bluuebunny/crossref_metadata_2025 huggingface dataset:
Aftercare under Section 117 of the Mental Health Act 1983: awareness and practice
Authors: Dibben Claire , Khandaker Golam , Ramana Rajini
Published: February 2010

The aim of this study is to investigate the level of awareness amongst consultants regarding Mental Health Act (MHA) Section 117 aftercare, their responsibilities and current practice. We conducted a cross-sectional survey alongside a retrospective study of the Trust Section 117 aftercare registers.

Seventy-four per cent of the consultants were aware of the Section 117 aftercare registers and the need for review of aftercare. Ninety-four per cent were aware of the financial implications of Section 117. However, only 52% of the consultants regularly contributed to the review process to identify patients who were no longer in need of aftercare under Section 117. Over a five-year period, 150 patients were discharged from Section 117, of whom only 4% were officially discharged following review of the care plan.

Health and social services have a legal obligation to provide aftercare to all eligible patients free of charge under Section 117. With the new Mental Health Act 2007 this will now include patients on Supervised Community Treatment Orders. It is important to have a clear understanding of Section 117 to ensure patients' needs are met and to allow effective use of resources.
Deaths of homeless unclaimed persons in South Delhi (2001-2005): a retrospective review
Authors: Kumar Arvind , Lalwani Sanjeev , Behera C. , Rautji Ravi , Dogra T.D.
Published: February 2010

Homeless people are at increased risk of death for several reasons. We reviewed 735 cases of homeless, unclaimed persons found dead in public places in South Delhi who were brought for autopsy at the Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi, during the study period from 2001-2005. Most of the deceased were male (n=645, 87.75%) with a M: F ratio of 7.17:1. The commonest age group involved was 31-40 years (n=228, 31.02%). Most victims (n=451, 61.36%) died from natural causes, followed by accidental deaths (n=233, 31.70%) and homicides (n=26, 3.54%). The majority of deaths were reported in the rainy season (n=284, 38.64%). The deceased were mostly recovered from the road or road side (n=352, 47.89%). Few studies on this subject have been published in India. More research is needed to identify the health-related problems of such people and possible contributory factors to mortality.
Acute intoxication by triazolam and promazine
Authors: Rossi Riccardo , De Giorgio Fabio , Benucci Giorgio , Oliva Antonio , Fucci Nadia
Published: February 2010

A fatality due to ingestion of triazolam and promazine is reported. Triazolam is a benzodiazepine widely prescribed as a hypnotic drug for the treatment of sleep disorders. Promazine is a neuroleptic drug. There is no previous evidence in the literature of death due to an overdose related to the contemporaneous intake of these two drugs. In this report the authors present the case of a 76-year-old woman who was found deceased at home with no evidence of trauma or asphyxia; near the body several empty pharmaceutical boxes containing triazolam and promazine were noticed. Toxicological analyses were performed and drug levels measured by means of gas chromatography coupled with mass spectrometry. The triazolam concentration in each specimen was as follows: blood 1100 ng/ml; gastric content 1300 ng/ml; the promazine concentration in blood and in gastric content was 3450 ng/ml and 5800 ng/ml respectively. Based on the autopsy findings, patient history and toxicological results, the cause of death was determined to be acute intoxication due to the effect of triazolam and promazine and the manner of suicide.
Appointed bullet – a premeditated murder followed by suicide
Authors: Behera C. , Rautji R. , Dogra T.D.
Published: February 2010

A 21-year-old girl was fatally injured by her 25-year-old brother-in-law, who was deeply in love with her. She was shot in the abdomen with a locally-made pistol. The man then shot himself in the front of his head with the same gun. He died on the spot while the girl, who was seriously injured, died in hospital two days later. Police recovered two empty cartridges from the alleged site that had the names of the boy and girl written on them in blue ink. Although shooting is the most common method of homicide and subsequent suicide, to the authors' knowledge the case described here is unique and has not been reported elsewhere in the literature.
Increasing the information available to coroners: the effect on autopsy decision-making
Authors: Carpenter Belinda , Tait Gordon , Barnes Michael , Adkins Glenda , Naylor Charles , Begum Nelufa
Published: February 2010

This paper details research completed in 2007 which investigated autopsy decision-making in a death investigation. The data was gathered during the first year of operation in Queensland, Australia, of a new Coroners Act which changed the process of death investigation in three ways which are important to this paper. First, it required a greater amount of information to be gathered at the scene by police: this included a thorough investigation of the circumstances of the death, including statements from witnesses, friends and family, as well as evidence gathering at the scene. Second, it required coroners, for the first time, to determine the level of invasiveness required in the autopsy to complete the death investigation. Third, it enabled any genuine family concerns to be communicated to the coroner. The outcome of such information was threefold: (i) a greater amount of information offered to the coroner led to a decrease in the number of full internal autopsies ordered, but an increase in the number of partial internal autopsies ordered; (ii) this shift in autopsy decision-making by coroners saw certain factors given greater importance than others in decisions to order full internal, or external only, autopsies; (iii) a raised family concern had a significant impact on autopsy decision-making and tended to decrease the invasiveness of the autopsy ordered by the coroner.
Middle finger length — a predictor of stature in the Indian population
Authors: Rastogi Prateek , Kanchan Tanuj , Menezes Ritesh G. , Yoganarasimha K.
Published: February 2010

Stature is an important indicator for identification. There are numerous means to establish stature and their significance lies in the simplicity of measurement, applicability and accuracy in prediction. The present study was conducted on 500 north and south Indian subjects in Manipal, India, to establish the stature of an individual using the middle finger length. Measurements were analysed statistically to establish the relationhip between a person's middle finger length and their stature. The study shows that the middle finger length bears a significant relation to stature and can be an important tool for stature estimation. Significant differences in measurements and formulae for males and females were found. These differences were insignificant when values were compared between subjects of the same sex in north and south Indians and also between the dominant and non-dominant hand.
A petition to Mr Peel: Gideon Mantell and the trial of Hannah Russell
Authors: Flanagan R.J. , Watson K.D.
Published: February 2010

In the summer of 1826, Hannah Russell was tried for petty treason, viz. the murder of her husband, Benjamin Russell, by poisoning. Their lodger, Daniel Leney, was indicted as her accomplice. The exact circumstances surrounding the death were unclear but Hannah was known to have purchased white arsenic (arsenious oxide). A local surgeon, Thomas Evans, supported at the post-mortem examination by two further surgeons, not only reported severe corrosion of the gastrointestinal tract, but also the recovery of nearly an eighth of an ounce of arsenic from the victim's stomach. Both accused were convicted and sentenced to death. Leney was executed, but Hannah Russell was respited because the trial judge, Sir Robert Graham, had doubts as to a direction he had given to the jury. The surgeon and paleontologist Gideon Mantell took up her case, stressing that death from arsenic could not have taken place as quickly as was alleged and maintaining that the chemical evidence of arsenic poisoning was inconclusive. He gained the support of some eminent chemists and physicians.

Subsequently, forensic toxicologists [Sir] Robert Christison and Alfred Swaine Taylor pointed out that Mantell's arguments as to the possible time to death in arsenic poisoning were quite wrong. Moreover, Evans gave details of the analyses he and his colleagues had undertaken to Christison, who pronounced the findings sound, as indeed did Mantell after Evans and his colleagues published details of their investigations in the Sussex Advertiser. Papers in The National Archives show that Hannah was pardoned for the offence for which she was indicted, leaving it open to prefer a lesser charge. That this was never done may have been due to Mantell's campaign, at least in part, but the pardon she did receive was due to the concern of the trial judge as to the implications of the evidence presented at trial.
An audit of parents'/guardians' wishes recorded after coronial autopsies in cases of sudden unexpected death in infancy: issues raised and future directions
Authors: Cohen M.C. , Blakey S. , Donn T. , McGovern S. , Parry L.
Published: February 2010

In the UK, cases of sudden unexpected death in infancy are under the jurisdiction of the Coroner and consent for a post-mortem is not required. Prior to the Human Tissue Act 2006 (HTA) there was also no requirement to request retention of tissue (blocks and slides). The HTA stipulates that parental/guardian consent is mandatory to retain or dispose of all tissues after the Coroners' purposes have been fulfilled. In 2007, in order to avoid confusion with the consent needed for hospital post-mortems, a new form was introduced by Sheffield Children's Hospital NHS Foundation Trust (SCH) called Record of parents'/guardians' wishes regarding samples taken at a Coroner's post mortem. This version specifically asks if blocks and slides may be retained as part of the medical record, or are to be disposed of, and for parental agreement (or not) for the frozen tissue, blocks and slides to be used for education, audit, quality control and medical research.

One hundred and nineteen Coroners' postmortems covering the years 2006-2007 were reviewed. All parents/guardians (P/G) were contacted and the outcomes of P/G wishes recorded by SCH staff, Coroners' Officers (CO) and Police Family Liaison Officers (PFLO) were analysed and compared (44% from CO were outstanding at the time of audit). Any delay in recording P/G wishes by these three groups was also compared.

In 2006, parental agreement to the use of blocks and slides for education, audit, quality control and medical research was 94%, 77% and 75% for SCH, CO and PFLO, respectively. In 2007 it was 84%, 37% and 100% for the same groups. Permission for the retention of frozen tissue given to SCH, CO and PFLO was 90%, 62% and 100% in 2006 and 90%, 44% and 100% in 2007, respectively. Cases where parents did not wish for the retention or use of tissue (including blocks and slides) were 3%, 15% and 0% in 2006 for SCH, CO and PFLO respectively, and 0% for all groups in 2007.

Training of staff in all aspects of post-mortem and bereavement care is essential for ascertaining parental wishes. Families should be provided with the knowledge that allows them to make informed choices. The analysis of the results of the audit supports this view.
Organ donation in France: legislation, epidemiology and ethical comments
Authors: Jousset Nathalie , Gaudin Arnaud , Mauillon Damien , Penneau Michel , Rougé-Maillart Clotilde
Published: February 2010

The Bioethics Laws revised in 2004 have defined rules concerning organ donation and transplantation. They have also permitted the creation of the French Biomedicine Agency which guarantees the right of enforcement. In France there are three situations in which organs may be harvested: from cadaveric donors, from living donors and, since 2005, from non heart beating donors.

Organ harvesting from cadaveric donors is permissible if the deceased did not make known his refusal during his lifetime (this may be recorded in the national registry set up for this purpose). The rule of presumed consent also applies in the case of organs taken after cardiac arrest.

With regard to organ harvesting from living persons, a panel of experts is required to give approval. The recipient's spouse, brothers or sisters, sons or daughters, grandparents, uncles or aunts and first cousins may be authorised to donate organs, as well as the spouse of the recipient's father or mother. The donor may be any person who provides proof of having lived with the recipient for at least two years.

Some ethical questions will need to be resolved; for example the relevance of maintaining the EEG for brain death diagnosis, enforcement of the law on presumed consent, the real nature of the will of living donors and the definition of death.
Autopsy findings of suicidal deaths committed by firearms in Ankara, Turkey
Authors: Canturk Gurol , Canturk Nergis , Odabasi Aysun Balseven , Erkol Zerrin , Bosgelmez Memnune
Published: February 2010

The purpose of this study was to examine autopsy findings from suicidal deaths using firearms in Ankara, Turkey, and to compare the results with those reported from other studies.

We retrospectively evaluated suicidal deaths by firearms referred for autopsy to the Morgue Department, Institute of Forensic Medicine, between 2002 and 2004. Results were subjected to discriminant analyses using SPSS 11.5 package program.

One hundred and fifteen cases (83.3%) were male, the ratio of male to female was 5 to 1 and the mean age was 31.96 years (range:12-85 years). Forty cases were aged between 12 years and 20 years, 28 were aged between 0 and 18 (20.29%). One hundred and thirty-three cases (96.4%) had one bullet entry and five cases (3.6%) had two bullet entries. Out of 143 bullet entries, 116 (81.12%) were caused by gunshots fired from contact or near contact range. Regarding bullet entry sites, 103 (72.03%) were on the head with 56 (54.37%) located on the right temporal region.

Gunshot related crimes are an increasing cause for concern in Turkey. However, a simple preventive measure may prevent the suicidal deaths of many young people.
Experimental analysis of the relationship between simulated low-velocity rear-end collisions and fetal outcomes of pregnant rats
Authors: Hitosugi Masahito , Motozawa Yasuki , Kawato Hitoshi , Nagai Toshiaki , Tokudome Shogo
Published: February 2010

Our study aimed to define the risk for a human fetus of rear-end vehicle collisions. We therefore performed drop tests using pregnant SLC Wistar rats. Pressure applied to the rat uterus and rectum at various stages of acceleration was measured. After being dropped, rats were observed throughout pregnancy. At birth, the numbers, weight and the occurrence of physical anomalies among pups were followed-up for 28 days. Uterine pressure increased exponentially from 2.1 ± 0.3 kPa at 19-fold gravity (G) to 13.9 ± 0.8 kPa at 92-fold G. These values are much lower than the mechanical failure level of human fetal membrane tissue or of those at risk of adverse fetal outcomes. Neither the average number of offspring per pregnant rat nor the average body weight of newborn pups differed significally between control pregnant rats and those which had been exposed to acceleration of 46-fold or 92-fold G. Other variables such as maternal mental distress, motion effects of amniotic fluid or seatbelt-induced uterine injuries might contribute to fetal loss.
Non-fatal injuries to the cervical spine facet joints after a fatal motor vehicle crash
Authors: Uhrenholt Lars , Nielsen Edith , Charles Annie Vesterby , Gregersen Markil
Published: February 2010

Injuries to the lower cervical spine facet joints may be identified in people killed in road traffic crashes. However, many of these injuries are not identified on diagnostic imaging procedures despite histological evidence of injury. This case report illustrates possible non-lethal pathological conditions in the facet joints following fatal road traffic trauma.

The cervical spine segments C4 to C7 were removed en bloc and examined with magnetic resonance imaging, computed tomography and conventional radiology. The specimen was fixated in alcohol, embedded in methylmethacrylate, and divided into 3 mm thick parasaggital slices from where 10μm thick sections were produced and evaluated with light microscopy.

Injuries identified on microscopy included haemarthrosis, capsular avulsion, synovial fold contusions and subchondral fractures. None of the injuries were detected on diagnostic imaging or at routine autopsy.

Discrete injuries to the cervical spine facet joints were identified using supplemental histological procedures in this case report. Post-mortem diagnostic imaging did not reveal these injuries and future studies should investigate the nature, prevalence and clinical relevance of such lesions.
Concentration distributions of the drugs most frequently identified in post-mortem femoral blood representing all causes of death
Authors: Jones Alan Wayne , Holmgren Anita
Published: February 2010

Interpreting the concentrations of drugs determined in post-mortem blood is not an easy task owing to poly-drug use, adverse drug-drug interactions, as well as a host of pre-analytical factors and various artefacts in post-mortem toxicology. Highly sensitive and specific methods (GC-FID, GC-NPD. GC-MS and LC-MS) were used to determine the concentrations of drugs in femoral blood from 24,876 autopsies representing all causes of death. Ethanol topped the list of psychoactive substances (N = 8,108 or 33%) at mean, median and highest concentrations of 1.43 g/L, 1.20 g/L and 8.0 g/L, respectively. In second place was paracetamol (N = 2,741 or 11%). Amphetamine and cannabis were the major illicit drugs at 13th and 15th positions, respectively. Newer antidepressants, citalopram (no 3), sertraline (no 14), venlafaxine (no 16) were prominent as were sedative-hypnotics, such as diazepam (no 4), zopiclone (no 5) and zolpidem (no 18). This compilation of drugs and their concentration distributions will be useful to identify and flag for a likely overdose or drug-related poisoning death. The drug concentration together with the findings at autopsy and the police report can then be used to reach a conclusion about the cause and manner of death.
Genetics and criminal behaviour: recent accomplishments
Authors: Lagoa Arlindo , Santos Agostinho , Pinheiro M. Fátima , Magalhães Teresa
Published: February 2010

The past two decades have seen an explosion in research in the fields of violence and behavioural genetics. Advances in human genetics have raised the possibility that genetic mechanisms can explain various aspects of human criminal and aggressive behaviour. However, this new knowledge can pose enormous challenges concerning the moral and legal conceptions of free will and responsibility. This paper reviews the main aspects of behavioural genetics, focusing on criminal and aggressive behaviour and describes the most important genes known to influence this behaviour.
An unrecognised case of withdrawal neuroleptic malignant syndrome
Authors: Ball Hadrian , de Waal Hugo , Craig Ken
Published: February 2010

Withdrawal neuroleptic malignant syndrome is a not widely recognised variant of the rare adverse consequence of neuroleptic medication, neuroleptic malignant syndrome (NMS). We present a case to bring the disorder to the attention of clinicians responsible for treating serious mental illness and medical and judicial officers who may be involved in investigating serious untoward incidents occurring within a mental health care setting.
Tipping and Concentration in Markets with Indirect Network Effects
Authors: Dubé Jean-Pierre H. , Hitsch Günter J. , Chintagunta Pradeep K.
Published: February 2010

This paper develops a framework for measuring “tipping”—the increase in a firm's market share dominance caused by indirect network effects. Our measure compares the expected concentration in a market to the hypothetical expected concentration that would arise in the absence of indirect network effects. In practice, this measure requires a model that can predict the counterfactual market concentration under different parameter values capturing the strength of indirect network effects. We build such a model for the case of dynamic standards competition in a market characterized by the classic hardware/software paradigm. To demonstrate its applicability, we calibrate it using demand estimates and other data from the 32/64-bit generation of video game consoles, a canonical example of standards competition with indirect network effects. In our example, we find that indirect network effects can lead to a strong, economically significant increase in market concentration. We also find important roles for beliefs on both the demand side, as consumers tend to pick the product they expect to win the standards war, and on the supply side, as firms engage in penetration pricing to invest in growing their networks.
The Effect of Signal Quality and Contiguous Word of Mouth on Customer Acquisition for a Video-on-Demand Service
Authors: Nam Sungjoon , Manchanda Puneet , Chintagunta Pradeep K.
Published: February 2010

This paper documents the existence and magnitude of contiguous word-of-mouth effects of signal quality of a video-on-demand (VOD) service on customer acquisition. We operationalize contiguous word-of-mouth effect based on geographic proximity and use behavioral data to quantify the effect.

The signal quality for this VOD service is exogenously determined, objectively measured, and spatially uncorrelated. Furthermore, it is unobserved to the potential subscriber and is revealed postadoption. For a subscriber, the signal quality translates directly into the number of movies available for viewing, thus representing a part of the overall service quality. The combination of signal quality along with location and neighborhood information for each subscriber and potential subscriber allows us to resolve the typical challenges in measuring causal social network effects.

We find that contiguous word of mouth affects about 8% of the subscribers with respect to their adoption behavior. However, this effect acts as a double-edged sword because it is asymmetric. We find that the effect of negative word of mouth arising from poor signal quality is more than twice as large as the effect of positive word of mouth arising from excellent signal quality. Besides contiguous word of mouth, we find that advertising and the retail environment also play a role in adoption.
Shared Metered-Dose Inhalers: Is Cross-Contamination Avoidable? Omega-3-Acid Melts through Foam Cup
Authors: Cohen Michael R. , Smetzer Judy L.
Published: February 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.

Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Milnacipran
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E.
Published: February 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent in print and are also available online. Monographs can be customized to meet the needs of a facility. Subscribers to The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800–322–4349. The July 2009 monograph topics are golimumab injection, tapentadol immediate-release tablets, iloperidone, benzyl alcohol 5% lotion, and artemether/lumefantrine. The DUE is on golimumab injection.
Federal Health Information Technology Efforts: The Stimulus is the Buzz
Authors: Fox Brent I. , Felkey Bill G.
Published: February 2010

Dire economic circumstances have led to tremendous potential for trans-forming the US health care system from a paper to an electronic industry. Traditionally, health care has been slow in adopting significant change. This column discusses the transformation that is poised to begin in the US health care system.
The Role of Pramlintide for Weight Loss
Authors: Dunican Kaelen C , Adams Nicole M , Desilets Alicia R
Published: February 2010

Objective:

To evaluate the weight-loss effects of pramlintide.

Data Sources:

A literature search was conducted in MEDLINE (1950–October week 4, 2009), International Pharmaceutical Abstracts (1970–October 2009), and Evidence Based Medicine Database (1991–2009 week 44) to identify relevant publications. Key words searched included pramlintide, weight loss, obesity, and overweight. Additional data sources were obtained through a bibliographic review of selected articles.

Study Selection/Data Extraction:

All studies conducted on humans and published in English that examined the effects of pramlintide on body weight as a primary or secondary endpoint were selected for analysis.

Data Synthesis:

Pramlintide is a human amylin analog approved by the Food and Drug Administration for use in conjunction with insulin therapy in patients with type 1 or 2 diabetes. In addition to its glucoregulatory actions, pramlintide has been shown to increase satiety and, therefore, decrease calorie Intake via a central mechanism. Several studies show that this translates into statistically significant weight loss in overweight or obese patients with type 1 or 2 diabetes; patients with type 1 diabetes lost up to 1.7 kg over 1 year with pramlintide 60 μg 3 times daily, while patients with type 2 diabetes experienced a placebo-subtracted weight loss of up to 3.7 kg after 16 weeks of pramlintide 120–240 μg administered 3 times daily. Preliminary trials assessing the use of pramlintide for weight loss in obese patients without diabetes have demonstrated weight loss of up to 8 kg after 1 year. In all studies, the drug was generally well tolerated, with nausea being the most commonly reported adverse effect.

Conclusions:

Based on preliminary evidence, pramlintide facilitates modest weight loss in obese or overweight patients with and without diabetes. However, current trials were limited by inconsistent study design, dosing, and patient population.
Evaluation of the Chronic Kidney Disease Epidemiology Collaboration Equation for Dosing Antimicrobials
Authors: Wargo Kurt A , English Thomas M
Published: February 2010

Background:

Since the derivation of the Modification of Diet in Renal Disease (MORD) equation for estimating glomerular filtration rate (GFR), investigators determined that it cannot be used for drug dosing. In 2009, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) derived an equation that was more accurate than the MORD estimation of GFR. Therefore, questions exist about which method should be preferred in making dosage adjustments for renally eliminated antimicrobials.

Objective:

To determine whether a difference exists when making antimicrobial dosage adjustments in patients with CKD based on estimation of GFR using the CKD-EPI and Cockcroft-Gault equations.

Methods:

A database of 409 patients with CKD admitted to a tertiary care facility was used. GFR was calculated using both the CKD-EPI equation(s) and the Cockcroft-Gault equation and compared using correlation and Bland-Altman methodology. Dosage discordance rates of antimicrobials were determined.

Results:

Average GFRs for all patients using the Cockcroft-Gault and CKD-EPI equations were 34.8 ± 12 mL/rnin and 39.9 ± 13 mL/min, respectively (5.09 [95% CI 4.60 to 5.59]; p < 0.001). The correlation coefficient between the 2 estimations was high (r = 0.91). The Bland-Altman plot yielded limits of agreement of 15.3 and -5.1; thus, the CKD-EPI estimation may range from 5.1 mL/min below to 15.3 mL/min above the Cockcroft-Gault estimation for 95% of the cases. A discordance rate of 15–25% existed among the recommended dosing adjustments of the selected antimicrobials when comparing the Ccckcroft-Gault and CKD-EPI estimations.

Conclusions:

Though this study did not determine which equation should be selected to dose adjust antimicrobials, it demonstrated statistically significant differences between the Cockcroft-Gault and CKD-EPI equations. The clinical significance of these differences is uncertain in the absence of data assessing clinical outcomes that result from the use of the discordant doses. Clinical judgment should be employed when making renal dosage adjustments of antimicrobials.
A Survey of Drug Information References Emergency Medicine Clinicians Utilize for Prescribing in Pregnant Patients
Authors: Jellinek Samantha P , Cohen Victor , Stansfield Lindsay , Likourezos Antonios , Sable Kenneth N
Published: February 2010

Background:

Clinicians practicing in Emergency Departments (EDs) using outdated pocket guides and other non–pregnancy-specific references when prescribing in pregnancy may place the pregnancy or fetus at risk.

Objective:

To identify the references that emergency medicine (EM) clinicians use for prescribing in pregnant patients, the prescribing trends when clinicians are given the pregnancy category information, and clinician awareness of access to drug information references.

Methods:

This cross-sectional survey was administered to EM clinicians. In part I, clinicians listed the top 3 drug information references that they routinely use in clinical practice. In part II, clinicians ranked their willingness to prescribe a Category A, B, C, D, or X drug using a 5-point Likert scale. In part III, clinicians selected from a list of electronic and print resources those that they consider available to them in the ED to find pregnancy-related drug prescribing information. Statistical analyses included frequency distribution and bivariate analysis.

Results:

Fifty-five clinicians with an average of 5.71 ± 7.95 years (± SD) in the profession completed the survey. The most commonly used references included Micromedex, Tarascon Pocket Pharmacopoeia, and Epocrates (29%, 18%, and 14%, respectively). Ten (18%) respondents stated that they would be willing to prescribe Category C drugs. Among the 5 pregnancy-specific drug information references that are available in our ED, only 20% of EM clinicians stated that these references were available to them.

Conclusions:

EM clinicians rely on general references to make prescribing decisions for pregnant patients and are willing to prescribe medications that have data to support safe use in pregnancy. A minority of EM clinicians acknowledged the availability of pregnancy-specific references in the ED. Increased awareness of references that incorporate human data into their pharmacotherapy recommendations is warranted to assist EM clinicians in achieving their goal of prescribing safely in the pregnant patient.
Problem-Oriented Policing and Promoting Public Confidence
Authors: Rogers Colin
Published: February 2010

The police in England and Wales appear to be losing the support of the communities that they are employed to engage with and to protect. It is argued that one way of regaining this lost ground is to revitalise the Problem-Oriented Partnership approach to tackling issues that matter to communities, thereby encouraging the police to engage with partnerships and the public. Highlighting areas of concern within the partnership approach to dealing effectively with problems, and illustrating how these may be overcome, this article suggests that, whilst not being the panacea for all community issues, the Problem-Solving approach appears to offer a credible alternative to traditional ideas about policing and at the same time assisting the regaining of public confidence in a time of severe economic constraints and complex social change.
Rural V Urban Policing: A Study of Taiwanese Officers' Occupational Attitudes
Authors: Sun Ivan Y. , Chu Doris C.
Published: February 2010

This study examines attitudinal differences between rural and urban police officers in Taiwan. Data used in this research were collected from a rural Taiwanese county, Hualien, and a metropolitan department, Taipei. Officers' occupational attitudes are assessed along four dimensions: group cohesion, citizen cooperation, aggressive enforcement, and order maintenance. The results indicate that, compared to their urban counterparts, rural officers are more likely to show higher levels of group cohesion and favour citizen cooperation. Rural and urban officers, however, do not differ significantly in their attitudes towards aggressive enforcement and order maintenance. Implications for future research and policy are discussed.
Asymmetric tandem reactions: New synthetic strategies
Authors: Fustero Santos , Sánchez-Roselló María , del Pozo Carlos
Published: February 2010

The use of domino and multicomponent reactions in asymmetric synthesis is constantly increasing nowadays. This allows for the synthesis of complex molecules in a single synthetic sequence, usually with high atom economy. Herein, we report three examples of new asymmetric tandem reactions recently developed in our laboratories, giving rise to new families of enantiomerically enriched fluorinated and nonfluorinated heterocycles. Thus, 1,4-dihydropyridines (1,4-DHPs) bearing fluorinated substituents at C6 were assembled by means of a Hantzsch-type reaction; cyclic β-amino carbonyl derivatives were prepared using a cross-metathesis (CM)–intramolecular aza-Michael sequence; while fluorinated indolines were obtained, for the first time, in a tandem nucleophilic addition–intramolecular aromatic substitution.
Impact of Increased Body Mass Index on Accuracy of B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP for Diagnosis of Decompensated Heart Failure and Prediction of All-Cause Mortality
Authors: Christenson Robert H , Azzazy Hassan ME , Duh Show-Hong , Maynard Susan , Seliger Stephen L , deFilippi Christopher R
Published: February 2010

Background: BNP and N-terminal proBNP (NT-proBNP) concentrations may be depressed in patients with increased body mass index (BMI). Whether increased BMI affects accuracy of these biomarkers for diagnosing decompensated heart failure (HF) and predicting outcomes is unknown.

Methods: We measured BNP and NT-proBNP in 685 patients with possible decompensated HF in a free-living community population subdivided by BMI as obese, overweight, and normal weight. HF diagnosis was adjudicated by a cardiologist blinded to BNP and NT-proBNP results. We tabulated all-cause mortality over a median follow-up of 401 days and assessed marker accuracy for HF diagnosis and mortality by ROC analysis.

Results: Of the 685 patients, 40.9% were obese (n = 280), 28.2% were overweight (n = 193), and 30.9% had normal BMI (n = 212). Obese patients had lower BNP and NT-proBNP compared with overweight or normal-weight individuals (P < 0.001) and decreased mortality compared with normal-weight individuals (P < 0.001). Both biomarkers added significantly to a multivariate logistic regression model for diagnosis of decompensated HF across BMI categories. NT-proBNP outperformed BNP for predicting all-cause mortality in normal-weight individuals (χ2 for BNP = 6.4, P = 0.09; χ2 for NT-proBNP = 16.5, P < 0.001). Multivariate regression showed that both biomarkers remained significant predictors of decompensated HF diagnosis in each BMI subgroup.

Conclusions: In this study population, obese patients had significantly lower BNP and NT-proBNP that reflected lower mortality. BNP and NT-proBNP can be used in all BMI groups for decompensated HF diagnosis, although BMI-specific cutpoints may be necessary to optimize sensitivity.
Open and closed languages in the postcolonial era
Authors: Benrabah Mohamed
Published: February 2010

In the global language system that is likely to emerge, the struggle between English and French seems to be in favour of the former language. The present article argues that the foreseeable receding of French internationally can be explained by the correlation between language and nationalism. The article is divided into four parts. The first one describes the evolution of ex-colonial subjects' attitudes towards the ex-colonial languages. The second part shows how English has adapted to new postcolonial contexts by liberating itself from its national origin and imperial past, while French has not. The third part examines French linguistic culture which is grounded in linguistic purism, assimilation and the refusal to accept non-white language users. The use of notions such as littrature francophone is an expression of the exclusive nature of this ideology which makes French a closed language. The fourth and final part presents some recent (nationalist) reactions towards ex-colonial languages in former colonies.
La Femme de Gilles de Madeleine Bourdouxhe, ou la fulgurante identit d'un roman belge de langue franaise
Authors: Migraine-George Thrse
Published: February 2010

La Femme de Gilles, a novel written by the Belgian author Madeleine Bourdouxhe and published in 1937, highlights the everyday life of a woman, lisa, in the working class world of the 1930s. By showing that lisa's passionate love for her husband Gilles allows her to escape the
domestic and social constraints of her existence, my analysis aims to point out the limiting effects of certain discourses that confine the cultural and aesthetic dimensions of literary works to a systematic theoretical field, such as that of francophonie or feminism. Bourdouxhe's novel can
be seen as illustrating not only the complex identity of Belgian literature in French, but also the questions raised by contemporary Francophone writers through their creation of a littrature-monde that claims its independence from restrictive categories.
Countering canons, confronting francophonie: worldwide women's literature in French
Authors: Rice Alison
Published: February 2010

There is a new proliferation of literary works composed in French by women from around the world. The manifesto, Pour une littrature-monde en franais (2007) bears the signatures of a stunningly diverse handful of women writers such as Maryse Cond, Ananda Devi, Nancy Huston, Anna Mo,
and Brina Svit, who exemplify this significant phenomenon. The contributions of authors like Eva Almassy and Chahdortt Djavann to the 2007 book, Pour une littrature-monde (Le Bris and Rouaud 2007), also give evidence of the fact that women from a variety of backgrounds are now making
unprecedented contributions to the French-language literary scene, and it is no accident that they are speaking out in favour of a movement that seeks to abolish hierarchical differences between French and Francophone that reign in the publishing world in France. If women from outside France
who have chosen to write in French almost uniformly argue for a new conception of francophonie, whether they are from former French colonies or elsewhere, it is because they are keenly aware of the complicated political and economic factors that make up the system in which they publish, and
they want their works of fiction to be read and accepted not for ethnological or anthropological reasons, but instead for their creativity and innovation, for their literary value.
World writing in French and the dimension of dialogue: the right to choose and the choice to write
Authors: Gormaile Pdraig
Published: February 2010

Littrature-monde in French cannot be divorced from world writing in other languages, nor can the choices made by writers in different languages be divided from each other: the right to choose and the choice to write in one or more languages have more in common than first meets the eye.
This essay sets out to explore the commonality within a diverse group: non-French natives who write in French, native English speakers who write in a language other than English and writers both in French and English whose writing in those languages is influenced by their own ethnic origins.
The examples include several writers: Canadian and Qubcois (Jacques Godbout, Nancy Huston, Larissa Lai), Belgian (Grgoire Polet), Chinese-French (Franois Cheng) and Canadian-Irish (Pdraig Siadhail). The distinction between vrai-faux (an object recognized at some levels as not authentic) and
faux-vrai (counterfeit) dilemma also confronts writers who cross linguistic and cultural barriers, leading to the question of what constitutes profound identity as opposed to legal identity in such cases.
Extracellular haemoglobin, oxidative stress and quality of red blood cells relative to perioperative blood salvage
Authors: Gueye Papa Madieye , Bertrand Françoise , Duportail Guy , Lessinger Jean-Marc
Published: February 2010

Background: The quality of blood-pack units in perioperative blood salvage was studied with respect to the presence of extracellular haemoglobin (Hb) and in terms of oxidative stress and the mechanical properties of red blood cells (RBC).

Methods: The study was performed on blood-pack units and patients' blood after retransfusion. Results were compared to those obtained in patients prior to autotransfusion. Free Hb, non-protein thiols (as antioxidant marker) and markers of oxidative stress (conjugated dienes, thiobarbituric reactive substances and protein carbonyl content) were measured. The mechanical properties of RBC were evaluated by their osmotic fragility, membrane fluidity by measuring the fluorescence anisotropy of an extrinsic probe and permeability by measurement of extracellular K+ and lactate dehydrogenase.

Results: Despite washing, extracellular Hb concentrations remained high (up to 0.7 g/L in blood-pack units) and was associated with a decrease of haptoglobin in patients, despite a concomitant inflammatory syndrome. In blood-pack units, we observed a decrease in antioxidant markers along with an increase in oxidative stress markers in association with an alteration of RBC membrane properties.

Conclusions: Haemolysis must be limited during perioperative blood salvage in order to prevent exposure to oxidative stress and improve the efficiency of autotransfusion.

Clin Chem Lab Med 2010;48:677–83.
Water sorption in wood and modified wood at high values of relative humidity. Part I: Results for untreated, acetylated, and furfurylated Norway spruce
Authors: Thygesen Lisbeth G. , Tang Engelund Emil , Hoffmeyer Preben
Published: February 2010

Desorption isotherms at 20°C for untreated, acetylated, and furfurylated Norway spruce [Picea abies(L.) Karst.] sapwood were established in the 91.9–99.9% relative humidity (RH) range. Three methods were employed to secure various constant RH levels: saturated salt solutions, climate chambers, and the pressure plate technique. The curve form for the untreated samples did not show an upward bend, except perhaps above 99.5% RH, indicating that – contrary to what has hitherto been assumed – capillary condensation does not play a significant role for water sorption in wood below fiber saturation. Three additional results corroborate this conclusion: (1) calculation of the theoretical contribution of capillary condensation to the moisture content (MC) in wood based on idealized microstructural geometries by means of the Kelvin and Laplace equations resulted in very small contributions to the equilibrium moisture content (EMC), i.e., below 0.35% moisture at 99.9% RH. (2) The ratio between the EMC of acetylated and untreated samples did not show an increasing trend for increasing RH, as would have been the case if capillary condensation had taken place in both untreated and acetylated wood. (3) Low field time domain nuclear magnetic resonance results showed that only the relaxation curves from the furfurylated samples were affected systematically by freezing, indicating that neither untreated nor acetylated wood contained significant amounts of capillary condensed water.
Electron spectroscopy on plasma treated lignin and cellulose
Authors: Klarhöfer Lothar , Viöl Wolfgang , Maus-Friedrichs Wolfgang
Published: February 2010

Cellobiose and lignin were plasma treated in synthetic air and argon using a dielectric barrier discharge at atmospheric pressure. Changes due to the plasma modification of the surfaces were studied by the techniques of X-ray photoelectron spectroscopy (XPS), ultraviolet photoelectron spectroscopy, and metastable impact electron spectroscopy. The combination of these techniques makes it possible to distinguish between hydroxyl and carbonyl groups at the surface, on the one hand, and conjugated and non-conjugated carbon bonds, on the other hand. This type of differentiation would not be easily possible based on XPS alone, even at very high resolution. The plasma treatment in oxygen containing atmospheres oxidizes the lignin surface by the generation of hydroxyl, carbonyl, and carboxyl groups and reduces cellulose surfaces by the degradation of hydroxyl groups and the formation of double bonds between carbon and oxygen. The plasma treatment in argon leads to the reduction of both lignin and cellulose by the formation of double bonds under degradation of hydroxyl groups.
Ageing of modified wood. Part 2: Determination of surface composition of acetylated, furfurylated, and thermally modified wood by XPS and ToF-SIMS
Authors: Bryne Lars Elof , Lausmaa Jukka , Ernstsson Marie , Englund Finn , Wålinder Magnus E.P.
Published: February 2010

The main objective of this work was to study the chemical composition of surfaces and ageing effects on acetylated pine (Pinus sylvestris), heat treated spruce (Picea abies), and furfurylated radiata pine (Pinus radiata) in comparison to unmodified wood. X-ray photoelectron spectroscopy (XPS) and time-of-flight secondary ion mass spectrometry (ToF-SIMS) were the instruments of choice. Observation with a low-vacuum scanning electron microscope (LV-SEM) complemented the study. The spectroscopic information was also linked to a parallel wettability study on matched wood samples by the Wilhelmy method. The results show that XPS and ToF-SIMS are two powerful tools that in combination give complementary information, both quantitative and qualitative, and are well suited for observation of the ageing process of different wood surfaces. The hydrophobization process as a result of migration of extractives during ageing was well quantified by the XPS measurements and the results correlated well with wetting results. Several specific hydrophobic substances could be identified by ToF-SIMS measurements.
Translation and timelessness
Authors: Boase-Beier Jean
Published: February 2010

Translating poetry raises various issues to do with the relationship between form and meaning, with linguistic and cultural relativity, and with the opposition between adapting the (foreign) world of the poem to the target audience and requiring the audience to enter that world. In this article I use the translation of poetry by German-Jewish poet Rose Ausländer to consider some of these issues as they affect, and are affected by, an apparent linguistic mismatch between English and German in the expression of time and uncertainty.