bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of Non-Gaussian Doppler Spectra Observed by Weather Radar in a Tornadic Supercell
Authors: Yu Tian-You , Rondinel Ricardo Reinoso , Palmer Robert D.
Published: August 2008

Radar Doppler spectra that deviate from a Gaussian shape were observed from a tornadic supercell on 10 May 2003, exhibiting features such as a dual peak, flat top, and wide skirt in the nontornadic region. Motivated by these observations, a spectral model of a mixture of two Gaussian components, each defined by its three spectral moments, is introduced to characterize different degrees of deviation from Gaussian shape. In the standard autocovariance method, a Gaussian spectrum is assumed and biases in velocity and spectrum width estimates may result if this assumption is violated. The impact of non-Gaussian weather spectra on these biases is formulated and quantified in theory and, consequently, verified using four experiments of numerical simulations.

Those non-Gaussian spectra from the south region of the supercell are further examined and a nonlinear fitting algorithm is proposed to estimate the six spectral moments and compare to those obtained from the autocovariance method. It is shown that the dual-Gaussian model can better represent observed spectra for those cases. The authors’ analysis suggests that vertical shear may be responsible for the flat-top or the dual-peak spectra in the lower elevation of 0.5° and their transition to the single-peak and wide-skirt spectra in the next elevation scan of 1.5°.
Observations of Kinematics and Thermodynamic Structure Surrounding a Convective Storm Cluster over a Low Mountain Range
Authors: Groenemeijer Pieter , Barthlott Christian , Corsmeier Ulrich , Handwerker Jan , Kohler Martin , Kottmeier Christoph , Mahlke Holger , Wieser Andreas , Behrendt Andreas , Pal Sandip , Radlach Marcus , Wulfmeyer Volker , Trentmann Jörg
Published: August 2008

Measurements of a convective storm cluster in the northern Black Forest in southwest Germany have revealed the development of a warm and dry downdraft under its anvil cloud that had an inhibiting effect on the subsequent development of convection. These measurements were made on 12 July 2006 as part of the field campaign Prediction, Identification and Tracking of Convective Cells (PRINCE) during which a number of new measurement strategies were deployed. These included the collocation of a rotational Raman lidar and a Doppler lidar on the summit of the highest mountain in the region (1164 m MSL) as well as the deployment of teams carrying radiosondes to be released in the vicinity of convective storms. In addition, an aircraft equipped with sensors for meteorological variables and dropsondes was in operation and determined that the downdraft air was approximately 1.5 K warmer, 4 g kg−1 drier, and therefore 3 g m−3 less dense than the air at the same altitude in the storm’s surroundings. The Raman lidar detected undulating aerosol-rich layers in the preconvective environment and a gradual warming trend of the lower troposphere as the nearby storm system evolved. The Doppler lidar both detected a pattern of convergent radial winds under a developing convective updraft and an outflow emerging under the storm’s anvil cloud. The dryness of the downdraft air indicates that it had subsided from higher altitudes. Its low density reveals that its development was not caused by negative thermal buoyancy, but was rather due to the vertical mass flux balance accompanying the storm’s updrafts.
Field of Study and Gender Segregation in European Labour Markets
Authors: Smyth Emer , Steinmetz Stephanie
Published: August 2008

This article explores the role of field of study in channelling tertiary graduates into gender-appropriate occupations and the extent to which this process varies across countries. Previous research has demonstrated that such cross-country differences can be attributed to the nature of the welfare regime. However, less attention has been devoted to the potential impact of educational institutions and labour market systems. Using the European Union Labour Force Survey 2004 for 17 EU Member States, results of the multilevel analysis reveal that cross-national variation in occupational gender segregation must be seen in the context of institutional variation in education and labour market systems. The representation of women in higher education and the labour force, the gender pay gap and the provision of childcare explain a significant proportion of cross-national variation in occupational segregation by gender.
Field of Study and Flexible Work
Authors: Giesecke Johannes , Schindler Steffen
Published: August 2008

In this article, the relationship between study programs in higher education and the risk of holding a temporary contract is investigated in a comparative perspective. We find that the effects fields of study have on the type of contract can be better explained by their link to occupational positions than by field specificity differentials. Furthermore, fields of study are more important in explaining the individual risk of holding a temporary contract in the German rather than in the UK labor market. This may be attributable to the higher degree of standardization of the German educational system.
State-Level Curricular, Assessment, and Accountability Policies, Practices, and Philosophies for Exclusionary School Settings
Authors: Calvin Gagnon Joseph
Published: August 2008

The purpose of the current study was to obtain a more comprehensive understanding of state-level policies and practices concerning youth with disabilities in secondary day treatment and residential (DTR) schools, as well as juvenile correctional (JC) schools for committed youth. A survey of state directors of special education or their designees focused on curricula, assessment, and accountability in these school settings. State-level administrators from 49 states and the District of Columbia responded to mail and online surveys. They reported that approximately one third of DTR schools and half of JC schools used state or district curricula. Moreover, although most respondents noted that students should participate in state assessments, only one third noted that DTR or JC schools were supervised to a great extent to ensure the alignment of curricula and assessments. Implications for policy and practice and suggestions for future research are discussed.
Long Leaves, Child Well-Being, and Gender Equality
Authors: Bergmann Barbara R.
Published: August 2008

Of the measures for resolving work—family conflict proposed by Janet Gornick and Marcia Meyers, government programs that provide or pay for nonparental child care would advance gender equality. However, paid parental leaves of six months for both parents, and the encouragement of part-time work, would retard it, and possibly reverse some of the advances toward gender equality that have been made in the home and the workplace. Female jobholders would increase their time at home to a much greater extent than would male jobholders, increasing the share women do of child care, cleaning, cooking, and laundry. In the workplace, employers would become more reluctant to place women in nonroutine jobs, where substitution of one worker for another is difficult. Finally, recent studies of the effect on young children of nonparental care are reviewed. They can be interpreted in more than one way, and the lessons drawn from them depend crucially on the opinions of those doing the analysis.
Reforming Care
Authors: Folbre Nancy
Published: August 2008

This essay argues that concerns regarding the impact of work/family balance on gender inequality should be extended to broader analysis of all care work. Paid or unpaid care devoted to all dependents (including the sick and elderly as well as children) has distinctive characteristics that contribute to disempowerment and underpayment. Expenditures of money as well as time increase economic vulnerability. Public policies should provide greater support for caregiving outside the market, improve the supply and quality of purchased care services, and challenge conventional accounting systems that mismeasure economic welfare.
Global Constraints on Gender Equality in Care Work
Authors: Hassim Shireen
Published: August 2008

Gornick and Meyers offer proposals for advancing gender egalitarianism in care of children and in the labor market. This article examines the extent to which these proposals can be extended beyond the United States and other wealthy countries. I argue that the Gornick and Meyers proposals are dependent on a particular set of global and national labor market factors, and on a peculiar configuration of institutions and political forces. The article lays out some of these key contours of the global care labor market, as well as the divergent nature of public and private institutions in developing countries. I venture that the Gornick and Meyers proposals for egalitarianism are not universalizable without radical changes in the global arena.
The Political Path to a Dual Earner/Dual Carer Society: Pitfalls and Possibilities
Authors: Morgan Kimberly J.
Published: August 2008

What are the political pathways to the dual earner/dual caregiver model? Are most countries likely to attain only a partial transformation of policies and societies, rather than a full embrace of this model? This article examines the development of work-family policies in Western Europe to probe the politics and consequences of these programs. In many countries, the political context frustrates efforts to enact a unified, comprehensive vision like the dual earner/dual caregiver model. Rather than achieving gender-egalitarian arrangements for work and care, countries may stall halfway there. Advocates should be careful in what they ask for and be aware of the challenge of keeping gender-egalitarian goals at the center of a policy-making process over which they will not have full control.
The Measures of Criminal Attitudes and Associates (MCAA)
Authors: Bäckström Martin , Björklund Fredrik
Published: August 2008

The validity of a Swedish translation of the Measures of Criminal Attitudes and Associates (MCAA) was evaluated. All four subscales showed acceptable reliability, but the Entitlement scale can be improved by replacing items with low loadings. Confirmatory factor analysis supported a model with one common criminal attitude factor and three subfactors (corresponding to subscales of the test). The Antisocial Intent scale failed to come out as a separate factor. The criterion-related validity was evidenced through offenders having more positive attitudes to criminality than a sample from a public Internet site, a treatment program having an effect on the ratings, and test scores being meaningfully related to criminal history variables. It was concluded that the MCAA has satisfactory psychometric properties.
Marcel Poëte's Bergsonian Urbanism
Authors: Terranova Charissa N.
Published: August 2008

Marcel Poëte was a founding figure of French urbanisme, or town planning, both its pedagogy and its codification as a discipline and practice in the early twentieth century. The philosophy of Henri Bergson was central to his writings on the city and teaching at the École des Hautes Études Urbaines. I argue that Poëte's use of Bergson's philosophy, his ideas of the vital impulse and duration, may be understood in two ways. First, Poëte's Bergsonian urbanism participates in the greater context of continental fascism wherein Bergson's vitalism fomented a critique of scientific positivism and class hierarchy. Second, Poëte imports Bergson's ideas of time, la durée or duration, and “creative evolution,” into urbanisme as a means of resistance to vulgar functionalism in architecture and town planning.
Play Pays
Authors: Howell Ocean
Published: August 2008

Existing literature on the explosion of playgrounds at the beginning of the twentieth century focuses on the theories and self descriptions of the leadership of the playground movement, particularly on their ideas about how and why children's play needed to be supervised. Actual playgrounds are represented as a product of the campaign to control children's play. However, supervision was in fact a controversial aspect of the playground movement, which occasionally even cost the movement funding and public support. This paper argues that any physical development must be understood in relation to complex urban land politics, in which the interests of a variety of stakeholders are decisive. Children from the target populations wanted playgrounds, if not the play leaders that accompanied them. Real estate professionals pushed for playgrounds, because they increased and stabilized land values. City planners also provided crucial support, because playgrounds increased land values and tax revenue.
The Cognitive and Affective Dimensions of Moral Conviction: Implications for Attitudinal and Behavioral Measures of Interpersonal Tolerance
Authors: Cole Wright Jennifer , Cullum Jerry , Schwab Nicholas
Published: August 2008

The present studies investigate the role of both cognitive and affective dimensions of moral conviction in contributing to negative interpersonal responses. After demonstrating that the cognitive and affective dimensions of moral conviction are distinct constructs, the studies show that the cognitive dimension is sufficient to produce many forms of interpersonal intolerance. Simply believing an issue to be moral (i.e., objectively grounded, non-negotiable) results in greater intolerance for (Study 1), less sharing with (Study 2), and greater distancing from (Study 3) people with divergent attitudes. The emotional intensity with which beliefs are experienced is not alone explanatory. Nonetheless, it interacts with moral beliefs to produce the highest levels of interpersonal intolerance, distancing from dissimilar others, and context insensitivity. This interaction pattern between moral beliefs and affect was specific to emotional intensity and not other measures of attitude strength (Study 3).
Nanotechnology and the Developing World
Authors: Mehta Michael D.
Published: August 2008

This article argues that advances in nanotechnology in general, and lab-on-chip technology in particular, have the potential to benefit the developing world in its quest to control risks to human health and the environment. Based on the “risk society” thesis of Ulrich Beck, it is argued that the developed world must realign its science and technology policy priorities to meet some of the most pressing needs of humanity.
Situating Identities: Enacting and Studying Europe at a Russian Elite University
Authors: Müller Martin
Published: August 2008

The majority of studies on identity in the discipline of International Relations have analysed identities from an analytical perspective of distance; they elide the fact that identities are situated productions which unfold in specific contexts and through different forms of signification. In this article, I seek to work towards greater attentiveness to the situatedness of identities. I propose a reconsideration of the concept of discourse for situating identities and argue that ethnography can be a useful methodology for analysing the discursive construction of identities in micro-settings. This conceptual argument is illustrated by drawing on data from ethnographic research within Moscow State Institute of International Relations (MGIMO), a Russian elite university. I analyse how identification with Europe shifts across multiple contexts as it is enacted in everyday life and represented in the multiple processes of studying international relations at this educational institution. Foregrounding the situatedness of identities in this way brings their ambiguities and instabilities into view, while cautioning against an all-too-easy universalization in identity research.
Men in the Feminist Gaze: What Does this Mean in IR?
Authors: Carver Terrell
Published: August 2008

Some of the contributors to the 1988 and 1998 special issues of Millennium on women/gender and IR queried conventional accounts of sex and gender. Some of these put down markers for the study of sexuality in IR. The political thrust of this enterprise was broadly inclusive in character, deriving from various forms of identity politics, while also presuming a transformative outcome of some sort. A few contributors looked forward to a world beyond the confines of gender hierarchy. This article poses the question: 'What would it be like if “feminist IR” actually were “IR tout court ”?' Answering this question requires a non-referential theory of language that goes 'all the way down' — as the 'constructivism' deployed in IR does not, because it relies instead on an unexamined acceptance of 'the material'. The answer also requires an analytical view of masculinity as both apparently ungendered and overtly gendered, thus asymmetrical with femininity. Following through on this analysis resolves the dilemma that many IR feminists feel they face: how to sustain a critique of the manly content and masculinized framing of IR without reinvoking the gender binary through which 'woman' and the feminine are always and already subordinated to men and masculinity, and marginalized as subject and object of knowledge.
Procedural Explanations in Mathematics Writing
Authors: Kline Susan L. , Ishii Drew K.
Published: August 2008

This study analyzes the procedural explanations written by remedial college mathematics students. Relevant literatures suggest that six communication activities might be key in effective procedural explanations in mathematics writing: (a) orienting the learner, (b) providing kernels or definitions of concepts and procedures, (c) using exemplars or worked examples, (d) providing descriptions of the process or procedure, (e) solidifying learner understanding, and (f) facilitating linguistic control of mathematical terms. Using this framework, 18 practices or types of difficulties were discovered in students' written explanations. Independent experts consistently evaluated student explanations more highly when the explanations contained arithmetic or algebraic exemplars, described specific actions and their meanings, linked new with prior knowledge, and used descriptive language; experts evaluated student explanations more negatively when students displayed difficulties reasoning with kernels, reasoning with exemplars, or with describing processes.
Controlling the Degradation of Covalently Cross-linked Carboxymethyl Chitosan Utilizing Bimodal Molecular Weight Distribution
Authors: Lu Guangyuan  , Sheng Baiyang  , Wang Gan  , Wei Yujun  , Gong Yandao  , Zhang Xiufang  , Zhang Lihai
Published: August 2008

Degradability is often a critical property of materials utilized in tissue engineering. Although chitosan, a naturally derived polysaccharide, is an attractive material due to its biocompatibility and ability to form scaffolds, its slow and uncontrollable rate of degradation can be an undesirable feature. In this study, we characterize chitosan derivatives formed using a combination of carboxymethylation and a bimodal molecular weight distribution. Specifically, chitosan is carboxymethylated to a theoretical extent of ~30% as described in our previous work, in which carboxyl groups possessing negative charges are created at a physiological pH. Carboxymethyl chitosan is used to form films and constructs by varying the ratio of high to low molecular weight (MW) while maintaining the mechanical properties of the polymer. The rate of degradation is found to be dependent upon both the carboxymethylation and the ratio of high to low MW polymer, as determined by dry weight loss in lysozyme solution in PBS. Subsequently, biocompatibility is examined to determine the effects of these modifications upon Neuro-2a cells cultured on these films. Neuro-2a cells adher and proliferate on the modified films at a comparable rate to those cultured on unmodified films. This data indicates that these chitosan derivatives exhibit tunable degradation rates and result in a promising material system for neural tissue engineering.
Defining the public, defining sociology: hybrid science—public relations and boundary-work in early American sociology
Authors: Evans Michael S.
Published: August 2008

In this paper, I examine how scientific disciplines define their boundaries by defining the publics with whom they engage. The case study is an episode in the development of early American sociology. In response to the dual challenge of credibility set up by the conflict between religious Baconian science and secular positivist science, key actors engaged in specific strategies of boundary-work to create their desired “sociological public”—a hybrid form of science—public relations that appealed to hostile university scientists while excluding a supportive religious audience from participation in the production of scientific knowledge. Using this case, I offer two specific insights. First I illustrate how, in the pursuit of scientific credibility, actors engage in boundary-work to differentiate audiences, not just practitioners. Such defining of publics is constitutive of scientific disciplines in their formative stage. Second, I demonstrate how audience boundaries can be redefined through the capture of existing boundary objects. Specifically, the removal of informational content in key boundary objects creates durable boundaries that are difficult to overcome.
Consultations of stakeholders on the roles of research in relation to genetically modified plants in France
Authors: Ricroch Agnès , Jésus Franck
Published: August 2008

This article reports the first consultations on the roles of research in relation to genetically modified plants in France. We present a new attempt at facilitating discussion towards acceptable decisions and their results. This method consists of three steps: individual in-depth interviews of 77 French stakeholders, analysis of the interviews to identify elements that could help a constructive debate among participants, and two round-table discussions to present this analysis to stakeholders and foster discussions among them. The interviews exhibit a diversity of perceptions that are vaster than the pro or against points of view within the media. The problems raised during interviews deal with how discussions on genetically modified organisms (GMOs) are being done, how risks are taken into account, how the information is diffused, and how there is a minimal level of attention paid to social needs in GMOs' production. A series of problems more specific to the subject of the study discuss the weaknesses of the public research system. On the basis of these problems, 21 elements were identified that the stakeholders would like to see improved. One request seemed to be important for all types of stakeholders: “Raising the objectivity of the debate on GMOs.” Our facilitation exercise led to a set of innovative concrete proposals for the design of an effective national debate.
Willingness to Care for Patients With HIV/AIDS
Authors: Välimäki Maritta , Makkonen Pekka , Blek-Vehkaluoto Mari , Mockiene Vida , Istomina Natalja , Raid Ulla , Vänskä Maj-Lis , Suominen Tarja
Published: August 2008

This study aims to describe and compare nurses' willingness to provide care for patients with HIV/AIDS and factors associated with this in three countries. An international cross-sectional survey was conducted among nurses working in medical, surgical and gynaecology units in Finland ( n =427), Estonia ( n =221) and Lithuania ( n =185) in early 2006. The response rates were 75% ( n = 322) in Finland, 54% ( n =119) in Estonia and 86% ( n = 160) in Lithuania. A modified version of a scale developed in 1994 by Dubbert et al. was applied. Our findings showed a general willingness of the nurse participants to provide care for patients with HIV/AIDS. However, this willingness varied both among and within countries and was also related to specific nursing interventions. The results underline the importance of providing education on ethical issues related to HIV/AIDS care in Europe and tailoring the content of this education to meet nurses' national educational needs.
Ethical Issues of Transplant Coordinators in Japan and the Uk
Authors: Arie Fumie
Published: August 2008

Ethical problems surrounding organ donation have been discussed since before technologies supported the procedure. In addition to issues on a societal level (e.g. brain-stem death, resource allocation), ethical concerns permeate the clinical practice of health care staff. These latter have been little studied. Using qualitative methods, this study, focused on transplant co-ordinators and their descriptions of dilemmas, ethical concerns and actions in response to them. Interviews with three co-ordinators in Japan and two in the UK revealed five areas in which dilemmas occurred: aspects of discrimination; conditions placed on who should be the recipient and the related issues of directed donation; respect for a person's right to make a decision and the extent of information provided and understood by donors and recipients; potential issues of coercion, compensation and rewards in live-related and live-unrelated donations; and potential conflicts in duties. This study describes the dilemma areas revealed. Their meaning for co-ordinators will be presented in a subsequent report.
Alleviation of Pain and Symptoms With a Life-Shortening Intention
Authors: van Bruchem-van de Scheur Grada (Ada) G , van der Arend Arie JG , Abu-Saad Huda Huijer , van Wijmen Frans CB , Spreeuwenberg Cor , ter Meulen Ruud HJ
Published: August 2008

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values.
The Need for a Framework for Combined Disability and Gender Budgeting
Authors: Hans Asha , Patel Amrita M. , Agnihotri S.B.
Published: August 2008

Women with disability (WWDs) represent the most vulnerable category in the realms of both disability and gender. A recent survey on government allocations and expenditure in the disability sector in four states in India, namely, Andhra Pradesh, Chhattisgarh, Orissa and West Bengal, has underscored the need to develop specific safety nets for their survival and well-being. In recent years gender budgeting has emerged as an effective tool for locating the gaps between the policy rhetoric on women's empowerment and the resources provided to match it. There is a similar need to develop a disability budgeting protocol and, more importantly, a combined gender and disability budgeting tool to ensure that WWDs are not left out of resource allocations by the state. This study attempts to look at the resource allocation to the disability sector in general. It has to be kept in mind that gender-disaggregated data are not available; therefore, the analysis of the budget on the sector as a whole will be indicative of the situation for the WWDs as well. Using tools of gender budgeting and the baseline data on WWDs in the four states, this article attempts to develop a framework for a composite gender–disability budgeting exercise.
From Mental Illness to Disability
Authors: Davar Bhargavi V.
Published: August 2008

This article traces the critical engagement of the women's movement with psychiatry, mental health and disability in India over the past two decades. Three phases can be discerned in this history. The first was a phase of radical intellectual disbelief about the very existence of mental illness as a valid knowledge category. In the second phase the experiential reality of women, who had to engage with their own emotional states, found expression in a variety of discourses about women and mental health. The marginalisation of women by the mainstream medical sciences was addressed, and the right to care was redefined as the creation of gender-sensitive sciences. In the third and present phase I interrogate the paths we have taken in the creation of such gender-sensitive mental health practices. A mental illness language has been exhausted of any positive content. The rights orientation to mental health can be developed from disability thinking, which is providing an alternative vision for the world, as well for persons labelled mentally ill.
Finland's Wolf Policy and New Governance
Authors: Ratamäki Outi
Published: August 2008

The wolf is an endangered species, and its conservation has been agreed on internationally. International agreements often contradict the needs and opinions at national and local levels. This politics from the top down may lead to lack of commitment at the local level. Ultimately, the wolf suffers. The research data from which this article is drawn were collected in Finland and consist of interviews, observations, policy follow-ups, and literary documents. Kooiman's theory of social-political governance is used for the analysis of the data, which shows that there is strong pressure for more cooperative instruments of policy and that actors outside the state administration are active in developing these instruments. This raises questions regarding the relation between administrative and nonadministrative policy actions and national government's roles in conflict management. In addition to the existing ecological strategy, the Finnish national government is facing a challenge to create a societal strategy for Finland's wolf policy.
Concurrent Meta-Evaluation
Authors: Hanssen Carl E. , Lawrenz Frances , Dunet Diane O.
Published: August 2008

Meta-evaluations reported in the literature, although rare, often have focused on retrospective assessment of completed evaluations. Conducting a meta-evaluation concurrently with the evaluation modifies this approach. This method provides the opportunity for the meta-evaluators to advise the evaluators and provides the basis for a summative judgment about the quality of the evaluation. The authors conducted a concurrent meta-evaluation of a new evaluation technique being developed by a federal governmental agency; the new evaluation technique was expected to be highly visible and widely applied. The differences between concurrent meta-evaluation and other meta-evaluations were continuous involvement, attendance at data collection events, and external verification of the evaluation data. The authors' experience conducting the concurrent meta-evaluation is described and challenges are discussed in this critique. The authors conclude that concurrent meta-evaluation holds promise for improving the practice of evaluation and of meta-evaluation.
Effective Behavior and Instructional Support
Authors: Sadler Carol , Sugai George
Published: August 2008

The purpose of this article is to describe the development and 10-year implementation of the effective behavior and instructional support model in a midsized northwestern Oregon school district. The district experienced a sustained reduction in students' discipline referral rates, an increase in the percentage of students on track for early reading benchmarks, and an improvement in special education evaluation of learning disabilities. These important outcomes were associated with the systematic integration of effective practices, including capacity building professional development, schoolwide positive behavior support, early literacy, early intervention, and special education evaluation and identification using student responsiveness to intervention. At school and district levels, a continuum of behavior and academic supports was established for all students, and specialized interventions were implemented for students struggling with behavior and/or academic challenges.
Venous thromboembolism in women
Authors: Rathbun Suman
Published: August 2008

Abstract

The risk of venous thromboembolism (VTE) varies throughout a woman’s life and is associated primarily with underlying hormonal exposure. Alteration in hemostatic mechanisms, including resistance to activated protein C, may explain this altered risk. Initially, development of VTE with the use of contraception in young adulthood may reveal inherited thrombophilia. Pregnancy, and particularly the post-partum period, likely confer the greatest risk of VTE, but the absolute risk is small. Guidelines for prevention of VTE during pregnancy are based on personal or family history of VTE, and known inherited thrombophilia. Use of hormone replacement therapy later in life is associated with increased risk of VTE, and may be safest if given as an estrogen-only preparation to young postmenopausal women for less than 5 years. Universal screening for thrombophilia prior to pregnancy or initiating hormonal therapy is not recommended; however, selected testing in high-risk groups may be warranted. The lack of firm recommendations for the prevention of VTE in women highlights the need for future investigation aimed at identifying high-risk groups and evaluating the efficacy of prophylactic measures.
A biomarker panel for peripheral arterial disease
Authors: Fung Eric T , Wilson Andrew M , Zhang Fujun , Harris Nathan , Edwards Kim A , Olin Jeffrey W , Cooke John P
Published: August 2008

Abstract

Peripheral arterial disease (PAD) is common, but often not diagnosed. A biomarker index would be useful to raise suspicion of PAD, so as to trigger appropriate vascular testing and management. The study comprised 540 individuals: 197 individuals with both coronary artery disease and peripheral arterial disease (CAD + PAD); 81 with CAD only; and 262 with no hemodynamically significant disease (NHSD) of the coronary or peripheral arteries. Multiple linear regression was performed to generate a biomarker panel score that could predict ankle–brachial index (ABI). Logistic regression was used to investigate the relationship between disease status and the panel score as well as other risk factors (e.g. age, diabetes status, smoking status). ROC analysis was performed to test the prediction power of the biomarker panel score. Among the plasma markers tested, beta 2 microglobulin (β2M) and cystatin C had the highest correlation with ABI, and higher than any of the conventional risk factors of age, smoking status, and diabetes status. A biomarker panel score derived from β2M, cystatin C, hsCRP, and glucose had an increased association with PAD status (OR = 12.4, 95% confidence interval (CI) 6.6–23.5 for highest vs lowest quartile), which was still significant after adjusting for known risk factors (OR = 7.3, 95% CI 3.6–14.9 for highest vs lowest quartile). In conclusion, after taking into account the traditional risk factors for PAD, a biomarker panel comprising β2M, cystatin C, hsCRP, and glucose adds useful information to assess the risk of disease.
National health care costs of peripheral arterial disease in the Medicare population
Authors: Hirsch Alan T , Hartman Lacey , Town Robert J , Virnig Beth A
Published: August 2008

Abstract

Lower extremity peripheral arterial disease (PAD) is prevalent in the Medicare population and is associated with high rates of myocardial infarction, stroke, amputation, and death. Nevertheless, national health expenditures for PAD are not known. We hypothesized that PAD-related costs are high, increase with age, and that treatment rates would be less than known PAD prevalence. The objective was to determine national health care expenditures for PAD in the United States. PAD-related treatment costs were calculated in the elderly, non-disabled Medicare population. The cost analysis relied on the 5% control population for the linked SEER-Medicare data and Medicare claims for the calendar year 2001, identifying PAD cases based on diagnosis and procedure codes. Costs were aggregated separately for inpatient and outpatient treatment and estimates adjusted to reflect the Medicare population. A total of $4.37 billion was spent on PAD-related treatment and 88% of expenditures were for inpatient care. Medicare program outlays totaled $3.87 billion, while enrollees (or their supplemental insurance) spent the remaining $500 million. In total, 6.8% of the elderly Medicare population received treatment for PAD. Treatment increased with age at rates of 4.5%, 7.5%, and 11.8% for individuals aged 65–74, 75–84, and >85 years, respectively. PAD-related costs accounted for approximately 13% of all Medicare Part A and B expenditures for the PAD-treated cohort, and 2.3% of total Medicare Part A and B expenditures. In conclusion, US national PAD-related costs are high, associated with inpatient care, and increase with age. PAD is treated at rates lower than the known PAD prevalence as only approximately one-third of the population with known PAD had detectable PAD-related health care costs in our analysis. The potential impact of earlier PAD detection and use of outpatient preventive strategies on total national PAD health care costs is unknown.
Irbesartan attenuates Ang II-induced BMP-2 expression in human umbilical vein endothelial cells
Authors: Zhang Ming , Zhou Sheng-hua , Zhao Shui-Ping , Liu Qi-ming , Li Xu-ping , Shen Xiang-Qian
Published: August 2008

Abstract

Bone morphogenetic protein-2 (BMP-2), a transforming growth factor-β superfamily member cytokine, plays a key role both in vascular development and in pathophysiological processes. However, the effects and mechanisms of angiotensin II (Ang II) on BMP-2 expression remain unknown in human umbilical vein endothelial cells (HUVECs). Here we show that Ang II treatment significantly increased BMP-2 expression, associated with NF-κB activation, which was suppressed by treatment with pyrrolidine dithiocarbamate (PDTC) or irbesartan. Furthermore, the increased levels of MDA (malondialdehyde) in conditioned media and the decrease in activities of total superoxide dismutases (SOD) caused by Ang II were reversed by irbesartan or PDTC treatment. Our findings indicate that Ang II-induced BMP-2 expression might contribute to NF-κB activation. BMP-2 expression induced by Ang II might involve excessive oxidative stress.
Environmental factors as predictors of alcohol use among ninth-grade adolescents in Pitkäranta (Russian Karelia) and in eastern Finland
Authors: Kemppainen Ulla , Tossavainen Kerttu , Vartiainen Erkki , Jokela Veikko , Puska Pekka , Pantelejev Vladimir , Uhanov Mihail
Published: August 2008

Background: In Russia, tobacco and alcohol use by adolescents are serious problems. In Finland, as in many other European countries, alcohol use is a growing concern. Aims: This study aimed to find out whether similar environmental factors predict adolescents' alcohol use among 15-year old adolescents in two politically and economically different cultures: in the Pitkäranta district in Russian Karelia and in eastern Finland. Methods: Research data gathered by self-administered questionnaires from the second North Karelia Youth Study and the Pitkäranta Youth Study were analysed. Path models using the structural equation modelling (SEM) approach were constructed to test whether similar path structures fit for boys and girls in both countries, and to test whether regression coefficients are similar between the cultures and by gender. Results: The results showed that alcohol use by family members and best friend is positively related to adolescents' alcohol use both directly and indirectly. The best friend's alcohol use was the most important predictor of adolescents' own alcohol use in every sub-sample. When indirect influences were also identified, the significance of parents' and siblings' alcohol use, in addition to alcohol use by the best friends, was strongly supported. Conclusions: The results highlighted the importance of the process of peer selection for adolescents' choices, and the importance of offering support to the parents and to the health personnel working with children and adolescents.
Demand, control and social climate as predictors of emotional exhaustion symptoms in working Swedish men and women
Authors: Magnusson Hanson Linda L. , Theorell Töres , Oxenstierna Gabriel , Hyde Martin , Westerlund Hugo
Published: August 2008

Aims: Most studies on burnout have been cross-sectional and focused on specific occupations. In the present study we prospectively investigated the association between demands, control, support and conflicts as well as downsizing and emotional exhaustion in men and women derived from a representative sample of the working population in Sweden. Methods: The study comprised working men (1,511) and women (1,493), who participated in the Swedish Work Environment Survey (SWES) in 2003 and had no physical exhaustion and prior sick leave at baseline. These participants were followed up in 2006 as part of the Swedish Longitudinal Occupational Survey of Health (SLOSH). Demands, decision authority, support from fellow workers and superiors, conflicts with fellow workers and superiors, and downsizing were utilized as predictors and the Maslach Burnout Inventory subscale of emotional exhaustion as the outcome in multiple logistic regression analyses. Results: High demands were a highly significant predictor of symptoms of emotional exhaustion (≥75th percentile). Downsizing and lack of support from superiors were also independent predictors for men as well as lack of support from fellow workers and low decision authority for women. Conclusions: This study indicates that high demands, low decision authority, lack of support at work and downsizing could be important predictors of emotional exhaustion symptoms among working men and women.
Schoolchildren's health as judged by Swedish school nurses — a national survey
Authors: Clausson Eva K. , Köhler Lennart , Berg Agneta
Published: August 2008

Aims: To use school nurses' knowledge and experience for a better understanding of schoolchildren's health problems and their association to socioeconomic background and gender. Methods: Mail questionnaires were sent to a nationally representative, random sample of Swedish school nurses (n=129). The questionnaire included structured and open-ended questions asking for school nurses' judgement of schoolchildren's health status; changes over the previous two years; estimation of schoolchildren's most common reasons for consulting the school nurse; and estimation of factors influencing schoolchildren's health. Results: Swedish school nurses judged schoolchildren's mental health to have deteriorated during the previous two years with increasing health complaints, especially among girls and in disadvantaged housing areas. Disturbed family relations were considered as one important explanatory factor. Girls were more inclined to consult school nurses with subjective health complaints. Boys more often consulted the nurses with physical injuries. Conclusions: School nurses work closely with the children and meet them continuously during the school age period. They have a genuine knowledge of schoolchildren's health, which should be used even more, both in research and practice. The results may be applicable in other countries with similarly organized school health systems.
Weaving a web: subaltern consumers, rising consumer culture, and television
Authors: Varman Rohit , Belk Russell W.
Published: August 2008

Cultivation analysis suggests that television influences local cultures through its complex repertoire of images and narratives, which constitute a representation. Through a discursive analysis of television content in India we contend that rising material aspirations and consumer culture are significantly influenced by this medium. Dialectics of turmoil and tranquility mark this development for the working class population. On the one hand, there is domestication of unrest among subaltern groups, as they withdraw from collective political struggles to narrower and more tranquil forms of emulation and economism. On the other hand, these attempts at emulation have resulted in the poorer sections of society devoting their limited resources to aping a lifestyle well beyond their reach and further compromising their quality of life. The other pole of the dialectic is the increase in turmoil that results from tearing the traditional social fabric and support systems. This turmoil progressively manifests itself in increasing materialism and greater monetization of relationships for these subaltern groups.
Incommensurable paradigms, cognitive bias and the politics of marketing theory
Authors: Tadajewski Mark
Published: August 2008

This paper examines the treatment of paradigm incommensurability in marketing theory. It is not the first to tackle the issue, although I will argue that existing attempts to negotiate the incommensurability thesis fail on their misunderstanding of Kuhn's work. I then highlight Kuhn's own shifting position regarding the incommensurability thesis. Despite Kuhn's proposal that incommensurability can be overcome, such a strategy would be risky in an environment where cognitive bias indicates a continued subscription to logical empiricism and behavioural scientific modes of inquiry.
AAA Repair: Sociodemographic Disparities in Management and Outcomes
Authors: Vogel Todd R. , Cantor Joel C. , Dombrovskiy Viktor Y. , Haser Paul B. , Graham Alan M.
Published: August 2008

Objective: To evaluate sociodemographic influences on utilization and outcomes of endovascular abdominal aortic repair (EVAR) for the treatment of abdominal aortic aneurysm (AAA).

Methods: Secondary data analysis of the State Inpatient Databases for New Jersey.

Results: Between 2001 and 2006, a total of 6227 adult subjects (mean [SD] age, 73.3 [8.3] years; 77.6% male) underwent AAA repair (3167 EVAR and 3060 open surgery [OS]). Patients receiving EVAR were older than those undergoing OS (mean [SD] age, 74.2 [8.0] vs 72.4 [8.6] years) ( P < .001). Men were 1.60 (95% confidence interval [CI], 1.39-1.77) times more likely to receive EVAR than women. White subjects had the same odds of undergoing EVAR as black subjects, and white subjects had 1.60 (95% CI, 1.29-2.06) times higher odds of receiving EVAR than Hispanics. Subjects with Medicare coverage were 3.90 (96% CI, 2.28-6.59) times more likely to receive EVAR than uninsured subjects. Logistic regression analysis demonstrated that older age, male sex, and Medicare coverage were significantly associated with increased utilization of EVAR and that uninsured subjects and Hispanics are less likely to receive EVAR. Octogenarians and black subjects (odds ratios: 3.69 CI: 2.31-5.91, and 2.59 CI: 1.47-4.54 respectively) had significantly greater likelihood of death after elective AAA repair.

Conclusions: For AAA repair, significant sociodemographic disparities exist in the use of endovascular technology and in mortality. The risk of death after elective AAA repair was significantly greater for black subjects. Further analysis is warranted to delineate inequalities of vascular care for AAA and to assist in formulating policy to address these disparities.