bluuebunny/crossref_metadata_2025 huggingface dataset:
Elastomer-based Microwave Absorbing Materials
Authors: Shtarkova R. , Dishovsky N.
Published: March 2009

Different elastomer-based composites for microwave absorbers are developed. The influence of chemical character and structure of the polymer matrix and chemical nature and concentration of fillers with high values of the imaginary part of the complex dielectric permittivity and magnetic permeability on the microwave properties of the absorbers is investigated. Natural rubber (NR), styrene butadiene rubber (SBR), butadiene rubber (BR), chloroprene rubber (CR), nitrile butadiene rubber (NBR) are tested as polymer matrix. Graphite, furnace carbon black, acetylene carbon black and active carbon are used as fillers with high dielectric losses; natural magnetite is used as filler with high magnetic losses in our experiments. Some more important microwave parameters of the absorbers as function of frequency and composition (mass ratio filler/rubber) are measured.
Risk, Control and Gender: Reconciling Production and Reproduction in the Risk Society
Authors: Malenfant Romaine
Published: March 2009

In the risk society, managing health risks underlines a social tension between a logic of rationalization and a logic of subjectivation. In the former, techno-scientific thought dominates and induces a certain form of dependence on scientific experts while, in the latter, the individuals tend to be seen to make independent choices to protect their health. This article examines the logics of the actors in the risk management process from a constructivist perspective. According to Dubet's sociology of experience, social experience is structured around three logics: the logic of integration, i.e. the social world seen through the membership group, role and social relations; the strategic logic, i.e. the social world seen as a market; and the logic of subjectivation, i.e. the ability to be a subject, to distance oneself from the surrounding world and to give meaning to one's actions and decisions. Our qualitative research involved the analysis of the discourse of workers and employers in relation to the risk for pregnancy of work activities. The study was conducted in Quebec (Canada), where employers are legally obliged to protect the health of pregnant workers and the latter have the right to safe working conditions without prejudice. The results show that scientific experts do not have a determining impact on organizational changes and the representations of risk held by employers and women workers. Scientific controversies about work risks for pregnancy are used by employers to maintain the status quo while, for workers, the climate of employment and economic insecurity plays a significant role in how they deal with work-related health risks. Based on the theory of the risk society, the results bring out the complex interplay between scientific rationality and social rationality whereby risk is defined according to the interests of the actors involved. But, not consistent with certain tenets of the risk society thesis, they also reveal one's ability to be critical of institutionalized risk.
Managing the Threat of Terrorism in British Travel and Leisure Organizations
Authors: Sullivan-Taylor Bridgette , Wilson David C.
Published: March 2009

This paper examines the perceived threats from terrorism in six organizations in the travel and leisure sector in the UK. These organizations are particularly exposed to such extreme threats. This paper examines how managers in organizations deal with uncertainty where probabilities are impossible or difficult to define and examines how they face the challenge of interpreting and acting upon these interpretations. Theoretically the paper draws upon two lenses: organizational resilience and institutional perspectives. The former assumes managers can act autonomously to increase organizational resilience. The latter argues that systemic features of organization are more accurate explanations of why managers and organizations fail to spot threats and impending disasters. The data indicate that perceptions of uncertainty and threats from terrorism and theories of action differ in and between organizations depending upon factors such as the accuracy and completeness of information; previous experience of terrorist events and whether or not these threats were prioritized over other uncertainties. Three organizations in the aviation industry prioritize threats from terrorism, whilst three organizations in the leisure and travel sector do not. Managers in the aviation industry tend to take a proactive, organizational resilience stance towards uncertainty, whilst managers in the other organizations are more reactive, or take little action, with systemic features of organization taking precedence over decisions and actions.
Revisiting Trust and Control
Authors: Şengün Ayşe Elif , Nazli Wasti S.
Published: March 2009

This study investigates the interaction between trust, social control, output control, and perceived performance (measured as the buyer's satisfaction) for the relationship of pharmacies with their primary drug wholesalers, where both parties are SMEs.A model generated by qualitative analysis is tested with survey data from 360 Turkish pharmacies.The results suggest a positive association between trust and social control and a negative association between trust and output control, in addition to a substitutive relationship between trust and output control regarding perceived performance.A positive association is found between social control and perceived performance, but output control seems to have no effect on the latter. Finally, output control and social control are negatively associated with each other and have a substitutive relationship while predicting perceived performance. While focusing on small businesses in a service industry, the study contributes to the general debates on the interrelationships of trust, control, and partnership performance.
Post-entry Internationalization Dynamics
Authors: Morgan-Thomas Anna , Jones Marian V.
Published: March 2009

This study is concerned with the post-entry internationalization dynamics of newly internationalizing firms, specifically the speed at which their international sales develop after initial entry. In contrast to studies of international new ventures, the focus here is on the newness of internationalization rather than the newness of the firm itself. Firms are differentiated by the speed of internationalization as indicated by international intensity achieved within ten years. A sample of 200 newly internationalizing firms is divided into three groups namely,`rapid',`regular', and `reluctant' internationalizers. The groups are then compared in relation to the influence of: (1) their knowledge intensity, (2) their reliance on ICTs, (3) their international diversification strategy and (4) international channel strategy.The results show that rapid international sales development is associated with higher dependence on one key country market, higher country market diversity of sales and higher reliance on ICTs.
Pill Taking From the Perspective of HIV-Infected Women Who Are Vulnerable to Antiretroviral Treatment Failure
Authors: Stevens Patricia E. , Hildebrandt Eugenie
Published: March 2009

We conducted this longitudinal qualitative study to gain in-depth understanding of HIV-infected women's experiences with antiretroviral (ARV) regimens, exploring from their perspective what medication taking was like for them and what it meant in the context of their everyday lives. We engaged 55 participants over a 2-year period in 10 narrative-eliciting interviews. From their medication stories, we were able to track a 2-year prospective pattern of self-reported adherence for each individual who was prescribed ARVs. In this article we focus on the medication experiences of a subsample of 14 women who persistently had difficulties taking ARVs as prescribed, detailing their descriptions and evaluations of pill taking. Results suggest that rather than judging themselves harshly for nonadherence, they perceived their at-odds pill taking to be personally meaningful and accomplished for good purpose. Their rationales provide insights for more nuanced, empowerment-based interventions for individuals who are vulnerable to ARV treatment failure.
Civic Organizations as Political Actors
Authors: Lelieveldt Herman , Dekker Karien , Völker Beate , Torenvlied René
Published: March 2009

Despite the scholarly consensus on the importance of civic organizations for the livability of neighborhoods, there are relatively few empirical studies examining to what extent these organizations engage in various forms of political participation to contribute to the quality of the neighborhood. The authors argue that to get a better overview of neighborhood-oriented forms of participation, it is necessary to look beyond those organizations with an explicit focus on the neighborhood and to include newer forms of participation such as coproduction, government-initiated plans that seek to address neighborhood issues through extensive cooperation with organizations. The authors argue that three groups of factors determine organizational participation: resources, engagement, and network position. An empirical analysis of survey data collected in 2007 from 400 organizations in eight neighborhoods in two Dutch cities shows that the impact of resources is virtually absent, whereas concern about the neighborhood and relations to pivotal organizations are positively related to participation.
Update on global trends in trauma
Authors: Leppaniemi AK
Published: March 2009

The significance of trauma as a mechanism and cause of mortality and morbidity on a global scale is increasing. The combination of both large-scale disasters, whether natural or man-made, and the every day accidents, and intentional violence pose a grave challenge to the ability of our medical systems' ability to cope with the increasing demands of trauma care at system level as well as on individual providers. Despite significant advances in clinical practice, the economical, educational, and organisational limitations prevent us from providing the best available care to many of our patients, at least on a global scale. Fresh solutions and new paradigms are needed, and in order to approach the key issues successfully a wider scope with a look at the global perspective forming the 'environment of trauma' is required. This review updates the recent trends in trauma with emphasis on the causes and manifestations of trauma on a global scale.
The management and treatment of peri-prosthetic fractures around both total hip and hemiarthroplasty
Authors: Higgins GA , Davis ET , Revell M , Porter K
Published: March 2009

Peri-prosthetic fractures are an increasingly common phenomenon. They are associated with a high mortality, morbidity and economic burden. We reviewed the literature and look at historical aspects, risk factors, clinical assessment, classification and management of peri-prosthetic fractures around the hip. This article is intended to provide an overview to enable safe initial management of peri-prosthetic fractures and insight into definitive treatment.
Integrating brand, retailer and end-customer perspectives
Authors: Glynn Mark
Published: March 2009

With increased retailer concentration, competition and the emphasis on private labels, it is easy to assume that manufacturers' brands are less important to retailers. Retailers manage their stores as brands and control the brand offering inside the store, coordinating the manufacturer's brand with the private label. However, manufacturers' brands are still important in determining retailer profitability and store image. This research paper seeks to clarify the value of manufacturers' brands to retailers within marketing channel relationships.
Naming and Translation/Naming in Translation: Toward a Close Reading of Don Quijote (Part I, Chapter I)
Authors: Charron Marc
Published: March 2009

AbstractThis article examines the indeterminate nature of the different "acts of naming and non-naming" in the first chapter of Part One of Don Quijote. For example, there is much doubt surrounding Don Quijote's family name and place of origin. In other cases to be explored, the naming process is slightly more concrete, such as Don Quijote's naming after that of his horse, and the naming of the lady of his thoughts. The indeterminacy surrounding these acts is particularly interesting when examined from the perspective of the work's various translations, which each add an astonishing multiplicity of semantic possibilities. Four recent (i.e. from the last fifteen years) English translations will be studied with the objective of showing how different translators have confronted these ambiguous passages, and broaching the questions the translations themselves raise regarding these famous literary acts of naming.
The NF-κB negative regulator TNFAIP3 (A20) is inactivated by somatic mutations and genomic deletions in marginal zone lymphomas
Authors: Novak Urban , Rinaldi Andrea , Kwee Ivo , Nandula Subhadra V. , Rancoita Paola M. V. , Compagno Mara , Cerri Michaela , Rossi Davide , Murty Vundavalli V. , Zucca Emanuele , Gaidano Gianluca , Dalla-Favera Riccardo , Pasqualucci Laura , Bhagat Govind , Bertoni Francesco
Published: March 2009

Unique and shared cytogenetic abnormalities have been documented for marginal zone lymphomas (MZLs) arising at different sites. Recently, homozygous deletions of the chromosomal band 6q23, involving the tumor necrosis factor alpha–induced protein 3 (TNFAIP3, A20) gene, a negative regulator of NF-κB, were described in ocular adnexal MZL, suggesting a role for A20 as a tumor suppressor in this disease. Here, we investigated inactivation of A20 by DNA mutations or deletions in a panel of extranodal MZL (EMZL), nodal MZL (NMZL), and splenic MZL (SMZL). Inactivating mutations encoding truncated A20 proteins were identified in 6 (19%) of 32 MZLs, including 2 (18%) of 11 EMZLs, 3 (33%) of 9 NMZLs, and 1 (8%) of 12 SMZLs. Two additional unmutated nonsplenic MZLs also showed monoallelic or biallelic A20 deletions by fluorescent in situ hybridization (FISH) and/or SNP-arrays. Thus, A20 inactivation by either somatic mutation and/or deletion represents a common genetic aberration across all MZL subtypes, which may contribute to lymphomagenesis by inducing constitutive NF-κB activation.
Transcriptional analysis of ESAT-6 cluster 3 in Mycobacterium smegmatis
Authors: Maciąg Anna , Piazza Aurora , Riccardi Giovanna , Milano Anna
Published: March 2009

Background

The ESAT-6 (early secreted antigenic target, 6 kDa) family collects small mycobacterial proteins secreted by Mycobacterium tuberculosis, particularly in the early phase of growth. There are 23 ESAT-6 family members in M. tuberculosis H37Rv. In a previous work, we identified the Zur- dependent regulation of five proteins of the ESAT-6/CFP-10 family (esxG, esxH, esxQ, esxR, and esxS). esxG and esxH are part of ESAT-6 cluster 3, whose expression was already known to be induced by iron starvation.

Results

In this research, we performed EMSA experiments and transcriptional analysis of ESAT-6 cluster 3 in Mycobacterium smegmatis (msmeg0615-msmeg0625) and M. tuberculosis. In contrast to what we had observed in M. tuberculosis, we found that in M. smegmatis ESAT-6 cluster 3 responds only to iron and not to zinc. In both organisms we identified an internal promoter, a finding which suggests the presence of two transcriptional units and, by consequence, a differential expression of cluster 3 genes. We compared the expression of msmeg0615 and msmeg0620 in different growth and stress conditions by means of relative quantitative PCR. The expression of msmeg0615 and msmeg0620 genes was essentially similar; they appeared to be repressed in most of the tested conditions, with the exception of acid stress (pH 4.2) where msmeg0615 was about 4-fold induced, while msmeg0620 was repressed. Analysis revealed that in acid stress conditions M. tuberculosis rv0282 gene was 3-fold induced too, while rv0287 induction was almost insignificant.

Conclusion

In contrast with what has been reported for M. tuberculosis, our results suggest that in M. smegmatis only IdeR-dependent regulation is retained, while zinc has no effect on gene expression. The role of cluster 3 in M. tuberculosis virulence is still to be defined; however, iron- and zinc-dependent expression strongly suggests that cluster 3 is highly expressed in the infective process, and that the cluster contributes to the antigenic profile during the course of infection. Moreover, cluster 3 induction in acid stress conditions strengthens the hypothesis that cluster 3 is expressed in the course of infection.

In M. smegmatis, the expression of msmeg0615 and msmeg0620 genes is broadly similar in differing growth phases and in stress conditions, with the exception of acid stress (pH 4.2). Differences in expression between cluster 3 genes can be explained by the presence of internal promoters, both in M. smegmatis and M. tuberculosis.
Effect of Dietary Adherence with or without Exercise on Weight Loss: A Mechanistic Approach to a Global Problem
Authors: Del Corral Pedro , Chandler-Laney Paula C. , Casazza Krista , Gower Barbara A. , Hunter Gary R.
Published: March 2009

Context: Weight loss using low-calorie diets produces variable results, presumably due to a wide range of energy deficits and low-dietary adherence.

Objective: Our objective was to quantify the relationship between dietary adherence, weight loss, and severity of caloric restriction.

Design and Setting: Participants were randomized to diet only, diet-endurance training, or diet-resistance training until body mass index (BMI) was less than 25 kg/m2.

Participants: Healthy overweight (BMI 27–30) premenopausal women (n = 141) were included in the study.

Interventions: An 800-kcal/d−1 diet was provided, and the exercise groups were engaged in three sessions per week.

Main Outcomes: Dietary adherence, calculated from total energy expenditure determined by doubly labeled water measurements and dual-energy x-ray absorptiometry body composition changes, and degree of caloric restriction were determined.

Results: All groups had similar weight loss (∼12.1 ± 2.5 kg) and length of time to reach target BMI (∼158 ± 70 d). Caloric restriction averaged 59 ± 9%, and adherence to diet was 73 ± 34%. Adherence to diet was inversely associated to days to reach target BMI (r = −0.687; P < 0.01) and caloric restriction (r = −0.349; P < 0.01). Association between adherence to diet and percent weight lost as fat was positive for the diet-endurance training (r = 0.364; P < 0.05) but negatively correlated for the diet-only group (r = −0.387; P < 0.05).

Conclusions: Dietary adherence is strongly associated with rates of weight loss and adversely affected by the severity of caloric restriction. Weight loss programs should consider moderate caloric restriction relative to estimates of energy requirements, rather than generic low-calorie diets.
Surface plastic strain in contact problems: Prediction by a simplified non-linear kinematic hardening model
Authors: Mazzù A
Published: March 2009

A previously published model for plasticity assessment in rolling contact, based on a simplification of the non- linear kinematic and isotropic hardening model of Chaboche and Lemaitre, is discussed, and an update is introduced in order to improve its accuracy in the plastic strain prediction within the region just underneath the contact surface. The update is based on a correction of the yield limit and of the strain rate as a function of the load ratio of the tensile stress in the direction parallel to the contact surface. The effectiveness and the accuracy of the updated model in not too severe conditions are demonstrated through comparisons with results obtained by finite element model (FEM) analyses. An application of the model to some experimental results obtained on rail and railway wheel steels is also carried out, and quite good agreement is found in plastic strain prediction, although some discrepancies are found. The method appears to be a valid tool for practical application, especially for its ability of combining the effects of different phenomena and of simulating a number of cycles of the order of millions in a reasonable time.
Ultrasonic assessment of wheel—rail contact evolution exposed to artificially induced wear
Authors: Pau M , Leban B
Published: March 2009

One of the most important effects that wear originates on the wheel—rail system is represented by the significant changes introduced in contact area features and contact pressure distribution. In fact, in most cases, even regular operation gradually modifies the profile of the contacting elements so as to transform the original Hertzian counterformal conditions into a conformal contact characterized by lower average pressures and relevant alterations in the size and shape of the contact patch.

On the basis of the aforementioned considerations, this study presents the results of a series of experimental tests carried out with an ultrasonic non-invasive technique, with the final purpose of assessing to what extent wear induces modifications in contact parameters. To this end, in a regular flanged wheel, increasing degrees of wear were artificially produced at the centre of the tread. The interface of the wheel—rail systems thus obtained was investigated with high-frequency ultrasonic waves and the observed coefficient of reflection (which is known to be related to contact conditions) was graphically processed to build contact maps from which to extract information about the size and shape of the contact area and pressure distribution.

The results allowed the monitoring of the transition from counterformal to conformal contact, and helped to establish an empirical relationship between the amount of wear and both the contact area value and average pressure. Moreover, contact pressure distribution (obtained with a dedicate calibration procedure) showed that conformal contacts lose the original ‘one-peak’ pressure trend and exhibit a multi-peak configuration. Thus, the ultrasonic method confirmed its capabilities to faithfully monitor contact conditions even in the case of randomly altered geometries of the contacting elements and, in the specific case, may represent an effective tool in validating the wear simulation models.
Medical engineering at Cardiff University. Part 1: Undergraduate programmes of study
Authors: Theobald P , Jones M D , Holt C A , Evans S L , O'Doherty D M
Published: March 2009

Cardiff University has offered a medical engineering undergraduate programme since 2001 and hence delivers one of the longest-running and most established medical engineering programmes within the UK. It currently offers BEng (Hons) and MEng (Hons) programmes that are both accredited by the Institution of Mechanical Engineers and include the option to undertake a year in industrial employment. The admissions policy ensures that the intake consists of a diverse range of students and is typically very successful in attracting female students. The programmes consist of six key academic threads which ensure that the content is both relevant and continuous, with all threads tailored to provide a patient-focused learning environment. Students initially learn core and fundamental principles in years 1 and 2, supported by a range of laboratories and practical experimentation. The latter years then encourage the students to corroborate and apply this knowledge, including involvement in a range of project-based learning exercises. The programme is delivered by a core of experienced academic medical engineers, with support from other engineering colleagues, as well as colleagues from the School of Biosciences, the School of Medicine, and the National Health Service. Thus, the programme delivers a wide range of modules which guarantee that graduating students have a thorough understanding of all possible career options. These two factors are significant in making it possible for students to follow their chosen career path upon graduation.
State-feedback stabilization of linear systems with input and state delays
Authors: Mahmoud M S
Published: March 2009

This paper develops new feedback stabilization criteria for a class of linear continuous-time systems with state and input delays. The state-delay is an unknown differentiable time-varying function satisfying some known bounding and the input delay is a known constant to guarantee practical implementation. With focus on state-feedback, an appropriate Lyapunov-Krasovskii functional is constructed to exhibit the delay-dependent dynamics and to avoid bounding methods. Injecting parametrized variables are effectively deployed to facilitate delay-dependent stability analysis and to provide a characterization of linear matrix inequalities (LMIs)-based conditions under which the linear nominal and polytopic feedback systems are asymptotically stable with an γ-level £2- gain. All the developed results are tested on representative examples.
Appearance of Anaphylactic Shock after Long-Term Intravenous Itraconazole Treatment
Authors: Chen Jie , Song Xianmin , Yang Peng , Wang Jianmin
Published: March 2009

Objective:

To report a rare but severe adverse effect of intravenous itraconazole, anaphylactic shock with hypotension and hypoxemia, in a female patient with acute lymphoblastic leukemia (ALL).

Case Summary:

A 36-year-old woman with ALL received antifungal therapy for pulmonary fungal infections. On day 17 of itraconazole treatment, she developed hypotension and hypoxemia shock after intravenous administration of itraconazole 200 mg, which was eventually reversed by steroid treatment. On days 18 and 19, the patient developed the same type of shock 2 more times in the course of itraconazole administration. These 2 episodes of shock occurred more quickly after intravenous itraconazole administration (100 mg on day 18, 40 mg on day 19), and were reversed by stopping itraconazole and applying steroid treatment. In the modified antifungal therapy, intravenous administration of itraconazole was replaced by oral administration of voriconazole 200 mg twice daily. Shock did not recur after discontinuation of itraconazole treatment. The Naranjo probability scale showed a probable relationship between itraconazole treatment and shock occurrence.

Discussion:

Itraconazole is a widely used antifungal drugs and is well tolerated. However, long-term itraconazole treatment might lead to serious and even life-threatening adverse effects such as anaphylactic shock, as seen in our patient. T cell reduction caused by immunosuppression and itraconazole accumulation in patients with ALL are considered to be important causal factors for this delayed-type hypersensitivity reaction.

Conclusions:

Anaphylactic shock represents a previously undocumented severe adverse effect associated with long-term itraconazole treatment; patients receiving this therapy and should be monitored closely.
Physician Use of Brand Versus Generic Drug Names in 1993–1994 and 2003-2004
Authors: Kwo Elizabeth C , Kamat Priya , Steinman Michael A
Published: March 2009

Background:

Physicians often refer to drugs by their brand names, which can result in brand name drugs being dispensed even when bioequivalent generic alternatives are available. As a result, use of brand-name terminology may result in increased drug costs.

Objective:

To evaluate how often physicians use brand and generic names of drugs, how the use of terminology changes over time, and factors associated with this change.

Methods:

This was a serial cross-sectional study using data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey in 1993/1994 and 2003/2004. Over the 4 study years, data were collected on 376,383 subjects. Using forms completed by physicians that described medication regimens, we determined the proportion of drug names that were recorded using brand vs nonproprietary (ie, generic) terminology.

Results:

In 1993/1994, the 25 most commonly mentioned drugs were referred to by their brand names a median of 89% of the time. Over the ensuing decade, use of brand-name terminology decreased by a median of 11%. Drugs that first faced generic competition within 10 years of the baseline study year had large declines in brand-name use (43–58% decline), whereas drugs that first faced generic competition more than 10 years before or after the baseline study year had minimal change in brand-name use (2–3% decline; p = 0.02 for difference in rate of decline among drug groups). Year of drug introduction, baseline rate of brand-name use, clinical setting, and national region were not associated with reductions in brand-name use.

Conclusions:

Brand-name terminology is commonly used and decreases over time with the introduction of generic competition. Interventions that standardize medication-naming practices may hasten this decline and increase use of nonproprietary terminology in medicine.
Using Community-Based Research Methods to Design Cancer Patient Navigation Training
Authors: Braun Kathryn L. , Allison Amanda , Tsark JoAnn U.
Published: March 2009

Background: Cancer mortality continues to be higher in Native Hawaiians than whites, and research has identified numerous barriers to good cancer care. Cancer navigator programs provide individualized assistance to patients and family members to overcome barriers, promoting early diagnosis and timely and complete treatment. Objectives: Our purpose was to design a training curriculum to provide community-based outreach workers serving Native Hawaiians with cancer patient navigator skills. Methods: The Ho`okele i ke Ola (Navigating to Health) curriculum was informed by data gathered from Native Hawaiian cancer patients and their family members, outreach workers in Native Hawaiian communities, and cancer care providers. Based on findings, the 48-hour curriculum focused on cancer knowledge, cancer resources, and cancer communications. Three versions were developed: (1) six days of training and on-site tours in urban Honolulu; (2) four days of training on a neighbor island, with 2 days of on-site tours in Honolulu; and (3) a 3-credit community college independent study course. Graduates were interviewed after each session and 3 months after graduation about application of navigation skills. Results: In 18 months, 62 health workers from community-based, clinical, and community college settings were trained —31 in Honolulu-based trainings, 29 in neighbor island trainings where earlier graduates served as co-faculty, and 2 through Maui Community College (MCC). Follow-up data suggest increased knowledge, skills, capacity, and feelings of competence among trainees. Conclusions: All three versions of the Ho`okele i ke Ola cur-riculum, developed with community input, have proven successful in increasing cancer patient navigation skills of trainees.
Institutionalizing a Comprehensive Tobacco-Cessation Protocol in an Indigenous Health System: Lessons Learned
Authors: Santos LorrieAnn , Braun Kathryn L. , Ae`a Kamuela , Shearer Leimomi
Published: March 2009

Background: Native Hawaiians have high smoking prevalence and high lung cancer mortality rates. Objectives: We sought to describe a comprehensive tobacco cessation protocol and share lessons learned in institutionalizing it across the five Native Hawaiian Health Care Systems (NHHCS). Methods: NHHCS representatives worked together to culturally tailor the Agency for Healthcare Research and Quality (AHRQ) protocol for smoking cessation. Process objectives included number of staff trained in tobacco cessation, inclusion of the Tobacco User Guide Sheet (TUGS) in the intake process and medical record, and expansion of programs for smokers who want to quit. Outcome objectives included percent of individuals asked about smoking status and percent of identified smokers that received brief intervention, set a quit date, were linked to services, and remained smoke free for 90 days. Results: After 18 months, the NHHCS were at different stages of protocol adoption. More successful NHHCS were more likely to have several champions for the program and administrative support for staff training, new programs, and integrating the TUGS into client charts. They also showed greater success in getting smokers to set a quit date and remain smoke free for 90 days. Conclusion: Although the five NHHCS helped to design the protocol, each operates independently. More effort and time are needed to help each system overcome internal barriers to institutionalizing a new protocol and to facilitate support for tobacco cessation champions among medical records and data management supervisors. These lessons may be useful to other organizations that want to institutionalize a comprehensive tobacco cessation protocol.
Quentin Burdick Program: Working in Rural Communities in Hawai`i
Authors: Chung-Do Jane , Ahedo Angelina , Gentry Lauren
Published: March 2009

Background: Because rural health disparities are complex and require solutions that involve a diversity of partners, the Hawai`i Quentin Burdick Rural Health Interdisciplinary Program (QB) has provided opportunities for students in health-related fields to live and work in rural communities on the islands of Moloka`i, Lāna`i, Kaua`i, and Hawai`i. The QB program is a hands-on, experiential learning program that allows students to gain insights on engaging community members to meet the health needs of the community. Objectives: The purpose of this article is to describe the Hawai`i QB Program and share the details of the community health projects of three public health graduate students, related to community-based participatory methods. Methods: Participating in training seminars, site visits, and a summer rural practicum helped students to develop their knowledge and skills for working in rural communities in the future. Conclusions: Specific principles of community-based participatory approaches, such as assessing community needs, utilizing community assets, and ensuring sustainability, were crucial to the process of community collaboration.
Cancer Assessment Methodology in a Native Hawaiian Community
Authors: Siu Andrea , Palakiko Donna-Marie
Published: March 2009

Background: Limited data have been collected on cancer in Native Hawaiian communities, although Native Hawaiians tend to have higher cancer mortality rates than other ethnic groups in Hawai`i. Objectives: We sought to describe the community-based participatory research (CBPR) process used to deliver a culturally tailored protocol, combining traditional Native Hawaiian practices and random sampling methods, to determine cancer screening practices and program preferences of residents of a Hawaiian Homes (HH) community. Methods: Following a culturally tailored protocol, we attempted to survey half of the 644 households in the Waimanalo Hawaiian Homes Community (WHHC). Pairs of Native Hawaiian college students performed the majority of data collection; a community member joined them if available. Visits to the selected homes were tracked and participation rates estimated. Additional information on this methodology emerged from discussions between researchers and community members. Results: Of the 449 households accessed, 187 (42%) completed the survey, with an average of two visits per household. Individuals at 63 (14%) households refused outright. The remaining 199 (44%) homes were visited up to five times, but produced no response. Although some homes were vacant, often it appeared that residents were home but unresponsive. Our sampling procedure (targeting every other house and requiring accrual of 75 individuals in each of four age–gender groups) reduced participation. Conclusions: The use of CBPR built capacity for all partners by engaging them in all levels of research. The results, however, suggest the need for a more inclusive sampling strategy and the continued use of CBPR.
Safe School Task Force: University–Community Partnership to Promote Student Development and a Safer School Environment
Authors: Adler Corey , Chung-Do Jane , Ongalibang Ophelia
Published: March 2009

Background: The Asian/Pacific Islander Youth Violence Prevention Center (APIYVPC) focuses its youth violence prevention efforts on community mobilization by partnering with Kailua High School and other local community groups. Objectives: This paper describes the development and activities of the Safe School Task Force (SSTF) and the lessons learned. Methods: In response to concerns of school, community members, and students, the SSTF was organized to promote student leadership in raising awareness about problems related to violence. Lessons Learned: Collaboration among the school, community, and the university places students in leadership roles to reduce school violence and enhances their self-efficacy to improve their school environment. To increase SSTF effectiveness, more attention must be paid to student recruitment, consistent community partnerships, and gaining teacher buy-in. Conclusions: This partnership may be useful in multicultural communities to provide students the opportunities to learn about violence prevention strategies, community mobilization, and leadership skills.
Participatory Drug Prevention Research in Rural Hawai`i With Native Hawaiian Middle School Students
Authors: Helm Susana , Okamoto Scott K. , Medeiros Howard , Chin Coralee I. H. , Kawano K. Nahe , Po`a-Kekuawela Ka`ohinani , Nebre LaRisa H. , Sele F. Petelo
Published: March 2009

Background/Objectives: This paper describes a prevention study focused on the drug use scenarios encountered by Native Hawaiian youth. Priorities from communities on the Big Island of Hawai`i helped to shape the qualitative data collection and analysis of middle school students participating in the study. Methods: Forty-seven youth from five different schools were interviewed in small, gender-specific focus groups during lunch hour or after school. Results: The findings indicated that youth were exposed to drug offers that were direct–relational or indirect–contextual in nature. Direct–relational offers were didactic exchanges where drugs or alcohol were offered from one individual to another (e.g., "Do you want some beer?"). Indirect–contextual offers reflected complex exchanges among individuals, where drugs or alcohol were involved, but not offered directly (e.g., "Do you want to hang out with us?"). Conclusions: Implications are discussed regarding drug prevention research and programs that highlight indirect– contextual drug offers that are place based and culturally grounded.
Genetic Research in Native Communities
Authors: Santos LorrieAnn
Published: March 2009

People are living longer because of advances made through biomedical research. The challenge in genetic research on indigenous peoples is that it raises a complex range of legal, ethical, social, spiritual, and political issues. The current research paradigm is one of paternalism and biocolonialism. Such was the case of the Havasupai, who believed their blood samples were to be solely used for their collective benefit and well-being, and Native Hawaiians, who are opposed to genetically modified taro. Pertinent questions that should be considered before conducting research with and amongst Native communities include: Is there informed consent or the need for re-consent? Is cultural knowledge respected? Are indigenous beliefs, values, and practices taken into account? Is there potential for group harm? Is there accountability to community? Establishing a community Institutional Review Board may be the most effective means toward achieving equal and ethical treatment in population/group-based research. Research should be about ethically rigorous processes and effectively tailored interventions that address community needs, interests, and values.
“Garments of Salvation”: Representations of Monastic Clothing in Late Antiquity
Authors: Krawiec Rebecca
Published: March 2009

This article examines descriptions of the clothing of male and female monks that abound in late antique monastic literature. These accounts sought to create a monastic “uniform” that would set the boundaries and establish the values of monastic life. Despite this attempt at standardization, I argue, contradictions appeared between worn, drab clothes and shining garments as the proper monastic attire, between the authority of male dress and female dress, between acceptable and unacceptable nakedness. These incongruities express the central tension of monasticism between sinful human and transcendent angelic identity. Ancient authors were aware of this paradox and so too possible misperceptions of monastic clothing and its meaning.
2008 NAPS Presidential Address: The Significance of Ambrosiaster
Authors: Hunter David G.
Published: March 2009

This essay, originally presented as the Presidential Address at the May 2008 annual meeting of the North American Patristics Society, argues that the late fourth-century biblical commentator now known as “Ambrosiaster” has been an unjustly neglected figure in patristic study. Overshadowed by his better known contemporaries, such as Ambrose, Jerome, and Augustine, Ambrosiaster deserves to be reexamined. His writings reveal to us the perspectives of a distinctively moderate and distinctively Roman clergyman active at Rome in the early 380s. His peculiarities as a writer—that is, both his deliberate anonymity and his tendency to revise his own writings—are illuminating, as are his reflections on church practice, clerical authority, and priestly celibacy.
No Child Left Behind: Knowledge and Violence in the Infancy Gospel of Thomas
Authors: Frilingos Chris
Published: March 2009

Recent studies have discerned a wide gap between the apparently low opinion of education in the Infancy Gospel of Thomas and the high regard for paideia under Rome. I shall argue instead that the Infancy Gospel of Thomas expresses ambivalence toward paideia . The extracanonical gospel describes the childhood of Jesus in episodes that gesture to the productive and troubling consequences of the widened flow of Greek culture under Rome. Like other writings of the period, the Infancy Gospel of Thomas is attuned to the routine brutality of imperial justice and education. The article has two specific goals: first, to put the gospel in relation to important cultural problems of the day, and second, to shed light on the gospel’s classroom episodes. The unruly and violent star of the narrative fashions new knowledge that mimics tradition: he is almost but not quite a student of paideia , almost but not quite a student of the “law.”
What Sort of Thing Is This Luminous Woman?: Thinking Sexual Difference in On the Origin of the World
Authors: Dunning Benjamin H.
Published: March 2009

This article explores the etiology of human sexual difference presented in On the Origin of the World . The Nag Hammadi text articulates sexually- differentiated human subjectivity through a set of complex hermeneutical negotiations based on readings of the “image” and “likeness” of Genesis 1.26. After the archons’ creation of Adam, the origin of sexual difference is explained through a counter-narrative of creation. Here Sophia models Eve on a different “image” and “likeness” than that used by the archons to create Adam. The result is an anthropological vision in which the sexual division is a primary one, rooted in two processes of creation that interweave the luminosity of the divine realm into the primordial male and female human beings in two distinct and inassimilable ways.
Augustine Accused: Megalius, Manichaeism, and the Inception of the Confessions
Authors: BeDuhn Jason David
Published: March 2009

Although no one motive or purpose accounts for the complex character of the Confessions , one relatively neglected factor in the context of its composition is the controversy within the African Catholic Church over Augustine’s Manichaean past, and the circumstances in which the Primate of Numidia, Megalius, objected to Augustine’s advancement to the episcopacy on these grounds and subjected him to an episcopal inquiry. By reconstructing the likely details of Megalius’s charges against Augustine and comparing them with the facts of Augustine’s history as they would have been viewed by those unsympathetic to him, we can better appreciate the dire circumstances in which Augustine composed several reflections in the mid-390s c.e . on the ethics of lying by either commission or omission, and how at least part of the Confessions’ narrative is likely to have taken shape in the context of Augustine’s strategic response to charges he could not answer on the record of his own known conduct. By making the issue one of the interior progress of his soul, invisible to those who only could see the lagging conduct of his behavior, Augustine won over the guardians of the African Catholica, and went on to build upon the foundation of his defense the Confessions as we now know it.
Joseph Conrad's Geographies Of Energy
Authors: MacDuffie Allen
Published: March 2009

This essay discusses Joseph Conrad's use of the rhetoric of energy and entropy in his critique of imperial dependency and inefficiency. It contextualizes works such as The Secret Agent , Heart of Darkness , and The Mirror of the Sea not simply in terms of their engagement with Victorian thermodynamic discourse, but by reference to the specific ways in which concerns about energy use and dissipation were linked to representations of the imperial project in the late nineteenth century.
Toward a Multicultural Mid-Tudor England: The Queen's Royal Entry Circa 1553, The Interlude of Wealth and Health , and the Question of Strangers in the Reign of Mary I
Authors: Oldenburg Scott
Published: March 2009

Through close-readings of Mary Tudor's royal entry, the anonymous interlude Wealth and Health , and John Christopherson's Exhortation alongside anecdotes of popular resistance to Mary Tudor's antiimmigrant proclamations, this article shows that rather than a strong identification with the monarch or some sense of Englishness, Londoners more closely identified with their multicultural metropolitan community for religious and economic reasons.
The Evolution of Ethnicity
Authors: Wilson Sarah
Published: March 2009

"The Evolution of Ethnicity" argues that early-twentieth-century Jewish American intellectuals (including Mary Antin, Abraham Cahan, and Horace Kallen) drew on evolutionary theories to formulate theories of ethnicity.
Radical Similarity: Wordsworth, Coleridge, and the Dejection Dialogue
Authors: Ulmer William A.
Published: March 2009

For most critics, the poems of Wordsworth and Coleridge's Dejection Dialogue--the "Immortality Ode," the "Letter" to Sara, and "Resolution and Independence"--reveal the poets disagreeing vehemently over the epistemological relationship of mind and nature. My essay argues conversely that Wordsworth and Coleridge cannot be segregated along an inner/outer perceptual axis, and that Coleridge's engagement of the Ode confirms and extends its leading claims. As reinterpreted here, the Dejection Dialogue sequence belies theories of poetic influence as a subject-centered rivalry, and thereby accommodates our increasing appreciation on the non-proprietary Grasmere culture in which Wordsworth and Coleridge actually produced their work.
Erasmus Darwin's Cosmopolitan Nature
Authors: Bewell Alan
Published: March 2009

No nature poem written during the 1790s was more controversial or more radical in defining what nature is in the modern world than Erasmus Darwin's Botanic Garden . By examining this poem and Henry Jones's "Kew Garden," this paper argues that to understand the Romantic period, we need to consider not only the rooted, unchanging, nativist nature that we have come to associate with Wordsworth, but also those new, dynamic, changing, heterogeneous, traveling, immigrant natures, which begin increasingly to appear during the eighteenth century. These modern natures, shaped by globalization, commerce, and consumerism, find their most powerful poetic voice in Darwin.