bluuebunny/crossref_metadata_2025 huggingface dataset:
“Bad for the Body, Bad for the Heart”: Prostitution Harms Women Even if Legalized or Decriminalized
Authors: Farley Melissa
Published: September 2004

With examples from a 2003 New Zealand prostitution law, this article discusses the logical inconsistencies in laws sponsoring prostitution and includes evidence for the physical, emotional, and social harms of prostitution. These harms are not decreased by legalization or decriminalization. The article addresses the confusion caused by organizations that oppose trafficking but at the same time promote prostitution as a justifiable form of labor for poor women. The failure of condom distribution/harm reduction programs to protect women in prostitution from rape, sexually transmitted diseases (STDs), and HIV is discussed. The success of such programs in obtaining funding and in promoting prostitution as sex work is also discussed.
City Caesars?
Authors: Mullin Megan , Peele Gillian , Cain Bruce E.
Published: September 2004

Recently, voters in many large cities have approved charter reforms that strengthen the power of the executive, suggesting that big city residents and mayors themselves view the formal authority of the office as an important influence on whether a mayor will be successful in solving urban problems. This article employs qualitative data from three California cities to specify how structural characteristics interact with personal factors to facilitate mayoral leadership. The authors find that city structure does not directly determine a mayor’s goals and leadership style, but it does create constraints and opportunities that influence whether a mayor’s personal strategies will succeed.
Assessing and Measuring the Fiscal Heath of Local Governments
Authors: Hendrick Rebecca
Published: September 2004

This study presents a framework for assessing the financial condition and fiscal health of municipal governments, develops indices for some dimensions of the framework, and applies the indices to 264 suburban municipalities in the Chicago metropolitan region. The framework is based on a systems view of local government financial condition. It shows that fiscal health is a complex and multidimensional concept with varying time frames. Furthermore, the dimensions are related but often in indirect or nonlinear ways, indicating they must be measured separately rather than combined into a comprehensive indicator of fiscal health. Indices developed here for targeted dimensions of the framework are assessed and compared to alternative indicators of fiscal health developed by others in the field.
Interrogating the Treadmill of Production
Authors: Wright Erik Olin
Published: September 2004

This commentary on “Interrogating the Treadmill of Production” by Gould, Pellow, and Schnaiberg takes up the challenge, invited by the article itself, of asking some of the questions that still seem unanswered by the model. Among the questions asked are: Why not refer to capitalism instead of the treadmill and to workers/owners instead of producers? Why is the temporal priority of production over consumption taken as its logical primacy? Why is sustainability equated with no growth? What are the specific reasons for denying that a green capitalism (a green treadmill?) is possible? Why is it that no alternative system is offered, as Marxists would offer socialism as an alternative to capitalism? What would constitute empirical evidence for/against the treadmill thesis? Arewe really running in place? It is suggested that these key questions still need to be answered if the treadmill theory is to be compelling to sociologists both inside and outside environmental sociology.
The Treadmill of Production
Authors: Buttel Frederick H.
Published: September 2004

The work of Pellow, Gould, Schnaiberg, and Weinberg (particularly Schnaiberg’s The Environment and his notion of the treadmill of production) became one of the most influential strands of North American environmental sociology during the late 1970s and early 1980s for a number of reasons. It is fair to say, however, that the treadmill of production is not as predominant in environmental sociology in the early 21st century as it was two decades ago. Some of the reasons for this are unfortunate products of our time—for example, the declining role of neo-Marxism in a scholarly community that must watch its back in an era of neoliberalism. In the final portion of this article, the author discusses some shortcomings of the treadmill framework that have led to its being less influential than formerly and lays out an agenda for further treadmill of production inquiry.
New Labor
Authors: Obach Brian K.
Published: September 2004

Within the treadmill of production framework, labor unions are considered one of the central actors propelling the system of environmental degradation. This article examines the evidence for this designation. American Federation of Labor–Congress of Industrial Organizations documents and other historical evidence indicate unions have been strong proponents of expanding production, lending support to the view that unions are rightfully considered key treadmill actors. Yet closer examination indicates labor has played a contradictory role. Unions have advocated for policies and engaged in workplace activities that slow the treadmill of production. Unions should be considered proponents of the treadmill system, but recent developments may be pushing labor away from that position. Economic globalization, changes in employment patterns, a corporate assault on labor, and newunion leadership have led to strategic changes within the labormovement—including greater willingness to work with environmental advocates—creating the potential for labor to more directly challenge the treadmill system.
The Treadmill of (Diversifying) Production
Authors: York Richard
Published: September 2004

A key issue in the debate between treadmill of production (To P) theorists and ecological modernization theorists centers on the effect of modernization on the environmental sustainability of societies. This article proposes that due in part to a focus on case study evidence, ecological modernization theorists often observe trends toward environmental sustainability only in specific and nonrepresentative cases rather than general trends in typical cases. The existence of specific cases (including nations and organizations) that appear to be improving environmental performance as part of the modernization process may not be due to a general trend toward sustainability associated with modernization but rather, due to a trend toward increased variability of environmental performance in institutions in late modernity. The environmental performance of institutions may be on average getting worse, as To P theorists expect, but the variability across institutions has increased, which leads to some extreme cases that appear to be “ecologically modernizing.”
Public Perceptions of the Midwest’S Pavements
Authors: Robinson Richard K. , Kuemmel David A.
Published: September 2004

With the budget crisis plaguing so many states, pavement management will compete more vigorously for limited funds. Findings reported from a tri-state pooledfund research project provide insights and guidelines for pavement improvement derived from the perceptions of the driving public. The Phase II responses from statewide surveys in Iowa, Minnesota, andWisconsin address the topics of perceptions of the State Departments of Transportation (DOTs), pavement repair tradeoffs, and pavement evaluation. The results disclose specific public perceptions of priorities for spending limited highway funds. Implications for pavement management, policy, planning, as well as for marketing to garner additional funds are explored.
Asymmetric Leadership and International Public Goods
Authors: M. Daniel G. Arce
Published: September 2004

The foreign assistance policies of major donor nations, the United NationsDevelopment Programme, and the World Bank have recently been redefined to explicitly address the provision of international public goods (IPGs). Examples of IPGs include peacekeeping, financial market stability, and biodiversity. Given the global heterogeneity across nations, it is therefore curious to find that most studies on which these redefinitions are based assume symmetric costs in the provision of IPGs. Within an evolutionary framework, the author analyzes the prospects for the voluntary provision of IPGs when the benefit/cost ratio varies across nations and characterizes the results for summation, weakest link, weaker link, best-shot, and better shot IPGs. The author demonstrates that a leading- by-example strategy by the country with the highest benefit/cost ratio can implement the cooperative outcome.
Feedback Information and Contributions to Not-for-Profit Enterprises: Experimental Investigations and Implications for Large-Scale Fund-Raising
Authors: Jones Michael , Mckee Michael
Published: September 2004

Not-for-profit enterprises often rely on donors for operating funds. Through fund-raising campaigns, individual donations are solicited, and the successes of fund-raising campaigns depend on various features of the campaign. In this article, the authors use experimental methods to investigate the effects of different types of feedback information during fund-raising campaigns. The basic setting is a linear public good. The major finding is that the nature of information has an impact on individual (and total) contributions and that these effects are systematic. The “optimal” campaign includes information on the relative sizes of received contributions and also offers a suggested level of contributions.
Three Visions of Masculine Success on American Farms
Authors: Barlett Peggy F. , Conger Katherine Jewsbury
Published: September 2004

Anthropological, sociological, historical, and psychological approaches are combined to explore three divergent orientations to masculine success among American farmers. With a focus on the moral economy of the family, we link dimensions of work, livelihood, and marital partnership to the emotional consequences of women’s off-farm work. We contrast agrarian and industrial ideals found in Georgia, Iowa, and Illinois and connect their emergence to the transformation of the American economy over the last 100 years. Psychological and survey data from an Iowa study show some preliminary support for the Georgia findings that a more industrial notion of farmers’masculinity, emphasizing income and lifestyle and an expectation that a man will be the sole breadwinner of the family, confers a heavier emotional burden in a time of financial crisis. The Midwestern sustainable agriculture movement has given rise to a “third wave” of masculinity, a less competitive and individualistic ideology, emerging from a more global ecological awareness.
Some Proposals for Strengthening Organizational Activity Theory
Authors: Thompson Mark P. A.
Published: September 2004

This paper seeks to highlight a perceived ‘drift’ of organizational activity theory: from an original concern with the social mediation of human consciousness through intersubjective interaction, to a focus on networked relations between organizational communities through intercollective interaction. It is argued that such a drift threatens the explanatory power of Vygotsky’s original formulation, which offers an explanation for the social conditioning of meaning, but which nonetheless acknowledges its location within individual human beings, not groups. In an attempt to address this perceived situation and to contribute to the further development of organizational activity theory, the paper draws upon two ideas from the Russian semiologist Bakhtin, incorporating these within a proposed framework for the application of activity theory within organizational settings that remains consistent with Vygotsky’s original ideas.
Innovation as Social Action
Authors: Hellström Tomas
Published: September 2004

The paper explicates the concept of innovation through the lens of social action. It is argued that the term ‘innovation’ carries within it certain semantic contradictions that cannot be resolved without recourse to the theory of social action underlying the process of innovation. By revisiting a number extant concepts and applications within innovation studies and unpacking these in the light of functionalist and conflict theoretical notions of social action, paradoxes as well as fruitful paths for empirical and analytical exploration are identified. A synthesis of how innovation may be interpreted in the language of social action is suggested, which builds on the dialectics between action as mental activity and physical work.
La Confusion des Genres
Authors: Rees-Roberts Nick
Published: September 2004

‘La confusion des genres’ (translatable as genre – but also gender – trouble) indicates a category error. I take up the argument that ‘transgender’ (the umbrella term for transsexuality and broad cross-gender identification – transgender butch/queen and drag) articulates uncertainty as to the categories of gender and sexual identities. My aim is to expose the strains between transsexual and lesbian and gay identities in the French context through a coverage of different media: from journalism (Hélène Hazera’s account of Algerian transgender prostitutes in Paris) to photography (Del LaGrace Volcano’s scathing assessment of the French lesbian and gay scene); from theory (a palette ranging from libertarian to psychiatric) to art-house cinema, now casting transgender actors in transgender roles. I end with extended readings of two films that either mix up gender identification with same-sex passion ( Ma vie en rose, 1997) or else play off one against the other – Patrice Chéreau’s Ceux qui m’aiment prendront le train (1998) offers not only a gay fantasy of transsexuality, but also weaves the effects of AIDS and loss on gay love into the social fabric of the film.
Trading Private and Public Spaces @ HGTV and TLC: On New Genre Formations in Transformation TV
Authors: Everett Anna
Published: September 2004

This article considers the amazing commercial success of the HGTV cable TV network, its tremendous influence on shows produced for the Discovery network’s The Learning Channel (TLC), the Arts and Entertainment (A&E) network, Bravo and BBC America, and their collective contributions to reality TV’s new global programming gold rush. Of particular interest in this analysis are the innovative ways that the HGTV network and its progeny remake key elements of traditional women’s media genres, reconfigure audience participation, and recode familiar televisual structures and narratives featuring identity politics vis-à-vis race, class, gender and sexuality.
The Perceived Effectiveness of Simultaneous Team-Teaching in a Dual Language Programme
Authors: Pardy Donna
Published: September 2004

Many international schools include a host country programme as part of their curriculum. Such programmes range from the study of local culture through to local language instruction. The administration and teachers of an international school (ISXX) felt they wanted to move beyond the traditional approaches to host country integration as well as dedicate more time to the units of inquiry (Primary Years Programme). In order to facilitate this, it was decided that the enquiry-based curriculum would be taught through both English and the host country language of German. This in itself did not appear to be entirely unique, however ISXX further decided that the German teachers and English-speaking class teachers would simultaneously team-teach the units. This study reveals how the children, parents and teachers felt about the first year of the programme.
Comparison of Selected Model Evaluation Criteria for Maintenance Applications
Authors: Kothamasu Ranganath , Shi J. , Huang Samuel H. , Leep H. R.
Published: September 2004

Model-based preventive maintenance relies on creating models that can either predict future operating states or upcoming failures directly. Since no modeling algorithm can guarantee a best solution in every situation, it becomes necessary to evaluate the solutions generated by these techniques. This paper reviews some popular criteria traditionally employed in model evaluation. Several evaluation criteria proposed in the literature are restricted in their applicability because of their assumptions about the modeling process/data. Some evaluation criteria are tested on two artificial data sets. The results from our tests indicate that Akaike Information Criterion (AIC) has superior performance. The conclusion has been used and verified in one industrial monitoring application.
Privation and Vulnerability to Victimization for Canadian Youth
Authors: Eisler Lauren , Schissel Bernard
Published: September 2004

This study examines the complex nature of the association between poverty and victimization of adolescents. Based on a survey of 2,600 school-aged youth in the province of Saskatchewan, the analysis focuses on the effects of being poor on fear and victimization in school, noncriminal victimization outside of school, and overall criminal victimization. The results illustrate clearly that poverty places youth at psychic and physical risk. Importantly, though, the damaging effects of poverty on youth security are different for male and female youth, for Aboriginal and non-Aboriginal youth, and for youth living in urban, rural, and satellite communities and are dependent on the dayto-day context inside and outside of school. The findings support the necessity for a complex understanding of the relationships among poverty, crime, and victimization that include structural and geographical considerations.
Personality Changes after Completion of Long-Term Group-Analytic Psychotherapy
Authors: Terlidou Christina , Moschonas Dimitris , Kakitsis Panagiotis , Manthouli Marina , Moschona Theano , Tsegos Ioannis K.
Published: September 2004

This study evaluates personality changes, after successful completion of long-term group-analytic psychotherapy, in an outpatient day treatment unit (Athens Open Psychotherapy Centre).1 Test-retest method was applied in thirty-nine patients, who were assessed by the MMPI test and the Rorschach projective technique. The results indicate that group-analytic treatment appears to have an impact on functional and certain structural dimensions of the patient personality. More specifically, a significant decrease of clinical symptomatology, improved social adaptation, more controlled and better-adjusted emotional expressions, maturity of internalized representations and ability to establish and maintain personal relationships are observed.
Sonographic Detection of the Normal Appendix
Authors: Scott Ted , Swan Hans , Jurriaans Eric , Voss M.
Published: September 2004

The purpose of this study was to determine if the application of tissue harmonic imaging (THI) and real-time spatial compounding (RTSC) would result in a significant difference in the rate of detection and quality of visualization of the normal appendix. Subjects were scanned using the experimental method (the combination of THI and RTSC) and the conventional method (without THI and RTSC). The rate of detection was 85% with the experimental method and 66% with the conventional method. The quality of visualization was measured across three scales—visualized length, walls, and lumen—with a total score equal to the sum of the three scales. The experimental method demonstrated a significant difference in visualized length and total score. The mean score for length using the conventional method was 2.18 compared with 2.56 for the experimental method. The mean score for all three scales for the conventional method was 7.97 compared with 8.67 for the experimental method.
Echocardiographic Assessment of Left Ventricular Structure in Hypertension and the Impact on Clinical Outcomes
Authors: Waggoner Alan D.
Published: September 2004

Hypertension (HTN) is present in nearly 50 million individuals, or approximately 29% of the adult US population. The prevalence of HTN is higher in men, increases with age, and varies among ethnic groups. Alterations of left ventricular structure and function can be present in patients with HTN and accurately characterized by echocardiography. The presence of left ventricular hypertrophy with increased left ventricular mass has prognostic implications in patients with HTN.
Gallbladder Carcinoma with the Unusual Occurrence of Squamous Cell Carcinoma
Authors: Rhodes Paula S.
Published: September 2004

Squamous cell carcinoma is a highly unusual form of gallbladder carcinoma. A detailed case study of this rare disease discovered in a patient sent for a diagnostic sonographic examination is presented. Possibilities for an etiology that is not well defined are explored. Common precursors for gallbladder cancer are discussed along with treatment options for a disease with a grim prognosis. A sonographer’s guide to scanning a mass found in the gallbladder includes a differential diagnosis for various types of masses.
Handling multiple testing while interpreting microarrays with the Gene Ontology Database
Authors: Osier Michael V , Zhao Hongyu , Cheung Kei-Hoi
Published: September 2004

Background

The development of software tools that analyze microarray data in the context of genetic knowledgebases is being pursued by multiple research groups using different methods. A common problem for many of these tools is how to correct for multiple statistical testing since simple corrections are overly conservative and more sophisticated corrections are currently impractical. A careful study of the nature of the distribution one would expect by chance, such as by a simulation study, may be able to guide the development of an appropriate correction that is not overly time consuming computationally.

Results

We present the results from a preliminary study of the distribution one would expect for analyzing sets of genes extracted from Drosophila, S. cerevisiae, Wormbase, and Gramene databases using the Gene Ontology Database.

Conclusions

We found that the estimated distribution is not regular and is not predictable outside of a particular set of genes. Permutation-based simulations may be necessary to determine the confidence in results of such analyses.
Functionally specified protein signatures distinctive for each of the different blue copper proteins
Authors: Giri Anuradha Vivekanandan , Anishetty Sharmila , Gautam Pennathur
Published: September 2004

Background

Proteins having similar functions from different sources can be identified by the occurrence in their sequences, a conserved cluster of amino acids referred to as pattern, motif, signature or fingerprint. The wide usage of protein sequence analysis in par with the growth of databases signifies the importance of using patterns or signatures to retrieve out related sequences. Blue copper proteins are found in the electron transport chain of prokaryotes and eukaryotes. The signatures already existing in the databases like the type 1 copper blue, multiple copper oxidase, cyt b/b6, photosystem 1 psaA&B, psaG&K, and reiske iron sulphur protein are not specified signatures for blue copper proteins as the name itself suggests. Most profile and motif databases strive to classify protein sequences into a broad spectrum of protein families. This work describes the signatures designed based on the copper metal binding motifs in blue copper proteins. The common feature in all blue copper proteins is a trigonal planar arrangement of two nitrogen ligands [each from histidine] and one sulphur containing thiolate ligand [from cysteine], with strong interactions between the copper center and these ligands.

Results

Sequences that share such conserved motifs are crucial to the structure or function of the protein and this could provide a signature of family membership. The blue copper proteins chosen for the study were plantacyanin, plastocyanin, cucumber basic protein, stellacyanin, dicyanin, umecyanin, uclacyanin, cusacyanin, rusticyanin, sulfocyanin, halocyanin, azurin, pseudoazurin, amicyanin and nitrite reductase which were identified in both eukaryotes and prokaryotes. ClustalW analysis of the protein sequences of each of the blue copper proteins was the basis for designing protein signatures or peptides. The protein signatures and peptides identified in this study were designed involving the active site region involving the amino acids bound to the copper atom. It was highly specific for each kind of blue copper protein and the false picks were minimized. The set of signatures designed specifically for the BCP's was entirely different from the existing broad spectrum signatures as mentioned in the background section.

Conclusions

These signatures can be very useful for the annotation of uncharacterized proteins and highly specific to retrieve blue copper protein sequences of interest from the non redundant databases containing a large deposition of protein sequences.
Cross-species comparison significantly improves genome-wide prediction of cis-regulatory modules in Drosophila
Authors: Sinha Saurabh , Schroeder Mark D , Unnerstall Ulrich , Gaul Ulrike , Siggia Eric D
Published: September 2004

Background

The discovery of cis-regulatory modules in metazoan genomes is crucial for understanding the connection between genes and organism diversity. It is important to quantify how comparative genomics can improve computational detection of such modules.

Results

We run the Stubb software on the entire D. melanogaster genome, to obtain predictions of modules involved in segmentation of the embryo. Stubb uses a probabilistic model to score sequences for clustering of transcription factor binding sites, and can exploit multiple species data within the same probabilistic framework. The predictions are evaluated using publicly available gene expression data for thousands of genes, after careful manual annotation. We demonstrate that the use of a second genome (D. pseudoobscura) for cross-species comparison significantly improves the prediction accuracy of Stubb, and is a more sensitive approach than intersecting the results of separate runs over the two genomes. The entire list of predictions is made available online.

Conclusion

Evolutionary conservation of modules serves as a filter to improve their detection in silico. The future availability of additional fruitfly genomes therefore carries the prospect of highly specific genome-wide predictions using Stubb.
Development of real-time PCR for detection of Mycoplasma hominis
Authors: Baczynska Agata , Svenstrup Helle F , Fedder Jens , Birkelund Svend , Christiansen Gunna
Published: September 2004

Background

Mycoplasma hominis is associated with pelvic inflammatory disease, bacterial vaginosis, post partum fever, sepsis and infections of the central nervous system often leading to serious conditions. Association with development of female infertility has also been suggested, but different publications present different results. We developed a sensitive and fast diagnostic real-time PCR to test clinical samples from women undergoing laparoscopic examination before fertility treatment. To develop a test for the detection and quantification of M. hominis we selected a housekeeping gene, glyceraldehyde-3-phosphate dehydrogenase (gap), as a target.

Results

Real-time PCR was optimized to detect 10 copies of M. hominis PG21 genomic DNA. A fluorescence signal was measured for all 20 other M. hominis isolates, and melting curves analysis showed variations in the melting temperature in agreement with sequence variation in the region of the probes. There was no amplification of other mycoplasmal DNA and human DNA. Eighty-three patient cervical swab samples from infertile women were cultured for M. hominis in the BEa medium. Two of the samples (2.4%) were positive after 48 hours of incubation. The real-time PCR detected the same two samples positive, and the DNA concentrations in the clinical specimens were calculated to 37.000 copies/ml and 88.500 copies/ml, respectively.

Conclusion

The results demonstrate that real-time PCR may prove to be a rapid alternative to the traditional cultivation method. Information on bacterial load in genital swabs can be obtained. The assay allowed detection of M. hominis in a closed system reducing the risk of contamination by amplicon carry-over.
The relationship between educational level and bone mineral density in postmenopausal women
Authors: Gur Ali , Sarac Ayşegül Jale , Nas Kemal , Cevik Remzi
Published: September 2004

Background

This study describes the influence of educational level on bone mineral density (BMD) and investigating the relationship between educational level and bone mineral density in postmenopausal women.

Methods

A total of 569 postmenopausal women, from 45 to 86 years of age (mean age of 60.43 ± 7.19 years) were included in this study. A standardized interview was used at the follow-up visit to obtain information on demographic, life-style, reproductive and menstrual histories such as age at menarche, age at menopause, number of pregnancies, number of abortions, duration of menopause, duration of fertility, and duration of lactation. Patients were separated into four groups according to the level of education, namely no education (Group 1 with 209 patients), elementary (Group 2 with 222 patients), high school (Group 3 with 79 patients), and university (Group 4 with 59 patients).

Results

The mean ages of groups were 59.75 ± 7.29, 61.42 ± 7.50, 60.23 ± 7.49, and 58.72 ± 7.46, respectively. Spine BMD was significant lower in Group 1 than that of other groups (p < 0.05). Trochanter and ward's triangle BMD were the highest in Group 4 and there was a significant difference between Group 1 and 4 (p < 0.05). The prevalence of osteoporosis showed an inverse relationship with level of education, ranging from 18.6% for the most educated to 34.4% for the no educated women (p < 0.05). Additionally, there was a significant correlation between educational level and spine BMD (r = 0.20, p < 0.01), trochanter BMD (r = 0.13, p < 0.01), and ward's BMD (r = 0.14, p < 0.01).

Conclusions

The results of the study suggest that there is a significant correlation between educational level and BMD. Losses in BMD for women of lower educational level tend to be relatively high, and losses in spine and femur BMD showed a decrease with increasing educational level.
Good physicians from the perspective of their patients
Authors: Schattner Ami , Rudin Dan , Jellin Navah
Published: September 2004

Background

It is not currently known what is the patient's viewpoint of a "good" physician. We set out to define patient's priorities regarding different physician's attributes in 3 domains important in medical care.

Methods

Patients hospitalized or attending clinics at a large teaching hospital selected the 4 attributes that they considered most important out of 21 listed arbitrarily in a questionnaire. The questionnaire included 7 items each in the domains of patient autonomy, professional expertise and humanism.

Results

Participating patients (n = 445, mean age 57.5 ± 16 years) selected professional expertise (50%), physician's patience and attentiveness (38% and 30%, respectively), and informing the patient, representing the patient's interests, being truthful and respecting patient's preferences (25–36% each) as the most essential attributes. Patient's selections were not significantly influenced by different demographic or clinical background. Selections of attributes in the domain of patient's autonomy were significantly more frequent and this was the preferred domain for 31% and as important as another domain for 16% – significantly more than the domain of professional expertise (P = 0.008), and much more than the domain of humanism and support (P < 0.0005).

Conclusions

Patients studied want their physicians to be highly professional and expert clinicians and show humaneness and support, but their first priority is for the physician to respect their autonomy.
Editorial: Wishful thinking
Authors: Maldonado George , Phillips Carl V ,   on behalf of the editors of Epidemiologic Perspectives & Innovations
Published: September 2004

As a supplement to our lead editorial, the editors of the new journal, Epidemiologic Perspectives & Innovations, provide a partial list of specific analyses and topic areas they would like to see submitted to the journal.
History of opioid allergy: what significance?
Authors: Gilbar Peter J , Ridge Alison M
Published: September 2004

Objective. To assess how health professionals would manage a patient’s pain when the patient is labelled as allergic to opioid analgesics.

Methods. A clinical case scenario, describing a patient obviously requiring opioid pain management but reporting a morphine allergy, was designed and pretested. This was distributed to medical (students, interns/residents, registrars, consultants) and nursing staff of Toowoomba Health Service District. All staff had some experience in pain management, though this varied widely. Respondents were asked to review the history and briefly comment on how the patient’s pain should be managed.

Results. Overall response rate was 46%. Doctors returned 47% (39/83) of scenarios, with 53% requesting further information on the nature of the allergy before using opioids. Nurses response rate was 45.2% (42/93), with only 21.4% requesting more information. Eighty three per cent (15/18) of doctors and 60% (20/33) of nurses, who didn’t query the nature of the morphine allergy, recommended opioid medication. No one specifically suggested using structurally dissimilar opioids to morphine if an allergy really existed.

Conclusion. Many health care staff either missed or ignored the allergy or assumed it was really an adverse effect and not significant, potentially placing the patient at risk of serious consequences, including anaphylaxis. Despite the low incidence of true opioid allergy, health professionals must fully investigate purported allergies to determine their validity. Patients should never be administered medications until their likelihood of experiencing a true allergy is determined.
Inappropriate labelling of patients as opioid allergic
Authors: Gilbar Peter J , Ridge Alison M
Published: September 2004

Objectives. To investigate the incidence of patients being inappropriately labelled as allergic to opioid medications and to assess the effect that this label may have had on the subsequent prescribing of opioids.

Methods. A study was conducted on patients admitted to Toowoomba Hospital over a three month period as to their perceived opioid allergy status. In addition to medication history interview, pharmacists recorded data on any claimed drug allergy attributed to opioid medications. Events were classified depending on the probability of the event being an allergic or immunological drug reaction. Medical records and medication charts of identified patients were checked to determine if allergy status had any effect on opioid prescribing.

Results. Thirty patients reported an opioid allergy. Morphine and codeine were most commonly implicated, with nausea and vomiting the most likely adverse events. Six patients were classified as high probability of allergic reaction, although anaphylaxis wasn’t reported. Most allergy documentation was incomplete, with the nature of reaction seldom recorded. Despite a ‘supposed’ opioid allergy, 70% of patients were prescribed subsequent opioids. Of the six patients in the high probability group, four were prescribed opioids. Three received alternate opioids without incident, while nurses refused to administer the same previously implicated drug to the fourth patient.

Conclusion. Opioid prescribing did not appear to be influenced by a reported allergy. Ignoring ‘real’ allergies, however rare, may put patients at risk of severe consequences. Staff must be educated regarding the importance of recording accurately and thoroughly the specifics of patients’ medication allergies and its importance in future safe prescribing.
Assimilation of Meteosat radiance data within the 4D‐Var system at ECMWF: Data quality monitoring, bias correction and single‐cycle experiments
Authors: Munro Rosemary , Köpken Christina , Kelly Graeme , Thépaut Jean‐Noël , Saunders Roger
Published: September 2004

This paper describes the direct assimilation of water vapour (WV) clear‐sky radiance (CSR) data from geostationary satellites within the context of the ECMWF four‐dimensional variational assimilation (4D‐Var) system. The assimilation of Meteosat–7 WV CSR data became operational on 9 April 2002. As 4D‐Var includes a time dimension, the high temporal resolution of the geostationary radiance data can be exploited to provide information not only on the upper‐tropospheric humidity but also on the upper‐tropospheric wind field. The data assimilated have a spatial resolution of approximately 80 km and a time resolution of 1 hour. Extensive pre‐operational monitoring of the CSR data has been carried out, showing a systematic warm bias of approximately 2–3 K in the Meteosat WV CSR data compared to radiances simulated from model first‐guess fields. The systematic biases between the brightness temperatures derived from the model and the observations are investigated and compared to other satellite radiance data. For assimilation purposes this is accounted for by using a bias correction based on a statistical regression. The monitoring also shows contamination of certain time slots caused by intruding solar stray light and a certain degree of residual cloud contamination present in the CSR. Data quality control is introduced to exclude affected data. Initial single‐cycle 3D‐Var with first guess at appropriate time and 4D‐Var experiments demonstrate both the direct and indirect effects of the Meteosat WV CSR data on the model fields, particularly of humidity and wind. The operational implementation of the assimilation of the Meteosat WV CSR data, including results from pre‐operational experiments and forecast impacts, is discussed in a companion paper. Copyright © 2004 Royal Meteorological Society
The dependence of retrieved cirrus ice‐crystal effective dimension on assumed ice‐crystal geometry and size‐distribution function at solar wavelengths
Authors: Baran A. J. , Havemann S.
Published: September 2004

The dependence of retrieved ice‐crystal effective dimension on assumed ice‐crystal shape and size‐distribution function is investigated at solar wavelengths (0.87, 1.6 and 3.7 µm). The dual viewing Along Track Scanning Radiometer is used to retrieve ice‐crystal effective dimension using a method of Optimal Estimation over semi‐transparent cirrus located in the tropics and mid‐latitudes. The ice‐crystal effective dimension is defined in terms of the effective diameter and it is retrieved assuming roughened hexagonal ice aggregates, pristine hexagonal ice columns, and four‐branched bullet rosettes. It is shown that if a phase function that well represents the scattering properties of cirrus is applied to each crystal type then the retrieved ice‐crystal effective diameter is only weakly dependent on ice‐crystal shape and size‐distribution function. Absolute differences between retrieved ice‐crystal effective diameter assuming hexagonal ice columns and ice aggregates combined with a representative phase function are generally well within ±5 µm. The findings of this paper have the important implication that, in climate models, simulation of cirrus cloudy radiances at solar wavelengths might be made to be independent of assumed ice‐crystal shape and size‐distribution function. © Crown copyright, 2004.
Evaluation and optimization of sampling errors for the Monte Carlo Independent Column Approximation
Authors: Räisänen Petri , Barker Howard W.
Published: September 2004

The Monte Carlo Independent Column Approximation (McICA) method for computing domain‐average broadband radiative fluxes is unbiased with respect to the full ICA, but its flux estimates contain conditional random noise. McICA's sampling errors are evaluated here using a global climate model (GCM) dataset and a correlated‐k distribution (CKD) radiation scheme. Two approaches to reduce McICA's sampling variance are discussed. The first is to simply restrict all of McICA's samples to cloudy regions. This avoids wasting precious few samples on essentially homogeneous clear skies. Clear‐sky fluxes need to be computed separately for this approach, but this is usually done in GCMs for diagnostic purposes anyway. Second, accuracy can be improved by repeated sampling, and averaging those CKD terms with large cloud radiative effects. Although this naturally increases computational costs over the standard CKD model, random errors for fluxes and heating rates are reduced by typically 50% to 60%, for the present radiation code, when the total number of samples is increased by 50%. When both variance reduction techniques are applied simultaneously, globally averaged flux and heating rate random errors are reduced by a factor of ∼3. Copyright © 2004 Royal Meteorological Society
Stochastic generation of subgrid‐scale cloudy columns for large‐scale models
Authors: Räisänen Petri , Barker Howard W. , Khairoutdinov Marat F. , Li Jiangnan , Randall David A.
Published: September 2004

To use the Monte Carlo Independent Column Approximation method for computing domain‐average radiative fluxes in large‐scale atmospheric models (LSAMs), a method is needed for generating cloudy subcolumns within LSAM columns. Here, a stochastic cloud generator is introduced to produce the subcolumns. The generator creates a cloud field on a column‐by‐column basis using information about layer cloud fraction, vertical overlap of cloud fraction and cloud condensate for adjacent layers, and density functions describing horizontal variations in cloud water content. The performance of the generator is assessed using a single day's worth of data from an LSAM simulation that employed a low‐resolution two‐dimensional cloud‐resolving model (CRM) within each LSAM column (a total of ∼59 000 cloudy domains). Statistical characteristics of generated cloud fields are compared against original CRM data, and radiative‐transfer biases associated with the generator are evaluated. When the generator is initialized to the greatest extent possible with information obtained from the CRM fields, overall biases are small. For example, global‐mean total cloud fraction exhibits a bias of −0.004, as compared with −0.024 for maximum‐random overlap (MRO) and 0.047 for random overlap. Biases in radiative fluxes and heating rates are in general ¼ to ½ those for MRO with horizontally homogeneous clouds. Copyright © 2004 Royal Meteorological Society
Necessity as a Justification in Re A (Children)
Authors: Kugler Itzhak
Published: September 2004

In criminal law theory, it is common to distinguish between the defence of necessity as a justification and the defence of necessity as an excuse. However, it is sometimes said that English law does not clearly distinguish between justification and excuse. In Re A (Children) the Court of Appeal permitted the separation of conjoined twins although the separation would lead to the immediate death of one of the twins. In his judgment, Brooke LJ invoked the defence of necessity and appears to be ready to base his decision on necessity as an excuse. It is, however, submitted in this article that Brooke LJ's decision should be interpreted as having been based on necessity as a justification. Consequently, it cannot be said any longer that English law does not distinguish between justification and excuse.
Analytical Validation of the Tag-It High-Throughput Microsphere-Based Universal Array Genotyping Platform: Application to the Multiplex Detection of a Panel of Thrombophilia-Associated Single-Nucleotide Polymorphisms
Authors: Bortolin Susan , Black Margot , Modi Hemanshu , Boszko Ihor , Kobler Daniel , Fieldhouse Dan , Lopes Eve , Lacroix Jean-Michel , Grimwood Rebecca , Wells Philip , Janeczko Richard , Zastawny Roman
Published: September 2004

Background: We have developed a novel, microsphere-based universal array platform referred to as the Tag-It™ platform. This platform is suitable for high-throughput clinical genotyping applications and was used for multiplex analysis of a panel of thrombophilia-associated single-nucleotide polymorphisms (SNPs).

Methods: Genomic DNA from 132 patients was amplified by multiplex PCR using 6 primer sets, followed by multiplex allele-specific primer extension using 12 universally tagged genotyping primers. The products were then sorted on the Tag-It array and detected by use of the Luminex xMAP™ system. Genotypes were also determined by sequencing.

Results: Empirical validation of the universal array showed that the highest nonspecific signal was 3.7% of the specific signal. Patient genotypes showed 100% concordance with direct DNA sequencing data for 736 SNP determinations.

Conclusions: The Tag-It microsphere-based universal array platform is a highly accurate, multiplexed, high-throughput SNP-detection platform.
Immunoquantification of α-Galactosidase: Evaluation for the Diagnosis of Fabry Disease
Authors: Fuller Maria , Lovejoy Melanie , Brooks Doug A , Harkin Miriam L , Hopwood John J , Meikle Peter J
Published: September 2004

Background: Fabry disease is an X-linked inborn error of glycosphingolipid catabolism resulting from a deficiency of the lysosomal exoglycohydrolase, α-galactosidase. Enzyme replacement therapy is currently available for Fabry disease, but early diagnosis before the onset of irreversible pathology will be mandatory for successful treatment. Presymptomatic detection would be possible through the use of a newborn-screening program. We report on the use of sensitive assays for the measurement of α-galactosidase protein and activity and for the protein saposin C, which are diagnostic markers for Fabry disease.

Methods: Two sensitive immunoassays for the measurement of α-galactosidase activity and protein were used to determine the concentrations of α-galactosidase in dried filter-paper blood spots and plasma samples from control patients and patients with a lysosomal storage disorder (LSD).

Results: Fabry hemizygous individuals were clearly identified from control populations by decreases in both α-galactosidase activity and protein. Fabry heterozygotes generally fell between the hemizygotes and controls. Including the measurement of saposin C enabled differentiation between Fabry heterozygotes and controls. In blood spots, all Fabry individuals could be distinguished from control blood spots as well as from 16 other LSD patients.

Conclusions: The determination of α-galactosidase activity or protein in dried filter-paper blood spots could be used for the diagnosis of Fabry patients. With further validation, these assays could be used for the identification of Fabry patients in newborn-screening programs and may also be suitable for screening high-risk populations.
BBC Radio 4’s Analysis and Africa: How the flagship current affairs programme covered Africa in the 1970s and early 1980s
Authors: Chignell Hugh
Published: September 2004

BBC Radio 4’s Analysis was first broadcast in April 1970 and quickly established itself as the pre-eminent exponent of radio current affairs. This paper considers how Southern Africa was represented, in particular at two stages of the programme’s evolution, in the early
1970s and again a decade after that. Between 1971 and 1973 five programmes on Africa were presented by Ian McIntyre, a central figure in British current affairs broadcasting, who went on to be Controller of both BBC Radio 4 and Radio 3. By 1980 McIntyre had been succeeded as the main presenter
of Analysis by another notable figure in British radio journalism and current affairs, Mary Goldring. Like McIntyre, Goldring visited Southern Africa to source her programmes. Both presenters can be criticized for over-attention to the white point of view and attempting the impossible in a
‘parachute’ mission. It could, however, be argued that they both achieved more than the British press and in their different ways clearly signalled the crises facing South Africa and Rhodesia.