypoglycaemia was similar with the two treatments (P = 0.351). The mean body mass index (BMI) Z‐score was lower with insulin detemir (P < 0.001).

Conclusions  Basal‐bolus treatment with insulin detemir or NPH insulin and premeal insulin aspart in children and adolescents with Type 1 diabetes mellitus improved HbA1c to a similar degree. The lower and more predictable fasting plasma glucose, lower risk of nocturnal hypoglycaemia and lower BMI observed with insulin detemir are clinically significant advantages compared with NPH insulin.
Magnetic resonance imaging: a reliable method for measuring pancreatic volume in Type 1 diabetes
Authors: Williams A. J. K. , Chau W. , Callaway M. P. , Dayan C. M.
Published: January 2007

Aim  To validate magnetic resonance imaging (MRI) for monitoring pancreatic atrophy in Type 1 diabetes.

Methods  Twelve male patients with Type 1 diabetes of duration ≥ 10 years (median age 28, range 19–32 years) and 12 healthy controls (median age 30, range 22–36 years) were invited for two abdominal MRI scans, 14 days apart. Four sequences were used: standard T1‐weighted; standard T2‐weighted; volumetric interpolated breath‐hold examination (VIBE); and T1‐weighted breath hold with fat suppression (T1BHFS). The pancreas was identified on coded images by one observer and volumes estimated by interpolation.

Results  Eleven patients and all controls were scanned twice. Visualization of the pancreas was best with VIBE and T1BHFS, allowing volume estimation from 47 and 46 scans, respectively. The pancreatic volume of patients estimated from these sequences were half those of controls (52.4 ml, ± 17.1 ml, mean ± sd) vs. (101 ml, ± 19.5 ml, P < 0.001) and estimates showed little bias between visits; mean difference 1.1 ml (95% CI; −3.1 to 5.3 ml, P = 0.61) using VIBE and −2.6 ml (−5.8 to 0.6 ml, P = 0.03) using T1BHFS. Both sequences gave similar precision; the standard deviation of the differences in volume estimates between visits was 9.7 ml for VIBE and 7.3 ml for T1BHFS, although mean volumes estimated from T1BHFS were 4.9 ml lower (−8.2 to −1.7 ml, P = 0.005).

Conclusions  Pancreatic volume can be measured reliably using MRI and shows a 48% reduction in long‐standing Type 1 diabetes as compared with age‐matched normal subjects. MRI should prove useful in determining the natural history of pancreatic atrophy in diabetes.
Paradoxical HDL‐C reduction during rosiglitazone and fibrate treatment
Authors: Shetty C. , Balasubramani M. , Capps N. , Milles J. , Ramachandran S.
Published: January 2007

Aims  Dyslipidaemia in Type 2 diabetes mellitus (T2DM) is one of the major contributors in the pathogenesis of atherosclerosis. Thiazolidinediones (TZD), a class of drugs used in the treatment of T2DM, also modify lipids, especially lowering serum triglycerides and raising high‐density lipoprotein cholesterol (HDL‐C).

Methods  We describe five patients taking rosiglitazone and a fibrate who showed a paradoxical fall in HDL‐C, which would have been missed if HDL‐C had not been routinely monitored. This could have had a major impact in increasing the cardiovascular risk in these patients.

Results  Our five patients showed marked variation in both the decrease in serum HDL‐C (50–89%) and also in the time taken for recovery of HDL‐C after withdrawal of rosiglitazone (between 5 and 20 weeks). Apolipoprotein A1 mirrored the drop in HDL‐C in four of the five patients but in one subject this was not seen, suggesting the possibility of multiple mechanisms leading to the phenomenon described, perhaps involving HDL metabolism. Improvements in glycaemic control with rosiglitazone (absolute HbA1c reduction between 0.6 and 3.0%) were seen in four of our patients. This suggests that the peroxisomal proliferator‐activated receptor γ signalling pathways relevant to glucose homeostasis were intact.

Conclusion  As atherosclerosis is associated with a decrease in the HDL‐C level, our observations reinforce the message that HDL‐C should be measured before and after the commencement of rosiglitazone and also on increasing the dosage
Cross‐Sectional Age Differences and Longitudinal Age Changes of Personality in Middle Adulthood and Old Age
Authors: Allemand Mathias , Zimprich Daniel , Hertzog Christopher
Published: January 2007

ABSTRACT
The present study examines different aspects of personality continuity (or change) in middle adulthood and old age both cross‐sectionally and longitudinally. The sample comprised 445 middle‐aged (42–46 years) and 420 older (60–64 years) participants, reassessed after a 4‐year interval. Personality was measured using the NEO‐FFI personality inventory. After having established strict factorial invariance, factor covariances were found to be equal for both age groups and at both testing occasions, indicating perfect structural continuity of personality. A number of age differences in personality emerged at both measurement occasions. Longitudinally, in both age groups, an average decline in Neuroticism was observed. Longitudinal stability coefficients were around .80 in middle‐aged and old participants, implying high, but not perfect, differential continuity. With respect to continuity of divergence, statistically significant cross‐sectional age differences were found for the variance of Openness at both measurement occasions. Eventually, concerning specific versus general continuity, a variety of medium effect‐sized correlated changes in the Big Five personality domains across the 4‐year period was established, implying that personality changes share a certain amount of commonality.
Africa and the WTO Doha Round: An Overview
Authors: Jensen Michael Friis , Gibbon Peter
Published: January 2007

Developing countries, and especially Least Developed Countries, were promised a WTO ‘Development Round’ at Doha in 2001. In fact, the Round's agenda became dominated by topics and proposals of little relevance and at times threatening for some groups of developing countries, particularly those in sub‐Saharan Africa. As a result, African engagement in the Round has been generally low and defensively articulated, though some fringe gains have been achieved. If and when the Round is revived, these could be complemented by a more aggressive stance on preferences. This, in turn, will need to be backed by greater exploitation of the heightened role of moral argument in international political and economic discourse.
Africa, Tropical Commodity Policy and the WTO Doha Round
Authors: Gibbon Peter
Published: January 2007

Despite their critical importance for Africa, and African efforts to the contrary, tropical commodity problems have been touched on only marginally in the WTO Doha Round. This article examines African proposals in the area, their reception in the WTO, and their relation to the current international policy debate. It goes on to provide an explanation, in political economy terms, for their relative success and failure, before concluding by discussing the prospects for finding any international forum where the issues raised by African countries could receive meaningful consideration.
TRIPs and Public Health: The Doha Declaration and Africa
Authors: Haakonsson Stine Jessen , Richey Lisa Ann
Published: January 2007

The Doha Declaration on the TRIPs Agreement and Public Health (2001), aimed at improving access to medicines, especially for HIV/AIDS, malaria and tuberculosis in developing and least developed countries, has not yet been used for compulsory licences to import generic medicines or for expanding production for export to poor countries. By analysing HIV/AIDS treatment in Uganda, this article discusses the variety of TRIPs‐related channels for ensuring drugs for domestic treatment, and argues that emphasising the restrictive nature of TRIPs provisions fails to grasp the scale of the obstacles involved. Lack of domestic resources leaves African countries dependent on donor financing, which in turn constrains their ability to exploit international trade provisions.
African Demands for Special and Differential Treatment in the Doha Round: An Assessment and Analysis
Authors: Jensen Michael Friis
Published: January 2007

Interest in Special and Differential Treatment (SDT) is experiencing a revival and Africa has made it a WTO priority. This article reviews the African SDT proposals and puts forward a political economy explanation of the strong focus on it. Small African economies cannot reap gains in the WTO through the use of reciprocity. However, there are still opportunities for them to influence the negotiations, if (i) no major trade interests of the main powers are in play, (ii) they can make a sufficient claim to the moral high ground and/or (iii) they can exploit the decision‐making procedures to block negotiations. This favours a prioritisation of negotiations on SDT, but potential gains here are fewer than they might be since the African approach to SDT is unfocused, substantially and politically.
Swimming Upstream: Market Access for African Fish Exports in the Context of WTO and EU Negotiations and Regulation
Authors: Ponte Stefano , Raakjær Jesper , Campling Liam
Published: January 2007

The changing nature of the international trade regime presents a series of new challenges to fish industries on the African continent. This article explores how WTO and EU trade negotiations and regulation impact market‐access possibilities for African fish exports. It comes to the conclusion that while bilateral negotiations with the EU have been beneficial for some African countries, collective bargaining power in the context of Economic Partnership Agreements might produce more strategic outcomes in the medium term.
Gender Inequalities and Economic Efficiency: New Evidence from Cassava‐based Farm Holdings in Rural South‐western Nigeria
Authors: Timothy Awoyemi Taiwo , Adeoti Adetola I.
Published: January 2007

Abstract:  It is a widely accepted fact that persistent inequality between men and women constrains a society's productivity and ultimately slows its rate of economic growth. The economy pays for this inequality in reduced labour productivity today and diminished national output tomorrow. Motivated by this, the study aim is to assess the possibilities of enhancing productivity gains by improving the efficiency of small‐scale agriculture through gender‐responsive intra‐household allocation of resources in south‐western Nigeria. The study adopts a stochastic parametric decomposition method which yields efficiency measures that are not distorted by statistical noise to estimate the efficiency level of resource allocation by small‐scale cassava producers. The results indicate that average overall productive efficiency in the sample was 75.78 per cent, implying that small‐scale cassava farmers in the sample could reduce total variable cost by 24.22 per cent if they reduce labour, fertilizer, land and capital applications to levels observed in the changing input mix (technical efficiency) and then obtain optimal input mix for the given input prices and technology (allocative efficiency). The average technical efficiency and allocative efficiency indexes for the sample were 82.2 per cent and 92.2 per cent respectively. Also, evidence from empirical analysis of data from the male respondents showed that the average economic, technical and allocative efficiency indexes were 88.06 per cent, 89.34 per cent and 78.67 per cent respectively while the same computed for the female sample were 94.9 per cent, 74.85 per cent and 71.03 per cent respectively. Labour was the most limiting factor in cassava production suggesting that the technologies that enhance the productivity of labour are likely to achieve significant positive effects on cassava production. The paper shares the notion that producers' control over the means of production and impact of development are related and has influence on the economic efficiency and growth of society. Again, technical inefficiency constituted a more serious problem than allocative inefficiency, thus most cost savings will accrue to improvement in technical efficiency.
Institutional Foundations for Shared Growth in Sub‐Saharan Africa*
Authors: Nissanke Machiko , Sindzingre Alice
Published: January 2007

Abstract: The paper examines the dynamically evolving triangular relationships between institutions, growth and inequality in the process of economic development, in order to deepen the understanding of institutional conditions for pro‐poor growth and shared growth. In this context, the paper discusses the institutional conditions found in sub‐Saharan Africa, which may have produced the growth pattern that is unequal and against the poor. The analysis shows that sub‐Saharan African countries require transforming institutions for embarking upon and sustaining a development path which would ensure shared growth in years to come. The paper first evaluates the growth‐inequality‐poverty nexus, as found in the recent literature, which increasingly challenges the trade‐off between growth and equity, as postulated in the traditional theories. Various definitions of pro‐poor growth are discussed and a sharper definition of the concept of ‘shared’ growth is provided. Definitions of institutions are then examined, as well as the triangular inter‐relationships between institutions, inequality and poverty. The paper finally analyses specific institutional conditions found in sub‐Saharan Africa that prevent economies from emerging out of low‐equilibrium poverty traps that are characterized by low economic growth, unequal distribution of income and wealth as well as unequal access to resources and power.
Shared Sectoral Growth Versus the Dual Economy Model: Evidence from Côte d'Ivoire, Ghana, and Zimbabwe
Authors: Blunch Niels‐Hugo , Verner Dorte
Published: January 2007

Abstract:  Though recently challenged, the dual economy view has affected development economics and development policy, either explicitly or implicitly, for more than half a century. According to this view, agriculture merely serves to build the industrial sector — in particular, agriculture has no role as an engine of growth in the long term. Examining agriculture, industry and service sector growth in Côte d'Ivoire, Ghana, and Zimbabwe over more than three decades, we find little empirical support for this view. On the contrary, our analyses find a large degree of interdependence in long‐run sectoral growth, implying that the sectors ‘grow together’ or, similarly, that there are externalities or spillovers between sectors. Policy implications are also discussed; these include directing more attention towards the interdependencies in sectoral growth broadly defined. In particular, our findings have implications for the design of education and health programs, as well. This improved understanding of inter‐sectoral dynamics at all levels may facilitate policy implementation aimed at increasing economic growth — and thereby ultimately improving peoples' livelihoods — in Africa and elsewhere.
Storming Heaven with Karl Barth? Barth's Unwitting Appropriation of the Genus Maiestaticum and what Lutherans Can Learn from It
Authors: MALYSZ PIOTR J.
Published: January 2007

Abstract:  This article seeks to demonstrate that Barth radically misunderstands the Lutheran doctrine of the communication of attributes, with its centerpiece the genus maiestaticum. However, misdirected as Barth's criticism is, the doctrine is not without its own problems and, instead of giving expression to the integrity of Christ's person and the co‐presence of his natures, is in danger of subverting itself. After showing that Barth's Christology actually employs what for all practical purposes is the majestic genus of the Lutherans, I propose that the Swiss theologian's thought may offer ways of resolving the tensions inherent in the Lutheran tenet, and that by means of resources that the Lutherans already possess.
The extension of healthcare coverage and protection in relation to the labour market: Problems and policies in Latin America
Authors: Mesa‐Lago Carmelo
Published: January 2007

In the past 25 years almost all 20 countries of Latin America have reformed their healthcare systems, but coverage by social insurance averages 53 per cent of the total population (less than the ILO minimum standard), ranges from 7 to 26 per cent in ten countries and has stagnated or decreased in at least eight, and access is insufficient. This article (1) analyses the transformation of the labour market and its impact on social insurance coverage; describes legal coverage of various groups; estimates statistical coverage/access and its trends in the three typical sectors (public, social insurance and private); documents the differences in coverage by income, geographical area and ethnic group; examines the difficulties in the incorporation of the informal economy, the rural population, indigenous peoples and the poor, as well as the causes of low coverage, and touches problems of access;(2) summarizes recommendations from international organizations on coverage and access; suggests specific policies to expand protection in general and to vulnerable groups, and identifies themes that require more statistics and research; and (3) summarizes findings and recommendations.

A preliminary version of this article was presented at the ISSA Regional Conference for the Americas held in Belize City, 28‐31 May 2006. Based on the author's book Las Reformas de Saluden América Latina y el Caribe: Su Impacto en los Principios de la Seguridad Social (Santiago, ECLAC/GTZ, 2006), the article summarizes and restructures all pertinent sections of that book, with numerous changes and new data. Useful comments were provided by two anonymous referees.
Microsatellite markers for population studies of the rice blast fungus, Magnaporthe grisea
Authors: ADREIT H. , SANTOSO  , ANDRIANTSIMIALONA D. , UTAMI D. W. , NOTTEGHEM J. L. , LEBRUN M. H. , THARREAU D.
Published: January 2007

We developed nine new microsatellite markers for rice blast (Magnaporthe grisea) population studies. These markers were used in addition to nine microsatellite markers previously developed by our group for mapping purpose. Altogether, the 18 markers were used in multiplex PCR (polymerase chain reaction) to characterize six populations from different geographical origins. The average number of alleles per locus across populations ranged from 1.2 to 7 and the total number of alleles detected from 2 to 19. Based on this large range of polymorphism, this set of markers is expected to be useful for different kind of population studies at different geographical scales.
The Myth of International Delegation: Limits to and Suggestions for Democratic Theory in the Context of the European Union
Authors: Agné Hans
Published: January 2007

This paper presents an argument as to why democratic states are unable to delegate authority to international organizations. Influential attempts to justify democratically such international bodies as the European Union by means of delegation are found to be untenable. At a more general level of theorization, it argues that the theory of delegation as involving the recoverability of delegated authority leaves us unable to identify democratic reforms for international organizations. As a remedy to the latter problem, the article proposes an alternative theory of democratic ‘delegation’– one that applies equally well to national and to international politics.
A Double‐Blind Evaluation of Gabapentin on Alcohol Effects and Drinking in a Clinical Laboratory Paradigm
Authors: Myrick Hugh , Anton Raymond , Voronin Konstantin , Wang Wei , Henderson Scott
Published: January 2007

Introduction: There has been increasing interest in the use of anticonvulsant agents in the treatment of alcoholism. Anticonvulsant agents have mostly been evaluated as an alternative to benzodiazepines in the treatment of alcohol withdrawal. Among the advantages of using anticonvulsant agents in this capacity is their purported lack of interaction with alcohol (i.e., interactions that could increase psychomotor deficits, cognitive impairment, and increase intoxication). This is particularly important in the treatment of alcohol withdrawal and relapse prevention in outpatients. Unfortunately, these untoward clinical interactions between anticonvulsants and alcohol in alcoholic patients have not been thoroughly assessed. The current clinical laboratory study was conducted to evaluate the safety and tolerability of the anticonvulsant gabapentin in alcoholic subjects. In addition, the ability of gabapentin to reduce alcohol craving and consumption was evaluated.

Methods: Thirty‐five non‐treatment–seeking alcoholic subjects were enrolled in a subacute human laboratory study and received double‐blind treatment with up to 1,200 mg of gabapentin (n=18) or placebo (n=17) for 8 days. The safety and tolerability of gabapentin were monitored in the natural environment during the first 5 days of medication treatment and during a free‐choice limited access consumption paradigm following an initial drink of alcohol in a bar–lab setting on Day 7.

Results: There was no overall effect of gabapentin on drinking or craving; however, it was tolerated (e.g., mood and sedation) as well as placebo over 5 days of natural drinking. During the bar–lab drinking session, there were no differences in subjective high or intoxication between subjects treated with gabapentin or placebo.

Discussion: This study provides initial evidence that the anticonvulsant gabapentin is safe if used in conjunction with alcohol consumption in alcoholic individuals. Further study is needed with this and other lab models to determine the utility and safety of gabapentin in the treatment of alcoholism.
Age‐Dependent Variation in Behavior Following Acute Ethanol Administration in Male and Female Adolescent Rhesus Macaques (Macaca mulatta)
Authors: Schwandt Melanie L. , Barr Christina S. , Suomi Stephen J. , Higley James D.
Published: January 2007

Background: There has been considerable focus on the adolescent stage of development in the study of alcohol use and the etiology of alcohol‐related problems. Because adolescence is a process of dynamic change rather than a discrete or static stage of development, it is important to consider ontogenetic changes in the response to ethanol within the adolescent time period. In rodents, levels of ethanol‐induced motor impairment have been shown to increase from early to late adolescence. This study investigated associations between behavior following acute ethanol administration and age, rearing condition (mother‐reared vs nursery‐reared), and serotonin transporter (rh5‐HTTLPR) genotype in a sample of alcohol‐naïve adolescent rhesus macaques.

Methods: Rhesus macaques (n=97; 41 males, 56 females), ranging in age from 28 to 48 months, were administered intravenous (IV) doses of ethanol (2.2 g/kg for males, 2.0 g/kg for females) twice in 2 separate testing sessions. A saline/ethanol group (n=16; 8 males, 6 females) was administered saline in 1 testing session and ethanol in the second session. Following each IV injection, subjects underwent a 30‐minute general motor behavioral assessment. Behavior in the saline/ethanol group was compared between the saline and ethanol‐testing sessions using analysis of variance. Behavioral data for the larger study sample were averaged between the 2 testing sessions and summarized using factor analysis. Rotated factor scores were used as dependent variables in multiple regression analyses to test for relationships between behavior and age, rearing condition, and rh5‐HTTLPR genotype.

Results: During the ethanol‐testing session, behaviors indicative of motor impairment (stumbles, falls, sways, bumping the wall, and unsuccessful jumps) were frequently observed in the saline/ethanol group, while they did not occur under the saline‐testing session. Factor analysis of behavior following ethanol administration in the larger study sample yielded 3 factors: Ataxia, Impaired Jumping Ability, and Stimulation. Significant negative correlations between age and Ataxia were found for both males and females. Females also exhibited positive correlations between age and Impaired Jumping Ability and age and Stimulation. No significant correlations were found with either rearing condition or rh5‐HTTLPR genotype.

Conclusions: These findings suggest that ontogenetic changes during adolescence in the behavioral response to ethanol differ between rodents and primates. Furthermore, sex differences in the behavioral response to ethanol appear to develop during adolescence.
Controlling for Serum Albumin Level Improves the Correlation Between Serum Fatty Acid Ethyl Esters and Blood Ethanol Level
Authors: Morfin John‐Paul , Kulig Clark , Everson Gregory , Beresford Thomas
Published: January 2007

Background: Fatty acid ethyl esters (FAEEs) are generated by the nonoxidative metabolism of alcohol and correlate positively with blood alcohol levels (BAL). As FAEEs are produced predominantly in the liver and bind to albumin in plasma, blood FAEE concentrations may be affected by serum albumin levels. The aim of this exploratory study was to define the relationship of FAEE levels with BAL after adjustment for serum albumin concentration.

Methods: Fatty acid ethyl ester, BAL, and albumin concentrations were measured from de‐identified, ethanol‐containing serum samples (N=18). The assay focused on 3 FAEE species ethyl palmitate, ethyl stearate, and ethyl oleate. The relationships of individual and total FAEE concentrations with BAL using albumin as a covariate were analyzed. Values for Pearson's r between the BAL and the natural log‐transformed FAEE (ln FAEE) levels were calculated, and then compared with partial correlation coefficients when controlling for albumin. The impact of serum albumin levels on the relationship between ln FAEE and BAL was evaluated by simple linear regression analysis.

Results: Concentrations of total FAEE ranged from 632 to 20,166 nM, and BAL ranged from 9 to 375 mg/dL. In the 18 samples, the Pearson correlation coefficient between BAL and total FAEE levels was 0.868, and increased to 0.909 when controlling for albumin (p<0.0001). Similar statistically significant increases in the partial correlation coefficient occurred for each of the individual species of FAEE when controlling for albumin. In simple linear regression, albumin significantly reduced the variability in the model correlating BAL and FAEE for each of the individual species, as well as for total FAEE.

Conclusions: The association between FAEE levels and BAL is enhanced by consideration of serum albumin concentrations. Our findings suggest that serum albumin should be included in any model attempting to define the relationship between BAL and FAEE.
Alcohol Consumption During Pregnancy in Nonindigenous West Australian Women
Authors: Colvin Lyn , Payne Jan , Parsons Deborah , Kurinczuk Jennifer J , Bower Carol
Published: January 2007

Background: High alcohol intake in pregnancy has been linked to abnormal fetal development. There are limited published data in Australia on standard drinks of alcohol consumed on a typical occasion during the periconceptional period or pregnancy.

Methods: During 1995 to 1997, a 10% random sample of all nonindigenous women giving birth in Western Australia was surveyed 12 weeks after delivery (N=4,839). Women were asked questions about alcohol consumption in each of the 4 time periods: the 3 months before pregnancy and each trimester of pregnancy. Questions were framed to measure volume, frequency, and type of alcoholic beverage.

Results: 46.7% of the women had not planned their pregnancy. Most women (79.8%) reported drinking alcohol in the 3 months before pregnancy, with 58.7% drinking alcohol in at least 1 trimester of pregnancy. The proportion of women consuming 1 to 2 drinks on a typical occasion did not change much during pregnancy, but the number of occasions declined. Although the proportion of women consuming more than 2 standard drinks on a typical occasion declined after the first trimester, 19.0% of women consumed this amount in at least 1 trimester of pregnancy and 4.3% of women consumed 5 or more standard drinks on a typical occasion in at least 1 trimester of pregnancy. In the first trimester of pregnancy, 14.8% of women drank outside the current Australian guideline for alcohol consumption in pregnancy, decreasing to 10% in the second and third trimesters.

Conclusions: Women generally reduced their average alcohol consumption and the number of standard drinks on a typical occasion as their pregnancy progressed, although 10 to 14% were drinking outside current guidelines for pregnancy. It is important that all women of child‐bearing age are aware, well before they consider pregnancy, of the risks of drinking alcohol during pregnancy so they can make informed decisions about their alcohol consumption in pregnancy.
Initial Experience Using a Forward Directed, High‐Intensity Focused Ultrasound Balloon Catheter for Pulmonary Vein Antrum Isolation in Patients with Atrial Fibrillation
Authors: NAKAGAWA HIROSHI , ANTZ MATTHIAS , WONG TOM , SCHMIDT BORIS , ERNST SABINE , OUYANG FEIFAN , VOGTMANN THOMAS , WU RICHARD , YOKOYAMA KATSUAKI , LOCKWOOD DEBORAH , PO SUNNY S. , BECKMAN KAREN J. , DAVIES D. WYN , KUCK KARL‐HEINZ , JACKMAN WARREN M.
Published: January 2007

Background: A high‐intensity‐focused ultrasound balloon catheter (HIFU‐BC) is designed to isolate pulmonary veins (PV) outside the ostia (PV antrum). This catheter uses a parabolic CO2 balloon (behind water balloon) to focus a 20‐, 25‐, or 30‐mm diameter ring of ultrasound forward of the balloon (parallel to catheter shaft). The purpose of this study is to test the safety and efficacy of the HIFU‐BC for PV antrum isolation in patients with atrial fibrillation (AF).

Methods and Results: Twenty‐seven patients with paroxysmal (19 patients) or persistent (8 patients) AF were studied. Double transseptal puncture was performed for left atrial deployment of a Lasso catheter (for PV mapping) and the 14 Fr HIFU‐BC. The HIFU‐BC was positioned outside the PV orifice over a guidewire. HIFU energy (acoustic power 45 watts) was applied for 40 seconds with a 20‐mm sonicating ring and 40 or 60 seconds with a 25‐mm or 30‐mm sonicating ring. No other ablation system was utilized. PV antrum isolation was attempted using HIFU‐BC in 78 of 104 PVs (25/27 RSPVs, all 23 LSPVs, all 23 LIPVs, all four left common trunks and 3/27 RIPVs). HIFU‐BC successfully isolated 68 (87%) of the 78PV antra with 1–26 (median 3) HIFU applications. The complications include transient bleeding from a distal branch of the left superior PV resulting from guidewire manipulation in one patient and right phrenic nerve injury in another patient. No PV stenosis (>50% narrowing) and no LA‐esophageal fistula occurred. At the 12‐month follow‐up, 16 (59%) of the 27 patients were free of symptomatic episodes of AF (only 3 of the 16 patients were receiving antiarrhythmic medications).

Conclusions: Forward‐focused HIFU applications isolated PVs outside the PV ostium with elimination of AF in 16 (59%) of the 27 patients at 12 months following the single ablation procedure.
Substrate‐Based Catheter Ablation of Epicardial Ventricular Tachycardia Related to an Anomalous Coronary Artery
Authors: NEUZIL PETR , BALAK JAN , KRALOVEC STEPAN , REDDY VIVEK Y.
Published: January 2007

Delayed enhancement magnetic resonance imaging is known for its ability to identify scarred myocardial tissue. This case report describes the use of MR imaging to define the location and transmural extent of infarcted tissue in a 45‐year‐old woman with an anomalous right coronary artery and hemodynamically unstable ventricular tachycardia. By demonstrating a predominantly epicardial infarct, MR imaging indicated that the pericardial approach was necessary for successful substrate‐based ventricular tachycardia ablation.
A Novel Algorithm for Determining Endocardial VT Exit Site from 12‐Lead Surface ECG Characteristics in Human, Infarct‐Related Ventricular Tachycardia
Authors: SEGAL OLIVER R. , CHOW ANTHONY W.C. , WONG TOM , TREVISI NICOLA , LOWE MARTIN D. , DAVIES D. WYN , BELLA PAOLO DELLA , PACKER DOUGLAS L. , PETERS NICHOLAS S.
Published: January 2007

Introduction: Characteristics of the 12‐lead ECG during VT are used to guide initial placement of mapping catheters in endocardial ventricular tachycardia (VT) ablation. Previously constructed algorithms for guidance in human infarct‐related VT are limited to patients known to have anterior or inferior infarcts only. We hypothesized that 12‐lead ECG characteristics could be used to determine VT exit site in patients with all types of infarction of unknown location.

Methods and Results: From noncontact activation maps of 121 LV VT in 51 patients undergoing catheter ablation, VT exit sites were determined and correlated with ECG characteristics according to bundle branch block configuration, limb lead polarity and patterns of precordial R‐wave transition. Eight ECG patterns were identified that accounted for 71% of all VT and gave a positive predictive value (PPV) ≥70% using the first two criteria. No correlation was found with patterns of R‐wave transition. Using these criteria an algorithm was developed, which was then applied prospectively and blinded to a further 17 VT in 11 patients. Of the 15 VT (88%) to which the algorithm predicted an exit site location (with a PPV ≥70%), 14 VT (93%) were correctly predicted by the algorithm.

Conclusion: This algorithm can be used to predict endocardial LV VT exit site location in patients undergoing catheter ablation of VT without knowledge of or reference to infarct location, and can be applied to patients with posterior and/or multiple sites of infarction.