bluuebunny/crossref_metadata_2025 huggingface dataset:
Prescriptivism, creativity and world Englishes
Authors: BHATT RAKESH M.
Published: February 2007

ABSTRACT: Relatively recently, Quirk (1990) discussed non‐native varieties of English, such as Indian English and Nigerian English, as ‘locally acquired deviations from the standard language’ and argued that the standard (British) English is the only pedagogically acceptable model for teaching of English in these non‐native contexts. This paper, first critiques some fundamental assumptions of Quirk's (1990) argument by presenting the logic of Indian English and then discusses the implications of using world Englishes as pedagogical models in the classroom. The main argument of this paper is that successful English language teaching in normative contexts must address the relationship between the forms that English manifests and its speakers’ perception of reality and the nature of their cultural institutions. Implicit in this argument is the premise that language use is constrained both by the ‘grammar of culture’(Bright, 1968; D'souza, 1988) and ‘cognitive economy’(Sridhar, 1992; Hancin‐Bhatt and Bhatt, 1992). Selected aspects of phonology and syntax of Indian English are discussed to develop the argument.
On understanding a text: reader response and Alan Duff's Once Were Warriors
Authors: TAWAKE SANDRA K.
Published: February 2007

ABSTRACT: This paper compares responses of two groups of readers from different cultures to the same novel as a means of shedding light on the text and uncovering differences in values, assumptions, and the ways words and actions are interpreted in the two cultures. Pacific‐island readers and non‐Pacific‐island readers responded to Once Were Warriors, the prize‐winning novel by New Zealand Maori Alan Duff. Analyses of the responses suggest differences in the ways Pacific‐island readers and non‐Pacific‐island readers respond to the diseased social order depicted in the novel and to the agents of change and images of healing that are presented as well as to concepts of knowledge, personal power, and physical courage evoked by the novel. The study has theoretical implications for the diversity and unity of English and applied implications for teacher training and curriculum development.
Coordinate structures in English
Authors: MEYER CHARLES F.
Published: February 2007

ABSTRACT: Comparable samples of speech and writing in the British and American components of the International Corpus of English were examined to study certain formal and functional properties of coordinate structures in English. This analysis indicated that and is a primary coordinator in English, and that but and or are more peripheral; that the concept of coordination without a coordinator (so‐called asyndetic coordination) should be made more precise by requiring that some other signal of coordination be present (e.g. ellipsis found only in coordinate structures); and that because coordinate structures in speech violate certain grammatical constraints on coordination, coordination is best viewed as a grammatical category whose constraints are sometimes violated in speech for purely pragmatic (i.e. communicative) reasons.
Imagint excusations: Missionary English in the nineteenth century Cape Colony, South Africa
Authors: MESTHRIE RAJEND
Published: February 2007

ABSTRACT: This case study of the English of early missionaries operating in South Africa in the first half of the nineteenth century serves three main functions. Firstly, it characterizes the interlanguages of some German and Dutch missionaries, which are interesting in their own. right, historically and theoretically. Secondly, it points out the disparity between the actual patterns of use we find in the missionary letters and characterizations of their abilities and repertoires by modern linguists. Finally, it suggests an important early source for the propagation of English in a variety of territories, missionary English is a missing ingredient in ‘New English’ scholarship which needs to be studied closely.
Learner hypothesis and past tense marking in Vietnamese English
Authors: TICKOO ASHA
Published: February 2007

ABSTRACT: A number of recent studies on tense in L2 have claimed that the past tense is acquired in developmental stages: verbs, such as ‘build’ and ‘work,’ which are lexico‐aspectually more event‐like (less state‐like) are claimed to be marked for past tense earlier in the developmental process than those, such as ‘be’ and ‘want,’ which are less event‐like (more state‐like). In this paper, I will closely examine seven samples of writing by L1 speakers of Vietnamese to show that grounding, rather than lexical aspect, properly accounts for the selective marking of past tense. I will suggest that the learner‐hypothesis that governs this use of English past tense derives from the transference of a grounding‐marking principle from a tense‐free language, and I will briefly address the pedagogical implications of this finding.
A note on using sociolingustic methods to study non‐native attitudes towards English
Authors: STARKS DONNA , PALTRIDGE BRIAN
Published: February 2007

ABSTRACT: A number of studies have been undertaken to determine what variety of English learners of English want as a learner goal (Benson, 1991; Shaw, 1983; Kachru, 1976; Sahgal, 1991; Starks and Paltridge, 1994). This paper describes the major types of studies used to determine language attitudes of native and non‐native speakers and highlights a number of differences in their methodologies. The paper then shows how one of the techniques used in sociolinguistic research with native speakers, called apparent time, would improve research into non‐native speaker attitudes; making it more useful to educationalists engaged in language planning and curriculum development. Apparent time is based on the assumption that language is not uniform and that language changes occur in society at different rates for different segments of the population. The results of a language attitude survey of Japanese students learning English in New Zealand illustrate how the technique works by presenting data both in a traditional way and by reanalyzing the data using apparent time differences.
English and Islam in Malaysia: resolving the tension?
Authors: DAN WASHIMA CHE , HAROON HARSHITA AINI , NAYSMITH JOHN
Published: February 2007

ABSTRACT: It is claimed that a conflict may exist between the implicit values underlying English language teaching and the values of Islam. This article describes two parallel pieces of research undertaken in a statefunded religious school in the state of Melaka in Malaysia aimed at investigating this claim. It concludes that the majority of students studying English in this context were well‐motivated towards English language learning and while recognizing the dangers of absorbing alien values through their language learning, felt able to resist these and to deploy English as a tool for the development of themselves and their nation without feeling that their identity as Malay and Muslim was compromised in any serious way.
The English of white Eastern Cape farmers in South Africa
Authors: GOUGH DAVID
Published: February 2007

ABSTRACT:This paper examines the features of the English used by a farming community in the Eastern Cape Province of South Africa. It shows how the farmers form a cohesive unit characterized by a particular style of speech. Aspects of this speech style include code‐switching with Xhosa (a local African language), as well as the prevalence of terms of address. The social significance of this speech style, especially codeswitching, is explored in terms of the identity the farmers wish to communicate. Discourse features are also examined, including the narrative style characteristic of the area. There is also a brief discussion of the linguistic features of the ‘deep’ farming community which is shown to conserve certain features of ‘settler’ English. The study ends with an examination of ‘dialect’ tales which are told in the area.
Code‐switching as a verbal strategy among Chinese in a campus setting in Taiwan
Authors: CHEN SU‐CHIAO
Published: February 2007

ABSTRACT: This study explores the verbal strategies performed by code‐switching in the speech community of National Hualien Teachers College of Taiwan. Code‐switching in this study is defined as embedding English words, sentences, or constituents in a Chinese‐based interaction. The verbal strategies are described in terms of the use of code‐switching to fulfill five kinds of language functions: expressive, directive, poetic, metalinguistic, and referential. Data for the study were collected ethnographically. Results show that code‐switching has a very dynamic relationship to the communicative intents of speakers. Two categories of intents are identified: code‐switching as a ‘we‐code’ to express group solidarity and as a ‘they‐code’ to establish social distance. This reveals that code‐switching is used as a language variety which expresses a linguistic style that is concerned with communicative appropriateness, as well as a social‐identity marker.
Free morpheme constraint revisited
Authors: AZUMA SHOJI
Published: February 2007

ABSTRACT: As one of the best‐known linguistic constraints on code‐switching, Poplack (1980) has proposed the ‘free morpheme constraint’ which predicts no switching between a free morpheme and a bound morpheme. Although the free morpheme constraint is attractive due to its simplicity, cross‐linguistic data do not support the constraint. The present study argues that semantic content of an item should be considered rather than its morphological form. As an alternative to the free morpheme constraint, a constraint based on the notion of semantic content is proposed.
VARIETIES OF ENGLISH
Authors: Nelson Cecil L.
Published: February 2007

Pakistani English: The Linguistic Description of a Non‐Native Variety of English. NIPS Monograph Series III. By Tariq Rahman.
SOCIOLINCUISTICS IN THE CLASSROOM
Authors: Yunick Stanley
Published: February 2007

Sociolinguistics and Language Teaching. Edited by Sandra Lee McKay and Nancy H. Hornberger.
Susceptibility of Helicobacter pylori to the Bactericidal Activity of Human Serum
Authors: Gonzalez‐Valencia Gerardo , Perez‐Perez Guillermo I. , Washburn Ronald G. , Blaser Martin J.
Published: February 2007

Background.Human serum represents an important barrier to the entry of most mucosal organisms into tissues and to the systemic circulation. If at all present, Helicobacter pylori within gastric tissue is rare, and bacteremia for this organism has been described only once.

Methods. To assess the susceptibility of H. pylori to the bactericidal activity present in normal human serum (NHS), we examined 13 H. pylori isolates. To assess the contributions of the classical and alternative complement pathways to killing, we added either C2‐deficient or factor B‐deficient serum, respectively, to heat‐inactivated NHS. Also we assessed the ability of the strains to bind 125I‐C3.

Results.After incubation for 60 minutes at 37°C, all 13 H. pylori strains were killed by NHS; heating to 56°C for 30 minutes ablated killing, indicating complement dependence for this phenomenon. In the absence of an antibody source, there was no killing when either an alternative or classical complement pathway source was used. Adding B‐deficient serum to heat‐inactivated normal human serum did not restore killing, but adding C2‐deficient serum permitted partial killing. All of the 13 strains bound 125I‐C3. Although the kinetics varied from strain to strain, C3 bound was significantly correlated (r= 0.61, p= 0.03) with serum susceptibility.

Conclusions.
H. pylori are susceptible to complement, alternative pathway activation appears critical, and C3 binding is a major locus of variability.
Natural and Experimental Helicobacter mustelae Reinfection Following Successful Antimicrobial Eradication in Ferrets
Authors: Batchelder Margaret , Fox James G. , Hayward Alison , Yan Lili , Shames Ben , Murphy James C. , Palley Lori
Published: February 2007

Background.Recrudescence or reinfection may occur after eradication of Helicobacter pylori in humans.

Materials and Methods.We used the ferret Helicobacter mustelae model to investigate the effect of prior infection and eradication on reinfection by experimental and natural routes. Two groups of ferrets with naturally acquired H. mustelae infection were treated with an eradication protocol using amoxicillin, metronidazole, and bismuth subsalicylate. The ferrets were monitored for recrudescence by repeated cultures of endoscopic gastric mucosal biopsies. The ferrets were challenged at 17 months (group I) and 6 months (group II) after eradication with a strain of H. mustelae having a distinctive restriction endonuclease analysis pattern. The eradication protocol was repeated to eliminate the infection produced by experimental challenge. The ferrets were then cohoused intermittently with naturally infected ferrets.

Results.The original H. mustelae infection was successfully eliminated by the eradication protocol. No recrudescence was observed in group I for 12 months nor for 3 months in group II after eradication. All ferrets became persistently reinfected with the challenge strain. The infection from the challenge strain was eradicated successfully. No ferrets in group I and all ferrets in group II became infected through cohousing.

Conclusions.These results suggest that though prior infection with H. mustelae may confer some protection against reinfection, such protection is not universal in all circumstances; that susceptibility to reinfection by contact with infected animals varies between individuals; and that age may be a factor in this individual variability. These results are applicable to studies of reinfection after eradication of H. pylori in humans.
Characterization and Therapy for Experimental Infection by Helicobacter mustelae in Ferrets
Authors: Czinn Steven J. , Bierman John C. , Diters Richard W. , Blanchard Thomas G. , Leunk Robert D.
Published: February 2007

Background.Numerous clinical trials evaluating the efficacy of various antimicrobial compounds against Helicobacter pylori infection have been performed in humans. A convenient animal model for Helicobacter infection would facilitate the evaluation of novel therapies. These experiments were performed to evaluate the use of ferrets as a model of Helicobacter infection.

Materials and Methods.Ferrets were infected experimentally with Helicobacter mustelae and subsequently treated with bismuth subsalicylate (BSS) triple therapy (BSS, metronidazole, and amoxicillin), or left untreated. The status of infection and serology was assessed during treatment and for 8 weeks posttreatment. Seven ferrets successfully treated with triple therapy were challenged with H. mustelae and monitored for infection for an additional 5 weeks.

Results.Infection of ferrets by H. mustelae was accompanied by gastritis and a specific antibody response. Treatment of H. mustelae‐infected ferrets with BSS suppressed bacterial growth in four of nine animals but did not eradicate infection. Triple therapy eradicated infection in all nine ferrets with a reduction in gastric inflammation. No relapse of infection occurred up to 8 weeks posttherapy. Challenge with H. mustelae of ferrets successfully treated with triple therapy resulted in a 100% rate of reinfection.

Conclusions.
H. mustelae infection can be eliminated by triple therapy, but this does not result in protective immunity against reinfection by H. mustelae. This model, using a strain of Helicobacter indigenous to the host, may be useful for assessing therapeutic efficacy of novel therapies for the treatment of human infection by H. pylori.
Helicobacter pylori and Socioeconomic Factors in Russia
Authors: Malaty Hoda M. , Paykov Valeri , Bykova Olga , Ross Allan , Graham David P. , Anneger John F. , Graham David Y.
Published: February 2007

Background.

The factors influencing the acquisition and prevalence of Helicobacter pylori infection remain incompletely understood. In Russia, the demographic and socioeconomic factors are relatively similar, allowing investigation of risk factors that might not be identifiable in a more diverse population.

Materials and Methods.Sero‐prevalence of H. pylori infection was studied in 520 asymptomatic individuals between the ages of 1 and 75 years, residing in St. Petersburg, Russia. Forty‐four children lived in orphanages or communal apartments. Demographic information and socioeconomic factors were evaluated, including educational level, income, and living conditions. Helicobacter pylori status was evaluated by using an enzyme‐linked immunosorbent assay for anti‐H. pylori IgG.

Results.The prevalence of H. pylori infection was 44% in children and 88% in adults (P < .001). In adults, H. pylori prevalence was independent of socioeconomic factors. The crude and the age‐adjusted odds ratios (ORs) in children showed an inverse correlation between the mother's educational level and H. pylori seropositivity [e.g., OR, 1.8; (95% confidence interval (CI) = 1–3.2] for children whose mothers completed only 8 to 10 years of school compared to children whose mothers completed university. Overcrowding in childhood also was associated with increased H. pylori prevalence. Children from orphanages and communal apartments had the highest crowding index and also were at the greatest risk for H. pylori acquisition (age‐adjusted OR, 2.1; 95% CI = 1.2–2.5).

Conclusions.The prevalence of H. pylori infection in Russia correlated with socioeconomic factors, suggesting there are differences sufficient to affect H. pylori transmission. The prevalence of H. pylori infection during childhood forms the basis for the variances in prevalence among populations.
Mixed Infection with cagA‐Positive and cagA‐Negative Strains of Helicobacter pylori
Authors: Fantry George T. , Zheng Qiao‐Xi , Darwin Peter E. , Rosenstein Andrew H. , James Stephen P.
Published: February 2007

Background
Helicobacter pylori infection has been implicated strongly in the pathogenesis of gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric lymphoma, but the reasons for these widely different clinical outcomes are unknown. The aim of this study was to determine whether these differences could be due in part to mixed infection in the same individual, with bacteria having differences in pathogenic factors associated with ulcers.

Materials and Methods.The cagA gene of H. pylori was used to test for mixed infection because it is present in only some strains, and its presence has been associated with ulcers. Polymerase chain reaction (PCR) assays for the cagA gene were applied to H. pylori culture isolates and endoscopic gastric aspirates. Individual bacterial clones were tested for genetic similarity by random primer amplification and restriction endonuclease digestion of urease gene PCR products.

Results.The majority of H. pylori‐positive patients had strongly cagA‐positive culture isolates and endoscopic samples (62.5% and 69.6%, respectively). However, many of these patients had evidence of mixed infection with cagA negative and cagA positive strais in cultures isolates and endoscopic samples (25% and 17.4%, respectively). Mixed infection was found to be due to genetically unrelated strains in two patients in whom genetic analysis was performed.

Conclusion. Mixed infection with differences in substrain pathogenic factors might occur in H. pylori infection and might contribute to differences in clinical outcome.
Double‐blind, Multicenter, Placebo‐Controlled Evaluation Of Clarithromycin And Omeprazole For Helicobacter Pylori‐Associated Duodenal Ulcer
Authors: O'Morain C. , Dettmer A. , Rambow A. , von Fritsch E. , Fraser A. G.
Published: February 2007

Background.Eradication of Helicobacter pylori leads to faster ulcer healing and a significant decrease in ulcer recurrence. Clarithromycin is the most effective monotherapy for eradicating H. pylori from the gastric mucosa, and omeprazole frequently is used for the treatment of duodenal ulcer disease, prompting the interest to investigate rigorously the combination of clarithromycin and omeprazole for eradicating H. pylori.

Materials and Methods.The aim of this double‐blind, randomized, multicenter (n=30), multinational (n=10) study was to compare clarithromycin and omeprazole with omeprazole monotherapy for the eradication of H. pylori from the gastric mucosa, endoscopic healing, and reduction of symptoms and ulcer recurrence in patients with active duodenal ulcer. Patients with active duodenal ulcer associated with H. pylori infection were randomized to receive omeprazole, 40 mg every morning for 14 days, with either clarithromycin, 500 mg, or placebo three times daily, which was followed by omeprazole, 20 mg every morning for 14 days. Patients underwent endoscopy before enrolling in the study, immediately after finishing treatment, and at 4‐ to 6‐week and 6‐month follow‐up evaluations or at the recurrence of symptoms.

Results.Two hundred and eight patients with active duodenal ulcer associated with confirmed H. pylori infection were randomized to treatment with either clarithromycin and omeprazole (n=102) or omeprazole and placebo (n=106). Four to six weeks after treatment was completed, H. pylori was eradicated in 74% (95% confidence interval, 63.0%–82.4%) of patients receiving clarithromycin and omeprazole, compared with 1% (0.0%–6.2%) of patients receiving omeprazole monotherapy (p < .001). Clarithromycin resistance developed in eight patients treated with clarithromycin and omeprazole and in none given omeprazole and placebo. Ulcers, which were healed following treatment in more than 95% of study patients, recurred by the 6‐month follow‐up visit in 10% (5%–19%) of dual therapy recipients, compared with 50% (39%–61%) of those who took omeprazole alone (p <.001).

Conclusion. Clarithromycin and omeprazole dual therapy is simple and well‐tolerated and leads to consistently high eradication rates for patients with duodenal ulcer associated with H. pylori infection.
Helicobacter pylori–Positive Duodenal Ulcer: A Long‐Term Double‐Blind Randomized Study in Patients Healed with H2‐Receptor Antagonists
Authors: Suriani R. , Ravizza M. , Pallante C. , Mazzucco D. , Cardesi E. , Colozza M. , Malandrino M. , Oneglio R. , Giacone G. Orso , Dusio P. , Vajo M.
Published: February 2007

Background.The NIH Consensus Conference in 1994 (1) concluded that all patients with peptic ulcr disease should be tested and treated for Helicobacter pylori and that further evaluation was needed for patients in remission.

Materials and Methods.We evaluated in a double blind randomization 30 patients whose duodenal ulcers had been healed with H2‐receptor antagonists and who remained in remission on maintenance therapy. After ulcer healing and the presence of H. pylori had been confirmed, these patients were randomized to receive eradication therapy or placebo and were followed for a mean period of 23 months.

Results.Almost all patients receiving placebo had ulcer recurrence, whereas the patients treated with antibiotics demonstrate a low recurrence rate.

Conclusion. These data suggest, for the first time to our knowledge, the importance of treating with antibiotics duodenal ulcer patients whose disease is in remission.
Effect of Omeprazole Therapy on the Survival of Helicobacter pylori, Urease Activity, and Antral Gastric Histology in Patients with Duodenal Ulcer
Authors: Nakshabendi Imad M. , Zhang Quibo B. , Mokhashi Mahesh , Gemmell Curtis G. , Lee Frederick D. , Russell Robin I.
Published: February 2007

Background.
Helicobacter pylori is associated with chronic active gastritis and peptic ulceration (PU). Omeprazole is a proton pump inhibitor that is effective in healing PU and reducing gastritis. Previously it has been found that omeprazole has some bacteriostatic activity against H. pylori both in vitro and in vivo and in inhibiting urease activity in vitro. Our aim was to evaluate the effect of omeprazole on H. pylori colonization of the gastric mucosa, urease activity in vivo, and the presence of associated gastritis in patients with duodenal ulcer (DU).

Materials and Methods.We studied 12 patients (7 men and 5 women, ages 22–68 yr) with Du larger than 5 mm in diameter with a positive CLOtest (Delta West Ltd., Australia). Omeprazole, 20 mg bid, was given for 8 weeks to each patient, patients were endoscoped at the end of this period to check for healing of DU, and repeat biopsies were obtained from the gastric antrum for histologyical analysis, CLOtest, and culture.

Results.DU healed completely in all patients. Likewise in all patients there was significant reduction in the urease activity, from 22.1=4.17 to 1.58 ± 0.92 units/ml (p <.001; 95% confidence interval of the difference between means, 32.7–14.1), and reduced H. pylori density, from 1,403.46 ± 128.23 to 422.5 ± 172.39 colony‐forming units (CFU) per milligram of tissue biopsy (p < .001; 95% confidence interval of the difference between means, 1,486.1–590.5). The numbers of H. pylori were reduced on the gastric mucosa after omeprazole therapy and disappeared in six patients, a result that correlated with a negative CLOtest reading after 24 hours.

Conclusion. Omeprazole, 20 mg bid, is capable of reducing H. pylori numbers and urease activity in vivo. There was no significant reduction in the severity of antral gastritis in DU patients studied.
Egg Passage of Rodshaped and Coccoid Forms of Helicobacter pylori: Preliminary Studies
Authors: Enroth Helena , Engstrand Lars
Published: February 2007

Background.We used egg passage of bacteria stored in water to evaluate the culturability of the coccoid form of Helicobacter pylori, as a complement to the results obtained from various animal models. Egg passage was performed, as it is a simple, rapid, and well‐characterized old method by which to culture and evaluate culturability of bacteria compared to experiments in animal models. Egg passage has been used in such experiments since 1938 for isolation and growth of, for example, Rickettsiae sp. and Chlamydia sp.

Materials and Methods.The rod‐shaped form of H. pylori was produced by plate cultures for 4 and 7 days. The coccoid form of H. pylori was produced by culture on agar plates for 10 days, followed by storage in water. These preparations then were inoculated into the yolk sac of differently aged fertilized eggs.

Results.Positive culture was obtained from 14 of 17 eggs (82%) inoculated with rod‐shaped H. pylori compared to 0 of 22 eggs (0%) inoculated with the coccoid form.

Conclusion. Culturability of H. pylori is reduced when it converts into the coccoid form produced by starvation and age followed by storage in water for several weeks at room temperature. Egg passage did not raise the culturability of the coccoid form of H. pylori. Our study demonstrates some clear differences between fresh rods and stored cocci forms of H. pylori in terms of culturability when passed through eggs.
Immunohistochemical Detection of Helicobacter pylori in the Surface Mucous Gel Layer and Its Clinicopathological Significance
Authors: Shimizu Toshiki , Akamatsu Taiji , Ota Hiroyoshi , Katsuyama Tsutomu
Published: February 2007

BackgroundAttempts have been made to develop an accurate method for detecting Helicobacter pylori in histological sections.

Materials and Methods.Biopsy specimens were obtained from the stomachs of 167 patients with gastric ulcer (33), duodenal ulcer (52), gastroduodenal ulcer (15), chronic gastritis (45), and normal mucosa (22) before antimicrobial treatment and from 108 of these patients after treatment. Biopsy specimens were (1) cultured, (2) fixed in 10% buffered formalin, or (3) fixed in Carnoy's solution. The latter method was employed to preserve the surface mucous gel layer (SMGL) covering gastric surface mucous cells. Histological sections were stained with hematoxylin and eosin (H&E), with immunostaining using a commercially available polyclonal anti‐H. pylori antibody.

Results.Cultures were positive for H. pylori in 61% of the cases before treatment and in 16% after treatment; by H&E staining using formalin‐fixed materials: 70% and 9%; by immunostaining using formalin‐fixed materials: 78% and 21%; and by immunostaining using Carnoy‐fixed materials: 85% and 41% of biopsy speciemens, respectively. The difference in detection rates between materials fixed in formalin and those in Carnoy's solution was due to the detection of H. pylori in the SMGL by the latter, especially after antimicrobial treatment.

Conclusions.Immunostaining for H. pylori using materials fixed in Carnoy's solution revealed H. pylori in the SMGL as well as on the surface mucous cells and in the gastric pits and permitted the optimal detection of H. pylori in tissue sections.
Serum and Gastric Luminal Epidermal Growth Factor in Helicobacter Pylori—Associated Gastritis and Peptic Ulcer Disease
Authors: Lynch Damien A. F. , Mapstone Nicholas P. , Lewis Fraser , Pentith Judith , Axon Anthony T. R. , Dixon Michael F. , Quirke Phillip
Published: February 2007

Background
Helicobacter pylori is the cause of chronic (type B) gastritis, duodenal ulceration (DU), and gastric ulceration (GU). Smoking is associated with delayed ulcer healing. Epidermal growth factor (EGF) is produced in the salivary and Brunner's glands of the upper gastrointestinal tract, inhibits gastri acid secretion, and is a powerful mitogen.

Materials and Methods.We sought to determine gastric luminal EGF (GL‐EGF) in smokers and patients with Hp‐associated DU and the effect of Hp eradication. Our aim was to determine GL‐EGF in patients with GU and the effect of ulcer healing and to measure serum EGF in patients with Hp gastritis with or without DU disease.

Results.GL‐EGF was reduced in smokers compared to control (p= .008). Subjects with HP gastritis had reduced GL‐EGF compared to controls (p= .0002). There was no difference in GL‐EGF between Hp‐positive subjects who had DU and those with chronic gastritis alone. Eradication of Hp from those patients with DU had no effect on the low levels of GL‐EGF. There was no difference between GL‐EGF in Hp gastritis alone and in Hp‐associated active GU. GL‐EGF fell after ulcer healing (p= .04), a difference confirmed by analysis of paired samples from patients before and after ulcer healing (p= .03). There was no difference in serum EGF between controls and subjects with Hp infection. There was no difference in serum EGF in subjects with DU‐associated and non‐ulcer‐associated gastritis.

Conclusions.Subjects with Hp gastritis, or those who smoke, had low concentrations of GL‐EGF regardless of whether DU was present. Eradication of Hp did not return the concentrations of GL‐EGF to normal in DU subjects. Individuals with Hp gastritis and inactive GU had low levels of GL‐EGF compared to non‐ulcer Hp infection. The relative increase in GL‐EGF that occurred with ulceration of the gastric mucosa may have resulted from the development of an ulcer‐associated cell lineage. Serum EGF did not play a role in the pathogenesis of Hp gastritis or of associated DU ulcer disease.
Development of a Murine Model of Helicobacter pylori Infection
Authors: Lachman Lawrence B. , Ozpolat Bulent , Rao Xiao‐Mei , Graham David Y. , Osato Michael
Published: February 2007

Background.

A murine model for Helicobacter pylori infection could facilitate vaccine development. This study was designed to determine the effect of various conditions of dose, frequency of administration, and fasting on H. pylori infection of mice.

Materials and Methods.

Balb/c and C3H/HeN mice were inoculated orogastrically with clinical isolates of H. pylori grown in liquid culture. At 2‐week intervals, the stomachs were removed for secondary culture on horse blood agar and for histological analysis. H. pylori from secondary cultures or homogenized stomach tissue from infected mice was inoculated a second time in naïve animals.

Results.

H. pylori was cultured with high frequency only from the stomachs of C3H/HeN mice. Fasting the mice and increasing the number of organisms inoculated did not increase the rate of infection. Histological analysis detected no inflammation, but mucus depletion and erosion were present in the stomachs of C3H/HeN mice. H. pylori organisms were not observed. Secondary cultures of H. pylori or homogenized infected stomach tissue did not cause infection when inoculated in naïve mice.

Conclusions.

Clinical isolates of H. pylori transiently infect C3H/HeN mice. This murine model is suitable for testing oral vaccines. Effective vaccination against H. pylori could prevent transient infection and reduce subsequent gastritis.
Clarithromycin Dual Therapy Regimens for Eradication ofHelicobacter pylori: A Review
Authors: Pipkin Graham A. , Dixon Jonathan S. , Williamson Russell , Wood John R.
Published: February 2007

Background.

Peptic ulcer disease can be cured by eradication ofHelicobacter pyloriduring treatment to heal the ulcer. Dual therapy regimens were among the first to be granted approval for use. Reports of dual therapies including clarithromycin as the sole antibiotic are reviewed.

Methods.

Reports were identified from literature up to May 1997. Information reviewed included patient population, medical diagnosis, trial design, eradication regimens, andH. pylorieradication rates. The great diversity between studies limits formal meta‐analysis but a measure of relative efficacy has been obtained by comparsion of eradication rates derived by clearly defined methods and by pooling data.

Results.

Seventy‐five reports of trials with 104 dual therapy treatment arms were reviewed.H. pylorieradication rates reported with ranitidine bismuth citrate plus clarithromycin range from 70–96% with a pooled observed rate of 85%. With omeprazole plus clarithromycin, reported eradication rates range from 27–90% with the pooled reported rate being 66%. Few data are available with either lansoprazole or ranitidine hydrochloride plus clarithromycin.

Conclusion.

HighH. pylorieradication rates derived by consistent and clearly defined methods have been seen with ranitidine bismuth citrate plus clarithromycin. Lower and more variable rates are reported with clarithromycin and either a proton pump inhibitor or a histamine H2‐receptor antagonist.
Comparison Between a Rapid Off ice‐Based and ELISA Serologic Test in Screening for Helicobacter pylori in Children
Authors: Elitsur Y. , Neace C. , Triest W.E.
Published: February 2007

Background.

The rapid diagnostic serological test for detection of Helicobacter pylori (H. pylori) infection in children has a significant advantage over the standard enzyme immunoassay (EIA) method, for its simplicity and rapid availability of results in a physician’s office setting. We compared the immunochromatographic test with a standard enzyme immunoassay test in the pediatric population.

Materials and Methods.

A retrospective analysis of 1147 serum samples from asymptomatic children and prospective analysis of 62 serum samples from symptomatic children undergoing diagnostic upper endoscopy were evaluated for the detection of H. pylori antibody by two commercially available serology tests. Each serum sample was tested by a rapid test (FlexSure® HP, SmithKline Diagnostics, Inc.) and compared to the standard EIA method (HM‐CAP, Enteric Products, Inc.).

Results.

The rapid test, FlexSure® HP, was comparable to the rapid EIA test in screening for H. pylori infection in symptomatic and asymptomatic children with sensitivity and specificity of 83–90% and 90–100%, respectively. Both methods had a comparable sensitivity and specificity for the detection of H. pylori‐associated gastritis (60–70% and 94%, respectively).

Conclusion.

The rapid test is comparable to the standard EIA test and may be used by physicians in symptomatic children. The use of FlexSure® HP as a screening tool for the prevalence of H. pylori infection in asymptomatic children may be limited by its low positive predictive value compared to the EIA method.
One Week Triple Therapy forHelicobacter pylori:Does High‐dose Clarithromycin Confer Additional Benef it?
Authors: O’connor Humphrey J. , Loane Joseph , Bindel Holger , Bhutta Abdul S. , Cunnane Kevin
Published: February 2007

Background.

Clarithromycin, a new acid stable macrolide antibiotic with proven efficacy againstHelicobacter pylori, has been widely incorporated into eradication regimens but its optimal dosage schedule remains controversial. The standard dose of clarithromycin is 250 mg twice daily.

Methods.

In a prospective study designed to evaluate the helicobactericidal efficacy, patient acceptability, and ulcer healing efficacy of a triple therapy regimen incorporating high dose clarithromycin, 100 consecutive patients withH. pylori‐positive peptic ulcer received omeprazole 20 mg twice daily in combination with metronidazole 400 mg twice daily and clarithromycin 500 mg twice daily for seven days.H. pyloristatus was assessed before and at least 4 weeks after therapy by rapid urease test and histology. Adverse events and compliance were assessed by direct questioning.

Results.

Only two patients failed to attend for repeat endoscopy, leaving 98 evaluable patients. Of these, 94 wereH. pylori‐negative after therapy, giving an intention‐to‐treat eradication rate of 94% (95% confidence interval, 89%–99%). The ulcer healing rate was 92% (86%–98%), and ulcer healing was significantly associated with H. pylori eradication (p < 0.01). Adverse events were reported by 33% of patients of which nausea was the commonest (14%). Noncompliance with therapy was significantly associated withH. pyloritreatment failure (p < 0.001).

Conclusions.

Seven day triple therapy incorporating high dose clarithromycin effectively eradicatesH. pyloriand heals ulcers, but it is disadvantaged by a relatively high rate of adverse events. In view of these findings and the fact that no direct comparison to date has shown increased efficacy from high dose clarithromycin, we would recommend continued use of low dose clarithromycin when combined with omeprazole and a nitroimidazole.
The Cerebellum and Migraine
Authors: Vincent Maurice , Hadjikhani Nouchine
Published: February 2007

Clinical and pathophysiological evidences connect migraine and the cerebellum. Literature on documented cerebellar abnormalities in migraine, however, is relatively sparse. Cerebellar involvement may be observed in 4 types of migraines: in the widespread migraine with aura (MWA) and migraine without aura (MWoA) forms; in particular subtypes of migraine such as basilar‐type migraine (BTM); and in the genetically driven autosomal dominant familial hemiplegic migraine (FHM) forms. Cerebellar dysfunction in migraineurs varies largely in severity, and may be subclinical. Purkinje cells express calcium channels that are related to the pathophysiology of both inherited forms of migraine and primary ataxias, mostly spinal cerebellar ataxia type 6 (SCA‐6) and episodic ataxia type 2 (EA‐2). Genetically driven ion channels dysfunction leads to hyperexcitability in the brain and cerebellum, possibly facilitating spreading depression waves in both locations. This review focuses on the cerebellar involvement in migraine, the relevant ataxias and their association with this primary headache, and discusses some of the pathophysiological processes putatively underlying these diseases.
Cross‐Country Measures for Monitoring Epilepsy Care
Authors: Begley Charles E. , Baker Gus A. , Beghi Ettore , Butler James , Chisholm Daniel , Langfitt John T. , Levy Pierre , Pachlatko Christoph , Wiebe Samuel , Donaldson Karen Lee ,   on behalf of the ILAE Commission on Healthcare Policy
Published: February 2007

Summary:  Purpose: The International League Against Epilepsy (ILAE) Commission on Healthcare Policy in consultation with the World Health Organization (WHO) examined the applicability and usefulness of various measures for monitoring epilepsy healthcare services and systems across countries. The goal is to provide planners and policymakers with tools to analyze the impact of healthcare services and systems and evaluate efforts to improve performance.

Methods: Commission members conducted a systematic literature review and consulted with experts to assess the nature, strengths, and limitations of the treatment gap and resource availability measures that are currently used to assess the adequacy of epilepsy care. We also conducted a pilot study to determine the feasibility and applicability of using new measures to assess epilepsy care developed by the WHO including Disability‐Adjusted Life Years (DALYs), responsiveness, and financial fairness.

Results: The existing measures that are frequently used to assess the adequacy of epilepsy care focus on structural or process factors whose relationship to outcomes are indirect and may vary across regions. The WHO measures are conceptually superior because of their breadth and connection to articulated and agreed upon outcomes for health systems. However, the WHO measures require data that are not readily available in developing countries and most developed countries as well.

Conclusion: The epilepsy field should consider adopting the WHO measures in country assessments of epilepsy burden and healthcare performance whenever data permit. Efforts should be made to develop the data elements to estimate the measures.
Seizures, Ataxia, and Neuronal Loss in Cystatin B Heterozygous Mice
Authors: Kaasik Allen , Kuum Malle , Aonurm Anu , Kalda Anti , Vaarmann Annika , Zharkovsky Alexander
Published: February 2007

Summary:  Unverricht‐Lundborg disease (EPM1) has been considered to be an autosomal‐recessive disease related with loss of function mutations in the gene encoding cystatin B. Although heterozygous carriers are generally asymptomatic, earlier studies in Finnish EPM1 families have reported minor symptoms together with slight changes in the EEG recordings also in near relatives of patients. Here we tested the hypothesis that EPM1 phenotype is expressed also in heterozygous subjects using 17‐month‐old cystatin B deficient mice as a model of disease. Western blot analysis demonstrated a 50% decrease in cystatin B expression in the cerebellum of these animals. Heterozygous mice showed significantly impaired rotarod performance and were weaker in the grid test. Also the total seizure‐rating score of heterozygous animals was higher than in wild‐type mice. The stereological analysis revealed a significant decrease in the number of neurons in cerebral cortex and the granule cell layer of cerebellum. These results suggest that partial decrease in cystatin B expression in heterozygous mice could lead to the development of mild EPM1 phenotype.
Shots for Tots: Louisiana's Infant Immunization Initiative
Authors: Broussard Lisa A. , Blankenship Faye B.
Published: February 2007

purpose. To describe the “Shots for Tots” immunization initiative, a community‐based approach to overcoming barriers to timely immunizations

population. Children in southwest Louisiana, ages 1 month to 5 years, requiring immunizations

conclusions. The “Shots for Tots” immunization initiative has been successful in improving immunization rates.

practice implications. With the increase in community‐based practice and the resurgence of many vaccine‐preventable diseases, this program can serve as an example to pediatric nurses involved in prevention and primary care in their efforts to improve immunization rates.
Worries of School‐Age Children
Authors: Neff E. Jo Ann , Dale Juanita C.
Published: February 2007

purpose. To determine how worrisome some situations are for school‐age children and if parents can identify how worrisome the situation would be for their child

design. Descriptive

setting. Families' homes

participants. 48 school age children (7–11 years old), 40 mothers, 8 fathers

main outcome measures. The 27‐item “What Worries You (Your Child) the Most” questionnaire

results. For the most part, parents were able to ascertain what would worry their child the most. However, they did underestimate the importance of pets to children as well as adequate family income. There were significant differences in child and parent perceptions of three items ranked among the most worrisome: “being asked to take drugs,”“being in a war,” and “hearing parents quarrel.” Age and gender of children were not significant factors in the distribution of scores.

conclusions. Findings indicate that considerable discrepancies can exist between what the parent and the child perceive as worrisome.
Health‐Related, Help‐Seeking Behaviors in Female Mexican‐American Adolescents
Authors: Rew Lynn
Published: February 2007

purpose. To explore and describe the health‐related, help‐seeking behaviors of young female Mexican‐American adolescents.

design. Qualitative exploratory‐descriptive design using focus groups.

setting. Community recreation centers.

participants. 18 female Mexican‐Americans ages 10–16 years residing in a South Central state.

main outcome measures. A demographic information form and semi‐structured interview designed for the study.

results. Subjects described two themes of help‐seeking behaviors: seeking help for physical health problems and preventive healthcare from formal sources (i.e., community health clinics, family physicians, and public schools), and seeking help for concerns about pubertal development and pregnancy from informal sources (i.e., their mothers, aunts, sisters, and friends).

conclusion. While young, female Hispanic adolescents may seek help from formal sources for preventive healthcare services and physical health problems not related to sexuality, they tend to seek help from informal sources for psychosocial and sexuality issues. Community‐based interventions should be developed that focus on the importance of this pattern of help‐seeking behaviors for young female Hispanics.
Values Influencing Nursing Practice: Responses From Neonatal Nurses
Authors: Raines Deborah A.
Published: February 2007

purpose. An analysis of narrative comments from neonatal nurses to illustrate the values that motivate behavior in the practice setting.

design. A descriptive study using content analysis of written, narrative text data.

participants. A self‐selected subsample (N = 97) of a larger random sample of the membership of the National Association of Neonatal Nurses (NANN).

main outcome measures. The application of philosophical concepts of human relationships, patient need, keeping promises, human dignity, and unrestricting circumstances in the neonatal care setting.

results. Individual participants made cognitive choices related to the application of conceptual ideals of the profession to the practice setting. However, there was a lack of congruence between what the individual nurse believes is important or good and the behavior enacted in the practice setting.

conclusion. As a discipline, nursing needs to identify and implement strategies that support proactive accountable nursing practice consistent with the philosophical foundation of the profession.
Legal Issues in Nonrelated Infant Adoption: Nursing Implications
Authors: Lobar Sandra L. , Phillips Suzanne , Simunek Linda A.
Published: February 2007

purpose. To highlight the legal issues surrounding nonrelated infant adoptions

population. Parties in the adoption triad—the infant, the biological parent(s), and the adoptive parent(s)

conclusions. Current adoption laws have been influenced by a historical stigmatization of adoption by society, states' sovereignty rights, and an individual's constitutional rights. Controversies surrounding nonrelated infant adoptions have highlighted the inadequacies of the present system of adoption laws and regulations. Nurses can take a proactive role in their practice by acquiring a clear understanding of the legal issues surrounding adoption.

practice implications. Knowledge about state adoption laws, regulations, and resources, as well as the legal issues surrounding infant adoption, will allow the nurse to take a proactive role in formulating and providing supportive interventions that assist all parties through the process.
Role Play: Staff‐Developed Posters—An Avenue to Enhance Nurses' Self‐Worth
Authors: Mohr Lynn , Woodring Barbara C.
Published: February 2007

Role play is an issues‐related forum to engender dialogue about the roles assumed by nurses who care for children and their families. This issue's column focuses on the educator role.