bluuebunny/crossref_metadata_2025 huggingface dataset:
From Want Ads to Web Sites
Authors: Rubaii-Barrett Nadia , Wise Lois Recasino
Published: February 2007

Job seekers are increasingly turning to the Internet. Government Web sites not only provide information about employment opportunities but also convey messages, whether intentional or not, about values and priorities that affect individuals' perceptions of the attractiveness of the state as an employer. This study replicates private sector–based research by examining the diversity messages reflected in text and visual imagery on 50 state government Web sites. Overall, in contrast with private companies, a majority of states do not demonstrate a clear commitment to diversity on their Web sites. Rather, the states place greater emphasis on customer service and efficiency. Given the increased importance of the Internet as a recruitment tool, findings suggest the need for greater attention to the diversity messages conveyed by state government Web sites. The article concludes with some practical recommendations for more effective use of this medium to advance diversity-related recruitment goals and suggestions for future research.
The Effect of Person–Job Fit on the Retention of Top College Graduates in Federal Agencies
Authors: Starks Glenn L.
Published: February 2007

The Outstanding Scholar Program (OSP) allows federal agencies to employ streamlined hiring processes and to offer higher starting salaries to college graduates with a grade point average of at least 3.5 or who graduate in the top 10% of their university or department. OSP data were analyzed from a data set of 47,976 OSP employees hired from 1991 through 2000. Based on job fit theory and generational theory, independent variables theorized to improve employee recruitment and retention rates were tested using chi-square tests and a logistic regression model. Independent variables found to improve these rates include occupations congruent to educational backgrounds, hiring agencies with higher proportions of white-collar professional occupations, and occupations with higher initial grade levels. Because OSP employees are age and knowledge cohorts within Generation X, agencies should also offer occupations with meaningful job content, job independence, good benefits, feedback, and opportunities for employees to learn new things.
State Government Employee Health Benefits in the United States
Authors: Reddick Christopher G. , Coggburn Jerrell D.
Published: February 2007

Employer-sponsored health benefits are an important but relatively understudied area in public sector human resource management. This study examines the choices that state governments make in the United States and the views of state human resource directors (HRD) on health benefits. Survey data, gathered from state HRDs in fall 2005, reveal several important findings: In terms of choices, the most common plan offered is the preferred provider organization (PPO); less than one third of states offer health benefits to nontraditional partners; health benefits improve employee satisfaction and the performance of the state government; and cost to the state government is the most important factor that affects choice of plan. There is not a high level of agreement on what strategies state government should pursue to reduce costs of health benefits; however, there is some agreement that premiums will be increasing in the near future.
The Legal and Managerial Challenge of Obesity as a Disability
Authors: Bradbury Mark D.
Published: February 2007

The Rehabilitation Act and the Americans with Disabilities Act prohibit discrimination against applicants and employees with disabilities. Following the elements of a prima facie claim of discrimination, this legal brief explores the conditions under which obesity has been deemed a disability. Although obesity is not generally considered a disabling impairment, plaintiffs have successfully brought obesity-related claims based on a rarely implicated definition of disability. The so-called regarded as definition protects those who are not substantially limited by any condition but are subjected to discrimination based on the perception that they are limited by a physical or mental impairment. Although employers have faired well in such obesity-related discrimination claims, a review of federal case law suggests that public human-resource managers are advised to adopt a strategy that reduces the likelihood of obesity-related discrimination, as it is more desirable to avoid potentially litigious behavior than to emerge victorious in court.
Globalization and Desire: A Case Study of International Graduate Student Education in Literacy Studies
Authors: Smith Beatrice Quarshie
Published: February 2007

Prospective graduate students from Sub-Saharan Africa continue to choose the United States as their destination for higher education. This choice has always been somewhat of a mixed blessing for African nations; some students return to share the benefits of their education but many stay on in the West. This “brain drain” effect has traditionally been seen as an unavoidable side effect of students’ desires for consumption of American higher education specifically and for the American “consumer” lifestyle more generally. But the current global restructuring of capital and culture offers an opportunity to reevaluate this dynamic and potentially to make adjustments in the ways American universities accommodate their African students. This article draws on a small data set from a case institution to test and articulate an alternative analysis that links desire to production and offers an alternative explanation of globalization and the education of graduate students from the region.
Integrating Service Learning Into the Study Abroad Program: U.S. Sociology Students in Mexico
Authors: Wessel Nancy
Published: February 2007

The program that is the topic of this case study was an integration of two forms of experiential education: service learning and study abroad. Participants in the program studied sociology and performed social service in Morelia, Michoacán, Mexico. Curriculum and planning issues of both study abroad and service learning are combined in the design and implementation of service in an international setting. This case study discusses how such concerns were addressed in this program and makes suggestions based on this experience.
Conflict Between International Graduate Students and Faculty Supervisors: Toward Effective Conflict Prevention and Management Strategies
Authors: Adrian-Taylor Shelley Rose , Noels Kimberly A. , Tischler Kurt
Published: February 2007

Recent research indicates that destructive conflict occurs in a significant number of international graduate student and faculty supervisor relationships. Unfortunately, a paucity of research exists to inform the effective management or prevention of this problem. To address this lacunae, international graduate students (n = 55) and faculty supervisors (n = 53) completed a survey that assessed their needs for managing and preventing destructive conflict with each other. Results indicate that 22% of international graduate students and 34% of faculty supervisors have experienced student-supervisor conflict. Some of the sources of these conflicts were lack of openness, time, and feedback; unclear expectations; and poor English proficiency. Several common needs for managing conflict were found, including a preference to use negotiation rather than more confrontational procedures such as arbitration. Recommendations regarding the management and prevention of international graduate student and faculty supervisor conflict are provided.
Study Abroad Survey Instruments: A Comparison of Survey Types and Experiences
Authors: Durrant Marie Bradshaw , Dorius Cassandra Rasmussen
Published: February 2007

This study examines different survey instruments used to assess the experiences of U.S. study abroad participants. The intended audience is international and area study practitioners interested in assessing study abroad programs through postprogram interviews. An interview with the top 20 universities for number of students sent on study abroad reveals a broad picture of the type of survey instruments used across the United States to assess student experiences. Within this context and based on 19 years of data collection from study abroad participants with four data collection modes (a standard questionnaire with multiple choice and open-ended questions, a multiple choice bubble sheet response format, a scanned form, and a Web-based survey), one university’s experience is analyzed in depth to expand on the benefits and drawbacks of specific survey types. Lessons learned about when each type might be appropriate for different institutional goals and situations are presented.
Global Position and Position Taking: The Case of Australia
Authors: Marginson Simon
Published: February 2007

From 1990 to 2003, Australia’s share of the global market in cross-border degrees grew from 1% to 9%. Full fee-paying foreign students now constitute one quarter of enrolments, and education is Australia’s third largest services export. Positioned as an Anglo-American system on the edge of Asia, Australia has differentiated itself from the United States and United Kingdom on price, location, safety, and climate, not academic content. The supply side keys to growth are deregulation and prolonged reductions in the public funding of universities. However, the Shanghai Jiao Tong University survey of research performance finds that Australia is less strong in research than cross-border degrees. Australia’s policy may have negative implications for its longer-term global standing and limit the range of position-taking strategies available to its universities. These themes are explored in the context of the emerging worldwide market and Australian policy changes that have enhanced institutional stratification.
The Relationship Between Culture, Gender, Structural Factors, Abuse, Trauma, and HIV/AIDS for Latinas
Authors: Moreno Claudia L.
Published: February 2007

The study, in which the author aim to understand the contextual risks of HIV-positive serostatus and intimate partner violence (IPV) of 32 Latina women, involved focus groups, in-depth face-to-face narratives, and community meetings. The data emerged into four themes: histories of trauma, living with HIV, vulnerability, and la suerte (luck). In addition to the themes, women in this study talked about how structural and cultural factors such as machismo, marianismo, and fatalism are implicated in the risk for HIV and IPV. Women in the study reconceptualized the notion of IPV to denote a form of situational abuse, such as threats of deportation, that is exacerbated by their HIV status.
Health and Illness Concepts Among Lower Income Nicaraguan Women
Authors: Ailinger Rita L. , Gonzalez Rose , Zamora Lidya
Published: February 2007

Concepts of health and illness are culturally defined; however, few researchers have reported on these concepts among Latina women. A purposive sample of 14 lower income Nicaraguan women living in a squatter settlement is the focus of this qualitative study. The authors used in-depth, tape-recorded interviews in Spanish to gather data on the women’s concepts of health and illness for adults and babies and of health maintenance activities. The authors analyzed the verbatim transcripts and analyzed them for themes. The women’s concepts of health and illness included four themes: activities, disposition, eating, and appearance. Health maintenance activities included hygiene and sanitation, medical intervention, nutrition, and the appearance of cleanliness. Nurses and other health care providers will find these themes instructive in developing and providing health services for similar Latina women.
Newborns With an Impairment: Discourses of Hospital Staff
Authors: Vehkakoski Tanja M.
Published: February 2007

The birth of a baby with an impairment goes against dominant cultural ideals about a happy event. Therefore, the interaction between professionals and parents is particularly important, from the hospital maternity ward to the home. In this article, the author examines both the representations of neonatal impairments constructed by professionals and the consequent subject positions for these babies with impairments. The study is based on interview data collected among 19 staff members of one Finnish county hospital. The author analyzed the data by means of qualitative discourse analysis and concludes that it would be important for health care professionals to provide many-sided elements for parents to consider in the construction of the image of their baby other than traditional tragically and negatively biased cultural interpretations.
“From the Heart of My Bottom”: Negotiating Humor in Focus Group Discussions
Authors: Wilkinson Clare E. , Rees Charlotte E. , Knight Lynn V.
Published: February 2007

Reporting and analyzing interactional data collected during focus groups can be a significant challenge for qualitative health researchers. In this article, the authors explore the use of humor among focus group participants as one area of interaction and negotiation that is methodologically interesting and theoretically insightful. They explore discussions about service user involvement in medical education across eight focus groups consisting of medical educators, medical students, and service users. The findings suggest that humor can be used among focus group participants to maintain solidarity, navigate coping strategies, and negotiate power. Not only is humor useful when exploring new concepts, it can also be an indication of wider views that might not be explicit in an analysis of focus group members’ comments alone. The authors urge qualitative health researchers to examine interactions among focus group participants, and their analysis of humor illustrates how this can be achieved.
Female Youths’ Perceptions of Smoking in Popular Films
Authors: Jetté Shannon , Wilson Brian , Sparks Robert
Published: February 2007

In this study, the authors used focus group interviews to explore how female adolescents in a Canadian high school interpreted and used tobacco imagery in films in their daily lives. Findings from interviews with 20 smokers led them to argue that smoking scenes in films might stimulate youth smoking and that cigarettes are an important symbol in youth peer groups with explicit social meanings and functions. Their analysis of interviews with 17 nonsmokers revealed that although the majority noticed smoking in movies, it did not detract from their viewing experience. Although both smokers and nonsmokers were aware that tobacco placements in films served as a form of product promotion, they typically focused on smoking’s function as a dramatic device for character development rather than its promotional value. Overall, both groups appeared capable of critical readings of smoking in films but tended not to use these capabilities when viewing movies.
The Role Familiarity With Science and Medicine Plays in Parents’ Decision Making About Enrolling a Child in Vaccine Research
Authors: Chantler Tracey E. A. , Lees Amanda , Moxon E. Richard , Mant David , Pollard Andrew J. , Fiztpatrick Ray
Published: February 2007

Parental consent to children’s participation in vaccine research has resulted in the licensure of essential vaccines. Recruitment to this type of research is typically difficult, however, and many parents decline. In this study, the authors interviewed parents about their decision for or against enrolling their child in a vaccine study. The data analysis suggests that parents’ ability to evaluate a vaccine study depends on how attuned they are with science and medicine, either professionally or as consumers of health services. Familiarity does not predispose parents to enrolling their child in research; rather, it is a predictor of parents’ confidence in their decision making. Many parents were motivated by altruism and trust, which, if uninformed, can leave the parents prone to exploitation. It is vital to ensure that parents are confident in their judgment of a study and its potential benefit to their child and society.
Young Women With Type 1 Diabetes’ Management of Turning Points and Transitions
Authors: Rasmussen Bodil , O’Connell Beverly , Dunning Patricia , Cox Helen
Published: February 2007

The authors used grounded theory to explore and develop a substantive theory to explain how 20 young women with type 1 diabetes managed their lives when facing turning points and undergoing transitions. The women experienced a basic social problem: being in the grip of blood glucose levels (BGLs), which consisted of three categories: (a) the impact of being susceptible to fluctuating BGLs, (b) the responses of other people to the individual woman’s diabetes, and (c) the impact of the individual women’s diabetes on other people’s lives. The women used a basic social process to overcome the basic social problem by creating stability, which involved using three interconnected subprocesses: forming meaningful relationships, enhancing attentiveness to blood glucose levels, and putting things in perspective. Insights into the processes and strategies used by the women have important implications for provision of care and service delivery.
The Role of Action Research in the Investigation and Diffusion of Innovations in Health Care: The PRIDE Project
Authors: Waterman Heather , Marshall Martin , Noble Jenny , Davies Helen , Walshe Kieran , Sheaff Rod , Elwyn Glyn
Published: February 2007

In this article, the authors discuss the role of action research in relation to the investigation and practical implementation of innovations in health care. The diffusion of innovations is an essential component of the modernization of health services worldwide. However, the literature shows that it is not an easy process to research. A paradox is noted that although action research has much to offer, it has had only a limited impact in the innovation field. Drawing on an example of a project in the United Kingdom, the authors discuss whether action research is a valuable method in the study of the diffusion of innovations. They analyze its strengths and limitations as a “whole systems approach” that combines researching with developing and diffusing innovations. They argue that it is best suited to the study of innovation diffusion where there is a need for high level of adaptation in each new setting.
Public Observability of Decisions and Voluntary Contributions in a Multiperiod Context
Authors: Noussair Charles , Tucker Steven
Published: February 2007

The authors conduct an experiment to explore whether contributions to a public good increase when public observation of contribution decisions is possible and whether any such increase is durable and transferable. Rege and Telle (2004) find that in one-shot games, public observation of all individuals' contribution decisions leads to higher contributions than would occur in the absence of such observation. In this study, the authors argue that public observation is ineffective in increasing contributions in a repeated game. Indeed, it actually reduces contribution rates relative to a treatment in which contribution decisions are not observable. Furthermore, prior experience with public observability reduces cooperative behavior in subsequent interaction in which decisions cannot be observed. The authors conjecture that approval incentives are more effective in leading to cooperative behavior when sanctioned parties are unable to avoid the expressions of disapproval they receive.
Do Women Behave Less or More Prosocially than Men?
Authors: Meier Stephan
Published: February 2007

The behavior of others and the price of giving are two important determinants of contributions to public goods. Using two field experiments, this article tests whether men and women differ in their reactions to either a change in the average behavior of the group or a change in the price of giving, that is, a contribution-matching mechanism. The results of the field experiments show that men and women do not differ in their reactions to a matching mechanism. However, substantial gender differences can be detected with respect to social comparison. Men tend to align their behavior with the average behavior of the group, whereas women seem to be insensitive to information about group behavior.
Debt Aversion and the Demand for Loans for Postsecondary Education
Authors: Eckel Catherine C. , Johnson Cathleen , Montmarquette Claude , Rojas Christian
Published: February 2007

The authors report the results of an experiment designed to measure the impact of different forms of subsidies on the demand for postsecondary education financing among a sample of adults ages 18–55 in Canada. The experiment presents subjects with a series of choices involving trade-offs between cash payments and grants or loans earmarked for full or part-time education. In addition, the experiment includes experimental measures of time and risk preferences, and an extensive survey of experience and attitudes. This article focuses on the role of a person's attitudes toward debt (debt aversion) and experience with debt ( debt use) in the decision to take up subsidized loans for postsecondary education. Using survey measures, the authors find no evidence that debt aversion is an important barrier to investment in postsecondary education. In addition, subjects with experience carrying and managing debt are more willing than others to take on additional debt to finance postsecondary education.
When the Shoe Is on the Other Foot
Authors: Ackert Lucy F. , Church Bryan K. , Dwyer Gerald P.
Published: February 2007

The method of elicitation has an important effect on valuations. We investigate the effect of perspective on decision makers' elicited values. We conduct experimental sessions in which participants act as sellers or buyers, and replicate the disparity between willingness to accept and willingness to pay: sellers want to collect more, and buyers want to pay less. We conduct additional sessions in which endowed decision makers provide values that are used to determine a price at which anonymous others transact. In these sessions, decision makers' experimental earnings are not affected by valuations but, rather, are determined by their endowment. Decision makers appear to consider their standing relative to anonymous others in providing valuations (i.e., decision makers' endowments affect their valuations). The results indicate that the disparity between willingness to accept and willingness to pay disappears when decision makers' endowments ensure that they are at least as well off as anonymous others.
Preferences over Income Distributions
Authors: Engelmann Dirk , Strobel Martin
Published: February 2007

Preferences over income distribution are the basis for a variety of models that aim at explaining results in economic experiments. The direct evidence concerning these preferences, however, is limited to a relatively small set of games. The authors discuss crucial evidence, including that from a recent large-scale Internet experiment and the different models' performance. It appears that subjects are highly heterogeneous and that the relative impact of different motives depends on a variety of factors. The authors present a general model that can help as a starting point for measuring distributional preferences.
On Modeling Voluntary Contributions to Public Goods
Authors: Cox James C. , Sadiraj Vjollca
Published: February 2007

This article addresses four “stylized facts” that summarize data from experimental studies of voluntary contributions to the provision of public goods. Theoretical propositions and testable hypotheses for voluntary contributions are derived from two models of social preferences, the inequity aversion model and the egocentric other-regarding preferences model. The authors find that the egocentric other-regarding preferences model with classical regularity properties can better account for the stylized facts than the inequity aversion model with nonclassical properties.
A Comparison of Taiwanese and American Police Supervisors' Attitudes
Authors: Chu Doris C. , Sun Ivan Y.
Published: February 2007

This article compares attitudinal differences between Taiwanese and American police supervisors. Although a growing number of cross-national studies of police have been conducted, very few have empirically assessed attitudinal distinctions among officers across countries. Using interview and survey data collected from two American and two Taiwanese police departments, this research assessed police supervisors' role orientations and their attitudes toward aggressive law enforcement, legal restrictions, and citizens. The findings show that Taiwanese police supervisors differ significantly from their American counterparts in all attitudinal scales. Compared to American supervisors, Taiwanese supervisors tended to have a broad role orientation, positive attitudes toward aggressive law enforcement and legal restrictions, and negative attitudes toward citizens. Implications for policy and future research are discussed.
Federal Subsidies and Evidence of Progressive Change
Authors: Helms Ronald , Gutierrez Ricky S.
Published: February 2007

This research reviews the history of police change, documents law enforcement's sustained effort to maintain legitimacy through change, and serves as a backdrop for an empirical assessment of recent efforts by law enforcement to adopt meaningful change. This research quantitatively assesses the effects of federal funding on two outcomes: the percentage change in police employment between 1993 and 1999 and an index of progressive policing practices that reflect the community-oriented policing (COP) philosophy. The authors use regression with robust standard errors and a sample of 177 municipal police agencies staffed with 100 or more full-time officers to assess competing explanations for variation in these outcomes. Findings support claims that federal assistance grants contributed to progressive changes for the recipient agencies. Organizations receiving manpower grants increased hiring to a noteworthy extent, and innovation grants were closely associated with reforms in street-level practices. Targeted federal assistance helped municipal police agencies make progressive changes consistent with the COP model.
Diabetes mellitus exacerbates advanced glycation end product accumulation in the veins of end-stage renal failure patients
Authors: Nazratun N , Mahmood A A , Kuppusamy U R , Ahmad T Sara , Tan S Y
Published: February 2007

The excess accumulation of advanced glycation end products (AGEs) contributes to the chronic complications of type 2 diabetes mellitus (DM) and renal failure. Biopsy specimens ( n = 184) of arterial ( n = 92) and venous ( n = 92) tissues were obtained (radial artery and cephalic vein) from end-stage renal disease (ESRD) patients with or without DM and normal healthy subjects ( n = 12) requiring surgery (trauma patients). Immunohistochemical assessment of the blood vessels revealed the presence of pentosidine (AGE marker) in both veins and arteries in 72% of the ESRD patients. The percentage of arteries and veins that showed positive pentosidine staining in ESRD patients with type 2 DM alone was 100% and 92% respectively, in the non-diabetic ESRD patients it was <70% (for arteries and veins), and in the ESRD patients with hypertension as an additional co-morbidity to type 2 DM it was 70% and 82%, respectively. The veins of ESRD patients with DM showed a strong (+++) positive staining and very strong (++++) positive staining was observed in the patients with DM and hypertension. Only mild (+) or moderate (++) pentosidine staining intensity was observed in the arteries of ESRD patients without or with comorbidities, respectively. The accumulation of AGE in the vein rather than the artery may be a better reflection of the extent of complications of ESRD.
Use of digital pressure measurements for the diagnosis of AV access-induced hand ischemia
Authors: Schanzer Andres , Nguyen Louis L , Owens Christopher D , Schanzer Harry
Published: February 2007

Diagnosis of hand ischemia secondary to an arteriovenous (AV) hemodialysis access is predominantly based on clinical findings. Occasionally, this diagnosis is unclear and more objective diagnostic testing is needed. No validated method of objective testing currently exists. The purpose of this study is to evaluate digital pressure measurements in the diagnosis of AV access-induced hand ischemia. A case–control study of 40 patients with an upper extremity AV access consisted of 15 patients (38%) with clinical AV access-induced hand ischemia and 25 patients (62%) without clinical evidence of ischemia. Arterial pressure in the third finger ipsilateral to the AV access was measured by digital photoplethysmography. Basal digital pressure (BDP), digital to contralateral brachial index (DBI), and change in digital pressure with access compression (CDP) were determined. Logistic regression modeling with gains tables and ROC calculations were used to determine optimal test thresholds and to test model discrimination for predicting AV access-induced hand ischemia. The mean BDP (30 vs 102 mmHg; p < 0.001) and mean DBI (0.3 vs 0.8; p < 0.001) were significantly lower in patients with AV access-induced hand ischemia than in those without. The accuracy for determining hand ischemia using a threshold-adjusted BDP of 60 mmHg was 92% (sensitivity 100%, specificity 87%) and using DBI of 0.4 was 94% (sensitivity 92%, specificity 96%). While the mean CDP was significantly higher in patients with hand ischemia (85 vs 40; p < 0.001), the accuracy for predicting ischemia was marginal (78%). In conclusion, a BDP less than 60 mmHg or a DBI less than 0.4 in a patient with an AV access were highly associated with hand ischemia. CDP's marginal discrimination ability likely stems from the presence of asymptomatic physiologic steal in the group without clinical steal. Nonetheless, CDP may be useful in identifying patients with ischemia who will not benefit from an intervention that specifically targets the AV access.
Effect of acute exercise on endothelial progenitor cells in patients with peripheral arterial disease
Authors: Shaffer Rebecca Gusic , Greene Sam , Arshi Arash , Supple Greg , Bantly Andrew , Moores Jonni S , Parmacek Michael S , Mohler Emile R
Published: February 2007

To determine whether exercise increases endothelial progenitor cells (EPCs) in patients with peripheral vascular disease, we developed a multi-parameter flow cytometry assay to rigorously assess EPCs and mature endothelial cells (ECs) in control subjects and patients with peripheral artery disease (PAD) subjected to graded exercise. Blood was collected from young healthy subjects (n = 9, mean age 33 years),older healthy subjects (n = 13,mean age 66 years),and older subjects with PAD (n = 15,mean age 69 years) before and 10 minutes after exercise. White blood cells were isolated and stained with a five-color antibody panel: FITC-anti-CD31, PE-anti-CD146, PE-anti-CD133, PerCP-Cy5.5-anti-CD3,-CD19,-CD33, PE-Cy7-anti-CD34, and APC-anti-VEGF-R2. Viability was assessed by propidium iodide exclusion. Viable, low, side scatter singlets that were CD3-, 19-, and 33-negative were counted. While baseline levels of EPCs and ECs were similar among all subjects, young healthy subjects demonstrated significantly greater (p < 0.05) levels of progenitor cells (PCs) than older healthy and PAD subjects. Levels of EPCs and ECs tended to increase in all subjects after exercise;however,increases in PCs were only observed in young healthy and PAD subjects. Further, trends in the magnitude of change of subsets with exercise were most similar between young and PAD subjects. Our findings suggest that aging may reduce baseline circulating levels of PCs, but not EPCs or ECs, and that exercise-induced mobilization of subsets may differ depending on age and presence of PAD.
The effects of quinapril and atorvastatin on the responsiveness to sildenafil in men with erectile dysfunction
Authors: Bank Alan J , Kelly Aaron S , Kaiser Daniel R , Crawford William W , Waxman Benjamin , Schow Douglas A , Billups Kevin L
Published: February 2007

Phosphodiesterase-5 (PDE-5) inhibitors are an effective therapy for the majority of men with erectile dysfunction (ED). However, many men with ED still report a suboptimal or partial response even after an adequate trial of oral PDE-5 therapy. Since ED is associated with impaired vascular function and both atorvastatin and quinapril have been previously shown to improve vascular function, we examined the effects of adjunctive treatment with these medications in men with vasculogenic ED who were suboptimal responders to 100 mg of sildenafil. Men with ED and suboptimal response to sildenafil were randomly assigned to 3 months of treatment with atorvastatin 40 mg ( n = 12), quinapril 10 mg ( n = 10), or placebo ( n = 13), along with continued adjunctive sildenafil use. Measured variables included: International Index of Erectile Function (IIEF) questionnaire, brachial artery flow-mediated dilation (FMD), endothelium-independent dilation (EID) via nitroglycerin, penile Doppler blood flow, blood pressure (BP), lipids, and C-reactive protein (CRP). Compared to placebo, quinapril ( p < 0.01) significantly improved symptoms of ED as measured by the IIEF-5 questionnaire. There was a trend toward a significant improvement in IIEF-5 with atorvastatin. Similarly, quinapril significantly improved the IIEF ED Domain ( p < 0.05). Other peripheral and penile vascular parameters were unchanged with drug therapy as compared to placebo. In conclusion, treatment with quinapril, in combination with sildenafil, improved ED in men with suboptimal response to sildenafil alone. Atorvastatin demonstrated a trend toward improved ED in this group.
Leg swelling due to urinary obstruction
Authors: Lokhandwala Juzar , Gornik Heather
Published: February 2007

An 85-year-old man presented with bilateral leg edema and urinary incontinence. Abdominal examination revealed a severely distended bladder. Venous duplex of the legs demonstrated monophasic waveforms bilaterally, suggesting obstruction of proximal lower extremity veins. Relief of urinary obstruction was associated with the prompt return of normal respiratory variation of flow in the veins and improvement of leg swelling. Non-thrombotic obstruction of the proximal veins of the lower extremities by a severely enlarged urinary bladder is an infrequent yet potentially reversible cause of lower extremity edema. Subtle clues in the Doppler waveforms of an otherwise normal lower extremity venous duplex examination are crucial in establishing this diagnosis.
Renal artery calcium: relationship to systemic calcified atherosclerosis
Authors: Allison Matthew A , DiTomasso Dominic , Criqui Michael H , Langer Robert D , Wright C Michael
Published: February 2007

In this study we tested the hypothesis that calcium due to atherosclerosis in the renal arteries would be significantly associated with calcium in multiple other vascular beds, independent of traditional risk factors for cardiovascular disease (CVD). Electron beam computed tomography was conducted in 1461 consecutive asymptomatic patients free of clinical CVD to determine the presence and extent of calcium in the renal arteries, coronary and non-coronary vasculature and the aortic and mitral annuli. The overall prevalence for calcium in either renal artery was 18.0%, with men having a significantly higher prevalence (20.2%) than women (15.0%) [p = 0.01]. Renal artery calcium (RAC) was significantly correlated with calcium located in the carotids, coronaries, thoracic aorta, abdominal aorta and iliac arteries and calcium in the mitral and aortic annuli (r range = 0.22–0.37). In a multi-variable model containing the traditional CVD risk factors, the presence of calcium in the renal arteries was significantly associated with age, male sex and a diagnosis of hypertension. After adjustment for these variables, the presence of calcium in the thoracic or abdominal aorta was significantly associated with RAC (OR = 2.1 and 2.0, respectively; p < 0.01 for both). The sensitivity for prevalent RAC was highest in those individuals with any calcium in the abdominal aorta (94.5%). In conclusion, calcium related to atherosclerosis in the renal arteries is highly associated with atherosclerotic calcification in other vascular beds, especially the aorta, and the valvular annuli. These relationships are independent of traditional CVD risk factors.
Moral Particularism: An Introduction
Authors: Kirchin Simon
Published: February 2007

Moral particularism is a contentious position at present and seems likely to be so for the foreseeable future. In this Introduction, I outline and detail its essential claim, which I take to be, roughly, that what can be a reason that helps to make one action right need not be a reason that always helps to make actions right. This claim challenges a central assumption on which most, if not all, normative ethical theories are supposedly based. We owe this way of characterizing moral particularism to Jonathan Dancy, around whose writings much of the present debate revolves.
Particularism and Default Valency
Authors: Kirchin Simon
Published: February 2007

In this paper, I concentrate on the notion of default valency, drawing on some of the distinctions made and thoughts given in my Introduction. I motivate why the notion is important for particularists to have up their sleeves by outlining a recent debate between particularists and generalists. I then move to the main aim of the piece which is to discuss how anyone, particularist and generalist alike, might seek to distinguish reason-generating features into different types. My main aim is not to argue for a specific way of dividing such features into types but to present various taxonomical options.
Ethics Without Reasons?
Authors: Crisp Roger
Published: February 2007

This paper is a discussion of Jonathan Dancy's book Ethics Without Principles (2004). Holism about reasons is distinguished into a weak version, which allows for invariant reasons, and a strong, which doesn't. Four problems with Dancy's arguments for strong holism are identified. (1) A plausible particularism based on it will be close to generalism. (2) Dancy rests his case on common-sense morality, without justifying it. (3) His examples are of non-ultimate reasons. (4) There are certain universal principles it is hard not to see as invariant, such as that the fact that some action causes of suffering to a non-rational being always counts against it. The main difficulty with weak holism is that justification can be seen as analogous to explanation, which will give us an atomistic and generalist conception of a normative reason.
Crisp's ‘Ethics Without Reasons?’: A Note on Invariance
Authors: Harcourt Edward
Published: February 2007

Crisp is right to detect a clash between Dancy's leading formulation of holism about reasons and the phenomenon of invariance. Replying to Crisp on behalf of the particularist, I suggest a better formulation of holism modelled on a standard treatment in the philosophy of language of context-sensitive expressions.
Practical Reasoning and Normative Relevance: A Reply to McKeever and Ridge
Authors: Thomas Alan
Published: February 2007

A putative problem for the moral particularist is that he or she fails to capture the normative relevance of certain considerations that they carry on their face, or the intuitive irrelevance of other considerations. It is argued in response that mastery of certain topic-specific truisms about a subject matter is what it is for a reasonable interlocutor to be engaged in a moral discussion, but the relevance of these truisms has nothing to do with the particularist/generalist dispute. Given that practical reasoning is plausibly a form of abductive reasoning, and is therefore non-monotonic, any arbitrary addition of information can change the degree of support evidence offers for a conclusion. Given this arbitrariness, it is no objection to the particularist if he or she represents the ‘normative landscape as flat’ in a way that does not display the ‘obvious’ relevance of certain considerations. The normative landscape is flat and our best account of practical reasoning represents it precisely as such. Appealing to a distinction between practical reasoning and moral reasoning does not help to resurrect this pseudoproblem for particularism.
Monoclonal TCR-Vβ13.1+/CD4+/NKa+/CD8−/+dim T-LGL lymphocytosis: evidence for an antigen-driven chronic T-cell stimulation origin
Authors: Garrido Pilar , Ruiz-Cabello Francisco , Bárcena Paloma , Sandberg Yorick , Cantón Julia , Lima Margarida , Balanzategui Ana , González Marcos , López-Nevot Miguel Angel , Langerak Anton W. , García-Montero Andrés C. , Almeida Julia , Orfao Alberto
Published: February 2007

Monoclonal TCRαβ+/CD4+ T-large granular lymphocyte (T-LGL) lymphocytosis is a T-cell disorder with a restricted TCR-Vβ repertoire. In the present study we explored the potential association between the expanded TCR-Vβ families, the CDR3 sequences of the TCR-Vβ gene, and the HLA genotype of patients with monoclonal TCRαβ+/CD4+ T-LGL lymphocytosis. For that purpose, 36 patients with monoclonal TCRαβ+/CD4+ T-LGL lymphocytosis (15 TCR-Vβ13.1 versus 21 non–TCR-Vβ13.1) were selected. For each patient, both the HLA (class I and II) genotype and the DNA sequences of the VDJ-rearranged TCR-Vβ were analyzed. Our results show a clear association between the TCR-Vβ repertoire and the HLA genotype, all TCR-Vβ13.1+ cases being HLA-DRB1*0701 (P = .004). Interestingly, the HLA-DR7/TCR-Vβ13.1–restricted T-cell expansions displayed a highly homogeneous and strikingly similar TCR arising from the use of common TCR-Vβ gene segments, which shared (1) unique CDR3 structural features with a constantly short length, (2) similar combinatorial gene rearrangements with frequent usage of the Jβ1.1 gene, and (3) a homolog consensus protein sequence at recombination junctions. Overall, these findings strongly support the existence of a common antigen-driven origin for monoclonal CD4+ T-LGL lymphocytosis, with the identification of the exact peptides presented to the expanded T cells deserving further investigations.
Plasma fatty acids and lipid hydroperoxides increase after antibiotic therapy in cystic fibrosis
Authors: Durieu I. , Abbas-Chorfa F. , Drai J. , Iwaz J. , Steghens J-P. , Puget M. , Ecochard R. , Bellon G.
Published: February 2007

The present authors investigated whether cystic fibrosis is linked to a defect in fatty acids and assessed the impact of the main patients' characteristics on the levels of several fatty acids, mostly during respiratory exacerbation and after antibiotic therapy.

Fatty acid phospholipid and cholesteryl ester levels were measured in stable-state patients and controls. No differences were found concerning either the fractions of palmitic and oleic acids or the cholesteryl esters of α-linolenic and arachidonic acids. However, phospholipids of α-linolenic and arachidonic acids, as well as cholesteryl esters and phospholipids of stearic and linoleic acids, were lower in patients than in controls, but fractions of dihomo-γ-linolenic, docosatetraenoic, docosapentaenoic, palmitoleic and eicosatrienoic acids were higher.

Fatty acid levels, oxidative stress markers, nutrients, body mass index and forced expiratory volume in one second (FEV1) were measured in patients before and after antibiotic courses for bronchial exacerbation. After adjustments, palmitic, stearic, α-linolenic, linoleic, arachidonic, palmitoleic and oleic acids generally decreased during exacerbation but almost all increased after antibiotic courses. Nearly all fractions increased along with FEV1and a positive relationship linked fatty acids to lipid hydroperoxides.

There was no general drop in fatty acids. Patients' fatty acid profiles depended on the pulmonary function and the inflammation state.
Analysis of the interbeat interval increment to detect obstructive sleep apnoea/hypopnoea
Authors: Roche F. , Celle S. , Pichot V. , Barthélémy J-C. , Sforza E.
Published: February 2007

The prevalence of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is underestimated and its diagnosis is costly and restricted to specialised sleep laboratories. The frequency component of interbeat interval increment (III) has been proposed as a simple and inexpensive diagnostic tool in OSAHS.

In a set of 150 patients with clinically suspected sleep-related breathing disorder, the actual predictive accuracy of the power spectral density of the III of the very low frequencies (%VLFI) was analysed by comparing with the apnoea/hypopnoea index (AHI), as assessed by synchronised polysomnography.

OSAHS was defined in 100 patients according to an AHI ≥15 events·h−1. Receiver operator characteristic curves built for %VLFI confirmed that this variable was able to separate OSAHS positive from OSAHS negative with statistical significance. Using an appropriate threshold (>4%), %VLFI demonstrated a positive predictive value of 80%. Misclassification of false-positive subjects occurred when the patient presented significant sleep discontinuity and sleep fragmentation (sleep fragmentation index ≥50 events·h−1) related to insomnia or periodic limb movements.

A power spectral density of the interbeat interval increment of very low frequencies >4% allowed correct classification of obstructive sleep apnoea/hypopnoea syndrome when the clinical history suggested sleep-related breathing disorders and when moderate-to-severe cases are considered. Higher power spectral density of the interbeat interval increment of very low frequencies may also indicate disrupted sleep in the absence of clear clinical symptoms of sleep apnoea/hypopnoea syndrome.
Positive effect of CPAP treatment on the control of difficult-to-treat hypertension
Authors: Martínez-García M. A. , Gómez-Aldaraví R. , Soler-Cataluña J-J. , Martínez T. G. , Bernácer-Alpera B. , Román-Sánchez P.
Published: February 2007

The aim of the present study was to analyse the role of continuous positive airway pressure (CPAP) treatment in patients with difficult-to-control hypertension (DC-HT) and sleep apnoea.

An AutosetTM(ResMed, Sydney, Australia) study was performed in 60 patients diagnosed with DC-HT based on two 24-h ambulatory blood pressure monitorisation (ABPM) studies. CPAP was offered to patients with an apnoea/hypopnoea index (AHI) ≥15 events·h−1. After 3 months of treatment, repeat ABPM was performed to evaluate the effect of CPAP upon the blood pressure values.

A total of 39 (65%) patients received CPAP treatment, but only 33 completed the study. The mean±sdsystolic and diastolic blood pressures (SBP and DBP, respectively) were 154.8±14 and 90±8.8 mmHg. Patients had a mean±sdAHI of 37.7±18.2 events·h−1. Only three patients presented a dipper nocturnal pressure pattern. CPAP treatment significantly reduced SBP (-5.2 mmHg), and particularly the nocturnal values (-6.1 mmHg), but not DBP. Considering only those patients who tolerated CPAP, the decrease in SBP was greater (-7.3 mmHg). Furthermore, CPAP treatment significantly increased the percentage of patients who recovered the dipper pattern (three (9.1%) out of 33versus12 (36.4%) out of 33).

Continuous positive airway pressure treatment significantly reduces systolic blood pressure, particularly at night, and normalises the nocturnal pressure pattern in patients with difficult-to-control hypertension and sleep apnoea.