bluuebunny/crossref_metadata_2025 huggingface dataset:
North American Monsoon and Convectively Coupled Equatorial Waves Simulated by IPCC AR4 Coupled GCMs
Authors: Lin Jia-Lin , Mapes Brian E. , Weickmann Klaus M. , Kiladis George N. , Schubert Siegfried D. , Suarez Max J. , Bacmeister Julio T. , Lee Myong-In
Published: July 2008

This study evaluates the fidelity of North American monsoon and associated intraseasonal variability in the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4) coupled general circulation models (CGCMs). Twenty years of monthly precipitation data from each of the 22 models’ twentieth-century climate simulations, together with the available daily precipitation data from 12 of them, are analyzed and compared with Global Precipitation Climatology Project (GPCP) monthly and daily precipitation. The authors focus on the seasonal cycle and horizontal pattern of monsoon precipitation in conjunction with the two dominant convectively coupled equatorial wave modes: the eastward-propagating Madden–Julian oscillation (MJO) and the westward-propagating easterly waves.

The results show that the IPCC AR4 CGCMs have significant problems and display a wide range of skill in simulating the North American monsoon and associated intraseasonal variability. Most of the models reproduce the monsoon rainbelt, extending from southeast to northwest, and its gradual northward shift in early summer, but overestimate the precipitation over the core monsoon region throughout the seasonal cycle and fail to reproduce the monsoon retreat in the fall. Additionally, most models simulate good westward propagation of the easterly waves, but relatively poor eastward propagation of the MJO and overly weak variances for both the easterly waves and the MJO. There is a tendency for models without undiluted updrafts in their deep convection scheme to produce better MJO propagation.
Influence of Tropical Cyclones on the Estimation of Climate Variability in the Tropical Western North Pacific
Authors: Hsu Huang-Hsiung , Hung Ching-Hui , Lo An-Kai , Wu Chun-Chieh , Hung Chih-Wen
Published: July 2008

By estimating the differences between the original and tropical cyclone (TC)-removed fields derived from the 40-yr (ECMWF) Re-Analysis (ERA-40) and NCEP–NCAR 40-Year Reanalysis, this study reveals that TCs contribute significantly (exceeding 50% in certain regions) to the seasonal mean and the intraseasonal and interannual variance of the 850-hPa vorticity along the TC tracks in the tropical western North Pacific. Similar effects on the precipitation are also seen, as presented by the examples located in Taiwan. While the low-frequency, large-scale circulation produces a clustering effect on TCs, the latter, which has a large positive vorticity and tends to occur in the positive vorticity background flow, significantly enhances the strength of the positive vorticity. The contribution from TCs, which is not offset by the synoptic systems with weak negative vorticity, can therefore leave marked footprints in the climate signal and variability. This effect is not removed by long-term averaging and low-pass filtering, which are often used to retrieve the climate perturbations. This study reveals that the climate variability, as it is defined, is not contributed to merely by the low-frequency large-scale fluctuations. Instead, the TC effect has to be taken into account to understand the climate variability in the tropical western North Pacific. Subsequently, the ensemble effect of TCs, at least in the statistical sense, has to be resolved in the climate model to obtain a better simulation of the climate variability in the TC-prone region, such as the tropical western North Pacific.
Global Teleconnections in Response to a Shutdown of the Atlantic Meridional Overturning Circulation*
Authors: Wu Lixin , Li Chun , Yang Chunxue , Xie Shang-Ping
Published: July 2008

The global response to a shutdown of the Atlantic meridional overturning circulation (AMOC) is investigated by conducting a water-hosing experiment with a coupled ocean–atmosphere general circulation model. In the model, the addition of freshwater in the subpolar North Atlantic shuts off the AMOC. The intense cooling in the extratropical North Atlantic induces a widespread response over the global ocean. In the tropical Atlantic, a sea surface temperature (SST) dipole forms, with cooling north and warming on and south of the equator. This tropical dipole is most pronounced in June–December, displacing the Atlantic intertropical convergence zone southward. In the tropical Pacific, a SST dipole forms in boreal spring in response to the intensified northeast trades across Central America and triggering the development of an El Niño–like warming that peaks on the equator in boreal fall. In the extratropical North Pacific, a basinwide cooling of ∼1°C takes place, with a general westward increase in intensity.

A series of sensitivity experiments are carried out to shed light on the ocean–atmospheric processes for these global teleconnections. The results demonstrate the following: ocean dynamical adjustments are responsible for the formation of the tropical Atlantic dipole; air–sea interaction over the tropical Atlantic is key to the tropical Pacific response; extratropical teleconnection from the North Atlantic is most important for the North Pacific cooling, with the influence from the tropics being secondary; and the subtropical North Pacific cooling propagates southwestward from off Baja California to the western and central equatorial Pacific through the wind–evaporation–SST feedback.
Reproducibility of South American Precipitation due to Subtropical South Atlantic SSTs
Authors: Taschetto Andréa S. , Wainer Ilana
Published: July 2008

This work investigates the reproducibility of precipitation simulated with an atmospheric general circulation model (AGCM) forced by subtropical South Atlantic sea surface temperature (SST) anomalies. This represents an important test of the model prior to investigating the impact of SSTs on regional climate. A five-member ensemble run was performed using the National Center for Atmospheric Research (NCAR) Community Climate Model, version 3 (CCM3). The CCM3 was forced by observed monthly SST over the South Atlantic from 20° to 60°S. The SST dataset used is from the Hadley Centre covering the period of September 1949–October 2001; this covers more than 50 yr of simulation. A statistical technique is used to determine the reproducibility in the CCM3 runs and to assess potential predictability in precipitation. Empirical orthogonal function analysis is used to reconstruct the ensemble using the most reproducible forced modes in order to separate the atmospheric response to local SST forcing from its internal variability. Results for reproducibility show a seasonal dependence, with higher values during austral autumn and spring. The spatial distribution of reproducibility shows that the tropical atmosphere is dominated by the underlying SSTs while variations in the subtropical–extratropical regions are primarily driven by internal variability. As such, changes in the South Atlantic convergence zone (SACZ) region are mainly dominated by internal atmospheric variability while the ITCZ has greater external dependence, making it more predictable. The reproducibility distribution reveals increased values after the reconstruction of the ensemble.
Global Interannual Trends and Amplitude Modulations of the Sea Surface Height Anomaly from the TOPEX/Jason-1 Altimeters
Authors: Polito Paulo S. , Sato Olga T.
Published: July 2008

This study uses the global Ocean Topography Experiment (TOPEX)/Jason-1 altimeters’ time series to estimate the 13-yr trend in sea surface height anomaly. These trends are estimated at each grid point by two methods: one fits a straight line to the time series and the other is based on the difference between the average height between the two halves of the time series. In both cases the trend shows large regional variability, mostly where the intense western boundary currents turn. The authors hypothesize that the regional variability of the sea surface height trends leads to changes in the local geostrophic transport. This in turn affects the instability-related processes that generate mesoscale eddies and enhances the Rossby wave signals. This hypothesis is verified by estimates of the trend of the amplitude of the filtered sea surface height anomaly that contains the spectral bands associated with Rossby waves and mesoscale eddies. The authors found predominantly positive tendency in the amplitude of Rossby waves and eddies, which suggests that, on average, these events are becoming more energetic. In some regions, the variation in amplitude over 13 yr is comparable to the standard deviation of the data and is statistically significant according to both methods employed in this study. It is plausible that in this case, the energy is transferred from the mean currents to the waves and eddies through barotropic and baroclinic instability processes that are more pronounced in the western boundary current extension regions. If these heat storage patterns and trends are confirmed on longer time series, then it will be justified to argue that the warming trend of the last century provides the energy that amplifies both Rossby waves and mesoscale eddies.
Boreal Winter Links between the Madden–Julian Oscillation and the Arctic Oscillation
Authors: L’Heureux Michelle L. , Higgins R. Wayne
Published: July 2008

There is increasing evidence that the Madden–Julian oscillation (MJO) modifies the mid- to high-latitude circulation and, in particular, appears to have a relationship to the leading mode of extratropical variability, the Arctic Oscillation (AO). In this study, new insights into the observed similarities between the MJO and the AO are explored. It is shown that the eastward progression of the convectively active phase of the MJO is associated with a corresponding shift in the tendency and sign of the AO index. Moreover, the AO and the MJO share several analogous features not only in the global circulation, but also in surface temperature fields. Also, the AO is linked to a pattern of eastward-propagating MJO-like variability in the tropics that is partially reproduced in free runs of the NCEP Climate Forecast System (CFS) model. Finally, it is shown that the structure of the AO, as defined by the leading mode in the 1000-hPa geopotential height field, is significantly altered based on the phase of the MJO.
Design and Validation of an Offline Oceanic Tracer Transport Model for a Carbon Cycle Study
Authors: Valsala Vinu , Maksyutov Shamil , Motoyoshi Ikeda
Published: July 2008

An offline passive tracer transport model with self-operating diagnostic-mode vertical mixing and horizontal diffusion parameterizations is used with assimilated ocean currents to find the chlorofluorocarbon (CFC-11) cycle in oceans. This model was developed at the National Institute for Environmental Studies (NIES) under the carbon cycle research project inside the Greenhouse Gas Observing Satellite (GOSAT) modeling group. The model borrows offline fields from precalculated monthly archives of assimilated ocean currents, temperature, and salinity, and it evolves a prognostic passive tracer with prescribed surface forcing. The model’s performance is validated by simulating the CFC-11 cycle in the ocean starting from the preindustrial period (1938) with observed anthropogenic perturbations of atmospheric CFC-11 to comply with the Ocean Carbon-Cycle Model Intercomparison Project Phase-2 (OCMIP-2) flux protocol. The model results are compared with ship observations as well as the results of candidate models of OCMIP-2 and a performance is assessed. The model simulates the deep-ventilation processes in the Atlantic Ocean appreciably well and yields a good agreement in the column inventory of the CFC-11 amplitude and phase compared to the observation. The statistical skill test shows that this model outperforms other candidate models of OCMIP-2 because of its higher resolution and assimilated offline input feeding, and it shows a potential role in improving transport calculation in the ocean with cost-effective computation.
The Annual Peak in the SST Anomaly Spectrum
Authors: Möller Jens , Dommenget Dietmar , Semenov Vladimir A.
Published: July 2008

The manner in which monthly mean sea surface temperature anomalies (SSTAs) show enhanced variance at the annual period in the extratropics (an annual peak in the variance spectrum) is illustrated by observations and model simulations. A mechanism, related to the reemergence of winter SST anomalies, is proposed to explain the annual peak in SST spectrum. The idea is supported by the analysis of a hierarchy of models, including Intergovernmental Panel on Climate Change model simulations.

The results of the model experiments further suggest that the annual peak is either weak or absent if decadal SST variability is forced by local air–sea interaction. However, if ocean subsurface temperature variability forces decadal SST variability, the annual peak is much stronger. Strong annual peaks may therefore be seen as an indication of ocean-forced decadal SST variability in the extratropics.
Pacific Sea Surface Temperatures in the Twentieth Century: An Evolution-Centric Analysis of Variability and Trend
Authors: Guan Bin , Nigam Sumant
Published: July 2008

A consistent analysis of natural variability and secular trend in Pacific SSTs in the twentieth century is presented. By focusing on spatial and temporal recurrence, but without imposition of periodicity constraints, this single analysis discriminates between biennial, ENSO, and decadal variabilities, leading to refined evolutionary descriptions, and between these natural variability modes and secular trend, all without advance filtering (and potential aliasing) of the SST record. SST anomalies of all four seasons are analyzed together using the extended-EOF technique.

Canonical ENSO variability is encapsulated in two modes that depict the growth (east-to-west along the equator) and decay (near-simultaneous amplitude loss across the basin) phases. Another interannual mode, energetic in recent decades, is shown linked to the west-to-east SST development seen in post–climate shift ENSOs: the noncanonical ENSO mode. The mode is closely related to Chiang and Vimont’s meridional mode, and leads to some reduction in canonical ENSO’s oscillatory tendency.

Pacific decadal variability is characterized by two modes: the Pan-Pacific mode has a horseshoe structure with the closed end skirting the North American coast, and a quiescent eastern equatorial Pacific. The mode exhibits surprising connections to the tropical/subtropical Atlantic, with correlations there resembling the Atlantic multidecadal oscillation. The second decadal mode—the North Pacific mode—captures the 1976/77 climate shift and is closer to Mantua’s Pacific decadal oscillation. This analysis shows, perhaps for the first time, the striking links of the North Pacific mode to the western tropical Pacific and Indian Ocean SSTs. The physicality of both modes is assessed from correlations with the Pacific biological time series.

Finally, the secular trend is characterized: implicit accommodation of natural variability leads to a nonstationary SST trend, including midcentury cooling. The SST trend is remarkably similar to the global surface air temperature trend. Geographically, a sliver of cooling is found in the central equatorial Pacific in the midst of widespread but nonuniform warming in all basins.

An extensive suite of sensitivity tests, including counts of the number of observational analogs of the modes in test analyses, supports the robustness of this analysis.
Modeling the Hydroclimatology of Kuwait: The Role of Subcloud Evaporation in Semiarid Climates
Authors: Marcella Marc P. , Eltahir Elfatih A. B.
Published: July 2008

A new subcloud layer evaporation scheme is incorporated into Regional Climate Model, version 3 (RegCM3), to better simulate the rainfall distribution over a semiarid region around Kuwait. The new scheme represents subcloud layer evaporation of convective as well as large-scale rainfall. Model results are compared to observations from rain gauge data networks and satellites. The simulations show significant response to the incorporation of subcloud layer evaporation as a reduction by as much as 20% in annual rainfall occurs over the region. As a result, the new model simulations of annual rainfall are within 15% of observations. In addition, results indicate that the interannual variability of rainfall simulated by RegCM3 is sensitive to the specification of boundary conditions. For example, forcing RegCM3’s lateral boundary conditions with the 40-yr ECMWF Re-Analysis (ERA-40) data, instead of NCEP–NCAR’s Reanalysis Project 2 (NNRP2), reduces interannual variability by over 25%. Moreover, with subcloud layer evaporation incorporated and ERA-40 boundary conditions implemented, the model’s bias and root-mean-square error are significantly reduced. Therefore, the model’s ability to reproduce observed annual rainfall and the year-to-year variation of rainfall is greatly improved. Thus, these results elucidate the critical role of this natural process in simulating the hydroclimatology of semiarid climates. Last, a large discrepancy between observation datasets over the region is observed. It is believed that the inherent characteristics that are used to construct these datasets explain the differences observed in the annual and interannual variability of Kuwait’s rainfall.
Understanding Melt Rheology and Foamability of Polypropylene-based TPO Blends
Authors: Gunkel F. , Spörrer A.N.J. , Lim G.T. , Bangarusampath D.S. , Altstädt V.
Published: July 2008

Rubber-toughened polypropylene (PP) is an important resin for many engineering applications. Through the structural foaming of materials, material cost-saving and lightweight structures can be achieved. In this study, physical blends of PP and poly(ethylene/octene) at various compositions were characterized for their melt strength and shear viscosity. The high pressure MuCell ® foaming process was used to obtain structural foams with average cell diameters of <50 μm and cell densities of approximately 8 million cells/cm3. This study presents key understandings between material rheology and its suitability for structural foaming that are in turn linked to blend composition and melt temperature.
Study of Thermoplastic PLA Foam Extrusion
Authors: Lee S.T. , Kareko Leonard , Jun Jenny
Published: July 2008

Various PLA resins have been tried with chemical blowing agent and physical blowing agent in extrusion process to study the expansion dependency of amount of blowing agent and cell density, respectively. It has been found that a `dip' exists in both cases; foam density decreases to a minimum, then increases. It suggests competing mechanisms during foaming. Bubble growth model with surface vaporization appears inadequate in describing the counterintuitive foam density increase at increased blowing agent loading. Investigating foam rod diameter suggests premature gas separation from the polymeric melt before foaming occurred at a higher gas loading. It adversely affects foaming efficiency. Also discussed is the foam density variation during aging.
Between Constructivism and Connectedness
Authors: Gordon Mordechai
Published: July 2008

Parker Palmer is correct in his claims that good teaching depends more on the capacity for connectedness than on technique and that helping teacher candidates cultivate a strong sense of personal identity is crucial. However, to what extent are Palmer's claims compatible with the various constructivist models of learning that are now prevalent in many colleges of education? Moreover, how are the goals of Palmer's approach integrated with those of constructivism? This essay responds to these questions and negotiates between constructivism and Palmer's educational approach. First the author lays out a predominant constructivist model of teaching and learning. Next, he explores some potential limitations facing constructivism and argues that Palmer's notion of connectedness can help mitigate against some of the shortcomings of constructivism. Finally, the author examines a specific example from an English methods course that represents an attempt to integrate the virtues of Palmer's approach with those of constructivism.
Collaborative Destination Marketing
Authors: Youcheng Wang
Published: July 2008

Collaborative initiatives are voluntary arrangements between tourism organizations involved in managing and promoting destinations. In the tourism domain, although collaboration issues have been studied from various perspectives, relatively little research has been conducted on the process of collaborative marketing at the destination level. This study attempts to examine the process of collaboration formation in the context of a destination within the domain of theories of interorganizational relations. The study chooses a destination as a case of investigation with a focus on marketing activities between and among the local tourism industry facilitated by the local destination marketing organization. Implications are discussed from both theoretical and practical perspectives.
Managing Collaborative Processes
Authors: Weber Edward , Khademian Anne M.
Published: July 2008

The study of managers in collaborative efforts continues to progress. In this article, the authors investigate the efforts by managers to build and maintain collaborative processes to address complex public problems that vary by policy area (emergency management, environmental regulation, and community renewal), focus on different dimensions of the problem, are prompted by different forms of system breakdown, and generate different collaborative responses. This study investigates whether there are essential characteristics of collaborative capacity building that cut across these three cases, and it is found that the key managers in each case build collaborative problem-solving capacity by adopting a common approach comprising the same six practices.
Separating Fact From Fiction: An Examination of Deceptive Self-Presentation in Online Dating Profiles
Authors: Toma Catalina L. , Hancock Jeffrey T. , Ellison Nicole B.
Published: July 2008

This study examines self-presentation in online dating profiles using a novel cross-validation technique for establishing accuracy. Eighty online daters rated the accuracy of their online self-presentation. Information about participants' physical attributes was then collected (height, weight, and age) and compared with their online profile, revealing that deviations tended to be ubiquitous but small in magnitude. Men lied more about their height, and women lied more about their weight, with participants farther from the mean lying more. Participants' self-ratings of accuracy were significantly correlated with observed accuracy, suggesting that inaccuracies were intentional rather than self-deceptive. Overall, participants reported being the least accurate about their photographs and the most accurate about their relationship information. Deception patterns suggest that participants strategically balanced the deceptive opportunities presented by online self-presentation (e.g., the editability of profiles) with the social constraints of establishing romantic relationships (e.g., the anticipation of future interaction).
Arousal, Processing, and Risk Taking: Consequences of Intergroup Anger
Authors: Rydell Robert J. , Mackie Diane M. , Maitner Angela T. , Claypool Heather M. , Ryan Melissa J. , Smith Eliot R.
Published: July 2008

Intergroup emotions theory (IET) posits that when social categorization is salient, individuals feel the same emotions as others who share their group membership. Extensive research supporting this proposition has relied heavily on self-reports of group-based emotions. In three experiments, the authors provide converging evidence that group-based anger has subtle and less explicitly controlled consequences for information processing, using measures that do not rely on self-reported emotional experience. Specifically, the authors show that intergroup anger involves arousal (Experiment 1), reduces systematic processing of persuasive messages (Experiment 2), is moderated by group identification (Experiment 2, posttest), and compared to intergroup fear, increases risk taking (Experiment 3). These findings provide converging evidence that consistent with IET, emotions triggered by social categorization have psychologically consequential effects and are not evident solely in self-reports.
Unpaid, Reproductive, Caring Labor? The Production of Labor Power? Theoretical and Practical Implications of Terms Used for Women's Work
Authors: Quick Paddy
Published: July 2008

The terms used to describe women's household production contain implicit theoretical conceptualizations of this work that are often problematic, but may have rhetorical power.
Review Paper: Chitosan Derivatives as Promising Materials for Controlled Drug Delivery
Authors: Prabaharan Mani
Published: July 2008

Chitosan, a natural based-polymer obtained by alkaline deacetylation of chitin, is nontoxic, biocompatible, and biodegradable. These properties make chitosan a good candidate for the development of conventional and novel drug delivery systems. Chitosan has been found to be used as a support material for gene delivery, cell culture, and tissue engineering. However, practical use of chitosan has been mainly confined to the unmodified forms. For a breakthrough in utilization, especially in the field of controlled drug delivery, graft copolymerization onto chitosan will be a key point, which will introduce desired properties and enlarge the field of the potential applications of chitosan by choosing various types of side chains. Chemical modification of chitosan is useful for the association of bioactive molecules to polymer and controlling the drug release profile. This paper reviews the various methods of preparation of chitosan derivatives intended for controlled drug delivery. From the studies reviewed it is concluded that chitosan derivatives are promising materials for controlled drug and nonviral gene delivery.
How Child Protection Workers Support or Further Victimize Battered Mothers
Authors: Johnson Susan P. , Sullivan Cris M.
Published: July 2008

This study explored battered mothers' perceptions of their interactions with child protectiv services (CPS) workers to increase understanding about how child welfare workers and pol cies can have negative as well as positive impacts on women's and children's lives. Th research was guided by two feminist frameworks: structured action theory and social entrap ment theory. Twenty women participated in the in-depth, qualitative interviews. Most felt mi understood and unsupported by their CPS workers and thought that this treatment directl harmed them and their children. Many batterers manipulated caseworkers and escaped sanc tions, which contributed to negative consequences. Some women received helpful response from their caseworkers and viewed such support as invaluable. Implications for social wor practice are discussed.
Nonsuicidal Self-Injury Among Nonclinical College Women
Authors: Kokaliari Efrosini , Berzoff Joan
Published: July 2008

This article presents a qualitative study that explored nonsuicidal self-injury among relatively psychologically healthy college women. It examines the phenomenon of self-injury through a social theoretical perspective using Foucault's concepts. Key arguments are that self-injury in women may be a reaction to an insidious form of social control and a reflection of the social pressures for productivity that are enacted on the body. Self-injury may regulate socially unacceptable affects and modify states of the ego so that women can regain their capacity to produce within a competitive and capitalist society. Implications for social work practice are discussed.
Portrait of a Pioneer
Authors: Moosa-Mitha Mehmoona , Ross-Sheriff Fariyal
Published: July 2008

Lena Dominelli is a scholar, social justice activist, and public intellectual. A pioneer in the field, she has long put social work under the microscope, revealing its gaps and contributions. In her work she analyzes the complex nature of the interrelationships among various social structures, including social work, which result in social injustices. Always inclusive of the distinctive voices of other scholars and activists, she also aims to make social workers effective participants in eliminating injustices in society. Her presence leaves an indelible mark on the profession.
Activist Formation in the Neoliberal Era
Authors: Curry-Stevens Ann , Lee Christine , Datta Julie , Hill Emily , Edwards Virginia
Published: July 2008

In one Canadian feminist classroom, four students with diverse social locations share their journey toward an engaged activist practice, moving through internal challenges and external barriers and assisted by the feminist activist classroom. Features of these transformational practices are identified as the instructor works with students to identify core features of this experience that are helpful in catalyzing and supporting these transitions.
Harnessing Social Enterprise for Local Public Services
Authors: Simmons Richard
Published: July 2008

The government's public service reform policy emphasizes the collaboration of local authorities with a network of other agencies in the locality, either through contracts or through partnership arrangements. Strong encouragement is currently being given to the involvement of `third sector' organizations (including social enterprises) in such partnering arrangements. This environment has opened up new opportunities for social enterprises. However, as the Department for Trade and Industry (DTI) has asserted in relation to social enterprise, `rhetoric rather than a robust evidence base continues to inform many arguments for its growth and support' (DTI, 2003a: 49). This article examines one of the most widespread examples of social enterprise in the provision of public services: `new leisure trusts'. It asks whether the combination of entrepreneurial skills and social purpose in social enterprises such as new leisure trusts provides a useful model upon which public service partnerships could be based. Findings show that these social enterprises can work to create synergy through improved input/output ratios, commitment to meeting social objectives and wider stakeholder involvement. However, there are issues of `incentivization' and relative autonomy that must be resolved within such partnerships, and more work needs to be done in some cases to build genuine social inclusion.
The Report of the 21st Century Social Work Review
Authors: Watson David , West Janice
Published: July 2008

Social Work Services in Scotland have recently undergone a major review of its purpose and function. The Review's conclusion was that cultural transformation was required if social work provision was to meet the needs of those receiving and providing the service in the 21st century. Central to this change process is that it would not be driven from the top down but involve all stakeholders, including service users and front-line providers. This article explores the early indications in relation to this more democratic approach to change. It considers three key areas: leadership, front-line involvement and performance measurement that are arguably central to the successful implementation of this Review. These areas are considered from the perspective of adopting a more inclusive approach to the transformation of the service. The conclusion of the article is that the ability to challenge traditional top down approaches to change is a problematic activity. Even at the early stage of the policy's implementation, top down methods of change have already started to reassert themselves.
The Risk of Cancer Progression in Women With Gynecological Malignancies and Thrombophilic Polymorphisms: A Pilot Case-Control Study
Authors: Tormene Daniela , Beltramello Paola , Perlati Marica , Brandolin Barbara , Barbar Sofia , De Toffoli Giuseppe , Simioni Paolo
Published: July 2008

Cancer produces a hypercoagulable state, which might lead to thrombosis, and on contrary, unprovoked venous thromboembolism might be the manifestation of an occult cancer. In this pilot case-control study, we assessed the risk of gynecological malignant diseases related to the presence of the factor V Leiden and prothrombin G20210A polymorphisms. Fifty-two women underwent an operation for gynecological malignancy and were enrolled in the study. Women who underwent an operation for gynecological nonmalignant disease in the same days of cases were considered as controls. The presence of factor V Leiden and prothrombin G20210A was assessed in case and control groups. In all, 7 out of 52 cases were carriers of the 2 polymorphisms compared with 20 out of 198 controls (odds ratio = 1.3; 95% confidence interval, 0.6-3.0). The results were also similar when the risk was considered separately for the site of cancer. As for advanced and metastatic malignancies, the odds ratios were 2.3 (95% confidence interval, 0.9-6.0) and 3.3 (95% confidence interval, 1.0-11), respectively, compared to noncancer patients. When these 2 groups were compared to nonadvanced cancer group, the odds ratios for carriers of polymorphisms were 2.7 (95%confidence interval, 0.7-11.0) and 3.9 (95%confidence interval, 0.8-18.6) for advanced cancer and metastatic malignancies, respectively. Women with factor V Leiden or prothrombin G20210A polymorphisms who developed gynecological malignancy might present with a higher stage of cancer at the time of surgery. Larger case-control studies in similar cohort of patients are needed to confirm these findings.
The Relation Between Cytokines, Soluble Endothelial Protein C Receptor, and Factor VIII Levels in Turkish Pediatric Stroke Patients
Authors: Yürürer Denizay , Teber Serap , Deda Gülhis , Egin Yonca , Akar Nejat
Published: July 2008

The aim of the authors is to examine the relationship between the cytokine levels that are thought to be involved in stroke etiopathogenesis (tumor necrosis factor [TNF]-α, interleukin [IL]-2, IL-6, IL-8, IL-11), soluble protein C receptor (sEPCR), and factor VIII (FVIII) levels. The study included 27 patients with stroke and 30 healthy controls, aged 0 to 18. In the comparison of the sEPCR, cytokine, and FVIII levels between patient and control groups, median levels of TNF-α, IL-2, IL-6, and IL-8 are found to be high in the patient group when compared with controls, whereas there is no difference in sEPCR, IL-11, and FVIII levels. In the patient group, a positive correlation is seen between TNF-α levels and IL-2 and IL-6 levels, between IL-2 and IL-6 levels, and between IL-6 and IL-8 levels, whereas a negative relationship is seen between sEPCR and FVIII. In the control group apart from the patient group, a negative relationship is seen between TNF-α and FVIII, whereas there is a positive relationship between IL-11 and sEPCR levels. Median sEPCR levels in patients who have normal or low FVIII levels are significantly high when compared with those with high FVIII levels. In conclusion, in the pediatric population, an increase in TNF-α, IL-2, IL-6, and IL-8 levels is seen. Also, an inverse relationship of sEPCR and FVIII levels is shown for the first time. This study provides a basis for ongoing studies that aim to clarify stroke etiopathogenesis. Studies with larger series of patients are warranted to confirm this hypothesis.
The Effectiveness of a Peer-Led HIV/AIDS and STI Health Education Intervention for Prison Inmates in South Africa
Authors: Sifunda Sibusiso , Reddy Priscilla S. , Braithwaite Ronald , Stephens Torrence , Bhengu Sibusisiwe , Ruiter Rob A. C. , van den Borne Bart
Published: July 2008

This article reports on the effectiveness of the first systematically developed health education intervention for the reduction of risky sexual behavior among soon-to-be-released prisoners in South Africa. Data from three out of four prisons are eligible for data analysis including 263 inmates. Using a nested experimental design, short-term evaluation while inmates were still in prison demonstrate that experimental groups showed higher knowledge of sexually transmitted infections and had a more positive intention to reduce risky behavior than the control group in two out of three prisons. Long-term assessment 3 to 6 months after release from prison indicates that experimental groups were more positive about sexual communication, self-efficacy, and intention. Groups educated by an HIV-negative educator perform marginally better than those in groups with an HIV-positive peer educator. It is argued that peer-led health education programs may be effective in reducing risky behavior amongst soon-to-be-released inmates.
Differential Effects of a Tier Two Behavior Intervention Based on Function of Problem Behavior
Authors: McIntosh Kent , Campbell Amy L. , Carter Deborah Russell , Rossetto Dickey Celeste
Published: July 2008

The purpose of this study was to investigate the effectiveness of a tier two daily behavior card intervention and differential effects based on function of problem behavior. The participants were 36 elementary school students nominated for additional intervention beyond universal School-Wide Positive Behavior Support. Measures included standardized behavior rating scales and rate of office discipline referrals before and after 8 weeks of intervention. A multivariate analysis of variance was used, and results showed statistically significant differences in response to intervention based on teacher-identified function of problem behavior. Results are discussed in terms of considering function of behavior in selecting tier two interventions and implementing a three-tier response to intervention model.
The role of percutaneous revascularization for renal artery stenosis
Authors: Dubel Gregory J , Murphy Timothy P
Published: July 2008

Abstract

Renal artery stenosis (RAS) is usually caused by atherosclerosis or fibromuscular dysplasia. RAS leads to activation of the renin-angiotensin-aldosterone system and may result in hypertension, ischemic nephropathy, left ventricular hypertrophy and congestive heart failure. Management options include medical therapy and revascularization procedures. Recent studies have shown angiotensin receptor blockers (ARB) and angiotensin converting enzyme inhibitors (ACE-I) to be highly effective in treating the hypertension associated with RAS and in reducing cardiovascular events; however, they do not correct the underlying RAS and loss of renal mass may continue. Renal artery angioplasty was first performed by Gruntzig in 1978. The routine use of stents has increased technical success rates compared with angioplasty, and surgery is now only rarely performed. Although numerous case series claimed benefit in terms of blood pressure control, no adequately powered randomized, controlled, prospective study of renal artery interventions has reported their effect on cardiovascular morbidity or mortality. The CORAL trial, an ongoing study of renal artery stent placement and optimal medical therapy (OMT) funded by the National Institutes of Health, is the first study to attempt to do so. Until the CORAL trial results are in, physicians will continue to be faced with difficult choices when determining the optimal management for RAS patients and deciding which, if any, patients should be offered revascularization.
Characterization of the brachial artery shear stress following walking exercise
Authors: Padilla Jaume , Harris Ryan A , Rink Lawrence D , Wallace Janet P
Published: July 2008

Abstract

Habitual exercise provides repeated episodes of elevated vascular shear stress (SS), which may be a mechanism for repair of endothelial dysfunction in disease. Our aim was to determine the brachial artery SS during the 3–hour period following single bouts of low, moderate, and high-intensity walking exercise. In a randomized crossover design, 14 men walked for 45 minutes on a treadmill at 25%, 50% and 75% of VO2peak separated by 2–7 days. Using Doppler ultrasonography, brachial artery SS was assessed immediately after exercise and then hourly for 3 hours. High-intensity walking elicited greater ( p < 0.05) post-exercise SS compared with low and moderate intensity. In addition, a 3 x 4 (intensity x time) ANOVA indicated an absence of interaction ( p = 0.369) and a decline in post-exercise SS over time ( p < 0.0001) which was abolished after 2 hours. Thus, we found that brachial artery SS is greatest following high-intensity walking and that the rate of decline in SS is similar across all walking intensities.
Sublingual administration of warfarin: a novel form of delivery
Authors: Batke-Hastings Susan , Carman Teresa L
Published: July 2008

Abstract

Current therapy for venous thromboembolism (VTE) includes the initiation of short acting parenteral agents, heparin, low-molecular-weight heparin, or fondaparinux, with subsequent conversion to oral warfarin therapy for the duration of anticoagulation. We present two patients who required long-term anticoagulation for VTE but because of gastrointestinal dysmotility issues were unable to use standard oral anticoagulation. Warfarin is water soluble and absorbed across the epithelium; therefore, we elected to administer warfarin sublingually in an effort to avoid the dysmotility issues while trying to achieve therapeutic anticoagulation. Using sublingual warfarin dosing we were able to achieve therapeutic anticoagulation without complications. Both patients required approximately 6 days to achieve a therapeutic International Normalized Ratio (INR). Neither patient reported adverse side effects related to the sublingual dosing. This unique form of warfarin delivery may be considered for patients with gastrointestinal dysmotility or other gastrointestinal issues which prevent oral use of medications.
Gene and stem cell therapy in peripheral arterial occlusive disease
Authors: Kalka C , Baumgartner Iris
Published: July 2008

Abstract

Peripheral arterial occlusive disease (PAOD) is a manifestation of systemic atherosclerosis strongly associated with a high risk of cardiovascular morbidity and mortality. In a considerable proportion of patients with PAOD, revascularization either by endovascular means or by open surgery combined with best possible risk factor modification does not achieve limb salvage or relief of ischaemic rest pain. As a consequence, novel therapeutic strategies have been developed over the last two decades aiming to promote neovascularization and remodelling of collaterals. Gene and stem cell therapy are the main directions for clinical investigation concepts. For both, preclinical studies have shown promising results using a wide variety of genes encoding for growth factors and populations of adult stem cells, respectively. As a consequence, clinical trials have been performed applying gene and stem cell-based concepts. However, it has become apparent that a straightforward translation into humans is not possible. While several trials reported relief of symptoms and functional improvement, other trials did not confirm this early promise of efficacy. Ongoing clinical trials with an improved study design are needed to conﬁrm the potential that gene and cell therapy may have and to prevent the gaps in our scientific knowledge that will jeopardize the establishment of angiogenic therapy as an additional medical treatment of PAOD. This review summarizes the experimental background and presents the current status of clinical applications and future perspectives of the therapeutic use of gene and cell therapy strategies for PAOD.
Rapid Assessment of Access to Primary Care in Remote Parts of the Developing World
Authors: Baker Jonathan B. , Bazemore Andrew W. , Jacobson C. Jeffrey
Published: July 2008

Physical access to primary care is poorly understood in most remote and underserved populations, although technology exists that can quickly help bridge this information gap. To improve health care delivery in these regions, it is essential to understand the factors that enable or inhibit health care use. One key factor is that of distance from residence to health facility. Assessment of the effect distance has on health facility use provides a clearer picture of how access can be attained. This article focuses on understanding the geographic character of access to care and the expediency of data collection using global positioning system technology. It shows how to quantify geographic access for a given health facility. This procedure can be performed within a relatively short period of time with the assistance of modern technology and some knowledge of geographic techniques.
Elderspeak Communication: Impact on Dementia Care
Authors: Williams Kristine N. , Herman Ruth , Gajewski Byron , Wilson Kristel
Published: July 2008

Resistiveness to care is common in older adults with dementia. Resistiveness to care disrupts nursing care, increasing costs of care by 30%. Elderspeak (infantilizing communication used by nursing staff) may trigger resistiveness to care in individuals with dementia. Videotaped care episodes (n = 80) of nursing home residents with dementia (n = 20) were coded for type of staff communication (normal talk and elderspeak) and subsequent resident behavior (cooperative or resistive to care). Bayesian statistical analysis tested relationships between staff communication and subsequent resident resistiveness to care. The probability of resistiveness to care varied significantly with communication (Bayes P = .0082). An increased probability of resistiveness to care occurred with elderspeak (.55, 95% CrI, .44-.66), compared with normal talk (.26, 95% CrI, .12-.44). Communication training has been shown to reduce elderspeak and may reduce resistiveness to care in future research.
Which Presidents Are Most Memorable?
Authors: Devi Gayatri , Zhivotovskaya Emiliya , Schultz Sarah
Published: July 2008

Background/rationale. Episodic memory loss is a hall-mark of Alzheimer’s disease (AD), with recall of recent events becoming progressively difficult. A commonly used tool, the recollection of US presidents, was assessed in evaluating episodic versus semantic memory loss among AD patients compared with spouse controls.

Methods. A total of 36 patients (12 men, 24 women) with possible or probable AD were asked to “give the names of 5 US presidents” and concurrently administered the Mini-Mental State Examination (MMSE). Twenty-three spouses (12 men, 11 women) were controls. The year 1980 demarcated “remote” versus “recent” presidents.

Results. Patients were older, had lower MMSE scores ( P < .001), and recalled fewer presidents than controls ( P < .005), after controlling for age. Among patients, men were more educated than women ( P < .05) and recalled more presidents ( P < .001). No gender differences were observed in controls.

Conclusions. Patients with AD preferentially recalled remote presidents, supporting retention of semantic memory in this group. There were no gender differences between groups.
Review: Caffeine: Neuroprotective Functions in Cognition and Alzheimer's Disease
Authors: Rosso Andi , Mossey Jana , Lippa Carol F.
Published: July 2008

Alzheimer's disease is a common problem in our elderly population. Although research is leading to improvements in our understanding of the underlying biology, we still have little understanding of the environmental risk factors associated with this disorder. Caffeine, an easily modifiable environmental factor, may have a protective effect on the likelihood of developing Alzheimer's disease. This article reviews the association between caffeine from both a biologic and epidemiologic perspective. Further studies are needed to determine whether caffeine consumption could have a major affect on the development of Alzheimer's disease or age-related cognitive decline.