bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunoprotection against murine bladder carcinoma by octaarginine‐modified liposomes incorporating cell wall of Mycobacterium bovis bacillus Calmette‐Guérin
Authors: Joraku Akira , Homhuan Atthachai , Kawai Koji , Yamamoto Takahiro , Miyazaki Jun , Kogure Kentaro , Yano Ikuya , Harashima Hideyoshi , Akaza Hideyuki
Published: November 2008

OBJECTIVE

To develop a prototype of a non‐live bacterial agent that consists of a cell wall (CW) preparation from heat‐killed bacillus Calmette‐Guérin (BCG‐CW) incorporated into octaarginine‐modified cationized liposomes as a vector (R8‐liposome‐BCG‐CW), and to evaluate its immunoprotective potentiation in mice, as although BCG is an established effective immunotherapy for nonmuscle‐invasive bladder cancer, more active and less toxic treatments are needed.

MATERIALS AND METHODS

The cellular interaction of R8‐liposome‐BCG‐CW co‐cultured with mouse bladder cancer cell line (MBT‐2) was examined by confocal laser scanning microscopy. MBT‐2 cells (7 × 105) were subcutaneously inoculated with 1 mg BCG, 0.1 mg or 1 mg BCG‐CW, 0.1 mg or 1 mg R8‐liposome‐BCG‐CW in female C3H/HeN mice. The MBT‐2 cells pretreated with BCG or R8‐liposome‐BCG‐CW were re‐challenged at 6 weeks. The sizes of the primary and re‐challenged tumours were evaluated at 4 and 10 weeks, respectively.

RESULTS

Confocal laser scanning microscopy showed the enhanced incorporation of R8‐liposome‐BCG‐CW into MBT‐2 cells after 1 h of co‐incubation. 0.1 mg R8‐liposome‐BCG‐CW completely inhibited the growth of MBT‐2 tumours while 0.1 mg BCG‐CW alone did not (P = 0.002). Mice vaccinated with a mixture of MBT‐2 cells and R8‐liposome‐BCG‐CW inhibited the growth of re‐challenged tumour of MBT‐2 cells pretreated with BCG or R8‐liposome‐BCG‐CW but did not inhibit that of MBT‐2 cells with no pretreatment at 10 weeks, with mean (sd) tumours sizes of 54 (60) mm2 (P < 0.001) or 69 (43) mm2 (P = 0.003) compared with 309 (125) mm2, respectively.

CONCLUSION

The immunotherapeutic potential of BCG‐CW was enhanced by improving cellular association using the R8‐liposomes delivery system. Development of this non‐live bacterial agent may contribute to providing a more active and less toxic tool as a substitute for live BCG as immunotherapy against nonmuscle‐invasive bladder cancer in the future.
Using community and population approaches to understand how contemporary and historical factors have shaped species distribution in river ecosystems
Authors: Bonada Núria , Múrria Cesc , Zamora‐Muñoz Carmen , El Alami Majida , Poquet José Manuel , Puntí Tura , Moreno José Luis , Bennas Nard , Alba‐Tercedor Javier , Ribera Carles , Prat Narcís
Published: November 2008

Aim  To examine how the employment of both community‐ and population‐level approaches can provide a wider view of the importance of contemporary and historical factors on current species distribution. We posit that community ecology should provide more information about contemporary factors, whereas population genetics should provide better information about historical factors.

Location  Rivers of the western Mediterranean Basin, including four subregions differing in geological history: the Iberian Plate, Transitional, Betic and Rif.

Methods  For a community‐level approach, Trichoptera richness and community composition were compared between subregions using species accumulation curves and a correspondence analysis. For a population‐level approach, the mtDNA cytochrome C oxidase subunit I (COI) gene of specimens of the Trichoptera midstream‐lowland species Chimarra marginata (L.) was sequenced and analysed using phylogeographical methods.

Results  The community approach revealed that historical events had more influence on headwater communities than contemporary ecological factors, whereas historical events had negligible influence on midstream‐lowland communities. In midstream‐lowland sites, however, the population approach showed that the genetic structure of C. marginata differed significantly between subregions and revealed patterns of historical gene migration. In terms of species richness, the Rif subregion had the lowest value per basin due to local climatic features and isolation.

Main conclusions  Both community‐ and population‐level approaches yielded information about the effects of historical factors on species distribution. However, the importance of historical events on current Trichoptera communities depends on the river zonation. Unlike headwater sites, midstream‐lowland sites showed signs of historical events at the population level but not at the community level at the scale used, indicating that both approaches should be employed together in biogeographical studies. Lack of detection of historical events at the community level does not necessarily mean that they are negligible. Most likely, the organizational level used is not appropriate. We also stress the importance of implementing conservation measures for rivers in the western Mediterranean, especially under future scenarios of climate change and human disturbances in the Mediterranean Basin.
Embodied infant attention
Authors: Robertson Steven S. , Johnson Sarah L.
Published: November 2008

Does real time coupling between mental and physical activity early in development have functional significance? To address this question, we examined the habituation of visual attention and the subsequent response to change in two groups of 3‐month‐olds with different patterns of movement–attention coupling. Insuppressors,the typical decrease in body movement at the onset of looks persists into the looks. Inrebounders,the initial decrease is more transient and movement quickly returns above baseline. Suppressors and rebounders did not differ on measures of looking during habituation, but when the stimulus changed rebounders looked more than suppressors. When it did not change, they looked less. In addition, during habituation rebounders spent more time lookingawayfrom the stimulus. Rapid motor reactivation soon after gaze locks onto a target, characteristic of rebounders, may influence visual foraging and the response to change by keeping attention near a threshold of engagement.
How Does Foreign Direct Investment Affect the Export Decisions of Firms in Ghana?
Authors: Abor Joshua , Adjasi Charles K. D. , Hayford Mac‐Clara
Published: November 2008

Abstract:  Foreign direct investment (FDI) has been identified to promote exports of host countries by augmenting domestic capital for exports, helping to transfer technology and new products for exports, facilitating access to new and large foreign markets, providing training for the local workforce, and upgrading technical and management skills. However, little is known on the role of FDI in the export behaviour of firms in developing countries. The main questions raised in this study are: how does FDI affect the export decisions of firms? How does FDI affect export performance of firms? This study examined the export‐decision and export performance within the Ghanaian manufacturing sector on a panel of plants from 1991 to 2002. Using a probit model, the results show that FDI has a positive effect on firms' decision to export. The random effect results also reveal a positive relationship between FDI and export performance. Clearly, the results of this study indicate that FDI is very relevant in influencing the export decisions and export performance of Ghanaian firms. The findings have significant implications for policy in terms of promoting initiatives to encourage more FDI inflows in the country.
Public Expenditure, Growth and Poverty Reduction in Rural Uganda
Authors: Fan Shenggen , Zhang Xiaobo
Published: November 2008

Abstract:  Using district‐level data for 1992, 1995, and 1999, the study estimated effects of different types of government expenditure on agricultural growth and rural poverty in Uganda. The results reveal that government spending on agricultural research and extension improved agricultural production substantially. This type of expenditure had the largest measured returns to growth in agricultural production. Agricultural research and extension spending also had the largest assessed impact on poverty reduction. Government spending on rural roads also had a substantial marginal impact on rural poverty reduction. The impact of low‐grade roads such as feeder roads is larger than that of high‐grade roads such as murram and tarmac roads. Education's effects rank after agricultural research and extension, and roads. Government spending in health did not show a large impact on growth in agricultural productivity or a reduction in rural poverty. Additional investments in the northern region (a poor region) contribute the most to reducing poverty. However, it is the western region (a relatively well‐developed region) where most types of investment have highest returns in terms of increased agricultural productivity.
Openness and the Effects of Fiscal and Monetary Policy Shocks on Real Output in Nigeria (1960–2003)*
Authors: Saibu M.O. , Oladeji S.I.
Published: November 2008

Abstract: This study investigates the effects of monetary and fiscal policies on the real output growth in a small open economy. It is a country‐specific, time series study that verifies the implication of increasing economic openness on the efficacy of monetary and fiscal policy. A modified GARCH model was used to estimate the anticipated and unanticipated shocks. Two measures of fiscal and monetary shocks were combined with openness and real oil price shocks in a VECM model to assess the effects of anticipated and unanticipated policy shocks on the output equations. The empirical results showed that anticipated and unanticipated fiscal and monetary shocks had no significant positive effects on real output. This suggests that the open macroeconomic version of the policy ineffectiveness proposition was valid for both monetary and fiscal policy shocks in Nigeria. This is in consonance with earlier works in this area. Furthermore, the degree of openness and oil price shocks had a negative implication on the efficacy of macroeconomic policy in Nigeria; also in agreement with the Dutch Disease Syndrome. Finally, the policy implication of this study therefore is that trade liberalization policy should be implemented cautiously. The Nigerian economy is weak to withstand the unwholesome consequences of full economic integration.
Financial Liberalization Policies and Economic Growth: Panel Data Evidence from Sub‐Saharan Africa
Authors: Fowowe Babajide
Published: November 2008

Abstract:  The paper conducts an empirical investigation into the effects of financial liberalization policies on the growth of 19 countries in sub‐Saharan Africa (SSA). Two indexes are constructed which measure the gradual progression and institutional changes involved in financial liberalization. Because these indexes track specific financial liberalization policies, they provide better measures of financial liberalization than the indicators of financial development often used in the literature. Panel data estimates show a significant positive relationship between economic growth and financial liberalization policies. Our results are robust to alternative specifications of the model, and also across slow‐ and fast‐growing countries.
Anthropology in the financial crisis
Authors: Hart Keith , Ortiz Horacio
Published: November 2008

This editorial considers the opportunities opened up for anthropologists by the financial crisis of 2008. The chief of these is the exposure of cracks in the intellectual hegemony of free‐market economics which contributed to an unnecessarily defensive posture on the part of most anthropologists during the period of neoliberal globalization. The authors claim that anthropology can bridge the gap between everyday life and the world at large by combining the study of ideas and social actions. We draw on Ortiz's research among financial professionals to show how working practices informed by economic liberalism can have extremely unequal consequences for the global distribution of resources. The perspectives of Mauss and Polanyi on political economy can help us to make sense of the current situation and to recommend a path forward beyond market fundamentalism. Their general ideas lend power to the concrete findings of field research. The mask of neoliberal ideology has been ripped from the politics of world economy. Anthropology's highest mission is to start from where people are and go with them wherever they take you. What better time to follow this imperative than when the model the world has been compelled to live by for three decades is in such disarray?
Facework on Facebook: The presentation of self in virtual life and its role in the US elections
Authors: Dalsgaard Steffen
Published: November 2008

This article analyses the phenomenon known as social networking services (e.g. websites such as Facebook and MySpace) with anthropological theory deriving mainly from Melanesia. It is argued that these websites engender what in Western countries is a new form of presentation of self‐ and personhood that focuses on the social relations of the person rather than the person as an individual. In this way, the article discusses consumption in cyberspace and the production of differentiation, rank and hierarchy on the Internet in relation to social identity.
Watching Wall Street: A global earthquake
Authors: Gudeman Stephen
Published: November 2008

When the liquidity crisis in the United States reached fever pitch in early October 2008, I began to keep a weekly journal to see if I could make sense of the event. I continued the diary for three weeks but sent it every seven days to Anthropology Today. In the journal, I used local or US expressions for the events and inserted some of my reactions as a participant ‐ observer. I did not survey the effects of the crisis on other countries or compare their experiences to those in the US. Little did I expect that anthropology would help clarify what happened in those 21 days, but it did. I found themes from postmodernism to spheres of value, and some anthropological ideas for other ways to manage the mess.
The development of ICT across the curriculum in Irish schools: A historical perspective
Authors: McGarr Oliver
Published: November 2008

This literature review explores the historical development of information and communication technology (ICT) in Irish postprimary/secondary schools and examines how the education system has responded to the various ICT initiatives and policy changes. The review has found that despite national policy and significant ICT initiatives, it appears that the use of computer technology has instead evolved independent of these changes. The various policy nudges throughout the past three decades have had limited impact on the nature of its use. The predominant use of the technology lies within discrete informatics subjects which tend to focus on learning about the technology rather than learning with it. Future ICT policy needs to be cognisant of the past, particularly how national ICT initiatives are mediated within schools and the powerful influence of the prevailing ICT culture on external ICT initiatives.
eCAF: A new tool for the conversational analysis of electronic communication
Authors: Duncan‐Howell Jennifer
Published: November 2008

Electronic communication is characteristically concerned with ‘the message’ (eM), those who send them (S), and those who receive and read them (R). This relationship could be simplified into the equation eM = S + R. When this simple equation is applied to electronic communication, several elements are added that make this straightforward act of sending and receiving a message more complex. These new elements are characteristics such as asynchronicity, unknown senders and readers, non‐linear text and the absence of non‐verbal cues. What is apparent is that the complexity of these messages lies in their impact outside the online environment. It is clear from the messages themselves that the information is being applied to real, authentic contexts and is not limited to the online environment. Conversational analysis frameworks must attempt to understand this complexity if the meaning of electronic messages is to be understood. This paper proposes a new conversational analysis framework, the electronic conversational analysis framework (eCAF), for use with electronic communication. The eCAF has been designed as a new methodological tool that incorporates the unique virtual/real worlds that individuals participate in and links these two locations to the phases of electronic discussions.
Comparison of older and younger adults' attitudes towards and abilities with computers: Implications for training and learning
Authors: Broady Tim , Chan Amy , Caputi Peter
Published: November 2008

Computers and associated technology have become central to modern life. In a society where the population is rapidly ageing, the acceptance and utilisation of developing technologies by an older population is becoming increasingly important. This review highlights similarities and differences between the attitudes and acceptance of technology by older and younger people, leading to the conclusion that similar factors influence both age groups—hence, older people could well be taught to use technology in a similar manner to younger people. While all learners, irrespective of age, should receive sufficient time for training in a positive and supportive environment, this review suggests that due consideration ought to be given to the amount of time allowed for older users to learn new skills and the manner in which learners are treated in a positive and valued manner.
Eye Movements and Visual Encoding During Scene Perception
Authors: Rayner Keith , Smith Tim J. , Malcolm George L. , Henderson John M.
Published: November 2008

The amount of time viewers could process a scene during eye fixations was varied by a mask that appeared at a certain point in each eye fixation. The scene did not reappear until the viewer made an eye movement. The main finding in the studies was that in order to normally process a scene, viewers needed to see the scene for at least 150 ms during each eye fixation. This result is surprising because viewers can extract the gist of a scene from a brief 40- to 100-ms exposure. It also stands in marked contrast to reading, as readers need only to view the words in the text for 50 to 60 ms to read normally. Thus, although the same neural mechanisms control eye movements in scene perception and reading, the cognitive processes associated with each task drive processing in different ways.
Cognitive Constraints on How Economic Rewards Affect Cooperation
Authors: Furlong Ellen E. , Opfer John E.
Published: November 2008

Cooperation often fails to spread in proportion to its potential benefits. This phenomenon is captured by prisoner's dilemma games, in which cooperation rates appear to be determined by the distinctive structure of economic incentives (e.g., $3 for mutual cooperation vs. $5 for unilateral defection). Rather than comparing economic values of cooperating versus not ($3 vs. $5), we tested the hypothesis that players simply compare numeric values (3 vs. 5), such that subjective numbers (mental magnitudes) are logarithmically scaled. Supporting our hypothesis, increasing only numeric values of rewards (from $3 to 300¢) increased cooperation ( Study 1 ), whereas increasing economic values increased cooperation only when there were also numeric increases ( Study 2 ). Thus, changing rewards from 3¢ to 300¢ increased cooperation rates, but an economically identical change from 3¢ to $3 elicited no gains. Finally, logarithmically scaled reward values predicted 97% of variation in cooperation, whereas the face value of economic rewards predicted none. We conclude that representations of numeric value constrain how economic rewards affect cooperation.
On modelling and diagnostic checking of vector periodic autoregressive time series models
Authors: Ursu Eugen , Duchesne Pierre
Published: November 2008

Abstract. Vector periodic autoregressive time series models (PVAR) form an important class of time series for modelling data derived from climatology, hydrology, economics and electrical engineering, among others. In this article, we derive the asymptotic distributions of the least squares estimators of the model parameters in PVAR models, allowing the parameters in a given season to satisfy linear constraints. Residual autocorrelations from classical vector autoregressive and moving‐average models have been found useful for checking the adequacy of a particular model. In view of this, we obtain the asymptotic distribution of the residual autocovariance matrices in the class of PVAR models, and the asymptotic distribution of the residual autocorrelation matrices is given as a corollary. Portmanteau test statistics designed for diagnosing the adequacy of PVAR models are introduced and we study their asymptotic distributions. The proposed test statistics are illustrated in a small simulation study, and an application with bivariate quarterly West German data is presented.
Encompassing: Concepts and Implementation*
Authors: Bontemps Christophe , Mizon Grayham E.
Published: November 2008

The encompassing principle has been carefully and precisely defined in various contexts, since its first appearance in the 1980s literature in numerous papers by Hendry, Mizon and Richard. Since then, several distinct notions of encompassing have been proposed and still coexist in the literature. We describe, illustrate and connect these notions in this paper. We start with the intuitive properties of exact encompassing between estimated models and compare it with its testable counterpart, approximate encompassing. We examine these notions and their main properties within static and dynamic, parametric and non‐parametric, classical and Bayesian models and estimators. Encompassing or the lack of encompassing, is also studied via the concepts of parsimonious and partial encompassing. Pseudo‐true values, which are central elements in measuring and testing approximate encompassing, are defined in line with the concept of specificity between models. We also examine the role played by the data generating process in the different approaches in the literature.
Cross‐data‐vintage Encompassing*
Authors: Cook Steve
Published: November 2008

The issues of model comparison and evaluation in the presence of data revision are examined. The initial analysis revisits the model validity and data accuracy tests of Hendry [Oxford Review of Economic Policy(1994) Vol. 10, pp. 86–106] to develop the concept of model and vintage coalescence (MVC). A taxonomy of MVC tests is proposed, with the finite‐sample properties of the tests examined via Monte Carlo simulation. The analysis proceeds to extend the encompassing principle [see Mizon and Richard,Econometrica(1986), Vol. 54, pp. 657–678;Contributions to Operations Research and Econometrics: The XXth Anniversary of CORE,Hendry and Richard (1989)MIT Press, Cambridge, MA] to permit the comparison of econometric models developed upon alternative vintages of data. The resulting cross‐data‐vintage encompassing tests are discussed, with their finite‐sample properties compared with those of conventional encompassing tests. The paper concludes by considering implications of the present analysis for econometric modelling.
Costly Tax Enforcement and Financial Repression
Authors: Gupta Rangan , Ziramba Emmanuel
Published: November 2008

Using an overlapping generations production‐economy model characterized by financial repression, purposeful government expenditures and cost of tax collection, we analyse whether financial repression can be explained by the cost of raising taxes. We show that with public expenditures affecting utility of the agents, modest costs of tax collection tend to result in financial repression being pursued as an optimal policy by the consolidated government. However, when public expenditures are purposeless, the above result only holds for relatively higher costs of tax collection. But, more importantly, costs of tax collection cannot produce a monotonic increase in the reserve requirements. What are critical, in this regard, are the weights the consumer assigns to the public good in the utility function and the size of the government.
Low prevalence of progranulin mutations in Finnish patients with frontotemporal lobar degeneration
Authors: Krüger J. , Kaivorinne A.‐L. , Udd B. , Majamaa K. , Remes A. M.
Published: November 2008

Background and purpose:  Mutations in the progranulin (PGRN) gene have recently been associated with frontotemporal lobar degeneration (FTLD). The frequency of these mutations varies between populations. The aim of this study was to determine mutations and genetic variations of the PGRN gene in Finnish patients with FTLD and FTLD with associated motor neuron disease (FTLD‐MND).

Subjects and methods:  All exons of the PGRN gene were sequenced from 69 Finnish patients with FTLD. The FTLD‐MND phenotype was present in 13 of the 69 patients.

Results:  No pathogenic PGRN mutations were identified in the cohort. Eleven sequence variations were detected, of which IVS8 + 15C>T, IVS4‐51_‐52insAGTC and IVS11 + 25G>A have not been reported previously. At least one single‐nucleotide polymorphism (SNP) of PGRN was detected in 83% of patients.

Conclusions:  We conclude that mutations in PGRN are rare among Finnish patients with FTLD and FTLD‐MND. However, SNPs were frequent suggesting high genetic variability of the PGRN gene.
ON ISOTOPES AND OLD BONES*
Authors: LEE‐THORP J. A.
Published: November 2008

This review charts the developments and progress made in the application of stable light isotope tools to palaeodietary adaptations from the 1970s onwards. It begins with an outline of the main principles governing the distribution of stable light isotopes in foodwebs and the quality control issues specific to the calcified tissues used in these analyses, and then proceeds to describe the historical landmark studies that have marked major progress, either in their archaeological applications or in enhancing our understanding of the tools. They include the adoption of maize agriculture, marine‐focused diets amongst coastal hunter–gatherers, trophic level amongst Glacial‐period modern humans and Neanderthals, and the use of savannah resources by early hominins in Africa. Particular attention is given to the progress made in addressing the challenges that have arisen out of these studies, including issues related to the routing of dietary nutrients. I conclude with some firm, and some more speculative, pointers about where the field may be heading in the next decade or so.
ORGANIC RESIDUE ANALYSIS IN ARCHAEOLOGY: THE ARCHAEOLOGICAL BIOMARKER REVOLUTION*
Authors: EVERSHED R. P.
Published: November 2008

Organic residue analysis utilizes analytical organic chemical techniques to identify the nature and origins of organic remains that cannot be characterized using traditional techniques of archaeological investigation (because they are either amorphous or invisible). The field is founded upon the principle that the biomolecular, or biochemical, components of organic materials associated with human activity survive in a wide variety of locations and deposits at archaeological sites. The archaeological information contained in organic residues is represented by the biomolecular components of the natural products that contribute to the formation of a given residue. By applying appropriate separation (chromatographic) and identification (mass spectrometric) techniques, the preserved, and altered, biomolecular components of such residues can be revealed. Once identified, the Archaeological Biomarker Concept can be applied, wherein the structure and even isotopic composition(s) of a given biomolecule or suite of biomolecules (the ‘chemical fingerprint’) can be related to the compositions of organisms exploited by humans in the past. As the organic residue field emerges from its pre‐paradigmatic phase, and the organic residue revolution gathers pace, the way is open for challenging many long‐held archaeological hypotheses and offering new perspectives on the study of human activity in the past.
Omega‐3 Fatty Acid Supplementation Effects on Weight and Appetite in Patients with Alzheimer's Disease: The Omega‐3 Alzheimer's Disease Study
Authors: Faxén Irving Gerd , Freund‐Levi Yvonne , Eriksdotter‐Jönhagen Maria , Basun Hans , Brismar Kerstin , Hjorth Erik , Palmblad Jan , Vessby Bengt , Vedin Inger , Wahlund Lars‐Olof , Cederholm Tommy
Published: November 2008

OBJECTIVES: To study the effects of omega (Ω)‐3 fatty acid (FA) supplements on weight and appetite in patients with mild to moderate Alzheimer's disease (AD) in relation to inflammatory biomarkers and apolipoprotein E ɛ4 (APOEɛ4).

DESIGN: Randomized, double‐blind, placebo‐controlled trial.

SETTING: Specialist memory clinics in the Stockholm catchment area.

PARTICIPANTS: Two hundred four patients (aged 73±9, 52% women) with mild to moderate AD.

INTERVENTION: Patients with AD received 1.7 g of docosahexaenoic acid (DHA) and 0.6 g of eicosapentaenoic acid (EPA) (Ω‐3/Ω‐3 group; n=89, aged 73±9, 57% women) or placebo 0.6 g of linoleic acid per day (placebo/Ω‐3 group; n=85, aged 73±9, 46% women) for 6 months. After 6 months, all patients received DHA and EPA for another 6 months.

MEASUREMENTS: Anthropometry, biochemical nutritional and inflammatory markers, and appetite assessed by caregiver.

RESULTS: Mean weight and body mass index (kg/m2) at baseline were 70.0±11.8 kg and 24.3±3.0 kg/m2, respectively. At 6‐ and 12‐month follow‐up, weight had increased 0.7±2.5 kg (P=.02) and 1.4±2.9 kg (P<.001) in the Ω‐3/Ω‐3 group. In the placebo group, weight was unchanged at 6 months but had increased (P=.01) at 12 months follow‐up after Ω‐3 supplementation was initiated. Appetite improved in the Ω‐3/Ω‐3 group over the treatment period (P=.01). In logistic regression analyses, not carrying the APOEɛ4 allele and high plasma DHA concentrations were independently related to weight gain in the combined group of patients at 6 months follow‐up.

CONCLUSION: A DHA‐enriched Ω‐3 FA supplement may positively affect weight and appetite in patients with mild to moderate AD. Not carrying the APOEɛ4 allele and high DHA were independently associated with weight gain.
Racial and Ethnic Differences in End‐of‐Life Care in Fee‐for‐Service Medicare Beneficiaries with Advanced Cancer
Authors: Smith Alexander K. , Earle Craig C. , McCarthy Ellen P.
Published: November 2008

OBJECTIVES: To examine racial and ethnic variation in use of hospice and high‐intensity care in patients with terminal illness.

DESIGN: Retrospective, secondary data analysis.

SETTING: Surveillance, Epidemiology, and End Results‐Medicare Database from 1992 to 1999 with follow‐up data until December 31, 2001.

PARTICIPANTS: Forty thousand nine hundred sixty non‐Hispanic white, non‐Hispanic black, Asian, and Hispanic fee‐for‐service Medicare beneficiaries aged 65 and older with advanced‐stage lung, colorectal, breast, and prostate cancer.

MEASURMENTS: Hospice use and indicators of high‐intensity care at the end of life.

RESULTS: Whereas 42.0% of elderly white patients with advanced cancer enrolled in hospice, enrollment was lower for black (36.9%), Asian (32.2%), and Hispanic (37.7%) patients. Differences between white and Hispanic patients disappeared after adjustment for clinical and sociodemographic factors. Higher proportions of black and Asian patients than of white patients were hospitalized two or more times (11.7%, 15.0%, 13.7%, respectively), spent more than 14 days hospitalized (11.4%, 17.4%, 15.6%, respectively), and were admitted to the intensive care unit (ICU) (12.0%, 17.0%, 16.2%, respectively) in the last month of life and died in the hospital (26.5%, 31.3%, 33.7%, respectively). Unadjusted differences in receipt of high‐intensity care according to race or ethnicity remained after adjustment.

CONCLUSION: Black and Asian patients with advanced cancer were more likely than whites to be hospitalized frequently and for prolonged periods, be admitted to the ICU, die in the hospital, and be enrolled in hospice at lower rates. Further research is needed to examine the degree to which patient preferences or other factors explain these differences.
Efficacy of recombinant activated Factor VII in patients with massive uncontrolled bleeding: a retrospective observational analysis
Authors: Berkhof Farida F. , Eikenboom Jeroen C.J.
Published: November 2008

BACKGROUND: Recombinant activated Factor VII (rFVIIa) is a prohemostatic agent used for treatment of hemophilia patients with inhibiting antibodies. It has also been used in the context of massive uncontrolled blood loss, but the efficacy has not been proven. The aim of this study was to evaluate the effectiveness of rFVIIa in massive uncontrolled blood loss.

STUDY DESIGN AND METHODS: In this retrospective observational analysis patients were included that had received rFVIIa between April 2004 and January 2008 in the context of bleeding that could not be controlled by conventional transfusion therapy. Data were retrieved from patient files, anesthesia reports, the electronic hospital information system, and the computer files of the hospital blood transfusion service. Baseline demographics, medication data, laboratory data, transfusion data, and surgical data were analyzed.

RESULTS: In 32 patients with massive uncontrolled blood loss, a significant reduction in transfusion requirements was observed after infusion of rFVIIa, when comparing the transfusions before and up to 48 hours after infusion of rFVIIa. Mean red blood cell (RBC) transfusions showed a reduction of 20.1 units before rFVIIa to 8.7 after rFVIIa (mean difference, 11.4 units; 95% confidence interval [CI], 6.4‐16.5) and fresh‐frozen plasma (FFP) transfusions showed a reduction of 19.3 units before rFVIIa to 9.3 after rFVIIa (mean difference, 9.9 units; 95% CI, 4.2‐15.6). Fifty‐six percent of patients receiving rFVIIa for uncontrolled life‐threatening bleeding were alive at discharge from the hospital.

CONCLUSION: This study suggests that rFVIIa may play a role in patients with massive uncontrolled blood loss by reducing the amount of RBC and FFP transfusions and by improving the coagulation variables.
Identification and characterization of a novel XK splice site mutation in a patient with McLeod syndrome
Authors: Arnaud Lionel , Salachas François , Lucien Nicole , Maisonobe Thierry , Le Pennec Pierre‐Yves , Babinet Jérôme , Cartron Jean‐Pierre
Published: November 2008

BACKGROUND: McLeod syndrome is a rare X‐linked neuroacanthocytosis syndrome with hematologic, muscular, and neurologic manifestations. McLeod syndrome is caused by mutations in the XK gene whose product is expressed at the red blood cell (RBC) surface but whose function is currently unknown. A variety of XK mutations has been reported but no clear phenotype‐genotype correlation has been found, especially for the point mutations affecting splicing sites.

STUDY DESIGN AND METHODS: A man suspected of neuroacanthocytosis was evaluated by neurologic examination, electromyography, muscle biopsy, muscle computed tomography, and cerebral magnetic resonance imaging. The McLeod RBC phenotype was disclosed by blood smear and immunohematology analyses and then confirmed at the biochemical level by Western blot analysis. The responsible XK mutation was characterized at the mRNA level by reverse transcription–polymerase chain reaction (PCR), identified by genomic DNA sequencing, and verified by allele‐specific PCR.

RESULTS: A novel XK splice site mutation (IVS1‐1G>A) has been identified in a McLeod patient who has developed hematologic, neuromuscular, and neurologic symptoms. This is the first reported example of a XK point mutation affecting the 3′ acceptor splice site of Intron 1, and it was demonstrated that this mutation indeed induces aberrant splicing of XK RNA and lack of XK protein at the RBC membrane.

CONCLUSION: The detailed characterization at the molecular biology level of this novel XK splice site mutation associated with the clinical description of the patient contributes to a better understanding of the phenotype‐genotype correlation in the McLeod syndrome.
The Rights of Children, the Rights of Nations: Developmental Theory and the Politics of Children's Rights
Authors: Daiute Colette
Published: November 2008

The Convention on the Rights of the Child (CRC), U.N. General Assembly (1989) is a major breakthrough in defining children as fully human and working to ensure them the attendant benefits worldwide. While children's rights as equal human beings may seem obvious in the 21st century, the politics of establishing and ensuring such rights are contentious. The CRC is a brilliant negotiation of conceptions of the child and international relations, yet certain tensions in the children's rights process lead to a lack of clarity in a global situation that continues to leave millions of children at risk. Analyzing the CRC and related practices from a developmental perspective can help identify obstacles to the advancement of children's rights, especially those related to opportunities for rights‐based thinking and the exercise of self‐determination and societal‐determination rights.

In this article, I offer a qualitative analysis of children's rights in the context of what I refer to as the CRC activity‐meaning system. I present a theoretical framework for considering this system of policy and practice as enacted in the CRC treaty and related monitoring, reporting, qualifying, and implementing documents. A discourse analysis of conceptions of the child and those responsible for ensuring their rights in seven representative documents (including the CRC Treaty, a report by the U.N. Committee on the Rights of the Child, minutes of a U.N. Security Council meeting, reports by a State‐Party, and a report by a civil society group in that country) reveals tensions inherent in the CRC activity‐meaning system.1 Emerging from this analysis is a tension between children's rights and nation's rights. Created in part via explicit and implicit assumptions about child development in the CRC as these posit responsibilities across actors in the broader CRC system, this tension challenges the implementation of children's rights and the development of children's rights‐based understandings. I use this analysis to explain why future research and practice should address the development of children's rights‐based understanding not only in terms of maturation or socialization but also as integral to salient conflicts in their every day lives.
Regardless of Frontiers: Adolescents and the Human Right to Information
Authors: Levesque Roger J.R.
Published: November 2008

Legal systems struggle to keep pace with rapid technological advances and changing social conditions that provide adolescents with much wanted and unwanted information. We examine this struggle as we note prevailing tensions guiding the development of adolescents' rights. We find that the United States typically adopts an inculcative approach, an approach that generally treats adolescents as in need of control and indoctrination into the values of prior generations. We also find an emerging human rights approach that adopts a more liberative view, one that seeks to bestow adolescents with greater control over their own rights and aims to shape informational environments that allow adolescents to prepare for their own futures. The divergence leads us to explore why adolescent jurisprudence—an approach to law that begins with adolescents' realities and charts ways to develop laws consistent with those realities—would benefit from taking human rights orientations more seriously. We end by highlighting how liberative approaches are consistent with our understanding of adolescents' realities and how such approaches appropriately urge us to revisit our society's fundamental commitments to justice.
Adolescents' Perceptions of Rights as Reflected in Their Views of Citizenship
Authors: Sherrod Lonnie R.
Published: November 2008

The UN Convention on the Rights of Children (CRC), ratified by the majority of the countries of the world, is an international document that recognizes children and adolescents as worthy of citizenship and human rights. The CRC also attempts to provide a balance between children's nurturance (care and protection) and self‐determination (participation) rights. Although there has been social cognitive research on children's understanding of rights, there has been little research examining adolescents' views of the specific rights they would expect to receive through citizenship. In addition, few studies have examined young people's views of the responsibilities inherent in citizenship. This article investigates adolescents' views of the rights and responsibilities of citizenship. Three hundred four adolescents, aged 13–18 years, were asked to rate the importance of various rights and responsibilities of citizenship. Findings indicated that adolescents' responses regarding rights reduced to two components, one related to entitlements (nurturance component of the CRC) and the other freedoms (self‐determination/participation component of the CRC). Responsibilities consist of civic‐oriented ones and polity‐oriented responsibilities. Both components of rights (entitlements and freedoms) correlated significantly with civic‐oriented forms of responsibilities; neither form of rights related to polity‐oriented responsibilities. The two components of rights also related to the individual variables of age, parental education, ethnicity, and aspects of political self‐concept. These results demonstrate the importance of research on the development of citizenship and also have implications for implementation of the CRC.
Schooling, Sexuality, and Rights: An Investigation of Heterosexual Students' Social Cognition Regarding Sexual Orientation and the Rights of Gay and Lesbian Peers in School
Authors: Horn Stacey S. , Szalacha Laura A. , Drill Karen
Published: November 2008

Within the United States, protecting the rights of lesbian, gay, bisexual, and transgender (LGBT) students in school elicits much controversy and debate. On one side is the argument that all students should be able to receive an education free from discrimination, harassment, and harm. On the other side is the argument that by protecting LGBT students'rights, schools are infringing on the rights of others to their individual beliefs about homosexuality. To investigate these competing arguments, we surveyed high school‐aged heterosexual adolescents (N = 1,076) regarding their beliefs and attitudes about sexual orientation and the rights of gay and lesbian peers. Results suggest that adolescents differentiate between their individual beliefs about homosexuality and the rights of others to be safe in school. Further, the results provide additional support for the idea that attitudes and beliefs about sexual orientation and the rights of gay and lesbian peers are multifaceted and draw from multiple domains of social knowledge. The implications of these findings will be discussed in relation to the rights of LGBT students and the obligations that schools have to create safe and supportive learning environments for all students regardless of sexual orientation or gender identity.
Antiplatelet Therapy: Anti‐Ischemic Benefits versus Bleeding Risk
Authors: GIBSON C. MICHAEL
Published: November 2008

Balance between efficacy and safety is a major concern in therapeutic interventions of patients with acute coronary syndromes. Identifying and managing the risks that may negatively affect this balance can potentially minimize the incidence of morbidity and/or mortality among patients with acute coronary syndromes. Unstable angina and non‐ST‐elevation myocardial infarction are potentially life‐threatening disorders and a major cause of hospitalization and emergency medical care. At the time of presentation, the use of algorithms that provide reasonable assessment of a patient's risk of cardiovascular events, such as the Thrombolysis in Myocardial Infarction risk score, can help clinicians identify which patients will most likely benefit from a specific strategy. The ultimate goal of treatment for non‐ST‐elevation myocardial infarction is to reduce short‐ and long‐term morbidity and mortality, as well as salvage myocardial cells and cardiac function. Pharmacologic intervention with antiplatelet and/or antithrombotic agents has proven to be effective in achieving this goal in numerous outcome studies. However, clinicians must balance anti‐ischemic efficacy with the need to minimize the risk of serious bleeding complications (e.g., hemorrhage). Issues related to safety include timing of the dose, duration of infusion, drug compatibility, errors in estimating a patient's weight and/or age, failure to adjust the dosage based upon renal function, and errors in drug preparation.
Nursing Implementation Science: How Evidence‐Based Nursing Requires Evidence‐Based Implementation
Authors: Van Achterberg Theo , Schoonhoven Lisette , Grol Richard
Published: November 2008

Purpose: Evidence is not always used in practice, and many examples of problematic implementation of research into practice exist. The aim of this paper is to provide an introduction and overview of current developments in implementation science and to apply these to nursing.

Methods: We discuss a framework for implementation, describe common implementation determinants, and provide a rationale for choosing implementation strategies using the available evidence from nursing research and general health services research.

Findings: Common determinants for implementation relate to knowledge, cognitions, attitudes, routines, social influence, organization, and resources. Determinants are often specific for innovation, context, and target groups. Strategies focused on individual professionals and voluntary approaches currently dominate implementation research. Strategies such as reminders, decision support, use of information and communication technology (ICT), rewards, and combined strategies are often effective in encouraging implementation of evidence and innovations. Linking determinants to theory‐based strategies, however, can facilitate optimal implementation plans.

Conclusions: An analytical, deliberate process of clarifying implementation determinants and choosing strategies is needed to improve situations where suboptimal care exists. Use of theory and evidence from implementation science can facilitate evidence‐based implementation. More research, especially in the area of nursing, is needed. This research should be focused on the effectiveness of innovative strategies directed to patients, individual professionals, teams, healthcare organizations, and finances.

Clinical Relevance: Implementation of evidence‐based interventions is crucial to professional nursing and the quality and safety of patient care.
Development of a Self‐Report Instrument to Measure Patient Safety Attitudes, Skills, and Knowledge
Authors: Schnall Rebecca , Stone Patricia , Currie Leanne , Desjardins Karen , John Rita Marie , Bakken Suzanne
Published: November 2008

Purpose: To describe the development and psychometric testing of the Patient Safety Attitudes, Skills and Knowledge Scale (PS‐ASK).

Methods: Content validity of a 35‐item instrument was established by a panel of experts. The instrument was pilot tested on 285 nursing students. Principal components analysis (PCA) with varimax rotation was conducted, and Cronbach's alphas were examined. Paired samples t‐tests were used to show responsiveness of the scales pre‐ and post‐patient safety curriculum.

Results: The final instrument consists of 26 items and three separate scales: attitudes, skills, and knowledge. The attitudes and skills scales each had a three‐factor solution. The knowledge items had a one‐factor solution. Both skills and knowledge were significantly increased at Time 2 (p<0.001).

Conclusions: The skills and knowledge subscales had satisfactory internal consistency reliability, evidence for construct validity, and responsiveness for use as independent scales in future studies. The attitudes subscale needs further refinement before implementation. Comparison with other measures of patient safety skills (e.g., observation) and knowledge are warranted.

Clinical Relevance: A tool to measure clinicians' attitudes, skills, and knowledge about patient safety might be useful to evaluate nurses and other clinicians during educational preparation and in practice.