bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Statins on Platelet Inhibition by a High Loading Dose of Clopidogrel
Authors: Müller Iris , Besta Felicitas , Schulz Christian , Li Zhongyan , Massberg Steffen , Gawaz Meinrad
Published: October 2003

Background—

Recent studies suggested that some HMG-CoA reductase blockers might inhibit the antiplatelet activity of clopidogrel. Therefore, we analyzed how various statins together with a high loading dose of clopidogrel (600 mg) affect platelet aggregation.

Methods and Results—

Seventy-seven patients with stable angina scheduled for elective coronary stenting were studied. Patients were randomized to receive atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin (each 20 mg), cerivastatin (0.3 mg), or placebo, plus a high loading dose of 600 mg of clopidogrel. ADP-induced platelet aggregation (5 and 20 μmol/L) was determined before and 2 and 4 hours after first clopidogrel administration. All patients were taking aspirin (100 mg/d) regularly. We found that none of the statins significantly influenced inhibition of platelet aggregation by clopidogrel.

Conclusions—

Concomitant use of statins with clopidogrel does not significantly inhibit antiplatelet activity, at least when clopidogrel is administered at a high loading dose of 600 mg.
Comparison of Coronary Thermodilution and Doppler Velocity for Assessing Coronary Flow Reserve
Authors: Fearon William F. , Farouque H.M. Omar , Balsam Leora B. , Cooke David T. , Robbins Robert C. , Fitzgerald Peter J. , Yeung Alan C. , Yock Paul G.
Published: October 2003

Background—

Thermodilution coronary flow reserve (CFR
thermo
) is a new technique for invasively measuring coronary flow reserve (CFR) with a coronary pressure wire and is based on the ability of the pressure transducer to also measure temperature changes. Whether CFR
thermo
correlates well enough with absolute flow-derived CFR (CFR
flow
) to replace Doppler wire–derived CFR (CFR
Doppler
) remains unclear.

Methods and Results—

In an open-chest pig model, CFR
thermo
was measured in the left anterior descending (LAD) artery and compared with CFR
Doppler
and CFR
flow
, measured with an external flow probe placed around the LAD. In 9 pigs, CFR was measured simultaneously by all 3 means in the normal LAD and after creation of an epicardial LAD stenosis. To determine the added effect of microvascular disease, measurements of flow reserve were also performed after disruption of the coronary microcirculation with embolized microspheres. Intracoronary papaverine (20 mg) was used to induce hyperemia. In a total of 61 paired measurements, CFR
thermo
correlated strongly with the reference standard CFR
flow
(
r
=0.85,
P
<0.001). CFR
Doppler
correlated less well with CFR
flow
(
r
=0.72,
P
<0.001). Bland-Altman analysis showed a closer agreement between CFR
thermo
and CFR
flow
.

Conclusion—

CFR
thermo
correlates better with CFR
flow
than does CFR
Doppler
.
Suppression of γ-Melanocyte–Stimulating Hormone Secretion Is Accompanied by Salt-Sensitive Hypertension in the Rat
Authors: Mayan Haim , Ni Xi-Ping , Almog Shlomo , Humphreys Michael H.
Published: October 2003

γ-Melanocyte–stimulating hormone (γ-MSH) is a natriuretic peptide derived from proopiomelanocortin (POMC) in the pituitary neurointermediate lobe (NIL); its plasma concentration in rats doubles after ingestion of a high (HSD; 8% NaCl) compared with a low sodium diet (LSD; 0.07%). Because NIL function is regulated through dopaminergic pathways, we asked whether dopaminergic stimulation with bromocriptine (5 mg/kg IP daily for 1 week) or inhibition with haloperidol (5 mg/kg IP for 1 week) alters the γ-MSH response to a HSD. In vehicle-treated rats, plasma γ-MSH and NIL γ-MSH content on the HSD were both markedly elevated over values in rats on the LSD (
P
<0.001); no difference in mean arterial pressure (MAP) occurred. In haloperidol-treated rats on the LSD, both plasma γ-MSH and NIL γ-MSH content were greater than in vehicle-treated rats (
P
<0.05) and did not increase further on the HSD; MAP was also no different. In bromocriptine-treated rats, neither plasma γ-MSH nor NIL γ-MSH content increased on the HSD versus LSD, and MAP was markedly elevated on the HSD (132±3 versus 106±3 mm Hg,
P
<0.001). Intravenous infusion of γ-MSH (0.4 pmol/min) to bromocriptine-treated rats on the HSD restored plasma γ-MSH concentration to a level appropriate for the HSD and lowered MAP from 131±6 to 108±5 mm Hg (
P
<0.01). These results demonstrate that the increases in NIL content and plasma concentration of γ-MSH normally occurring during ingestion of the HSD are prevented by dopaminergic suppression of NIL function. This results in deficiency of γ-MSH on the HSD and is accompanied by elevated blood pressure, which is corrected by infusion of the peptide. γ-MSH may be an important component in the normal response to a HSD; interruption of this response leads to salt-sensitive hypertension.
Gene Therapy With Human Tissue Kallikrein Reduces Hypertension and Hyperinsulinemia in Fructose-Induced Hypertensive Rats
Authors: Zhao Chunxia , Wang Peihua , Xiao Xiao , Chao Julie , Chao Lee , Wang Dao Wen , Zeldin Darryl C.
Published: October 2003

This study investigates gene therapy with human tissue kallikrein as a treatment for fructose-induced hypertension in rats. Hypertension was induced by addition of 10% fructose to drinking water. Fructose-fed rats also had increased serum insulin and triglycerides, decreased urine osmolarity, increased urine volume and endothelin-1, and increased aortic endothelin-1, endothelin-A receptor, and angiotensin II receptor type 1 mRNA levels. Fructose-induced hypertensive and control rats were injected intravenously with a construct containing the human tissue kallikrein cDNA. Two weeks after injection of hypertensive rats, systolic blood pressure and serum insulin levels normalized, urine osmolarity increased, urine endothelin-1 levels decreased, and aortic endothelin-1, endothelin-A receptor, and angiotensin II receptor type 1 mRNA levels decreased. In contrast, injection of the human tissue kallikrein cDNA had minimal effect on blood pressure or insulin levels in control rats. These results suggest that gene therapy with human tissue kallikrein may have potential as a treatment for hypertension and associated insulin resistance. Moreover, our data suggest that the beneficial effects of human tissue kallikrein on these parameters are associated with changes in endothelin-1, endothelin-A receptor, and angiotensin II receptor type 1 expression.
Effects of Hypertension and Obesity on the Sympathetic Activation of Heart Failure Patients
Authors: Grassi Guido , Seravalle Gino , Quarti-Trevano Fosca , Dell’Oro Raffaella , Bolla Gianbattista , Mancia Giuseppe
Published: October 2003

Previous studies have shown that congestive heart failure is characterized by sympathetic and reflex dysfunctions. Whether these alterations are potentiated in the presence of obesity and hypertension, two conditions that also display neuroadrenergic abnormalities and markedly increase the risk of heart failure, is unknown. In 14 healthy control subjects (C; age, 55.1±3.0 years; mean±SEM), 13 lean hypertensive subjects (H), 15 obese normotensive subjects (O), 14 lean normotensive subjects with congestive heart failure (CHF, New York Heart Association class II), 14 lean hypertensive subjects with CHF (CHFH), 14 obese normotensive subjects with CHF (CHFO), and 13 obese hypertensive subjects with CHF (CHFOH), all age-matched with C, we measured mean blood pressure (Finapres), heart rate (ECG), and muscle sympathetic nerve traffic (MSNA, microneurography) at rest and during baroreflex testing. Compared with C, body mass index was similarly increased in O, CHFO, and CHFOH, whereas mean blood pressure was similarly increased in HF, CHFH, and CHFOH, and left ventricular ejection fraction (echocardiography) was similarly reduced in CHF, CHFH, CHFO and CHFOH. Compared with C, MSNA was significantly increased in O, H, and CHF (43.0±2.2 versus 54.1±2.8, 53.1±2.5, and 57.4±2.8 bursts/100 heart beats,
P
<0.01). When O or H was combined with CHF, the MSNA increase was significantly more pronounced and maximal when O and H were concomitantly associated with CHF. Baroreflex sensitivity was reduced in O and H, with a further reduction in CHF and a minimal value in CHFOH. These data show that the sympathetic activation characterizing CHF is markedly potentiated when O and H alone or combined together are associated with a low cardiac output state and that this may depend on an arterial baroreflex impairment.
Renal Effects of Omapatrilat and Captopril in Salt-Loaded, Nitric Oxide–Deficient Rats
Authors: Ying Lu , Flamant Martin , Vandermeersch Sophie , Boffa Jean-Jacques , Chatziantoniou Christos , Dussaule Jean-Claude , Chansel Dominique
Published: October 2003

Inhibition of nitric oxide synthases causes systemic hypertension and renal injury in rats. Our objective was to examine whether omapatrilat, a vasopeptidase inhibitor that inhibits both angiotensin-converting enzyme (ACE) and neutral endopeptidase, could induce better regression of renal injury than ACE inhibitor alone. Ten groups of rats were studied. They were fed either a normal (0.8% NaCl) or a high (4% NaCl) sodium diet. Eight of these groups received
N
G
-nitro-
l
-arginine methyl ester (
l
-NAME, 20 mg · kg
−1
· d
−1
) in their drinking water. After 4 weeks, 1 group on each diet was killed and considered the
l
-NAME group, whereas the others received
l
-NAME alone, captopril (200 mg · kg
−1
· d
−1
) plus
l
-NAME, or omapatrilat (80 mg · kg
−1
· d
−1
) plus
l
-NAME for 4 additional weeks. In rats receiving
l
-NAME alone for 8 weeks, the mortality rate was ≈90%, irrespective of the diet. In contrast, all rats survived in the captopril and the omapatrilat groups. In rats fed a normal-sodium diet, captopril and omapatrilat normalized systolic blood pressure and induced a complete regression of renal injury. Creatinine clearance and proteinuria were also normalized. In the high-sodium-diet groups, both treatments were less efficient: blood pressure remained elevated, and the regression of renal fibrosis was only partial. Although proteinuria decreased significantly with captopril or omapatrilat, creatinine clearance remained lower than in the controls. These results demonstrate that, in nitric oxide–deficient rats fed a normal-sodium diet, ACE and vasopeptidase inhibitors exhibit a marked renoprotective effect, whereas these treatments are less efficient in rats fed a high-sodium diet.
Role of Androgens in Mediating Renal Injury in Aging SHR
Authors: Fortepiani Lourdes A. , Yanes Licy , Zhang Huimin , Racusen Lorraine C. , Reckelhoff Jane F.
Published: October 2003

Men have an increased risk of cardiovascular and renal diseases and develop greater renal injury despite similar levels of blood pressure when compared with women. The mechanisms responsible for this predisposition are unknown. Using the spontaneously hypertensive rat (SHR), we have found that androgens play an important role in the development of hypertension in young male SHR. However, the role that androgens play in age-related renal injury and dysfunction in SHR is unknown. Our hypothesis was that despite reductions in serum testosterone with age, androgens mediate renal injury and dysfunction in male SHR. Male SHR were castrated at 8 months of age, studied at 18 months of age, and compared with age-matched, intact males and young intact males (4 months). Serum testosterone was reduced by 30% in aging males compared with young SHR. With castration, blood pressure (mean arterial pressure [MAP]) was decreased by >20 mm Hg compared with old males, glomerular filtration rate (GFR) was increased by >35%, and renal vascular resistance (RVR) was reduced by >40%. MAP, GFR, and RVR in castrated, old males were similar to values in young males. With castration, glomerular sclerosis was reversed and proteinuria was also decreased by >80% when compared with old intact males. In addition, in castrated old males, plasma renin activity was decreased by 30% compared with old males and by 60% compared with young rats. The data support the hypothesis that despite a reduction in testosterone with age, androgens play an important role in age-related renal injury and dysfunction in SHR.
Heparan Sulfate Proteoglycan Is a Mechanosensor on Endothelial Cells
Authors: Florian Jeffry A. , Kosky Jason R. , Ainslie Kristy , Pang Zhengyu , Dull Randal O. , Tarbell John M.
Published: October 2003

The objective of this study was to test whether a glycosaminoglycan component of the surface glycocalyx layer is a fluid shear stress sensor on endothelial cells (ECs). Because enhanced nitric oxide (NO) production in response to fluid shear stress is a characteristic and physiologically important response of ECs, we evaluated NO
x
(NO
2
−
and NO
3
−
) production in response to fluid shear stress after enzymatic removal of heparan sulfate, the dominant glycosaminoglycan of the EC glycocalyx, from cultured ECs. The significant NO
x
production induced by steady shear stress (20 dyne/cm
2
) was inhibited completely by pretreatment with 15 mU/mL heparinase III (E.C.4.2.2.8) for 2 hours. Oscillatory shear stress (10±15 dyne/cm
2
) induced an even greater NO
x
production than steady shear stress that was completely inhibited by pretreatment with heparinase III. Addition of bradykinin (BK) induced significant NO
x
production that was not inhibited by heparinase pretreatment, demonstrating that the cells were still able to produce abundant NO after heparinase treatment. Fluorescent imaging with a heparan sulfate antibody revealed that heparinase III treatments removed a substantial fraction of the heparan sulfate bound to the surfaces of ECs. In summary, these experiments demonstrate that a heparan sulfate component of the EC glycocalyx participates in mechanosensing that mediates NO production in response to shear stress. The full text of this article is available online at http://www.circresaha.org.
Integrin-Associated Protein Binding Domain of Thrombospondin-1 Enhances Insulin-Like Growth Factor-I Receptor Signaling in Vascular Smooth Muscle Cells
Authors: Maile Laura A. , Clemmons David R.
Published: October 2003

Insulin-like growth factor-I (IGF-I) stimulates vascular smooth muscle cell (SMC) proliferation and migration. The response of smooth muscle cells to IGF-I is determined not only by activation of the IGF-I receptor but also by at least three other transmembrane proteins, α
V
β
3
, integrin-associated protein (IAP), and SHPS-1. This regulation seems to be attributable to their ability to regulate the transfer of SHP-2 phosphatase, a key component of IGF-I signaling. Ligand occupancy of SHPS-1 with IAP is required for the recruitment and transfer of SHP-2 and subsequent signaling in response to IGF-I. The extracellular matrix protein thrombospondin-1 stimulates an increase in the cell proliferation response to IGF-I. Because thrombospondin-1 is a ligand for IAP, we wished to determine whether the enhancing effect of thrombospondin-1 was mediated through IAP binding. To examine the effect of thrombospondin-1 binding to IAP, we used a peptide termed 4N1K derived from the IAP binding site of thrombospondin-1. Preincubation with 4N1K increased IGF-I–stimulated mitogen-activated protein kinase activation and DNA synthesis. This enhancement seemed to be attributable to its ability to increase the duration of IGF-I–stimulated receptor and insulin receptor substrate-1 (IRS-1) phosphorylation. Preincubation with 4N1K delayed IGF-I stimulation of SHPS-1 phosphorylation (attributable to an alteration in IAP–SHPS-1 interaction), resulting in a delay in SHP-2 recruitment. This delay in SHP-2 transfer seems to account for the increase in the duration of IGF-I receptor phosphorylation and for enhanced downstream signaling. These observations support the conclusion that thrombospondin-1 and IGF-I seem to function coordinately in stimulating smooth muscle proliferation via the thrombospondin-1 interaction with IAP.
Site of Origin and Molecular Substrate of Atrioventricular Junctional Rhythm in the Rabbit Heart
Authors: Dobrzynski Halina , Nikolski Vladimir P. , Sambelashvili Alexandre T. , Greener Ian D. , Yamamoto Mitsuru , Boyett Mark R. , Efimov Igor R.
Published: October 2003

During failure of the sinoatrial node, the heart can be driven by an atrioventricular (AV) junctional pacemaker. The position of the leading pacemaker site during AV junctional rhythm is debated. In this study, we present evidence from high-resolution fluorescent imaging of electrical activity in rabbit isolated atrioventricular node (AVN) preparations that, in the majority of cases (11 out of 14), the AV junctional rhythm originates in the region extending from the AVN toward the coronary sinus along the tricuspid valve (posterior nodal extension, PNE). Histological and immunohistochemical investigation showed that the PNE has the same morphology and unique pattern of expression of neurofilament160 (NF160) and connexins (Cx40, Cx43, and Cx45) as the AVN itself. Block of the pacemaker current,
I
f
, by 2 mmol/L Cs
+
increased the AV junctional rhythm cycle length from 611±84 to 949±120 ms (mean±SD, n=6,
P
<0.001). Immunohistochemical investigation showed that the principal
I
f
channel protein, HCN4, is abundant in the PNE. As well as the AV junctional rhythm, the PNE described in this study may also be involved in the slow pathway of conduction into the AVN as well as AVN reentry, and the predominant lack of expression of Cx43 as well as the presence of Cx45 in the PNE shown could help explain its slow conduction.
Reversal of Chronic Molecular and Cellular Abnormalities Due to Heart Failure by Passive Mechanical Ventricular Containment
Authors: Sabbah Hani N. , Sharov Victor G. , Gupta Ramesh C. , Mishra Sudhish , Rastogi Sharad , Undrovinas Albertas I. , Chaudhry Pervaiz A. , Todor Anastassia , Mishima Takayuki , Tanhehco Elaine J. , Suzuki George
Published: October 2003

Passive mechanical containment of failing left ventricle (LV) with the Acorn Cardiac Support Device (CSD) was shown to prevent progressive LV dilation in dogs with heart failure (HF) and increase ejection fraction. To examine possible mechanisms for improved LV function with the CSD, we examined the effect of CSD therapy on the expression of cardiac stretch response proteins, myocyte hypertrophy, sarcoplasmic reticulum Ca
2+
-ATPase activity and uptake, and mRNA gene expression for myosin heavy chain (MHC) isoforms. HF was produced in 12 dogs by intracoronary microembolization. Six dogs were implanted with the CSD and 6 served as concurrent controls. LV tissue from 6 normal dogs was used for comparison. Compared with normal dogs, untreated HF dogs showed reduced cardiomyocyte contraction and relaxation, upregulation of stretch response proteins (p21ras, c-fos, and p38 α/β mitogen-activated protein kinase), increased myocyte hypertrophy, reduced SERCA2a activity with unchanged affinity for calcium, reduced proportion of mRNA gene expression for α-MHC, and increased proportion of β-MHC. Therapy with the CSD was associated with improved cardiomyocyte contraction and relaxation, downregulation of stretch response proteins, attenuation of cardiomyocyte hypertrophy, increased affinity of the pump for calcium, and restoration of α- and β-MHC isoforms ratio. The results suggest that preventing LV dilation and stretch with the CSD promotes downregulation of stretch response proteins, attenuates myocyte hypertrophy and improves SR calcium cycling. These data offer possible mechanisms for improvement of LV function after CSD therapy.
Abciximab Reduces Monocyte Tissue Factor in Carotid Angioplasty and Stenting
Authors: Kopp Christoph W. , Steiner Sabine , Nasel Christian , Seidinger Daniela , Mlekusch Irene , Lang Wilfried , Bartok Andrea , Ahmadi Ramazanali , Minar Erich
Published: October 2003

Background and Purpose—

Abciximab, a nonselective glycoprotein IIb/IIIa inhibitor, was shown to reduce peri-interventional stroke rate in carotid stenting. We evaluated the effect of adjunct abciximab therapy on monocyte-platelet cross talk and neurological deficit in unprotected carotid stenting and compared its efficacy with distal filter protection.

Methods—

Fifty patients were randomized to either standard antithrombotic therapy (n=30) consisting of aspirin, clopidogrel, and heparin or adjunct bolus (0.25 mg/kg) and 12-hour infusion (0.125 μg · kg
−1
· min
−1
) of abciximab (n=20). A third cohort of patients was stented with filter protection (n=30). Monocyte-platelet aggregate formation and monocyte tissue factor expression were determined by whole blood flow cytometry, and F1.2 generation and soluble CD40 ligand (sCD40L) were determined by immunoassay.

Results—

The incidence of peri-interventional ischemic episodes (23% versus 10%;
P
=0.2) and the number of de novo ischemic lesions detected by diffusion-weighted MRI (47% versus 30%;
P
=0.17) were not significantly different between standard antithrombotic therapy and adjunct abciximab but were reduced with filter protection (
P
=0.023). However, the number of transient ischemic attacks was lower (
P
=0.05) and the National Institutes of Health Stroke Score rapidly decreased in patients with adjunct abciximab. This clinical improvement was paralleled by a reduction in the postinterventional percentage of activated monocyte-platelet aggregates (CD62P+/CD14+;
P
=0.018) and the number of tissue factor–positive monocytes (TF+/CD14+;
P
=0.005). Both abciximab and filter protection suppressed F1.2 generation and significantly reduced sCD40L.

Conclusions—

Abciximab limits thrombus propagation and thrombus stabilization after carotid stenting by reducing monocyte-platelet cross talk and sCD40L. Although abciximab seems inferior to filter devices in peri-interventional cerebral protection, it may be considered in patients who do not allow placement of protection devices.
Effect on Cerebral Vasospasm of Coil Embolization Followed by Microcatheter Intrathecal Urokinase Infusion Into the Cisterna Magna
Authors: Hamada Jun-ichiro , Kai Yutaka , Morioka Motohiro , Yano Shigetoshi , Mizuno Takamasa , Hirano Teruyuki , Kazekawa Kiyoshi , Ushio Yukitaka
Published: October 2003

Background and Purpose—

Vasospasm remains the leading cause of death and permanent neurological disability in patients with aneurysmal subarachnoid hemorrhage (SAH). The objective of our prospective randomized trial of coil embolization followed by intrathecal urokinase infusion into the cisterna magna (ITUKI therapy) was to test its effectiveness in preventing or alleviating the severity of ischemic neurological deficits caused by vasospasm.

Methods—

We enrolled 110 patients with ruptured intracranial aneurysms eligible for coil embolization and randomly assigned them to embolization with (n=57) or without (n=53) ITUKI therapy performed within 24 hours of aneurysmal SAH. The incidence of symptomatic vasospasms and the clinical outcomes, based on the Glasgow Outcome Scale, 6 months after SAH onset were assessed.

Results—

There were no side effects or adverse reactions attributable to ITUKI therapy. Symptomatic vasospasm occurred in 5 patients (8.8%) with and 16 (30.2%) without ITUKI therapy; the difference was significant (
P
=0.012). Although the mortality rate did not differ between the groups, patients with ITUKI therapy had significantly better outcomes than those without (
P
=0.036).

Conclusions—

Our results demonstrate that ITUKI therapy significantly reduced the occurrence of symptomatic vasospasm. Although it did not completely prevent vasospasms, ITUKI therapy resulted in a lower rate of permanent neurological deficits.
Intraventricular Infusion of TrkB-Fc Fusion Protein Promotes Ischemia-Induced Neurogenesis in Adult Rat Dentate Gyrus
Authors: Gustafsson Elin , Lindvall Olle , Kokaia Zaal
Published: October 2003

Background and Purpose—

We have previously shown that delivery of brain-derived neurotrophic factor (BDNF) through direct intrahippocampal gene transduction with a viral vector suppresses the formation of new dentate granule cells triggered by global forebrain ischemia. Here, we investigated whether inhibition of endogenous BDNF alters ischemia-induced neurogenesis in the dentate gyrus.

Methods—

Rats were subjected to 30 minutes of global forebrain ischemia and then received intraventricular infusion of either the BDNF scavenger, TrkB-Fc fusion protein, or control Hu-Fc for 2 weeks. In parallel, all animals were injected intraperitoneally with the mitosis marker 5-bromo-2′-deoxyuridine-5′-monophosphate (BrdU). Animals were killed at 2 or 6 weeks after the ischemic insult, and neurogenesis was then assessed immunocytochemically with epifluorescence or confocal microscopy.

Results—

Infusion of TrkB-Fc fusion protein gave rise to elevated numbers of ischemia-generated new neurons, double-labeled with BrdU and the early neuronal marker Hu or the mature neuronal marker NeuN, in the dentate subgranular zone and granule cell layer at 2 and 6 weeks after the insult.

Conclusions—

Our findings provide evidence that endogenous BDNF counteracts neuronal differentiation, but not cell proliferation or survival, in ischemia-induced dentate gyrus neurogenesis.
Case Scenarios to Assess Australian General Practitioners’ Understanding of Stroke Diagnosis, Management, and Prevention
Authors: Middleton Sandy , Sharpe David , Harris John , Corbett Alastair , Lusby Robert , Ward Jeanette
Published: October 2003

Background and Purpose—

Stroke represents the third-leading cause of death in Western society. Prompt and appropriate intervention for those with stroke or at risk of stroke is highly dependent on general practitioners’ (GPs’) knowledge and referral practices.

Methods—

We randomly selected 490 eligible GPs from New South Wales, Australia, to complete our self-administered questionnaire. Case scenarios were used to assess GPs’ knowledge of transient ischemic attack/ stroke risk factors, stroke prevention strategies, and management of asymptomatic and symptomatic patients.

Results—

We received 296 completed questionnaires (60% response rate). Nearly all GPs (286, 96.6%) strongly agreed or agreed that stroke is a medical emergency. Most were aware that management by multidisciplinary teams improves outcomes (strongly agree or agree, 279; 94.3%). GPs endorsed the effectiveness of aspirin and warfarin in reducing stroke morbidity. GPs also were aware of the benefit of carotid endarterectomy (CEA) for symptomatic patients with >80% carotid stenosis but were less aware of the value of CEA for symptomatic patients with moderate stenosis. Vascular surgeon was the specialist of choice for referral of patients with high-grade carotid stenosis. Few GPs reported having seen the Cochrane Collaboration reviews of CEA for symptomatic (3.0%) and asymptomatic (1.7%) patients.

Conclusions—

GPs were well apprised of the evidence to support CEA for symptomatic patients with high-grade carotid stenosis. Our findings, however, invite more purposeful and effective education of GPs about stroke prevention, diagnosis, and management if optimal outcomes are to be realized.
Cures That Harm: Unanticipated Outcomes of Crime Prevention Programs
Authors: McCord Joan
Published: October 2003

This review highlights the importance of recognizing the possibility for doing harm when intentions are good. It describes several examples showing that well-planned and adequately executed programs provide no guarantee for safety or efficacy. The author concludes with recommendations for scientifically credible evaluations to promote progress in the field of crime prevention.
When can we Conclude that Treatments or Programs “Don’t Work”?
Authors: Weisburd David , Lum Cynthia M. , Yang Sue-Ming
Published: October 2003

In this article, the authors examine common practices of reporting statistically nonsignificant findings in criminal justice evaluation studies. They find that criminal justice evaluators often make formal errors in the reporting of statistically nonsignificant results. Instead of simply concluding that the results were not statistically significant, or that there is not enough evidence to support an effect of treatment, they often mistakenly accept the null hypothesis and state that the intervention had no impact or did not work. The authors propose that researchers define a second null hypothesis that sets a minimal threshold for program effectiveness. In an illustration of this approach, they find that more than half of the studies that had no statistically significant finding for a traditional, no difference null hypothesis evidenced a statistically significant result in the case of a minimal worthwhile treatment effect null hypothesis.
Methodological Quality Standards for Evaluation Research
Authors: Farrington David P.
Published: October 2003

Evaluation studies vary in methodological quality. It is essential to develop methodological quality standards for evaluation research that can be understood and easily used by scholars, practitioners, policy makers, the mass media, and systematic reviewers. This article proposes that such standards should be based on statistical conclusion validity, internal validity, construct validity, external validity, and descriptive validity. Methodological quality scales are reviewed, and it is argued that efforts should be made to improve them. Pawson and Tilley's challenge to the Campbell evaluation tradition is also assessed. It is concluded that this challenge does not have any implications for methodological quality standards, because the Campbell tradition already emphasizes the need to study moderators and mediators in evaluation research.
Those Confounded Moderators in Meta-Analysis: Good, Bad, and Ugly
Authors: Lipsey Mark W.
Published: October 2003

One of the more revealing aspects of meta-analysis is the relationship between effect sizes and moderator variables representing differences among studies in their methods, samples, and interventions. However, interesting moderator variables are generally related to each other as well as to effect sizes. This confounding among moderator variables can make the results of any analysis focusing on a single moderator variable misleading. Despite the ambiguity of such results, this form of analysis is common in meta-analytic studies of intervention. The hazards and complexities of investigating and interpreting confounded moderator variables are illustrated in this article by the author's examining the difference in effect sizes associated with randomized versus nonrandomized designs in a large meta-analytic database of delinquency intervention studies.
Effects of Child Skills Training in Preventing Antisocial Behavior: A Systematic Review of Randomized Evaluations
Authors: Lösel Friedrich , Beelmann Andreas
Published: October 2003

This article reports a meta-analysis on social skills training as a measure for preventing antisocial behavior in children and youth. From 851 documents, 84 reports containing 135 comparisons between treated and untreated youngsters ( N = 16,723) fulfilled stepwise eligibility criteria (e.g., randomized control-group design, focus on prevention). Despite a wide range of positive and negative effect sizes, the majority confirmed the benefits of treatment. The best estimated mean effects were d = .38 (postintervention) and .28 (follow-up). Effects were smaller on antisocial behavior than on related social and cognitive measures. Studies with large samples produced lower effect sizes than those with smaller samples. Programs targeting at-risk groups had better effects than universal programs. Modes of treatment did not differ significantly; however, cognitive-behavioral programs had the strongest impact on antisocial behavior. More well-controlled studies with large samples, hard outcome criteria, and long follow-up periods are needed, particularly outside the United States.
Effects of Closed-Circuit Television on Crime
Authors: Welsh Brandon C. , Farrington David P.
Published: October 2003

This article reports on the findings of a systematic review--incorporating meta-analytic techniques--of the available research evidence on the effects of closed-circuit television (CCTV) on crime in public space. A number of targeted and comprehensive searches of the published and unpublished literature and contacts with leading researchers produced twenty-two CCTV evaluations that met our criteria for inclusion in this review. CCTV had a significant desirable effect on crime, although the overall reduction in crime was a rather small 4 percent. All nine studies showing evidence of a desirable effect of CCTV on crime were carried out in the United Kingdom. Conversely, the other nine studies showing no evidence of any desirable effect of CCTV on crime included all five North American studies. CCTV was most effective in reducing crime in car parks. It had no effect on violent crimes but had a significant desirable effect on vehicle crimes.
A Two-Step Informational Strategy for Reducing Littering Behavior in a Cinema
Authors: Hansmann Ralf , Scholz Roland W.
Published: October 2003

A field experiment investigated the effects of a two-step informational strategy to reduce littering in a cinema. Step 1 consisted of ambiguous information and aimed at inducing high cognitive motivation for a central processing of the subsequent information. Step 2 resolved the ambiguity and presented the antilittering information. In the experimental condition, the two-step antilittering information was given before the movie show, whereas in the control condition, no manipulation was included. Twenty-one shows with 4,329 visitors were analyzed. The informational strategy of the experimental condition (11 shows) resulted in a significant reduction (28.3%) in the weight of litter per person as compared to the control condition (10 shows). Thus, contrary to a previous conclusion of Horsley, ambiguous signs can be effectively used to reduce littering. Considering previous research, it is argued that the fit between communication strategy, the internal norms of the recipients, and the resulting motivation of the recipients is crucial for the design of an effective anti- littering campaign.
Global Warming and U.S. Crime Rates
Authors: Rotton James , Cohn Ellen G.
Published: October 2003

Two archival analyses were performed to examine the association between annual temperatures and U.S. crime rates. The first was based on area-averaged temperatures in the United States as a whole for the years 1950 through 1999. Box-Jenkins time-series analyses indicated that annual temperatures were associated with assault but not murder rates in analyses that controlled for yearly population, ethnicity, and three economic variables. The second analysis was based on state-centered crime rates from 1960 through 1998 and included the same controls. Contrary to the general aggression model, cross-sectional time-series analyses indicated that annual temperatures were associated with rates for assault, rape, robbery, burglary, and larceny, but not murder or motor vehicle theft. The results are consistent with a routine activity theory interpretation of everyday and criminal behavior.
Environmental Worldview and Behavior
Authors: Nooney Jennifer G. , Woodrum Eric , Hoban Thomas J. , Clifford William B.
Published: October 2003

This research investigates the potential dimensionality of environmental worldviews using a scale derived from the New Environmental Paradigm (NEP). It delineates the substantive consequences of dimensionality for our understanding of environmental behavior and both demographic and religious correlates of environmentalism. We found that our NEP-based Scale of Worldview contained two distinct dimensions that were differentially predicted by demographic and religious variables. Of particular importance was the relationship of religious fundamentalism to the two subscales thereby highlighting the inherent religious implications of NEP item wording. In general, we found that Worldviews do not contribute substantially to the prediction of Environmental Behavior. Additionally, Worldviews do not allow us to account for demographic differences in the performance of Environmental Behavior. We concluded that environmental worldviews have limited policy implications given the lack of correspondence to behavior but that they remain an important prerequisite to such behavior which is deserving of careful study.
A Tribute To Frank Barron: He Helped Bend A Century
Authors: Arons Mike
Published: October 2003

This is a tribute to the late Frank X. Barron, whose research and writings were a personal stimulation to the author and countless other colleagues and students. His contribution to the field of psychology-specifically, creativity and personality theory-is reviewed in light of the academic and social mindset of the era that it helped to radically alter: He achieved this by identifying vital, complex, contradictory, and eccentric forces not outside but within the order of both the science and the society of his day. His explorations and insights helped mark creativity research as an insurgency within its field, whose insights, merging with those of humanistic psychology, provided scholarly grounds of support for a vastly expanded vision of psychology (i.e., method, subject, and psychological health) as well as for the society-wide new consciousness revolution that marked the 1960s.
People Are More Important Than Pills In Recovery From Mental Disorder
Authors: Fisher Daniel B.
Published: October 2003

Long-term research has shown that many people diagnosed with schizophrenia fully recover. Helping relationships, including psychotherapy, play a much more important role than medications in recovery. This vital information, which could bring hope to countless millions, is routinely suppressed by the pharmaceutical industry. The industry's control of psychiatric research, publications, and training has insured the dominance of the unfounded assertion that all mental illnesses are due to biological brain disorder. Instead, research conducted at the National Empowerment Center (NEC) has emphasized the importance of hope, self-determination, and assistance from people who believe in you. Recovery is facilitated by helping relationships based on trust, understanding, and safety. NEC has developed a new training program, Personal Assistance in Community Existence (PACE), which is based on these principles. PACE is designed to shift the culture of mental health care from an overreliance on pills. People, not pills, are crucial to recovery.
Informed Consent And The Psychiatric Drugging Of Children
Authors: Breeding John , Baughman Fred
Published: October 2003

The legal doctrine of informed consent requires a physician to disclose sufficient information for a patient to make an informed decision about a proposed treatment. True consent is the informed exercise of choice and requires an opportunity to evaluate knowledgeably the options available and the risks attendant on each. In the case of children, this doctrine must be interpreted to mean that parents have a legal right to sufficient information necessary to make a fully informed choice on behalf of their children. This article examines the issue of informed consent in the psychiatric drugging of school-age children in the United States, where millions of parents have agreed to the recommendation that their children take psychiatric drugs. The authors argue that informed consent is systematically violated in this domain and present a look at what authentic informed consent for parents to decide about psychiatric drugs for their children would entail.
Neighborhood Drug Arrest Rates: Are They A Meaningful Indicator Of Drug Activity? A Research Note
Authors: Warner Barbara D. , Coomer Brandi Wilson
Published: October 2003

Criminologists have long debated the validity of arrest data as a measure of crime at the aggregate level. It has been argued that arrest data may reflect differences in police behavior across neighborhoods rather than differences in offending rates. Consequently, criminologists have generally come to favor less processed data. Unfortunately, official counts of drug offenses are generally available only in terms of arrests, making official drug data particularly susceptible to validity questions. In this study, the authors examine the validity of drug arrest data at the neighborhood level by analyzing the extent to which police arrest rates for drug trafficking can be accounted for by survey measures of the frequency of drug trafficking, as well as neighborhood-level variables thought to be associated with police discretion. Findings suggest support for the use of drug arrest data as a meaningful measure of the relative level of visible drug activity among neighborhoods.
The Police Role In Preventing Homicide: Considering The Impact Of Problem-Oriented Policing On The Prevalence Of Murder
Authors: White Michael D. , Fyfe James J. , Campbell Suzanne P. , Goldkamp John S.
Published: October 2003

Criminal justice practitioners and scholars have traditionally held that homicide is relatively immune from police suppression efforts. Recently, the widespread adoption of community and problem-oriented policing and concomitant decreases in violent crime have raised questions about what the police can reasonably be expected to accomplish. This article examines a joint effort by the Bureau of Justice Assistance and the city of Richmond, California, to apply the lessons of problem-oriented policing to homicide work. Analyses of Richmond homicides from 1985 to 1998 suggest that the nature and pattern of murders changed notably following adoption of the new policing philosophy, and interrupted time-series analysis with homicide data from 75 other California cities suggests the changes in Richmond were unique. Results indicate that homicide prevention is a critical police responsibility and that by employing problem-oriented strategies and garnering citizen involvement, police may be able to effectively reduce the prevalence of such violence.
Influence Measures in Contingency Tables With Application in Sampling Zeros
Authors: Poon Wai-Yin , Tang Man-Lai , Wang Shu-Jia
Published: October 2003

Based on the local influence approach with an appropriate perturbation scheme, measures are developed to assess the influence of an individual cell in contingency tables. The authors demonstrate that the developed measures are particularly suitable for sensitivity analysis in tables with sampling zeros. The independence model and the log-linear model, together with numerical examples, are presented for illustration.
Knowledge and Collective Preferences
Authors: Sturgis Patrick
Published: October 2003

This article compares estimates of “informed” public opinion derived from the regression-based approach of Bartels, Delli Carpini and Keeter, and Althaus with those from the deliberative polling method of Fishkin on the same sample of respondents. Contrary to low-information rationality perspectives, both methods indicate that across a range of prominent policy domains, level of political awareness has a strong impact on the expressed preferences of individuals. And while self-canceling across respondents tends to translate these individual-level influences into only rather modest effects in the aggregate, on a significant minority of issues, substantial shifts in collective opinion remain. The broad similarity of the estimates produced by these two very different methods, in addition to their convergence with previous studies of information effects, lends some simultaneous support to the validity and reliability of both approaches.
Context Effects in Attitude Surveys
Authors: Tourangeau Roger , Singer Eleanor , Presser Stanley
Published: October 2003

The authors present the results from parallel experiments in two surveys about privacy attitudes. Concerned that the order of the questions might affect the answers, they systematically varied the order of some of the key questions in the questionnaire. In both surveys, four of five question order experiments produced significant effects on responses to the items involved, but the question order variables did not affect responses to attitude items that came later in the questionnaire or relations between the attitude items whose order the authors varied and background characteristics of the respondents. They were also able to determine for most respondents whether their household had mailed back its census questionnaire. Question order did not have a consistent impact on the correlations between the survey responses and actual census returns. These results suggest that question order effects may be common with conceptually related items but that their impact is generally local, affecting answers to the items themselves but not answers to later questions, correlations with respondent background characteristics, or relations to subsequent behaviors.
Modeling Response Bias in Count: A Structural Approach With an Application to the National Crime Victimization Survey Data
Authors: Li Tong , Trivedi Pravin K. , Guo Jiequn
Published: October 2003

This article considers modeling response bias when the response is a count. The authors adopt a “structural approach” by using a generalized negative binomial mixture of Poisson distribution to model misreported counts, assuming that the distribution of the true response follows a negative binomial distribution. The model may be interpreted as a “stopped-sum” model. A simulated maximum likelihood estimator is proposed, and its finite sample performance is investigated through Monte Carlo simulations. The approach is then applied to analyzing school victimization data drawn from the National Crime Victimization Survey, which allows the authors to identify the individual- and school-related characteristics that could contribute to school crime victimization and to the possible biases on the reported number of repeat victimizations. The authors find that for the reported number of thefts, about 12 percent of respondents overreport the numbers, most of whom actually have not had any item stolen at school.
“Paying the Rent”
Authors: Forsell HÅKan
Published: October 2003

The article explores the social and political meanings attributed to the “home” and the domestic sphere from the late nineteenth century to the interwar period. How did the significance of the dwelling in the city change due to the interplay between technical improvements and social policy? The main example in the study is the city of Stockholm, which, like other major cities on the European continent in the second half of the nineteenth century, experienced a vast spread of large tenement houses, increasing prices of land, and an accelerated housing problem for industrial workers. The article argues that the recognition of technology became an integrated part in the activity of the social housing reformers. Household modernization tied the single apartment closer to a formal economy and thereby contributed to a decisive change not only of the built environment but also of family economy and gender relations in the city.
Mothers and Daughters
Authors: Ogle Jennifer Paff , Damhorst Mary Lynn
Published: October 2003

The interpretive study reported in this article focused on the process by which mothers and daughters interact about body and dieting. In-depth interviews were conducted with 20 mothers and their adolescent daughters. Constant comparison analysis of data revealed four patterns of mother-daughter interaction about body and dieting: (a) the direct verbal approach, including encouragement/facilitation, dissuasion, and fault-finding messages; (b) the avoidance/guardedness approach; (c) the modeling approach; and (d) the laissez-faire approach. These four patterns of communication varied in terms of content and were used in different contexts and combinations. These mother-daughter interactions (a) were shaped by mothers’ and daughters’ thoughts about the self, the other, and the mother-daughter relationship; (b) were used by mothers and daughters to plan future interactions with one another; and (c) served to guide lines of personal action with respect to dieting, especially in the case of daughters.