bluuebunny/crossref_metadata_2025 huggingface dataset:
Accounting for the Value Generated from Innovation
Authors: Rapley Keith
Published: May 2004

Successful Knowledge Management programmes can demonstrate clearly defined links to the value proposition ‐ its bottom line being a contribution to business benefits. This is apparent at British Airways where a programme of external intelligence about information technology (IT) developments is being converted into useful IT applications. This paper explains British Airways’ approach to innovation and examines the difficulty in assigning a specific measure to this intangible asset. It also sets out ways in which innovation can produce improvements in business performance.
Corporate Social Reporting: Emerging Trends in Accountability and the Social Contract
Authors: Gray Rob , Owen Dave , Maunders Keith
Published: May 2004

The article suggests that discord in Corporate Social Reporting (CSR) can be related to differing assumptions about (a) society, and (b) the role of CSR in the society/organisation relationship. It is then argued that, with this perspective, the major trends in CSR can be seen to be built around differing views of the world and that recent major developments in the subject focus upon the concepts of accountability and the social contract.
Research in Public Sector Accounting: An Appraisal
Authors: Lapsley Irvine
Published: May 2004

An overview of recent research in finance, financial accounting and accountability, internal accounting and management information systems and audit in the public sector. To date, most such research activity has focused on financial accounting and accountability. Nevertheless, there are still unresolved issues in this area. This article also highlights distinctive aspects of other areas of public sector accounting, including current developments and areas of neglect. One notable development is the application of current research methodologies in management accounting to the internal accounting of public sector institutions. A major area of neglect by public sector accounting researchers is that of the financing of public sector institutions.
Reliability and Validity in Field Research: Some Strategies and Tactics
Authors: McKinnon Jill
Published: May 2004

This article is concerned with issues of validity and reliability in field research. It examines the nature of, and threats to validity and reliability in field studies and documents some strategies and tactics that may be employed to counter those threats. At a time when field research is becoming an increasingly important and necessary method for more accounting researchers, it is hoped that an article such as this may provide useful reference for the conduct, communication and evaluation of field research in accounting.
The Struggle Over Meaning in Accounting and Corporate Research: A Comparative Evaluation of Conservative and Critical Historiography
Authors: Tinker Tony , Neimark Marilyn
Published: May 2004

This article examines the construction of systems of meaning at two levels: the writing of the history of the corporation; and the role of annual reports in constructing a system of meaning about the experiences of individual corporations.We argue that the transaction cost explanation of corporate history, which stresses the formative roles of technological and market forces, and management's quest for efficiency, serves to legitimate the modern corporate form and oligopolistic market structures. We provide an alternative, critical framework, which emphasises the importance of conflict over the distribution of income and wealth to our understanding of the emergence of modern corporate structures, strategies and accounting information systems.This alternative approach is illustrated through the history of General Motors' (GM) relations with the US State. The annual reports of the company are used as the primary, although not exclusive, source of data. We show that these documents represent history and current events in a partisan manner that makes them weapons in distributional conflicts.
Perspectives on Accounting Systems and Human Behaviour
Authors: Ferris Kenneth R. , Haskins Mark E.
Published: May 2004

The extant literature with regard to the impact of accounting systems on human behaviour is described. How accounting systems, the components of such systems and the information produced by such systems induce both intended and unintended behavioural outcomes is focused on.
Accounting in its Social Context: An Analysis of the Accounting Systems of the Church of England
Authors: Laughlin Richard C.
Published: May 2004

Accounting systems find their meaning and nature in the historical and social context of the organisations of which they are part. These social and technical aspects are amplified and their interrelationships traced through a specific study of the accounting systems in the Church of England. Although many of the insights are situation specific to this institution, some more general points are raised.
Interpretive Sociology and Management Accounting Research — A Critical Review
Authors: Fong Chua Wai
Published: May 2004

Management accounting researchers have borrowed eclectically from interpretive sociology. Such borrowing has been associated with ethnographic studies of accounting in action in particular organisational contexts. However, the eclectic nature of the borrowing has also resulted in little theory development and inconsistent arguments. Deeper theoretical and empirical analysis is required in order that testable, “universal” relationships about management accounting processes may be developed and investigated in the future.
Development and the environment: an introduction
Authors: Perman Roger , Anand P.B.
Published: May 2004

This paper has two objectives. First, it investigates some conceptual linkages between the sub‐disciplines of development economics and environmental economics. We find common methodological orientations, and shared interests in growth processes, resources and sustainability, international trade, market mechanisms and market failure, institutions, and co‐operative international behaviour. Second, it introduces the other papers that appear in this special issue, and sets them within the context of the common orientations and themes that have been identified here. Finally, we offer some recommendations for the design of syllabuses in the field of development and environmental economics.
Sustainability, growth and development
Authors: Perrings Charles , Ansuategi Alberto
Published: May 2004

The Brundtland Report (WCED, 1987) encouraged the view that the main threats to the environmental sustainability of development are poverty‐driven depletion of environmental resources in the developing world, and consumption‐driven pollution of the biosphere by the developed world. Recent work on the empirical relationship between per capita GDP growth and certain indicators of environmental quality seems to contradict this view. Some indicators of local air and water quality first worsen and then improve asper capitaincomes rise. This paper reconsiders both these findings, and the empirical relation between environmental quality and measures of poverty, consumption and human development. It finds that deepening poverty at one end of the scale and increasing affluence at the other both have implications for the environment. But these implications are different. Deepening poverty is associated with environmental effects that tend to have immediate and local implications for the health and welfare of the communities concerned. Increasing affluence is associated with environmental effects which are much more widespread and much longer‐lasting. The environmental consequences of growth increasingly tend to be displaced on to others – either geographically distant members of the present generation or members of future generations. The paper argues that the relevant question is not whether economic growth has environmental consequences: it is whether those consequences threaten the resilience of the ecological systems on which economic activities depend. Since loss of ecological resilience implies that the economic activities concerned are environmentally unsustainable, it should be a major focus of strategies for sustainable development.
Biodiversity, trade and international agreements
Authors: Barbier Edward B.
Published: May 2004

The global market failure problem of international biodiversity loss can be mitigated through the use of trade interventions or by the creation of new international markets and institutions for the global environmental benefits generated by the biodiversity conserved by host countries. However, it may be difficult to reach a mutually agreed “trade for nature” deal when the biodiversity in the host country is threatened mainly by habitat conversion. On the other hand, if the threat is from over‐exploitation, unilateral trade interventions by the recipient countries are also likely. Although there may be strong incentives for the latter countries to negotiate an international biodiversity agreement, if such incentives exist, then these countries may act unilaterally to compensate host countries for their conservation efforts. Rich countries therefore need convincing that they are likely to gain from reducing global biodiversity loss.
Public policy and technological change in Africa
Authors: Clark Norman
Published: May 2004

This paper explores the notion of “capacity building” from the standpoint of the technological expertise needed for sustainable development policy analysis and execution. It argues that this definition is probably at the root of the concept since it captures the fundamental creativity of an economic system while at the same time mapping on other definitions of “capacity”. After defining it more completely in terms of “technological capability” the paper couches its analysis in the more general context of knowledge, its pursuit, validation, dissemination and use. In turn this suggests that conventional institutional structures, such as those normally associated with tertiary education, are probably ill suited on their own to play the necessary transformational role needed by many African countries. This is especially so in the complex field of environmental policy. The paper ends by making a number of suggestions on alternative modes illustrated by a programme currently in operation in East and Southern Africa.
Untying the knots of international environmental agreements
Authors: Clunies Ross Anthony
Published: May 2004

Curbing (without banning) potentially environmentally‐damaging activities that have global, rather than local, effects raises challenges analogous to those faced by a community lacking legislative powers that has to restrict access to a common pasture in order to make its use sustainable. A local community achieves autonomy in a matter such as this by consensual cooperation. In the absence of a world coercive authority, global environmental problems (in which a measure of world autonomy is needed) have to be met similarly by consensual co‐operation among governments. The conditions under which local consensual cooperation have been observed to be successful may also be relevant to global consensual cooperation. In particular there must be clear rules, and devices for interpreting them; they must be acceptable to all parties; and monitoring of compliance is crucial. Even in such cases of quasi‐voluntary compliance, graduated sanctions for infringement, or analogous arrangements, are quite likely to play a vital part. In an international regime for reducing greenhouse‐gas emissions, it is essential that rules should be devised that will appeal as fair and practically tolerable to opinion in both rich and poor countries and to both high and low per capita emitters. This will rule out a regime of uniform percentage reductions without balancing compensation. It will also rule out a regime based on equal per capita claims to engage in the restricted activity. It is desirable that the rules also act to make the allocation of the reductions in the potentially damaging activity efficient. This will favour rules under which financial signals reflecting marginal costs or benefits play some part in the allocation of any target aggregates. It will probably be essential, given prevalent views of justice and differing valuations of environmental goals between rich and poor nations, that the arrangements involve transfers of resources from richer, higher‐per‐capita polluting countries to poorer, lower per capita polluting countries. Nevertheless, reducing emissions sufficiently through a system of tradable quotas summing to the targeted total of emissions – which might seem to meet both this requirement and the need for efficient marginal incentives – has, in its simple form in which the quotas issued are proportional to countries’ populations, little chance of being acceptable to rich, high‐emitter nations. An attempt is made to explore solutions to these dilemmas, leading on from the arrangements made under the Kyoto protocol of the UN Framework Convention on Climate Change.
Economic dimensions of technological and global responses to the Kyoto protocol
Authors: Grubb Michael
Published: May 2004

This paper examines economic aspects of the Kyoto protocol on climate change, focusing on the protocol’s longer‐term impact and possible global evolution. Specifically, the analysis considers the economics of likely technological responses to the protocol and the implication of international dissemination of technologies and institutional practices, including the wider future development of policies and commitments. It is argued that these factors, in tandem with the protocol’s provisions on the clean development mechanism, technology transfer, and the structure of rolling commitment periods, mean that the protocol offers an effective basis for long‐term solutions to the problem of climate change.
Some reflections on project economics and environmental issues
Authors: Weiss John
Published: May 2004

This paper discusses briefly some of the outstanding theoretical and operational issues relating to the application of environmental economics to the appraisal of projects. Section 1 considers whether it is necessary to take a global as opposed to a national focus in project work and considers some of the implications of this perspective. Section 2 addresses the difficulty of valuing diverse environmental effects in monetary terms. Section 3 introduces the problem of time and notes the recent debates on the link between discounting and the environment. Finally section 4 discusses recent attempts to deal with problems of human health in project work.
The Nordic Electronic Research Library in different dimensions
Authors: Klara Hannesdóttir Sigrún
Published: May 2004

Abstract: The Nordic Electronic Research Library is a concept which NORDINFO, the Nordic Council for Scientific Information, will use as an umbrella for its activities during the coming years. The concept is based on national developments within the research library sector in each of the five Nordic countries, Denmark, Finland, Iceland, Norway and Sweden. The goals of the Nordic Electronic Research Library are built on national goals, which in general terms are to make scientific and technical information easily available in all the Nordic region, independent of subject area, publication form and location of the user. This paper explores briefly the developments of the electronic research library in the Nordic region and how the concept is carried out. NORDINFO provides grants and project money to support coordination and cooperation within the field and the question is raised as to how NORDINFO can assist this development and increase cooperative efforts.
Library software in use in southern Africa: a comparative analysis of search engines, database fine‐tuning and maintenance tools
Authors: Adeniran Olatunde R.
Published: May 2004

Our survey of 728 questionnaires covered all types of libraries in the following countries: Botswana, Lesotho, Mozambique, Namibia, South Africa, Swaziland and Zimbabwe. At the end of April 1997, this study identified 29 software packages from 22 per cent useable survey returns. The first set of off‐the‐shelf packages in the region has come a long way since 1982, when Musiker identified one or two such packages.
What do employers expect? The educating systems librarian research project 1
Authors: Xu Hong , Chen Hsin‐liang
Published: May 2004

An investigation of 133 job advertisements for systems librarians in American Libraries in 1996‐1997 was conducted to examine the increasingly important role that systems librarians play in the ever‐changing information environment, and to identify the knowledge, skills and qualifications of systems librarians expected by employers in various types of libraries. The results show that although systems librarians in different types of libraries may play different roles and have different emphases in their duties, the responsibility and knowledge requirements for them are generally expanding. Systems librarians are not only technology experts but also managers and coordinators. Positions for systems librarians in most academic and public libraries require at least one year of work experience. Employers expect systems librarians to have a strong computer and network background. Over two‐thirds of the position in public and academic libraries and more than half of the openings in other libraries require MLIS/MLS degrees.
Leading the field: the role of the information professional in the next century
Authors: Marfleet Jackie , Kelly Catherine
Published: May 2004

Considers the role of the information professional in the next century in addition to informational retrieval skills. Covers the need to develop the role as trainer and facilitator of information retrieval. Identifies the need to be able to adapt to change, work closely with IT specialists and specialize in the subject of their industry.
Analysing foreign market entry – The choice between greenfield investment and acquisitions
Authors: Görg Holger
Published: May 2004

This paper formalises the choice a firm has to face when entering a foreign market via FDI as between setting up an entirely new plant (greenfield investment) or acquiring an existing indigenous firm. We assume the existence of an asymmetric duopoly in the host country, and these duopolists face the entry of a technologically advanced foreign firm in the market. The analysis shows how different constellations of entry costs and the post‐entry competition affect the foreign firm’s entry mode choice. Simulation results show that the foreign entrant will in most cases be best off by acquiring an existing indigenous high‐technology firm, thus, forming a duopoly with an indigenous low‐technology firm. We also discuss briefly the strategic dimension to the model, where the foreign firm has the possibility of crowding out the indigenous incumbents through lowering the price.
XML: how it will be applied to digital library systems
Authors: Kim Hyun‐Hee , Choi Chang‐Seok
Published: May 2004

The purpose of this paper is to show how XML is applied to digital library systems. For a better understanding of XML, the major features of XML are reviewed and compared with those of HTML. An experimental XML‐based metadata retrieval system, which is designed as a subsystem of the Korean Virtual Library and Information System (VINIS) is demonstrated. The metadata retrieval system consists of two modules: a retrieval module and a browsing module. The retrieval module allows the retrieval of metadata stored in Microsoft Access files and the display of search results in an XML file format, while the browse module permits browsing of metadata in XML/XSL document formats. Finally, some issues for a more efficient application of XML to digital libraries are discussed.
The UK children’s publishing house – adapting to change for the multimedia market
Authors: Anthoney Audrey , Royle Josephine M. , Johnson Ian M.
Published: May 2004

Reports the results of the first stage of research (in progress, 1997‐2000), which aims to develop an understanding of the challenges facing publishers who have entered the children’s multimedia market in the UK in the 1980s and 1990s. The findings of the first stage of the research amongst established UK publishers producing multimedia for children are described. These point to a number of factors that appear to be critical to the success of publishers in the multimedia market: modification of corporate culture, internal structures and processes; branding of the company’s chosen multimedia identity; focusing on the added value element of multimedia products; promotion of organisational learning, innovation and creativity within the company; and sourcing necessary skills effectively. A second study will examine the perceptions of new media companies which have entered this market.
Agency costs and corporate control devices in the Turkish manufacturing industry
Authors: Uĝurlu Mine
Published: May 2004

Documents evidence on the interdependence between the mechanisms used to control the agency costs in Turkish manufacturing firms where the external control devices are restricted and most of the firms have concentrated ownership. The ownership concentration, board size and composition, managerial shareholdings, institutional shareholdings, and family shareholdings are the selected devices. Evidence reveals that the proportion of insiders on the board is positively related to the percentage of family shareholdings and negatively related to the percentage of foreign institutional shareholdings and ownership concentration. Board size shows a significant negative relation with all the control mechanisms except the debt ratio. The finding that the managerially controlled firms have lower debt ratio than the institutionally controlled firms and the family controlled firms supports the entrenchment hypothesis. The capital market seems to complement the institutional shareholdings, family shareholdings, and ownership concentration in monitoring the CEOs.
Enterprise knowledge portals: two projects in the United States Department of the Navy
Authors: Reneker Maxine H. , Buntzen Joan L.
Published: May 2004

Two projects in the US Department of the Navy to develop enterprise portals for facilitating knowledge discovery and dissemination are discussed. The authors describe efforts within a global organization to capitalize on current knowledge management concepts and technologies for knowledge access and sharing in order to provide users with more personalized, responsive, and integrated information systems. The Next Generation Library supports knowledge management and networking objectives, as well as providing high‐quality content access at the desktop. The Naval Postgraduate School Knowledge Portal, still under development, is designed to link internal administrative databases with current message traffic and external scholarly information resources.
The Hundred Years War started today: an exploration of electronic peer review
Authors: Peters John
Published: May 2004

Discusses electronic peer review of academic papers on the Internet. Looks at the changes which may occur with the shift from paper to electronic media. Proposes some guidelines for authors, editors and reviewers using electronic publishing.
Design of an Internet‐based system for remote Dutch auctions
Authors: Rockoff Todd E. , Groves Michael
Published: May 2004

Outlines the principle of the Dutch auction, whereby the price begins at a high level and decreases by steps until a bid is made. Describes an integrated hardware and software system which uses Internet communications to enable remotely created bidders to participate in real‐time Dutch auctions and which meets the stringent requirement that synchrony be maintained among bidders’ terminals to ensure that each bidder has a fair chance to bid at the current offer price. Defines the principal functions of the system and characterizes its available resources. Illustrates implementation using a prototype design. Pays particular attention to bidder terminal synchronization, bidder authentication, and auction client security. Includes the possibility of a system variant using ISDN interconnect and PC‐based bidders’ terminals.
ALIBI: a novel approach to resource discovery
Authors: Flater David , Yesha Yelena
Published: May 2004

Provides a new answer to the resource discovery problem, which arises because although the Internet makes it possible for users to retrieve enormous amounts of information, it provides insufficient support for locating the specific information that is needed. ALIBI (Adaptive Location of Internetworked Bases of Information) is a new tool that succeeds in locating information without the use of centralized resource catalogs, navigation, or costly searching. Its powerful query‐based interface eliminates the need for the user to connect to one network site after another to find information or to wrestle with overloaded centralized catalogs and archives. This functionality was made possible by an assortment of significant new algorithms and techniques, including classification‐based query routing, fully distributed cooperative caching, and a query language that combines the practicality of Boolean logic with the expressive power of text retrieval. The resulting information system is capable of providing fully automatic resource discovery and retrieval access to a limitless variety of information bases.
A Large‐Scale Dynamic Multi‐Regional Cge Model with an Illustrative Application
Authors: Giesecke James A. , Madden John R.
Published: May 2004

This paper describes FEDERAL‐F, a large‐scale general‐purpose multiregional computable general equilibrium model. The model is dynamic and can be used for forecasting, policy analysis and historical analysis. Large‐scale CGE models are commonly used in Australia and play a central role in policy analysis. In this paper we provide an overview of the core of FEDERAL‐F's equations via a stylized representation that expresses the model's equations in functional form. An illustrative application demonstrating the power of the model is undertaken. It demonstrates that a feasible state government fiscal policy to halt Tasmania's declining share of national GDP does not exist.
Climate Change Policies and Tax Recycling Schemes: Simulations with a Dynamic General Equilibrium Model of the Italian Economy
Authors: Roson Roberto
Published: May 2004

A dynamic general equilibrium model of the Italian economy is used to assess the impact of carbon taxation (or auctioned carbon permits), where additional revenue is used to cut either existing taxes on labor or on capital income. Simulation results do not support the existence of the so‐called “double dividend” when labor taxes are reduced, whereas lower tax rates on capital have mild positive effects on growth and welfare, with progressivity properties on income distribution. These findings hinge on the assumptions of open economy, given world interest rate, and capital mobility.
Evaluation of a Renewable Energy Scenario in India For Economic and Co2 Mitigation Effects
Authors: Rana Ashish
Published: May 2004

Renewable energy technologies (RETs) are attractive for sustainable energy supply and CO2 mitigation. In this paper, a CGE model is used to analyze the effects of rapid reduction of costs of solar power generation, an important RET, in India. Alternate scenarios of cost reduction of solar power, hybrid scenarios with a carbon tax and a scenario of only carbon tax are compared with a reference scenario. Simulation results show that under such a scenario, high penetration of solar technology, economic gains, and modest emission reduction are achieved. The analysis shows that compared to accelerated solar technology scenario, a carbon tax achieves superior mitigation. Broad policy implications for developing countries are drawn in the context of global climate change debate.
An Applied General Equilibrium Model to Assess the Impact of National Tax Changes on a Regional Economy
Authors: Cardenete Manuel Alejandro , Sancho Ferran
Published: May 2004

This paper presents two versions of an applied general equilibrium model for the regional economy of Andalusia, Spain, that differ in the closure rule adopted to describe the behavior of the public sector. We use the model with to analyze the impact that the reform of the personal income tax (Act 40/98) implemented in Spain as a whole would have had on the Andalusian region in particular. The model is of the neoclassical variety and includes not only the productive sectors of the economy but also the foreign sector and the government, which are usually absent from theoretical general equilibrium models. Both versions of the model are calibrated by using a Social Accounting Matrix of Andalusia for 1995. The analysis shows that the reform is not self‐financing, not even partially, despite governmental claims. It also indicates that there is a positive but smaller than anticipated economic stimulus. In welfare terms, we find that the category of Urban Salaried consumers is the one that benefits the most in real income terms.
Growth and Distributional Impacts of Urban Housing Supply: An Application of Urban Land Use and a CGE Model For Seoul
Authors: Kim Ju Euijune, Jaeuk
Published: May 2004

This paper assesses economic effects of housing supplies on the urban growth and income distribution of Seoul, using an urban land use and Computable General Equilibrium model of Seoul economy. The simulation shows that the housing development with the conversion of the green or the industrial land uses into the residential land use leads to an increase of the Gross Regional Product by approximately 1% at the worse income inequality. The aggregate welfare effects in terms of Hicksian Compensating Variation range from 1.746 trillion Korean Won to 1.768 trillion Korean Won on a ten‐period average, depending on the type of the land conversion.
Changing Geographies and the Geography of Change: Some Reflections
Authors: Savage Victor R.
Published: May 2004

To celebrate the 50th anniversary of the Singapore Journal of Tropical Geography and the 75th anniversary of the teaching of geography in the Department of Geography, National University of Singapore, the home of the Journal, this article, based on personal reflections and “objective” academic materials, provides an overview of developments in geography in the Department and Journal. The paper argues that the department's and Journal's“identities”, since the post‐World War II period, have been shaped by Singapore's changing domestic politics, the changing university academic environment, the personalities and academic interests of heads of the department and the Journa's editors, the state of the changing regional and global political economic environment, and the individual research interests of faculty in the department, and reflects a complex mix of colonial/post‐colonial, modern/post‐modern, North‐South and East‐West discourses. While a defined Singapore school of geography has yet to emerge, the article shows that both the department and the Journal have made major strides in meeting the challenges of globalisation and, in the process, have gained international visibility and academic legitimacy. In particular, the Journal has consolidated its position as a major voice for academics in lesser developed countries, its platform for “tropical world” discourse and maintaining its edge in the colonial/post‐colonial and modern/post‐modern discourses of states within the tropics.
Hydrological Studies and Water Resource Concerns in Southeast Asia
Authors: Chuan Goh Kim
Published: May 2004

Water supply shortage has become a pressing issue in Southeast Asia in recent years. While on the one hand water demand is escalating with rapid economic development, urbanisation and related population concentrations, on the other, surface water supply sources are increasingly being threatened by the resultant land use changes. Therefore, any understanding of the region's water supply concerns necessarily takes into account the hydrological processes and changes consequent to human interference of the natural environment. Changes to the environment that curtail the quantity of water supply and affect its quality will in turn have implications for water resource issues in megacities and other urban areas. Equally critical to the supply of water are water resource and management issues, in particular, the adequate provision of safe water for human consumption, regarded as not only meeting a basic need but also a human right. This paper provides an overview of hydrological processes and water resource concerns and suggests the scope for further investigation, particularly by geographers.
Where Have All the Beaches Gone? Coastal Erosion In The Tropics
Authors: Wong P.P.
Published: May 2004

From a physical geography perspective, tropical coasts are characterised by coral reefs, mangroves and carbonate beaches on atolls and low reef islands. They face threats not only from sea level rise, but also from human activities that destroy mangroves, degrade coral reefs and accelerate beach erosion. Physical conditions in the tropics are suitable for the ideal tourist beach. Conceptually, the tourist coast can be considered as the integration of a physical system (the coast) and a human system (tourism). Studies have been carried out on various types of tourist coasts in Southeast Asia. For many atoll island states, sea level rise is more than just a threat to their tourism; it also determines their survival. In recent years, assessments of their vulnerability and adaptation have favoured a more integrative approach of physical and human sciences. Hopefully, this should result in a better analytical tropical geography that could play an important role in reducing coastal erosion and assist the small island states.
Cerebrospinal fluid leptin levels in preeclampsia: relation to maternal serum leptin levels
Authors: Celik Onder , Hascalik Seyma , Ozerol Elif , Hascalik Mehmet , Yologlu Saim
Published: May 2004

Background.  To determine whether cerebrospinal fluid (CSF) and circulating levels of leptin differ between women with preeclampsia and women who had an uncomplicated pregnancy.

Methods.  Maternal serum and CSF leptin concentrations obtained in the third trimester of the gestation were compared in 16 women with mild preeclampsia and 23 normotensive pregnant women who underwent cesarean section. Before administering local anesthetic for spinal anesthesia, 2 mL CSF and 4 mL venous blood sample were taken and were stored at −30 °C until serum and CSF leptin levels were measured by enzyme‐linked immunosorbent assay (ELISA).

Results.  Mean CSF leptin concentrations were not significantly different between the two groups (preeclampsia 9.7 ± 4.2 ng/mL, normotensive 13.6 ± 4.3 ng/mL, p = 0.952). Similarly, mean serum leptin concentrations were similar between the two groups (mild preeclampsia 21.7 ± 7.1 ng/mL, normotensive 18.3 ± 6.7 ng/mL, p = 0.698). CSF leptin levels are inversely related to the serum leptin concentrations in preeclamptic patients (r = −0.87, p = 0.000). An inverse relationship was also detected between CSF and serum leptin levels in normotensive pregnant subjects (r = −0.66, p = 0.000).

Conclusions.  CSF and serum leptin levels were similar in patients with preeclampsia and normotensive pregnant women. However, the CSF leptin was negatively correlated with the serum leptin concentrations in preeclamptic and normotensive control subjects, suggesting that leptin enters the brain by a saturable transport system. Further work is needed to confirm our findings.
A population‐based risk factor scoring will decrease unnecessary testing for the diagnosis of gestational diabetes mellitus
Authors: Caliskan Eray , Kayikcioglu Fulya , Öztürk Nilgun , Koc Sevgi , Haberal Ali
Published: May 2004

Background.  To determine the effectiveness of a population‐based risk factor scoring to decrease unnecessary testing for the diagnosis of gestational diabetes mellitus (GDM).

Methods.  We formed a risk factor scoring over five, which questions maternal age, body mass index and first‐degree relatives with a diagnosis of diabetes mellitus, a prior macrosomic fetus and adverse outcome during the previous pregnancies. All participants underwent a 50‐g glucose challenge test (GCT) followed by a 100‐g oral glucose tolerence test (OGTT). We opened the 50‐g GCT envelope if the participant had a risk score ≥ 1 and opened the 100‐g OGTT envelope if the 50‐g GCT value was ≥ 7.2 mmol/l. After all patients delivered we also built other strategies and tested their detection rates.

Results.  Fourteen patients (3.3%) were diagnosed as having gestational diabetes mellitus via a 100‐g OGTT. None of the patients with a score of zero had gestational diabetes mellitus. Logistic regression analysis revealed that an increase in the score by one caused a three times increase in gestational diabetes mellitus risk (OR = 3, CI = 1.9–5). Compared with the universal screening, our strategy to screen if the risk score was ≥ 1, followed by a 50‐g GCT with a 7.2‐mmol/l cut‐off value, decreased the number of women to be screened by 30% and diagnosed all cases with GDM. Screening the patients with a score ≥ 2 would have decreased the number of women to be screened by 63%, still diagnosing 85% of cases with GDM. Also, risk factor‐based screening strategies cause a 50% and 53% reduction in the number of OGTT applied, respectively.

Conclusion.  A well integrated, population‐based scoring will decrease the number of unnecessary testing but still diagnose 85–100% of GDM cases.
Fatty acid synthase expression and clinicopathological findings in endometrial cancer
Authors: Tsuji Takahiro , Yoshinaga Mitsuhiro , Togami Shinichi , Douchi Tsutomu , Nagata Yukihiro
Published: May 2004

Background.  Over‐expression of fatty acid synthase (FAS), the enzyme involved in the anabolic conversion of dietary carbohydrates to fatty acid, has been reported in many human malignancies. This study investigated whether clinicopathological findings [histological grade, myometrial invasion, vessel permeation, lymphatic permeation, nodal metastasis, and Federation of International Gynecologic Obstetrics (FIGO) stage] and body fat distribution differ with the level of FAS expression in endometrial cancer.

Methods.  Subjects were 73 postmenopausal women (mean age, 62.2 ± 7.4 years; range, 49–75 years) with endometrioid adenocarcinoma. Baseline characteristics included age, height, body weight (BW), body mass index (BMI), and years since menopause (YSM). Percentage of body fat and the trunk‐leg fat mass ratio were measured by dual‐energy X‐ray absorptiometry. FAS expression was determined using immunohistochemical methods in formalin‐fixed and paraffin‐embedded cancer specimens. FAS expression was defined as none, low, and high.

Results.  Sixty‐six (90.4%) cases showed positive FAS status. Sixty‐nine percent of cases showed myometrial invasion ≥1/2, 50% of cases showed myometrial invasion <1/2, and 23% of cases without myometrial invasion demonstrated a positive FAS status. Lymphatic permeation, vessel permeation, nodal metastasis, and advancing FigO stage were associated with FAS status. The trunk‐leg fat ratio and BMI in high and low FAS status groups were significantly greater than that in those not expressing FAS (p < 0.05). However, age, height, weight, YSM, and percentage of body fat did not differ with FAS status.

Conclusion.  FAS expression in endometrial cancer is associated with cancer progression and upper body fat distribution.
Nordic gynecologists’ opinion on quality assessment registers
Authors: Dueholm Margit , Rokkones Erik , Löfgren Mats , Härkki Päivi , Arason Guðmundur
Published: May 2004

Background.  The Board of the Nordic Federation of Societies of Obstetrics and Gynecology established a Quality Group for Gynecological Surgery connected with benign diseases with one member from each of the Nordic countries. The aim was to suggest guidelines for the quality assessment of such surgery.

Methods.  A questionnaire study was carried out in all Nordic gynecological departments concerning quality assessment and the elaboration of guidelines.

Results.  Most of the departments (80.4%) want to participate in establishing and maintaining a quality register. The majority of responders strongly agree that registers detect areas of satisfactory as well as unsatisfactory quality, and are necessary for comparison of treatment results among departments. Several departments are hesitant about joining a register if it will incur financial costs (59.5%) and/or extra work (47.6%). Most departments (71.4–94.6%) consider that all major gynecological surgery should be monitored. The departments agree that pre‐, per‐, and post hospital patient events should be included in any register. These results are incorporated into common general guidelines for quality assessment of gynecological surgery in the Nordic countries.

Conclusion.  The gynecological departments in the Nordic countries agree on the necessity for and the main content of registers for quality assessment, but the interest drops when extra work is needed, and if the departments have to pay to participate, which emphasize the need for simple and low‐cost registers. In accordance with the results of the Nordic questionnaire, common general quality guidelines for gynecological surgery are suggested.
Maternal and neonatal outcome of 93 consecutive triplet pregnancies with 71% vaginal delivery
Authors: Alran Séverine , Sibony Olivier , Luton Dominique , Touitou Séverine , Fourchotte Virginie , Féraud Olivia , Oury Jean‐FranÇois , Blot Philippe
Published: May 2004

Background.  The aim of this study was to investigate neonatal and maternal data in a large series of triplet pregnancies as a function of the decision regarding the route of delivery.

Methods.  A retrospective series of 93 triplet pregnancies managed and delivered between 1989 and 2001 in a single perinatal department was analyzed. Seventy‐eight women with triplet gestations who underwent a trial of labor were compared with 15 women with triplet gestations who delivered their infants by elective cesarean delivery. Neonatal outcomes assessed included respiratory distress syndrome, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage and Apgar scores. Maternal outcomes assessed included preeclampsia, blood transfusion, endometritis and urinary tract infection.

Results.  Sixty‐six of 78 women (84%) who underwent a trial of labor had a successful vaginal delivery of all three neonates. The other 12 delivered their infants by cesarean delivery. Perinatal mortality referred to 104 triplet pregnancies was 48/1000.

Conclusions.  Our experience suggests that offering vaginal delivery is an acceptable management plan for triplet gestation in a center with a sufficient number of triplet deliveries.
Power Doppler vascularity index for predicting the response of neoadjuvant chemotherapy in cervical carcinoma
Authors: Chen Chi‐An , Cheng Wen‐Fang , Lee Chien‐Nan , Su Yi‐Ning , Hsieh Chang‐Yao , Hsieh Fon‐Jou
Published: May 2004

Background.  To evaluate whether the power Doppler vascularity index (PDVI) can predict the response to neoadjuvant chemotherapy (NACT) in cervical carcinoma.

Methods.  Twenty‐five women with bulky early stage cervical carcinoma treated by NACT followed by surgery were enrolled. Their response to NACT was evaluated. Clinical characteristics and pathologic data were recorded. Transvaginal power Doppler was performed before, during and after NACT. PDVI was detected using power Doppler and a quantitative image processing system. Factors that can potentially correlate with the response to NACT were analyzed.

Results.  Twelve (48%) patients showed a response (responders) to NACT and 13 (52%) were unchanged or had progressive disease (nonresponders) after NACT. Higher PDVI values were noted in tumors with lymphovascular emboli and pelvic lymph node metastasis both before and after NACT. The mean values of the PDVI of the nonresponders before (19.27 ± 6.01 vs. 12.28 ± 7.06, p = 0.014), during (20.2 ± 1.5 vs. 12.9 ± 2.1, p = 0.009) and after NACT (18.1 ± 6.0 vs. 9.3 ± 5.4, p = 0.001) were significantly higher than those of the responders. When the cutoff point for predicting nonresponders to NACT was set at a PDVI value of 15%, the sensitivity was 92.3% and the specificity 66.7%.

Conclusions.  The power Doppler vascularity index can predict the response to neoadjuvant chemotherapy in cervical cancer, and might be useful for the evaluation of response to chemotherapy in cancer patients in the future.
Elevated plasma homocysteine levels in gestational diabetes mellitus
Authors: Tarim Ebru , Bagis Tayfun , Kilicdag Esra , Erkanli Serkan , Aslan Erdogan , Sezgin Nurzen , Kuscu Esra
Published: May 2004

Objective.  This prospective study investigated the occurrence of hyperhomocysteinemia in a population of patients with gestational diabetes. The aim was to determine whether elevated plasma homocysteine is associated with gestational diabetes in Turkish women.

Study design.  This prospective controlled study was conducted in the Department of Obstetrics and Gynecology of the Baskent University Faculty of Medicine between April 2002 and June 2003, and involved 304 Turkish women with uncomplicated pregnancies who were at 24–28 weeks gestation. The women in the study were assigned to one of three groups according to the results of the 50‐g glucose screening and the oral glucose tolerance test (OGTT): group 1 comprised women who had normal glucose levels (≤ 135 mg/dL) after the 50‐g challenge; group 2 comprised women with abnormal screening test results (> 135 mg/dL) but normal OGTT results; and group 3 comprised patients with gestational diabetes mellitus (GDM) according to the OGTT. Levels of fasting glucose, homocysteine, vitamin B12 and folic acid, total cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides, low density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) cholesterol levels were measured in the three groups. Levels of insulin sensitivity were calculated using the homeostasis model assessment (HOMA) formula.

Results.  The mean level of homocysteine in group 1 was significantly lower than the levels in groups 2 and 3 (p < 0.001) The mean triglyceride and VLDL levels in group 3 were significantly higher than the corresponding levels in group 1 (p < 0.05 for both). There were no significant differences among the groups with respect to levels of total cholesterol, vitamin B12, folic acid, creatinine, fasting glucose or insulin. The mean HOMA value in group 3 was significantly higher than that in group 1 (p < 0.05). Only the blood glucose level after the 50‐g glucose screening [p = 0.000, 95% confidence interval (CI) 0.009–0.027] had a significant correlation with homocysteine levels.

Conclusion.  In this prospective study of Turkish women, we found that patients with gestational diabetes and women with abnormal screening test results (> 135 mg/dL) but normal OGTT results have higher homocysteine levels than normal pregnant women. This increased level seems to be related to an abnormal 50‐g test but not to insulin resistance. Further investigations are needed to follow up for these patients in the postpartum period and later in their life.