bluuebunny/crossref_metadata_2025 huggingface dataset:
Reproducing normative and marginalized masculinities: Adolescent male popularity and the outcast
Authors: Phillips Debby A.
Published: August 2005

Every day, in professional work and in our personal lives, we reproduce by words and behaviors particular understandings of life and how it works. This includes understandings about what is ‘normal’ and ‘not normal’ masculinity and who are ‘normal’ and ‘not normal’ boys and men. Being marginalized or outcast from the norm is rarely a free choice. The language that constructs normal and abnormal is not innocent and does not simply arrive in our minds transparently reflected in our behavior or in our client advice or student education. Examining words and behaviors from adolescent boys and from media sources, this research explores the role of cultural discourses in producing normative and marginalized masculinities. It builds upon recent scholarship that questions cultural prescriptions for masculinity and traditional male norms. Feminist, poststructural, psychoanalytic discourse analysis and multiple methods were used to explore links between cultural discourses of masculinity and performativity of masculinity. Practices of heterosexuality, homophobia, athleticism, economic privilege, toughness, and violence provided pathways toward achieving and/or maintaining status as the hegemonic masculine norm in adolescence. ‘Popularity’ signified the norm and ‘outcasts’ from the norm signified marginalized masculinities.
Does Counting Count for 3‐ to 4‐year‐olds? Parental Assumptions about Preschool Children's Understanding of Counting and Cardinality
Authors: Fluck Michael , Linnell Maggie , Holgate Melanie
Published: August 2005

Research indicates that children do not typically understand the connection between counting and cardinality for several months after learning to count, yet parents speak to 3‐year‐olds as though they already understood the significance of counting. The present research was designed to investigate mothers’ awareness of the discrepancy between children's procedural and conceptual mastery of counting. In Study 1 mothers of a hundred 3‐ to 41/2‐year‐olds completed an anonymous questionnaire asking them to anticipate how their child would respond to a series of real‐life vignettes based on widely used experimental measures of cardinal understanding. Most anticipated that their child, irrespective of age, would (1) understand the significance of the last word of a count, and (2) be able accurately to give a specified non‐subitizable number of objects. Comparison with the performance of 54 children from the same local population supported the hypothesis that parents overestimate children's understanding of the cardinal significance of counting. Mothers reported a range of impromptu number‐related activities in which their child had recently participated at home; most of these involved simple procedural counting. In Study 2, 35 mothers of 3‐ to 41/2‐year‐olds completed a modified questionnaire concerning procedural aspects of counting as well as cardinality; their responses were then compared with the performance of their own children. Again, mothers overestimated their children's cardinal understanding, but this was shown not to be a result of a general tendency to overestimate their counting abilities. It is suggested that preschoolers’ counting generally occurs during joint activities in which caregivers may be unaware of the support that they provide, and, provided that the jointly executed count procedures are error‐free, parents implicitly assume a ‘common knowledge’ regarding the cardinal significance of counting.
Are You Sitting Comfortably?
Authors: Meacock Susan
Published: August 2005

This article shows how consideration of seating arrangements in theatres can be used as a basis for constructing an interesting probability model.
The Price is Right
Authors: Fletcher Mike
Published: August 2005

This article considers some probability calculations for a television game show.
Going MAD in Degrees of Unfairness!
Authors: Perry Mike
Published: August 2005

This article discusses concepts of unfairness in allocations of objects (coins) to positions (students) and introduces possible measures for unfairness based on intuition.
A Closer Look at a Relatively Neglected Mean
Authors: Lann Avital , Falk Ruma
Published: August 2005

The self‐weighted mean (WS) – in which each value is weighted by itself – is presented in several contexts and illustrated. It is incorporated in a set of more familiar means. Intuitions concerning WS are explored.
FISH: A New Computer Program for Friendly Introductory Statistics Help
Authors: Brooks Gordon P. , Raffle Holly
Published: August 2005

All introductory statistics students must master certain basic descriptive statistics, including means, standard deviations and correlations. Students must also gain insight into such complex concepts as the central limit theorem and standard error. This article introduces and describes the Friendly Introductory Statistics Help (FISH) computer program, which is free and easy‐to‐use software designed to help students learn such introductory statistical concepts.
Public Opinion Polls, Chicken Soup and Sample Size
Authors: Nguyen Phung
Published: August 2005

Cooking and tasting chicken soup in three different pots of very different size serves to demonstrate that it is the absolute sample size that matters the most in determining the accuracy of the findings of the poll, not the relative sample size, i.e. the size of the sample in relation to its population.
Hemispheric division of labour in reading
Authors: Shillcock Richard C. , McDonald Scott A.
Published: August 2005

We argue that the reading of words and text is fundamentally conditioned by the splitting of the fovea and the hemispheric division of the brain, and, furthermore, that the equitable division of labour between the hemispheres is a characteristic of normal visual word recognition. We report analyses of a representative corpus of the eye fixations of normal readers in the realistic reading of text where we compare hemispheric processing, quantified in terms of uncertainty about the orthographic, phonological and semantic representations of the words of the text. The analyses show that normal reading is accurately understood in terms of an equitable division of labour in the construction of the orthographic identity of the word and that, for English, a semantic division patterns closely with the orthographic division. We infer that impaired inter‐hemispheric co‐ordination of orthographic information may be best compensated for by a reliance on the inter‐hemispheric co‐ordination of semantic information, as in phonological dyslexia.
The relationship between dyslexia and Meares‐Irlen Syndrome
Authors: Kriss Isla , Evans Bruce J.W.
Published: August 2005

Meares‐Irlen Syndrome (MIS) is characterised by symptoms of visual stress and visual perceptual distortions that are alleviated by using individually prescribed coloured filters. Coloured overlays (sheets of transparent plastic that are placed upon the page) are used to screen for the condition. MIS is diagnosed on the basis of either the sustained voluntary use of an overlay or an immediate improvement (typically of more than 5%) on the Wilkins Rate of Reading Test (WRRT). Various studies are reviewed suggesting a prevalence of 20–34% using these criteria. Stricter criteria give a lower prevalence: for example, 5% of the population read more than 25% faster with an overlay. It has been alleged that MIS is more common in dyslexia, but this has not been systematically investigated. We compared a group of 32 dyslexic with 32 control children aged 7–12 years, matched for age, gender and socio‐economic background. Participants were tested with Intuitive Overlays, and those demonstrating a preference had their rate of reading tested using the WRRT with and without their preferred overlay. Both groups read faster with the overlay, and more so in the dyslexic group. ANOVA revealed no significant effect of group, but a significant improvement in WRRT with overlay (p=0.009) and a significant interaction between group and overlay (p=0.031). We found a similar prevalence of MIS in the general population to that in previous studies and a prevalence in the dyslexic group that was a little higher (odds ratio for >5% criterion: 2.6, 95% confidence limit 0.9–7.3). The difference in prevalence in the two groups did not reach statistical significance. We conclude that MIS is prevalent in the general population and possibly a little more common in dyslexia. Children with dyslexia seem to benefit more from coloured overlays than non‐dyslexic children. MIS and dyslexia are separate entities and are detected and treated in different ways. If a child has both problems then they are likely to be markedly disadvantaged and they should receive prompt treatments appropriate to the two conditions. It is recommended that education professionals as well as eye‐care professionals are alert to the symptoms of MIS and that children are screened for this condition, as well as for other visual anomalies.
Visual stress in adults with and without dyslexia
Authors: Singleton Chris , Trotter Susannah
Published: August 2005

The relationship between dyslexia and visual stress (sometimes known as Meares‐Irlen syndrome) is uncertain. While some theorists have hypothesised an aetiological link between the two conditions, mediated by the magnocellular visual system, at the present time the predominant theories of dyslexia and visual stress see them as distinct, unrelated conditions, a view that has received some support from studies with children. Studies of visual stress in adults are rare, yet recent reports of a high incidence of this phenomenon amongst university students with diagnosed dyslexia call for further investigation of the issue. This study sought to clarify the relationship between visual stress and dyslexia by comparing the reading performance of dyslexic and non‐dyslexic adults with, and without, colour. Degree of susceptibility to visual stress was determined by means of a symptom rating scale. Optimal colour was determined using an Intuitive Colorimeter, which was also employed to assess reading speed under the two experimental conditions. Only the dyslexic students with high visual stress showed significant gains in reading speed when using optimal colour. The use of response to treatment (rather than symptomatology) as a diagnostic criterion for visual stress is questioned, especially when applied to adults, as this may give misleading findings. On the basis of reported symptomatology, students who experience high levels of visual stress are more likely to show improvements in reading rate with optimal colour if they also have dyslexia than if they do not have dyslexia. Although not establishing an aetiological link, these findings imply an interaction between the two conditions with major implications for theory, diagnosis and treatment.
Awareness of number in children with severe and profound learning difficulties: three exploratory case studies
Authors: Porter Jill
Published: August 2005

This paper reports on exploratory work investigating how children with severe and profound learning difficulties register an awareness of small quantities and how they might use this information to inform their understanding. It draws on studies of typically developing children and investigates their application to pupils whose response to conventional mathematical tasks are often limited because they lack relevance and interest. The responses of the three pupils to individualized learning contexts mirror the progression suggested in the literature, namely from awareness of number to simple actions using number cues to problem‐solving behaviour.
An investigation of students’ with mild learning disabilities reactions to participating in sexuality research
Authors: Thomas Gail , Kroese Biza Stenfert
Published: August 2005

This study investigates 35 students’ with mild learning disabilities reactions to participating in a research project exploring their sexual knowledge, attitudes and behaviour. Students completed an informed consent procedure prior to their participation in the sexuality research and all were interviewed using a confidential interview procedure. During the research interviews, each student's reaction to participation was observed and recorded by their interviewer. Following the interviews, each student's reaction to participation was observed and recorded by their college tutor. Researchers observed that although some students were embarrassed discussing certain sexual topics, none chose to stop their interviews when invited. Ten students requested additional information from their interviewers about the issues discussed. Tutors reported that no students appeared anxious or distressed following their interviews and that no inappropriate sexualized behaviour, or talk, were observed. Tutors also reported that several students appeared to have been positively affected by their participation. No tutors expressed concern about their students participating in similar research in the future. It is concluded that a number of methodological and participant factors may have accounted for the positive outcomes reported. The implications of these findings and recommendations for future research are discussed.
‘I won't think of meself as a learning disability. But I have’: social identity and self‐advocacy
Authors: Beart Suzie
Published: August 2005

In this paper the small body of research which looks at how people labelled as having learning disabilities view this social identity is considered. The author argues that this research has implications for our assumptions about self‐advocacy groups for people with learning disabilities.
The magnitude of abortion complications in Kenya
Authors: Gebreselassie Hailemichael , Gallo Maria F. , Monyo Anthony , Johnson Brooke R.
Published: August 2005

Objective  To estimate and describe the magnitude of abortion complications presenting at public hospitals in Kenya.

Design  Cross‐sectional descriptive study.

Setting  Hospital‐based.

Population  Records of all women presenting prior to 22 weeks of gestation with abortion‐related complications at selected hospitals during a three‐week study period. All public tertiary and provincial hospitals were included; stratified random sampling was employed to select a subset of 54 district hospitals nationwide.

Methods  Data collectors identified 809 patients with abortion complications on all hospital wards and completed a standardised questionnaire for each by extracting information from the patient's hospital record.

Main outcome measures  Incidence, aetiology, morbidity and mortality of abortion complications.

Results  Most women (80%) presented with incomplete abortion. Approximately 34% of the women had reached the second trimester of pregnancy. Adolescents (14–19 years old) accounted for approximately 16% of the study sample. Manual vacuum aspiration was used to manage 80% of first trimester cases. The projected annual number of women with abortion complications admitted to public hospitals in Kenya is 20,893. The case fatality rate was estimated to be 0.87% (95% CI 0.71–1.02%), so an estimated 182 (95% CI 148–213) of these women die annually. The annual incidence of incomplete abortion and other abortion‐related complications per 1000 women aged 15 to 49 years is projected to be 3.03.

Conclusions  The high rate of abortion‐related morbidity and mortality documented in the study highlights the critical need to address the issue of unsafe abortion in Kenya.
A 50‐year audit of maternal mortality in the Peninsula Maternal and Neonatal Service, Cape Town (1953–2002)
Authors: Fawcus S.R. , van Coeverden de Groot H.A. , Isaacs S.
Published: August 2005

Objective  To audit trends in maternal mortality in the Peninsula Maternal and Neonatal Service (PMNS) over a 50‐year period, with respect to rates and patterns of causation.

Design  Retrospective and prospective audit.

Setting  The PMNS, an integrated perinatal service composed of primary, secondary and tertiary facilities in Cape Town.

Population All women giving birth in the area of the Cape Peninsula served by the PMNS over the 50‐year period.

Methods  Data on maternal deaths were collected for 1953–2002 inclusive, from annual obstetric and gynaecological reports. Three triennia (1954–1956, 1981–1983 and 1999–2001) were selected for a detailed comparison of trends in rates and causes of death.

Main outcome measures  Maternal mortality rates (MMRs). Causes of maternal deaths.

Results  Total deliveries increased from 7315 in 1953 to 27,575 in 2002. The MMR declined from 301 deaths per 100,000 deliveries in 1953 to 31.2 in the triennium, 1987–1989. From 1999, the MMR increased, reaching 112 in 2002. Comparing 1954–1956 (MMR of 253.9) with 1981–1983 (MMR of 43.8), there was a marked decline in the MMR related to hypertension (80.4 to 11.3), haemorrhage (50.8 to 4.2), abortion (55 to 4.2), suspected pulmonary embolism (25.4 to 2.8), pregnancy‐related sepsis (8.5 to 4.2) and cardiac disease (21.2 to 2.8). Comparing 1981–1983 (MMR of 43.8) with 1999–2001 (MMR of 59.4), there was a decline in the MMR associated with abortion (4.2 to 0). The MMR for haemorrhage, suspected pulmonary embolism and cardiac disease remained the same. There was a slight increase in the MMR attributed to hypertension (11.3 to 14.5) and pregnancy‐related sepsis (4.2 to 7.3). There was a marked increase in the MMR associated with non‐pregnancy‐related infections/AIDS (4.2 to 18.2).

Conclusions  The MMR for all causes of maternal death declined significantly from 1953 to 1981 as a result of several interventions. From 1999, there has been a non‐significant increase in MMR, predominantly due to the burden of HIV/AIDS‐related mortality.
Emergency obstetric care in developing countries: impact of guidelines implementation in a community hospital in Senegal
Authors: Dumont Alexandre , Gaye Alioune , Mahé Patricia , Bouvier‐Colle Marie‐Hélène
Published: August 2005

Objective  To evaluate, with volunteer professionals in a resource‐poor setting, an approach of audit and feedback to promote local implementation of emergency obstetric guidelines.

Design  Triple cohort observational time series study.

Setting  A 46‐bed obstetric unit in an academic‐affiliated community hospital in Senegal.

Population  All pregnant women with haemorrhagic and hypertensive complications who were admitted to the maternity unit during the study periods.

Methods  To assess the benefits of guidelines implementation, maternal outcomes during the intervention period were compared with those occurring in two one‐year periods when staff daily supervision was the main potentially effective action on clinical management.

Main outcome measures  The intervention strategy was criteria‐based audits with regular feedback over a one‐year period. The clinical focus was haemorrhage and hypertension the most frequent causes of maternal death in the study population. Hospital charts were audited by external reviewers. The primary outcome was the case fatality rate (CFR) among patients with haemorrhage and hypertension.

Results  There was an increase in morbidity diagnoses during the intervention period. In addition, there was a marked increase in obstetric interventions, especially for transfusions and caesarean deliveries. Patients characteristic‐adjusted case fatality decreased by 53% between baselines I and II and during the intervention period by 33% and 24%, compared with baseline periods I and II, respectively. Outcome improvements were different for haemorrhage and hypertension.

Conclusion  While staff daily supervision may have improved maternal outcome before the intervention period, audit and feedback produced marked effects on emergency obstetric care, specially for complications requiring highly trained management (e.g. pre‐eclampsia). Audit and feedback are one of the potentially effective guidelines implementation strategies that should be considered for further studies in resource‐poor health facilities.
Personal accounts of ‘near‐miss’ maternal mortalities in Kampala, Uganda
Authors: Weeks Andrew , Lavender Tina , Nazziwa Enid , Mirembe Florence
Published: August 2005

Objective  To explore the socio‐economic determinants of maternal mortality in Uganda through interviews with women who had ‘near‐misses’.

Design  Observational study using qualitative research methods.

Setting  The postnatal and gynaecology wards of a large government hospital in Kampala, Uganda.

Sample  Thirty women who had narrowly avoided maternal deaths with diagnoses of obstructed labour (7), severe pre‐eclampsia/eclampsia (3), post caesarean infection (6), haemorrhage (5), ectopic pregnancy (5) and septic abortion (4).

Methods  The semi‐structured interviews were conducted in the local language by a woman unconnected to the hospital, and were recorded before being translated and transcribed. Analysis was conducted in duplicate using commercial software.

Results  The predominant theme was powerlessness, which occurred both within and outside the hospital. It was evident in the women's attempts to get both practical and financial help from those around them as well as in their failure to gain rapid access to care. Financial barriers and problems with transport primarily governed health‐seeking behaviour. Medical mistakes and delays in referral were evident in many interviews, especially in rural health centres. Women were appreciative of the care they received from the central government hospital, although there were reports of overcrowding, long delays, shortages and inhumane care. There were no reports of bribery.

Conclusions  Women with near‐miss maternal mortalities experience institutional and social powerlessness: these factors may be a major contributor to maternal mortality.
Misoprostol and declining abortion‐related morbidity in Santo Domingo, Dominican Republic: a temporal association
Authors: Miller Suellen , Lehman Tara , Campbell Martha , Hemmerling Anke , Brito Anderson Sonia , Rodriguez Hector , Vargas Gonzalez Wilme , Cordero Milton , Calderon Victor
Published: August 2005

Objective  To validate anecdotal reports that abortion‐related complications decreased in the Dominican Republic after the introduction of misoprostol into the country.

Design  Retrospective records reviews and cross‐sectional surveys, interviews and focus groups.

Setting  Family planning clinics, pharmacies, door‐to‐door canvassing and a tertiary care maternity hospital in Santo Domingo, Dominican Republic.

Population  Women of reproductive age in Santo Domingo, Dominican Republic.

Methods  Qualitative and quantitative methods were used. Individual interviews and focus groups of reproductive health professionals, non‐governmental organisation leaders and women's group leaders (n= 50) were conducted to discover the role of misoprostol in the Dominican Republic. Local women (n= 157) were surveyed to determine their knowledge of misoprostol as an abortifacient and mystery client visits were made to 80 pharmacies in order to purchase misoprostol without a prescription. Sales data were obtained that documented when misoprostol was introduced to the Dominican Republic pharmacies. Hospital admissions for abortions from the prior eight years were reviewed and hospital emergency room consultation ledgers of 31,190 visits for the period 1994–2001 were reviewed for abortion complications.

Main outcome measures  Frequencies of maternal morbidities and knowledge of misoprostol.

Results  Mystery clients purchased misoprostol without a prescription in nearly 64% of pharmacies; staff provided little additional information or counselling. Reliable sales data documented the introduction of misoprostol in 1986. Abortion complications decreased from 11.7% of abortions in 1986 to 1.7% in 2001. The majority of professionals interviewed felt that knowledge of these findings should be made public.

Conclusions  The data were of too poor quality to validate the verbal reports reliably, but misoprostol appears to have been widely used over a period when abortion‐related morbidity fell. It remains plausible that the use of misoprostol contributed to the reduction.
Routines in facility‐based maternity care: evidence from the Arab World
Authors:   Choices and Challenges in Changing Childbirth Research Network
Published: August 2005

Objectives  To document facility‐based practices for normal labour and delivery in Egypt, Lebanon, the West Bank (part of the Occupied Palestinian Territory) and Syria and to categorise common findings according to evidence‐based obstetrics.

Design  Three studies (Lebanon, West Bank and Syria) interviewed a key informant (providers) in maternity facilities. The study in Egypt directly observed individual labouring women.

Setting  Maternity wards.

Sample  Nationally representative sample of hospitals drawn in Lebanon and Syria. In the West Bank, a convenience sample of hospitals was used. In Egypt, the largest teaching hospital's maternity ward was observed.

Methods  Shared practices were categorised by adapting the World Health Organization's (WHO) 2004 classification of practices for normal birth into the following: practices known to be beneficial, practices likely to be beneficial, practices unlikely to be beneficial and practices likely to be ineffective or harmful.

Main outcome measures  Routine hospital practices for normal labor and delivery.

Results  There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately and practices of unproven benefit were also documented. Some documented childbirth practices are potentially harmful to mothers and their babies.

Conclusion  Facility practices for normal labour were largely not in accordance with the WHO evidence‐based classification of practices for normal birth. The findings are worrying given the increasing proportion of facility‐based births in the region and the improved but relatively high maternal and neonatal mortality ratios in these countries. Obstacles to following evidence‐based protocols for normal labour require examination.
Misoprostol in the management of the third stage of labour in the home delivery setting in rural Gambia: a randomised controlled trial
Authors: Walraven Gijs , Blum Jennifer , Dampha Yusupha , Sowe Maimuna , Morison Linda , Winikoff Beverly , Sloan Nancy
Published: August 2005

Objective  To assess the effectiveness of 600 μg oral misoprostol on postpartum haemorrhage (PPH) and postpartum anaemia in a low income country home birth situation.

Design  Double blind randomised controlled trial.

Setting  Twenty‐six villages in rural Gambia with 52 traditional birth attendants (TBAs).

Sample  One thousand, two hundred and twenty‐nine women delivering at home under the guidance of a trained TBA.

Methods  Active management of the third stage of labour using three 200‐μg misoprostol tablets and placebo or four 0.5‐mg ergometrine tablets (standard treatment) and placebo. Tablets were taken orally immediately after delivery.

Main outcome measures  Measured blood loss, postpartum haemoglobin (Hb), difference between Hb at the last antenatal care visit and three to five days postpartum.

Results  The misoprostol group experienced lower incidence of measured blood loss ≥500 mL and postpartum Hb <8 g/dL, but the differences were not statistically significant. The reduction in postpartum (compared with pre‐delivery) Hb ≥ 2 g/dL was 16.4% with misoprostol and 21.2% with ergometrine [relative risk 0.77; 95% confidence interval (CI) 0.60–0.98; P= 0.02]. Shivering was significantly more common with misoprostol, while vomiting was more common with ergometrine. Only transient side effects were observed.

Conclusions  Six hundred micrograms of oral misoprostol is a promising drug to prevent life‐threatening PPH in this setting.
REVIEW: Appropriate technology to prevent maternal mortality: current research requirements
Authors: Tsu Vivien Davis
Published: August 2005

Maternal mortality involves a complex mixture of clinical, infrastructural and social issues and will require a multifaceted approach if we are to see meaningful reductions occur. That includes thoughtful attention to appropriate technologies for low‐resource countries. An international group of specialists meeting in Bellagio, Italy, in 2003 identified important needs and opportunities related to new and underutilized technologies to reduce pregnancy‐related mortality. Research to fill in critical information gaps was a recurrent theme. Research, whether it is for product development, for building the evidence base about effectiveness and safety or for helping refine introduction strategies and guide practice, plays a critical role in the development and widespread use of technologies. Priority research needs related to the five major causes of maternal mortality—haemorrhage, puerperal sepsis, unsafe abortion, pre‐eclampsia and eclampsia and obstructed labour—have been identified. Appropriate collaborations of investigators and other stakeholders and adequate financial resources are urgently needed to move the research agenda forward.
SYSTEMATIC REVIEW: WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture
Authors: Justus Hofmeyr G. , Say Lale , Metin Gülmezoglu A.
Published: August 2005

Objective  To determine the prevalence of uterine rupture worldwide.

Design  Systematic review of all available data since 1990.

Setting  Community‐based and facility‐based reports from urban and rural studies worldwide.

Sample  Eighty‐three reports of uterine rupture rates are included in the systematic review. Most are facility based using cross‐sectional study designs.

Methods  Following a pre‐defined protocol an extensive search was conducted of 10 electronic databases as well as other sources. Articles were evaluated according to specified inclusion criteria. Uterine rupture data were collected along with information on the quality of reporting including definitions and identification of cases. Data were entered into a database and tabulated using SAS software.

Main outcome measures  Prevalence of uterine rupture by country, period, study design, setting, participants, facility type and data source.

Results  Prevalence figures for uterine rupture were available for 86 groups of women. For unselected pregnant women, the prevalence of uterine rupture reported was considerably lower for community‐based (median 0.053, range 0.016–0.30%) than for facility‐based studies (0.31, 0.012–2.9%). The prevalence tended to be lower for countries defined by the United Nations as developed than the less or least developed countries. For women with previous caesarean section, the prevalence of uterine rupture reported was in the region of 1%. Only one report gave a prevalence for women without previous caesarean section, from a developed country, and this was extremely low (0.006%).

Conclusion  In less and least developed countries, uterine rupture is more prevalent than in developed countries. In developed countries most uterine ruptures follow caesarean section. Future research on the prevalence of uterine rupture should differentiate between uterine rupture with and without previous caesarean section.
Clonidine Prevents Corticotropin Releasing Factor‐Induced Epileptogenic Activity in Rats
Authors: Marrosu Francesco , Giagheddu Marcello , Gessa Gian Luigi , Fratta Walter
Published: August 2005

Summary: Studies have shown that intracerebroventricular (i.c.v.) injection (10–20 μg) of corticotropin releasing factor (CRF) in rats induces epileptiform activity characterized by a regular (pacemaker‐like) spiking pattern located in hippocampal leads. CRF has also been shown to increase the firing rate of noradrenergic neurons in the locus ceruleus. Our experiments clarified the possible role of norepinephrine (NE) in mediating hippocampal activity of CRF. Intraperitoneal (i.p.) injection of the α2–agonist clonidine at a dose of 0.5–5 μg/kg prevented, in a dose‐related manner, the hippocampal epileptiform activity induced by CRF (20 μg i.c.v.). Our results suggest a possible role of NE in CRF‐induced spiking activity.
Age‐Dependent Differences in the Anticonvulsant Effects of 2–Amino‐7‐Phosphono‐Heptanoic Acid or Ketamine Infusions Into the Substantia Nigra of Rats
Authors: Wurpel John N. D. , Sperber Ellen F. , Moshé Solomon L.
Published: August 2005

Summary: Infusions of 2‐amino‐7‐phosphonoheptanoic acid (AP7) or ketamine into the substantia nigra pars reticulata (SNPR) of adult rats increase the latency of onset to seizures induced by the convulsant ether flurothyl. Nigral infusions of AP7 or ketamine in concentrations up to 10 times greater than the adult dose are ineffective in 16‐day‐old rats. These results suggest that differences in seizure susceptibility between adult and immature rats may be related to differences in excitatory amino acid neurotransmission in the SN.
Epilepsy, Driving Laws, and Patient Disclosure to Physicians
Authors: Salinsky M. C. , Wegener K. , Sinnema F.
Published: August 2005

Summary: To avoid loss of driving privileges, patients with epilepsy may elect not to report seizures to their physician or to the Department of Motor Vehicles (DMV). Reporting to the physician may differ depending upon the type of law in effect, i.e., mandatory physician reporting versus patient reporting to the DMV. Nondisclosure to the physician may have important consequences with regard to seizure management. We surveyed patients at two adult seizure clinics to determine the effect of driving laws on patients' reporting to their physician. One hundred fifty‐eight patients completed an anonymous questionnaire asking whether they would report a breakthrough seizure under a physician versus a patient DMV reporting system. Under patient reporting, 96% would inform their physician and 56% would report to the DMV. Under physician reporting, 84% would inform their physician. This falls to 72% when considering currently driving patients only. An additional 9–17% of patients would continue to drive with a suspended license. In all, 53% would remain driving under patient reporting and 33% under physician reporting; however, with physician reporting, half of the illegally driving patients would have compromised their medical care, potentially increasing driving risk.
Epilepsy in Ancient India
Authors: Manyam Bala V.
Published: August 2005

Summary: The ancient Indian medical system, Ayurveda, meaning science of life, is the oldest system of medicine in the world. Epilepsy is defined as Apasmara: apa, meaning negation or loss of; smara, meaning recollection or consciousness. Aura was recognized and was called Apasmara Poorva Roopa. A large number of symptoms indicative of aura were listed. Worthy of mention are subjective sensation of sounds, sensation of darkness, feeling of delusion, and dreamlike state. An actual attack of Apasmara includes falling down; shaking of the hands, legs, and body; rolling up of the eyes; grinding of the teeth; and foaming at the mouth. Four major types of epilepsy based on the disturbance of doshas (humors) that govern the physiological and physiochemical activities of the body are mentioned. Apasmara is considered a dangerous disease that is chronic and difficult to treat. Several causes are mentioned. Treatment included correcting the etiological factors and dietary regimen and avoiding dangerous places that may result in injuries.
Occipital Lobe Seizures Related to Clinically Asymptomatic Celiac Disease in Adulthood
Authors: Ambrosetto Giovanni , Antonini Luisa , Tassinari C. Alberto
Published: August 2005

Summary: We report the electroclinical ictal findings of four epileptic patients with clinically asymptomatic celiac disease (CD). Celiac disease diagnosis was suspected by past history and/or computed tomography (CT) findings in all patients and confirmed by laboratory tests and jejunal biopsy. All patients had paroxysmal visual manifestations and ictal EEG discharges arising from the occipital lobe. Epilepsy evolution was favorable in two patients and severe in 2, regardless of CT evidence of occipital corticosubcortical calcifications in 2 patients. Occipital lobe seizures may be characteristic of the epilepsy related to CD, and epileptic patients with these seizures of unknown etiology should be carefully investigated for malabsorption. If past history and/or laboratory tests suggest gastrointestinal (GI) dysfunction they should also undergo small intestinal biopsy even if they do not have GI tract symptoms.
Epilepsy After Stroke
Authors: Kotila Mervi , Waltimo Olli
Published: August 2005

Summary: A retrospective follow‐up of 200 consecutive stroke patients [ischemic brain infarction (IBI) 157, intracerebral hemorrhage (ICH) 20, subarachnoid hemorrhage (SAH) 231 who were in need of ambulatory rehabilitation was conducted for a mean period of 40 months after stroke. Epilepsy developed in 33 (17%) patients. The occurrence of epilepsy was 14% in IBI, 15% in ICH, and 35% in SAH. Significantly more patients developed epilepsy in the SAH group than in the IBI group (8 of 23 vs. 22 of 157, p < 0.05). Of the 33 patients, 15% had their first seizures within the first 2 weeks after stroke, and 55% developed epilepsy in 6 months. Forty‐eight percent of the patients had generalized seizures. Antiepileptic drug (AED) treatment was started in 28 of 33 patients, of whom 17 still had seizures during follow‐up. Epilepsy was an important consequence of stroke among patients who needed rehabilitation, especially in SAH patients. In most, this was due to arterial spasm leading to IBI.
Unilateral Opercular Macrogyria and Benign Childhood Epilepsy with Centrotemporal (Rolandic) Spikes: Report of a Case
Authors: Ambrosetto Giovanni
Published: August 2005

Summary: An 18‐year‐old mentally normal epileptic boy had frequent left brachiofacial or unilateral motor seizures which started at age 4 years and ceased 10 years later. Seizures were exclusively sleep‐related. No relapse followed antiepileptic drug (AED) discontinuation. Left arm slight paresis and left hand astereognosia occurred at age 10 years. Awake EEGs showed persistent right rolandic discharges increased by sleep. Somatosensory evoked potentials (SEPs) were giant with left median nerve stimulation. Computed tomography (CT) and magnetic resonance imaging (MRI) disclosed right opercular macrogyria. We suggest that the structural brain lesion was causally related to his “idiopathic” partial epilepsy. Similar case reports and pathologic studies will elucidate the morphologic substrate of the underlying functional disorder in idiopathic partial epilepsies.
Rotatory Seizures
Authors: Meshram Chandrashekhar M. , Prabhakar Sudesh , Sawhney Inder Mohan S. , Dhand Upinder K. , Chopra Jagjit S.
Published: August 2005

Summary: We report seven cases of “rotatory seizures” with patients rotating around their axis one or several times. Contralateral EEG foci were localized in frontal and temporal regions. Computed tomography scan of three patients showed no structural lesion.
Morphological Patterns of Seizures Recorded Intracranially
Authors: Spencer Susan S. , Guimaraes Pedro , Katz Amiram , Kim Jung , Spencer Dennis
Published: August 2005

Summary: We analyzed the frequency and morphological characteristics of the initial EEG manifestations of spontaneous seizures recorded from depth and subdural electrodes in 26patients for whom pathological analysis of the area of seizure onset was available after resective surgery. Pathological features considered to be positive findings included well‐defined structural lesions (hamartoma, neoplasm) or strictly defined mesial temporal sclerosis. Seizure onset was characterized by the frequency of the rhythmic discharge >2 Hz in the first second and by the presence or absence of periodic low‐frequency spikes (<2 Hz) preceding this stable change in background frequency. These features were correlated with the presence or absence of pathologic abnormalities in temporal and extratemporal locations. Although all patterns and frequencies of seizure onset were recorded in both medial temporal and extratemporal locations, medial temporal seizure onset was significantly more likely to have high frequency (>13 Hz, p < 0.05) and no periodic spikes before seizure onset tended to periodic spikes prior to the seizure when it was associated with medial temporal sclerosis compared to when it was not. Extratemporal seizure onset associated with abnormal pathological substrate was significantly more likely to have a lower frequency (<13 Hz, p < 0.05) and no periodic spikes before seizure onset (p < 0.00001) than extratemporal seizure onset recorded from areas without pathological findings. Variability of seizure onset frequency was a characteristic of temporal, but not extra temporal, seizures (p < 0.01). The existence of such differences between seizures of temporal and extratemporal origin suggests that the underlying anatomy may in part determine these patterns, and that interpretation of EEG records of seizures beginning in different cerebral locations requires recognition of these differences.
Is 2‐Propyl‐4‐Pentenoic Acid, a Hepatotoxic Metabolite of Valproate, Responsible for Valproate‐Induced Hyperammonemia?
Authors: Kondo Tsuyoshi , Ishida Masayuki , Kaneko Sunao , Hirano Takayuki , Otani Koichi , Fukushima Yutaka , Muranaka Hideki , Koide Nobuo , Yokoyama Masaru , Nakata Shinichi , Kudo Hajime
Published: August 2005

Summary: To investigate the association between valproate metabolism (VPA) and VPA‐induced hyperammonemia together with the contribution of VPA hepatotoxicity risk factors such as young age, polypharmacy, and high serum VPA levels to VPA‐induced hyperammonemia, plasma ammonia (NH3) levels, serum levels of VPA and its metabolites, and biochemical parameters were determined in 98 patients treated with VPA (53 monopharmacy cases and 45 polypharmacy cases). In monopharmacy patients, plasma NH3 levels did not depend on age, VPA dosage or serum levels. Serum level of 2‐propyl‐4‐pentenoic acid (4‐en) showed a negative correlation with plasma NH3 level in the monopharmacy group. In polypharmacy patients, plasma NH3 levels, serum glutamic pyruvic transaminase, and γ‐glutamyltranspeptidase were significantly higher, while level/dose VPA ratio, 2‐en‐VPA serum level, and bilirubin were significantly lower than those in monopharmacy patients. These results suggest that young age and relatively high VPA serum levels within the therapeutic range were unlikely to be risk factors for common hyperammonemia associated with VPA therapy and that 4‐en was not causally related to this adverse effect. The decreased serum level of 2‐en‐VPA in polypharmacy patients may be a reflection of a certain mitochondrial dysfunction, which might be a mechanism of the increased NH3 levels. The changes in biochemical parameters in polypharmacy patients were considered results of the enzyme‐inducing activity of coadministered antiepileptic drugs (AEDs).
Serum Copper and Zinc Levels in Epileptic Children with Valproate Treatment
Authors: Kaji Masayuki , Ito Masatoshi , Okuno Takehiko , Momoi Toru , Sasaki Hiroshi , Yamanaka Chutaro , Yorifuji Tohru , Mikawa Haruki
Published: August 2005

Summary: Valproate (VPA) induces zinc (Zn) deficiency in experimental animals, but whether VPA treatment induces deterioration of serum trace metal homeostasis in humans is uncertain. We measured serum copper (Cu) and Zn levels in epileptic children treated with VPA and/or other antiepileptic drugs (AEDs). Patients treated with VPA monotherapy had significantly lower levels of serum Cu (82.2 ± 16.6 μg/dl) than normal controls (97.3 ± 23.0 μg/dl). Patients treated with VPA in addition to some other AED also had significantly lower levels of serum Cu (84.8 ± 20.0 μg/dl). Serum Cu concentrations in patients treated with AEDs except for VPA (87.7 ± 19.1 pg/dl) were not statistically different from those of control subjects. In contrast to the reported results of animal experiments, serum Zn levels were not altered in patients with VPA treatment. Although none of our patients showed any symptoms of Cu deficiency, we should pay attention to potential Cu deficiency in patients with VPA treatment.
Action of Antiepileptic Drugs Against Kainic Acid‐Induced Seizures and Automatisms During Ontogenesis in Rats
Authors: Velíšek Libor , Kubová Hana , Velíšková Jana , Mareš Pavel , Ortová Marta
Published: August 2005

Summary: Kainic acid (KA 4–14 mg/kg) administered intraperitoneally (i.p.) produces automatisms (scratching until third postnatal week, “wet dog” shakes thereafter), and clonic and tonic‐clonic seizures in rats aged 7, 12, 18, 25, and 90 days. Administration of carbamazepine (CBZ) i.p. (25 or 50 mg/kg), phenobarbital (PB 20–80 mg/kg), clonazepam (CZP 0.2 or 1 mg/kg), or valproate (VPA 200 mg/kg) influenced neither incidence nor latency of automatisms. Clonic seizures that are regularly observed after the third postnatal week in controls were either abolished or substantially suppressed by any of the aforementioned antiepileptic drugs (AEDs). Tonic‐clonic seizures observed in the first 3 postnatal weeks were suppressed only by solvent [including propyleneglycol (PEG), ethanol, and water]; the effect of AEDs on tonic‐clonic seizures was proconvulsant instead. The automatisms were most resistant to AED therapy. These results induce some doubts about the adequacy of the KA model for identifying AEDs effective against complex partial seizures, but forthcoming AEDs that suppress automatisms in the KA rat model might also be active against human complex partial seizures.
Anticonvulsant Effect of DN‐1417, a Derivative of Thyrotropin‐Releasing Hormone, and Liposome‐Entrapped DN‐1417, on Amygdaloid‐Kindled Rats
Authors: Mori Norio , Fukatsu Toshihiko
Published: August 2005

Summary: The effects of γ‐butyrolactone‐γ‐carbonyl‐L‐histidyl‐L‐propinamide citrate (DN‐1417), a derivative of thyrotropin‐releasing hormone, and liposome‐entrapped DN‐1417 (DN‐L) were examined in amygdaloid‐kindled rats. The animals were tested 2 h after intraperitoneal (i.p.) drug administration and then again every 24 h without further drug treatment. DN‐1417 did not suppress the kindled seizure at 2 h but did beginning 1–6 days after injection. DN‐L suppressed the kindled seizure at 2 h and had a more prolonged anticonvulsant effect than DN‐1417. After liposomes were given i.p. once daily for 2 weeks, there was no morphologic evidence that liposomes damaged brain neurons. These results, together with previously published data, suggest that as drug delivery vehicles, liposomes can enhance the effectiveness of drugs in the CNS without producing overt brain damage.
Electrophysiological Studies of Cervical Vagus Nerve Stimulation in Humans: I. EEG Effects
Authors: Hammond Edward J. , Uthman Basim M. , Reid Steven A. , Wilder B. J.
Published: August 2005

Summary: Evidence from studies of experimental animals indicates that electrical stimulation of the vagus nerve alters EEGs under certain stimulus parameters. We report EEG effects of electrical stimulation of the vagus nerve in 9 patients with medically intractable seizures as part of a clinical trial of chronic vagal stimulation for control of epilepsy. The mechanism of action of the vagal antiepileptic effect is unknown, and we believed that analysis of electrophysiologic effects of vagal nerve stimulation would help elucidate the brain areas affected. The left vagus nerve in the neck was stimulated with a programmable implanted stimulator. Stimulation at various stimulus frequencies and amplitudes had no noticeable effect on EEG activity whether the patient was under general anesthesia, awake, or asleep, but vagus nerve stimulation may interrupt ongoing ictal EEG activity.