bluuebunny/crossref_metadata_2025 huggingface dataset:
High‐Commitment Work Practices and Downsizing Harshness in Australian Workplaces
Authors: IVERSON RODERICK D. , ZATZICK CHRISTOPHER D.
Published: June 2007

This study examines the relationship between high‐commitment work practices (HCWP) and downsizing. The results based on a large, representative sample of Australian workplaces supported our predictions. Consistent with previous research, HCWP was positively related to workforce reduction. However, workplaces with more HCWP used less harsh strategies (e.g., more employee‐friendly approaches to downsizing) such as voluntary layoffs and early retirement than the harsher strategy of compulsory layoffs. The implications of these findings are discussed.
Defined Contribution Plans and the Distribution of Pension Wealth
Authors: EVEN WILLIAM , MACPHERSON DAVID
Published: June 2007

Over the past 20 years, the defined benefit (DB) plan has been replaced by the defined contribution (DC) plan as the most popular form of pension plan. This study examines the likely consequences of this transformation for both the level and distribution of future pension wealth using a sample of DB and DC plans from the Survey of Consumer Finances. The results reveal that the shift from DB to DC plans is likely to simultaneously increase the level and inequality of pension wealth at retirement. The evidence also suggests that the shift to DC plans may result in less pension wealth at retirement for low‐income workers, women, and minorities.
Decentralization of Collective Agreements and Rising Wage Inequality in Israel
Authors: KRISTAL TALI , COHEN YINON
Published: June 2007

This paper presents a systematic analysis of the decentralization of the Israeli system of collective bargaining and its contribution to the rise in earnings inequality. We quantitatively analyze all collective agreements that were signed between 1957 and 2003, and present the scale, scope, and timing of five dimensions of decentralization. The findings suggest that decentralization started in the mid‐1970s when national agreements were less likely to be extended to nonunion employees; it was intensified in 1975–1980 when nationwide industrial agreements were supplanted by occupational and local agreements. Decentralization became fully consolidated by 1987 when peak‐level agreements covering the entire private sector were no longer signed. We then present evidence (including time‐series analyses that control for union density and macroeconomic indicators) that the process of decentralization, especially the decline in the use of extension orders and the proliferation of local agreements, explains a significant part of the sharp rise in earnings inequality in Israel during 1970–2003.
State Dependence, Accommodations, and the Postinjury Employment of Disabled Workers
Authors: CAMPOLIETI MICHELE
Published: June 2007

This paper examines the postinjury employment patterns of disabled workers from Ontario, Canada by estimating a dynamic probit model with unobserved effects. The estimates indicate that there is some state dependence in the conditional probability of leaving employment for health reasons and that an employer accommodation can reduce the conditional probability of leaving employment for health reasons by 33 percent. Moreover, a supplementary cross‐sectional analysis confirms that accommodations can reduce the probability of leaving employment.
Poverty, welfare problems and social exclusion
Authors: Halleröd Björn , Larsson Daniel
Published: June 2007

This article investigates whether, and to what degree, poverty is linked to other types of welfare problems and, in larger perspective, whether the situation can be understood in terms of social exclusion. Two different measures of poverty – income poverty and deprivation poverty – and 17 indicators of welfare problems were used in the analysis. It was shown that income poverty was rather weakly related to other types of welfare problems, i.e. the most commonly used measure of poverty seems to discriminate a section of the population that does not suffer from the kinds of problems we usually assume that poverty causes. Deprivation poverty, identifying those who most often had to forgo consumption of goods and services, did correlate strongly with other types of welfare problems. Hence, people living under poor conditions do suffer from welfare problems even though this section of the population is not always captured by income poverty measures. The final analysis showed that the types of welfare problems that were most likely to cluster were deprivation poverty, economic precariousness, unemployment, psychological strain and health problems. Whether these types of accumulated welfare problems, from a theoretical perspective, can be seen as indicators of social exclusion is more doubtful.
Social Justice as a Guide to Planning Theory and Practice: Analyzing the Portuguese Planning System
Authors: CARDOSO RICARDO , BREDA‐VÁZQUEZ ISABEL
Published: June 2007

The first utilizations of social justice theory as a guide to planning theory and practice were founded on David Harvey's attempt to incorporate issues of redistributive justice into geographical methods of analysis. Later conceptualizations utilize Iris Marion Young's view of social justice as an institutional condition that enables participation and overcomes oppression and domination through the achievement of self‐development and self‐determination. These two conceptual paths create a constructive argumentative tension that should underlie contemporary spatial planning in democratic societies. This means that, in order to contribute to more socially just urban societies, planning needs to be focused not only on patterns of distribution, but also on the relational social structures and institutional contexts in which these come about. Comprehensive and functionalist, mainstream planning in Portugal is unmistakably situated within the modernist planning project. We argue that the normative disposition of the identified argumentative tension undermines the theoretical capacity of modernist practices to achieve socially just territories. The aim of this article is to study the validity of this argument by analyzing the Portuguese planning system against a twofold set of social justice criteria.

Les premiers recours à la justice sociale comme guide en matière de théorie et pratique de l’aménagement urbain s’appuyaient sur la tentative de David Harvey d’intégrer des aspects de justice redistributive dans les méthodes d’analyse géographiques. Plus tard, d’autres conceptions se serviront de la perspective d’Iris Marion Young sur la justice sociale comme condition institutionnelle permettant la participation tout en surmontant oppression et domination grâce au développement personnel et à l’autodétermination. Ces deux voies conceptuelles créent une tension argumentaire constructive qui devrait sous‐tendre l’aménagement spatial contemporain dans les sociétés démocratiques. Autrement dit, pour contribuer à des sociétés urbaines plus justes socialement, l’aménagement doit s’attacher, non seulement aux schémas de distribution, mais aussi aux structures sociales relationnelles et cadres institutionnels dans lesquels ses schémas opèrent. L’aménagement urbain portugais, conventionnel, général et fonctionnaliste, se situe immanquablement dans un projet d’urbanisation moderniste. Selon nous, la nature normative de la tension argumentaire établie entrave la capacité théorique des pratiques modernistes à aboutir à des territoires justes au plan social. L’article étudie la validité de cet argument en analysant le système d’aménagement urbain portugais en fonction de deux gammes de critères de justice sociale.
Taking City Regions Seriously? Response to Debate on ‘City‐Regions: New Geographies of Governance, Democracy and Social Reproduction’
Authors: HARDING ALAN
Published: June 2007

This article takes up the invitation extended by the co‐editors of the recent IJURR debate on city‐regions for others to join them in ‘a wider dialogue over the constitutive role of politics in the brave new world of ‘city‐regions’. It begins by considering the extent to which the collection was successful in describing this ‘brave new world’ and in populating it with the variety of social and environmental concerns which, the co‐editors claimed, have so far been neglected in recent debates about the significance of city‐regions. Adjudging the debate to have been only partially successful in these respects, the article goes on to argue that the goal the co‐editors strove for — effectively to liberate ‘city‐regionalism’ from its ostensible captors — is unlikely to be achieved unless and until its critics (1) engage more explicitly and seriously with claims that are made for the significance of changes in the material circumstances of city‐regions, and (2) recognize that there is nothing inherently ‘neoliberal’ or regressive about the concept of the city‐region or the way it is used. These arguments are illustrated with reference to the economics of city‐regions and the politics of city‐regionalism in England.

Répondant à l'invitation des co‐responsables du dernier débat publié dans IJURR sur les régions métropolitaines, cet essai vient ‘élargir le dialogue sur le rôle constitutif de la politique dans l'univers idéal des régions métropolitaines’. Pour commencer, il étudie dans quelle mesure cet ensemble d'articles a réussi à décrire ce ‘meilleur des mondes’ et à le nourrir de diverses questions sociales et environnementales qui, d'après les co‐responsables, ont jusqu'alors été ignorées dans les récentes discussions sur l'importance de ces régions. Etablissant que le débat n'a qu'en partie atteint ces objectifs, l'article affirme ensuite qu'on ne parviendra probablement pas au but poursuivi — libérer le ‘régionalisme métropolitain’ de ses entraves apparentes —à moins que ses critiques (1) ne s'attachent plus explicitement et sérieusement aux arguments sur l'importance des changements apportés aux situations matérielles des régions métropolitaines, et (2) ne reconnaissent qu'il n'y a rien d'intrinsèquement ‘néolibéral’ ni régressif dans le concept de région métropolitaine ou dans son exploitation. Cette démonstration est illustrée à partir de l'économie des régions métropolitaines et de la politique de régionalisme métropolitain en Angleterre.
The lipid profile in psoriasis: a controlled study
Authors: Akhyani M , Ehsani AH , Robati RM , Robati AM
Published: June 2007

Background  Psoriasis is an inflammatory dermatosis that is characterized with hyperproliferation of keratinocytes and inflammatory infiltration in the epidermis and dermis. The high prevalence of atherosclerosis has been reported in psoriatic patients. High serum lipid level has been suggested in the pathogenesis of this phenomenon. In this study, our purpose was to compare the lipid profile in psoriatic patients with non‐affected persons.

Methods  This study was designed and conducted as a case–control assay with 50 cases in the patient and control groups, respectively. The lipid profile, including serum level of triglyceride, cholesterol, low‐density lipoprotein (LDL), and high‐density lipoprotein (HDL), were assessed in both groups.

Results  The patient and control groups each consisted of 50 cases (39 male and 11 female). The serum triglyceride, cholesterol, and LDL was significantly higher in psoriatic patients (P < 0.05) but not for HDL (P = 0.29).

Conclusion  This study, like previous assays, shows that high serum lipid level is significantly more common in psoriasis. This fact may be responsible for higher prevalence of cardiovascular accident in psoriatic patients. It may be useful to do early screening and treatment of hyperlipidaemia in psoriasis to prevent the atherosclerosis and its complications.
Age‐dependent changes in the pigeon bursa of Fabricius vasculature: a comparative study using light microscopy and scanning electron microscopy of vessel casts
Authors: Abbate Franco , Pfarrer Christiane , Jones Carolyn J. P. , Ciriaco Emilia , Germanà Giovanni , Leiser Rudolf
Published: June 2007

The present study was carried out to analyse the vascularization of the pigeon bursa cloacalis of Fabricius and to determine whether it undergoes age‐dependent changes during its functionally most important growth period after hatching of the pigeon. Morphological assessment of vascular corrosion casts, studied qualitatively and quantitatively, was applied for the first time to investigate the vascularization of the pigeon pigeon bursa of Fabricius. This also allowed us to analyse the microvasculature and morphological aspects of the vessel interrelationships as occurring in the natural state. The casts were compared with histological sections stained by haematoxylin‐eosin and by binding of the lectin e‐PHA (Phaseolus vulgaris, erythroagglutinin) to blood vessels. The vascular architecture of the bursa of Fabricius of the pigeon revealed that the organ is irrigated via two pathways, first through the terminal capillary system of lymphoid follicles arising from the internal pudendal artery, and secondly through arteries originating from the cloacal vasculature of the collum of the organ supplying the periluminal capillary system of the pigeon bursa of Fabricius. Both systems are drained by a venous system which is collateral to the system of the internal pudendal artery and clearly functions as a direct link between the lumen and vasculature of the cloaca or gut, respectively, and the bursa fabricii. This could allow the lymphocytes to be confronted with antigens from the contents of the gut, and their subsequent transport into the secondary lymphoid organs of the organism. Our results demonstrate that the blood vessels, as major and supplying part of the lymphoid system of the bursa Fabricii, clearly reflect three different phases of development: the evolution phase from about day 20 until day 50 post‐hatching, the mature phase from days 50 to 90, and the involution phase after day 90. During the evolution phase the density of the vessel system rapidly increases, while in the mature phase the vascular architecture is maintained. The involution phase is dominated by vascular degeneration combined with shrinkage of the whole organ. Therefore, the morphology of the vasculature distinctly reflects the functional status of this primary lymphoid organ during its lifespan.
Splice variation in the cytoplasmic domains of myelin oligodendrocyte glycoprotein affects its cellular localisation and transport1
Authors: Boyle Louise H. , Traherne James A. , Plotnek Gemma , Ward Rosemary , Trowsdale John
Published: June 2007

Although myelin oligodendrocyte glycoprotein is a candidate autoantigen in multiple sclerosis, its function remains unknown. In humans, mRNA expressed by the myelin oligodendrocyte glycoprotein gene is alternatively spliced resulting in at least nine unique protein isoforms. In this study, we investigated the sub‐cellular localisation and membrane trafficking of six isoforms by cloning them into mammalian expression vectors. Confocal microscopy revealed that these protein products are expressed in different cellular compartments. While two full‐length isoforms (25.6 and 25.1) are expressed at the cell surface, three alternatively spliced forms (22.7, 21.0 and 20.5) have a more intracellular distribution, localising to the endoplasmic reticulum and/or endosomes. Isoform 16.3, which lacks a transmembrane domain, is secreted. A switch in the sub‐cellular localisation of myelin oligodendrocyte glycoprotein may have profound effects on receptor:ligand interactions and consequently the function of the protein. The structural features of the alternative isoforms and their differential, sub‐cellular expression patterns could dictate the exposure of major immunogenic determinants within the central nervous system. Our findings highlight myelin oligodendrocyte glycoprotein splicing as a factor that could be critical to the phenotypic expression of multiple sclerosis.
Mechanism of 6‐hydroxydopamine neurotoxicity: the role of NADPH oxidase and microglial activation in 6‐hydroxydopamine‐induced degeneration of dopaminergic neurons
Authors: Rodriguez‐Pallares J. , Parga J. A. , Muñoz A. , Rey P. , Guerra M. J. , Labandeira‐Garcia J. L.
Published: June 2007

Cell death induced by 6‐hydroxydopamine (6‐OHDA) is thought to be caused by reactive oxygen species (ROS) derived from 6‐OHDA autooxidation and by a possible direct effect of 6‐OHDA on the mitochondrial respiratory chain. However, the process has not been totally clarified. In rat primary mesencephalic cultures, we observed a significant increase in dopaminergic (DA) cell loss 24 h after administration of 6‐OHDA (40 μmol/L) and a significant increase in NADPH subunit expression, microglial activation and superoxide anion/superoxide‐derived ROS in DA cells that were decreased by the NADPH inhibitor apocynin. Low doses of 6‐OHDA (10 μmol/L) did not induce a significant loss of DA cells or a significant increase in NADPH subunit expression, microglial activation or superoxide‐derived ROS. However, treatment with the NADPH complex activator angiotensin II caused a significant increase in all the latter. Forty‐eight hours after intrastriatal 6‐OHDA injection in rats, there was still no loss of DA neurons although there was an increase in NADPH subunit expression and NADPH oxidase activity. The results suggest that in addition to the autooxidation‐derived ROS and the inhibition of the mitochondrial respiratory chain, early microglial activation and NADPH oxidase‐derived ROS act synergistically with 6‐OHDA and constitute a relevant and early component of the 6‐OHDA‐induced cell death.
Reduced histamine levels and H3receptor antagonist‐induced histamine release in the amygdala ofApoe−/−mice
Authors: Van Meer Peter , Pfankuch Tim , Raber Jacob
Published: June 2007

The histamine H3receptor is a constitutively active G protein‐coupled receptor for the neurotransmitter histamine that serves a negative feedback function. A role for the histamine H3receptor has been suggested in neurodegenerative diseases, such as Parkinsons disease and Alzheimer’s disease. Mice deficient in apolipoprotein E (apoE), a protein involved in development, regeneration, neurite outgrowth, and neuroprotection, show increased measures of anxiety and reduced sensitivity to effects of histamine H3receptor antagonists on measures of anxiety. In this study, we tested whether in mice lacking apoE (Apoe−/−) histamine levels and histamine release in brain areas involved in the regulation of anxiety are altered. H3receptor antagonist‐induced histamine release was lower in the amygdala ofApoe−/−than wild‐type mice. In contrast, there were no genotype differences in histamine release in the hypothalamus. Consistent with these data, histamine immunohistochemistry revealed lower total and synaptic histamine levels in the central nucleus of the amygdala ofApoe−/−than wild‐type mice. Such changes were not seen in the hypothalamus, hippocampus, or cortex. InApoe−/−mice, chronically decreased histamine levels and reduced histamine release in the amygdala might contribute to increased measures of anxiety.
Could Selective Mutism be Re‐conceptualised as a Specific Phobia of Expressive Speech? An Exploratory Post‐hoc Study
Authors: Omdal Heidi , Galloway David
Published: June 2007

Background:  Selective mutism (SM) is now widely seen as a symptom of social anxiety. However, observations of children's interactions in the natural contexts of home and school/kindergarten suggest that this may be in need of review.

Method:  Data were available from two sources: first, interviews with six adults who had recovered from SM in childhood and adolescence; second, informal observations of five SM children in home and school/kindergarten, and semi‐structured interviews with their parents and teachers. The research had three stages: (i) Data were examined for the presence of social anxiety and/or determined or stubborn behaviour, but neither provided a satisfactory explanation for the SM. (ii) The data suggested that SM could be reconceptualised as a specific phobia of their own speech. It is argued that if this is the case, SM should respond to intervention at school based broadly on a cognitive behaviour therapy methodology. (iii) A post hoc examination of observation and interview transcripts was used to test this hypothesis.

Results:  (i) Apart from two adults, no evidence was found of social anxiety. Determined and stubborn behaviour was observed but was inadequate as an explanation of SM. (ii) Two children recovered when exposed to classroom interactions that could be seen as consistent with the principles of graded in vivo flooding. Three children who were not exposed to similar interactions did not improve.

Conclusions:  SM may be understood and treated successfully at school/kindergarten as a specific phobia of expressive speech.
Training Health Professionals for Child and Adolescent Mental Health Care in Nigeria: A Qualitative Analysis
Authors: Omigbodun Olayinka , Bella Tolulope , Dogra Nisha , Simoyan Olapeju
Published: June 2007

There is no organised training and service for CAMH in Nigeria. A 3‐day course in child mental health aimed at multidisciplinary health professionals was developed and evaluated to inform future training. Developing the course involved multi‐professional consultation. Course evaluation involved the completion of questionnaires by delegates (present from 5 of the 6 geopolitical zones of Nigeria) before and after the training. Training needs expressed include skills to manage CAMH problems in their own context, greater understanding of normal child development and strategies to train others. Most participants reported that their expectations were met and would affect their practice especially with regard to collaboration.
Democrats with adjectives: Linking direct and indirect measures of democratic support
Authors: SCHEDLER ANDREAS , SARSFIELD RODOLFO
Published: June 2007

Abstract.  Major cross‐national surveys measure popular support for democracy through direct questions about democracy in the abstract. Since people may entertain competing democratic ideas and ideals, however, the academic community ignores the extent to which standard questions capture citizen support for liberal democracy. To solve the validity problems associated with direct measures of democratic support, this article proposes linking them to more concrete, indirect measures of support for democratic principles and institutions. It employs the statistical technique of cluster analysis to establish this linkage. Cluster analysis permits grouping respondents in a way that is open to complex and inconsistent attitudinal profiles. It permits the identification of ‘democrats with adjectives’ who support democracy in the abstract, while rejecting core principles of liberal democracy. The article demonstrates the fruitfulness of this approach by drawing a map of ‘illiberal democrats’ in Mexico on the basis of the country's 2003 National Survey on Political Culture.
Agree to reform? The political economy of conditionality variation in International Monetary Fund lending, 1983–1997
Authors: KANG SEONJOU
Published: June 2007

Abstract.  This article analyzes variation in International Monetary Fund (IMF) conditionality. Conditions attached to IMF loans vary qualitatively and quantitatively across time and space, contrary to the allegations of inflexibility and insensitivity. This study theorizes that despite the IMF's official rules to determine conditionality by economic criteria, variation arises because the strategic interests of the five biggest contributors to the IMF (the United States, the United Kingdom, Japan, Germany and France) interfere with IMF policy, which potentially compromises the effectiveness of its programs. This theory is tested empirically against 398 conditionality agreements contracted between 1983 and 1997 using an event‐count method based on the Poisson distribution to obtain statistical results supportive of the theory.
High Density Lipoprotein and Coronary Heart Disease: Lessons From Recent Intervention Trials
Authors: Rubins Hanna Bloomfield
Published: June 2007

Epidemiologic studies have consistently implicated low plasma high density lipoprotein cholesterol as an important, independent risk factor for the development of coronary heart disease. However, clinical trials specifically designed to evaluate the role of lipid therapy in patients with low high density lipoprotein cholesterol have only been recently reported. They include two trials with angiographic end points, the Lopid Coronary Angiography Trial and the Bezafibrate Coronary Atherosclerosis Intervention Trial, and three clinical end points trials, the Air Force/Texas Coronary Atherosclerosis Prevention study, the Department of Veterans Affairs High Density Lipoprotein Intervention Trial, and the Bezafibrate Infarction Prevention study. These and other trials clearly indicate that persons with coronary heart disease and high low density lipoprotein cholesterol (>130 mg/dL [3.36 mmol/L]), with or without low high density lipoprotein cholesterol, benefit from statin therapy. The Air Force/Texas Coronary Atherosclerosis Prevention study showed that persons at high risk of coronary heart disease but without known disease, who have moderate levels of low density lipoprotein cholesterol as well as low levels of high density lipoprotein cholesterol, also appear to benefit from statin therapy although the cost effectiveness of this approach is unclear. The results from the Department of Veterans Affairs High Density Lipoprotein Intervention Trial provide convincing evidence that patients without high low density lipoprotein cholesterol and with established coronary heart disease and low high density lipoprotein cholesterol benefit from gemfibrozil. This drug may be particularly beneficial for patients who, in addition to low high density lipoprotein cholesterol, present with other features of the metabolic syndrome, such as obesity, glucose intolerance, and high triglycerides. Whether other fibrates, niacin, or statins lower coronary heart disease risk in persons with low high density lipoprotein cholesterol in the absence of high or moderately high low density lipoprotein cholesterol is unknown.
Hormone Replacement Therapy (Estrogen and Progesterone): Is it Necessary for Heart Disease Prevention?
Authors: Freeman Ruth
Published: June 2007

This is a brief review of the rationale for estrogen replacement as prevention of coronary artery disease. Epidemiological data suggest that premarin (0.625 mg) together with medroxyprogesterone acetate (2.5 mg) can prevent or delay the onset of coronary artery disease in postmenopausal women. The major effects of estrogens are: improving the lipid profile by lowering low density lipoprotein and raising high density lipoprotein; acting on vessel walls to reduce intimal damage and plaque formation; dilating vessels by both an endothelial dependent and an independent pathway; and acting as an antioxidant, thereby reducing the oxidation of low density lipoprotein and increasing the production of nitric oxide locally in the blood vessel. Oral estrogens and transdermal estrogens may act differently on coagulation factors and lipids. The role of specific estrogen receptor modulators as possible treatment for postmenopausal women in part will depend on the effect of these drugs in preventing coronary artery disease. The specific estrogen receptor modulators decrease low density lipoprotein and prevent triglyceride increases but it is unknown if they have estrogenic effects on blood vessel walls. Better compliance with estrogen replacement therapy will depend on educating women about their risk of getting coronary artery disease, and assisting them in decision making, as well as reducing side effects. The Heart and Estrogen/Progestin Replacement Study provides evidence that Prempro™ (Premarin/medroxyprogesterone acetate) should not be given to someone who already has heart disease without careful monitoring.
How Much Exercise is Enough for the Coronary Patient?
Authors: Franklin Barry A.
Published: June 2007

Prescribing exercise for cardiac patients is comparable in many ways to prescribing medications; that is, one recommends an optimal dosage according to individual needs and limitations. For in‐patients, simple exposure to orthostatic or gravitational stress can obviate much of the deterioration in exercise tolerance that normally follows a cardiovascular event or intervention. On the other hand, the continuum of exercise therapy for outpatients may range from brisk walking to marathon running. Upper body and resistance training also have been shown to be safe and effective for clinically stable patients. Moderate intensity exercise training can produce beneficial changes in functional capacity, cardiac function, coronary risk factors, psychosocial well being, and possibly improve survival in patients with coronary artery disease. These findings may be especially relevant for the previously sedentary patient, in whom the subjective discomfort of vigorous exercise may serve as a deterrent to long term compliance with physical training.
The Role of Exercise in Type II Diabetes Mellitus
Authors: Schneider Stephen H. , Elouzi Elhadi B.
Published: June 2007

A number of studies have demonstrated a beneficial effect of regular physical activity on levels of HgbA1C in patients with type II diabetes mellitus, largely due to an increase in insulin sensitivity. Benefits are related to short term improvements in insulin sensitivity following individual exercise bouts. Regular exercise can prevent or delay the onset of type II diabetes in high risk populations. The insulin resistant state is associated with a cluster of cardiovascular risk factors all of which improve with regular physical activity. Because of the high incidence of occult coronary disease, patients need a cardiovascular evaluation when initiating an exercise program. High intensity exercise may result in retinal hemorrhage and transient worsening of diabetic proteinuria. The most common complication is hypoglycemia. A combination of aerobic and light resistance exercise is appropriate. Patients should exercise a minimum of three times a week for 30–60 minutes at 50% to 75% of their Vo2max.
Safety and Efficacy of Resistive Training in Patients With Coronary Heart Disease
Authors: Stewart Kerry J.
Published: June 2007

In the past 10–15 years, there have been several studies on the acute and chronic responses to resistive training in patients with cardiovascular disease. As a result, the safety and efficacy of resistive exercise has become more evident. Resistive training appears to be safe and effective for promoting fitness and improving risk factors in patients with coronary heart disease. This review addresses the health and fitness benefits in these patients, the established guidelines regarding inclusion and exclusion into programs, guidelines for resistive training exercise prescriptions, and how these guidelines have evolved in recent years.
Lipid Risk Factor Correlates of Ischemic Heart Disease as Diagnosed by Myocardial Perfusion Scintigraphy
Authors: Bybee Kevin A. , O'Keefe James H. , Harris William S. , Garg Shamila , George Sabu J. , Bateman Timothy M.
Published: June 2007

Patients with known coronary artery disease frequently change their lifestyles (e.g., diet, exercise, and smoking habit) after the diagnosis is made. Such changes can alter lipid risk factor levels and obscure etiologic risk factor associations with the presence of coronary artery disease. It is therefore preferable to determine the contribution of potential risk factors before the diagnosis of coronary artery disease has been established. In this trial, we used stress nuclear myocardial perfusion imaging to diagnose coronary artery disease in patients presenting for evaluation of chest pain. Two groups of age‐ and sex‐matched patients were identified: a normal group (patients with no evidence of coronary artery disease), and an abnormal group (patients whose scans indicated the presence of significant coronary artery disease due to either fixed or reversible perfusion defects). Blood samples were drawn before scanning and analyzed for lipid risk factors. Compared to the normal group, the abnormal group had higher levels of triglycerides (189±91 vs. 135±51 mg/dL, p=0.003), lower levels of high density lipoprotein cholesterol (39±9 vs. 45±14 mg/dL, p=0.037), and higher levels of small, dense low density lipoprotein (LDL3) (42±18 vs. 32±13 mg/dL, p=0.007). Total cholesterol, low density lipoprotein, and lipoprotein(a) levels were similar between groups. These findings suggest that ischemic heart disease, as assessed by myocardial perfusion scintigraphy, is more closely associated with the low high density lipoprotein/high triglyceride syndrome than with increased low density lipoprotein or total cholesterol levels.
Prevalence of Coronary Artery Disease, Ischemic Stroke, and Symptomatic Peripheral Arterial Disease and of Associated Risk Factors in Older Men and Women With and Without Diabetes Mellitus
Authors: Ness Jose , Aronow Wilbert S. , Ahn Chul
Published: June 2007

The authors performed a retrospective analysis of the prevalence of coronary artery disease, ischemic stroke, and symptomatic peripheral arterial disease and of associated risk factors in 99 men (mean age 79±8 years) with diabetes mellitus vs. 368 men (mean age 81±8 years) without diabetes mellitus, and in 260 women (mean age 80±8 years) with diabetes mellitus vs. 1184 women (mean age 81±8 years) without diabetes mellitus. All patients were seen in an academic outpatient geriatrics practice. Diabetic men had a higher prevalence of coronary artery disease, ischemic stroke, and symptomatic peripheral arterial disease (p<0.0001); a higher prevalence of smoking (p=0.023), hypertension (p<0.0001), and obesity (p=0.0007); higher levels of serum total and low density lipoprotein cholesterol (p<0.0001) and triglycerides (p=0.003); and lower levels of serum high density lipoprotein cholesterol (p=0.0001) than men without diabetes mellitus. Diabetic women had a higher prevalence of coronary artery disease, ischemic stroke, and symptomatic peripheral arterial disease (p<0.0001); a higher prevalence of hypertension and obesity (p<0.0001); higher levels of serum total and low density lipoprotein cholesterol (p=0.0001) and triglycerides (p=0.005); and lower levels of serum high density lipoprotein cholesterol (p=0.0001) than women without diabetes mellitus.
Six‐Month Patient Outcomes in a Preventive Cardiology Center
Authors: Calfas Karen J. , Criqui Michael H. , Sallis James F. , Langer Robert D. , Rupp Joan W. , Kashani Iraj A. , McCann Theresa J.
Published: June 2007

More effective ways to improve lifestyle behaviors need to be developed. Two hundred forty adult patients at a preventive cardiology clinic were randomly assigned to receive either one or five sessions of behavioral instruction to improve cardiovascular risk behaviors. Results for 102 patients from 6‐month follow‐up data revealed few significant differences between the two groups. However, in the two groups combined, there were significant reductions in total calories, percent of calories from total fat, percent of calories from saturated and monounsaturated fat, and dietary cholesterol. Reductions were also found in systolic blood pressure, triglycerides, body mass index, and weight. In multiple regression analyses, changes in physiologic variables were primarily associated with baseline and demographic characteristics. Changes in total calories, percent of calories from polyunsaturated fat, and walking were predicted by changes in social support or knowledge. Although most patients improved, the intensity of behavior change instruction was not related to the amount of change in cardiovascular risk factors.
Health Perception of Patients after Cardiovascular Risk Detection and after Intervention in General Practice
Authors: Van Drenth Bernard B. , Hulscher Marlies E.J.L. , Mokkink Henk G.A. , Van De Lisdonk Eloy H. , Van Der Wouden Johannes C. , Grol Richard P.T.M.
Published: June 2007

Background
. To explore unfavorable effects, health perception was assessed in patients enrolled in a cardiovascular program in general practice. Methods. A prospective questionnaire survey was conducted shortly after risk detection and after 1 year of intervention. Patients (n=413) with an elevated risk were selected from 27 practices in The Netherlands. The outcome measure was patients' perceptions of their general health status. Results. The response rate was 62%. Two thirds of the patients did not show any change in general health status at either point in time. Substantially more patients showed improvement after 1 year of intervention. Compared to reference data, no major differences were found. Conclusion. Enrollment in a cardiovascular risk detection and intervention program did not lead to unfavorable perceptions of general health status, either shortly after risk detection or after 1 year of intervention.
Maintaining the Endothelium: Preventive Strategies for Vessel Integrity
Authors: Lissin Lynette Wroblewski , Cooke John P
Published: June 2007

The endothelium is a diaphanous membrane, only one cell layer thick, that lines all of our blood vessels. Despite its apparent fragility, it exerts profound control over vascular tone, structure, and intersection with circulating blood elements. One of the factors that the endothelium synthesizes is nitric oxide, which is the most potent endogenous vasodilator known. In addition to its blood flow regulating effects, nitric oxide also inhibits key processes in atherosclerosis, including monocyte adherence, platelet aggregation, and proliferation of vascular smooth muscle cells. Nitric oxide synthesis is impaired, and its degradation is accelerated, in many of the conditions associated with atherosclerosis, including hypercholesterolemia. Restoration of nitric oxide synthesis and activity in these disorders can improve blood flow, relieve symptoms, and perhaps reduce the progression of atherosclerosis.
Reducing the Global Burden of Cardiovascular Disease: The Role of Risk Factors
Authors: Levenson James W. , Skerrett Patrick J. , Gaziano J. Michael
Published: June 2007

During the last century, cardiovascular disease (CVD) has burgeoned from a relatively minor disease worldwide to a leading cause of morbidity and mortality. By 2020 it is projected that CVD will surpass infectious disease as the world's leading cause of death and disability. Some of this increase in the relative importance of CVD is due to improved public health measures and medical care leading to longer life spans and reduced mortality from other causes. However, a substantial portion of the increasing global impact of CVD is attributable to economic, social, and cultural changes that have led to increases in risk factors for CVD. These changes are most pronounced in the countries comprising the developing world. Because the majority of the world's population lives in the developing world, the increasing rate of CVD in these countries is the driving force behind the continuing dramatic worldwide increase in CVD. In order to blunt the impact of the global explosion in CVD, it will be crucial to attempt to understand and reduce the global increase in CVD risk factors. In this review, the authors describe the changes responsible for the global epidemic of CVD, with particular attention to the contributions of established risk factors and their impact on the growth of CVD among the world's various economic sectors. The authors outline the major challenges facing countries in different economic sectors, and discuss ways to address these challenges with the goal of reducing the global burden of CVD. (Prev Cardiol.
Attempts at Changing Dietary and Exercise Habits to Reduce Risk of Cardiovascular Disease: Who's Doing What in the Community?
Authors: Thomas Randal J. , Kottke Thomas E. , Brekke Mark J. , Brekke Lee N. , Brandel Catherine L. , Aase Lee A. , DeBoer Stephen W.
Published: June 2007

The objective of this study was to characterize adults in Olmsted County, MN who were attempting to change both their dietary and physical activity habits. A random digit‐dial telephone survey was taken of 1232 adults, with questions about lifestyle, medical conditions, demographics, and receipt of previous lifestyle advice from a health care professional. Respondents were grouped in four categories: 1) changing neither diet nor exercise habits (22%); 2) changing diet habits only (20%); 3) changing exercise habits only (9%); and 4) changing both diet and exercise habits (49%). Along with several demographic and behavioral factors, receipt of physician advice to change exercise and dietary habits was a strong predictor of attempts to change both lifestyle habits. Only a minority of the population (23%), however, reported having received such advice. These results support the positive impact of health professional advice on dietary and exercise change in the population. Public health campaigns should be aimed at increasing the provision of such advice.
The Importance of Lipid Evaluation and Management in the Prevention and Treatment of Acute Myocardial Infarction
Authors: Malach Monte , Imperato Pascal James
Published: June 2007

There is an obvious need to measure low‐density lipoprotein cholesterol in all patients with acute myocardial infarction and coronary artery disease. The recent guidelines of the National Cholesterol Education Program have established the desired level for low‐density lipoprotein cholesterol for such patients at <100 mg/dL. However, several studies have demonstrated a lack of low‐density lipoprotein cholesterol measurement and lipid‐lowering therapy with statins in patients with acute myocardial infarction and coronary artery disease. These findings point to a need for quality of care improvement efforts to foster both lipid measurement and statin use in such patients. Many studies have demonstrated the numerous beneficial effects of statin use. In addition to lipid lowering, these include plaque stability and antiplatelet, antimacrophage, and antiatherothrombotic activities as well as enhanced endothelial activity. As a class of drugs, the statins have been shown to offer significant benefits with little in the way of associated risks.
ALLHAT and AFFIRM
Authors: Liebson Philip R.
Published: June 2007

Because of the proliferation of clinical trials relevant to preventive cardiology, this new section of the journal is being initiated to review recently published findings from randomized clinical studies with the potential to significantly alter medical practice. Each issue of Preventive Cardiology will address one or more of these trials with commentary by Philip R. Liebson, MD, editor of the section. Dr. Liebson is Professor of Medicine and Preventive Medicine and Associate Director, Section of Cardiology, Rush Medical College, Rush‐Presbyterian‐St. Luke's Medical Center, Chicago, IL. He is a member of our founding Editorial Board with extensive experience and investigative activity in clinical cardiology and preventive cardiology. It is hoped that this series will promote discussion and comment by our readers on recent publications concerning the prevention of cardiovascular disease and we welcome letters to the editor.
Current Recommendations for Prevention of Cardiovascular Disease in Patients With Diabetes Mellitus
Authors: Hupfeld Christopher J. , Wong Gail A.
Published: June 2007

Patients with diabetes mellitus are at a high risk of developing cardiovascular disease, and therefore stand to benefit greatly from a preventive strategy. Recommendations regarding assessment and management of traditional risk factors are basically similar for diabetic and nondiabetic patients with several important differences. Several nontraditional risk factors also play a substantial role in the development of cardiovascular disease in diabetic patients, and need to be addressed if full preventive care is to be provided. In this second in a two‐part series, we present current recommendations for reducing the risk of cardiovascular disease in the diabetic patient.
It Is Never Too Late: Change in Physical Activity Fosters Change in Cardiovascular Risk Factors in Middle‐Aged Women
Authors: Owens Jane F. , Matthews Karen A. , Räikkönen Katri , Kuller Lewis H.
Published: June 2007

The purpose of the study was to determine the effect of physical activity, particularly change in physical activity over time, on cardiovascular risk factors in women. The 520 women in this analysis are part of an ongoing epidemiologic investigation of the effects of menopause on risk for cardiovascular disease; the investigation spans almost 20 years. The findings show that on average, physically active women have healthier risk factor profiles over time, and that as women change their activity level, their risk factor profiles change as well. Thus, for middle‐aged women going through the menopausal transition, it is never too late to reduce their cardiovascular risk by increasing their activity level.
The Effects of Exercise on Resting Blood Pressure in Children and Adolescents: A Meta‐Analysis of Randomized Controlled Trials
Authors: Kelley George A. , Kelley Kristi S. , Tran Zung Vu
Published: June 2007

Resting blood pressure in children and adolescents can track into adulthood. The purpose of this study was to use the meta‐analytic approach to examine the effects of exercise on resting systolic and diastolic blood pressure in children and adolescents. Twelve randomized, controlled trials representing 16 outcomes in 1266 subjects met the inclusion criteria. Reductions in blood pressure were approximately 1% and 3% for resting systolic and diastolic blood pressures, respectively. However, random‐effects modeling using 5000 bootstrap confidence intervals revealed that neither result was statistically significant (systolic, ±SEM=−1±2; 95% bootstrap confidence intervals=−2 to 0 mm Hg; diastolic, ±SEM=−2±1; 95% bootstrap confidence intervals=−3 to 0 mm Hg). The results of this study suggest that short‐term exercise does not appear to reduce resting systolic and diastolic blood pressure in children and adolescents. However, a need exists for additional studies, especially in hypertensive children and adolescents.
Alcohol Use and Prognosis in Patients With Coronary Heart Disease
Authors: Mukamal Kenneth J.
Published: June 2007

Substantial evidence has shown that moderate drinkers have lower rates of coronary heart disease (CHD) than abstainers, but the effects of alcohol consumption among patients with established CHD are less clear. Alcohol intake has important effects on risk factors for reinfarction, including higher levels of high‐density lipoprotein cholesterol and triglycerides, lower levels of fibrinogen and other prothrombotic factors, lower fibrinolytic potential, and antiplatelet activity. Studies of patients at risk for CHD, such as those with diabetes, hypertension, and hyperlipidemia, have shown that the association of moderate drinking and CHD is at least as strong as it is in the general population. Most recently, studies have found that survivors of acute myocardial infarction who drink moderately have a risk of death approximately 20%–30% lower than do abstainers or rare drinkers. Nonetheless, the risks and benefits of alcohol use remain complex, even among patients with CHD, and no simple recommendation regarding alcohol consumption can be made for all patients.
Implication of Earlier Carotid Atherosclerosis for Stroke and Its Subtypes
Authors: Nagai Yoji , Kitagawa Kazuo , Matsumoto Masayasu
Published: June 2007

In addition to advanced stenosis, earlier stages of carotid atherosclerosis are associated with the risk for stroke. Based on a recent report, this review will focus on the associations between carotid atherosclerosis and stroke subtypes. The authors report increased severity of carotid atherosclerosis in atherothrombotic and lacunar infarction patients, compared to nonstroke patients. However, the severity was similar between nonstroke patients and those with cardioembolic infarction and cerebral hemorrhage. By receiver operating characteristic curve analyses, although evaluation of carotid atherosclerosis appears to help for risk assessment of atherothrombotic and lacunar infarction, the potential for benefit may be greater for atherothrombotic. Large prospective studies are still necessary to establish the link between earlier carotid atherosclerosis and the future risk for specific stroke subtypes.