bluuebunny/crossref_metadata_2025 huggingface dataset:
Phasic and tonic firing properties in rat oculomotor nucleus motoneurons, studied in vitro
Authors: Nieto‐Gonzalez Jose Luis , Carrascal Livia , Nunez‐Abades Pedro , Torres Blas
Published: April 2007

Alert‐chronic studies show that ocular motoneurons (Mns) exhibit a phasic and tonic firing correlated with eye saccade‐velocity and position (fixation), respectively. Differences in the phasic and tonic firing among Mns depend on synaptic inputs and/or the intrinsic membrane properties. We have used in vitro slice preparation to investigate the contribution of membrane properties to firing properties of Wistar rat oculomotor nucleus Mns. We recorded different discharge patterns and focused on Mns with sustained discharge (type I) because they were the most abundant, and their firing pattern resembles that reported in alert preparations. Various differences divided these Mns into types IA and IB; the afterhyperpolarization (AHP) phase of the spike was monophasic in IA and biphasic in IB; IA Mns showed tonic or phasic‐tonic firing depending on the current intensity, while IB Mns showed phasic‐tonic discharge; the phasic firing was higher in IB than in IA Mns; IA Mns fired in a narrower range than did IB Mns; and IA Mns showed lower maximum frequency than did IB Mns. In conclusion, IA and IB Mns show different phasic firing properties and dynamic range, supported by intrinsic membrane properties. We suggest that IA and IB Mns innervate fast‐twitch muscle fibres with different contraction speeds, and could contribute to generating a fine phasic signal for a graded muscle contraction. Finally, we have demonstrated an inverse relationship between Mn thresholds and tonic firing gain, concluding that intrinsic membrane properties could not support the covariation between tonic firing gain and recruitment thresholds reported in alert studies.
Order‐specific quantitative patterns of cortical gyrification
Authors: Pillay Praneshri , Manger Paul R.
Published: April 2007

Why the extent of cortical gyrification varies across mammals of different brain sizes is a problem that is not clearly understood. The aim of the present study was to test a hypothesis indicating that the order is a significant phylogenetic grouping in terms of quantifiable gyrification indices (GIs) and thus variation between mammals. The GI was determined from serial sections of the brain of 25 different mammalian species, representing four different orders: primates, carnivores, ungulates and rodents. Image J analysis was used to measure the contours of the cerebral cortex, and the GI was calculated using three different methods of analysis: complete vs outer; gyral vs sulcal; and outer vs inner surface contours. The measurements were then computed against the brain weights of each species within the order. An increasing GI correlates with an increasing brain weight in all the mammalian orders. Each order has its own specific allometric pattern that is significantly different from the other orders. The ungulates were the mammals with the most gyrencephalic brains, these species being significantly more gyrencephalic than all other mammals when species of similar brain weights are compared. The North American beaver has an atypically lissencephalic brain for its size, differing from the trend for increased gyrencephaly found in the other rodent species examined. Our results show definite trends and patterns specific to each order; thus, it would seem that the order is a significant phylogenetic grouping in terms of this neural parameter, from which we can predict with a reasonable degree of certainty the GI of any species of a particular order given the brain weight.
Economic Growth and Potential Punishment Under Dictatorship
Authors: Escribà‐Folch Abel
Published: April 2007

This paper explores whether the probability of being punished after losing power leads dictators to restrain their level of predation and, thus, increase economic growth. To do so, a simple model of predatory rule is developed, and the consequences of an increasing probability of punishment after loosing power explored. New data on dictators' post‐exit fate have permitted to estimate the predicted probability of punishment taking place by using multinomial logit. Outgoing dictators' strength and the international context are shown to be the main determinants of post‐exit scenarios. The probability of punishment is proven to have a positive and significant effect on the rate of growth of GDP under alternative specifications of growth regressions.
Intra‐firm Wage Dispersion and Firm Performance – Is There a Uniform Relationship?
Authors: Jirjahn Uwe , Kraft Kornelius
Published: April 2007

Empirical studies examining the impact of intra‐firm wage dispersion on firm performance report extremely mixed results. Yet, almost all of the studies implicitly assume that there is a uniform relationship between wage dispersion and firm performance across all types of firms. In contrast, we argue that the effects of wage dispersion depend on the industrial relations regime and the type of incentive scheme employed. Using data on a sample of manufacturing establishments in Germany, our findings confirm that wage dispersion interacts with internal promotions, individual and group piece rates, works council presence and collective bargaining coverage. This strongly supports the notion that moderating factors play an important role in the relationship between intra‐firm wage dispersion and productivity.
Governance and Growth Revisited
Authors: Seldadyo Harry , Nugroho Emmanuel Pandu , De Haan Jakob
Published: April 2007

Recent studies yield diverging outcomes on the governance‐growth relationship. In this paper we construct a new index of governance using a latent variable approach and test whether this index is related to growth with varying samples of countries and different conditioning variables. The results show that our index has a positive and significant impact on economic growth. This conclusion is fairly robust for various samples and conditioning variables.
Old Dilemmas or New Challenges? The Politics of Gender and Reconstruction in Afghanistan
Authors: Kandiyoti Deniz
Published: April 2007

This article situates the politics of gender in Afghanistan in the nexus of global and local influences that shape the policy agenda of post‐Taliban reconstruction. Three sets of factors that define the parameters of current efforts at securing gender justice are analysed: a troubled history of state–society relations; the profound social transformations brought about by years of prolonged conflict; and the process of institution‐building under way since the Bonn Agreement in 2001. This evolving institutional framework opens up a new field of contestation between the agenda of international donor agencies, an aid‐dependent government and diverse political factions, some with conservative Islamist platforms. At the grassroots, the dynamics of gendered disadvantage, the erosion of local livelihoods, the criminalization of the economy and insecurity at the hands of armed groups combine seamlessly to produce extreme forms of female vulnerability. The ways in which these contradictory influences play out in the context of a fluid process of political settlement will be decisive in determining prospects for the future.
Escaping Violence, Seeking Freedom: Why Children in Bangladesh Migrate to the Street
Authors: Conticini Alessandro , Hulme David
Published: April 2007

In Bangladesh, as in many developing countries, there is a widespread belief amongst the public, policy makers and social workers that children ‘abandon’ their families and migrate to the street because of economic poverty. Ignoring and avoiding mounting evidence to the contrary, this dominant narrative posits that children whose basic material needs cannot be met within the household move to the street. This article explores this narrative through the analysis of detailed empirical research with children in Bangladesh. It finds that social factors lie behind most street migration and, in particular, that moves to the street are closely associated with violence towards and abuse of children within the household and local community. These findings are consistent with the wider literature on street migration from other countries. In Bangladesh, those who seek to reduce the flow of children to the streets need to focus on social policy, especially on how to reduce the excessive control and emotional, physical and sexual violence that occur in some households. Economic growth and reductions in income poverty will be helpful, but they will not be sufficient to reduce street migration by children.
Community Driven Development, Collective Action and Elite Capture in Indonesia
Authors: Dasgupta Aniruddha , Beard Victoria A.
Published: April 2007

In response to the well documented limitations of top‐down, modernist and authoritarian approaches that have dominated development, practitioners and academics increasingly promote more community‐based approaches. The World Bank uses the term ‘community driven development’ to describe projects that increase a community's control over the development process. In an analysis of a community driven poverty alleviation project in Indonesia, this article examines the vulnerability of such an approach to elite capture. The expected relationships among a community's capacity for collective action, elite control over project decisions and elite capture of project benefits were not found. In cases where the project was controlled by elites, benefits continued to be delivered to the poor, and where power was the most evenly distributed, resource allocation to the poor was restricted. Communities where both non‐elites and elites participated in democratic self‐governance, however, did demonstrate an ability to redress elite capture when it occurred.
Changes in Food Consumption and the Implications for Food Security and Undernourishment: India in the 1990s
Authors: Ray Ranjan
Published: April 2007

This article examines the changes in the nature and quantity of food consumption in India during the reform decade of the 1990s, and analyses their implications for calorie intake and undernourishment. The study documents the decline in cereal consumption, especially in the urban areas, and provides evidence that suggests an increase in the prevalence of undernourishment over the period 1987/88 to 2001/2002. The results also point to a significant number of households, even in the top expenditure decile, suffering from undernourishment. This calls for a reassessment of the current strategy of directing the Targetted Public Distribution System (TPDS) exclusively at households ‘below the poverty line’. This study shows that, both as a source of subsidized calories and as a poverty reducing instrument, the PDS is of much greater importance to female‐headed households than it is to the rest of the population. Another important result is that, notwithstanding the sharp decline in their expenditure share during the 1990s, rice and wheat continue to provide the dominant share of calories, especially for the rural poor. The overall message is that, especially in a period of significant economic change, one needs to go beyond the standard expenditure‐based money metric measures to assess the changes in the living standards of households.
Gender and Hurricane Mitch: reconstructing subjectivities after disaster
Authors: Cupples Julie
Published: April 2007

Much of the gender and disaster literature calls for more gender‐sensitive disaster relief and research by focusing on the ways in which women are more vulnerable in a disaster or on their unique capabilities as community leaders or natural resource managers, which are often overlooked or underutilised in emergency management strategies. As well as seeking to overcome the (strategic) essentialism that is part of these calls and debates, this paper pays closer attention to gender identity and subjectivity as these are constructed and reworked through the disaster process to highlight the complexities and contradictions associated with women's responses to a disaster. This focus, while crucial to gaining a deeper understanding of the gendered dimensions of disaster, also complicates attempts to create more gender‐sensitive frameworks for disaster response. It draws on qualitative research conducted with a number of women in the wake of Hurricane Mitch (1998) in Nicaragua.
A tool to aid emergency managers and communities in appraising private dam safety and policy
Authors: Pisaniello John D. , McKay Jennifer
Published: April 2007

Issues concerning dam safety and equitable sharing of catchment run‐off are receiving more attention throughout the world. This paper assesses these matters in the context of Australia, and the need for policy responses. Landholders often overlook the common law obligation to review/design dams to current standards because of high costs, leaving them vulnerable to litigation if their dam fails. The paper reports on an innovative spillway design/review procedure, applicable to southeast Australia, but transferable to any region worldwide. Dam safety policy models and guidelines derived from international best practice are linked to the procedure and intended to aid government decision‐making. The procedure minimises costs to landholders and provides an acceptable level of safety assurance to downstream communities. Also discussed are recent surveys testing community attitudes to the procedure and implemented dam safety and water allocation policies. These further guide any government wanting to implement this‘integrated engineering and community partnerships’approach to preventing potential disasters due to private dam failure and achieving sustainable and safe water storage and use.
RESPONSIBILITY FOR CONTROL; ETHICS OF PATIENT PREPARATION FOR SELF‐MANAGEMENT OF CHRONIC DISEASE
Authors: REDMAN BARBARA K.
Published: April 2007

Patient self‐management (SM) of chronic disease is an evolving movement, with some forms documented as yielding important outcomes. Potential benefits from proper preparation and maintenance of patient SM skills include quality care tailored to the patient's preferences and life goals, and increase in skills in problem solving, confidence and success, generalizable to other parts of the patient's life. Four central ethical issues can be identified: 1) insufficient patient/family access to preparation that will optimize their competence to SM without harm to themselves, 2) lack of acknowledgement that an ethos of patient empowerment can mask transfer of responsibility beyond patient/family competency to handle that responsibility, 3) prevailing assumptions that preparation for SM cannot result in harm and that its main purpose is to deliver physician instructions, and 4) lack of standards for patient selection, which has the potential to exclude individuals who could benefit from learning to SM. Technology assessment offers one framework through which to examine available data about efficacy of patient SM and to answer the central question of what conditions must be put in place to optimize the benefits of SM while assuring that potential harms are controlled.
ACCULTURATION AND END‐OF‐LIFE DECISION MAKING: COMPARISON OF JAPANESE AND JAPANESE‐AMERICAN FOCUS GROUPS
Authors: BITO SEIJI , MATSUMURA SHINJI , SINGER MARJORIE KAGAWA , MEREDITH LISA S. , FUKUHARA SHUNICHI , WENGER NEIL S.
Published: April 2007

Variation in decision‐making about end‐of‐life care among ethnic groups creates clinical conflicts. In order to understand changes in preferences for end‐of‐life care among Japanese who immigrate to the United States, we conducted 18 focus groups with 122 participants: 65 English‐speaking Japanese Americans, 29 Japanese‐speaking Japanese Americans and 28 Japanese living in Japan.

Negative feelings toward living in adverse health states and receiving life‐sustaining treatment in such states permeated all three groups. Fear of being meiwaku, a physical, psychological or financial caregiving burden on loved ones, was a prominent concern. They preferred to die pokkuri (popping off) before they become end stage or physically frail. All groups preferred group‐oriented decision‐making with family. Although advance directives were generally accepted, Japanese participants saw written directives as intrusive whereas Japanese Americans viewed them mainly as tools to reduce conflict created by dying person's wishes and a family's kazoku no jo– responsibility to sustain the dying patient. These findings suggest that in the United States Japanese cultural values concerning end‐of‐life care and decision‐making process are largely preserved.
REGULATION OF CLINICAL RESEARCH AND BIOETHICS IN PORTUGAL
Authors: CARVALHO FATIMA LAMPREIA
Published: April 2007

This article presents an overview of the Portuguese transposition of the European Directive on Good Clinical Practice (2001/20/E) concerning scientific and academic debates on bioethics and clinical investigation. Since the Directive was transposed into Portuguese law by its National Assembly, the bureaucracy of clinical trials has been ever more complex. Despite demands for swift application processes by the Pharmaceutical industry, supported by the European Parliament, the Directive's transcription to the national law has not always delivered the expected outcome. However, this has led to an increased number of applications for clinical trials in Portuguese hospitals. In this article I revise bioethical publications and decree‐laws enabling an informed appraisal of the anxieties and prospects for the implementation of the clinical trials Directive in Portugal. This article also places the European Directive in the field of sociology of bioethics, arguing that Portuguese bioethical institutions differ from those of the US, and also from Northern European counterparts. The main divergence is that those people in Portugal who claim expertise in ‘legal’ bioethics do not dominate either the bureaucratic structure of research or ethics committees for health. Even experts in the applied ethics field now claim that ‘professional bioethicists do not exist’. The recent creation of a national Ethics Committee for Clinical Investigation (CEIC) in line with the European Directive on Good Clinical Practice (GCP) will not change the present imbalance between different professional jurisdictions in the national bioethical debate in Portugal.
Foundation for problem‐based gaming
Authors: Kiili Kristian
Published: April 2007

Educational games may offer a viable strategy for developing students' problem‐solving skills. However, the state of art of educational game research does not provide an account for that. Thus, the aim of this research is to develop an empirically allocated model about problem‐based gaming that can be utilised to design pedagogically meaningful games. The proposed model was evaluated through a business simulation game. The interviews indicated that authenticity, collaboration and learning by doing were found to be the most important characteristics of effective educational games. Results also showed that the proposed model describes well the problem‐based gaming process in which the reflection phase seems to be a vital factor. The outcome of the reflection phase may be personal synthesis of knowledge, validation of hypothesis laid or a new playing strategy to be tested. However, because of the small sample size of this study, more research on the topic is recommended. Especially, ways to support reflection in games needs to be studied.
An application of games‐based learning within software engineering
Authors: Connolly Thomas M. , Stansfield Mark , Hainey Thomas
Published: April 2007

For some time now, computer games have played an important role in both children and adults' leisure activities. While there has been much written on the negative aspects of computer games, it has also been recognised that they have potential advantages and benefits. There is no doubt that computer games are highly engaging and incorporate features that are extremely compelling. It is these highly engaging features of computer games that have attracted the interests of educationalists. The use of games‐based learning has been growing for many years now; however, within software engineering, there is still a dearth of empirical evidence to support this approach. In this paper, we examine the literature on the use of computer games to teach software engineering concepts and describe a computer game we have been developing to teach these concepts.
Games and learning come together to maximise effectiveness: The challenge of bridging the gap
Authors: Pannese Lucia , Carlesi Maria
Published: April 2007

The authors are designing and carrying out some training sessions based on serious games with customers from different business environments and with some university student groups, both in northern Italy. Some business case studies are described in this article specifying the context, the training goal, the adopted training solution and the main characteristics of the designed game. Some screenshots are also shown. Furthermore, the authors are carrying out a survey both in the business and the university environment to analyse how the learners perceive these kinds of games in terms of effectiveness, engagement, pleasure, usability and freedom of behaviour while playing. Some results are reported in this paper, and the comparison between students' and employees' perception is shown. The questionnaire used can be found in the Appendix.
Flow experiences of children in an interactive social game environment
Authors: Inal Yavuz , Cagiltay Kursat
Published: April 2007

This study examines children's flow experiences in an interactive social game environment. A total of 33 children aged from 7 to 9 years participated in the study for 6 weeks. Data were collected through observations and interviews. In order to measure the flow experiences of the children, items of a flow scale were administered to the children through interviews. Results revealed that flow experiences occur more among boys than girls during gameplay. While ludology had more effect on the flow experiences of boys when compared with the narratology of computer games, narratology had more effect among girls. Challenge and complexity elements of games had more effect on the flow experiences of the children than clear feedback.
Blending video games with learning: Issues and challenges with classroom implementations in the Turkish context
Authors: Tüzün Hakan
Published: April 2007

The research design for this study focuses on examining the core issues and challenges when video games are used in the classroom. For this purpose three naturalistic contexts in Turkey were examined in which educational video games were used as the basis for teaching units on world continents and countries, first aid, and basic computer hardware and peripherals, in primary, secondary and higher education contexts respectively. Methods employed in the data collection include observing lessons, taking field notes, interviewing students and teachers, saving online discourse data, and collecting student artifacts and reflections. Findings identified issues related to (1) the design of the video game environment, (2) school infrastructure, (3) the nature of learning, the role of the teacher and classroom culture, and (4) engagement.
Sex, lies and video games
Authors: Kearney Paul , Pivec Maja
Published: April 2007

Sex and violence in video games is a social issue that confronts us all, especially as many commercial games are now being introduced for game‐based learning in schools, and as such this paper polls teenage players about the rules their parents and teachers may or may not have, and surveys the gaming community, ie, game developers to parents, to ascertain their views on who is responsible for the guidelines on game content. Although the authors do not condone excessive sexual and violent video games, we advocate the value in games in general and the ‘hidden value’ of this genre in many areas, including game‐based learning. The aim of this paper is to show the multidimensionality and complexity of the topic that often exceeds the domain of video games.
A methodological proposal for learning games selection and quality assessment
Authors: Dondi Claudio , Moretti Michela
Published: April 2007

This paper presents a methodological proposal elaborated in the framework of two European projects dealing with game‐based learning, both of which have focused on ‘quality’ aspects in order to create suitable tools that support European educators, practitioners and lifelong learners in selecting and assessing learning games for use in teaching and learning processes. Both projects Uni‐Game (Game‐Based Learning for Universities and Life Long Learning) and Sig‐Glue (Special Interest Group for Game‐Based Learning in Universities and Lifelong Learning) have been cofunded by the European Commission since 2002, and both have involved organisations from different European countries, backgrounds and expertises, and as a result of this work, a ‘classification of games by learning purposes’ and an ‘evaluation framework for assessing games’ have been designed and placed at the disposal of European educators, practitioners and lifelong learners.
Sustainability or Ruin of a Common Resource Economy with Random Jump
Authors: Fujisaki Masatoshi , Katayama Seiichi , Ohta Hiroshi
Published: April 2007

We consider a common resource economy in which agents exploit the common resource, and use it to produce goods and consume the goods produced. Also the agents can invest in private and productive capital. The resource extracted from the common resource is non‐renewable and the common pool is under uncertainty in the sense that it could have a sudden increase or decrease in the course of extraction. In this model we shall explore the probability of sustainability or ruin of the economy. We compare and discuss the optimal extraction rules and the probabilities under cooperative and non‐cooperative regimes.
Trade Reform and Informal Wages
Authors: Marjit Sugata , Kar Saibal , Beladi Hamid
Published: April 2007

When trade reform contracts protected formal sectors in developing countries and the formal workers move to the informal sector for employment, does that reduce informal wages? Using a 2 × 2 Heckscher–Ohlin–Samuelson (HOS) structure with formal–informal production organization for the same commodity, we show that a tariff cut in the import‐competing sector increases both informal wage and employment under very reasonable assumptions. An increase in the price of the export commodity will also increase informal wages, although aggregate informal employment unambiguously falls even if the informal export sector is labor intensive. Furthermore, the formal–informal segmentation of each sector opens up an interesting, hitherto unexplored, possibility that the informal export sector may contract despite a price increase in this sector. Change in the overall size of the export sector is also ambiguous and conditional on the relative strengths of changes in these two segments.
A Model of Outsourcing and Foreign Direct Investment
Authors: Stähler Frank
Published: April 2007

This paper presents a model in which two firms may use foreign direct investment or outsourcing in order to reduce the production cost of an intermediate input. Outsourcing requires training which is costly and creates a positive spillover. The paper shows that the equilibrium depends on the level of training costs. If they are high, only bilateral outsourcing is possible in equilibrium. If bilateral outsourcing is incomplete, it will not change prices compared to no outsourcing. If they are low, only complete outsourcing is possible. If complete outsourcing is unilateral (bilateral), the price increases (decreases) with the degree of spillovers.
Endogenous Growth and Publicly Funded Knowledge Accumulation
Authors: Truong Công Nghê , Tran‐Nam Binh
Published: April 2007

We investigate a centrally planned, infinite horizon, single good economy in which new knowledge is generated in a separate R&D sector with government subsidy. The rate of growth of new ideas is assumed to be linear in the amount of labor devoted to R&D. Perpetual growth in per capita output and consumption is sustained by the spillover effects of knowledge creation. Using an isoelastic social welfare function and a general production function, the unique balanced growth path is characterized and the conditions for balanced growth to take place derived. In analyzing standard balanced growth, we demonstrate that so long as physical capital and knowledge grow at some arbitrarily constant rates along an optimal time path, the two rates must necessarily be equal. Using a Cobb–Douglas production function, the dynamic evolution of the economy is explicitly described in closed form for each state and control variables. In particular, it is shown that the economy either (i) attains the balanced growth path from the initial time, or (ii) converges monotonically to the balanced growth path. An asymptotic balanced growth path along which labor input in manufacturing tends to zero in the long run is ruled out by the tranversality condition on knowledge.
Temporary and Permanent Immigration under Unionization
Authors: Zhao Laixun , Kondoh Kenji
Published: April 2007

This paper investigates permanent and temporary immigration and remittance under the coexistence of unionized and non‐unionized manufacturing firms in a two‐sector economy. The impacts of immigration and remittance on respectively wages, employment, the union–non‐union wage gap and national welfare are analyzed. It is found that both permanent immigration (economy‐wide) and temporary immigration in agriculture bring positive effects on most variables (except the competitive wage), but widens the wage gap and causes income redistribution in the host country. However, if temporary immigrants work in manufacturing only, then all wages and the union–non‐union wage gap fall. That is, workers become more equally paid but poorer. In addition, remittance and globalization cause negative effects on union workers and employers. It is perhaps such consequences and the income redistribution effect of immigration that cause the media to paint a negative image of immigration.
Are innovative, participatory and deliberative procedures in policy making democratic and effective?
Authors: PAPADOPOULOS YANNIS , WARIN PHILIPPE
Published: April 2007

Abstract. The overall project aims to establish a dialogue between normative democratic theory and research on policy formulation and implementation. This introductory article first notes the growth of various participatory and deliberative procedures in policy making, portrays the context of this growth and justifies the cases selected. It then presents the conceptual framework used for the study of these procedures, which mainly draws on participatory and deliberative democratic theory and the literature on the shift from ‘government’ to ‘governance’. Based on this conceptual framework, the article focuses on four research questions the authors consider particularly important for the assessment of the contribution of the devices under scrutiny to democratic and effective decision making: questions of openness and access (input‐legitimacy); questions regarding the quality of deliberation (throughput); questions of efficiency and effectiveness (output‐legitimacy); and the issue of their insertion into the public space (questions of transparency and accountability).
How deliberation makes better citizens: The Danish Deliberative Poll on the euro
Authors: ANDERSEN VIBEKE NORMANN , HANSEN KASPER M.
Published: April 2007

Abstract.  This article presents results from a Danish national Deliberative Poll on the single European currency. A representative sample of 364 Danish citizens assembled to deliberate on Denmark's participation in the single currency. As a quasi‐experiment, the Deliberative Poll is an example of deliberative democracy. Four research questions regarding these deliberative processes are analyzed: openness and access, the quality of deliberation, efficiency and effectiveness, and publicity and accountability. The participants' responses reflect a deliberative process characterized by considerable changes in political opinions as the Poll proceeds, increase in level of knowledge and an improved ability to form reasoned opinions. A mutual understanding on the subject matter prevailed among the participants. At the same time, self‐interest and domination also appeared during the deliberative process. The article emphasizes the need for further elaboration of the theory of deliberative democracy so that it better reflects these features of ‘real‐life’ politics.
Transfrontier conservation areas: Integrating biodiversity and poverty alleviation in Southern Africa
Authors: Munthali Simon M.
Published: April 2007

Sub‐Saharan Africa continues to face the daunting challenge of alleviating poverty due to slow economic growth. In southern Africa, most countries are adopting policies that promote the integration of biodiversity conservation and rural development to contribute to rural poverty alleviation. Numerous approaches have been undertaken in this endeavour, including Transfrontier Parks (TFPs) and Transfrontier Conservation Areas (TFCAs). This paper discusses some of the limitations of the TFPs. In conclusion I posit that unlike TFPs, which are state controlled and managed, TFCAs, which promote multi‐land use and multi‐stakeholder participation are attainable and have a higher probability of sustaining biodiversity conservation and contributing to the alleviation of rural poverty, if: (i) areas of high biodiversity conservation within communal areas can be identified, zoned and leveraged to biodiversity conservation and managed in partnership between the communities and the private sector; (ii) local communities can secure legal rights to their customary land being devoted to biodiversity conservation and use such pieces of land as collateral in negotiating partnerships with the private sector in developing conservation‐based enterprises; (iii) functional community natural resource governance institutions can be established and empowered to represent their constituencies in securing fair equity from profits made from sustainable use of the conserved biodiversity assets and tourism businesses; (iv) concerted effort can be invested in developing and implementing family planning and fertility reduction strategies that would slow down human population growth to levels that can be sustained by the available natural resources; and (v) if sustainable financing mechanisms can be developed, and the governance of protected areas occurring in the TFCAs can be broadened to include other stakeholders.
Skin Cancer Prevention in the Primary Care Setting: Assessment Using a Standardized Patient
Authors: Hornung Robin L. , Hansen Lori A. , Sharp Lisa K. , Poorsattar Solmaz P. , Lipsky Martin S.
Published: April 2007

Abstract:  Our objective was to utilize the standardized patient technique in assessing the ability of primary care physicians to identify and counsel primary prevention for patients at high risk for skin cancer. A secondary goal was to test the feasibility of this technique as a measure of actual physician behaviors in the outpatient setting. We used a convenience sample of 15 primary care physicians. The standardized patient was an 18‐year‐old woman with skin phototype I. She presented to physicians as needing a general physical examination for a summer lifeguard job at a beach. She stated a family history of skin cancer. Physician performances were rated using a standard checklist completed by the standardized patient following each visit. We found that none of the physicians asked questions specifically related to skin phototype or sun exposure habits such as childhood sunburns. Only 13% asked about mole changes. For counseling, 67% of physicians recommended sunscreen use; only 7% discussed sunscreen types or procedures for effective use. Only 13% counseled other skin protective behaviors. No significant differences by physician gender were found in these areas; however, female physicians counseled more global health behaviors than male physicians (p ≤ 0.01). Our pilot data suggest that little skin cancer primary prevention counseling is performed for high‐risk patients. The standardized patient technique worked well in obtaining outcome data for physicians’ preventive practices.
Health Provider Factors Associated with Nonattendance in Pediatric Dermatology Ambulatory Patients
Authors: Cohen Arnon D. , Goldbart Aviv D. , Levi Itzhak , Shapiro Jonathan , Vardy Daniel A.
Published: April 2007

Abstract:  Nonattendance for dermatology appointments disrupts the management of medical delivery and leads to inefficient allocation of resources and lost revenue. The factors that determine nonattendance in pediatric dermatology patients have not been well documented. We investigated health provider factors for nonattendance in pediatric dermatology patients. We assessed the effects of waiting time for an appointment and the timing of the appointment (during the day, week, and year) on nonattendance proportions during a 1 year period. Chi‐squared tests were used to analyze statistically significant differences of categorical variables. Logistic regression was used for multivariate analyses. A total of 1696 children visits were included in the study. The overall rate of nonattendance at the dermatology clinic was 30.5%. Nonattendance was 29.7% during the periods between 8 a.m. to 1 p.m. and 3 p.m. to 7 p.m. and 40.7% during the periods between 1 p.m. to 3 p.m. and 7 p.m. to 8 p.m. (p = 0.013). Nonattendance was 21.1% when the waiting time for an appointment was short (1–7 days), 32.5% when it was intermediate (8–14 days) and 43.5% when the wait time was long (15 days and above) (p‐value < 0.001). A multivariate logistic regression model demonstrated that the hour of the day and the waiting time for an appointment were significantly associated with nonattendance (p value = 0.009, p value < 0.001, respectively). We conclude that in children attending a dermatology clinic, health provider factors that determine nonattendance include the waiting time for an appointment and the hour of the appointment within the day.
Hemorrhagic Subcutaneous Nodules: An Initial Clinical Sign of Hemophilia A
Authors: Davis Georganna , Butler David F. , Greene Jr. John
Published: April 2007

Abstract:  A 9‐month‐old boy presented with multiple hemorrhagic subcutaneous nodules after treatment with oral antibiotics for an upper respiratory tract infection. Excessive bleeding after an incisional biopsy led to a diagnosis of hemophilia A. While this was an unexpected presentation of hemophilia, screening laboratory coagulation studies prior to biopsy would have revealed the etiology. Similar presentations should alert dermatologists to suspect an underlying coagulation defect prior to biopsy, thus averting bleeding complications.
Linear Cutaneous Lupus Erythematosus in the Lines of Blaschko
Authors: Dendy E. Engelman , Edward A. Kotz , John C. Maize
Published: April 2007

Abstract:  Eleven patients with linear cutaneous lupus erythematosus following the lines of Blaschko have been previously reported in the literature. We describe a child with this entity following Blaschko lines on the trunk. The patient responded to oral hydroxychloroquine therapy combined with topical flurandrenolide tape resulting in resolution with atrophic scarring. The clinical and histological features of linear cutaneous lupus erythematosus are discussed and a review of the literature is presented.
Epstein–Barr Virus‐Associated Genital Ulcers: An Under‐recognized Disorder
Authors: Barnes Cheryl J. , Alió Alessandra B. , Cunningham Bari B. , Friedlander Sheila Fallon
Published: April 2007

Abstract:  Infectious mononucleosis is the best‐known syndrome associated with primary Epstein–Barr virus infection. Although a variety of cutaneous and mucosal manifestations are recognized in infectious mononucleosis, genital ulcers have only rarely been described. We describe an otherwise healthy 14‐year‐old girl in whom painful genital ulcers developed during an episode of serologically‐confirmed primary Epstein–Barr virus infection. Clinical, serologic, and histopathologic evaluation failed to disclose evidence of any other etiologic explanation for her lesions. The patient remains well, without recurrence. To date, only 13 instances of genital ulceration in females attributable to Epstein–Barr virus infection have been reported.
The Hair Collar Sign as a Marker for Neural Tube Defects
Authors: Harrington Brian C.
Published: April 2007

Abstract:  The hair collar sign has been described as a marker of cranial dysraphism, including encephaloceles, meningoceles, and heterotropic brain tissue. This report describes a male born with a hair collar sign who subsequently was found to have a Klippel‐Feil anomaly, diastematomyelia, multiple segmental spine and rib anomalies, and a translocation between chromosomes 1 and 4; t(1;4) (q44;q10). While not previously documented, spine abnormalities may be an associated abnormality with the hair collar sign. Physicians should consider radiographic evaluation of the spine in all newborns with a hair collar sign, as well as genetic screening.
Mosaic Chromosome 6 Trisomy in an Epidermal Nevus
Authors: Sobey Glenda J. , Quarrell Oliver W. , Williams Steven , McGrath Helen M.
Published: April 2007

Abstract:  We report a 2‐year‐old boy with a linear epidermal nevus. Mosaicism for chromosome 6 in skin fibroblasts of affected skin was discovered. Trisomy 6 has not been previously implicated as an isolated finding in epidermal nevi or cutaneous mosaicism.
Linear Morphea Presenting as Acquired Unilateral Edema
Authors: Fiala Katherine H. , Wells Michael J. , Mullinax Kimberly A. , Stetson Cloyce L. , Paulger Brent R.
Published: April 2007

Abstract:  We describe a 2‐year‐old African‐American boy with a 4‐month history of gradually worsening unilateral edema that was initially noted on his left hand and then approximately 2 weeks later on his left lower extremity. In addition, linear hypopigmented patches were noted along the left forearm and leg, with no appreciable scarring or induration. The edema on the left‐hand side of his body progressed so that he developed tense bullae on his left hand. Two months later, the hypopigmented patches were indurated and bound‐down, especially over the left groin and thigh. A biopsy specimen from this area showed features characteristic of morphea. In this patient, dilated lymphatic channels secondary to the sclerosis of the morphea caused the bullae. Bullous morphea is a rare condition. We were unable to find any reports its occurrence in children under 18 with associated lymphedema. This entity should be included in the differential for acquired unilateral edema in children.
Generalized Erythrodermic Pemphigus Foliaceus in a Child and Its Successful Response to Rituximab Treatment
Authors: Connelly Elizabeth Alvarez , Aber Cheryl , Kleiner Gary , Nousari Carlos , Charles Carlos , Schachner Lawrence A.
Published: April 2007

Abstract:  Pemphigus foliaceus is an autoimmune disease that clinically manifests with cutaneous blisters of the superficial skin. The nonendemic or sporadic form of this entity is rare in children and typically presents with a milder, more localized rash that usually follows a benign course of short duration. We describe an affected patient atypical in both her young age and the severity of skin findings. Our patient presented with a full body exfoliative erythroderma at 21 months of age. After an extensive work‐up to determine the etiology of her exfoliative erythroderma, direct and indirect immunofluorescence studies confirmed the diagnosis of pemphigus foliaceus. Rituximab therapy was initiated based on the patient's refractory disease course to multiple immunosuppressive agents. Rituximab is a therapeutic monoclonal antibody targeting CD20, an integral membrane protein highly expressed on the surface of pre‐B lymphocytes and activated mature B lymphocytes. The patient's skin exhibited marked clinical improvement after the start of rituximab infusions over 12 weeks. Her initial desmoglein 1 antibody level was greater than 1:1280, which decreased to 1:16 after seven rituximab treatments. She has had no skin flares since initiating treatment with rituximab therapy. Based on this clinical and serologic response, the use of rituximab may be helpful in the treatment of pediatric pemphigus foliaceus refractory to mainstays of therapy.
Impact of Hepatitis C on HIV Progression in Adults With Alcohol Problems
Authors: Cheng Debbie M. , Nunes David , Libman Howard , Vidaver John , Alperen Julie K. , Saitz Richard , Samet Jeffrey H.
Published: April 2007

Background: Coinfection of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a substantial medical and public health concern due to its increasing prevalence and complex patient management. Alcohol use may worsen HCV‐related liver disease and interfere with adherence to antiretroviral therapy (ART) and medical care. We therefore studied the association between HCV infection and markers of HIV disease progression in adults with alcohol problems.

Methods: This is a longitudinal study of 396 HIV‐infected persons with alcohol problems, 199 (50%) of whom were coinfected with HCV (positive HCV RNA test). CD4 cell counts and HIV RNA levels were assessed at baseline and then every 6 months for up to 42 months. Hepatitis C virus RNA status was determined at study enrollment. We examined the relationship between HCV infection and laboratory markers of HIV progression (CD4 cell count and log10 HIV RNA) by fitting multivariable longitudinal regression models for each outcome.

Results: Among subjects who were adherent to ART, the presence of HCV infection was associated with a lower CD4 cell count (adjusted mean difference −46.0 cells/μL, p=0.03). There was no association observed between HCV infection and CD4 cell count among those not adherent to ART or those not taking ART. No significant association was observed between HCV infection and HIV RNA regardless of ART status.

Conclusions: Hepatitis C virus infection has an adverse effect on CD4 cell count in patients with alcohol problems who are adherent to ART. Addressing HCV coinfection among these patients may confer additional immunologic benefit for this patient population.
Carotid Artery Stenting: A Therapeutic Alternative in Subtotal Internal Carotid Artery Occlusions
Authors: ZACHARIAS SONI J. , KALAPURA THOMACHAN , ABRANTES‐PAIS FATIMA , HENNEBRY THOMAS A.
Published: April 2007

Carotid artery stenting (CAS) is emerging as a less invasive modality for treating atherosclerotic occlusive disease of the internal carotid artery (ICA). Randomized trials like the SAPPHIRE trial have demonstrated that CAS is not inferior to carotid endarterectomy (CEA) in the treatment of carotid artery stenosis, and maybe even superior in high‐risk symptomatic patients. However, patients with subtotal ICA occlusions with thrombus are excluded from randomized CAS trials and CAS registries. To our knowledge, carotid angioplasty with stenting has not been attempted in these cases. We present three cases of symptomatic subtotal ICA occlusions successfully treated with CAS without any periprocedural complications. With careful patient selection and technical expertise, endovascular management could be considered as a treatment option in subtotal carotid occlusions.
Against Hauerwas
Authors: Hobson Theo
Published: April 2007

This essay questions the theological position developed by Stanley
Hauerwas over three decades. It first traces the origins of his thought, and
argues that the alliance of radical Reformation ecclesiology with postmodern
philosophy leads to an intensely idealistic ecclesiology. Hauerwas's
exaltation of particular communal practices is ultimately unreal, as he
fails to locate these practices in a particular institution. Due to the
unreality of his ecclesiology his attack on Christendom and Constantinianism
lacks substance. In the end he undermines his own position by identifying
the truth of Christianity with the concrete practices of a distinctive
community that he cannot identify.