bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpersonal and social network influences on gay men's communication about unprotected sex
Authors: Smith Anthony M A , Grierson Jeffrey , Wain David , Pitts Marian , Pattison Phillipa
Published: March 2006

This study documents gay men's communication patterns about unprotected sex. Gay men ( n = 206) completed a structured interview about their social networks. The 167 men who had had unprotected sex identified 1390 social relations; 32.6% had involved discussing an episode of unprotected sex. Discussions about unprotected sex were associated with the nature of the relationship, whether the other party was gay or lesbian, how often the parties spent time together, whether the relationship had been sexual, and the density of the other parties' social network. Social networks provide an important context for the maintenance of safe sex cultures.
Persistent genital arousal in women – a new syndrome entity
Authors: Goldmeier David , Leiblum Sandra R
Published: March 2006

The persistent sexual arousal syndrome (PSAS) is a newly described entity where women become involuntarily aroused genitally for extended periods in time in the absence of sexual desire. Genital vasoengorgement and oedema have been observed. These women are found to be usually very distressed. The cause of the syndrome in the majority of cases is unknown, although a number of women report symptoms after withdrawal from selective serotonin reuptake inhibitors (SSRI) antidepressants. There is no specific therapy at present, although electroconvulsive therapy (ECT) has resulted in clinical improvement in cases where there was concomitant severe depression.
Cohort analysis of two multidisciplined adherence intervention programmes for patients on antiretroviral therapy
Authors: Doxanakis A , Read T , Levy R , Mijch A , Fairley C K
Published: March 2006

The aim was to analyse data from two randomized controlled trials (RCTs) to determine if an adherence intervention programme for antiretroviral therapy (ART) resulted in a reduction in viral load. A cohort analysis of pre- and post-intervention viral loads and CD4 counts using paired analysis was undertaken on participants who received the intervention programme. Analysis was also undertaken on a control group. The intervention participants had an increase in mean CD4 count (450–478, P = 0.26), and a decline in log viral load (2.48–2.36, P = 0.056). The control group had a decline in mean CD4 counts (596–570, P = 0.53), and an increase in log viral load (2.09–2.11, P = 0.78). The use of an adherence intervention programme is associated with a decrease in mean viral load, which is in contrast to the control group that demonstrated an increase in viral load over time.
Lactobacillus acidophilus bacteraemia after use of a probiotic in a patient with AIDS and Hodgkin's disease
Authors: LeDoux David , LaBombardi Vincent J , Karter Dennis
Published: March 2006

We report the case of a patient who developed bacteraemia and septic pulmonary emboli with Lactobacillus acidophilus after taking a probiotic containing this organism.
Does size matter? The relationship between volume and outcome in the care of major trauma
Authors: Freeman Jenny , Nicholl Jon , Turner Janette
Published: March 2006

Objectives: To investigate the relationship between case volume and outcome for major trauma patients.

Methods: Prospective follow-up study of all major trauma patients (with injury severity score >15) arriving alive, with no invariably fatal injury, at 14 English emergency departments between 1990 and 1993. Using the stratified W statistic, an age and severity adjusted measure of outcome, the relationship between volume of cases and outcome was initially examined using the Spearman correlation coefficient. Multiple regression analysis was used to explore further the relationship, after adjustment for hospital-level characteristics.

Results: The smallest department saw five major trauma cases each year, the largest saw 96. The results of the initial correlation analyses indicated that there was little evidence that outcome improved with increasing volumes for all major trauma ( ρs = 0.12, 95% confidence interval [CI]: −0.36 to 0.55) nor for the cases presenting out-of-hours ( ρs = 0.30, 95% CI: −0.19 to 0.67). However, there was evidence that patients with multiple injury ( ρs = 0.65, 95% CI: 0.27 to 0.86) and those with severe head injuries ( ρs = 0.52, 95% CI: 0.08 to 0.79) did better in high volume departments. This pattern, of a positive relationship for more complex cases was also in evidence from the results of the multiple regression analyses and, in particular, for patients with multiple injuries, was stable over time.

Conclusions: While there was little evidence that all patients with major trauma do better in higher volume departments, there was evidence that patients with complex needs, such as the multiple injured or those with head injuries, had better outcomes.
Values underlying the National Service Framework for coronary heart disease in England: a discourse analysis
Authors: Rayner Mike , Scarborough Peter , Allender Steven
Published: March 2006

Objectives:The National Service Framework (NSF) for Coronary Heart Disease – published by the English Department of Health in 2000 – sets out how those within the health service should seek to prevent and treat coronary heart disease and care for people with the disease. Its prescriptions are partly based on what is known about coronary heart disease and partly on its underlying 'values'. This paper seeks to identify those values.

Methods:An analysis of the discourses within the text of the NSF based on critical discourse analysis.

Results: Three different discourses can be identified: the managerial, the clinical and the political. The managerial discourse is dominant. Each discourse has its own values. The main 'aspirational' values within the NSF are effciency, effectiveness, autonomy (choice), universalism and equity. Some aspirational values – particularly equity – appear to be largely rhetorical and lead to few recommendations or prescriptions. Some values that might have been expected to underlie the framework, such as compassion and democracy, are largely absent.

Conclusions: Discourse analysis provides a more systematic and transparent method of describing the values behind health care policy than the methods that have been used previously.
Leakage of Octyl(Phenyl)-N,N-Di-Isobutylcarbamoylmethylphosphine Oxide from a Macroporous Silica-Based Chelating Polymeric Adsorption Material and its Recovery by Some Selected Porous Adsorbents
Authors: Zhang Anyun , Wei Yuezhou , Hoshi Harutaka , Kumagai Mikio , Koma Yoshikazu
Published: March 2006

The leakage behaviour of a neutral chelating agent, i.e. octyl(phenyl)- N,N-di-isobutylcarbamoylmethylphosphine oxide (CMPO), from its macroporous silica-based (CMPO/SiO2-P) extraction resin (a novel polymeric adsorption material developed in the MAREC process) and the recovery of CMPO by some selected polymer- and silica-based porous adsorbents were investigated by column operation in 0.01 M HNO3 at 25°C or 50°C. The concentration of CMPO in the effluent leaking from CMPO/SiO2-P was determined as ca. 48 ppm at 25°C and ca. 37 ppm at 50°C. The corresponding elution volumes and the amounts of CMPO leaking were 8700.9 BV/g and 239.3 mg/g at 25°C and 11 842.9 BV/g and 359.4 mg/g at 50°C, respectively. The adsorption experiment showed that a polymer-based porous material, SEPABEADS® SP-825, was capable of recovering CMPO effectively from 0.01 M HNO3. Its adsorption ability towards CMPO was considerably greater than those of macroporous silica-based SiO2-P particles, polymer-based Amberlite™ XAD-7 and activated carbon. The bed volume and the amount of CMPO adsorbed by SEPABEADS® SP-825 at the breakthrough point at 25°C were 13 549.2 BV/g and 498.7 mg/g, respectively, thereby demonstrating that SEPABEADS® SP-825 was promising for the recovery of CMPO from Am(III)- and Cm(III)-containing solutions in the MAREC process.
Competitive and Cooperative Adsorption of Aromatic Acids and Bases onto a New Aminated Macroreticular Adsorbent
Authors: Zhang Wei-Ming , Chen Jin-Long , Pan Bing-Cai , Zhang Quan-Xing
Published: March 2006

The adsorption behaviour of three aromatic acids [phenol, benzoic acid (BCA) and 2-naphthalene sulphonic acid (2-NSA)] and of one aromatic base (aniline) on an aminated macroreticular adsorbent (NDA103) were investigated employing single or binary batch systems at 293 K and 313 K, respectively. All the adsorption isotherms in the studied systems could be adequately fitted by the Langmuir model, thereby indicating the existence of an exothermic adsorption process for phenol, BCA and aniline. At low equilibrium concentrations, the individual uptakes in the single-component systems were higher than those in binary-component systems because of competition between the two types of adsorbate molecules towards the adsorption sites. On the other hand, it is noteworthy that the total molar uptakes of adsorbates in the binary-component systems at high equilibrium concentrations were larger than the uptakes in the single-component systems. In binary-component systems, a large excess of aromatic acids was noted on the adsorbent surface at saturation, presumably as a result of a cooperative effect arising primarily from acid–base interaction between the loaded adsorbates.
Comparison of the Properties of Vegetable Oil/Water and n-Tetradecane/Water Emulsions Stabilized by α-Lactalbumin or β-Casein
Authors: Wiącek Agnieszka Ewa , Chibowski Emil
Published: March 2006

The properties of a refined vegetable oil (a mixture of rape and sunflower oils) and of n-tetradecane emulsions in the presence of proteins, i.e. α-lactalbumin and β-casein, were investigated. These proteins differ in their surface affinity, size and structure, and were therefore expected to show some differences in adsorption at the oil droplet/water interface. The oil samples (0.5–5.0 ml in 100 ml water) were emulsified mechanically in the presence of 1.0–5.0 mg of the protein.

The stability of the emulsions was investigated via the effective diameter and multimodal size distribution of the droplets using the dynamic light-scattering technique. In addition, the zeta potentials of the emulsions were measured and found to be negative and in the range −5 mV to −20 mV in all systems.

Multimodal size distribution analysis showed that soon after preparation the emulsions were quite well monodispersed. In general, α-lactalbumin appeared to be a good or even better emulsifier than β-casein for both kinds of emulsion (vegetable oil and n-tetradecane in water). Moreover, it appeared that for stability of these emulsions, the optimal ratio of oil and protein content was very important.
Solar Cycles 24 and 25 and Predicted Climate Response
Authors: Archibald David C.
Published: March 2006

Projections of weak solar maxima for solar cycles 24 and 25 are correlated with the terrestrial climate response to solar cycles over the last three hundred years, derived from a review of the literature. Based on solar maxima of approximately 50 for solar cycles 24 and 25, a global temperature decline of 1.5°C is predicted to 2020, equating to the experience of the Dalton Minimum. To provide a baseline for projecting temperature to the projected maximum of solar cycle 25, data from five rural, continental US stations with data from 1905 to 2003 was averaged and smoothed. The profile indicates that temperatures remain below the average over the first half of the twentieth century.
Observed Climate Change in Australia over the past Century
Authors: Nicholls Neville , Collins Dean
Published: March 2006

Temperatures across nearly all of Australia increased through the 20th century, as did sea surface temperatures in the surrounding oceans. It seems likely that much of the warming is due to increased atmospheric concentrations of greenhouse gases. Rainfall trends have been less spatially consistent than the temperature trends with areas of increase (especially in the northwest) and areas of decrease (especially in the southwest). There is some evidence suggesting that some of the rainfall trends are the result of human influences, but this evidence is less convincing than is the case with the increases in temperature.
Recent Development of Concrete Block Masonry in Mainland China
Authors: Tang Dai-Xing , Ding Da-Jun
Published: March 2006

This article introduces some recent developments in Mainland China in concrete small hollow block masonry, including experimental studies of concrete block masonry conducted for the China Design Code GB50003–2001 and related practical tall building engineering examples.
Optimal Stiffness Distribution of Steel Moment Frames under Extreme Earthquake Loading
Authors: Gong Yanglin
Published: March 2006

The paper presents a design optimization method for steel moment frames under extreme earthquake loading. Seismic demands of the structures are evaluated using a nonlinear pushover analysis procedure. Least structural weight is taken explicitly as one design objective. The other objective, pursuing uniform ductility demands in all stories, is realized indirectly by imposing an equal limit to the plastic interstory drift ratio of each story. Explicit forms of the objective function and constraints in terms of member sizing variables are formulated to enable computer solution for the optimization model. The proposed design formulation seeks a least-weight design with an optimal lateral stiffness distribution for steel moment frames. The concepts are illustrated for a three-story moment frame example.
Modernising dental careers: a personal perspective
Authors: Franklin Chris
Published: March 2006

Many of you will know that Modernising Medical Careers (MMC) is well under way. The Postgraduate Medical Education and Training Board (PMETB) is also well established and is changing the way postgraduate medical training is run and assessed. PMETB guidance is already having an influence on dental training at deanery level. The GDC has approved the specialist list review and some of the recommendations mirror those of PMETB.
Renewing old links
Authors: Ribeiro Bernard
Published: March 2006

The old FRCS examination proved a magnet for many overseas doctors wishing to obtain an internationally renowned qualification in surgery. Many were successful in acquiring the primary FRCS in their own countries and so many of our College examiners forged links with surgeons in Accra, Cairo and Baghdad. These links proved invaluable and made it possible to assist some overseas trainees to experience training in the UK through the offices of the overseas doctors training scheme (ODTS). Professor Peter Bevan and Professor Jerry Kirk, past Council members, were closely involved with ODTS and, with the support of Sir Ian Todd (past president 1986–1989) and Sir David Innes Williams, they developed the first basic surgical skills course for Africa.
Politico-moral Transactions in Indian AIDS Service: Confidentiality, Rights and New Modalities of Governance
Authors: Misra Kavita
Published: March 2006

This article examines the rise of non-governmental AIDS service in India as a space of cultural politics and of possibilities for social transformation. Drawing on ethnographic material from an AIDS service NGO in an urban North Indian setting, and the network of organizations that it is part of, the article describes the emergence of a transnationally mobile community of AIDS experts, their relationship to the non-governmental and the state and the circulation of ideas and practices between the global and the local. It focuses on the politico-moral transactions around confidentiality and embedded within it, the discourse of rights to show how they reflect changing configurations of governance and citizenship, and redefinitions of health.
Anti-Aging Medicine: Predictions, Moral Obligations, and Biomedical Intervention
Authors: Mykytyn Courtney Everts
Published: March 2006

The emergence and proliferation of anti-aging medicine since the 1990s situates the process of aging—rather than "age-associated" disease—as a target for biomedical intervention. Bypassing the notion of disease entirely, anti-aging proponents argue that biological aging is the problem. The shift tendered by anti-aging proponents proceeds largely upon predictions for the future. A compelling prediction must have built into it a sense of feasibility and a sense of moral purpose. Feasibility is principally predicated upon a particular history and a map for the endeavors' imagined success. The notion that aging is painful and costly both for the individual and for society links with the powerful ethic of scientific progress to ground anti-aging predictions in the here and now of scientific funding, research and practice. Imagining this kind of future demands, in this sense, its pursuit. And its pursuit then refashions our relationship to our past by reifying the particular history in which it is embedded.
"Neither of meate nor drinke, but what the Doctor alloweth": Medicine amidst War and Commerce in Eighteenth-Century Madras
Authors: Chakrabarti Pratik
Published: March 2006

Madras in the eighteenth century was a site of continuous warfare sparked mostly by trading interests. This paper studies how these influences of hostility and commerce shaped the medical establishment of the English East India Company. It begins by analyzing the struggle of the medical establishment to cope with military and logistical requirements; it then shows how the Coromandel trade provided a peculiar dynamic to the practice of medicine in Madras. By aligning the history of medicine with that of trade, the paper traces the parallel trajectories of intellectual and material wealth. The development of modern medicine is seen as a process of adjusting to and engaging with diverse ideas and items—sometimes co-opting them, sometimes realigning them in new modes of production.
Patterns of Medical Culture in Colonial Bengal, 1835-1880
Authors: Hochmuth Christian
Published: March 2006

Scholars of colonial medicine have not paid sufficient attention to the role of indigenous practitioners educated in scientific medicine. This paper examines the context of education in scientific medicine through a number of medical texts written by indigenous authors; it also analyzes the in-patient and out-patient work of indigenous practitioners in government dispensaries by means of yearly dispensary reports, a resource that has hitherto not been researched systematically. Such an analysis offers valuable insights into the way that scientific medicine was accommodated by the local environment, and was combined with principles of indigenous medicine.
Taking Biology Seriously: The Next Task for Historians of Addiction?
Authors: Kushner Howard I
Published: March 2006

Despite more than a century of attempts to control the use of addictive substances, prevalence rates continue to grow for most of them. Exceptions are alcohol and tobacco use, which, nevertheless, remain major public health concerns. Why have these attempts at drug control had little success? This question is addressed in the histories of substance use that are examined in this essay. While these studies show that there are multiple histories, definitions, and frames of addiction that have shifted over time, some broad themes emerge. Foremost is the argument that the classification of a substance as licit or illicit has had more to do with cultural values than with the substance itself. Historians, skeptical of essentialist categories, have questioned whether addictions are diseases and the wisdom of selectively criminalizing drug use. They argue that the socioeconomic status of users has influenced attitudes toward addicts and the legal classifications of substances.
Trauma Surgery and Traffic Policy in Germany in the 1930s: A Case Study in the Coevolution of Modern Surgery and Society
Authors: Schlich Thomas
Published: March 2006

This paper analyzes how in Germany in the first half of the twentieth century the development of surgery and modern automobile traffic were intertwined. It describes the mutual influence of traffic policy and trauma surgery under the conditions of National Socialist politics of modernization. This coevolutionary development provides an example of how the rise of much of modern surgery can be better understood by taking into account other, nonmedical developments in society.
On Cannabis, Chloral Hydrate, and Career Cycles of Psychotrophic Drugs in Medicine
Authors: Snelders Stephen , Kaplan Charles , Pieters Toine
Published: March 2006

This article compares the careers of two psychotropic drugs in Western psychiatry, with a focus on the nineteenth century: Cannabis indica and chloral hydrate. They were used by doctors for similar indications, such as mania, delirium tremens, and what we would now call drug dependence. The two show similar career paths consisting of three phases: initial enthusiasm and therapeutic optimism; subsequent negative appraisal; and finally, limited use. These cycles, which we term "Seige cycles," are generally typical of the careers of psychotropic drugs in modern medicine. However, differences in the careers of both drugs are also established. The phases of chloral show relatively higher peaks and lower valleys than those of cannabis. Chloral is the first typically "modern" psychotropic drug; a synthetic, it was introduced in 1869 at a time of growing asylum populations, pharmaceutical interests, and high cultural expectations of scientific medicine. Cannabis indica, introduced in the 1840s, is typically a "premodern" drug steeped in the climate of cultural Romanticism. We conclude that the analytical concept of the Seige cycle is a useful tool for future research into drug careers in medicine.
Number Agreement in British and American English: Disagreeing to Agree Collectively
Authors: Bock Kathryn , Butterfield Sally , Cutler Anne , Cutting J. Cooper , Eberhard Kathleen M , Humphreys Karin R
Published: March 2006

British andAmerican speakers exhibit different verb number agreement patterns when sentence subjects have collective headnouns. From linguistic andpsycholinguistic accounts of how agreement is implemented, three alternative hypotheses can be derived to explain these differences. The hypotheses involve variations in the representation of notional number, disparities in how notional andgrammatical number are used, and inequalities in the grammatical number specifications of collective nouns. We carriedout a series of corpus analyses, production experiments, andnorming studies to test these hypotheses. The results converge to suggest that British and American speakers are equally sensitive to variations in notional number andimplement subjectverb agreement in much the same way, but are likely to differ in the lexical specifications of number for collectives. The findings support a psycholinguistic theory that explains verb and pronoun agreement within a parallel architecture of lexical andsyntactic formulation.
Revisiting Anaphoric Islands
Authors: Harris Alice C
Published: March 2006

Postal (1969) discusses words as anaphoric islands. So-called OUTBOUND ANAPHORA was further discussed in a series of papers published in the 1970s through the early 1990s, but INBOUND ANAPHORA, such as Postal's *himite (beside McCarthyite), has received less attention. It is shown here that a wide variety of words in Georgian are based on pronouns, including fully referential personal pronouns, reflexive pronouns, question words, quantifiers, and negative pronouns. Thus, the nonoccuring combinations of English are a language-particular problem.
Enhancement and Overlap in the Speech Chain
Authors: Keyser Samuel Jay , Stevens Kenneth N.
Published: March 2006

A model of speech production is proposed in which the input is a planning stage at which lexical items are arrayed, accompanied by the full panoply of phonological representations from distinctive features to their attendant tree structures. A set of instructions for control of the vocal tract is calculated leading to a sound output. Two parallel processes are involved in the calculation of these instructions, both of which replace the planning-stage representation by the appropriate motoric instructions. One of these processes is universal and involves replacing each distinctive feature with an appropriate set of motoric instructions, either unmodified or modified by the process of overlap. We postulate a parallel language-specific process that is sensitive to those features in danger of losing their perceptual saliency as a consequence of the environment in which they appear. This process, referred to as ENHANCEMENT, adds additional motoric instructions to enhance the saliency of the jeopardized features. We provide a number of examples to illustrate how enhancement works. We conclude from these examples that whereas defining gestures related to distinctive features are, in many instances, weakened or even absented from the speech stream, enhancement gestures, once added to the set of motoric instructions, appear never to be subject to obliteration by overlap.
The Grammar of Accusative Case in Kannada
Authors: Lidz Jeffrey
Published: March 2006

This article examines the distribution of accusative case morphology in Kannada, detailing the syntactic, semantic, and morphological factors that contribute to its occurrence. Accusative case morphology is optional on inanimate direct objects. When optional, its presence indicates a specific reading, which I argue is best modeled as a choice function. The specific readings due to morphological formare distinct fromspecific readings that arise fromsyntactic position. Positional specificity is detectable only on morphologically noncasemarked object NPs. When the accusative case morpheme is obligatory, specificity effects are positional and not due to the presence of the morpheme. In this situation, additional morphology is required to achieve an inherently specific interpretation, suggesting a separation between morphological signals and meaning
Artaud, Germ Theory, and the Theatre of Contagion
Authors: Garner Stanton B.
Published: March 2006

This article explores the influence of Pasteurian germ theory on Antonin Artaud's concept of theatre as plague. Drawn to the corporeal focus of germ theory while resisting its medicalized discourse, Artaud's theatre of cruelty tropes the Pasteurian body, refigures its structures of time and space, and imposes an ecstatic performativity on its narrowly microbial understanding of contagion. In so doing, Artaud points to a broader epidemiological modernity in which scientific and cultural notions of contagious disease propose new and often contending ways of theorizing individual and collective bodies.
Figuring the "Spells" / Spelling the Figures: Suzan-Lori Parks's "Scene of Love (?)"
Authors: Johung Jennifer
Published: March 2006

Suzan-Lori Parks's full scene of "spells," from her play Venus, demands a visual-verbal interpretation that exceeds the standards of dramatic writing in their relation to conventional theatrical practice. Identifying certain terms and concepts that are capable of operating simultaneously within and across verbal, visual, and spatial vocabularies, this essay reconsiders Parks's seemingly unspecific notational marks as index, supplement, and score in order to expand the determination of textual marks and their relationship to spatial and bodily performance, and thus proposes new interpretative frameworks that coincide with the alternate material conditions of the specifically raced bodies that ultimately embody these marks.
Stories from under Occupation: Performing the Palestinian Experience
Authors: Nassar Hala Khamis
Published: March 2006

A plethora of research has been done on the Palestinian-Israeli conflict; however, few have ventured to investigate and theorize its subjects or the articulation of Palestinian culture. Theatre and drama in the Arab world are under-researched, and when cultural production is studied, Palestinian theatre is nowhere mentioned. The history of Palestinian theatre dates back to 1850 when it was in tune with the neighboring cultural centers of the Arab world, i.e. Beirut and Cairo. Occupation since 1967 has had a great impact on Palestinian theatre, which has become a vehicle for asserting Palestinian identity and collective memory in the face of cultural annihilation. Through the use of al-Hakawati (the traditional storyteller) combined with narratives of memories, current theatre aims to portray life in turmoil caused by the political situation and the frustrations of the peace process with Israel.
Rape's Metatheatrical Return: Rehearsing Sexual Violence Among the Early Moderns
Authors: Solga Kim
Published: March 2006

What happens when theatre crosses the line, risks danger in the real? This paper explores the pernicious theatricalization of sexual violence in early modern England, its trouble-making uptake in Shakespeare's Titus Andronicus, and Julie Taymor's contemporary response in her 1999 film version of the play. Along the way the article probes a handful of questions about theatre's social efficacy: what are the consequences of understanding theatre as a potentially malevolent form of public art and expression? How do we account for those moments when theatre poses genuine risk? And, more importantly, how do we build a response to, an ethics of, that risk into our own work as scholars and practitioners?
Metatheatre and Authentication through Metonymic Compression in John Mighton's Possible Worlds
Authors: Stephenson Jenn
Published: March 2006

Self-voiding works of metatheatre pose problems for the authentication of fictional existence under the narrative model of possible worlds semantics. John Mighton's play Possible Worlds shows how the creation of metonymic bridges can break through the barriers between worlds, allowing access to higher-order intelligence and thus to authentication. Authentication through metonymic compression is, however, a double-edged sword which while granting existence to fictional worlds simultaneously destroys those worlds. In Mighton's play, this experience of rebirth in death is reiterated on three levels: by the character of George as he attempts to determine his ontological status, by the detectives investigating his murder, and by the audience engaged with metatheatre.
Belief in the Inevitability of Suicide: Results from a National Survey
Authors: Miller Matthew , Azrael Deborah , Hemenway David
Published: March 2006

To examine public opinion regarding the effectiveness of means restriction as an approach to preventing suicide we asked a national sample of 2,770 respondents a hypothetical question about what effect a suicide barrier might have had on the ultimate fate of the more than 1,000 people who have jumped to their death from the Golden Gate Bridge. Thirty‐four percent of respondents believed that every single jumper would have found another way to complete suicide and an additional 40% believed that “most” would have completed suicide using other means. The strongest predictors of belief in complete substitution were firearm ownership and cigarette smoking. Belief in the inevitability of suicide may be a political impediment to adopting potentially effective suicide prevention efforts.
Social Inequalities in Suicide Mortality: Spain and France, 1980–1982 and 1988–1990
Authors: Lostao Lourdes , Joiner Thomas E. , Lester David , Regidor Enrique , Aïach Pierre , Sandín Bonifacio
Published: March 2006

In this study we analyzed the socioeconomic differences in mortality from suicide in the economically active male population aged 25–64 years in Spain and France in 1980–1982 and 1988–1990; in the case of Spain the data came from the Eight Provinces Study (Regidor, Gutierrez‐Fisac, & Rodríguez, 1995). Individuals were grouped into four categories: professional/managerial, clerical/sales/service, agricultural, and manual workers. For 1980–1982, among those aged 25–44, professionals and managers had the lowest risk of mortality in Spain, and clerical/sales/service workers in France. These socioeconomic differences in mortality increased in 1988–1990. In 1980–1982, among those aged 45–64, clerical/sales/service workers had the lowest risk of mortality from suicide relative to the other occupational groups in both countries, but this difference was not maintained in 1988–1990. Thus, differences in suicide mortality for men by occupational status depended in the present study upon both the nation studied and the time period chosen for study.
Suicidal Ideation and Attitudes Toward Suicide
Authors: Gibb Brandon E. , Andover Margaret S. , Beach Steven R. H.
Published: March 2006

Although hopelessness and depression are known risk factors for suicide, most individuals who are hopeless or depressed never make a suicide attempt. In this study, we tested the hypothesis that college students’ (n = 230) attitudes toward suicide (the degree to which they see it as an acceptable option under some circumstances) would moderate the link between both hopelessness and depressive symptoms and their levels of suicidal ideation. This moderation hypothesis was supported, but only among men. Specifically, among men, levels of hopelessness and depressive symptoms were significantly related to suicidal ideation among only those with relatively positive attitudes toward suicide.
Prevalence of Suicidal Ideation in Patients with Atopic Dermatitis
Authors: Kimata Hajime
Published: March 2006

The prevalence of suicidal ideation in patients with mild, moderate, and severe atopic dermatitis between the age of 15 to 49 years were 0.21%, 6%, and 19.6%, respectively. In addition, the prevalence of homicide‐suicidal ideation in mothers or fathers of patients (aged 0–14 years) with mild, moderate, and severe atopic dermatitis were 0.11%, 0.35%, and 3.28%, respectively. These results indicate that patients with atopic dermatitis or even parents of patients with atopic dermatitis have high prevalence of suicidal ideation.
The Cycle of Schizoaffective Disorder, Cognitive Ability, Alcoholism, and Suicidality
Authors: Goldstein Gerald , Haas Gretchen L. , Pakrashi Manish , Novero Ada M. , Luther James F.
Published: March 2006

In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM‐IV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a history of suicide attempts or suicidal ideation. Discriminant analysis was used to identify cognitive test performance measures that distinguished those with versus those without suicidal behavior. None of the cognitive measures discriminated between the two groups. The rates of suicidal behavior (suicidal ideation and suicide attempts) did not differ between participants with versus those without comorbid alcohol use. An association was found between suicidal behavior and the diagnosis of schizoaffective disorder. It was concluded that the history of prominent mood syndromes characteristic of schizoaffective disorder contributes to increased risk of suicidal behaviors. Cognitive dysfunction and/or alcoholism did not contribute additionally to risk in this study.
Correlates of Suicide Among Home Health Care Utilizers Who Died by Suicide and Community Controls
Authors: Rowe Jennifer L. , Bruce Martha L. , Conwell Yeates
Published: March 2006

Home health care patients often have several late‐life risk factors for suicide and constitute a high risk group for suicidal behaviors. In this study, we examined the characteristics of 14 older adult home health care utilizers who died by suicide and four community controls who used similar services. Both groups of home health care utilizers had multiple health problems and, with one exception, all were functionally impaired. Descriptive comparison suggests that suicide decedents were more likely than their counterparts to suffer from depressed mood, suicidal ideation, prior suicide attempt(s), alcohol dependence, chronic pain, strained family relationships, lack of social support, and financial difficulties. Identifying suicide risk factors that place older adult home health care utilizers at particularly high risk for suicidal behaviors within this population will further help target suicide preventive interventions by home care providers.
Predictors of Suicide Ideation and Depression in Hong Kong Adolescents: Perceptions of Academic and Family Climates
Authors: Lee Margaret T.Y. , Wong Betty P. , Chow Bonnie W.‐Y. , McBride‐Chang Catherine
Published: March 2006

The unique dimensions of perceptions of school and family contributing to depression and suicide ideation in Hong Kong adolescents were examined in two studies. In Study 1, among 327 Hong Kong Chinese female students ages 13–18, 47% reported some suicide ideation. Suicide ideation was significantly associated with depression, test anxiety, academic self‐concept, and adolescents' perceived parental dissatisfaction with academic performance. The correlation between test anxiety and depression was especially high (r = .51). Study 2 examined how three different aspects of perceived family relationship were associated with depression and suicide ideation. Among 371 Hong Kong Chinese adolescents ages 14–20, 52.6% reported suicide ideation. Low levels of family cohesion and support and high levels of parent‐adolescent conflict were positively related to depression and suicide ideation in both genders. Across both studies, depression mediated associations between academic‐ and family‐related variables and suicide ideation. Findings underscore the importance of both academic and family climate in understanding depression and suicide ideation among Chinese adolescents.
Suicide Attempts in Israel: Age by Gender Analysis of a National Emergency Departments Database
Authors: Levinson Daphna , Haklai Ziona , Stein Nechama , Gordon Ethel‐Sherry
Published: March 2006

An analysis of all emergency department admissions in Israel classified as an attempted suicide in the years 1996–2002 was done to examine attempted suicide rates by age and gender with particular attention to adolescents and young adults. Gender differences in attempted suicide rates were significant only during adolescence and young adulthood, ages 13 to 26. The highest rate for females was 3 years earlier than the highest rate for males. The results lead to the conclusion that women do not attempt suicide more than men, except for 13–26 year olds.
Personal and Professional Issues in Private Consulting
Authors: Newell Alan S.
Published: March 2006

Working at a for-profit historical consulting firm can present public historians with unique ethical challenges. The historian may differ politically or philosophically with a client on a specific issue and must decide whether this disagreement prevents him or her from accepting the work. When there are a number of historians involved in the "history business," this problem can be exacerbated and can have profound business consequences. One approach to addressing this situation is to focus on the professional relationship with the prospective client. Assessing whether or not the client respects the professional dictates of history can lead to a satisfactory resolution of any perceived ethical questions involved in the work.
A Shared Inquiry into Shared Inquiry
Authors: Corbett Katharine T. , Miller Howard S. (Dick)
Published: March 2006

Shared inquiry is a key component of reflective public history practice. All good historical practice is reflective, but public history requires a special commitment to collaborate, to respond, to share both inquiry and authority. Because trained practitioners and lay people often seek different pasts for different purposes, public historians may find themselves poised between advocacy and mediation, monitoring and adjusting their own behavior through the process of shared inquiry. Since public history is inherently situational, there is no one-size-fits-all methodology. Drawing on thirty years of shared public history experience, the authors reflect on situations in which they strove to share both inquiry and authority.
Public History Curriculum: Illustrating Reflective Practice
Authors: Stowe Noel J.
Published: March 2006

Public history curricula must prepare students for a reflective approach to public historical practice and introduce students to different models of practice. By teaching reflective practice techniques through concrete components assembled in linked course assignments, internships, and capstone projects, programs educate students to become history practitioners. A distinct, robust body of public historical knowledge and reflective practice constitutes a public history degree. Public history programs, as professionally oriented programs, prepare students in the high-order practice of the discipline, grounded in reflective practice techniques appropriate to applied history.
Harry Miller's Vision of Arkansas, 1900–1910: A Case Study in Sponsored Projects
Authors: Blatti Jo
Published: March 2006

This essay discusses one museum's experience with its first donor-supported exhibit and catalog project. The author explores the roles of donor relations, communications, institutional policies, and issues of "shared authority" in developing the Harry Miller photographic project. The author questions whether a distinctive ethical dimension distinguishes public history. She locates the truly distinctive element as "negotiations of personal and professional ethics in highly public arenas."
Judgments of Value, Judgments of Fact: The Ethical Dimension of Biohistorical Research
Authors: Lewis Russell
Published: March 2006

The public increasingly views DNA testing as an unassailable way to verify the identity of historical figures. The Chicago Historical Society explored the appropriateness of DNA analysis and other forensic scientific methods to authenticate Lincoln assassination-related artifacts in its collection. The study concluded that DNA testing would damage or destroy the artifacts. More importantly, it determined that DNA and other scientific analysis of historical artifacts or historical figures' remains should be done only in the context of an ethical framework. The article discusses the development of ethical guidelines for museums and historians to follow when considering such studies.
Body composition during GH replacement in adults – methodological variations with respect to gender
Authors: Koranyi Josef , Bosaeus Ingvar , Alpsten Magne , Bengtsson Bengt-Åke , Johannsson Gudmundur
Published: March 2006

Objective: Men with growth hormone deficiency (GHD) may be more sensitive to GH treatment than women in terms of changes in body composition. We have studied whether age, body-mass index (BMI) and the different types of methodology used to assess body composition may explain these differences.

Design: Forty-four men and forty-four women with GHD, closely matched for age and BMI, were studied before and after 6 months of GH replacement. The dose of GH was individually adjusted. Body composition was assessed by measurements of potassium-40, total body nitrogen (TBN), tritiated water dilution, dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Four- and five-compartment models for body composition were also calculated.

Results: The total daily dose of GH was similar in men and women at 6 months. Serum insulin-like growth factor-I (IGF-I) was higher in men than women at baseline and after 6 months of treatment (P = 0.01, paired t-test). The increment was, however, similar. In women, GH treatment reduced body weight and increased TBN. In both men and women, total body water and body cell mass increased, while total body fat (BF) mass decreased. At baseline, mean total BF varied considerably depending on the methodology used, with the highest value obtained from DXA. The changes in BF were, however, less dependent on the methodology, but DXA and BIA demonstrated the largest inconsistency between men and women.

Conclusions: These results suggest that gender differences in body composition in response to GH treatment are small, if adjustments are made for baseline factors such as age, BMI and dose of GH. Different methods of body composition measurements produce different results, but changes in response to GH administration are less inconsistent.
Efficacy of rituximab treatment for thyroid-associated ophthalmopathy as a result of intraorbital B-cell depletion in one patient unresponsive to steroid immunosuppression
Authors: Salvi Mario , Vannucchi Guia , Campi Irene , Rossi Stefania , Bonara Paola , Sbrozzi Francesco , Guastella Claudio , Avignone Sabrina , Pirola Giacinta , Ratiglia Roberto , Beck-Peccoz Paolo
Published: March 2006

One patient with Graves’ hyperthyroidism and ophthalmopathy in its active phase and unresponsive to steroid, was treated with the anti-CD20 monoclonal antibody, rituximab (RTX), as part of an open study. The effect of RTX in the thyroid and the orbital tissues was studied. The ophthalmopathy responded to RTX therapy by ameliorating the eye signs with a decrease in the clinical activity score from 5 to 2 in 3 months, while the patient had peripheral B-cell depletion. Hyperthyroidism did not improve during the 6 months of B-cell depletion and serum TSH-receptor antibodies (TRAb) levels did not significantly change after RTX therapy. Therefore, the patient underwent total thyroidectomy and few B-cells were found in the thyroid tissue specimens. While the patient eye disease remained stable (clinical activity score = 2), we performed corrective orbital decompression and we found absence of lymphocytes in the orbital tissue specimens. We believe that RTX treatment in Graves’ disease may cause amelioration of ophthalmopathy by depleting total lymphocytes population in the orbit. The persistence of Graves’ hyperthyroidism suggests that a single cycle of RTX does not result in complete lymphocyte depletion in thyroid tissue and thus no decline in serum TRAb was observed.
Amiodarone-induced thyrotoxicosis: left ventricular dysfunction is associated with increased mortality
Authors: O’Sullivan Anthony J , Lewis Mridula , Diamond Terrance
Published: March 2006

Objective: Amiodarone-induced thyrotoxicosis (AIT) is a challenging management problem, since patients treated with amiodarone invariably have underlying heart disease. Consequently, thyrotoxicosis can significantly contribute to increased morbidity and mortality. The aim of this study was to compare the clinical outcome and hormone profiles of patients with AIT (n = 60) with those with Graves’ thyrotoxicosis (n = 49) and toxic multinodular goitre (MNG, n = 40).

Design: A retrospective study of patients with AIT in a single institution was conducted.

Methods: Data from patients with AIT over 12 years were collected.

Results: Mean TSH levels were significantly suppressed in all three groups. However, there was no intergroup significant difference. Free thyroxine (T4) levels were significantly higher in AIT (45.6 ± 3.5 pmol/l) and Graves’ disease (44.6 ± 4.0 pmol/l) compared with toxic MNG (31.5 ± 5.1 pmol/l, P < 0.05). In contrast, free triiodothyronine (T3) levels were only significantly higher in Graves’ disease (14.7 ± 1.5 pmol/l, P = 0.002) compared with AIT (8.6 ± 0.7 pmol/l) and toxic MNG (7.4 ± 0.5 pmol/l). Six deaths occurred in the patients with AIT (10.0%, P < 0.01) and no deaths occurred in the other groups. Amiodarone treatment (P = 0.002) was the most significant predictor of death, whereas free T4, free T3 and age did not affect outcome. Within the amiodarone-treated group severe left ventricular dysfunction (P = 0.0001) was significantly associated with death.

Conclusions: (i) AIT differs from other forms of thyrotoxicosis, and (ii) severe left ventricular dysfunction is associated with increased mortality in AIT.