bluuebunny/crossref_metadata_2025 huggingface dataset:
Child Care Health Consultation Programs in California: Models, Services, and Facilitators
Authors: Alkon Abbey , Bernzweig Jane , To Kim , Mackie Joanna F. , Wolff Mimi , Elman Jeremy
Published: February 2008

ABSTRACT
Objective: To summarize findings from a descriptive evaluation study of 20 county‐level child care health consultation programs, services provided, and factors that facilitated the development of the programs.

Design: A 3‐year intervention study of 20 county‐level child care health consultation programs, selected through a competitive review process, was conducted in California.

Sample: Study participants were the child care health consultation program staff, lead agency administrators and health consultants, and early care and education (ECE) staff, including health advocates and directors.

Measurement and Intervention: Data collection included focus groups, interviews, consultant activity logs, and surveys. Health consultation intervention services included health and safety assessments, on‐site consultation, and workshops for ECE providers and parents.

Results: 4 child care health consultation models were established based on the type of administrative agency. Health consultants and advocates primarily provided on‐site consultation and education and training on child health promotion issues. Consultation programs were facilitated by the linkages formed among agencies, community characteristics, personal relationships, lead agency support, and consultant training and knowledge.

Conclusions: Child care health consultation programs can address the health and safety needs for ECE programs, but they need administrative support, trained staff, and sustainable relationships with local ECE programs.
Clinical and Life Quality Differences Between Mexican American Diabetic Patients at a Free Clinic and a Hospital‐Affiliated Clinic in Texas
Authors: García Alexandra A.
Published: February 2008

ABSTRACT
Objective: This paper explores the contribution of personal, cultural, and disease characteristics, diabetes knowledge, number of symptoms, and 2 specific clinics to the explained variance in glycosylated hemoglobin (A1c) and quality of life among Mexican Americans with type 2 diabetes.

Design: This descriptive correlational study used hierarchical multiple regression analysis.

Sample: 87 Mexican American patients with type 2 diabetes were recruited from 2 clinics, 1 hospital‐affiliated and 1 free clinic, that served a primarily minority and indigent population.

Measurements: A language‐based acculturation scale, the Diabetes Knowledge Questionnaire‐24, Diabetes Symptom Self‐Care Inventory, and Self‐Anchoring Striving Scale were administered in one‐on‐one interviews. Medical records were reviewed for recent A1c and health history.

Results: The participants' clinic explained an additional 13% of the variance in A1c and 6% of the variance in quality of life after controlling for gender, acculturation, time since diagnosis, number of diabetes medications, diabetes knowledge, and number of symptoms. Clinics differed in patient characteristics, beyond the variables entered in the regression model, and in their care delivery.

Conclusions: Clinic characteristics and their influence on diabetes outcomes should be explored to maximize patients' abilities to steer the course of their diabetes away from complications.
Public Health Nursing Competencies for Public Health Surge Events
Authors: Polivka Barbara J. , Stanley Sharon A. R. , Gordon Deanna , Taulbee Kelly , Kieffer Gloria , McCorkle Sheryl M.
Published: February 2008

ABSTRACT Objective:

To develop consensus regarding public health nursing competencies in the event of a public health surge event related to disaster.

Design and methods: Using a 3‐round Delphi approach, public health nurses (PHNs) and directors of nursing from local health departments, state nursing leaders, and national nursing preparedness experts reviewed and commented on 49 draft competencies derived from existing documents.

Results: The final 25 competencies were categorized into Preparedness (n=9), Response (n=8), and Recovery (n=7). The Preparedness competencies focus on personal preparedness; comprehending disaster preparedness terms, concepts, and roles; becoming familiar with the health department's disaster plan, communication equipment suitable for disaster situations; and the role of the PHN in a surge event. Conducting a rapid needs assessment, outbreak investigation and surveillance, public health triage, risk communication, and technical skills such as mass dispensing are Response phase competencies. Recovery competencies include participating in the debriefing process, contributing to disaster plan modifications, and coordinating efforts to address the psychosocial and public health impact of the event.

Conclusions: Identification of competencies for surge events that are specific to public health nursing is critical to assure that PHNs are able to respond to these events in an effective and efficient manner.
The ExploreSurge Trail Guide and Hiking Workshop: Discipline‐Specific Education for Public Health Nurses
Authors: Stanley Sharon A. R. , Polivka Barbara J. , Gordon Deanna , Taulbee Kelly , Kieffer Gloria , McCorkle Sheryl M.
Published: February 2008

ABSTRACT
Generic preparedness education and training for the public health workforce has increased in availability over the past 5 years. Registered Nurses also have more opportunities available for participation in emergency and disaster preparedness curricula. Discipline‐ and specialty‐specific training and education for public health nurses (PHNs) incorporating their population‐based practice, however, remains a largely unexplored area that is not accessible except for sporadic local venues. The Public Health Nursing Surge Curriculum provides 50 hr of nursing continuing education and activity‐based aggregate focused learning experiences that are completed within a 12‐month period, including an in‐classroom seminar. The Public Health Nursing Surge Curriculum was developed on a foundation of 25 competencies linking PHNs and their population‐based practice to surge capability. The curriculum was built in partnership with statewide public health directors of nursing over a 12‐month period and is evaluated by a 3‐level process to include self‐rated confidence in performance. The curriculum's use of a blended learning methodology enables staff‐level PHNs to master individual competencies toward surge capability within the public health response system.
Graduate Education for Advanced Practice Public Health Nursing: At the Crossroads
Authors: Levin Pamela F. , Cary Ann H. , Kulbok Pamela , Leffers Jeanne , Molle Mary , Polivka Barbara J.
Published: February 2008

ABSTRACT
The complexity of public health problems and advancement of science framing public health demand an expansion of traditional educational approaches and curriculum to prepare a futuristic advanced practice public health nursing (APPHN) workforce. This position paper sponsored by the Association of Community Health Nursing Educators challenges nurse educators to apply innovative strategies in preparing public health nursing (PHN) professionals and to expand curriculum paradigms to promote PHN's ecological approach to solving problems. To meet the challenges of ensuring public health in the 21st century, advanced practice public health nurses must have greater foundational knowledge in critical content areas discussed in this document. Competence in these areas will enable advanced practice public health nurses to address future health care challenges such as rapidly changing social structures, escalating knowledge explosion, globalization, and growth of new technologies. This education will prepare nurses to forge new knowledge and establish health care teams to create effective solutions.
Randomized Controlled Trial of Intravenous Dexamethasone to Prevent Relapse in Acute Migraine Headache
Authors: Rowe Brian H. , Colman Ian , Edmonds Marcia L. , Blitz Sandra , Walker Alan , Wiens Sheldon
Published: February 2008

Objectives.— Migraine headache is a common presentation in the emergency department (ED). Inflammation is thought to play a role in the pathophysiology of migraine and there is conflicting evidence regarding the effect of corticosteroids on reducing early recurrences. We conducted a randomized clinical trial to test the hypothesis that dexamethasone (DEX) reduced headaches after discharge and examine the factors associated with relapse.

Methods.— Consenting adults (18 and older) presenting with acute migraine at 4 EDs were enrolled. In addition to standard intravenous (IV) abortive therapy, using concealed allocation patients were randomized to receive IV DEX (15 mg) or placebo (PLA) in a double‐blind fashion. Relapse was defined as a return to the ED, an urgent clinic visit, or a headache that precluded normal activity reported during follow‐up telephone interviews 48‐72 hours and 7 days after ED discharge. Intention to treat was used for all final analyses.

Results.— A total of 130 patients were randomized; 126 patients are included in the analysis (one patient left prior to treatment and 3 enrolled twice); 64 received DEX and 62 received PLA. Mean age was 35 years, 81% was female; most (77%) suffered from headaches at least monthly. On a 10‐point visual analog scale (VAS), the median pain scores were 8 at presentation, and 2 at discharge. At 48‐72 hours, relapses occurred in 14/64 (22%) in the DEX group and 20/62 (32%) in the PLA groups (OR = 0.6; 95% CI: 0.3‐1.3). By day 7, 18/64 (28%) in the DEX group had relapsed, compared with 25/62 (40%) in the PLA group (OR = 0.6; 95% CI: 0.3‐1.3). Controlling for treatment assignment, relapse was more common when headache pain was incompletely relieved (VAS > 2) at ED discharge (OR = 2.2; 95% CI: 1.1‐5.4).

Conclusions.— The overall relapse rate differed from those previously reported; however, DEX failed to reduce headache relapses after ED discharge. Relapse was closely associated with incomplete pain relief at discharge. Further research is needed to determine the factors associated with migraine relapse.
Effect of Early Intervention With Almotriptan vs Placebo on Migraine‐Associated Functional Disability: Results From the AEGIS Trial
Authors: Freitag Frederick , Smith Timothy , Mathew Ninan , Rupnow Marcia , Greenberg Steven , Mao Lian , Finlayson Gary , Wright Pamela , Biondi David
Published: February 2008

Objective.— To investigate the effect of early acute migraine intervention with almotriptan vs placebo on functional disability and health‐related quality of life (HRQoL) indicators.

Design/Methods.— In this multicenter, double‐blind, parallel‐group trial, adults with international classification of headache disorders‐defined migraine, with or without aura, were randomized 1:1 to treat 3 consecutive headaches with either almotriptan 12.5 mg or placebo. Patients were instructed to take their study medication at the first sign of migraine headache pain of any intensity, within 1 hour of onset. Patients recorded level of functional disability (normal, disturbed, bed rest required, emergency room [ER]/hospitalization required) at baseline (pretreatment), 0.5, 1, 2, 4, and 24 hours posttreatment and at time of pain‐free. Patients completed the Migraine Disability Assessment Scale (MIDAS) at randomization and completed the Migraine Quality‐of‐Life Questionnaire (MQoL) at 24 hours after each attack.

Results.— Results are presented for 315 patients (160 almotriptan, 155 placebo) in the evaluable for efficacy population. At 2 hours posttreatment of Attack 1, 54.4%, 32.5%, 13.1%, and 0%, respectively, of almotriptan‐treated patients reported normal function, disturbed function, bed rest required, and ER/hospitalization required compared with 38.1%, 45.2%, 16.1%, and 0.6%, respectively, of placebo‐treated patients. The differences in level of functional disability between the 2 treatment groups were statistically significant at 2 hours (P = .007; Cochran‐Mantel‐Haenszel, stratified by center) and at 4 hours (P < .001). Resolution of pain was associated with a normal level of function; at 2 hours posttreatment, 91.7% of patients in the total population who achieved pain‐free reported normal function compared with 44.8%, 8.0%, and 0% of patients with mild, moderate, and severe pain, respectively. The absence compared with the presence of photophobia, phonophobia, and nausea at 2 hours also was associated with less disability (P < .0001 for each symptom). Treatment with almotriptan compared with placebo resulted in consistently better 24‐hour MQoL scores with significant results for all 3 migraine headache attacks in the social function and feelings/concern domains. A logistic regression model determined that pretreatment functional level (P = .0117), pretreatment pain intensity (P = .0089), and pretreatment MIDAS score (P = .0152) were significant covariates of the proportion of patients who achieved normal function at 2 hours posttreatment.

Conclusions.— Early treatment with almotriptan within 1 hour of migraine pain onset significantly reduced levels of functional disability at 2 and 4 hours posttreatment compared with placebo. Consistency in improvement of HRQoL indicators was observed across 3 headaches treated.
The Italian Contribution to the Problem of Reflex Epilepsy
Authors: VIZIOLI R.
Published: February 2008

In a historical survey the important discoveries of Amantea, Martino, Clementi, Moruzzi and many other Italian scientists and their schools in the field of reflex epilepsy are discussed.

L'CARauteur jette un coup d'carœil sur l'carhistoire des importantes découvertes d'Amantea, Martino, Clementi, Moruzzi et plusieurs autres savants italiens et leurs écoles dans le domaine de l'carépilepsie réflexe. Il en fait la discussion.
Experimental Reflex Epilepsy (Audiogenic Epilepsy)
Authors: ŠTERC J.
Published: February 2008

Some basic questions and the results attained in our laboratory within the last five years are discussed. One of the most common experimental models of reflex epilepsy is the audiogenic epilepsy of rats. In its analysis we have concentrated our attention on the three main epileptogenic factors: stimulus, focus and paroxysmal susceptibility. We have produced epileptogenic foci by alumina cream in the auditory and motor cortical areas, in the colliculus inferior and in the amygdala. The results showed a close functional parallel between manifestations of these foci and the behaviour of naturally epileptic rats.

By the method of conditioned reflexes the changes of functional state of the acoustic analyzor were studied during the latent period of the seizure and the sequelae of the seizures were analyzed. The course of the seizure was studied by EEG examination, by analysis of the symptomatology and by testing the temporal changes of paroxysmal susceptibility.

Discussion de quelques questions fondamentales et des résultats obtenus dans notre laboratoire au cours des cinq dernières années. L'CARuri des types expérimentaux les plus communs d'carépilepsie réflexe est l'carépilepsie audiogénique des rats. Nous avons, dans cette analyse, concentré toute notre attention sur les trois facteurs épileptogènes principaux: stimulus, foyer et susceptibilité paroxystique. Nous avons provoqué des foyers épileptogènes par de la crème d'alumine placée dans les régions corticales auditives et mo trices, dans les tubercules quadrijumeaux inférieurs et dans les amygdales. Les résultats ont démontré un étroit parallélisme fonctionnel entre les manifestations de ces foyers et le comportement de rats naturellement épileptiques.

Les changements de l'carétat fonctionnel de l'caranalyseur auditif ont étéétudiés pendant la période latente des crises par la méthode des réflexes conditionnés; les séquelles des attaques ont été analysées. Le cours des crises a étéétudié au moyen d'examens d'EEG, de l'caranalyse de la symptomatologie et du test des changements temporaux de la susceptibilité paroxystique.
The Problem of Human Reflex Epilepsy and the Possible Role of Masked Epileptogenic Factors
Authors: VIZIOLI R.
Published: February 2008

On the basis of analysis of many typical cases where specific sensory precipitation, of epileptic seizures took place, the role of reflex mechanisms in provocation as well as inhibition of seizures is discussed.

Discussion du rôle des mécanismes de réflexe, dans la provocation aussi bien que dans l'inhibition des crises, basee sur l'car'analyse de plusieurs cas typiques, dans lesquels il y avait eu précipitation sensorielle spéciflque de crises épileptiques.
Reflex Influences in the Pathogenesis of Epilepsy in the Light of Clinical Statistics
Authors: SERVíT Z. , Machek J. , ŠTERCOVÁ A. , DUDÁŠ D. , Krištof M. , ČErvenková V.
Published: February 2008

By means of statistical processing of anamnestic data of a group of 895 patients it was stated that in approximately 40% one or more activating or inhibitory stimuli were identified which seriously influenced the number of attacks. The activating and inhibitory influences assert themselves in almost the same measure. To the most outstanding aptivating influences belong the neurotizing situation and inactivity, and/or mental and physical relaxation, whereas to the inhibitory factors belongs concentration upon some motor or psychical activity.

L'Car etude statistique de dates anamnésiques d'un groupe de 895 malades a révélé qu'a peu pres en 40% de ces cas, on a pu identifier un ou plusieurs stimuli activateurs ou inhibiteurs susceptibles d'influencer serieusement le nombre des attaques. Les influences d'activation et d'inhibition se manifestent a peu pres dans la meme mesnre. On compte parmi les influences activatrices les plus importantes la situation neurotisante et l'inactivite, et/ou la relaxation mentale et physique, tandis que la concentration sur une activite psychique ou motriee appartient aux facteurs inhibiteurs.
Aurae and their Role in Reflex Mechanisms of Epileptic Seizures
Authors: HENNER K.
Published: February 2008

Our knowledge of aurae has made great progress since the period of the first application of electroencephalography and since the time of Penfield's and Jasper's surgical treatment.

The localization of aurae as it has been elaborated during the last 15 years has furnished good results and confirms the reflex mechanisms in the development of the entire seizure. Aurae enable many patients to prevent an on‐coming seizure by various reflex means and perhaps to diminish even the potency of the epileptogenic focus. In this respect, the epileptic susceptibility can also be diminished reflexly and conditionally if the patient has succeeded several times in using this inhibition. In essence we are dealing with a reflex inhibition of reflexes.

Nos connaissances des aurae se sont considérablement augmentées depuis la période de la premiére application de l'carélectroencéphalographie et celle du traitement chirurgical de Penfield et Jasper.

La localisation des aurae telle qu'elle a étéétudiée durant les 15 derniéres années, a donné de bons résultats et confirme le rôle du mécanisme réflexe dans le développement de l'carensemble de la crise. Les aurae peuvent aider de nombreux malades à prévenir la venue d'une crise par des moyens réflexes et meme a diminuer, peut‐être, le potentiel du focus épileptogénique. Sous ce rapport, la susceptibilitéépileptique peut être aussi diminuee réflexivement et conditionnellement si le malade a déjà, plusieurs fois, fait usage de cette inhibition. Essentiellement parlant, c'est de l'car in‐hibition réflective de réflexes qu'il s'agit ici.
Blocking of Petit‐mal Attacks by Sensory Arousal and Inhibition of Attacks by an Active Change in Attention during the Epileptic Aura*
Authors: JUNG R.
Published: February 2008

The blocking effect of sensory arousal and of active attention on epileptic seizures is studied in 200 cases of petit‐mal and 20 cases of grand mal with focal onset. The mechanisms of the seizure block may be similar to desynchronization and reciprocal inhibition of neuronal activity in the cortex during arousal. They may arise from the non‐specific thalamo‐reticular system which is activated by sensory afferents or attention.

L'effet du blocage d'une excitation sensorielle et de l'attention active dans des crises épileptiques a été observé en 200 cas de petit mal et 20 cas de grand mal ayant eu un début focal. Les mécanismes du blocage pendant la crise peuvent être semblables à une désynchronisation et à une inhibition réciproque de l'activité neuronale dans le cortex durant l'excitation. lis peuvent provenir du système thalamo‐réticulaire non spécifique qui est activé par des afférents sensoriels ou par l'attention.
Paradoxical Lateralization of Parasagittal Sharp Waves in a Patient with Epilepsia Partialis Continua
Authors: Adelman Steven , Lueders Hans , Dinner Dudley S. , Lesser Ronald P.
Published: February 2008

Summary: We present a patient with epilepsia partialis continua involving the right leg who demonstrated sharp waves paradoxically distributed over the vertex and right hemisphere. Posterior tibial nerve evoked potentials also showed a similar paradoxical lateralization. We postulate that generators situated on the mesial surface of the left hemisphere projected their activity obliquely, leading to paradoxical lateralization of the recorded electrical activity.

Nous présentons un patient ayant une épilepsie partielle continue qui intéressait la jambe droite et chez qui l'on mettait en évidence des “sharp waves” localisées de façon paradoxal sur le vertex et l'hémisphere droit. Les potentiels évoqués du nerf tibial postérieur montraient aussi une latéralisation paradoxale. Nous faisons l‐hypothése que les générateurs situés sur la face mesiale de l'hémisphère gauche projetaient leur aclivité obliquement, conduisant à la lateralisation paradoxale des activités électriques enregistrées.

Se presenta un pacienta con epilepsia parcial continua afectando a la pierna derecha que presentaba ondas agudas distribuídas de modo paradójico en el vertex y en el hemisferio derecho. Los potenciales evocados tras estímulos del nervio tibial posterior también demostraron una lateralización paradójica similar. Nosotros postulamos que ciertos generadores situados en la superficie medial del hemisferio izquierdo proyectan su actividad oblicuamente lo que conduce a una lateralización paradójica de la actividad eléctrica registrada.

Wir berichten über einen Patienten mit Epilepsia partialis continua, die das rechte Bein betraf. Der Patient zeigte sharp waves die paradoxerweise über dem Vertex und der rechten Hemisphäre auftraten. Evozierte Potentiale vom N. tibialis posterior zeigten ebenfalls eine paradoxe Lateralisation. Wir folgern, daß Generatoren, die an der mesialen Oberfläche der linken Hemisphäre sitzen ihre Aktivität so projezieren, daß sie zur paradoxen Lateralisation führt.
Alcohol in a Social Context: Findings From Event‐Contingent Recording Studies of Everyday Social Interactions
Authors: Aan Het Rot Marije , Russell Jennifer J. , Moskowitz Debbie S. , Young Simon N.
Published: February 2008

Background:  Data concerning the effects of alcohol on social interaction in everyday life are limited.

Methods:  Healthy volunteers in 4 studies of social behaviors and mood were instructed to complete record forms immediately after a social interaction had occurred, a method known as event‐contingent recording. Record forms asked questions about quarrelsome, agreeable, dominant, and submissive behaviors; about aspects of mood; and, in 3 studies, about perceptions of others. Each form also contained a question about alcohol consumption prior to a social interaction. For the present report, only social interactions taking place in the evening and outside the work setting were included. Only individuals who consumed alcohol at least once in these circumstances were included (n = 171).

Results:  Social interactions involving alcohol were primarily characterized by higher levels of agreeable behaviors, by perceptions of greater agreeableness in others, and by more positive mood. Alcohol consumption was not associated with higher levels of quarrelsomeness.

Conclusions:  Alcohol consumption in a social context may have predominantly positive effects, an observation which is at odds with most alcohol‐induced aggression experiments performed in laboratory settings. Drinking in everyday life may be less likely to result in aggression because, unlike in most laboratory experiments, individuals can choose among a variety of behaviors in response to social cues and the alcohol dose consumed is usually lower. Event‐contingent recording provides a new approach for the study of alcohol’s effects in everyday life and the conditions in which alcohol might result in interpersonal aggression.
Prospective Study of Alcohol Consumption in the United States: Quantity, Frequency, and Cause‐Specific Mortality
Authors: Breslow Rosalind A. , Graubard Barry I.
Published: February 2008

Background:  Alcohol average volume (quantity multiplied by frequency) has been associated with mortality in drinkers. However, average volume may mask associations due to quantity or frequency alone.

Methods:  We prospectively assessed relationships between alcohol quantity and frequency, and mortality from all‐causes, cardiovascular disease, cancer, and other‐causes in a cohort created by linking the 1988 National Health Interview Survey (response rate 87%) to the National Death Index through 2002. Participants were 20,765 current drinkers age ≥ 18 years. At 14‐year follow‐up 2,547 had died.

Results:  For quantity, among men who consumed ≥5 drinks (compared to 1 drink) on drinking days, adjusted relative risks (RR) of mortality were: for cardiovascular disease, 1.30 [95% confidence interval (CI) 0.96–1.75; p for linear trend (p‐trend) = 0.0295], for cancer, 1.53 (95% CI 1.11–2.09; p‐trend = 0.0026), and for other‐causes, 1.42 (95% CI 1.08–1.87; p‐trend = 0.0029); among women for other‐causes, 2.88 (95% CI 1.61–5.12; p‐trend = 0.0010). For frequency, among men in the highest frequency quartile (compared to the lowest), RR were: for cardiovascular disease, 0.79 (95% CI 0.63–0.99; p‐trend = 0.0330), for cancer, 1.23 (95% CI 0.95–1.59; p‐trend = 0.0461), and for other‐causes, 1.30 (95% CI 1.01–1.67; p‐trend = 0.0070); among women, for cancer, 1.65 (95% CI 1.12–2.45, p‐trend = 0.0031). Average volume obscured effects of quantity alone and frequency alone, particularly for cardiovascular disease in men where quantity and frequency trended in opposite directions.

Conclusions:  Alcohol quantity and frequency were independently associated with cause‐specific mortality. Accumulating evidence of their differential effects may, in the future, be useful for clinical and public health recommendations.
Effects of Alcohol Consumption on the Allergen‐Specific Immune Response in Mice
Authors: Linneberg Allan , Roursgaard Martin , Hersoug Lars‐Georg , Larsen Søren Thor
Published: February 2008

Background:  There is evidence that chronic alcohol consumption impairs the T‐helper 1 (Th1) lymphocyte‐regulated cell‐mediated immune response possibly favoring a Th2 deviation of the immune response. Moreover, a few epidemiological studies have linked alcohol consumption to allergen‐specific IgE sensitization.

Objective:  To investigate the effects of alcohol consumption on the allergen‐specific immune response in mice.

Methods:  BALB/cJBomTac mice were immunized intraperitoneally with ovalbumin (OVA) using a low dose sensitization protocol. Throughout the experiment, mice were kept on isocalorical liquid diets containing 0 to 6.2% ethanol. Evaluation of immunomodulatory effects of ethanol was based on measurements of total serum IgE, as well as OVA‐specific IgE, IgG1, and IgG2a. Furthermore, levels of OVA‐induced interleukin (IL)‐4 and interferon‐γ were determined in ex vivo splenocyte cultures.

Results:  Alcohol intake decreased the level of OVA‐specific IgG2a in a dose‐dependent manner, whereas high levels of alcohol markedly increased the level of total IgE, but not OVA‐specific IgE. Th1 suppression was supported by the cytokine profile.

Conclusions:  Alcohol consumption induced a marked decrease in markers of the Th1‐type allergen‐specific immune response and an increase in total serum IgE. In this model, there was no effect of alcohol on OVA‐specific IgE. Studies using other routes of immunization may be warranted.
Level of Response to Alcohol Within the Context of Alcohol‐Related Domains: An Examination of Longitudinal Approaches Assessing Changes Over Time
Authors: Trim Ryan S. , Schuckit Marc A. , Smith Tom L.
Published: February 2008

Background:  The manner in which a low level of response (LR) to alcohol relates to domains that enhance the risk for heavy drinking has traditionally been studied through cross‐sectional models. However, many of the relevant domains, such as the maximum number of drinks consumed in 24 hours (MAXDRINK) and drinking among peers (PEER) typically decrease across adulthood. This study evaluated whether a person’s LR to alcohol predicted alcohol‐related domains at multiple time‐points and examined longitudinal relations among these domains in a sample of probands from the San Diego Prospective Study.

Methods:  LR to alcohol was assessed in 174 male probands from the San Diego Prospective Study at baseline (T1), and measures of MAXDRINK, PEER, and drinking to cope (COPE) were collected at the 15‐year (T15), T20, and T25 follow‐ups.

Results:  A low LR to alcohol at T1 predicted higher levels of MAXDRINK and COPE at T15, consistent with prior studies. Using latent growth curve models, higher levels of T15 MAXDRINK predicted less decreases in PEER drinking over time. Additional analyses found a time‐specific effect of T20 COPE on T25 MAXDRINK even after accounting for the growth factors of both domains.

Conclusion:  These evaluations illustrate that LR prospectively predicted relevant outcomes, and clarify how alcohol‐related domains related to each other as the probands progressed through middle adulthood. Treatment implications are discussed and drinking to cope may be an important intervention target for problematic alcohol use.
Gender Differences in Time Use Among Adolescents in Developing Countries: Implications of Rising School Enrollment Rates
Authors: Lloyd Cynthia B. , Grant Monica , Ritchie Amanda
Published: February 2008

This comparative analysis of gender differences in time use among adolescents uses surveys from five developing countries and is motivated by an interest in gender role socialization and gendered patterns of behavior during adolescence. Exploring differences in work (both noneconomic household work and labor market work) and leisure time among adolescents according to school enrollment status, we examine the implications of school enrollment for adolescent development. Consistent differences in time use patterns exist between students and nonstudents across a range of settings. Students spend many fewer hours than nonstudents in work activities and the type of work they do is primarily domestic. Although females carry a heavier workload and enjoy less leisure time than males during their adolescent years regardless of enrollment status, the distribution of their time and the types of activities they participate in are much more similar to their male peers when they are students.
Light and Heavy Heterosexual Activities of Young Canadian Adolescents: Normative Patterns and Differential Predictors
Authors: Williams Trish , Connolly Jennifer , Cribbie Robert
Published: February 2008

The objectives of this research were to explore patterns of heterosexual activity in early adolescence and to examine the differential pathways to light and heavy heterosexuality. We utilized the National Longitudinal Survey of Canadian Children and Youth (NLSCY) in which heterosexual behaviors, as well as puberty, parenting processes, peer self‐concept, and problem behaviors were examined. The heterosexual activities of the majority of 12‐ and 13‐year‐old adolescents were largely confined to light activities of hugging, holding hands, and kissing. Heavy activities such as petting and sexual intercourse were reported less often. Using predictor variables from Cycle 1 of the NLSCY when participants were 10‐ and 11‐year‐olds, SEM analyses indicated that puberty and higher peer self‐concept shared significant direct pathways to both light and heavy heterosexuality. Heavy sexual activity, however, was uniquely associated with the risk factors of adolescent problem behaviors. Positive and hostile parenting styles were indirectly associated with light sexual activity through peer self‐concept. Positive and hostile parenting styles were also indirectly associated with heavy sexual activity through both peer‐oriented self‐concept and problem behaviors. Results support differential patterns and predictors of light and heavy sexuality in early adolescence.
Modified Hygienic Epitec System Abutment for Magnetic Retention of Orbital Prostheses
Authors: Yoshida Kazuya , Takagi Akira , Tsuboi Yoichi , Bessho Kazuhisa
Published: February 2008

Maintenance of healthy periimplant soft tissue is a significant problem for orbital prosthesis wearers. Two female patients with orbital defects after malignant tumor resection were treated using custom‐made retentive components of an individual magnet for an Epitec System orbital prosthesis. Freestanding hygienic retentive components for an individual magnet were fabricated. An abutment replica was trimmed and modified, and using pattern resin, a magnetic keeper was cast and soldered to the abutment. The patients could maintain good hygiene and healthy periimplant soft tissue. This type of freestanding retentive component may be advantageous for the hygiene maintenance of periimplant soft tissue.
Chivalry and the Moderating Effect of Ambivalent Sexism: Individual Differences in Crime Seriousness Judgments
Authors: Herzog Sergio , Oreg Shaul
Published: February 2008

Previous studies have shown that female offenders frequently receive more lenient judgments than equivalent males. Chivalry theories argue that such leniency is the result of paternalistic, benevolent attitudes toward women, in particular toward those who fulfill stereotypical female roles. Yet to date, studies have not examined whether such leniency is indeed associated with paternalistic societal attitudes toward women. The present study goes beyond the investigation of demographics and employs Glick and Fiske's (1996) concepts of hostile and benevolent sexism. We use these concepts to highlight the role of individual differences in attitudes toward women as a key to our understanding of lenient attitudes toward female offenders. Eight hundred forty respondents from a national sample of Israeli residents evaluated the seriousness of hypothetical crime scenarios with (traditional and nontraditional) female and male offenders. As hypothesized, hostile and benevolent sexism moderate the effect of women's “traditionality” on respondents' crime seriousness judgments and on the severity of sentences assigned.
Effect of Ischemia on Implantable Defibrillator Intracardiac Shock Electrograms
Authors: WILLIAMS JEFFREY L. , STUART MENDENHALL G. , SABA SAMIR
Published: February 2008

Introduction: Few attempts have been made to extract information from the ventricular electrogram (EGM) recorded by implantable cardioverter defibrillators (ICD) aside from the discrimination of supraventricular tachycardia and ventricular tachycardia. The current study aims to examine the effect of ischemia in the major coronary artery distributions on the shock EGM from ICDs.

Methods: Domestic crossbred pigs (n = 10, 20–40 kg) were implanted with a dual‐coil right ventricular defibrillation system. Through the femoral approach, percutaneous balloon occlusion of the major coronary arteries was performed. The left anterior descending (LAD), left circumflex (LCx), and right coronary (RCA) arteries were occluded in random order for 3–5 minutes with 30‐minute periods of reperfusion in between and the shock EGMs were recorded and analyzed.

Results: During peak ischemia, R wave amplitude increased by a mean of 204.3% (P = 0.003), increased by a mean of 73.8% (P = 0.0009), and decreased by a mean of 28.0% (P = 0.109) in the LAD, LCx, and RCA territories, respectively. During peak ischemia ST segments elevated by a mean of 105.3% (P = 0.041), elevated by a mean of 114.9% (P = 0.064), and decreased by a mean of 584.5% (P = 0.006) in the LAD, LCx, and RCA territories, respectively.

Conclusions: Ischemia affects ICD shock EGMs in a manner that appears to vary depending on the culprit vessel. Our data demonstrate the feasibility of ischemia detection from ICD shock EGMs.
Diagnostic Accuracy of Arterial Phase 64‐Slice Multidetector CT Angiography for Left Atrial Appendage Thrombus in Patients Undergoing Atrial Fibrillation Ablation
Authors: GOTTLIEB ILAN , PINHEIRO AURÉLIO , BRINKER JEFF A. , CORRETTI MARY C. , MAYER SUSAN A. , BLUEMKE DAVID A. , LIMA JOAO A.C. , MARINE JOSEPH E. , BERGER RONALD D. , CALKINS HUGH , ABRAHAM THEODORE P. , HENRIKSON CHARLES A.
Published: February 2008

Introduction: Multidetector CT (MDCT) is used prior to atrial fibrillation ablation (AFA) to anatomically guide ablation procedures. Whether 64‐slice MDCT also can be used to diagnose left atrial thrombus is not known.

Methods: We sought to determine the accuracy and interobserver variability of MDCT in the evaluation of left atrial thrombus prior to AFA. We enrolled 50 patients scheduled for AFA who underwent 64‐slice MDCT scan and transesophageal echocardiography prior to the procedure. Three experienced observers reviewed all the MDCT images for the presence of a left atrial thrombus, and two different readers interpreted the transesophageal echocardiograms (TEE), which were used as the gold standard. All observers were blinded to clinical data and each other.

Results: Interobserver variability between the three MDCT readers was poor (highest kappa statistic 0.43, P = 0.001). Diagnostic accuracy was highly variable, with sensitivities ranging from 100% to 50% and specificities ranging from 85% to 44%. TEE reader agreement was 98%.

Conclusion: MDCT demonstrates high interobserver variability and has only modest diagnostic accuracy for the detection of left atrial thrombus in patients undergoing AFA procedure. Potential factors affecting the accuracy of MDCT include image quality and the difficulty of distinguishing clot from pectinate muscle. MDCT likely is not the optimal method to detect left atrial thrombus using current techniques and standards of interpretation.
Complications Associated with Generator Replacement in Response to Device Advisories
Authors: COSTEA ALEXANDRU , RARDON DAVID P. , PADANILAM BENZY J. , FOGEL RICHARD I. , PRYSTOWSKY ERIC N.
Published: February 2008

Introduction: Device recalls create problems for patients and physicians, for the risks associated with replacement may be greater than the device failure rate. In 2005, Medtronic, Guidant, and St. Jude had implantable cardioverter defibrillator (ICD) recalls on several of their devices. There were no national standards to guide physicians on the management of such patients. We report the reasons for and outcomes of ICD and pacemaker generator changes from our practice resulting from these advisories.

Methods and Results: After an advisory was issued, the patients with an affected device were contacted, evaluated in the office by one of the electrophysiologists in our group, and a management plan was determined. Two hundred and twenty‐two of 1,039 (Medtronic 273, Guidant 766) (21.4%) patients with advisory devices underwent device replacement. Nine minor complications occurred: hematoma managed conservatively (n = 6); local discomfort (n = 1); and incisional infections treated successfully with oral antibiotics (n = 2). Major complications occurred in nine patients (4.1%). Four atrial leads were damaged, two of which were repaired, one during the same procedure and the other at a later date. One patient required a reoperation to tighten a loose ventricular lead set screw. Hematoma requiring evacuation occurred in one patient, and pocket revision was necessary in two patients secondary to severe discomfort due to the positioning of the device in the pocket. One patient had a cerebrovascular accident preoperatively. There were no perioperative deaths or infections requiring system removal.

Conclusion: Even with experienced operators complications can occur when replacing generators for a device recall. Careful risk assessment for each individual patient should be performed and efforts made to minimize generator changes.
GOLDART—Gold Alloy Versus Platinum–Iridium Electrode for Ablation of AVNRT
Authors: STÜHLINGER MARKUS , STEINWENDER CLEMENS , SCHNÖLL FELIX , WINTER SIEGMUND , FREIHOFF FRITZ , WURTZ SABINE , HINTRINGER FLORIAN
Published: February 2008

Introduction: Radiofrequency (RF) catheter ablation targeting the slow pathway is currently the most effective treatment for patients with atrioventricular nodal reciprocating tachycardia (AVNRT). Gold exhibits a more than four times greater thermal conductivity than platinum, and the creation of deeper lesions was demonstrated in ex vivo animal experiments. The current clinical trial was initiated to compare gold catheters with standard platinum–iridium (Pt–Ir) material and to analyze differences in the increase of power or temperature as a function of time during RF ablation.

Methods: A prospective, randomized multicenter study design was used to compare RF deliveries at the slow pathway with standard Pt–Ir tip catheters (128 patients), as well as gold alloy tip electrodes (124 patients) during AVNRT ablation.

Results: Although there was a trend towards higher power delivery in the gold group (4.96 vs. 4.28 W/s), this trend was not statistically significant. Likewise, cumulative duration of all RF ablations, total procedure time, and power delivered at other time points were not significantly different between the groups. Also, the occurrence of AV‐block and sensations of pain were similar in both treatment groups. However, charring on the catheter tip after the intervention was observed eightfold more frequently in the Pt–Ir group.

Conclusion: In conclusion, power delivery cannot be significantly increased by RF ablation of AVNRT with gold electrodes. But the electrode material seems to be safe and well‐tolerated and specifically did not increase the risk of AV‐block. The significant reduction of coagulum formation on gold tips suggests a possible advantage of this material beyond its better conduction properties.
Nurses' Perceptions of Research Utilization in a Corporate Health Care System
Authors: McCloskey Donna Jo
Published: February 2008

Purpose

: To explore selected characteristics of nurses based upon educational level (masters, baccalaureate, associate degree/diploma), years of experience, and hospital position (management, advanced practice, staff nurse) that might affect perceived availability of research resources, attitude towards research, support, and research use in practice.

Design

: A descriptive nonexperimental mailed survey design was used for this study.

Methods

: Nurses in five hospitals within a corporate hospital system were surveyed using the Research Utilization Questionnaire (RUQ). The RUQ was used to measure nurses' perceptions of research utilization in the four dimensions of perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities.

Findings

: ANOVA was used to analyze the data. Statistically significant differences (p<.001) were found in the perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities based on educational level and organizational position. No significant differences were found in the perception of nurses based on years of experience.

Conclusions

: The results of this study have implications for staff nurses, administrators, advanced practice nurses, and educators working in hospital systems. The different perceptions based upon educational level and hospital position can be integrated and used at all levels of nursing practice to promote research utilization and evidence‐based practice initiatives within the organizational structure.

Clinical Implications

: The results of this study have nursing implications within administration and for nursing practice. The different perceptions that were found based upon educational level and hospital position can be positively integrated and used by administrators and by nurses all levels of nursing practice to promote research utilization and evidence based practice initiatives within the organizational structure.
Composition‐Size Effects in Nickel–Zinc Ferrite Nanoparticles Prepared by Aqueous Coprecipitation
Authors: Naughton Brian T. , Clarke David R.
Published: February 2008

Nickel–zinc ferrite nanoparticles across the solid solution range, Ni1−xZnxFe2O4, from nickel ferrite to zinc ferrite were prepared by aqueous precipitation of mixed nitrate solutions at the same pH of 12.3. There is a linear relationship between the nanoparticle diameter and composition, decreasing with increasing zinc concentration across the solid solution. The nanoparticles are highly resistant to coarsening and some of them are faceted, suggesting that they are close to thermodynamic equilibrium. Measurements of the surface charge density of the nanoparticles, based on simultaneous conductimetric and potentiometeric titration, are presented as a function of composition for the zinc‐rich compositions. A trend exists between the surface charge density and the zinc concentration, suggesting that they may be stabilized by charge.
Properties of Calcined Clay Waste and its Influence on Blended Cement Behavior
Authors: Frías Moisés , Rodríguez Olga , Vegas Iñigo , Vigil Raquel
Published: February 2008

This paper describes research on clay wastes (CWs) produced in the paper manufacture process. Once activated under controlled thermal conditions, CW is transformed into calcined clay products providing added value as supplementary cementing materials. The obtention of a pozzolanic material (metakaolin (MK)) from valorized CW constitutes an alternative source of pozzolans for the elaboration of blended Portland cements, as well as a priority research line from the environmental point of view. This research work presents the properties of calcined CW (chemical, mineralogical, and pozzolanic) and its influence on Portland cements containing 10% calcined clay product. The results obtained with different characterization techniques (XRF, DTA, XRD, SEM‐EDX) showed that the thermally activated CW exhibits acceptable properties to be used as supplementary cementing materials in the manufacture of commercial Portland cements. The derived MK can react with calcium hydroxide, from cement hydration, producing hydrated phases with hydraulic properties (calcium silicate hydrate gels, tobermorite, C4AH13, zeolite). These novel blended cements comply with the chemical, physical, and mechanical specifications established in the existing standards.
Healing Following Cranial Trauma*
Authors: Barbian Lenore T. , Sledzik Paul S.
Published: February 2008

Abstract:  This paper reports on the gross appearance of the initial osseous response following cranial gunshot wounds. A total of 127 adult crania and cranial sections were analyzed for four types of bone response: osteoblastic, osteoclastic, line of demarcation, and sequestration. In general, no osteoblastic or osteoclastic response was noted during the first week. This response was followed by an increasing prevalence of expression after this time. By the sixth week postfracture both osteoclastic and osteoblastic activity was scored for 100% of the sample. Further, our observations suggest that the line of demarcation may establish the boundary between the living bone and bone not surviving the fracture. Sequestration appears to be a long‐term event and was scored as present well past the eighth week of healing. The osseous expression of infection following fracture was also considered.