bluuebunny/crossref_metadata_2025 huggingface dataset:
Involvement and the tourist shopper: Using the involvement construct to segment the American tourist shopper at the mall
Authors: Josiam Bharath M. , Kinley Tammy R. , Kim Youn-Kyung
Published: May 2005

There is great interest in understanding the complex behaviors of consumers. One facet of consumer behavior is the ‘involvement’ construct. Involvement is a person’s perceived relevance of the object based on inherent needs, values, and interests.

There is a plethora of shopping malls all over the US. Major metropolitan cities are over-malled! Despite the abundance of malls close to their residence, American travelers shop at comparable malls while tourists in another city. There exists a gap in the literature about this phenomenon.

This study surveyed 485 tourist shoppers residing in metropolitan areas to address this gap. It examined the interplay of their shopping involvement with demographics, push motivators, pull motivators, shopper-tourist cluster typologies, and the amount of time and money spent shopping while on a trip. This study created a profile of tourists based on their level of shopping involvement. It segmented them into high-, medium-, or low-involvement tourist shoppers.

The more highly involved tourist shoppers were female and had limited formal education. Further, they indicated they were more interested in shopping than in many other activities. Involvement levels were consistently associated with both push and pull factors in a hierarchical manner. Respondents strongly motivated to shop by push and pull factors were consistently found to be highly involved tourist shoppers. Involvement was a significant predictor of overall satisfaction with a shopping center. Involvement levels were significantly linked to tourist-shopper cluster typologies. High-involvement tourist shoppers were significantly more likely to have saved for shopping on their trip. However, involvement was not found to be a predictor of time or money spent on shopping while on a trip.
Tourists’ use of restaurant webpages: Is the internet a critical marketing tool?
Authors: Litvin Stephen W. , Blose Julia E. , Laird Stephen T.
Published: May 2005

No one questions the power of the internet as a means of information dissemination. But how effective is the medium for restaurant marketing? Are tourists using the tool, and does it influence their purchase behavior? Though there is no shortage of consultants and technology companies touting the importance of the internet and their abilities to harness the medium for their restaurant clients, little empirical research has been performed to determine its effectiveness in tourism settings. This paper reflects the results of an empirical study of tourist restaurant selection in a vacation destination, and notes that while a reasonable percentage of vacationers believe the medium to be a useful research tool, few in fact translate research into patronage; a disconnect that should be of significant interest to restaurateurs considering the investment return of their internet marketing dollars. Implications and suggestions for restaurants catering to vacation travelers are discussed.
Image formation, information sources and an iconic Australian tourist destination
Authors: Hanlan Janet , Kelly Stephen
Published: May 2005

Tourist destination brand image is a major influencing factor in traveller destination choice. This exploratory research into the information sources from which destination brand image evolves provides insights which have the potential to improve tourism destination brand development strategies. In-depth interviews with 21 international backpackers on Australia’s northern New South Wales coast indicate that mainstream media play little or no part in the formation of respondents’ image of the coastal destination of Byron Bay. Rather, word of mouth and autonomous independent information sources were the key media through which respondents formed their image of this iconic Australian tourist destination. Findings also show the importance of destination experience in the image formation process and suggest that destination marketing organizations (DMOs) can and should go beyond traditional mainstream media to communicate their brand message. Additionally, findings suggest the need for DMOs to provide leadership within the destination’s tourism industry to improve service delivery and exceed the ‘brand promise’.
Carbon Monoxide Emissions from Joss or Incense Sticks
Authors: Croxford B. , Kynigou D.
Published: May 2005

A recent Department of Health funded project investigating carbon monoxide (CO) levels in homes found one home with CO concentrations above World Health Organisation (WHO) guideline levels. The source was identified as burning joss or incense sticks. This paper reports on a study investigating the CO emissions of 5 different types of commonly available joss sticks. All 5 brands emit significant amounts of CO with each joss stick producing as much as 557mg of CO, compared to 60mg CO from a typical cigarette. Experiments confirm that burning as few as 2 joss sticks (Lemon Grass brand) in a well sealed room would breach the WHO 1-hour guideline levels for CO of 26ppm within an hour.
Exposure Risks from Pollutants in Domestic Environments: The Urban Exposure Project
Authors: Coulson Guy , Bartonova Alena , Bøhler Trond , Broday David M. , Colbeck Ian , Fløisand Inga , Fudala Janina , Hollander Werner , Housiadas Christos , Lazaridis Mihalis , Smolik Jiri
Published: May 2005

The Urban Exposure Project is an EU funded project to produce a state of the art, user-friendly management decision software tool for administrators to help them quantify and deal with the real health risks associated with pollution in urban environments. The project, which began in December 2002 will run for 3 years and will quantify the relationship between outdoor pollution measurements and actual exposure suffered by people in urban indoor environments. The resulting product will be extensively field tested in 2 European urban centres before being made available to administrators. This paper gives an overview of the project and a summary of its achievements at the end of its first year.
Effect of Indoor and Outdoor Sources on Particulate Matter Concentration in a Naturally Ventilated Flat (URBAN-AEROSOL Project - Prague)
Authors: Braniš Martin , Hovorka Jan , Řezáčcová Pavla , Domasová Markéta , Lazaridis Mihalis
Published: May 2005

Indoor and outdoor characteristics of particulate matter (PM) were studied in a naturally ventilated flat. Twenty-four-hour concentrations of indoor PM1, PM2.5 and PM10 and outdoor PM2.5 were measured. In winter all indoor concentrations of PM fractions were highly correlated (r 0.97 to 0.98). High correlation was also found between ambient PM10 and outdoor PM2.5 (r 0.99). In summer, the correlations between all PM fractions were lower. Human activity had a stronger effect on indoor PM concentrations in winter than in summer but only when the outdoor levels were low. During the second winter campaign higher outdoor concentrations were able to mask indoor sources. The presence of people corresponded to elevated levels of coarse particle fractions, cooking was associated with higher levels of fine particles. In summer with windows open, indoor PM values were not associated with human activity. A significant negative association was registered between wind speed and indoor PM.
GC-MS Measurements of Ambient Levels of Volatile Organic Compounds
Authors: Culea Monica , Cozar Onuc , Melian Claudiu , Ristoiu Dumitru
Published: May 2005

A qualitative and quantitative method for measuring volatile organic compounds by pre-concentration on active charcoal followed by gas chromatography-mass spectrometry (GC-MS) analysis was developed. The method was tested for the investigation of the emissions from different materials, adhesives, combustion sources or tobacco smoke. The MS was operated in the selected ion monitoring mode. The compounds of interest eluted in less than 9min. Validation of the method adopted demonstrated the ability to identify and to measure reliably the yields of benzene and other compounds: toluene, ethylbenzene, m- and p-xylene, o-xylene. The method is simple and rapid, shows good linearity, precision and accuracy for the compounds studied.
Exposure Assessment of Nicotine and Cotinine by GC-MS
Authors: Culea Monica , Cozar Onuc , Nicoara Simona , Podea Răzvan
Published: May 2005

Environmental tobacco smoke exposure of human subjects in different public houses was evaluated. The levels of airborne nicotine from environmental tobacco smoke and changes in urinary cotinine and nicotine levels between smoking and non-smoking subjects were compared. A gas chromatography-mass spectrometric (GC-MS) quantitative method for nicotine and cotinine levels in the indoor air and in urine was developed. A Thermo Quest Trace DSQ GC-MS equipped with a Rtx-5MS capillary column, 15m 0.25mm, 0.25 m film thickness, was used in a temperature programme starting from 50°C, for 2min, then increased at 8°C·min-1 to 250°C and held for 10min. The method was validated and gave good linearity, precision, accuracy and limit of detection. A significant correlation between urinary cotinine increase and airborne nicotine is presented.
Colonization tendencies in the development of the world wide web
Authors: Salter Lee
Published: May 2005

While many studies of the web and related technologies of communication have focused on its use, there has been little engagement with the structural properties of the web and related technologies from a broadly social theoretic point of view. This article analyses pressures on the technological development of the web from the perspective of the Habermasian concepts of colonization and juridification. On this analysis, legal and quasi-legal tendencies can be seen to restrict the uses and development of the structures of the world wide web, as I will show with the use of several case studies.
From shoebox to performative agent: the computer as personal memory machine
Authors: Van Dijck José
Published: May 2005

Digital technologies offer new opportunities in the everyday lives of people: with still expanding memory capacities, the computer is rapidly becoming a giant storage and processing facility for recording and retrieving ‘bits of life’. Software engineers and companies promise not only to expand the capacity of personal memory infinitely, but even revolutionize its nature. Both in the past and recent years, the idea of a universal memory machine has been conceptualized in fantasies and actual projects (e.g. Vannevar Bush’s ‘Memex’, 1945). Discussing the intentions of contemporary technical projects (Shoebox, Experience on Demand) as well as visionary projects (Lifestreams, Memories for Life, MyLifeBits), this article critically analyses how digital personal memory machines use the computer as a model for the way in which memory works. Rather than looking at computers as jukeboxes of memory, it proposes to pay attention to the performative nature of machines in the acts of remembering.
Gaming at a LAN event: the social context of playing video games
Authors: Jansz Jeroen , Martens Lonneke
Published: May 2005

An exploratory survey was undertaken about the appeal of playing video games at a Local Area Network (LAN) event where personal computers are linked in order to play both face-to-face and online. First, we wanted to know who the visitors of a LAN event were, because there is hardly any research available about this class of gamers. Second, we wanted to know why they participated in a LAN event. The survey showed that LAN gamers were almost exclusively male, with a mean age of 19.5 years. They devoted about 2.6 hours each day to gaming. They were motivated by social contact and a need to know more about games. The competition motive was third in the total sample. A subgroup of heavy gamers obtained a higher score on competition. This article emphasizes the importance of the social context of gaming and interprets its results as a nuance of the stereotype of the solitary, adolescent gamer.
Let it flow
Authors: Haller Dieter
Published: May 2005

The concept of diaspora is applied to all kinds of groups characterized spatially by its links between locality and a ‘homeland’. In this article I will argue that the analytical value of the concept of diaspora could be strengthened by focusing on the third spatial relationship characteristic to diasporas but often neglected: the lateral relationship of individual communities. This essay deals with all three spatial connections and focuses on how diasporic groups can be approached anthropologically. It argues that despite recent claims to pursue a more and more mobile research methodology, in practice these claims often cannot be carried out due to various circumstances that prevent the researcher from being mobile himself. Using my field-research on the Sindhis of Gibraltar, it points out two possible approaches of how stationary anthropological field research still can be carried out in diasporic situations. It shows how relevant space relations both to the diaspora as a whole as well as to India as the mythic land of origin are created, performed, maintained, lived and given sense locally, arguing that both public discourse and counter-narratives about Gibraltar, India and the diasporic web are expressions of various power struggles over spatial and social control.
Being Rapa Nui, speaking Spanish
Authors: Makihara Miki
Published: May 2005

In recent years, increased attention has been drawn to the situation of endangered minority languages and the complexity of sociolinguistic processes surrounding their evolution and future prospects. The Rapa Nui (Polynesian)-Spanish bilingual community of Easter Island, Chile has been experiencing language shift toward Spanish over the last four decades. At the same time, however, political struggles over land, political decision-making rights, and control over the heritage tourism economy have been converging to lead the Rapa Nui community to publicly and intensively assert and reconstruct their cultural identity. Although the majority of Rapa Nui children today are native and dominant speakers of Spanish, their positive ethnic identification and participation in public cultural activities and in bilingual and syncretic conversational interactions are providing opportunities for community revaluation and maintenance of their ancestral language. Using ethnographic and linguistic analysis of face-to-face verbal interaction, this article examines the role of children in the dynamics of sociolinguistic changes and the construction of the ethnolinguistic community.
MBA and the Education of Leaders: The New Playing Fields of Eton?
Authors: Gabriel Yiannis
Published: May 2005

This article takes a critical look at the management education offered by business schools, seeking to establish whether it encourages the emergence and development of leadership qualities. The author introduces a teaching experiment he carried out as part of an MBA programme aimed at assessing whether it is possible to teach a leadership course in which the students do not assume the role of followers, but rather find themselves leading others, taking responsibility and operating without the conventional safety net provided by the lecturer. The author concludes that the structure, ideology and ethos of MBA programmes are fundamentally opposed to an education of leaders, arguing MBA experience is one for educating followers rather than leaders - committed followers, obstinate, hardened lieutenants perhaps, but not generals. It is in this sense then that MBAs may be seen as a contemporary parallel to the playing fields of Eton. They are uniquely suited to people who can survive and even prosper in the merciless fields of today’s business.
Reframing The Art of Framing: Problems and Prospects for Leadership
Authors: Fairhurst Gail T.
Published: May 2005

This article offers three explanations for why some leaders embrace the skill of framing and others struggle with it. The first explanation draws from philosophical arguments in social constructionism over relativism, essentialism, and agency to draw boundaries around that which is open to framing and that which is not. The second explanation draws from O’Keefe’s (1988; 1997) theory of ‘Message Design Logics’, which argues that the logics that managers employ to produce and receive messages likely impacts framing ability. The third explanation grapples with questions of whether framing is a teachable skill and the contingencies associated with effective learning. Finally, the article concludes with an argument for the interrelationship among the three explanations.
Leadership and Politics: A Case for a Closer Relationship?
Authors: Peele Gillian
Published: May 2005

In this article I advance the argument that political scientists and students of leadership should engage with each other more extensively. In the first part of the article I look at some of the reasons why political scientists may have treated the phenomenon of leadership with suspicion in the past despite the resurgence of interest in issues associated with leadership in the last 20 years. In the second part of the article I sketch some key dimensions of political leadership and examine a selection of the key political science writings (including some recent ones) on the subject. In the third part of the article I suggest some areas where leadership studies and political science have a mutual research agenda and where gaps in our knowledge might be remedied by collaborative work between the disciplines.
Efficient migration of dendritic cells toward lymph node chemokines and induction of TH1 responses require maturation stimulus and apoptotic cell interaction
Authors: Bertho Nicolas , Adamski Henri , Toujas Louis , Debove Martine , Davoust Jean , Quillien Veronique
Published: May 2005

Dendritic cells (DCs) have the unique ability to initiate primary immune responses, and they can be conditioned for vaccinal purposes to present antigens after the engulfment of apoptotic cells. To recruit the rare antigen-specific naive T cells, DCs require a maturation step and subsequent transport toward lymph node (LN). To date, prostaglandin E2 (PGE2) is the best-characterized compound inducing this LN-directed migration in vitro, but PGE2 may skew the immune responses in a TH2 direction. We demonstrate here that on incubation with apoptotic tumor cells and tumor necrosis factor-α (TNF-α) or lipopolysaccharide (LPS), human monocyte-derived DCs become fully mature and acquire high migratory capacities toward LN-directing chemokines. The migration of TNF-α-treated DCs occurs only after cotreatment with apoptotic cells but not with necrotic cells. DC migration requires CD36 expression and incubation with apoptotic cells in the presence of heat-labile serum components. Moreover, on treatment with apoptotic cells and LPS, the migrating DCs are able to recruit naive T cells to generate TH1 immune responses. Our results show that the cotreatment of DCs with apoptotic tumor cells and inflammatory signals is promising for the design of an antitumoral DC-based vaccine. (Blood. 2005;106:1734-1741)
Tolerance induction by bone marrow transplantation in a multiple sclerosis model
Authors: Herrmann Martin M. , Gaertner Susanne , Stadelmann Christine , van den Brandt Jens , Böscke Robert , Budach Wilfried , Reichardt Holger M. , Weissert Robert
Published: May 2005

Experimental autoimmune encephalomyelitis (EAE) in rats is a highly valuable model of multiple sclerosis (MS) because it mimics major hallmarks of the human disease. EAE induced with myelin-oligodendrocyte-glycoprotein (MOG) in DA rats is relapsing/remitting, and lesions in the central nervous system show inflammation, demyelination, and axonal and neuronal loss. Recently, bone marrow transplantation (BMT) was introduced as a novel strategy to treat MS, but its efficiency and the underlying mechanism are debatable. In MOG-induced EAE we found that BMT at the peak of EAE but not in the chronic phase leads to disease attenuation. In both settings, rats receiving bone marrow (BM) transplants were protected from subsequently induced relapses. These findings could be confirmed by histopathology in which rats receiving BM transplants did not have lesions compared with controls not receiving transplants. Importantly, the protective effect was achieved by allogeneic, syngeneic, and BM grafts from diseased rats. BMT resulted in increased numbers of CD4+CD25bright regulatory T cells, increased Foxp3 expression, a shift in T-cell epitope recognition, and a strong reduction of autoantibodies even after rechallenge with MOG. Thus, our results indicate potential mechanisms of how BMT may contribute to the improvement of MS and provide a rationale for its application in patients suffering from various autoimmune diseases. (Blood. 2005;106:1875-1883)
Are scale-free networks robust to measurement errors?
Authors: Lin Nan , Zhao Hongyu
Published: May 2005

Background

Many complex random networks have been found to be scale-free. Existing literature on scale-free networks has rarely considered potential false positive and false negative links in the observed networks, especially in biological networks inferred from high-throughput experiments. Therefore, it is important to study the impact of these measurement errors on the topology of the observed networks.

Results

This article addresses the impact of erroneous links on network topological inference and explores possible error mechanisms for scale-free networks with an emphasis on Saccharomyces cerevisiae protein interaction networks. We study this issue by both theoretical derivations and simulations. We show that the ignorance of erroneous links in network analysis may lead to biased estimates of the scale parameter and recommend robust estimators in such scenarios. Possible error mechanisms of yeast protein interaction networks are explored by comparisons between real data and simulated data.

Conclusion

Our studies show that, in the presence of erroneous links, the connectivity distribution of scale-free networks is still scale-free for the middle range connectivities, but can be greatly distorted for low and high connecitivities. It is more appropriate to use robust estimators such as the least trimmed mean squares estimator to estimate the scale parameter γ under such circumstances. Moreover, we show by simulation studies that the scale-free property is robust to some error mechanisms but untenable to others. The simulation results also suggest that different error mechanisms may be operating in the yeast protein interaction networks produced from different data sources. In the MIPS gold standard protein interaction data, there appears to be a high rate of false negative links, and the false negative and false positive rates are more or less constant across proteins with different connectivities. However, the error mechanism of yeast two-hybrid data may be very different, where the overall false negative rate is low and the false negative rates tend to be higher for links involving proteins with more interacting partners.
The effects of normalization on the correlation structure of microarray data
Authors: Qiu Xing , Brooks Andrew I , Klebanov Lev , Yakovlev Andrei
Published: May 2005

Background

Stochastic dependence between gene expression levels in microarray data is of critical importance for the methods of statistical inference that resort to pooling test-statistics across genes. It is frequently assumed that dependence between genes (or tests) is suffciently weak to justify the proposed methods of testing for differentially expressed genes. A potential impact of between-gene correlations on the performance of such methods has yet to be explored.

Results

The paper presents a systematic study of correlation between the t-statistics associated with different genes. We report the effects of four different normalization methods using a large set of microarray data on childhood leukemia in addition to several sets of simulated data. Our findings help decipher the correlation structure of microarray data before and after the application of normalization procedures.

Conclusion

A long-range correlation in microarray data manifests itself in thousands of genes that are heavily correlated with a given gene in terms of the associated t-statistics. By using normalization methods it is possible to significantly reduce correlation between the t-statistics computed for different genes. Normalization procedures affect both the true correlation, stemming from gene interactions, and the spurious correlation induced by random noise. When analyzing real world biological data sets, normalization procedures are unable to completely remove correlation between the test statistics. The long-range correlation structure also persists in normalized data.
The complexity of selection at the major primate β-defensin locus
Authors: Semple Colin AM , Maxwell Alison , Gautier Philippe , Kilanowski Fiona M , Eastwood Hayden , Barran Perdita E , Dorin Julia R
Published: May 2005

Background

We have examined the evolution of the genes at the major human β-defensin locus and the orthologous loci in a range of other primates and mouse. For the first time these data allow us to examine selective episodes in the more recent evolutionary history of this locus as well as the ancient past. We have used a combination of maximum likelihood based tests and a maximum parsimony based sliding window approach to give a detailed view of the varying modes of selection operating at this locus.

Results

We provide evidence for strong positive selection soon after the duplication of these genes within an ancestral mammalian genome. Consequently variable selective pressures have acted on β-defensin genes in different evolutionary lineages, with episodes both of negative, and more rarely positive selection, during the divergence of primates. Positive selection appears to have been more common in the rodent lineage, accompanying the birth of novel, rodent-specific β-defensin genes. These observations allow a fuller understanding of the evolution of mammalian innate immunity.

In both the rodent and primate lineages, sites in the second exon have been subject to positive selection and by implication are important in functional diversity. A small number of sites in the mature human peptides were found to have undergone repeated episodes of selection in different primate lineages. Particular sites were consistently implicated by multiple methods at positions throughout the mature peptides. These sites are clustered at positions predicted to be important for the specificity of the antimicrobial or chemoattractant properties of β-defensins. Surprisingly, sites within the prepropeptide region were also implicated as being subject to significant positive selection, suggesting previously unappreciated functional significance for this region.

Conclusions

Identification of these putatively functional sites has important implications for our understanding of β-defensin function and for novel antibiotic design.
Software for optimization of SNP and PCR-RFLP genotyping to discriminate many genomes with the fewest assays
Authors: Gardner Shea N , Wagner Mark C
Published: May 2005

Background

Microbial forensics is important in tracking the source of a pathogen, whether the disease is a naturally occurring outbreak or part of a criminal investigation.

Results

A method and SPR Opt (S NP and P CR-R FLP Opt imization) software to perform a comprehensive, whole-genome analysis to forensically discriminate multiple sequences is presented. Tools for the optimization of forensic typing using Single Nucleotide Polymorphism (SNP) and PCR-Restriction Fragment Length Polymorphism (PCR-RFLP) analyses across multiple isolate sequences of a species are described. The PCR-RFLP analysis includes prediction and selection of optimal primers and restriction enzymes to enable maximum isolate discrimination based on sequence information. SPR Opt calculates all SNP or PCR-RFLP variations present in the sequences, groups them into haplotypes according to their co-segregation across those sequences, and performs combinatoric analyses to determine which sets of haplotypes provide maximal discrimination among all the input sequences. Those set combinations requiring that membership in the fewest haplotypes be queried (i.e. the fewest assays be performed) are found. These analyses highlight variable regions based on existing sequence data. These markers may be heterogeneous among unsequenced isolates as well, and thus may be useful for characterizing the relationships among unsequenced as well as sequenced isolates. The predictions are multi-locus. Analyses of mumps and SARS viruses are summarized. Phylogenetic trees created based on SNPs, PCR-RFLPs, and full genomes are compared for SARS virus, illustrating that purported phylogenies based only on SNP or PCR-RFLP variations do not match those based on multiple sequence alignment of the full genomes.

Conclusion

This is the first software to optimize the selection of forensic markers to maximize information gained from the fewest assays, accepting whole or partial genome sequence data as input. As more sequence data becomes available for multiple strains and isolates of a species, automated, computational approaches such as those described here will be essential to make sense of large amounts of information, and to guide and optimize efforts in the laboratory. The software and source code for SPR Opt is publicly available and free for non-profit use at http://www.llnl.gov/IPandC/technology/software/softwaretitles/spropt.php.
Synergistic effect of intrathecal fentanyl and bupivacaine in spinal anesthesia for cesarean section
Authors: Bogra Jaishri , Arora Namita , Srivastava Pratima
Published: May 2005

Background

Potentiating the effect of intrathecal local anesthetics by addition of intrathecal opiods for intra-abdominal surgeries is known. In this study by addition of fentanyl we tried to minimize the dose of bupivacaine, thereby reducing the side effects caused by higher doses of intrathecal bupivacaine in cesarean section.

Methods

Study was performed on 120 cesarean section parturients divided into six groups, identified as B8, B10 and B 12.5 8.10 and 12.5 mg of bupivacaine mg and FB8, FB10 and FB 12.5 received a combination of 12.5 μg intrathecal fentanyl respectively. The parameters taken into consideration were visceral pain, hemodynamic stability, intraoperative sedation, intraoperative and postoperative shivering, and postoperative pain.

Results

Onset of sensory block to T6 occurred faster with increasing bupivacaine doses in bupivacaine only groups and bupivacaine -fentanyl combination groups. Alone lower concentrations of bupivacaine could not complete removed the visceral pain. Blood pressure declined with the increasing concentration of Bupivacaine and Fentanyl. Incidence of nausea and shivering reduces significantly whereas, the postoperative pain relief and hemodynamics increased by adding fentanyl. Pruritis, maternal respiratory depression and changes in Apgar score of babies do not occur with fentanyl.

Conclusion

Spinal anesthesia among the neuraxial blocks in obstetric patients needs strict dose calculations because minimal dose changes, complications and side effects arise, providing impetus for this study. Here the synergistic, potentiating effect of fentanyl (an opiod) on bupivacaine (a local anesthetic) in spinal anesthesia for cesarian section is presented, fentanyl is able to reduce the dose of bupivacaine and therefore its harmful effects.
Recruitment of ethnic minority patients to a cardiac rehabilitation trial: The Birmingham Rehabilitation Uptake Maximisation (BRUM) study [ISRCTN72884263]
Authors: Jolly Kate , Lip Gregory Y , Taylor Rod S , Mant Jonathan W , Lane Deirdre A , Lee Kaeng W , Stevens Andrew J ,   the BRUM Steering Committee
Published: May 2005

Background

Concerns have been raised about low participation rates of people from minority ethnic groups in clinical trials. However, the evidence is unclear as many studies do not report the ethnicity of participants and there is insufficient information about the reasons for ineligibility by ethnic group. Where there are data, there remains the key question as to whether ethnic minorities more likely to be ineligible (e.g. due to language) or decline to participate. We have addressed these questions in relation to the Birmingham Rehabilitation Uptake Maximisation (BRUM) study, a randomized controlled trial (RCT) comparing a home-based with a hospital-based cardiac rehabilitation programme in a multi-ethnic population in the UK.

Methods

Analysis of the ethnicity, age and sex of presenting and recruited subjects for a trial of cardiac rehabilitation in the West-Midlands, UK.

Participants: 1997 patients presenting post-myocardial infarction, percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery.

Data collected: exclusion rates, reasons for exclusion and reasons for declining to participate in the trial by ethnic group.

Results

Significantly more patients of South Asian ethnicity were excluded (52% of 'South Asian' v 36% 'White European' and 36% 'Other', p < 0.001). This difference in eligibility was primarily due to exclusion on the basis of language (i.e. the inability to speak English or Punjabi). Of those eligible, similar proportions were recruited from the different ethnic groups (white, South Asian and other). There was a marked difference in eligibility between people of Indian, Pakistani or Bangladeshi origin.

Conclusion

Once eligible for this trial, people from different ethnic groups were recruited in similar proportions. The reason for ineligibility in the BRUM study was the inability to support the range of minority languages.
Clinicians' management strategies for patients with dyspepsia: a qualitative approach
Authors: Knutsson Kerstin , Ohlsson Bodil , Troein Margareta
Published: May 2005

Background

Symptoms from the upper gastrointestinal tract are frequently encountered in clinical practice and may be of either organic or functional origin. For some of these conditions, according to the literature, certain management strategies can be recommended. For other conditions, the evidence is more ambiguous. The hypothesis that guided our study design was twofold: Management strategies and treatments suggested by different clinicians vary considerably, even when optimal treatment is clear-cut, as documented by evidence in the literature. Clinicians believe that the management strategies of their colleagues are similar to their own.

Methods

Simulated case histories of four patients with symptoms from the upper gastrointestinal tract were presented to 27 Swedish clinicians who were specialists in medical gastroenterology, surgery, and general practice and worked at three hospitals in the southern part of Sweden. The patients' histories contained information on the patient's sex and age and the localisation of the symptoms, but descriptions of subjective symptoms and findings from examinations differed from history to history. Interviews containing open-ended questions were conducted.

Results

For the same patient, the management strategies and treatments suggested by the clinicians varied widely, as did the strategies suggested by clinicians in the same speciality. Variation was more pronounced if the case history noted symptoms but no organic findings than if the case history noted unambiguous findings and symptoms. However, even in cases with a consensus in the scientific literature on treatment, the variations in clinicians' opinion on management were pronounced.

Conclusion

Despite these variations, the clinicians believed that the decisions made by their colleagues would be similar to their own. The overall results of this study indicate that we as researchers must make scientific evidence comprehensible and communicate evidence so that clinicians are able to interpret and implement it in practice. Of particular significance is that scientific evidence leads to an evidence-based care which is effective clinical practice and to the promotion of health from the perspective of the patient, together with cost-effectiveness as a priority.
Prevalence and risk factors of syphilis infection among drug addicts
Authors: Scherbaum Norbert , Baune Bernhard T , Mikolajczyk Rafael , Kuhlmann Thomas , Reymann Gerhard , Reker Martin
Published: May 2005

Background

Recent epidemiological data show an increased trend of official estimates for syphilis infection in the general population. Many of the infected cases remain undetected leaving an underestimation of the true prevalence of syphilis in the general population, but also among subpopulations such as illicit drug users. There is limited epidemiological data published on the proportion and risk factors of syphilis infections associated with illicit drug abuse.

Methods

Illicit drug addicts (n = 1223) in inpatients units in Germany were screened (2000–01) for syphilis and interviewed regarding patterns of drug use and sexual behaviour. TPHA-test for initial screening and FTA-ABS-IgM test in TPHA-positive patients were used.

Results

In total, TPHA-tests were positive in 39 (3.3%) and 7 patients (0.6%) were IgM positive. The prevalence rate for syphilis in males was 1.9% and for women it was 8.5%. Female patients were 4.56 (CI 95% 2.37–8.78) times more likely to have a positive TPHA test than males. Sexual behaviours such as high number of sexual partners, sex for drugs/money, sex on the first day were associated with syphilis infection only in women. Females with frequent sex for drugs or money had 4.31 (CI 95% 2.32–8.52) times more likely a reactive TPHA test than remaining patients. Neither the sociodemographic factors nor sexual behaviour were statistically significant associated with syphilis infection among men at all.

Conclusion

Our data suggest the need for screening for syphilis among these illicit drug users in inpatient settings, in particular among sexual active women. This conclusion is corroborated by the finding of increasing numbers of syphilis infections in the general population. The identification of syphilis cases among drug addicts would give treatment options to these individuals and would help to reduce the spread of infection in this population, but also a spread into heterosexual populations related to prostitution.
Echinococcal disease in Alberta, Canada: more than a calcified opacity
Authors: Somily Ali , Robinson Joan L , Miedzinski Lilly J , Bhargava Ravi , Marrie Thomas J
Published: May 2005

Background

Most cases of echinococcal disease (ED) acquired in Canada are thought to be due to the sylvatic form of Echinococcus granulosus, which may be more benign than ED due to either Echinococcus multilocularis or the pastoral form of E. granulosus. There are limited descriptions of the clinical course and outcome of Canadian patients with ED in the modern era.

Methods

A retrospective chart review was performed of patients hospitalized with echinococcal disease (ED) from 1991 to 2001 in Edmonton, Alberta.

Results

Forty-two cases of ED were identified of which 19 were definite, 3 probable, and 20 possible. Further analysis was limited to the 22 definite and probable cases, of which 77% were female and 41% aboriginal, with an age range of 5 to 87 years. Nine patients (40%) had pulmonary involvement and 11 (50%) hepatic involvement. One patient had an intracardiac mass presenting as a cerebrovascular event and one had a splenic cyst. Seven of the 22 patients had combined surgical resection and medical treatment, six had surgical resection of the cyst alone, four had cyst aspiration, one had medical treatment alone and four had no specific treatment. There was no mortality attributable to ED but three patients died of unrelated illnesses.

Conclusion

Echinococcal disease in northern Alberta has a marked diversity of clinical presentations, and generally has a good prognosis despite a wide variety of therapeutic interventions.
Hepatitis E virus infection in hemodialysis patients: A seroepidemiological survey in Iran
Authors: Taremi Mahnaz , Khoshbaten Manouchehr , Gachkar Latif , EhsaniArdakani MohammadJavad , Zali MohammadReza
Published: May 2005

Background

The hepatitis E virus (HEV) has a global distribution and is known to have caused large waterborne epidemics of icteric hepatitis. Transmission is generally via the fecal-oral route. Some reports have suggested parenteral transmission of HEV. Anti-HEV prevalence data among chronic hemodialysis (HD) patients are few and give conflicting results.

Methods

This cross-sectional study was conducted in August of 2004. We tested 324 chronic HD patients attending three different units in the city of Tabriz, northwestern part of Iran, for anti-HEV antibody. A specific solid- phase enzyme-linked immunoassay (Diapro, Italy) was used.

Results

The overall seroprevalence of hepatitis E was 7.4 %(95% CI: 4.6%–10.6%). The prevalence rate of HBV and HCV infection were 4.6% (95% CI: 2.3%–6.9%) and 20.4% (95% CI: 16%–24.8%), respectively. No significant association was found between anti-HEV positivity and age, sex, duration of hemodialysis, positivity for hepatitis B or C virus infection markers and history of transfusion.

Conclusion

We observed high anti-HEV antibody prevalence; there was no association between HEV and blood borne infections (HBV, HCV, and HIV) in our HD patients. This is the first report concerning seroepidemiology of HEV infection in a large group of chronic HD individuals in Iran.
Rural residence is not a risk factor for frequent mental distress: a behavioral risk factor surveillance survey
Authors: Rohrer James E , Borders Tyrone F , Blanton Jimmy
Published: May 2005

Background

Residents of rural areas may be at increased risk of mental health problems. If so, public health programs aimed at preventing poor mental health may have to be customized for delivery to rural areas. The purpose of this study was to examine the relationship between residing in a rural area and frequent mental distress, which is one indicator of poor mental health.

Methods

The Behavioral Risk Factor Surveillance System (BRFSS) survey for the state of Texas was the source of information about obesity, demographic characteristics, and frequent mental distress (FMD). FMD was defined as poor self-rated mental health during at least half of the days in the last month. Adjusted odds for FMD were computed for rural and suburban respondents relative to urban respondents.

Results

FMD was found to be independently associated with lower education, being younger, being non-Hispanic, being unmarried, and being female. FMD also was associated with being obese or underweight and suburban residence (relative to metro-central city). FMD was not more common among rural respondents than in the metro-central city.

Conclusion

Rural respondents were not at greater risk of frequent mental distress than urban respondents in this sample. Programs seeking to improve community mental health should target persons with less education and extremes in body weight, along with women and single persons, regardless of whether they live in rural or urban areas.
Prevalence of nonvitamin, nonmineral supplement usage among students in a Turkish university
Authors: Ayranci Unal , Son Nazan , Son Osman
Published: May 2005

Background

There have been multiple studies carried out in many countries with regard to the use of nonvitamin, nonmineral (NVNM) supplements. These studies have shown that the use of NVNM supplements is on the increase throughout the world, particularly in western countries. The aim of this study was to assess the extent of NVNM supplement use among Turkish university students.

Methods

The survey was conducted between September and December 2004 at Osmangazi University, a public university located in the west of Turkey. Responses were analysed, using the chi-square (x2) test, t test and percent (%) ratios, according to gender and consumers. Differences were considered significant for p ≤ 0.05.

Results

Of 2253 students attending the university, 1871 participated in the survey (909 men and 962 women). Overall, the prevalence of NVNM supplement use was 16.5% (16.6% in men and 16.3% in women, p < 0.05).

The three most commonly given reasons for use were 'improvement of energy and vitality (78.6%)', 'promotion of weight loss (71.1%)', followed by 'enhancement of athletic performance (64.3%)'. Twenty-six of the 308 reported NVNM users (26/308, 8.4%) reported having experienced an adverse reaction. Television (76.3%), magazines/newspapers (41.5%) and internet websites (37.3%) were the most frequently used sources for obtaining information about NVNM supplements. The three most frequently used NVNM supplements were echinacea, ginseng, and gingko biloba (38.6%, 36.4%, and 32.8%, respectively). Nutritional scores were higher in NVNM supplement users than in non-users (66.510.8 vs. 62.712.7) (p < 0.001). Users and nonusers of NVNM supplements differed significantly according to sex, age, Body Mass Index (BMI) values, types of school, mother and fathers' education levels, family income, most permanent place of residence up to the time of survey, smoking status, and participating in sports.

Conclusion

The results indicate that the prevalence of NVNM supplement use is relatively modest among Turkish university students and more information is needed on why people use particular NVNM supplements.
Screening for asthma in Cantonese-speaking immigrant children
Authors: Greenfield Robyn O , Lee Angela C , Tang Roland , Brugge Doug
Published: May 2005

Background

Asthma prevalence among Chinese immigrant children is poorly understood and attempts to screen these children have produced varied outcomes. We sought to learn how to improve screening for asthma in Chinese immigrant children.

Methods

Children (n = 152) were administered the Brief Pediatric Asthma Screen in either Cantonese or English, they then viewed and reacted to a video showing people wheezing and subsequently took a pulmonary function test.

Results

The diagnosed asthma prevalence for our study population was 27.0%, with another 5.3% having possible undiagnosed asthma. Very few children had spirometry findings below normal. In multivariate analysis, being native born (p = 0.002) and having a family history of asthma (p = 0.003) were statistically associated with diagnosis of asthma. After viewing the video, 35.6% of respondents indicated that the images differed from their conception of wheezing. Of four translations of the word "wheeze" no single word was chosen by a majority.

Conclusion

Our findings suggest that asthma diagnoses are higher for Chinese children who were born in the US suggesting that desegregation of data might reveal at risk subpopulations. Care needs to be taken when diagnosing asthma for Cantonese speakers because of the centrality of the word wheeze and the challenges of translation.