bluuebunny/crossref_metadata_2025 huggingface dataset:
Should Stroke Trials Adjust Functional Outcome for Baseline Prognostic Factors?
Authors:   The Optimising the Analysis of Stroke Trials (OAST) Collaboration
Published: January 2009

Background and Purpose—

Many stroke trials have provided neutral results. Suboptimal statistical analyses may be failing to detect effective interventions. Adjusting outcomes for baseline prognostic factors in the analysis may improve the efficiency of analysis of outcomes.

Methods—

Data from 23 stroke trials (25 674 patients) assessing functional outcome were included. The prognostic variables considered were age, sex, and baseline severity. Unadjusted and adjusted ordinal logistic regression models were compared using simulated data from each trial (10 000 simulations per trial). Three levels of treatment effect were assessed with ORs of 0.95, 0.74, and 0.57. The reduction in sample size gained from using the adjusted models, as compared with an unadjusted model, was then calculated as a reflection of the increase in statistical power.

Results—

Adjusting outcome for baseline factors led to a reduction in sample size, which was similar across all 3 treatment effects (median percentage reduction, interquartile range): OR=0.95: 35.3% (21.0 to 42.1); OR=0.74: 38.4% (29.4 to 42.7); and OR=0.57: 38.4% (27.4 to 42.2). As the treatment effect increased, the proportion of simulations in which the treatment effect for the adjusted model was greater than for the unadjusted model also increased.

Conclusion—

Adjusting for prognostic factors in stroke trials can reduce sample size by at least 20% to 30% (the lower interquartile range) for a given power. Conversely, trialists may want to power for an unadjusted analysis and then increase statistical power by adjusting for prognostic factors.
Impact of Prehypertension on Common Carotid Artery Intima-Media Thickness and Left Ventricular Mass
Authors: Manios Efstathios , Tsivgoulis Georgios , Koroboki Eleni , Stamatelopoulos Kimon , Papamichael Christos , Toumanidis Savas , Stamboulis Elefterios , Vemmos Konstantinos , Zakopoulos Nikolaos
Published: January 2009

Background and Purpose—

Prehypertension has been recently introduced by JNC 7 as a new blood pressure (BP) category, associated with increased target-organ damage. Subclinical atherosclerosis by means of common artery intima-media thickness (CCA-IMT) has been incompletely investigated in prehypertensive patients. The aim of our study was to assess the extent of CCA-IMT and left ventricular mass (LVM) in prehypertensive adults in comparison to normotensive and untreated hypertensive subjects.

Methods—

From a total of 5221 consecutive patients screened to our Hypertension Unit we selected 896 consecutive individuals according to prespecified inclusion criteria, who underwent 24-hour ambulatory BP monitoring, carotid artery ultrasonographic, and echocardiographic measurements. Patients who received antihypertensive treatment during the BP monitoring were excluded. According to the office BP levels, patients were divided into 3 subgroups: normotensives (office BP <120/80 mm Hg), prehypertensives (120/80 mm Hg≤office BP<140/90 mm Hg), and hypertensives (office BP ≥140/90 mm Hg). Statistical analyses were performed by means of 1-way ANOVA, χ
2
test, and ANCOVA.

Results—

According to the office BP levels, the distribution of the study population was: normotensives (14.4%), prehypertensives (23.7%), and hypertensives (61.9%). Prehypertensive patients had higher CCA-IMT (
P
=0.038) and LVM (
P
=0.030) values than normotensive subjects, even after adjustment for baseline characteristics. Greater CCA-IMT values were observed in hypertensive patients in comparison to prehypertensives (
P
=0.002).

Conclusions—

Prehypertensive patients had higher CCA-IMT and LVM than their normotensive counterparts. Prehypertension status is cross-sectionally associated with subclinical atherosclerosis and target-organ damage.
Monocytes Are Major Players in the Prognosis and Risk of Infection After Acute Stroke
Authors: Urra Xabier , Cervera Álvaro , Obach Víctor , Climent Núria , Planas Anna M. , Chamorro Ángel
Published: January 2009

Background and Purpose—

Monocytes participate in adaptive and innate immune responses. Monocyte numbers increase in patients with stroke associated infection (SAI) or severe stroke. Whether changes in monocytes are related to specific effects, or simply mark brain damage, remains unsettled.

Methods—

We used flow cytometry in 45 consecutive strokes and 12 healthy controls to assess the time course of monocytes, their phenotype, and the production of cytokines after stimulation. Cortisol, TNF-α, IFN-γ, and IL-10 were measured in serum and metanephrine in plasma. The effects of humoral and cellular parameters on the risk of SAI and poor outcome were tested in multivariate analyses adjusted for confounders (NIHSS score, age, and tube feeding).

Results—

Surface expression of human leukocyte antigen-DR, Toll-like receptor-2, and production of TNF-α in monocytes were independently associated with stroke. Distinct immune mechanisms were related with functional outcome and the risk of SAI; the signature of SAI included an increase of cortisol, metanephrine, and IL-10 in serum, and reduced production of TNF-α in monocytes; poor outcome was associated with increased expression of Toll-like receptor-4 in monocytes (OR, 9.61; 95% CI, 1.27–72.47). SAI did not predict poor outcome (OR, 5.63; 95% CI, 0.45–70.42;
P
=0.18).

Conclusions—

In human stroke, poor outcome is associated to innate responses mediated by Toll-like receptor-4 in monocytes. SAI may result from the immunosuppressive and antiinflammatory effects of corticoids, catecholamines, IL-10, and deactivated monocytes. Early treated SAI does not contribute significantly to additional brain damage. These findings encourage the exploration of strategies aimed to inhibit Toll-like receptor-4 signaling in acute stroke.
Impact of Monocyte Chemoattractant Protein-1 Deficiency on Cerebral Aneurysm Formation
Authors: Aoki Tomohiro , Kataoka Hiroharu , Ishibashi Ryota , Nozaki Kazuhiko , Egashira Kensuke , Hashimoto Nobuo
Published: January 2009

Background and Purpose—

Recent studies have suggested that chronic inflammation actively participates in cerebral aneurysm (CA) formation. Macrophages accumulate in CA walls and express proinflammatory genes promoting CA progression, but the molecular mechanisms of monocyte/macrophage recruitment into CA walls remain to be elucidated.

Methods—

Monocyte chemoattractant protein-1 (MCP-1) expression in experimentally induced CAs was assessed by immunohistochemistry and Western blotting. The role of MCP-1 in CA formation was examined by MCP-1
−/−
mice and a plasmid DNA encoding a dominant negative mutant of MCP-1 (7ND). MCP-1 expression in human CAs was examined by immunohistochemistry.

Results—

MCP-1 expression was upregulated in aneurysmal walls at the early stage of CA formation. MCP-1
−/−
mice exhibited a significant decrease of CA formation and macrophage accumulation with decreased expression of matrix metalloproteinase-2, -9, and inducible nitric oxide synthase. Immunohistochemistry for the DNA binding form of nuclear factor-kappa B showed nuclear factor-kappa B activation in MCP-1-expressing cells. Blockade of MCP-1 activity by 7ND resulted in the inhibition of CA progression in rats. In human CAs, MCP-1 was also expressed in CA walls.

Conclusions—

These data suggest that MCP-1 plays a crucial role in CA formation as a major chemoattractant for monocyte/macrophage. MCP-1 expression in CA walls is induced through nuclear factor-kappa B activation. MCP-1 may be a novel therapeutic target of medical treatment preventing CA progression.
Frequency and Outcome of Carotid Atheromatous Disease in Patients With Stroke in Pakistan
Authors: Wasay Mohammad , Azeemuddin Muhammad , Masroor Imrana , Sajjad Zafar , Ahmed Rasheed , Khealani Bhojo A. , Malik Muhammad Ashar , Afridi Maria Babar , Kamal Ayeesha
Published: January 2009

Background and Purpose—

Limited data exist on the frequency and outcome of carotid artery disease in Pakistan. Such information would help guide the usefulness of screening for the condition in this low-middle income health care setting.

Methods—

A prospective, descriptive study was conducted among 3 large teaching hospitals in Karachi, Pakistan. Patients referred for carotid Doppler ultrasound examination were included if they had experienced a stroke or TIA within the previous month. The severity and morphology of carotid disease were characterized by trained technicians using standardized criteria. Demographic and risk factor data were collected at baseline, and the outcome of patients was assessed at least 6 months later.

Results—

A total of 672 patients underwent bilateral carotid Doppler ultrasound (1344 carotid examinations). The findings revealed 0% to 50% stenosis in 526 (78%), 51% to 69% stenosis in 57 (8%), 70% to 99% stenosis in 82 (12%), and total occlusion in 7 patients (1%). Potentially surgically correctable disease, defined as 70% to 99% carotid artery stenosis, was present in only 79 (12%) patients, of whom 47 (60%) were ipsilateral symptomatic, 15 (20%) asymptomatic, and 17 (20%) had status unknown. Outcome information at ≥6 months follow-up was available for 36 of the 47 (76%) surgically correctable and only 4 of these patients (12%) had undergone surgical or radiological intervention (carotid endarterectomy in 3 patients and carotid stenting in 1 patient).

Conclusion—

The frequency of carotid artery disease of at least moderate severity is very low in patients with recent stroke or TIA and there is low utilization of high-cost, carotid intervention procedures in Pakistan. These data raise questions regarding the applicability and cost-effectiveness of routine carotid ultrasound screening in our country and similar population in Asia. The local socio-economic and clinical data do not support routine carotid Doppler ultrasound in every patient with stroke and TIA in Pakistan. Studies are warranted to determine predictors of significant carotid artery stenosis in stroke/TIA patients of our country to develop reliable stroke guidelines appropriate for local population.
Unsupervised Type and Token Identification of Idiomatic Expressions
Authors: Fazly Afsaneh , Cook Paul , Stevenson Suzanne
Published: January 2009

Idiomatic expressions are plentiful in everyday language, yet they remain mysterious, as it is not clear exactly how people learn and understand them. They are of special interest to linguists, psycholinguists, and lexicographers, mainly because of their syntactic and semantic idiosyncrasies as well as their unclear lexical status. Despite a great deal of research on the properties of idioms in the linguistics literature, there is not much agreement on which properties are characteristic of these expressions. Because of their peculiarities, idiomatic expressions have mostly been overlooked by researchers in computational linguistics. In this article, we look into the usefulness of some of the identified linguistic properties of idioms for their automatic recognition. Specifically, we develop statistical measures that each model a specific property of idiomatic expressions by looking at their actual usage patterns in text. We use these statistical measures in a type-based classification task where we automatically separate idiomatic expressions (expressions with a possible idiomatic interpretation) from similar-on-the-surface literal phrases (for which no idiomatic interpretation is possible). In addition, we use some of the measures in a token identification task where we distinguish idiomatic and literal usages of potentially idiomatic expressions in context.
Exploring the Challenges and Prospects for Polycentricity in International Humanitarian Relief
Authors: Stephenson Max , Schnitzer Marcy
Published: January 2009

The coordination of relief in international humanitarian crises has long been viewed as fraught with problems of inadequate oversight and coordination. Contrary to this claim, this article argues that the international relief system, viewed as interdependent actors, is better understood on the basis of the principle of polycentricity. The authors sketch the conditions necessary to secure a polycentric social order and compare these to the international humanitarian relief framework. They argue that polycentricity may be a more apt aspiration for participants in the international relief system than are calls for new and more stringent forms of monocentric coordination, but its conditions too may be difficult for the relevant participants to realize. The authors explore the tensions and possibilities implicit in this reframing at both the strategic and operating scales.
Why Organizational Ecology Is Not a Darwinian Research Program
Authors: Reydon Thomas A. C. , Scholz Markus
Published: January 2009

Organizational ecology is commonly seen as a Darwinian research program that seeks to explain the diversity of organizational structures, properties and behaviors as the product of selection in past social environments in a similar manner as evolutionary biology seeks to explain the forms, properties and behaviors of organisms as consequences of selection in past natural environments. We argue that this explanatory strategy does not succeed because organizational ecology theory lacks an evolutionary mechanism that could be identified as the principal cause of organizational diversity. The “evolution” of organizational populations by means of selection, which organizational ecologists put forward as the mechanism responsible for the extant diversity of organizational forms, is not evolution in any proper sense, because organizational populations do not have what it takes to participate in evolutionary processes. This implies that organizational ecology is not a Darwinian research program and that it cannot explain organizational diversity.
Challenges in the Clinical Development Requirements for the Marketing Authorization of New Medicines in Southeast Asia
Authors: Kudrin Alex
Published: January 2009

A rapid growth of investment into clinical research and new drug development has manifested itself by an exponential increase of new products coming onto the worldwide market. The emerging pharmaceutical and biotech markets in Southeast Asia are believed to be extremely promising from a commercial point of view in the next decade. The unique position of the Asian market and the diversity in clinical research initiatives are linked with diverse regulatory requirements for clinical development and registration of new medicines. Some of these differences have an impact on timelines for marketing authorizations in South Korea, China, Thailand, Japan, Singapore, and other countries. One of the approaches to streamlining regulatory strategy in different countries is the initiation of multicountry international clinical trials trying to address requirements and allowing registration in several regional countries simultaneously. Increasing cooperation between South Asian countries in relation to regulatory requirements and clinical development will facilitate the registration of innovative medicines in this rapidly developing region of the world and enable improved cohesiveness between countries in a drug safety framework.
Adherence to Practice Guidelines, Clinical Outcomes, and Costs Among Medicaid Enrollees With Severe Mental Illnesses
Authors: Stiles Paul G. , Boothroyd Roger A. , Dhont Kelley , Beiler Pamela F. , Green Amy E.
Published: January 2009

The treatment of Medicaid enrollees diagnosed with depression or schizophrenia was examined to determine whether adherence to treatment guideline was associated with health care financing strategy, clinical outcomes, and cost-effectiveness. Individuals in a fee-for-service condition were significantly more likely to receive treatment consistent with guidelines than those in managed care. Mental health costs were higher for individuals diagnosed with schizophrenia, individuals in an acute phase of illness at intake into the study, and those receiving treatment consistent with practice guidelines. Being in an acute phase of illness and having treatment that comported with recommended practice guidelines were associated with higher total social costs. Policy implications of the findings and recommendations for future research are discussed.
Stress in Junior Enlisted Air Force Women With and Without Children
Authors: Hopkins-Chadwick Denise L. , Ryan-Wenger Nancy
Published: January 2009

The objective was to determine if there are differences between young enlisted military women with and without preschool children on role strain, stress, health, and military career aspiration and to identify the best predictors of these variables. The study used a cross-sectional descriptive design of 50 junior Air Force women with preschool children and 50 women without children. There were no differences between women with and without children in role strain, stress, health, and military career aspiration. In all women, higher stress was moderately predictive of higher role strain (39.9% of variance explained) but a poor predictor of career aspiration (3.8% of variance explained). Lower mental health scores were predicted by high stress symptoms (27.9% of variance explained), low military career aspiration (4.1% of variance explained), high role strain (4.0% of variance explained), and being non—White (3.9% of variance explained). Aspiration for a military career was predicted by high perceived availability of military resources (16.8% of variance explained), low family of origin socioeconomic status (4.5% of variance explained), and better mental health status (3.3% of variance explained). Contrary to theoretical expectations, in this sample, motherhood was not a significant variable. Increased role strain, stress, and decreased health as well as decreased military career aspiration were evident in both groups and may have more to do with individual coping skills and other unmeasured resources. More research is needed to determine what nursing interventions are needed to best support both groups of women.
Psychiatrists’ attitude towards and knowledge of clozapine treatment
Authors: Nielsen J. , Dahm M. , Lublin H. , Taylor D.
Published: January 2009

Clozapine is, in most countries, underutilized and the initiation of clozapine is often delayed. The purpose of this study is to investigate the reasons for the delay and the underutilization of clozapine. One hundred psychiatrists were interviewed by phone. The interview was a structured interview with questions regarding attitude to, knowledge of and experiences with clozapine. Forty-eight (48%) psychiatrists had treatment responsibility of fewer than five patients treated with clozapine and 31 of the interviewed psychiatrists (31%) had started clozapine within the last 3 months. Seven psychiatrists (7%) had never prescribed clozapine despite the fact that they had been working more than five years in general psychiatry. Sixty-four psychiatrists (64%) would rather combine two antipsychotics than use clozapine. Sixty-six psychiatrists (66%) believed that patients treated with clozapine were less satisfied with their treatment when compared with those treated with other atypical antipsychotics. Many psychiatrists are reluctant to use clozapine and this might be due to less experience and knowledge of clozapine. A reason for the low awareness of clozapine’s properties might be that clozapine is now a generic drug, and therefore, the marketing and education in using the drug is sparse.
Cognitive effects of antipsychotic dosage and polypharmacy: a study with the BACS in patients with schizophrenia and schizoaffective disorder
Authors: Élie D. , Poirier M. , Chianetta JM , Durand M. , Grégoire CA , Grignon S.
Published: January 2009

Antipsychotic polypharmacy and high doses have been associated with poorer outcome, longer hospital stays, and increased side effects. The present naturalistic study assessed the cognitive effects of antipsychotics in 56 patients with a diagnosis of schizophrenia or schizoaffective disorder, using the Brief Assessment of Cognition in Schizophrenia (BACS). Antipsychotic daily dose (ADD) was expressed as mg risperidone equivalents/day (RIS eq), using a model based on drug doses from the Clinical Antipsychotic Trials in Intervention Effectiveness (CATIE) study for second generation antipsychotics (SGA) and chlorpromazine equivalents for first generation antipsychotics (FGA), with a 1/1 equivalence between haloperidol and risperidone. Increasing age was associated with polypharmacy, FGA prescription and decreasing BACS score. FGA prescription, in turn, predicted a poorer cognitive functioning, independently of age, PANSS subscores and ADD. ADD was associated with decreasing cognitive scores, an effect that remained significant after controlling for age, PANSS or polypharmacy. The detrimental cognitive effects of polypharmacy, in turn, appeared to be mediated by ADD. Different methods of data fitting suggested that ADD above 5—6 mg RIS eq/day were associated with lower BACS scores. Overall, these results show that increasing antipsychotic daily dose is associated with poorer cognitive functioning at doses lower than previously thought, independently of the number of antipsychotic drugs.
Prospective Actuarial Risk Assessment
Authors: Rettenberger Martin , Matthes Anna , Boer Douglas P. , Eher Reinhard
Published: January 2009

This study examines the predictive validity of the most commonly used risk assessment instruments for sexual offenders: Static-99, Rapid Risk Assessment for Sexual Offense Recidivism, Sex Offender Risk Appraisal Guide, Sexual Violence Risk—20, and Psychopathy Checklist—Revised in a prospective research design. Although risk assessment is part of a regime leading to various efforts to reduce risk by treatment and aftercare, all instruments show good predictive validity. However, depending on the instrument, recidivism category, and subgroup, the predictive accuracy varies markedly. Furthermore, the authors fail to demonstrate predictive validity for sexual violent reoffences—for the whole sample and for all subgroups. The results, nevertheless, support the utility and predictive validity of actuarial risk assessment complementary to treatment efforts to reduce risk. On the other hand, forensic practitioners have to be aware of the limitations of actuarial risk assessment methods, in particular as regards to variable predictive accuracy for different sexual offender subgroups and reoffence categories.
Hyaluronic Acid Viscosupplementation and Osteoarthritis
Authors: Strauss Eric J. , Hart Jennifer A. , Miller Mark D. , Altman Roy D. , Rosen Jeffrey E.
Published: January 2009

Intra-articular hyaluronic acid viscosupplementation is gaining popularity as a treatment option in the nonoperative management of patients with osteoarthritis. Recent clinical studies have demonstrated that the anti-inflammatory, anabolic, and chondroprotective actions of hyaluronic acid reduce pain and improve patient function. With evidence mounting in support of the efficacy of this treatment modality for patients with osteoarthritis, its potential use in additional patient populations and for other pathologies affecting the knee is being investigated. The current article reviews the use of intra-articular hyaluronic acid viscosupplementation in the management of knee osteoarthritis and presents the potential for expanding its indications for other joints and alternative patient subpopulations. Additionally, future directions for the use of hyaluronic acid and areas of active research are discussed.
Large Shear Deformation of E-glass/ Polypropylene Woven Fabric Composites at Elevated Temperatures
Authors: Zhu B. , Yu T.X. , Tao X.M.
Published: January 2009

Stamping operation of textile composite sheets in industry involves a process of heating and cooling of the material. In the present article, the in-plane large shear deformation of woven fabric composite sheets at elevated temperatures is studied. Using the modified ‘picture frame’ test, the effects of temperature on the shear behavior of the material and the onset of wrinkling were investigated. In addition to the reduction in yarn width, the change of physical and mechanical properties of polypropylene (PP) fibers with temperature also plays a significant role. The initial shear stiffness of the composite sheets and the onset of wrinkling are reasonably explained by inter-yarn friction measurement. To simply consider the temperature effect, the introduction of a temperature-dependent factor for the simulation of stamping operation is suggested.
An Experimental Study on Energy Absorption Behavior of Polyurethane Foams
Authors: Deb Anindya , Shivakumar N.D.
Published: January 2009

This article is concerned with a study on the energy absorption behavior of polyurethane (PU) foams such as flexible high resilience (HR), flexible viscoelastic (VE) and semi-rigid (SR) foams as a function of the overall foam density. Foam samples were prepared in the form of cubes by mixing appropriate polyol and isocyanate compounds produced by Huntsman International India Pvt. Ltd. in varying proportions leading to a range of densities for each type of foam. The cubical samples were tested under compressive load in a standard UTM. Based on the measured load—displacement behaviors, variations of peak load and energy-absorption attributes with respect to density are plotted for each type of foam and the possible existence of an optimum foam density is shown.
Meeting Developmental Challenges During Emerging Adulthood
Authors: Shulman Shmuel , Kalnitzki Esther , Shahar Golan
Published: January 2009

A one-year follow-up study examined the role of developmental challenges, personality (dependency, self-criticism, and personal efficacy), and support systems in adaptation among Israeli emerging adults ( N = 236) participating in a preparatory academic program. Participants were assessed during their enrollment in the preparatory academic program and one year later, after graduation, when their academic success or failure could be determined. Personal efficacy predicted higher levels of goal investment and goal progress, as well as more positive life events. In contrast, self-criticism predicted lower goal investment, higher goal stress, and a reduced number of positive events. Self-criticism also predicted elevated levels of amotivation and an increase in depressive and anxiety symptoms. Paternal social support predicted young people's more favorable adaptation one year later. Among young adult males, academic failure predicted later level of symptoms and more negative events. These findings encourage further examination of the role of personality and family relationships in the transition to adulthood.
The Use of Adolescents as Domestic Servants in Ibadan, Nigeria
Authors: Okafor Emeka Emmanuel
Published: January 2009

The use of adolescents as domestic servants has become prevalent in most urban centers in Nigeria. This study focused on adolescents who work as domestic househelps in urban centers with special reference to Ibadan, Nigeria. The main objective of the study is to examine their mode of recruitment, the nature of their work as well the impact of such work on them. In-depth interviews were conducted with 20 adolescent domestic servants and 5 employers selected through a combination of simple and purposive sampling techniques. The result of the findings showed that most of the adolescents were girls who were recruited through various sources and got into the job because their families were largely poor. Although most of them considered their work as laborious and demanding, yet some agreed that they were receiving some material benefits from the work in the absence of any real alternative to the precarious condition of their impoverished families. All their employers were working women who considered the engagement of these adolescents for work as a form of reciprocity, and as such thought that they had not violated any secular law. The study identified poverty and high demand for domestic servants by working women as the push and pull factors exacerbating the use of adolescents for domestic service in most urban centers in Nigeria.
“I'm Not Going to Be a Girl”
Authors: Oransky Matthew , Marecek Jeanne
Published: January 2009

This study examines the peer relations and emotion practices of adolescent boys in light of their expectations and assumptions about masculinity. We carried out semistructured interviews with middle-class and upper-middle-class boys from an independent high school. The boys reported that they assiduously avoided displays of emotional or physical pain and disparaged such displays in other boys. They tied tough, stoic self-presentations to manliness; moreover, they said that their peer groups derided expressions of hurt and worry and of care and concern for others as “gay” or “girly.” Boys described interactions with boys as centering on taunting, mocking, and “shoving around.” Although these practices were hurtful, boys valued them as means of bolstering one another's masculinity. The study points out that securing masculinity demands ongoing efforts from boys and their peers. Moreover, it points to feeling rules and emotion practices as important constituents of young White masculinities.
Understanding, Connection, and Identification
Authors: Sebanc Anne M. , Hernandez Maria D. , Alvarado Maria
Published: January 2009

Bilingual undergraduates may have closer friendships with other bilinguals than with monolinguals. This study investigated this hypothesis and explored the friendship features of 46 bilingual Spanish and English speaking undergraduates by combining quantitative analyses of surveys and qualitative analyses of interviews. Survey results indicated that participants rated their friendships with bilinguals to be more secure, closer, and to provide more help and companionship than their friendships with monolinguals. During interviews, participants described understanding, connection, and identification with their bilingual friends. These features were considered reasons for their friendships with other bilinguals and reasons for their greater quality. Bilingual friendships also helped bilingual undergraduates navigate a challenging sociopolitical context and have pride in their ethnolinguistic identity.
Agenesis of Internal Carotid Artery in a Child with Ipsilateral Horner's Syndrome
Authors: Fons Carmen , Vasconcelos Monica , Vidal Mariona , Puy Ramón , Capdevila Antonio , Sanchez Laia , Campistol Jaime
Published: January 2009

Horner's syndrome is characterized by a classic triad of ipsilateral pupillary miosis, partial eyelid ptosis, and facial anhydrosis. This case study reports a 7-year-old boy with right miosis, mild blepharoptosis, and iris hypopigmentation detected in a routine pediatric follow-up without ipsilateral facial anhydrosis, flushing, or pain. There was no history of birth trauma and test with cocaine provoked no response of the right pupil, suggesting right Horner's syndrome. Mediastinal tumor was ruled out and brain magnetic resonance imaging incidentally showed absence of flow in the right internal carotid artery. Subsequent magnetic resonance angiography demonstrated agenesis of the right internal carotid artery without other vascular-associated malformations. The final diagnosis was right, congenital Horner's syndrome due to ipsilateral internal carotid agenesis. We describe in detail the radiological findings and pathophysiological mechanisms of this unusual association.
Inside the Serbian War Machine
Authors: Glaurdić Josip
Published: January 2009

This article examines the arguably most interesting pieces of evidence used during the trial of Slobodan Milošević at the International Criminal Tribunal for the former Yugoslavia—more than two hundred recordings of intercepted conversations that took place in 1991 and 1992 between Milošević, Radovan Karadžić, Dobrica Ćosić, and various other protagonists on the Serbian side of the wars in Croatia and Bosnia and Herzegovina (BiH). Analysis of the intercepts presented in this article makes several important contributions to the interpretation of events in former Yugoslavia during that period. First, it identifies the ideological foundations of Milošević-led Serbian war campaigns in the political influence of Dobrica Ćosić and his platform of “unification of Serbs.” Second, it contributes to the vigorous debate regarding the possible deal between Milošević and the Croatian president Franjo Tuđman for the division of BiH. It confirms that negotiations took place, but that Milošević and his associates had no intention of respecting any agreement and wanted the whole of BiH until at least late 1991. Third, it provides indications that Milošević held the position of the de facto commander-in-chief in the operations of the Yugoslav People's Army in Croatia and BiH. And fourth, it establishes that the two institutions of force Milošević had direct legal control over—Serbia's State Security Service and Ministry of Interior—were his principal means of control over Croatian and Bosnian Serbs and instruments in the aggression against BiH even after its international recognition.
My Experience as a Paid Informer of the Polish Security Service
Authors: Kulczycki John J.
Published: January 2009

An agent of the Polish Security Service posing as a journalist contacted me in January 1970 while I was doing research in Poznań, Poland, for a Ph.D. dissertation as a graduate student of Columbia University. He commissioned an autobiographical account of my life "on the road to a doctorate" for which I was paid. But the actual goal was to recruit me as an informer concerning professors at Columbia, particularly Zbigniew Brzeziński, and my fellow students and their connections with the FBI and the CIA. When my suspicions were finally aroused, on the advice of the American consulate in Poznań, I returned the money and broke off contact. This ended my career as an informer, while the agent pocketed the money. As a result of this contact, the Intelligence Unit of the Polish Ministry of Internal Affairs created a file on me currently in the Institute of National Remembrance.
Breastfeeding as a Moral Imperative: An Autoethnographic Study
Authors: Crossley Michele L.
Published: January 2009

In recent years, breastfeeding has been heavily promoted in the UK. This has been partly premised on the health benefits for women and infants, but there has also been a strong rhetoric of `the natural' that has surrounded childbirth practices more generally. Some feminist thought has been influential in promoting breastfeeding as a way of `resisting' the medicalization of childbirth and motherhood, associating it with women's personal agency and empowerment. Despite the strong cultural pressure to breastfeed, however, many women `fail' to do so, with only 25 percent of women in the UK breastfeeding exclusively when the infant is four months old. Recent research has begun to look at the negative psychological and emotional effects experienced by women in the light of this `failure'. Exploring these issues further, this article uses an autoethnographic approach and utilizes sociological concepts such as the `body-project' to illustrate how the act of breastfeeding can be fraught with tension as contradictory pressures in contemporary society pull women in various ways. The article concludes that, far from being an `empowering' act, breastfeeding may have become more of a `normalized' moral imperative that many women experience as anything but liberational. Accordingly, an uncritical appropriation of the idea that `breast is best' may not only be disempowering for women, but also problematic for babies.
The Spaces and Faces of Critical Terrorism Studies
Authors: Jarvis Lee
Published: January 2009

This article explores the burgeoning academic interest in establishing a critical terrorism studies research programme. It begins by reviewing the debates over definition, causation and response that still dominate mainstream discussions of terrorism. The analytical and normative limitations of these debates, it argues, open considerable space for the emergence of a critically oriented body of literature. A second section then explores two distinct efforts at overcoming these limitations: the broadening and interpretivist faces of critical terrorism studies. The broadening face refers to attempts to expand our understanding of terrorism beyond non-state violence alone, while the interpretivist face comprises critical explorations of terror in image and narrative. Although each of these approaches offers scholars a more engaged role than the problem-solving orientation of the mainstream debates, the article argues that only the interpretivist face is capable of addressing their analytical limitations. The article concludes by calling for further attention to the notion of critique within the relevant critical literature.
Argument and Identity Change in the Atlantic Security Community
Authors: Kitchen Veronica M.
Published: January 2009

The Atlantic community shares more than just dependable expectations of peaceful change. Its members also share a reflexive political community they sense is worth preserving and a view that their security is intertwined. Existing accounts of the Atlantic security community have identified the importance of renewed emphasis on common values as a factor in preserving and expanding the security community after the Cold War. But, debates at the end of the Cold War also turned on the question of what the allies would do together and what responsibilities they had to each other and to other states. This article outlines a discursive framework and a set of rhetorical strategies used by members of the Atlantic community that explain how they worked to maintain and change their community during debates about their mandate for cooperation. This framework is then applied to the Atlantic community's debates over common action during the Yugoslav wars.
The Rise of the Choral Court: Use of Concurrence in the Burger and Rehnquist Courts
Authors: Maveety Nancy , Turner Charles C. , Way Lori Beth
Published: January 2009

Justices’ goals when writing concurrences continue to elude scholars. This project extends Baum’s contention that justices’ goals are bifurcated. The authors argue that justices use concurrences as means to both speak about their legal policy preferences and win by being members of the majority voting coalition. An analysis of the Burger and Rehnquist Courts’ concurring behavior illustrates that members of the Court are both authoring and joining concurrences in ways previously undocumented. Specifically, justices have become comfortable not only authoring concurrences but regularly joining others’ separate opinions as well—a trend the authors call choral-Court decision making.
Reflexive Positioning in a Politically Sensitive Situation
Authors: Possick Chaya
Published: January 2009

For the past 7 years, the author has conducted qualitative research projects revolving around the experiences of West Bank settlers. The political situation in Israel in general, and the West Bank in particular, has undergone rapid and dramatic political, military, and social changes during this period. In highly politically sensitive situations such as this, the researcher is faced with physical, professional, emotional, and ethical threats. This article presents a conceptual discussion and case illustration of the use of four types of reflexive positioning: (a) identification with respondents, (b) emotional enmeshment, (c) personal associations, and (d) auto-ethnography. These reflexive positions reduce risks to the trustworthiness of the research and transform threats into opportunities to enrich qualitative data analysis.
The Philosopher Leader: On Relationalism, Ethics and Reflexivity—A Critical Perspective to Teaching Leadership
Authors: Cunliffe Ann L.
Published: January 2009

The issue of teaching from a critical perspective is particularly important and challenging at the Executive MBA level, where students are senior managers in influential positions and often deeply enmeshed in prevailing managerial ideologies, structures of control and systems of power. Questioning taken-for-granted systems can be perceived as threatening and needless, especially when one's career is dependent on the current system. Therefore one of the major challenges of teaching leadership from a critical perspective lies in persuading students of the need to think differently about leadership, organizations and themselves as leaders. The challenge can become particularly acute if the EMBA programme is based on conventional pedagogical premises and as a result, students come into the course expecting to be given tools to simplify their lives in the form of leadership principles and techniques. I will offer one way of thinking about leadership, drawing on the philosophical themes of relationalism, ethics and reflexivity. I begin by setting the context of the article in my experience of teaching an Executive Leadership course on a conventionally taught Executive MBA programme. I go on to introduce the three themes, which emerge from my interests in phenomenological philosophy, and examine their relevance and value to leadership and CMS, before discussing how each theme relates to the idea of a philosopher leader.
Poverty and non-communicable diseases in South Africa
Authors: Schneider Michelle , Bradshaw Debbie , Steyn Krisela , Norman Rosana , Laubscher Ria
Published: January 2009

Background: High levels of wealth inequality with improved health statistics in South Africa (SA) provide an important opportunity to investigate non-communicable diseases (NCDs) among the poor. Aims: This paper uses two distinct national data sets to contrast patterns of mortality in rich and poor areas and explore the associations between poverty, risk factors, health care and selected NCDs diseases in South African adults. Methods: Causes of premature mortality in 1996 experienced in the poorest magisterial districts are compared with those in the richest, using average household wealth to classify districts. Logistic and multinomial regression are used to investigate the association of a household asset index and selected chronic conditions, related risk factors and healthcare indicators using data from the 1998 South African Demographic and Health Survey. Results: NCDs accounted for 39% and 33% of premature mortality in rich and poor districts respectively. The household survey data showed that the risk factors hypertension and obesity increased with increasing wealth, while most of the lifestyle factors, such as light smoking, domestic exposure to ``smoky'' fuels and alcohol dependence were associated with poverty. Treatment status for hypertension and asthma was worse for poor people than for rich people. Conclusions: The study suggests that NCDs and lifestyle-related risk factors are prevalent among the poor in SA and treatment for chronic diseases is lacking for poor people. The observed increase in hypertension and obesity with wealth suggests that unless comprehensive health promotion strategies are implemented, there will be an unmanageable chronic disease epidemic with future socioeconomic development in SA.
Association between social position and congenital anomalies: A population-based study among 19,874 Danish women
Authors: Olesen Charlotte , Thrane Nana , Rønholt Ann-Margrethe , Olsen Jørn , Henriksen Tine B
Published: January 2009

Aims: To examine the association between maternal and paternal educational level and household income and the risk of giving birth to a baby with a congenital anomaly in a population of Danish women. Methods: We performed a population-based cohort study, based on record linkage of data from Danish administrative registries. For each pregnant woman in the cohort, we described financial and educational resources and congenital anomalies in her offspring. We used logistic regression to model the association between social position and congenital anomalies. Results: The analyses included all 19,874 primiparous singleton deliveries in North Jutland county, Denmark, from 1991 to 1998. There were 1025 (5.2%) babies with congenital anomalies. The odds ratios (ORs) for giving birth to a baby with a congenital anomaly showed a dose— response decline, as the mothers' educational level increased. Women with less than 10 years of schooling had an almost three-fold increased risk of giving birth to an infant with a congenital anomaly, as compared with women with more than 4 years of higher education (OR=2.9, 95% confidence interval = 1.8—4.6). Paternal educational level and household income were, to a lesser degree, associated with congenital anomalies in the offspring. Conclusions: Maternal educational level, and to a lesser degree paternal educational level and household income, were associated with the risk of giving birth to a baby with a congenital anomaly. However, the analysis did not take into account maternal health status, and the results might be due to differential misclassification or residual confounding.
Comprehensive Environmental Assessment for Cooling Towers with Various Controls
Authors: Yu F.W. , Chan K.T.
Published: January 2009

Cooling towers are generally used in water-cooled chiller systems, which provide cooling energy for commercial buildings. This article assesses how the various control systems of cooling towers influence plume emissions and the electricity and water consumption of a chilled water system. Integrated with real control of cooling tower fans, chiller and cooling tower models were developed to analyze how the energy performance of a chiller and the water loss rate varied under different operating conditions. The status of air flows through the cooling tower was investigated to judge plume formation under various cooling tower controls. A simulation analysis on a chilled water system serving an office building showed that optimizing the fan speed control of cooling towers enables the annual electricity and water consumption costs to save 4.6% while also reducing the plume generation. The optimum control means adjusting the temperature of cooling water leaving the cooling tower in response to the chiller load and wet bulb outdoor temperature. The results of this article provide important insights into how to enhance the environmental performance of cooling towers for use in water-cooled chiller systems.
The Influence of Alternative Layouts for Air-circulation on Airflow Patterns in the Processing Area of a Cleanroom
Authors: Wang F.J. , Lai C.M. , Zheng Y.R.
Published: January 2009

The particle-free conditions provided by cleanrooms are essential for many modern manufacturing industries. Cleanrooms have to be first designed, constructed, and then on-site tested to ensure they achieve their performance specification. The on-site testing needs to be continued repeatedly even at the fully operational stage. In this study, field-testing of cleanrooms looking at parameters such as: airborne particle counts, airflow volume, turbulence intensity, temperature and pressure difference, were carried out under different occupational states in a newly constructed cleanroom. It was found that improved contamination control was needed due to the high particle counts at specific sampling locations. Consequently, a computational fluid dynamics simulation was conducted to investigate airflow characteristics based on the existing field-test results. Improvement strategies with less expenditure were proposed and have been assessed comprehensively. The results from computer simulation showed that an improvement of airflow could be achieved, not only by increasing the number of fan-filter units, but also by better arrangement of the return air grilles at both sides of the cleanroom.