bluuebunny/crossref_metadata_2025 huggingface dataset:
Inter‐Rater Reliability of the Diagnoses of Psychosis and Depression in Individuals with Intellectual Disabilities
Authors: Einfeld S. , Tonge B. , Chapman L. , Mohr C. , Taffe J. , Horstead S.
Published: August 2007

Background  There is a history of over‐prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under‐prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study examining one aspect of validity, namely whether skilled clinicians can agree on whether an individual with an ID is psychotic or depressed.

Materials and Methods  Pairs of clinicians assessed 52 individuals. Agreement was assessed using Cohen’s kappa statistic and agreement proportion.

Results  Overall agreement was high for both psychosis and depression. Whether the individual had mild ID or moderate/severe ID did not have a significant impact on agreement.

Conclusions  Experienced clinicians achieved a high level of agreement as to whether a person with ID was psychotic or depressed similar to that found for those without ID. The findings provide some support for treatment interventions based on diagnosis.
Children with Developmental Disabilities and Sleep Problems: Parental Beliefs and Treatment Acceptability
Authors: Keenan Ruth A. , Wild Matt R. , McArthur Irene , Espie Colin A.
Published: August 2007

Background This exploratory study investigated the relationships between illness beliefs and treatment acceptability among parents of children with a developmental disability living at home who had sleep onset or maintenance problems.

Materials and Methods A within‐subject correlational design was employed. The parents of 58 children each completed questionnaires assessing their beliefs and attributions towards the sleep problem and the acceptability of two common treatments (behavioural and melatonin).

Results Parents believed sleep problems to be chronic, to have negative consequences, yet to be potentially curable/controllable. They rated behavioural treatment and melatonin similarly in terms of acceptability. Behavioural treatment acceptability was related to how long parents believed the sleep problem would last and to a number of causal attributions. The acceptability of melatonin was related to how severe the consequences of the sleep problem were believed to be and to a specific causal attribution. Parents who preferred melatonin to behavioural treatment believed that their child’s sleep problem had more negative consequences on their child’s life.

Conclusions Specific beliefs held by parents about their child’s sleep problems might influence treatment acceptability and treatment choice. Parents are split between those who would prefer behavioural treatment and those who would prefer melatonin. However, as the sleep problem becomes more severe, it seems more likely that parents would choose the pharmacological treatment.
Mental Health Services for Individuals with Intellectual Disabilities in Canada: Findings from a National Survey
Authors: Lunsky Y. , Garcin N. , Morin D. , Cobigo V. , Bradley E.
Published: August 2007

Background  People with intellectual disabilities are known to have a high prevalence of mental health problems but few studies have considered how such mental health problems are addressed in Canada. The purpose of the present study was to document both the range of mental health services available to individuals with intellectual disabilities across Canada and the perceived service gaps.

Material and Methods  A 30‐item questionnaire was developed that included questions on mental healthcare services for children, adolescents and adults with intellectual disabilities. This survey was sent to key informants in the 10 Canadian provinces and three territories.

Results  More than half of the respondents reported that generic mental health providers were poorly equipped to meet the needs of individuals with intellectual disabilities and mental health issues. Certain specialized services (inpatient treatment, emergency room expertise) were reported to exist by less than half of the respondents. Waitlists for specialized services were typically 4 months or longer. Respondents thought that training for staff and professionals was very important.

Conclusion  Some specialized services for individuals with intellectual disabilities and mental health issues were reported to exist in Canada but the need for more specialized services and further training was identified. Documentation of these service gaps should lead to further efforts in Canada for the improvement in services and developing policy.
Consumption of Mental Health Services by People with Intellectual Disabilities
Authors: Spiller Mary Jane , Costello Helen , Bramley Agnieszka , Bouras Nick , Martin Graham , Tsakanikos Elias , Holt Geraldine
Published: August 2007

Background  Although research is starting to identify those factors that predict contact with mental health services in individuals with intellectual disabilities, very little is known about the patterns of service use following referral. Yet, this information is vital for effective service planning and development. We therefore examined the factors associated with service consumption.

Methods  We constructed a service consumption index based on the number of outpatient clinics attended, contacts with the community psychiatric nurses, home visits by a psychiatrist and the number of admissions. This consumption index was used to divide the sample (n = 115) into two groups: heavy and light service users.

Results and conclusions  Logistic regression analysis indicated that, after controlling for the length of service contact, individuals with a diagnosis of schizophrenia spectrum disorder and those with a greater number of affective/neurotic symptoms were more likely to be heavy service users. Age, living situation and the degree of intellectual disabilities were not found to be significant predictors of service consumption. The results also suggest that a small proportion of service users consumed almost half of the service resources.
How far merit selection? Social stratification and the labour market1
Authors: Jackson Michelle
Published: August 2007

The question of how societies allocate occupational positions and subsequent rewards has long been of interest to sociologists. According to one influential theory, the needs of modern industrial societies and economies demand that high‐level and functionally important occupational positions are allocated according to meritocratic principles. I argue that, ultimately, employers get the final say about which characteristics are rewarded in the labour market. In order to examine which skills and attributes are required by employers for particular occupations I analyse data drawn from a content analysis of c.5000 British newspaper job advertisements. The results show that both merit and non‐merit characteristics are requested by employers in job advertisements, even for occupations falling within the higher classes. I also find evidence that employers have similar requirements for similar occupations, cross‐cutting class boundaries.
Sociology, ethics, and the priority of the particular: learning from a case study of genetic deliberations
Authors: Haimes Erica , Williams Robin
Published: August 2007

There are growing debates about the relationship between the two disciplines of sociology and ethics, particularly as they each become increasingly involved in research and policy formation on the life sciences, especially genetics. Much of this debate has been highly abstract, often stipulating the seemingly different character of the two disciplines and speculating on their theoretical potential – or lack thereof – for future collaborative work. This article uses an existing collaboration between a sociologist and an ethicist, on a study of participation in genetic databases, to explore some of the challenges, for both disciplines, of working together. Building upon this case study, we examine the suggestion that the Aristotelian concept of ‘phronesis’ provides the grounds for establishing one possible theoretical framework with which the disciplines can be bridged. Further exploration of this approach leads to suggestions for ways of thinking about the apparently fundamental divides between the disciplines and for ways of adding to notions of a ‘public sociology’.
geophylobuilder 1.0: an arcgis extension for creating ‘geophylogenies’
Authors: KIDD DAVID M. , LIU XIANHUA
Published: August 2007

Evolution is inherently a spatiotemporal process; however, despite this, phylogenetic and geographical data and models remain largely isolated from one another. Geographical information systems provide a ready‐made spatial modelling, analysis and dissemination environment within which phylogenetic models can be explicitly linked with their associated spatial data and subsequently integrated with other georeferenced data sets describing the biotic and abiotic environment. geophylobuilder 1.0 is an extension for the arcgis geographical information system that builds a ‘geophylogenetic’ data model from a phylogenetic tree and associated geographical data. Geophylogenetic database objects can subsequently be queried, spatially analysed and visualized in both 2D and 3D within a geographical information systems.
Market Size and the Survival of Foreign‐owned Firms*
Authors: FALVEY ROD , GREENAWAY DAVID , YU ZHIHONG
Published: August 2007

We develop a general equilibrium model with heterogeneous firms and foreign direct investment cost uncertainty and investigate the survival of foreign‐owned firms. The survival probabilities of foreign‐owned firms depend on firm‐level characteristics, such as productivity, and host country characteristics, such as market size. We show that a foreign‐owned firm will be less likely to be shut down when its parent firm's productivity is higher and its indigenous competitors are less productive. Although a larger market size will always reduce the survival probability of indigenous firms, it can lead to a higher survival probability for foreign‐owned firms if their parent firms are sufficiently productive.
Alfred Marshall's Mecca: Reconciling the Theories of Value and Development*
Authors: METCALFE J. STANLEY
Published: August 2007

The purpose of this paper is to explore the evolutionary nature and content of Marshall's theory of value and the relation it bears to his theory of growth and development. In Marshall's work the two theories are inextricably linked, and the subsequent attempt to separate them has not only marginalised Marshall's rich analysis but also made it impossible to appreciate the role he gave to innovation, and its corollary the growth of knowledge and organisation, in the workings of a market economy. At its core is the relation between the growth of firms and the growth of markets, but this is not steady‐state growth theory; rather, it is the different, mutually determined and ever changing growth rates of different groups of firms that is at the centre of attention. Quite how variation is linked to progress is the central topic of this essay, and the elucidation of its central role necessarily means that we must resurrect the representative firm. We conclude that Marshall was correct in stating that ‘the tendency to variation is a chief source of progress’ (Principles, V, 4, p. 355). We develop a set of evolutionary tools to show how and why this is so. But evolution is more than variation; it requires the organisation of firms and the market process to generate that correlation between differential knowledge and economic advance. Most importantly of all, the concept of a representative firm is re‐established as an indispensable element in a Marshallian evolutionary analysis.
Serial determination of biomarkers of oxidative stress and antioxidant status in dogs with naturally occurring gastric dilatation‐volvulus
Authors: Walker Thomas G. , Chan Daniel L. , Freeman Lisa M. , Milbury Paul E. , Blumberg Jeffrey B.
Published: August 2007

Objective:To serially determine the biomarkers of oxidative stress and antioxidant status of dogs with gastric dilatation‐volvulus (GDV) over 48 hours.

Design:Prospective study.

Setting:Veterinary teaching hospital intensive care unit.

Animals:Thirteen client‐owned dogs with GDV.

Interventions:None.

Measurement and main results:For all dogs, biomarkers of oxidative stress and antioxidant status were ascertained. Indicators of oxidative stress measured included F2α‐isoprostanes (isoprostanes) and malondialdehyde (MDA). Vitamin C, vitamin E, glutathione peroxidase (GSHPx), and oxygen radical absorbance capacity (ORAC) were measured to assess antioxidant status. Oxidants and antioxidants were measured at the time of admission and at 24 and 48 hours post‐admission. There were significant decreases in vitamin E (P=0.002), vitamin C (P=0.001), ORAC (P=0.02), and MDA (P=0.001) during hospitalization. There was no significant change in GSHPx and isoprostane concentrations over time.

Conclusion:Oxidative stress and antioxidant capacity in dogs with GDV change over time. Further studies measuring oxidative stress in more severely affected dogs and performing measurements earlier in the disease process may be beneficial in determining when oxidative stress is most severe during the course of GDV management.
Systematic Review and Meta‐analysis from Chinese Literature: the Association Between Helicobacter pylori Eradication and Improvement of Functional Dyspepsia
Authors: Jin Xi , Li You‐ming
Published: August 2007

Objectives:  To evaluate the effect of eradicating Helicobacter pylori on dyspeptic symptoms in patients with functional dyspepsia in China.

Data sources:  Randomized controlled trials conducted in China and those published between 1989 and April 2007.

Review methods:  The articles were retrieved from Chinese biomedicine Web database and Chinese scientific Journals database using proper MESH headings and assessed by two independent investigators according to established inclusion criteria. The characteristics of chosen articles were displayed for further analysis, and summary odds ratio were calculated to determine the overall effect of H. pylori eradication. All the data were entered and analyzed using review manager 4.1, and p < .05 was defined as statistically significant in all analysis.

Results:  Seven qualified trials were enrolled, and the summary odds ratio for improvement in dyspeptic symptoms in patients with functional dyspepsia in whom H. pylori was eradicated was 3.61 (95%CI: 2.62, 4.98, p < .00001). The difference in the follow‐up period did not influence the final outcomes.

Conclusions:  An improvement in dyspeptic symptoms occurred among Chinese patients with functional dyspepsia in whom H. pylori was eradicated.
Anti‐inflammatory Effect of Capsaicin in Helicobacter pylori‐Infected Gastric Epithelial Cells
Authors: Lee In Ohk , Lee Kwang Hyoung , Pyo Jae Hee , Kim Jie Hyun , Choi Yeun Jung , Lee Yong Chan
Published: August 2007

Background and aim:  Capsaicin, the main pungent ingredient of hot red and chilli pepper, has been considered as not only a cytoprotective but also a detrimental agent to the gastric mucosa. However, the effect and mechanism of capsaicin that modulate the induction of pro‐inflammatory cytokine in Helicobacter pylori‐infected epithelial cells have not been investigated previously. Herein, we demonstrated that capsaicin inhibited the release of pro‐inflammatory cytokine, interleukin‐8 (IL‐8) by H. pylori‐infected gastric epithelial cells through nuclear factor‐κB (NF‐κB) signal pathway.

Materials and methods:  AGS or MKN45 cells as gastric epithelial cells and Vac A+, CagA+ wild‐type H. pylori strain ATCC 49503 were used. Gastric epithelial cells were pre‐treated with various concentrations of capsaicin and infected with H. pylori for different periods of time to determine IL‐8 concentrations in culture supernatant by an ELISA assay. We measured IL‐8 mRNA transcripts in H. pylori‐infected gastric epithelial cells co‐treated with capsaicin by reverse transcriptase‐polymerase chain reaction analysis. We performed electrophoretic mobility shift assay to examine the NF‐κB DNA binding activity with capsaicin and immunofluorescence microscopy to examine nuclear staining of p65. We also performed immunoblotting for IκB, IKK activity with capsaicin.

Results:  Capsaicin inhibits H. pylori‐induced IL‐8 production by gastric epithelial cells in dose‐ and time‐dependent manner. Capsaicin as low as 100 µmol/L significantly inhibited IL‐8 production in H. pylori‐infected MKN45 cells (43.2% of control) at 24 hours incubation, whereas inhibited IL‐8 production in H. pylori‐infected AGS cells (70% of control). We confirmed that capsaicin inhibited IL‐8 mRNA expression after infection of gastric epithelial cells with H. pylori for 6 hours. The addition of capsaicin (100 µmol/L) suppressed H. pylori‐induced NF‐κB activation in gastric epithelial cells at 1 hour post‐infection. We also found that the degradation of IκB and IKK activation were inhibited by capsaicin.

Conclusions:  Nontoxic dose of capsaicin inhibited H. pylori‐induced IL‐8 production by gastric epithelial cells through the modulation of IκB‐, NF‐κB‐, and IL‐8 pathways. We conclude that capsaicin can be proposed as a potential anti‐inflammatory drug by inhibition of the production of IL‐8 in H. pylori‐infected gastric epithelium.
Brazilian Green Propolis on Helicobacter pylori Infection. A Pilot Clinical Study
Authors: Vaz Coelho Luiz Gonzaga , Ferreira Bastos Esther Margarida Alves , Resende Clarissa Carvalho , Paula e Silva Celso Mirra , Fernandes Sanches Bruno Squarcio , De Castro Flávio José , Moretzsohn Luciana Dias , Dos Santos Vieira Washington Luiz , Trindade Osmar Reni
Published: August 2007

Recent in vitro studies suggest that propolis and some of its phenolic components are able to inhibit Helicobacter pylori growth. To date, there are no clinical studies.

Aims:  To evaluate the effect of Brazilian green propolis on H. pylori‐infected individuals.

Patients and methods:  Eighteen (11 females, 7 males, mean age 47 years) participants were included. Before treatment, all participants were submitted to gastroscopy, and H. pylori infection was confirmed by histology, urease test, and 13C‐urea breath test (UBT). Participants with UBT showing a delta over baseline (DOB) value higher than 4‰ were considered positive for H. pylori infection. Twenty drops from an alcoholic preparation of Brazilian green propolis were administered three times a day for 7 days. Clinical evaluation and UBT were performed at 1–3 days and at 40 days after the end of therapy to evaluate H. pylori suppression or eradication, respectively.

Results:  All participants took all medication and completed the study. Eighty‐three percent of the subjects did not succeed in suppressing or eradicating H. pylori. Two participants reached partial suppression after treatment, but became positive again at UBT performed 40 days after treatment. Another participant presented negative at UBT 40 days after treatment, not confirmed by a second UBT performed 100 days after treatment.

Conclusions:  Brazilian green propolis used in popular dose showed minimal effect on H. pylori infection. Larger studies with longer duration, larger dose, and different frequency of administration of propolis extract should be undertaken to define its role on H. pylori therapy.
Pathogenesis ofHelicobacter pyloriInfection
Authors: Maeda Shin , Mentis Andreas F.
Published: August 2007

The clinical outcome ofHelicobacter pyloriinfection is determined by a complex interaction between the bacterium and the host. The main bacterial factors associated with pathogenicity comprise outer membrane proteins, including BabA, SabA, OipA, AlpA, and AlpB, the vacuolating cytotoxin VacA and the products ofcagPAI. The multitude of putative virulence factors makes it extremely difficult to test the contribution of each individual factor. Much effort has been put into identifying the mechanism associated withH. pylori‐associated carcinogenesis. Interaction between bacterial factors such as CagA and host signal transduction pathways seems to be critical for mediating cell transformation, cell proliferation, invasion, apoptosis/anti‐apoptosis, and angiogenesis. An animal model using the Mongolian gerbil is a useful model for showing gastric pathology due toH. pyloriinfection which is similar to that in humans and can be used to evaluate virulence factors including CagA, host responses, and environmental factors such as salt intake.
Helicobacter pylori Infection in Pediatrics
Authors: Veres Gabor , Pehlivanoglu Ender
Published: August 2007

During the last year, epidemiologic studies have shown that spontaneous clearance of Helicobacter pylori infection has a less significant role in countries with high prevalence and, in contrast to adults, there is no male predominance of H. pylori infection in children. Early acquisition of H. pylori may play a role in the development of recurrent abdominal pain in children less than 5 years of age. In this very young age group, the adequate performance of stool antigen test and 13C urea‐breath test demonstrated satisfactory sensitivity and specificity as non‐invasive methods to diagnose H. pylori infection. In the current paper, the most relevant pediatric studies on H. pylori infection published between April 2006 and March 2007 are reviewed.
Diversity of Helicobacter pylori cagA and vacA Genes in Costa Rica: Its Relationship with Atrophic Gastritis and Gastric Cancer
Authors: Con Sergio A. , Takeuchi Hiroaki , Valerín Ana L. , Con‐Wong Reinaldo , Con‐Chin Gil R. , Con‐Chin Vicky G. , Nishioka Mitsuaki , Mena Fernando , Brenes Fernando , Yasuda Nobufumi , Araki Keijiro , Sugiura Tetsuro
Published: August 2007

Background:  Associations between Helicobacter pylori gene diversity and gastric cancer have not been reported on in Costa Rica, despite its being one of the countries with the highest gastric cancer incidence and mortality rates in the world. The aim of this study was to determine the prevalence of H. pylori cagA and vacA genes and investigate whether it could be correlated with atrophic gastritis (AG) and gastric cancer (GC) in Costa Rica.

Materials and methods:  Genomic DNAs from isolates of 104 patients classified into two groups: non‐atrophic gastritis group (n = 68) and atrophic gastritis group (n = 36), were subjected to PCR‐based genotyping of cagA and vacA genes and their correlation with clinical outcome was investigated. Total DNA extractions from gastric tissues of 25 H. pylori‐infected gastric cancer patients were utilized for comparative purposes.

Results:  The presence of cagA (75.3%), vacA s1b (75.3%), and vacA m1 (74.2%) was detected, and colonization by strains with different vacA genotypes in the same stomach was found in 9.7% of the patients. Age‐ and sex‐adjusted vacA s1b and vacA m1 were associated with GC while only vacA m1 was significantly associated with AG. A tendency for association between cagA and vacA s1b, and AG was reported.

Conclusions:  The prevalence status of the cagA and vacA (s1/m1) genes in Costa Rica seems to fall between that found in European/North American and East Asian countries, and both cagA and vacA seem to have clinical relevance in this country.
Treatment of Helicobacter pylori
Authors: Egan B. J. , Katicic M. , O’Connor H. J. , O'Morain C. A.
Published: August 2007

Since the discovery of Helicobacter pylori in the early 1980s many treatment regimes have been developed to effectively treat this infection. International guidelines have allowed consensus on the best management and improved eradication rates. In recent years, increasing antimicrobial resistance has resulted in falling eradication rates with standard therapies. In this article, we review the most recent studies and guidelines in the treatment of H. pylori. Currently, the first‐line treatment remains clarithromycin, amoxicillin or metronidazole and proton pump inhibitor twice daily, but a number of recent studies have shown low eradication rates with this treatment. Increased duration of therapy has been recommended to overcome the falling eradication rates. However, conflicting findings have been reported on the benefits of extending the length of traditional therapy. Sequential therapy may be an effective alternative to standard triple therapy in regions of increased antimicrobial resistance. Probiotics reduce side‐effects from traditional regimens and may improve eradication rates. A quinolone‐based second‐line triple therapy appears to be effective and well tolerated. Bismuth‐based quadruple therapy is also an effective alternative if available. In the future, regional antimicrobial resistance and eradication rates will determine the best treatment for H. pylori.
Helicobacter and Gastric Malignancies
Authors: Moss Steven F. , Malfertheiner Peter
Published: August 2007

Over the past year Helicobacter pylori has been confirmed as the most important risk factor for non‐cardia gastric adenocarcinomas and gastric mucosa‐associated lymphoid tissue (MALT) lymphomas. Eradication therapy has been proven to be beneficial when given prior to the development of intestinal metaplasia, but is less efficacious when administered later. However, the best data from clinical trials indicate that H. pylori eradication alone will have only a moderate effect on gastric cancer incidence worldwide. The mechanisms responsible for H. pylori‐associated gastric carcinogenesis continue to be dissected. Accumulating evidence suggests that some H. pylori may be able to invade through the gastric epithelial barrier, though pro‐carcinogenic effects may also be related to the complex and evolving pathways of altering signal transduction pathways within gastric epithelial cells that are stimulated by adherence and translocation of H. pylori products through its type IV secretory system. Determinants of the host response to H. pylori infection continue to focus on polymorphisms in genes related to the innate and acquired immune responses, including NOD2, COX‐2, and TLR‐4. H. pylori eradication is indicated for low‐grade gastric B‐cell MALT lymphoma and may even provide “cure” in some apparently H. pylori‐negative cases. How and why does H. pylori promote lymphomagenesis? Some evidence from human and murine models points to specific chromosomal translocations and host genetic polymorphisms as relating to the outcome of infection. Finally, Helicobacter hepaticus infection has been linked to both intestinal and breast tumorigenesis in susceptible strains of female mice – a provocative and novel finding warranting further investigation.
CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: Reversing the Risk Factor Paradox: Is Daily Nocturnal Hemodialysis the Solution?
Authors: Pauly Robert P. , Chan Christopher T.
Published: August 2007

Reverse epidemiology or risk factor paradox refers to observations that traditional cardiovascular risk factors may not portend the same poor outcomes in the end‐stage renal disease (ESRD) population, and may even be protective. If the underlying cause of this paradox is the “unphysiology” of the uremic milieu, as exemplified by the malnutrition‐inflammation‐complex syndrome, oxidative stress, and other aberrations of normal physiology, we propose that correcting this “unphysiology” could normalize the relationship between the traditional risk factors and their corresponding outcomes. In this review we summarize the growing body of evidence suggesting that daily nocturnal hemodialysis (NHD), a novel intensive form of home‐based renal replacement therapy, normalizes many physiological processes, in an effort to support the hypothesis that NHD may reverse the risk factor paradox.
CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: It Is Important to Lower Homocysteine in Dialysis Patients
Authors: Zoccali Carmine , Mallamaci Francesca , Tripepi Giovanni
Published: August 2007

Homocysteine has been implicated in atherosclerotic and thrombotic vascular disease in the general and in the end‐stage renal disease (ESRD) population as well. Although not strong, the risk associated with raised homocysteine (25% risk excess for a 5 μm increase) is quite consistent across studies in the general population. Likewise, individuals harboring a polymorphism leading to higher homocysteine levels coherently display an increased risk for cardiovascular events in comparison with individuals without such a polymorphism. Randomized controlled trials of homocysteine‐lowering therapy performed so far failed to prove causality but the size effect of these interventions is still compatible with the hypothesis that reducing the plasma levels of this aminoacid may be beneficial. In ESRD, high homocysteine is a coherent predictor of death and adverse cardiovascular events in patients without malnutrition and inflammation. In the sole randomized placebo‐controlled study performed in this population folic acid produced a small beneficial effect which, because of the lack of power, failed to achieve statistical significance. In another randomized study testing the effect of a well established homocysteine‐lowering agent, N‐acetyl‐cysteine, a 40% reduction in cardiovascular events was observed. There is still insufficient knowledge to draw definitive conclusions on the causal implication of homocysteine in the high risk of ESRD. The contention that the homocysteine pathway cannot be used for interventions aimed at curbing cardiovascular risk in this population is, at least by now, unwarranted.
CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: Reverse Epidemiology beyond Dialysis Patients: Chronic Heart Failure, Geriatrics, Rheumatoid Arthritis, COPD, and AIDS
Authors: Horwich Tamara B. , Fonarow Gregg C.
Published: August 2007

“Reverse epidemiology” refers to paradoxical and counterintuitive epidemiologic associations between survival outcomes and traditional cardiovascular risk factors such as obesity, high blood pressure, and high cholesterol. Reverse epidemiology has been well described in end stage renal disease, but also has been observed in chronic disease states, including chronic heart failure, rheumatoid arthritis, chronic obstructive pulmonary disease, and Acquired Immune Deficiency Syndrome, and in elderly populations. This review will highlight the recent medical literature on reverse epidemiology in these populations. Common pathophysiologic underpinnings in these chronic disease states may help explain the reversal of risk factors observed in these diverse populations. Furthermore, guidelines for the general population for optimal goals of weight, cholesterol levels, and blood pressure may not apply to special populations, including patients with chronic diseases or elderly persons.
CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: Body Mass Index and Peritoneal Dialysis: “Exceptions to the Exception” in Reverse Epidemiology?
Authors: Abbott Kevin C. , Oliver David K. , Hurst Frank P. , Das Neal P. , Gao Sam W. , Perkins Robert M.
Published: August 2007

Until recently, it was not apparent whether apparent paradoxical associations of body mass index (BMI), lipids, and blood pressure with survival observed in hemodialysis (HD) patients, which contradict observations from the general population, also applied to peritoneal dialysis (PD) patients. Studies of survival in PD patients must account for differences in adjusted survival relative to HD patients, namely, early equivalent to superior survival, but after about 1–2 years, inferior survival. Several recent observational studies have analyzed the association between BMI and survival in PD patients from different perspectives and using different patient populations. In general, these studies found that any survival advantage associated with obesity is significantly less likely in PD than HD patients. Among PD patients, those who are obese can be said to have equivalent survival to PD patients with normal BMI. Studies of lipids and blood pressure in PD patients also yield conflicting associations with survival. Obese patients, especially if diabetic, may have increased risk of death after starting on PD compared to HD, although firm conclusions are premature given the limitations of current evidence. At present, the levels of lipids and blood pressure which are best associated with survival in PD patients are not well‐defined.
CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: Obesity‐Survival Paradox—Still a Controversy?
Authors: Schmidt Darren S. , Salahudeen Abdulla K.
Published: August 2007

Since the original description of the obesity‐survival paradox in 1999, which suggested a survival advantage for overweight and obese patients undergoing hemodialysis, a large body of evidence supporting the paradox has accumulated. The reason for the paradox has yet to be defined. Better nutrition may be a partial explanation, or it may be that in uremic milieu, excessive fat and surplus calories might confer some survival advantage. The “surplus calorie theory” as a potential mechanism for the paradox is of great interest. If proven to be correct, it might explain why peritoneal dialysis patients who receive excessive calories through dialysis do not exhibit the paradox and, secondly and more importantly, therapy could be directed to enhance a greater caloric intake by renal failure patients to engender a better survival outcome. Finally, other clinical settings, for example, congestive heart failure, have their own obesity‐survival paradox. Thus, the paradox appears to be a wider phenomenon and might merely be the external expression of a larger principle yet to be uncovered.
CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: Is There a Reversal of Reverse Epidemiology in Renal Transplant Recipients?
Authors: Chavalitdhamrong Disaya , Danovitch Gabriel M. , Bunnapradist Suphamai
Published: August 2007

Similar to the general population, cardiovascular disease is the leading cause of death in patients with a functioning renal graft. Recent studies have shown an inverse relationship between cardiovascular risk factors and outcomes in dialysis patients. Low blood pressure, low body mass index (BMI) and low serum cholesterol levels are correlated with a higher risk of adverse cardiovascular outcomes in dialysis patients. The explanation for these observations is unclear. In renal transplant recipients (RTR), these parameters are correlated with a lower risk of cardiovascular adverse outcomes, a phenomenon labeled as “reversal of reverse epidemiology.” The aims of this review are: (1) to explore the association between cardiovascular risk factors and outcomes in RTR; (2) to assess whether these effects are reversal of the reverse epidemiology in dialysis predecessors; and (3) to determine the strategies for minimizing cardiovascular risk in RTR. This article also compares the determinants of cardiovascular risk factors among the general population, maintenance dialysis patients and RTR. Because definitive evidence on optimal intervention is lacking, population‐specific clinical trials are needed to define optimum targets for treatment of these risk factors in maintenance dialysis patients and RTR separately.
Factors Influencing Brand Launch in a Global Marketplace
Authors: Yeniyurt Sengun , Townsend Janell D. , Talay Mehmet Berk
Published: August 2007

The purpose of this study is to explore the factors that influence the launch of brands into new markets in a global environment. Although multiple streams of literature exist with respect to the entry of brands into new markets and the diffusion of new brands within and across markets, the process of launching products and brands globally over time has received relatively limited attention. To address this issue, this study incorporates multiple indicators of activities that can contribute to experiential learning relevant for launching brands in a global marketplace. Market uncertainty and experiential learning provide a conceptual foundation for the development of relevant hypotheses, which are tested in the context of the global automotive industry from 1981 to 2004. A discrete time event history analysis with time‐varying independent variables is employed to estimate the effects of the independent variables on the probability of a brand being launched in a specific market. The global brand launch observations are extracted from a proprietary dataset containing the global dispersion of automotive brands including 22 countries of origin and 42 countries of brand entry. The sample yields 50,572 spells, derived from 99 companies, 173 brands, and 700 market entries. The results of this study contribute to the literature in a variety of ways. Market attractiveness positively influences the propensity of a brand to be launched into a new market. This supports the idea that potential demand conditions are an important managerial consideration in product introduction decisions. The results reveal significant effects with respect to the role of psychic distance and experiential learning. Brands are reluctant to launch into countries that are culturally and economically less similar to the home market. Yet firms tend to place a lower degree of emphasis on factors of cultural distance when launching brands into larger markets, and global experience enables companies to overcome the uncertainties associated with launching brands into international markets that are economically distant. The results also suggest that companies are more likely to introduce additional brands in markets where they already have a presence. Overall, global dispersion and geographic scope, coupled with local market knowledge facilitate the launch of brands globally. From a managerial perspective, this study suggests companies should focus on acquiring both local and global experience to facilitate the launch of products and brands in the global marketplace.
The Role of Globalization, Time Acceleration, and Virtual Global Teams in Fostering Successful Global Product Launches
Authors: Harvey Michael G. , Griffith David A.
Published: August 2007

The present article presents a conceptualization of how firms can respond to the issues of globalization and time‐based competition through the use of virtual global teams to foster successful global product launches. It is argued that by combining input, managerial, and transformation‐based competencies effectively, the firm can configure a repertoire of strategic choices (e.g., marketing plans throughout the product development process) based on the national competitive environment, while at the same time being mindful of the need to maintain consistency within the firm's intermediaries operations—both in product development and global product launch. It is further argued that the linkages between globalization and time‐based competition necessitate managerial adjustments in decision frameworks to incorporate accelerated timescapes to maximize effectiveness in global product launch. In an effort to capture the varying impact of time on global decision makers a timescapes perspective is employed, where timescapes are analogous to landscapes because they include the temporal features of socioeconomic events in a variety of socially constructed contexts inclusive of timeframe, tempo, degree of path dependency, synchronization of events, sequence, anticipation, and ubiquity. The recognition of timescapes accentuates the contextual complexity of competition and creates the interface among events, environments, and individuals beyond the traditional numeric concept of clock time, thus requiring modification of a manager's decision‐making perspective. Further, it is argued that due to the rapid pace of globalization, many multinationals in their global product launches require that products, services, technical support, and prices throughout the world need to be coordinated. To effectively accomplish this goal of coordination as an accommodation, firms and their networks can form global virtual teams (i.e., culturally diverse, geographically dispersed, electronically communicating work group of members, who think and act in concert with the diversity of the global environment and intermediary needs–expectations) to enhance global product launch success. Lastly, it is argued that the hypercompetitive global marketplace cannot be managed ex post due to the level of cognitive complexity but must be managed ex ante by developing strategies capable of maintaining flexibility. To accomplish the task of competing in a hypercompetitive landscape, management must understand and incorporate a timescape of events that integrates the various perspectives of those involved in the global product development and launch decision‐making processes. Without a well‐articulated perspective of social time, managers will limit their ability to effectively coordinate global product development and launch across markets, thus hindering the firm's ability to maximize returns.
The Role of Information Communications Technology in Retrieving Local Community
Authors: Ashton Hazel , Thorns David C.
Published: August 2007

The article explores the decline in social connectivity and the questions of whether and how local populations can use information–communications technologies (ICTs) to help reconnect. At the center of this debate are problems in conceptualizing community in today's globalizing network society. As well as challenges to older ideas about community, these problems include the impacts of numerous contemporary societal and global pressures on communities themselves. The first step of community renewal is what Scott Lash (1994) refers to as the “retrieval” of community, which is to be a genuinely participatory process, rather than presuming community already exists or engineering a consensus about what it is or what it wants. Some governments are now suggesting that a way to reconnect local populations in order to recover lost sociability and rebuild social infrastructure is through using ICTs as a major tool. Using the New Zealand Government policy contained in the Connecting Communities programme (2002) and the Digital Strategy (2004), the article explores and provides a critique of the strategies being advocated, particularly with respect to the use of the concepts of community and connectivity. A case study of the development and use of ICT tools for community retrieval within a particular local area is used to identify some pitfalls and argue for approaches to connectivity that effectively utilize ICTs as community networking tools.
Positive photocontact responses are not elicited to sunscreen ingredients exposed to UVA prior to application onto the skin
Authors: Wahie Shyamal , Lloyd James J , Farr Peter M
Published: August 2007

Photocontact allergic reactions to sunscreen chemicals are investigated by photopatch testing. It has generally been assumed that for photocontact allergy to be shown, the putative pro‐allergen must be in the skin at the time of ultraviolet A (UVA) exposure. However, this assumption has not, to our knowledge, been tested. The objective of this study was to determine whether positive photocontact responses can still be elicited when sunscreen chemicals are exposed to UVA prior to application onto the skin. 3 patients known to have positive photocontact reactions to a total of 6 sunscreen chemicals were studied. For conventional photopatch testing, patch test strips were applied onto the back and removed 1 D later, and the area was irradiated with UVA (5 J/cm2). For pre‐irradiated testing, patches were exposed to the same dose of UVA immediately before application onto the back and then removed 1 D later. Skin responses were visually assessed by a blinded investigator 1 and 2 D after patch test removal. The same photocontact responses of the same magnitude, as previously documented for each patient, were seen at each of the conventional UVA‐exposed patch test sites. However, in no patient was a positive response elicited at any of the sites where pre‐irradiated patches had been applied. This study shows that positive photocontact responses to sunscreen chemicals do not occur when the putative pro‐allergen is irradiated prior to application onto the skin. This suggests that for a photoallergic reaction to occur, the sunscreen chemical needs to be within the skin when activated by UVA.
10‐year prevalence of contact allergy in the general population in Denmark estimated through the CE‐DUR method
Authors: Thyssen Jacob Pontoppidan , Uter Wolfgang , Schnuch Axel , Linneberg Allan , Johansen Jeanne Duus
Published: August 2007

The prevalence of contact allergy in the general population has traditionally been investigated through population‐based epidemiological studies. A different approach is the combination of clinical epidemiological (CE) data and the World Health Organization‐defined drug utilization research (DUR) method. The CE‐DUR method was applied in Denmark to estimate the prevalence of contact allergy in the general population and compare it with the prevalence estimates from the Glostrup allergy studies. Contact allergy prevalence estimates ranging from very liberal (‘worst case’) to conservative (‘best case’) assumptions were based on patch test reading data in combination with an estimate of the number of persons eligible for patch testing each year based on sales data of the ‘standard series’. The estimated 10‐year prevalence of contact allergy ranged between 7.3% and 12.9% for adult Danes older than 18 years. The 10‐year prevalence of contact allergy measured by CE‐DUR was slightly lower than previous prevalence estimates from the Glostrup allergy studies. This could probably be explained by a decrease in nickel allergy. The CE‐DUR approach holds the potential of being an efficient and easy monitoring method of contact allergy prevalence.
The epidemiology of contact allergy in the general population – prevalence and main findings
Authors: Thyssen Jacob Pontoppidan , Linneberg Allan , Menné Torkil , Johansen Jeanne Duus
Published: August 2007

A substantial number of studies have investigated the prevalence of contact allergy in the general population and in unselected subgroups of the general population. The aim of this review was to determine a median prevalence and summarize the main findings from studies on contact allergy in the general population. Published research mainly originates from North America and Western Europe. The median prevalence of contact allergy to at least 1 allergen was 21.2% (range 12.5–40.6%), and the weighted average prevalence was 19.5%, based on data collected on all age groups and all countries between 1966 and 2007. The most prevalent contact allergens were nickel, thimerosal, and fragrance mix. The median nickel allergy prevalence was 8.6% (range 0.7–27.8%) and demonstrates that nickel was an important cause of contact allergy in the general population and that it was widespread in both men and women. Numerous studies demonstrated that pierced ears were a significant risk factor for nickel allergy. Nickel was a risk factor for hand eczema in women. Finally, heavy smoking was associated with contact allergy, mostly in women. Population‐based epidemiological studies are considered a prerequisite in the surveillance of national and international contact allergy epidemics.