bluuebunny/crossref_metadata_2025 huggingface dataset:
The organization of care: its influence on health education practice on acute wards
Authors: MABEN JILL , LATTER SUE , CLARK JILL MACLEOD , WILSON‐BARNETT JENIFER
Published: November 2007

Summary

This paper explores the relationship between organization of care and nurses' health education practice at ward level and is based on data from a larger 2‐year Department of Health‐funded study examining the health education and health promotion role of the nurse in acute‐ward settings.

Concepts such as continuity of care, autonomy, accountability and responsibility are examined in terms of their association with organization of care and primary nursing in particular.

Other factors closely associated with organization of care such as ward democracy and the empowerment of nurses, are also discussed in relation to ward‐based health education practice.

Data analysis reveals that the way in which care is organized on the ward may have a direct influence on the type, quality and consistency of health education advice given to patients.
The impact of nurses' encounters with cancer on their attitudes towards the disease
Authors: CORNER JESSICA
Published: November 2007

Summary

A study to develop understanding of nurses' knowledge, confidence and educational needs in relation to cancer care was undertaken.

Data from this study on nurses' attitudes and the effect of professional encounters with cancer on such attitudes are presented.

A cancer attitude scale was completed by 127 nurses, and 68 of the sample were interviewed in depth.

Data presented reveal a pervasive negative attitude towards cancer amongst these nurses, and the important negative impact that professional encounters with cancer have on nurses' feelings about the disease.

Data presented are taken from a larger study, which is reported elsewhere (Corner, 1990; Corner & Wilson‐Barnett, 1992).
The Psychological and Psychiatric Morbidity Questionnaire (PPMQ): a measure to assess and predict psychological and psychiatric morbidity in individuals following burn trauma
Authors: BOSWORTHRGN CHRISSIE , REGEL STEPHEN
Published: November 2007

Summary A pilot study is described which aims to:

assess the predictors of psychological and psychiatric morbidity of patients following burn trauma;

assess the reliability of the Psychological and Psychiatric Morbidity Questionnaire (PPMQ). Implications for training, supervision and post‐burn rehabilitation are discussed.
Change in process: bringing about change in health care through action research
Authors: EAST LINDA , ROBINSON JANE
Published: November 2007

A 2‐year action‐research project aiming to facilitate the management of change was carried out in a district general hospital.

Hospital managers and senior ward nurses had very different views concerning the source of challenges and problems within the hospital organization.

A case‐study of nurses' experience of change at ward level was produced as part of the diagnostic phase of the action research.

The results of the case‐study indicated that general managers and professionals had different agendas for change hut that there is common ground between them.
How to choose: nurses' judgements of the effectiveness of a range of currently marketed continence aids
Authors: GIBB HEATHER , WONG GRACE
Published: November 2007

Continence is a costly health problem, both in terms of financial burden in continence aids, but also in terms of quality‐of‐life issues for the person who has continence problems.

Manufacturers arc often perturbed as to why products specially designed to help continence problems are not popular, or do not appear to be applied as intended.

This paper reports on a study involving a quantitative evaluation of a range of continence aids presently being marketed, as applied in a large elderly care centre.

The evaluation used nursing judgements on a series of comfort and effectiveness criteria: amount of leakage around the pad, comfort to the client when the pad was cither wet or dry, skin integrity and snugness of fit, as well as whether the pad concealed well beneath clothing.

Five body pads were evaluated two disposable and three washable and three bed wider‐sheets.

Effectiveness of pads was found to vary substantially according to sex of client and voiding type, that is whether the client had heavy or moderate incontinent episodes.
Student midwives' learning experience on the wards
Authors: McCREA HALLY , THOMPSON KATE , WELL LESLIE CARS , WHITTINGTON DOROTHY
Published: November 2007

This paper is based on an investigation into the learning experiences of student midwives in the clinical setting in one maternity unit in the Republic of Ireland.

A questionnaire approach was adopted for the data collection and 42 student midwives participated in the study.

A number of factors were identified which appear to influence students' experiences of ‘learning on the job’. The quality of their clinical teaching and their observations of the way in which trained staff practise midwifery may influence their decision to continue practising midwifery following registration.

These findings clearly point to the importance for midwives to reassert their true role as ‘independent practitioners’ of normal maternity care.
The USA's nurse managers and UK's ward sisters: critical roles for empowerment
Authors: CAMERON‐BUCCHERI ROBIN , OGIER MARGARET E.
Published: November 2007

The nurse manager/ward sister* role is becoming endangered as many of these nurses are being asked to take fiscal and personnel responsibility for multiple units/programmes and supervise more non‐registered nursing staff.

Loss of this important nurse manager/ward sister role could severely decrease nursing's voice in the development and implementation of policies that affect nurses arid the care they deliver.

The authors review 20 years of literature from both the USA and the UK regarding supportive supervision and the role of the nurse manager/ward sister. Nurse managers/ward sisters were found to be key individuals within the entire health‐care organization.

Nurse managers/ward sisters can empower the nurses they surpervise to initiate changes that will improve patient care. Nurse managers/ward sisters can also improve the working conditions and thus increase the job satisfaction and retention of those they supervise.

Strategies for being more supportive of these overworked and endangered nurse managers/ward sisters are suggested.
Supporting families of critically ill children
Authors: AMICO JUDY , DAVIDHIZAR RUTH
Published: November 2007

Having a critically ill child can be a heartbreaking experience. The sudden transformation of a healthy child to a critically ill or injured child causes parents to undergo feelings of pain and shock.

Parents with a critically ill child are in acute need of support and intervention by caregivers.

This article describes a parents' support group, conducted as part of a nursing programme student experience, in a pediatric critical‐care unit. This experience provides information concerning the group that others may wish to replicate.
Experiences of social support among participants in self‐help groups related to coronary heart disease
Authors: HILDINGH C. , SEGESTEN K. , BENGTSSON C. , FRIDLUND H.
Published: November 2007

Self‐help groups for coronary heart disease (CHD) patients were initiated by the Swedish National Association for Heart and Lung Patients in co‐operation with Halland University College of Caring Science. Professional support was given in the form of a guidebook with health advice to be used at group meetings.

The aims of this study were to describe the experiences of social support and the effects of health advice among people suffering from CHD and their next‐of‐kin participating in self‐help groups.

A questionnaire was developed containing three scales with questions about social support in connection with group participation and the effects of health advice shared during the programme.

The results showed that 84% of participants knew about risk factors; all group members had changed their attitudes in some way concerning their life‐style and 65% thought that they had changed their daily life activities as a consequence of the group participation. Most participants had experienced social support, through both support received (82%) and their own ability to provide support (7.1, scale range 0–10).

In self‐help groups layman support is the most effective kind of support, but the results indicate that health professionals also have an important role to play. In future research and clinical planning of rehabilitation of people with CHD, self‐help groups, both from a human and economic point of view arc well worth considering.
Reading research critically. I. An introduction to appraisal: designs and objectives
Authors: AVIS MARK
Published: November 2007

This is the first of two articles providing an introduction to appraising published research critically.

In this paper three styles of research are presented and the basic types of research objectives and designs are briefly described.
How do registered nurses think and experience nursing. A phenomenological investigation
Authors: GRAHAM IAIN
Published: November 2007

This research adopts a phenomenological approach to investigate how registered nurses think and experience nursing.

Findings from the study highlighted the dynamic nature of how nurses think and experience nursing. This dynamic nature demonstrates the often vulnerable and stressed position nurses find themselves in today when trying to meet their professional aspirations within a medically dominated, bureaucratic health‐care system.

The findings suggest that not only is educational reform required, but nurses need skills to enable them to form change strategies so that their paradigm of health care can be established. This study represents the very beginning of trying to create that paradigm inductively.
A review of primary health‐care organization
Authors: WOOD NEIL , FARROW STEPHEN , ELLIOTT BERNADETTE
Published: November 2007

A contract for the provision of community nursing and associated services was drawn up between the Plymouth Community Unit and general practitioners associated with a fundholding practice at a health centre in Devon in October 1991.

This project, which aimed at applying purchaser/provider principles, contained some novel features and was subject to evaluation and review after 6 months.

An evaluation which had four main aspects was carried out, consisting of interviews and questionnaire assessment of staff attitudes, patients' views of the effectiveness of aspects of the practice health‐promotion activity, an analysis of staff activity data before and during the pilot phase and an examination of the documentation concerned with critical issues which had arisen.

Questionnaire data indicated that staff motivation and enthusiasm for the project was high and that patients' views on the practice facilities were generally positive.

The role of the Macmillan nursing service at this practice was greatly enhanced during the pilot project with a fourfold increase in the number of visits carried out.

Over 120 h were spent by health visiting and district nursing staff on issues surrounding the pilot project including attending additional meetings.

The results are discussed in relation to service benefits to patients, the effect on the cohesion of the primary health‐care team and issues of fundholding and are considered in the context of models put forward for the future development of community‐based nursing care.
Monitoring diabetic control
Authors: COATES VIVIEN E.
Published: November 2007

Recent research from America has confirmed that the quality of metabolic control achieved by people with insulin‐dependent diabetes does influence the onset and progression of diabetic complications.

More than ever before diabetic individuals now have good reasons for striving to attain as good a standard of diabetic control as is possible. Regular monitoring of diabetic status is essential if good control is to be achieved.

This article will focus upon the concept of control and consider aspects of diabetic monitoring which may be undertaken either by patients or through professional services.

Both direct and indirect monitoring methods will be discussed and strengths and weaknesses considered.
Reading research critically. II. An introduction to appraisal: assessing the evidence
Authors: AVIS MARK
Published: November 2007

This is the second of two articles providing an introduction to the critical appraisal of research reports.

In this paper guidelines for evaluating the quality of evidence and the validity of conclusions are suggested, and a check‐list of evaluation points is presented.
Identifying feelings engendered during triage assessment in the accident and emergency department: the use of visual analogue scales
Authors: CROUCH ROBERT , DALE JEREMY
Published: November 2007

Feelings engendered during 585 triage nursing assessments made by a total of 10 nurses were studied.

Marked differences in nurses' feelings were demonstrated towards patients attending the accident and emergency (A&E) department with ‘primary care’ needs compared with those assessed as having ‘A&E&’ needs. In particular, nurses demonstrated more negative feelings, in the form of less sympathy, more irritation and less motivation to help, towards patients with ‘primary care’ needs. Nurses' feelings were adversely affected by delays in patient presentation following the occurrence of illness or injury.

Nurses perceived patients' attendance as illegitimate when it had deviated from expected norms of health‐care‐seeking behaviour.

These findings were elicited using visual analogue scales completed immediately following the triage assessment of the patients. This work is part of a larger study into developing the primary care role of accident and emergency nurses.

The culture of the A&E department is discussed, and the need to challenge and change this culture to ensure it becomes more responsive to individual patients' needs is advocated. This paper calls for development of triage training and education and further investigation into the effects of nurses' attitudes on patient assessment.
The ethics of smoke‐free zones: an exploration of the implications and effectiveness of a non‐smoking policy as a health‐promotion strategy in the context of an orthopaedic trauma ward
Authors: PHILPOT TERENCE K.
Published: November 2007

Pressure to reduce the incidence of smoking is increasing and widespread, coming from health professionals, independent research groups and Government policy objectives.

Moves to introduce non‐smoking policies within health‐service premises are gaining acceptance, and form an element of the Government's overall health plan.

This paper considers the background to smoking prohibition in hospitals, its merits and drawbacks as a health‐promotion strategy, and some of the health and ethical issues that may arise.

In particular, the paper explores the application of non‐smoking policies in the speciality of orthopaedic trauma, the benefits and conflicts that may occur, and the scope for nurses in this area to resolve problems resulting from these policies.
A review of lay health beliefs research: insights for nursing practice in health promotion
Authors: DINES ALISON
Published: November 2007

Recent sociological research in the field of lay health and illness beliefs is reviewed and discussed in the light of nursing practice in health promotion.

How the findings might deepen nurses' understanding of difficulties in adhering to desired health behaviours is outlined.

The distinctions between ‘public’ and ‘private’ accounts of health, the ‘taken‐for‐grantedness’ of health, the emotive nature of health and the difficulty of accessing ‘unpolluted’ lay views of health is considered. The implications for nurses working in health promotion are discussed.

There is a need for further research into the relationship between health beliefs and behaviour, the health beliefs of various groups within society and a need to examine how health beliefs arise and change.
‘It's the little things that count’: the hidden complexity of everyday clinical nursing practice
Authors: MACLEOD MARTHA
Published: November 2007

This article reports on one aspect of a phenomenological study of everyday experience in nursing and how it contributes to the development of nursing expertise.

The study was carried out with 10 ‘excellent, experienced’ surgical ward sisters in two Scottish teaching hospitals.

The ward sisters were found to help individual patients towards recovery by making the ward work for all.

When moment‐by‐moment nursing practice, the context of nursing experience, is examined, it is found to be patient‐centred and complex, geared towards multi‐layered goals.

Three distinct yet inextricably intertwined processes–noticing, understanding and acting–characterize how nurses practise nursing. The quality of these processes contributes to the effectiveness of nurses' caring practices.

The ‘little things’ of nursing practice make a difference to patients because they are imbued with nursing knowledge and skill.
Successful isolation and long‐term establishment of a cell line with stem cell‐like features from an anaplastic medulloblastoma
Authors: Raso A. , Negri F. , Gregorio A. , Nozza P. , Mascelli S. , De Marco P. , Merello E. , Milanaccio C. , Ravegnani M. , Cama A. , Garrè M. L. , Capra V.
Published: November 2007

Aims: Herein we report on the successful isolation and establishment of a novel, long‐term, primary, neurosphere‐like cell line called 1603‐MED from a 5‐year‐old boy affected by a highly aggressive anaplastic medulloblastoma. Methods: Elaboration of the new protocol for neurosphere assay is extensively discussed, together with a complete immuno‐histochemical and cytogenetic characterization of 1603‐MED. Results: Clinical course and histopathology are briefly discussed. The 1603‐MED possesses a high capacity for proliferation, CD133 expression, self‐renewal and differentiation, thus indicating that anaplastic medulloblastoma contains a subpopulation of cancer stem cells as observed in classic medulloblastoma. Conclusions: 1603‐MED provides us with the first in vitro model of anaplastic medulloblastoma that may be suitable for studying both tumour progression and the genetic mechanisms related to therapy resistance, and may lead to the development and testing of chemosensitivity and new therapeutic targets.
The Prevalence and Determinants of Obesity in Adults with Intellectual Disabilities
Authors: Melville C. A. , Cooper S.‐A. , Morrison J. , Allan L. , Smiley E. , Williamson A.
Published: November 2007

Background  Obesity is a major public health concern internationally and this study aimed to measure the prevalence of obesity in adults with intellectual disabilities in comparison with general population data, and examine the factors associated with obesity.

Methods  This was a cross‐sectional study of all adults with intellectual disabilities, in a defined geographical area, in the context of a primary care health screening programme. A total of 945 adults with intellectual disabilities were involved, all of whom were living in the community. Body mass index (BMI), demographic characteristics, socio‐economic deprivation, level of intellectual disabilities and various health parameters were measured.

Results  Overall, 39.3% of women and 27.8% of men were obese, compared with 25.1% of women and 22.7% of men in the comparison general population. The mean BMI of women with intellectual disabilities (28.8, range 12.3–59, SD 7.8) was significantly greater than the mean BMI of men with intellectual disabilities (26.7, range 12.6–49, SD 5.9), and women were more likely to be obese than men with intellectual disabilities (χ2 = 29.6, P < 0.001). Regression analyses showed that for both women and men, the risk of overweight and obesity reduced as the severity of intellectual disabilities increased, and Down syndrome was associated with an increased risk of overweight and obesity.

Conclusions  There is a need to carry out research to further our understanding of the reasons behind the increased prevalence of obesity in adults with intellectual disabilities. Effective weight management interventions and accessible clinical services are required to reduce the health inequalities experienced by adults with intellectual disabilities.
From ‘Woman‐Loving Woman’ to ‘Queer’: Historiographical Perspectives on Twentieth‐Century British Lesbian History
Authors: Jennings Rebecca
Published: November 2007

Historiographical approaches to 20th‐century British lesbian history have been shaped by a range of political perspectives. Lesbian feminist historians writing in the 1980s and 1990s emphasised the role of female friendships and lesbian relationships in supporting the lives and work of key figures such as Radclyffe Hall, as well as the negative impact of patriarchal oppression. In the 1990s, definitions of ‘the lesbian’ and the notion of the interwar period as a defining moment in modern lesbian history were challenged by queer and post‐structural approaches, which encouraged an interpretation of categories of sexual identity as unstable. The recent historical concern with geographies of sexuality has prompted lesbian historians to explore the impact of space and the material world on the construction of lesbian identity and experience.
The ‘Culture de guerre’ and French Historiography of the Great War of 1914–1918
Authors: Smith Leonard V.
Published: November 2007

Since the late 1980s, the historiography of the Great War of 1914–1918 has experienced something of a renaissance, particularly among French historians and historians influenced by French historiography. Scholarship has centered around the notion of ‘war culture’ (culture de guerre), defined as the sum total of the means through which contemporaries understood the conflict and persuaded themselves to continue fighting it. This article focuses on two aspects of the culture de guerre– consent, a form of commitment to prevailing in the conflict that deepened with adversity; and brutalization, the ferocity with which contemporaries fought the war in ways often overlooked by previous historiography. The article concludes with a consideration of some of the critics of the culture de guerre.
Marital Satisfaction and Depression: A Replication of the Marital Discord Model in a Latino Sample
Authors: HOLLIST CODY S. , MILLER RICHARD B. , FALCETO OLGA G. , FERNANDES CARMEN LUIZA C.
Published: November 2007

The Marital Discord Model of Depression maintains that marital discord is an important antecedent in the development of depression. Although empirical evidence supports this premise, none of this research has been done with Latinos. The purpose of this study was to test the longitudinal relationship between marital satisfaction and depression among 99 Brazilian women. Using structural equation modeling, results indicated that marital satisfaction was a strong predictor of depression 2 years later. Marital satisfaction was also related to cooccurring depression. These results provide evidence that the Marital Discord Model of Depression is an appropriate theoretical model for the conceptualization of marital discord and depression with Latina women and suggest the potential utility of using couples therapy for treating depression among this population.
An Interpersonal Perspective on Depression: The Role of Marital Adjustment, Conflict Communication, Attributions, and Attachment Within a Clinical Sample
Authors: HEENE ELS , BUYSSE ANN , VAN OOST PAULETTE
Published: November 2007

Previous studies have focused on the difficulties in psychosocial functioning in depressed persons, underscoring the distress experienced by both spouses. We selected conflict communication, attribution, and attachment as important domains of depression in the context of marital adjustment, and we analyzed two hypotheses in one single study. First, we analyzed whether a clinical sample of couples with a depressed patient would differ significantly from a control group on these variables. Second, we explored to what degree these variables mediate/moderate the relationship between depressive symptoms and marital adjustment. The perspectives of both spouses were taken into account, as well as gender differences. In total, 69 clinical and 69 control couples were recruited, and a series of multivariate analyses of variance and regression analyses were conducted to test both hypotheses. Results indicated that both patients and their partners reported less marital adjustment associated with more negative perceptions on conflict communication, causal attributions, and insecure attachment. In addition, conflict communication and causal attributions were significant mediators of the association between depressive symptoms and marital adjustment for both depressed men and women, and causal attributions also moderated this link. Ambivalent attachment was a significant mediator only for the female identified patients. Several sex differences and clinical implications are discussed.
“You” and “I,”“Us” and “Them”: A Systemic‐Discursive Approach to the Study of Ethnic Stereotypes in the Context of British‐Greek Heterosexual Couple Relationships
Authors: TSELIOU ELEFTHERIA , EISLER IVAN
Published: November 2007

Systemic family therapy accounts of ethnic stereotypes in the context of ethnically mixed couple relationships have tended to focus on the interpersonal‐psychological realm of the couple relationship. Discourse analytic research, on the other hand, has highlighted the role of such stereotypes in the construction of national identity and has stressed the importance of a historical and ideological approach. In this article, we will present our attempt to develop a systemic‐discursive approach to the study of stereotypes in the particular context of British‐Greek heterosexual couple relationships by building on both fields.
Acute allograft rejection and immunosuppression: influence on endogenous melatonin secretion
Authors: Cardell Markus , Jung Florian Johannes , Zhai Wei , Hillinger Sven , Welp Andre , Manz Bernhard , Weder Walter , Korom Stephan
Published: November 2007

Abstract:  Melatonin displays a dose‐dependent immunoregulatory effect in vitro and in vivo. Exogenous high‐dose melatonin therapy exerted an immunosuppressive effect, abrogating acute rejection (AR), significantly prolonging transplant survival. Endogenous melatonin secretion, in response to heterotopic rat cardiac allograft transplantation (Tx), was investigated during the AR response and under standardized immunosuppressive maintenance therapy with cyclosporin A (CsA) and rapamycin (RPM). Recipients of syngeneic transplants, and recipients of allogeneic grafts, either untreated or receiving immunosuppressive therapy constituted the experimental groups. Endogenous circadian melatonin levels were measured at 07:00, 19:00, and 24:00 hr, using a novel radioimmunoassay (RIA) procedure, under standardized 12‐hr‐light/dark‐conditions (light off: 19:00 hr; light on: 07:00 hr), before and after Tx. Neither the operative trauma, nor the challenge with a perfused allograft or the AR response influenced endogenous melatonin peak secretion. Immunosuppressive therapy with CsA led to a significant increase in peak secretion, measured for days 7 (212 ± 40.7 pg/mL; P < 0.05), 14 (255 ± 13.9 pg/mL; P < 0.001), and 21 (219 ± 34 pg/mL; P < 0.01) after Tx, as compared with naïve animals (155 ± 25.8 pg/mL). In contrast, treatment with RPM significantly decreased the melatonin peak post‐Tx up to day 7 (87 ± 25.2 pg/mL; P < 0.001), compared with naïve animals (155 ± 25.8 pg/mL). These findings imply a robust nature of the endogenous circadian melatonin secretion kinetics, even against the background of profound allogeneic stimuli. Immunosuppressive maintenance therapy with CsA and RPM modulated early melatonin secretion, indicating a specific secondary action of these drugs. Further studies are necessary to disclose the long‐term effect of immunosuppressive therapy on circadian melatonin secretion in transplant recipients.
The Association of Couples’ Relationship Status and Quality With Breastfeeding Initiation
Authors: Gibson‐Davis Christina M. , Brooks‐Gunn Jeanne
Published: November 2007

Using data from the Fragile Families and Child Wellbeing Survey (N= 3,567), we examine the links between relationship status, relationship quality, and race and ethnicity in breastfeeding initiation. We consider four relationship types: married, cohabiting, romantically involved but not cohabiting (termed visiting), and nonromantically involved mothers. We find that even after adjusting for a wide range of sociodemographic factors, married mothers were more likely to breastfeed than unmarried mothers and that racial and ethnic differences in breastfeeding do not result from differences in marriage rates. Among unwed mothers, paternal provision of money or other assistance during pregnancy decreases the likelihood of breastfeeding. We conclude that relationship status, above and beyond demographic characteristics, is an important correlate of breastfeeding.
Marital Conflict and Children’s Adjustment: Evaluation of the Parenting Process Model
Authors: Schoppe‐Sullivan Sarah J. , Schermerhorn Alice C. , Cummings E. Mark
Published: November 2007

This investigation tested whether parenting mediates longitudinal associations between marital conflict and children’s adjustment. Data were drawn from a three‐wave study of 283 families with children aged 8 – 16 years at Wave 1. Relations among marital conflict, parenting (behavioral control, psychological autonomy, and warmth), and children’s adjustment (externalizing and internalizing) were examined. Structural equation models indicated multiple dimensions of parenting mediated relations between marital conflict and children’s adjustment. When including controls for earlier adjustment, behavioral control continued to mediate relations between marital conflict and change in children’s internalizing symptoms over time. These results advance parenting process models for relations between marital conflict and child adjustment and provide impetus for study of other pathways, including direct and child effects.
Of Sex and Romance: Late Adolescent Relationships and Young Adult Union Formation
Authors: Raley R. Kelly , Crissey Sarah , Muller Chandra
Published: November 2007

To better understand the social factors that influence the diverse pathways to family formation young adults experience today, this research investigates the association between opposite‐gender relationships during late adolescence and union formation in early adulthood. Using data from the first and third waves of the Add Health (n= 4,911), we show that, for both men and women, there is continuity between adolescent and adult relationship experiences. Those involved in adolescent romantic relationships at the end of high school are more likely to marry and to cohabit in early adulthood. Moreover, involvement in a nonromantic sexual relationship is positively associated with cohabitation, but not marriage. We conclude that the precursors to union formation patterns in adulthood are observable in adolescence.
Intergenerational Coresidence Among Small Farmers in Brazilian Amazônia
Authors: VanWey Leah K , Cebulko Kara B
Published: November 2007

This article examines intergenerational coresidence among rural farm families near Santarém, Pará, Brazil using survey data collected by the authors on 896 children whose parents live in 175 households on 150 farms. Married adult children, daughters, and the best educated are more likely to live off their parents’ rural property (vs. on the property). Results support arguments that coresidence results from the interests of children rather than the control that parents exert over children. These results have implications for our understanding of intergenerational relations in the developing world and for the future development of similar areas.
Golden Years? The Labor Market Effects of Caring for Grandchildren
Authors: Wang Ying , Marcotte Dave E.
Published: November 2007

The number of Americans raising grandchildren has been rising steadily. In this article, we expand what is known by focusing on the economic implications of this trend. We compile a unique data set from the Panel Study of Income Dynamics along with its Parent Identification File on 3,240 nonretired grandparent household heads and estimate the effect of taking in a grandchild on labor force participation and hours worked. We estimate models that distinguish between grandparents living alone from those only with grandchildren (skipped‐generation households) and those also with their own children (3‐generation households). We find that caring for grandchildren increases labor force attachment, with grandfathers more likely to work and grandmothers working longer, if another adult is available to supervise the grandchildren.
Managing Money in Marriage: Multilevel and Cross‐National Effects of the Breadwinner Role
Authors: Yodanis Carrie , Lauer Sean
Published: November 2007

We examine whether institutionalized practices and beliefs regarding breadwinning roles are associated with the choice of more or less equal money management strategies in marriage. Using cross‐national data from 21 country contexts in the International Social Survey Programme and multilevel modeling, we find that in contexts of shared breadwinning, there is a greater likelihood of shared management of money, controlling for the relative income contribution of each spouse. We also find some evidence that the effect of spouses’ relative income contributions diminishes in contexts of shared breadwinning. Our analysis comparing women’s and men’s money management is consistent with previous research indicating that women’s management may be more work than power.
Married and Cohabiting Parents’ Relationship Stability: A Focus on Race and Ethnicity
Authors: Osborne Cynthia , Manning Wendy D. , Smock Pamela J.
Published: November 2007

We draw on three waves of the Fragile Families Study (N=2,249) to examine family stability among a recent birth cohort of children. We find that children born to cohabiting versus married parents have over five times the risk of experiencing their parents’ separation. This difference in union stability is greatest for White children, as compared with Black or Mexican American children. For White children, differences in parents’ education levels, paternal substance abuse, and prior marriage and children account for the higher instability faced by those born to cohabiting parents, whereas differences in union stability are not fully explained among Black and Mexican American children. These findings have implications for policies aimed at promoting family stability and reducing inequality.
Creating an Environment for Successful Nonfamily CEOs: An Exploratory Study of Good Principals
Authors: Blumentritt Timothy P. , Keyt Andrew D. , Astrachan Joseph H.
Published: November 2007

Nonfamily CEOs are an important part of the managerial efforts of many family businesses. However, little academic work has focused on these managers, who reside in the dual worlds of business and family. This article presents a study based on interviews with 27 family members and nonfamily CEOs (NFCs) with the objective of exploring what makes for successful NFCs. We find that successful nonfamily CEO engagements are characterized by the selection of an individual with both business and interpersonal competencies, and the support of both family business boards and councils.
The Role of Low Density Lipoprotein Apheresis in the Treatment of Familial Hypercholesterolemia
Authors: Thompson Gilbert R. , Kitano Yuri
Published: November 2007

Abstract: The chief indication for low density lipoprotein (LDL) apheresis is the treatment of homozygous familial hypercholesterolemia (FH), a potentially fatal condition that responds poorly to conventional therapy. Dextran sulfate/cellulose adsorption columns (Kaneka) and on‐line heparin precipitation (HELP) are the most popular systems used in LDL apheresis. Weekly or biweekly procedures plus concomitant drug therapy enable LDL cholesterol to be maintained at 30–50% of its untreated level, with regression of xanthomas, arrest of progression of coronary atherosclerosis, and improved life expectancy. However, aortic stenosis may progress despite apheresis and necessitate valve replacement. Better control of hypercholesterolemia results from combining apheresis with a new 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitor, atorvastatin. LDL apheresis can also be useful in treating drug‐resistant FH heterozygotes with coronary disease. However, the FH Regression Study showed no evidence that reduction by apheresis of both LDL and lipoprotein(a), was more advantageous than reduction by combination drug therapy of LDL alone.
Mechanisms of Immunomodulatory Action of Intravenous Immunoglobulin in Autoimmune and Systemic Inflammatory Diseases
Authors: Vassilev Tchavdar , Kazatchkine Michel D.
Published: November 2007

Abstract: Pooled therapeutic intravenous immunoglobulin (IVIg) is increasingly used for the treatment of autoimmune and systemic inflammatory diseases. The lack of a clear understanding of the mode of action of IVIg has been an obstacle to a more rational use and schedule of administration of IVIg and to the improvement of the existing IVIg preparations. Several nonmutually exclusive mechanisms have been proposed to account for the beneficial immunomodulatory effects of IVIg. These include the functional blockade of Fc receptors on phagocytes, inhibition of the deposition of activated complement components on target cells, modulation of the secretion of cytokines and cytokine antagonists, interference with T and B cell proliferation, neutralization of pathological autoantibodies, and long‐term selection of immune repertoires.
LDL Apheresis in Clinical Practice: Long‐Term Treatment of Severe Hyperlipidemia
Authors: Bambauer R. , Schiel R. , Latza R. , Klinkmann J. , Schneidewind J.M.
Published: November 2007

Abstract: Thirty patients (13 males, 17 females) suffering from familial hypercholesterolemia resistant to diet and lipid‐lowering drugs were treated for 48.7 ± 19.2 months (range, 2–87 months) with low density lipoprotein (LD‐L) apheresis. Three different systems (dextran sulfate adsorption for 27 of 30 [Kaneka, Liposorber, Japan], immunoadsorption system for 2 of 30 [Baxter, Therasorb, Germany], immunoadsorption system with special lipoprotein a [Lp(a)] columns for 1 of 30 patients [Lipopak, Pocard, Russia]) were applied. Before LDL apheresis 24 of 30 patients suffered from coronary heart disease (CHD) with angina symptoms. With LDL apheresis, reductions of 46% for total cholesterol, 49% for LDL, 30% for Lp(a), and 38% for triglycerides were reached. Severe side effects such as shock or allergic reactions were very rare (0.5%). In the course of treatment, an improvement in general well‐being and increased performance were experienced in 27 of 30 patients. A 60 to 100% reduction of nitrate medication was observed in 17 of 24 patients. Regarding the different apheresis systems used, at the end of the trial there were no significant differences with respect to the clinical outcome experienced by the patients and concerning total cholesterol, LDL, high density lipoprotein, and triglyceride concentrations. But to reduce high Lp(a) levels, the immunoadsorption method with special Lp(a) columns seems to be the most effective (‐57% versus 25% [Kaneka] and 23% [Baxter]). The present data clearly demonstrate that treatment with LDL apheresis of patients suffering from familial hypercholesterolemia, resistant to maximum conservative therapy, is very effective and safe, even in long‐term application.
Sequential Treatment of Guillain‐Barré Syndrome with Extracorporeal Elimination and Intravenous Immunoglobulin
Authors: Haupt Walter F. , Rosenow Felix , van der Ven Christian , Borberg Helmut , Pawlik Gunter
Published: November 2007

Abstract: Plasma exchange and administration of intravenous immunoglobulin (IgG) are established treatments for Guillain‐Barré syndrome (GBS). Elimination of postulated pathogenetic factors by plasma exchange or selective adsorption treatment using affinity‐type adsorption columns and subsequent immunomodulation by intravenous IgG may provide a more effective treatment. Forty‐five patients with acute GBS were prospectively examined using a clinical score. We treated 11 patients by plasma exchange, 13 patients by selective adsorption using a tryptophan‐linked polyvinyl alcohol gel adsorbent, and 21 patients by selective adsorption followed by intravenous IgG. The patients treated sequentially by selective adsorption and intravenous IgG improved significantly better than the patients who received plasma treatment only. The results suggest that sequential treatment of GBS may be superior to plasma treatment alone. The higher cost of combined treatment may be offset by lower overall expenditure.
Immunoadsorption in Systemic Connective Tissue Diseases and Primary Vasculitis
Authors: Schneider M. , Gaubitz M. , Perniok A.
Published: November 2007

Abstract: Immunoadsorption offers some advantages over plasmapheresis; until recently the primary advantage has been avoidance of substitution fluids. In collagen vascular disorders, immunoadsorption is performed for the same indications as plasma exchange; most often adsorbers with binding capacities for IgG and circulating immune complexes are used. Tested ligands are protein A, anti‐IgG antibodies, Clq, phenylalanine, and tryptophan. Human IgG was utilized to adsorb rheumatoid factor and dextran sulfate, DNA, or specific anti‐idiotypes for anti‐DNA antibodies in systemic lupus erythematous (SLE). Most applications have used immunoadsorbent columns in pre‐transplantation treatment of patients with high panel reactivity and in patients with idiopathic thrombocytopenic purpura (ITP). For these indications, as for systemic connective tissue diseases, randomized trials have yet to be conducted. SLE controlled trials have been completed for IMPH‐350 and Ig‐Therasorb. Results indicated excellent biocompatibility and good clinical responses. Using protein A in primary systemic vasculitis, histologically proven inactivation of renal involvement was demonstrated, but the patients were also treated with immunosuppressive drugs. Randomized controlled trials are mandatory to provide continued support to the therapeutical opportunities offered only by immunoadsorption.—
Extracorporeal Photochemotherapy: A Treatment for Organ Graft Rejection
Authors: Heshmati F. , Tavakoli R. , Michel A. , Achkar A. , Guillemain R. , Couetil J. P. , Andreu G.
Published: November 2007

Abstract: Extracorporeal photochemotherapy (ECPC) has been investigated experimentally and in clinical conditions in transplant rejection treatment and prevention. Repeated injections of photochemically modified syngeneic alloreactive T cells prior to transplant significantly delay rejection in a mouse skin graft model as well as in a heterotopic heart transplant model in rats. In the latter, we found this effect to be dependent on 3 main parameters, i.e., treatment intensity (number of injections), schedule (injections before and after transplant), and associated immunosuppression (because there is no detectable effect in animals without immunosuppression). In human beings, ECPC was first used for the treatment of acute rejection episode after heart transplantation. At least 2 studies provided evidence that ECPC is as effective as high dose corticosteroids in controlling moderate acute rejections, and several case reports showed that ECPC could be effective in recurrent and/or steroid resistant rejections. ECPC has also been investigated in an open trial to prevent rejection episodes after heart transplantation in patients at high risk of acute rejection because of human leukocyte antigen (HLA) immunization and/or a second or third transplant and found to be successful. In heart transplant recipients at standard risk of rejection episodes, a small scale randomized trial showed a reduction in both rejection episodes and infections in the ECPC treated vs. the standard group. Beyond these studies and other isolated case reports, several large scale randomized trials in heart, lung, and even kidney transplantations (some of them already ongoing), will enable us to define the role of ECPC in the management of transplant recipients.—
Plasma Exchange Versus Intravenous Immunoglobulin for Guillain‐Barré Syndrome
Authors: Hughes Richard Anthony Cranmer
Published: November 2007

Abstract: Previous randomized controlled trials in the U.S.A. and France have provided strong evidence that plasma exchange (PE) hastens recovery from Guillain‐Barré syndrome (GBS). A Dutch trial compared intravenous immunoglobulin (IVIg) with PE in an open study and showed that recovery was as fast or slightly faster in the group treated with IVIg. This report was followed by accounts of a small series of patients who had seemed to progress or relapse after treatment with IVIg. To resolve this controversy, the Plasma Exchange Sandoglobulin GBS Trial Group (PS GBS Trial Group) selected 383 patients randomly to receive PE, IVIg, or PE followed by IVIg. After 4 weeks, the outcome was similar in each of the 3 groups. These 3 regimens also had similar outcomes during 48 weeks of follow‐up.—
Advantages of Isovolemic Large‐Volume Erythrocytapheresis as a Rapidly Effective and Long‐Lasting Treatment Modality for Red Blood Cell Depletion in Patients with Polycythemia Vera
Authors: Kaboth U. , Rumpf K.W. , Liersch T. , Vehmeyer K. , Krieter D. , Kaboth W.
Published: November 2007

Abstract: Long‐term survival of patients with polycythemia vera (PV) is essentially determined by the ability to reduce the risk of thromboembolic complications resulting from the altered rheological conditions by the high red blood cell (RBC) mass of these patients. RBC depletion to normal hematocrit (Hct) values is the first line therapy and should be preferred to chemotherapy (or P32) because of the long‐term risk of acute leukemia or other secondary malignancies. RBC depletion is accomplished much more effectively and rapidly by erythrocytapheresis (EA) than by repeated phlebotomies and has been shown to be well tolerated and accepted by the patients (8). The main indications for EA for a PV patient (often newly diagnosed) are high risk Hct values of >55–60% that can be reduced to the normal range within 1–2 h. The long‐lasting effect (median interval between 2 EA treatments: ca. 6 months) is partially the result of the massive loss of iron, a growth factor for erythropoesis. This has been shown by in vitro studies in erythroid progenitor cells of PV patients before and after EA (11). The advantages and possible disadvantages of EA treatment are discussed.—
Present Status of Apheresis Technologies: Part 2. Membrane Plasma Fractionator
Authors: Sueoka Akinori
Published: November 2007

Abstract: This article is the second of a 4 part series describing currently available apheresis devices and technologies. The sections will include: Part 1: Membrane Plasma Separator (published in Vol. 1); Part 2: Membrane Plasma Fractionator; Part 3: Leukocyte Filter; and Part 4: Adsorbent.—