bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between Human Milk SIgA and Maternal Immune, Infectious, Endocrine, and Stress Variables
Authors: Groer Maureen , Davis Mitzi , Steele Kathryn
Published: April 2004

Fifty breastfeeding mothers were studied at 4, 5, or 6 weeks postpartum. Morning hind milk, serum samples, and stress and infection data were collected to examine whether milk secretory immunoglobulin A (SIgA) is related to demographic, stress, immune, and infection factors. The authors investigated relationships between milk SIgA and maternal stress, mood, symptoms of infection, serum proinflammatory and proimmune cytokines, and cortisol. Older women had lower SIgA, and smokers and lower-income women had higher SIgA. There was a relationship between postpartum infection symptoms and SIgA concentration. The Profile of Mood States-anger score was correlated with higher SIgA and perceived stress with lower SIgA. Positive life events were correlated with higher SIgA. In regression analysis, age, postpartum infections, and serum interferon (IFN)-γ were significant predictors of milk SIgA. The data suggest that milk SIgA is primarily affected by maternal immune/infection status, but several other stress and mood variables may potentially influence the concentration of milk SIgA.
Reverse Pressure Softening: A Simple Tool to Prepare Areola for Easier Latching During Engorgement
Authors: Cotterman K. Jean
Published: April 2004

Successful breastfeeding requires efficient milk transfer through the nipple-areolar complex, which includes subareolar tissue. Subareolar tissue resistance increases during engorgement, when expanded circulation and excess interstitial fluid compete for space with increasing milk volumes. Physiologic and iatrogenic events often combine to produce distortion of breast anatomy. Resulting latch difficulty, delayed milk ejection reflex, poor milk transfer, pain, and nipple damage discourage many mothers. The rationale and technique for a simple intervention developed in practice are described: reverse pressure softening (RPS) before latching significantly reduces resistance of subareolar tissue, temporarily freeing it to interact more efficiently with the baby’s mouth. RPS also triggers the milk ejection reflex promptly. The health care provider can perform RPS or teach the mother and her significant others, even by telephone.
Treating Postpartum Breast Edema With Areolar Compression
Authors: Miller Voni , Riordan Jan
Published: April 2004

This case study describes an occurrence of gross edema in the breast and areolar tissue of a mother in the first 2 days postpartum that interfered with the early initiation of breastfeeding. The mother developed severe generalized fluid retention during labor and early postpartum. Her breasts were naturally large. The edema in her breasts made the areola and nipple tissue firm and nonpliable. The mother successfully latched her newborn onto her breast after being shown areolar compression (AC), a technique developed and named by the authors. AC reduces nipple and areola edema by using gentle positive pressure on the areola. The baby continued to successfully latch onto the breast after AC was used and taught to the mother.
Knowing Women
Authors: King Neal
Published: April 2004

This article analyzes data available in published studies of rapists’ self-reports and argues that according to their own accounts, many men developed inaccurate impressions of women’s desires through a confident form of role-taking. While rapists’ inaccuracies have been previously described as instances of “miscommunication”or lapsed role-taking, they do not always indicate lack of emotional or intellectual depth to role-taking. The article adds to the profeminist, symbolic interactionist literature on role-taking by arguingthat relations of disavowedmale-male desire andthe exchange of women make the possibility of men’s sensitive knowledge of women’s sexual desires problematic. Some of these forms of knowledge are outlined, and an approach to rape prevention is briefly suggested.
Feminists Or “Postfeminists”?
Authors: Aronson Pamela
Published: April 2004

In contrast to popular presumptions and prior research on women ofthe “postfeminist” generation, this study found anappreciation for recent historicalchanges in women’s opportunities, and an awareness of persisting inequalities and discrimination. The findings reveal support for feminist goals, coupled with ambiguity about the concept offeminism. Although some of the women could be categorized alonga continuum of feminist identification, half were “fence-sitters” or were unable to articulate a position. There were variations in perspectives amongthose with different life experiences, as well as by racial and class background.
Trafficking, Migration, and the Law
Authors: Chapkis Wendy
Published: April 2004

The Trafficking Victims’ Protection Act of 2000 has been presented as an important tool in combatingthe exploitation and abuse of undocumented workers, especially those forced into prostitution. Through a close reading of the legislation and the debates surrounding its passage, this article argues that the law makes strategic use of anxieties over sexuality, gender, and immigration to further curtail migration. The law does so through the use of misleading statistics creating a moral panic around “sexual slavery,” through the creation of a gendered distinction between “innocent victims” and “guilty migrants,” and through the demand that aid to victims be tied to their willingness to assist in the prosecution of traffickers. As a result, the legislation is less a departure from, than of a piece with, other recent antisex and antiimmigrant policies.
Korean “Comfort Women”
Authors: Min Pyong Gap
Published: April 2004

During the Asian and Pacific War (1937-45), the Japanese government mobilized approximately 200,000 Asian women to military brothels to sexually serve Japanese soldiers. The majority of these victims were unmarried young women from Korea, Japan’s colony at that time. In the early 1990s, Korean feminist leaders helped more than 200 Korean survivors of Japanese military sexual slavery to come forward to tell the truth, which has further accelerated the redress movement for the women. One major issue in the redress movement and research relating to the so-called “comfort women” issue is whether Japan’s colonization of Korea or gender hierarchy was a more fundamental cause of the Korean women’s suffering. Using an intersectional perspective, this article analyzes how colonial power, gender hierarchy, and class were inseparably tied together to make the victims’ lives miserable. By doing so, it shows that a one-sided emphasis on colonization or gender hierarchy will misrepresent the feminist political issue and misinterpret the “comfort women’s” experiences.
The Myth of Postfeminism
Authors: Hall Elaine J. , Rodriguez Marnie Salupo
Published: April 2004

Accordingto the mass media, a postfeminist era emerged in the 1990s. The first objective is to develop a definition of the postfeminist perspective. Based on an informal content analysis of popular articles, the authors identify four postfeminist claims: (1) overall support for the women’s movement has dramatically eroded because some women (2) are increasingly antifeminist, (3) believe the movement is irrelevant, and (4) have adopted a “no, but..”.version of feminism. The second objective is to determine the extent of empirical support for these claims. Usingexistingpublic opinion data, the authors find little support for the four postfeminist claims. Implications of the unsubstantiated post-feminist argument are discussed.
Puerto Rican Wannabes
Authors: Wilkins Amy C.
Published: April 2004

The “Puerto Rican wannabe” is one contemporary, local expression of contested racial identities—identities that are also inflected with class and gender meanings. This study uses interviews with local youth and young adults to explore their use of the caricature of the wannabe to create and contest race, class, and gender boundaries. The wannabe’s challenge to racially designated categories provides a symbol onto which nonwannabe kids project their own stereotypes, anxieties, and desires. The stories told about the wannabe in this study reveal both the persistence and the fragility of race, class, and gender identities and underline the centrality of sexuality in bolstering and undermining them. Boundary negotiations in one category rely on and affect other categories: In this study, the contestation of racial boundaries reestablishes heteronormative and hierarchical gender relations.
The “Feminist” Mystique
Authors: Peltola Pia , Milkie Melissa A. , Presser Stanley
Published: April 2004

The authors examine the claim that the most recent cohort of U.S. women is reluctant to identify as feminist although it has egalitarian gender attitudes. Using two national surveys, they show that the most recent generation is no less likely than prior cohorts to identify as feminist. However, Baby Bust women are less apt to identify as feminist than are older women, once background characteristics and attitudes related to feminist identification are controlled. Analyses suggest this reluctance is not due to an aversion to feminism but reflects the “off” timing of the feminist movement in the lives of Baby Bust women. The authors also find important differences among cohorts in the correlates of feminist identity. Most notably, the relationships of political ideology and gender attitudes to feminist identity are stronger among Baby Boom women, who came of age during the feminist movement’s second wave, than among older and younger women.
Men in Crisis in Russia
Authors: Ashwin Sarah , Lytkina Tatyana
Published: April 2004

A key feature of economic transition in Russia has been the demoralization of men at the lower end of the labor market. Rather than focusing on the labor market directly, this article looks at how men’s position within the household influences their ability to deal with their employment difficulties. Men’s main role within the household is as primary breadwinners, and there are few other tasks in the urban Russian household that are seen as masculine. Using longitudinal qualitative data, the authors argue that men who are unable to perform as breadwinners have their labor market problems compounded by a damaging domestic marginalization.
Changing Gender Practices within the Household
Authors: Sullivan Oriel
Published: April 2004

While recent emphasis has been placed on transformations of gender in the public sphere, changes in gender relations between heterosexual couples in the domestic sphere have been less fully developed in the theoretical literature. The author presents evidence for change at various levels, from the discursive to the quantitative. She outlines a theoretical framework for the analysis of such change based on the “doing gender” and gender consciousness perspectives, readdressed in the light of the new emphasis on discourses of reflexivity and intimacy. She argues for a conception of change that is slow and uneven, in which daily practices and interactions are linked to attitudes and discourse, perhaps over generations.
The Gender Division of Labor
Authors: Cohen Philip N.
Published: April 2004

This article explores the effect of women’s movement into the labor market on the gender segregation of work, using the Current Population Survey from 1972 to 1993. The author includes as working those respondents who were “keeping house” and codes keeping house as an occupation. The results show higher estimates of gender segregation, and slightly steeper declines over time, than were seen in previous studies. Analysis of one-year longitudinal changes reveals less movement out of female-dominated occupations when keeping house is included as an occupation. Finally, a decomposition of the segregation trend shows that the movement of women away from keeping house contributed as much to the overall decline in gender segregation as did the desegregation of paid occupations. The author concludes that the movement of women’s work from the household to the labor market has been a driving force in the changing nature of gender inequality.
Thermal and Geometrically Nonlinear Stress Analyses of an Adhesively Bonded Composite Tee Joint with Double Support
Authors: Apalak M. Kemal , Apalak Z. Gul , Gunes Recep
Published: April 2004

Carbon fiber reinforced plastics (CFRP) can be successfully joined to metal or composite structural components using the adhesive bonding technique [Semerdjiev, S. (1970). Metal to Metal Adhesive Bonding, Business Books Ltd., London.]. The stress and deformation fields occurring in the adhesive joints due to the thermal loads as well as the structural loads play an important role on the joint strength since the thermal and mechanical properties of the adhesive and adherends are different. Previous thermal stress analyses of the adhesive single-lap joints with simple geometries assumed a uniform temperature distribution through the adhesive joint, consequently predicted uniform thermal strain and stress distributions. In this study, the thermal stress analysis of an adhesively bonded tee joint with double support made of unidirectional CFRP was carried out for variable thermal loading conditions along its outer boundaries and different plate edge conditions. The large displacement and rotation effects were considered using the small strain-large displacement theory. The stress fields in the adhesive layer and the composite members of two tee joints bonded to a rigid base and a flexible plate were investigated. In the thermal analysis, a reference uniform temperature was attributed to all joint members for its stress free state, and air streams with different temperature and velocity were specified along the outer surfaces of the adhesive joint. In addition, the air streams were specified in the vertical or horizontal directions to the composite plates and adhesive layer. The consideration of convective and conductive heat transfer showed that nonuniform temperature distributions occurred in the adhesive tee joints. High heat fluxes took place along the free surfaces of the adhesive fillets at the free ends of the adhesive layers. Geometrical nonlinear stress analyses of two tee joints were carried out using the calculated temperature fields for two different plate edge conditions. Since the adhesive joints consist of materials with different thermal and structural properties, the thermal strains become incompatible along the adhesive layer–plate interfaces. Consequently, the stress concentrations occurred inside the adhesive fillets around the adhesive free ends, and in the regions near the adhesive layer–composite plate interfaces. The adhesive fillets, middle region of the horizontal plate, the elbow sections of the left and right supports appeared as most critical regions of the tee joints. In addition, the support length did not have similar effect of reducing the normal and shear stresses at these critical adhesive and adherend locations.
Fiber Orientation during Equal Channel Angular Extrusion of Short Fiber Reinforced Thermoplastics
Authors: Creasy T. S. , Kang Y. S.
Published: April 2004

Glass-fiber/polyacetal cylindrical rods prepared by conventional compounding and extrusion were processed by equal channel angular extrusion (ECAE). The initial material contained 109.8 mm long fibers with uniformly distributed fiber angle orientations between 11.8 and 56.0. One extrusion pass with a soft matrix at 73 C directed the fibers to a loglogistic distribution with a mean orientation angle of 23.5. ECAE at room temperature did this with mean fiber angles becoming 20.8 and 23.6 for one and two passes respectively. The interquartile range of the angles narrowed with reduced processing temperature and number of processing passes.
Continuous Glass Fiber–Polypropylene Composites Made by Melt Impregnation: Influence of Processing Method
Authors: Nygard Per , Gustafson Claes-Goran
Published: April 2004

The efficiency of different melt impregnation methods for producing continuous glass fiber–polypropylene tapes has been evaluated. The selected methods were the common pin assisted method, a crosshead impregnation die including different vibration techniques and a slit die. The degree of melt impregnation was studied qualitatively with optical microscopy and determined quantitatively by opacity measurements. Excellent results were obtained using the radial slit die, followed by the pin chamber impregnation method. The crosshead impregnation die gave poor impregnation. With the radial slit die it was possible to achieve high fiber volume fraction and it was easy to control the fiber–matrix content. The haul off speed ranged from 1–10 m/min.
Experimental Characterization of an Integrated Sandwich Composite Using 3D Woven Fabrics as the Core Material
Authors: Shiah Y. C. , Tseng Liang , Hsu Jui Che , Huang Jin H.
Published: April 2004

In this article, an integrated sandwich composite adopting 3D woven fabrics as the core material was experimentally characterized for its effective elastic modulus as well as its capacity of receiving impact energy. Featured by its porous core for leak detection and high strength to weight ratio, the integrated sandwich composite was an ideal candidate to be fabricated into a large part to store volatile chemical liquids or gas. To characterize the integrated sandwich composite for such applications, a series of unidirectional tensile tests as well as impact experiments were conducted for the sandwich composite fabricated using two different types of reinforced lamina as the face-sheets.
Thermoforming-Stamping of Continuous Glass Fiber/Polypropylene Composites: Interlaminar and Tool–Laminate Shear Properties
Authors: Lebrun Gilbert , Bureau Martin N. , Denault Johanne
Published: April 2004

The results of interlaminar and tool–laminate shear tests performed on a twill 2 2 PP/glass fabric are described in this paper. The influence of the laminate temperature, pullout velocity and normal pressure on the interlaminar shear stress and friction coefficient are evaluated, as well as the effect of cooling the specimen from the melt to simulate real forming conditions. Opposite trends were observed for the variation of the shear stress and friction coefficient whether the tests were performed above the melt temperature of the matrix or above the crystallization temperature (135, 140, and 155 after cooling from the melt temperature. For the interlaminar shear tests, this was caused by the shift from an interlaminar to an intralaminar shear deformation mode occurring. For the tool–laminate shear tests, this was caused by the shift from matrix shear at the interface tool–laminate to direct Coulomb friction of the fibers with the tool with an increase of the normal pressure and/or an increase of the matrix viscosity with decreasing temperatures. Above the melt temperature of the matrix, the friction coefficient and shear stress were higher at the tool–laminate interface than in the interlaminar region while at temperatures close to the crystallization temperature they became lower at the tool–laminate interface. A summary of these observations is made and a discussion of their possible impact on the forming of parts is enlightened.
Stamp Thermo-Hydroforming: A New Method for Processing Fiber-Reinforced Thermoplastic Composite Sheets
Authors: Zampaloni Michael A. , Pourboghrat Farhang , Yu Woong-Ryeol
Published: April 2004

The stamp thermo-hydroforming process involves supporting the thermoplastic sheet with a bed of heated viscous fluid that applies a hydrostatic pressure across the part throughout the forming process. This hydrostatic pressure produces a through-thickness compressive stress that delays the onset of delamination, reduces the formation of wrinkles due to frictional traction forces, and results in better-formed parts. The overall goal of this research is to verify, through experimentation and numerical modeling, that the stamp thermo-hydroforming process provides a suitable alternative to conventional thermoforming methods, such as bag molding and stamp forming, as a means for processing glass-mat fiber-reinforced thermoplastic materials. The goal of this paper is to solely address whether the use of a counteracting pressure can be beneficial during the forming of fiber-reinforced thermoplastic sheets more specifically; this paper addresses the experimental setup that was developed and built to conduct small-scale stamp thermo-hydroforming experiments with a hemispherical punch, and discusses some results obtained using this setup. Experiments were performed on a random oriented continuous glass-mat fiber-reinforced polypropylene with hydrostatic pressure applied locally on the top surface of the composite sheet, as it was being stretched by a hemispherical punch. An increase of up to 10% in draw depth was achieved by applying local hydrostatic pressures up to 207 kPa (30 psi). In addition to the draw depth improvements, the application of the counteracting hydrostatic pressure also delayed the onset of delamination.
Transplant Immunology
Authors: Crompton Jason A.
Published: April 2004

Since the early days of transplantation, it has been known that the immune system is the major barrier to long-term graft survival. Due to the unique “fingerprint” of different individuals’ cells, donor organs are detected as foreign, invasivematerial by the recipient’s immunesystem and, subsequently, attacked and rejected. The difficulty that has continuously faced the transplant community is the multifaceted nature of the immune response and halting the numerous pathways of immune stimulation. The ultimate goal of all transplant research is graft acceptance, also known as tolerance, without the use of long-term immunosuppressant medication. Various reviews of the different facets of transplant rejection exist. The following summary will attempt to outline the major known pathways involved in organ recognition and acute rejection.
Immunosuppressive Agents on the Horizon
Authors: McDevitt Lisa M.
Published: April 2004

The evolution of immunosuppression in organ transplantation has resulted in decreasing rates of rejection and improved allograft survival. The current successes, however, comes at the price of intense drug monitoring, frequent adverse affects, and long-term toxicity. New immunosuppressive agents offer the hope for decreased toxicity and improved long-term results. This article highlights those novel agents that are currently in late-stage clinical studies including new calcineurin inhibitor analogs and formulations, mycophenolate acid sodium, everolimus, FK-778, FTY720, and various monoclonal antibodies. The diverse mechanisms of action of these agents, coupled with promising efficacy and adverse effect profiles, may land each of them a unique niche for immunosuppression in organ transplantation.
Community Pharmacists’ Opinions About Having Diagnostic Data Provided with Prescriptions
Authors: Armstrong Edward P. , Goodman Natalie M. , Zachry Woodie M.
Published: April 2004

Objectives. To determine if community pharmacists felt that diagnostic information providedwith prescriptions would (1) help provide pharmaceutical care, (2) help reduce dispensing errors, and (3) violate patient confidentiality. Methods. A mail questionnaire was distributed to 200 metropolitan community pharmacists in Arizona. The questionnaire consisted of 14 opinion statements and 6 demographic items. Results . Atotal of 75 usable questionnaireswere returned (a 38.5% response rate). Pharmacists agreed that they were responsible for providing pharmaceutical care and that diagnostic data would help them provide this care. Pharmacists believed that receiving diagnostic data with prescriptions would help reduce-dispensing errors, help them counsel patients, and help them abide by state and federal laws. Pharmacists felt that diagnostic data would not violate patient confidentiality. The majority of pharmacists (73.6%) believed that the indication for prescribing a medication was the most important information that could be included on a prescription. Conclusion . Overall, community pharmacists had positive perceptions of the value of diagnostic data being provided with prescriptions. Additional research is needed to evaluate how providing this important information will affect other members of health care teams.
Antibody Agents in Solid Organ Transplantation
Authors: Somerville K. Troy
Published: April 2004

Antibody agents play an important role in the pharmacotherapy of solid organ transplantation. These agents can be either monoclonal or polyclonal, derived from an animal source or genetically engineered utilizing human antibody sequences. This reviewpresents basic pharmacology and therapeutic issues related to the antibody preparations utilized in transplantation including equine and rabbit antithymocyte globulins, muromonab-CD3, daclizumab, and basiliximab. The parameters covered for these agents include mechanism of action, pharmacokinetics, pharmacodynamic monitoring strategies, clinical dosing, adverse effects, and clinical trials. The brief overviewof current clinical data related to these agents focuses on kidney transplantation. The use of these very powerful agents in different patient populations needs to be individualized based on certain risks and these data are presented to help in the decision-making process, especially for renal allograft recipients.
Inhibitors of Calcineurin
Authors: Holt Curtis D. , Ingle Gordon , Sievers Theodore M.
Published: April 2004

Before the early 1980s, patient and allograft survival for solid organ transplant recipients was dismal. By 1983, the first calcineurin blocker, cyclosporine (Sandimmun), had been introduced, and outcomes were dramatically improved. However, cyclosporine macroemulsion had suboptimal pharmacokinetics, significant drug interactions, and several adverse effects, including nephrotoxicity, neurotoxicity, hyperlipidemia, and hypertension. Recent advances with cyclosporine include the introduction of modified dosage formulations: Neoral, a microemulsion, and several generic microemulsion products. The potent second-generation calcineurin blocker tacrolimus (Prograf) was introduced in 1994 and has become the drug of choice for several types of transplant recipients. Although tacrolimus has improved pharmacokinetics and therapeutic drugmonitoring parameters, it has adverse effects such as nephrotoxicity, neurotoxicity, and diabetes. Thus, current immunosuppressive regimens implementing calcineurin blockers often involve additional immunosuppressive agents to “spare” the use of these agents, minimizing their adverse effects. This article reviews the mechanisms of action, pharmacokinetics, clinical use, therapeutic drug monitoring, drug interactions, adverse effects, and dosing of cyclosporine and tacrolimus in solid organ transplant recipients.
Pharmacokinetic/Pharmacodynamic Considerations in Community-Acquired Lower Respiratory Tract Infections
Authors: Smith Candace
Published: April 2004

To accomplish the goal of both clinical and microbiological cure in the treatment of lower respiratory tract infections, microbiological data along with pharmacokinetic and pharmacodynamic data should be used. Recent studies have determined 2important antibacterial pharmacokinetic/ pharmacodynamic parameters that differ among classes of antimicrobial agents. The 2major groups include the antibiotics that exhibit concentration-dependent killing with a postantibiotic effect and time-dependent killing with minimal to moderate postantibiotic effects. For drugs that are concentration dependent (aminoglycosides, fluoroquinolones), the area under the concentration-time curve (AUC/MIC) is the most important predictor of bacteriological eradication. Alternatively, for antibiotics that exhibit time-dependent killing (-lactams, macrolides), time above the MIC ( T >MIC) is probably the major parameter that determines efficacy. Using these parameters provides the tools needed for appropriate antibiotic dosing.
Self-monitoring Blood Glucose (SMBG): Now and the Future
Authors: Briggs Amber L. , Cornell Susan
Published: April 2004

In 2002, the cost of diabetes in the United States reached $132 billion. There is a well-established relationship between blood glucose control and the risk of diabetes-related complications. Tight blood glucose control, through intensive diabetes therapy, reduces the risk and delays the onset of diabetesrelated microvascular complications. Regular and consistent self-monitoring of blood glucose (SMBG) is and should be a part of all diabetes disease state management programs. Pharmacists can truly increase the numbers of patients who use SMBG by being aware and familiar with the monitoring devices available to patients and identifying the physical and psychological issues surrounding SMBG. Results from SMBG and hemoglobin A1C are the basis formost of the medical decisions made for patients with diabetes. This review discusses the best time for patients to test their blood glucose, information regarding blood glucose monitoring devices, alternative site testing, and the newest technology available in glucose monitoring.
Oral Antidiabetic Agents: A Comparative Review
Authors: Koski Renee R.
Published: April 2004

Type 2 diabetes mellitus is a chronic disease characterized by insulin resistance, impaired insulin secretion, and/or increased hepatic glucose production. The mainstays of drug treatment are the oral antidiabetic agents. Insulin is usually reserved for patients who do not achieve fasting plasma glucose or A1C goals with or cannot tolerate the oral antidiabetic agents. There are 5 classes of oral antidiabetic agents available in the United States: sulfonylureas, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, and nonsulfonylurea secretagogues. They have differences and similarities with respect to their pharmacology and role in diabetes. This article reviews the pharmacology, efficacy, safety, and selection of the oral agents used to treat type 2 diabetes mellitus.
Hypertension Management in the Diabetes Patient
Authors: Durst Stephen W. , Schering Deb
Published: April 2004

Approximately 11 million of the 17 million US citizens with type 2 diabetes mellitus also have hypertension. The development of diabetic nephropathy in patients with type 1 diabetes is frequently associated with hypertension, and both may present several years after the onset of diabetes. In type 2 diabetes, hypertension may precede the development of diabetes by several years. Differences that exist between type 1 and type 2 diabetes and the development of hypertension may indicate differences in the concomitant disease processes, yet the inevitable development of both diseases contributes to significant increases in risk of cardiovascular disease.The pharmacist must be familiar with blood pressure treatment goals in the hypertensive-diabetic patient and appropriate pharmacotherapeutic management. This article outlines treatment goals in the patient with diabetes and concurrent hypertension, reviews trials assessing pharmacologic treatments, and provides a summary of monitoring parameters to guide the pharmacist in the management of this population.
Pharmacotherapy of Diabetic Foot Ulcers
Authors: Smith Curtis L.
Published: April 2004

The incidence of diabetes and diabetic foot ulcers is increasing significantly in the United States. These ulcers and infections are the result of long-term complications of diabetes including neuropathy and vascular insufficiency. These infections can be classified into mild, limb threatening, and life threatening. This classification helps clarify the expected organisms involved and consequently appropriate, empiric antibiotic therapy. Mild infections are generally caused by Gram-positive organisms and can usually be treated as an outpatient with oral antibiotics. Antibiotics used for mild infections-include cephalexin, clindamycin, and amoxicillin/ clavulanate. Moderate to severe or limb-threatening infections are usually polymicrobial and frequently require hospitalization. These infections are typically treated with more broad-spectrum antibiotics including ampicillin/sulbactam, imipenem, or the combination of clindamycin and a fluoroquinolone. Severe or life-threatening infections also require broad-spectrum antibiotics. Other therapeutic options besides antibiotics include growth factors, such as becaplermin, and various skin substitutes.
Current Management of Urinary Incontinence
Authors: Knight-Klimas Tanya C.
Published: April 2004

Urinary incontinence is an underreported, underdiagnosed, and undertreated condition erroneously thought by many patients to be a normal part of aging. This article briefly discusses transient urinary incontinence and then focuses on the different types of established incontinence. Specifically, the article discusses preferred terminology associated with urinary incontinence and describes the different types, causes, nonpharmacologic options, and pharmacologic options for managing overactive bladder syndrome, stress incontinence, and overflow incontinence. It briefly discusses mixed urinary incontinence and functional incontinence. The role of the pharmacist in working with patients, caregivers, and other health care professionals to optimize management of urinary incontinence is discussed throughout.
Prevention and Treatment of Pressure Ulcers
Authors: O’Neil Christine K.
Published: April 2004

Pressure ulcers are a serious health concern for elders in acute care, long-term care, and home care settings. The occurrence of a pressure ulcer is considered a sentinel event in terms of quality of care. Pressure ulcers may result in significant morbidity and mortality and are associated with high cost in terms of human suffering, cost of treatment, and possible litigation. Several risk factors have been identified for the development of pressure ulcers. Identification of elderly patients at risk of pressure and implementation of preventative measures are essential. Management of a pressure ulcer involves debridement, cleansing, selection of an appropriate dressing, and prevention of infection. This article reviews suggested guidelines for the prevention and management of pressure ulcers.
Demographics, Pharmacoeconomics, Assessment, and Treatment of Pain in the Elderly
Authors: Berdine Hildegarde J. , Mihalyo Mary Grace
Published: April 2004

The burden of pain in the elderly population of our society is observed by the greater numbers of the aged who suffer from pain as compared to their younger counterparts. The elderly present difficult challenges for pain clinicians in terms of the ability to assess for pain, amid other medical and pain problems, due to cognitive, sensory, and functional impairment. Treatment with pharmaceuticals may be altered by the impact of aging. Finally, the elderly suffer financial restraints that often prevent optimal treatment of pain even if pain is identified. Principles of pain management in the elderly are reviewed in the context of special attention to assessment tools for the elderly, the evaluation of comorbid factors in the presentation of pain, and pharmacokinetic/pharmacodynamic concerns in the aging. Pharmacologic and nonpharmacologic treatment strategies are described relative to the elder.
Volunteering in Retirement: Perceptions of Midlife Workers
Authors: Smith Deborah B.
Published: April 2004

Using a life course perspective as well as continuity and role theories, this research investigates midlife workers’perceptions of volunteering as part of anideal retirement life style. The Study of Midlife gathered data from 258 working respondents ages 50 to 64 on demographic information, retirement plans, and voluntarism. The data are consistent with continuity and role theories. Those who consider the volunteer role highly salient are much more likely to see volunteering as part of an ideal retirement lifestyle as are those who frequently attend religious services. Workers less than 5 years away from planned retirement are less likely to see voluntarism as part of an ideal retirement lifestyle, regardless of age, indicating that location in one’s own life course influences perceptions of volunteering in retirement. Implications for volunteer recruitment strategies for nonprofit organizations are discussed.
Gender Inequality in the Work Environment at Institutes of Higher Learning in Science and Technology in India
Authors: Gupta Namrata , Sharma A. K.
Published: April 2004

Analyses of the work environment in any professional organization in terms of western conceptual categories remain incomplete, in the case of a developing country, without an understanding of the social context in which the organization is placed. This article analyses the problems faced by women academic scientists in the work environment at four institutes reputed for excellence in teaching and research in science and technology in India.‘Patrifocality’ in Indian society forms an essential backdrop to an understanding of this subject. The article examines the rule-related aspects referred to as the ‘formal environment’, and the ‘informal’ interaction in the work situation. The findings reveal that social stereotypes infiltrate the workplace and that there are latent aspects in the work environment that place women academic scientists at a disadvantage. These disadvantages are a function of a ‘patrifocal’ structure of Indian society, a general ‘lack of critical mass’ of women scientists and a lack of ‘universalism’ in science.
Extending Conceptual Boundaries: Work, Voluntary Work and Employment
Authors: Taylor Rebecca F.
Published: April 2004

Traditional social theory has conceptualized work in terms of a dichotomy of public paid employment and private unpaid labour that oversimplifies the complexity of traditional and contemporary work practices and excludes voluntary work from sociological understandings of work. This article explores the lives of five workers from two voluntary sector organizations, whose experiences highlight the weaknesses of concepts such as ‘career’ and suggest that work’s conceptual boundaries be extended. A framework based on the ‘total social organization of labour’ is developed that distinguishes between paid and unpaid work within the setting of institutional, community and family relations. This provides a basis for mapping individuals’ labour and exploring both the interconnections between their work positions and the boundaries of their work identity. At the structural level it highlights how health care and community work constitute labour markets or ‘fields’; hierarchical structures governed by rules that shape how positions are accessed.
The Position of Policewomen: A Discourse Analytic Study
Authors: Dick Penny , Cassell Catherine
Published: April 2004

This article is concerned with exploring issues surrounding the position of policewomen in UK police forces, with the aim of problematizing the notion that women are difficult to retain because they are unable to meet the demands of police work once they have children.The article examines how policing is socially constructed, and why policewomen ‘consent’ to dominant, yet potentially ‘oppressive’ constructions of police work. In the article, the research interview is seen as an interactional context that predicates ‘identity work’. Using Foucauldian principles, the article argues that the power relations operating in both the interview and the broader socio-cultural context are productive of discourses through which individuals constitute their identities. It is this constitutive act that produces women’s consent to dominant constructions of policing because at the same time, this ‘resists’ broader ideological discourses that threaten their integrity.
Bias in the Heavenly Chorus
Authors: Lowery David , Gray Virginia
Published: April 2004

Counts of lobbying organizations before government long have been used to assess overall bias in the politics of interest representation (Schattschneider, 1960). We argue that this effort is fundamentally flawed, that we cannot extract useful conclusions about interest system bias from one-shot lists of organizations seeking influence. We first examine the extensive literature on bias in interest representation, highlighting the uneven attention of scholars to its two core assumptions. We then turn to enumerating the many ways in which the distribution of interests in society and before government are unlikely to be isomorphic over time or over space. Finally, we return to the still vital question of bias in interest representation to consider how it can be addressed in a more satisfactory, if indirect, manner.
Pressure Politics
Authors: Ward Hugh
Published: April 2004

A common mental model sees lobbies pushing policy in a certain direction from the status quo with a certain force, the outcome being a function of how hard lobbies push and in what direction, according to the `parallelogram of political forces' at work. When this model is formalized and lobbies are seen as playing a game in which they are attempting to maximize their payoffs, net of lobbying costs, the prediction is that lobbies seldom if ever will push in the direction of what they ideally want, for their lobbying will partly aim to offset the efforts of others, leading to waste of resource. There will often appear to be more conflict of interest between two lobbies than actually is the case. This calls into question methodologies for studying and for measuring power that assume that we can infer groups' preferences from their lobbying behaviour. From observing their behaviour we can infer things about their power if we know their preferences or we can infer things about their preferences if we know their power. But it is not possible to make both inferences.
The Tyranny of the Supermajority
Authors: McGann A. J.
Published: April 2004

This article demonstrates that majority rule offers more protection to the worst-off minority than any other system in that it maximizes the ability to overturn an unfavorable outcome. It is known (May, 1952; Dahl, 1956) that majority rule is the only decision rule that completely respects political equality. However, it is frequently argued that other decision rules (such as a system of checks and balances, which are implicitly supermajoritarian) better serve the goals of protecting minorities' rights and preserving stability. This article argues that this trade-off is illusory and that majority rule actually provides most protection to minorities. Furthermore, it does so precisely because of the instability inherent in majority rule, which overcomes the problem of majority tyranny.
Presidentialism, Elections and Representation
Authors: Samuels David J. , Shugart Matthew Soberg
Published: April 2004

How does presidentialism affect various forms of representation? All else being equal, presidentialism is likely to impede the prospects for ‘mandate’ representation but enhance the prospects for ‘accountability’ representation. The degree of mandate or accountability representation is a function of the balance of powers and the degree of separation of purpose between the branches. Strong presidentialism works against mandate representation by freeing the president from his/her legislative copartisans and promoting ‘policy switching’. In contrast, a high ‘separation of purpose’, defined primarily by a country’s electoral institutions, clarifies for voters the responsibility of each branch for policy. Thus presidentialism - under certain common institutional configurations - provides accountability representation to a degree overlooked by existing research.
The Critique of Intellectuals in a Time of Pragmatist Captivity
Authors: Fuller Steve
Published: April 2004

The ‘critique of intellectuals’ refers to a genre of normative discourse that holds intellectuals accountable for the consequences of their ideas. A curious feature of the contemporary, especially American, variant of this genre is its focus on intellectuals who were aligned with such world-historic losers as Hitler and Stalin. Why are Cold War US intellectuals not held to a similar standard of scrutiny, even though they turn out to have been aligned with the world-historic winners? In addressing this general question, some self-serving tendencies of intellectual history are observed, in particular the asymmetry between the ease with which intellectuals are credited with the good consequences of their ideas and the difficulty with which they are blamed for the bad consequences. This asymmetry is particularly noted in Richard Rorty, whose pragmatism treats past ideas as a legacy intended for the (American) reader’s benefit. As a corrective, I advocate, in Paul Ricoeur’s terms, a ‘hermeneutic of suspicion’ that treats intellectual life as fraught with danger, as our adoption of ideas always amounts to passing judgement over those who have borne them in the past.
Preparation and Properties of Optically Clear Poly[(Arylenedioxy)(Diphenylsilylene)]s and Poly[(Alkylenedioxy)(Diphenylsilylene)]
Authors: Tamai S. , Tanaka C. , Abe T. , Kuroki T. , Ishikawa J.
Published: April 2004

Several types of poly[(arylenedioxy)(diphenylsilylene)]s and poly[(alkylenedioxy)(diphenylsilylene)] were synthesized from various diols and dichlorodiphenylsilane by the step polymerization method. The thermal properties, solubility in organic solvents and optical properties of the obtained polymers were investigated by focusing on the chemical structures of their repeating structural units. The weight-average molecular weight ( Mw) of the obtained polymers based on polystyrene ranged from 43000 to 194000. High molecular weight, ductile materials with a high degree of optical clarity were obtained. These polymers display glass transition temperatures ( Tg) between 96 and 130°C. The obtained poly[(arylenedioxy) (diphenylsilylene)]s and poly[(alkylenedioxy)(diphenylsilylene)] were soluble in chloroform and toluene. The refractive index ( nd) was 1.64 for a biphenol-based poly[(arylenedioxy)(diphenylsilylene)] and 1.61 for a bisphenol-A based poly[(arylenedioxy)(diphenylsilylene)]. The poly[(arylenedioxy)(diphenylsilylene)]s and poly[(alkylenedioxy)(diphenylsilylene)] display very low birefringence (Δ n) between 0.0005 and 0.0022. The 70 μm thick film transmission of bicyclohexanol-based poly[(alkylenedioxy)(diphenylsilylene)] was 91% at a 350 nm wavelength.
6F-Polyimides with Phenylethynyl Endcap for 315-370 °C Applications
Authors: Chuang Kathy C. , Bowman Cheryl L. , Tsotsis Thomas K. , Arendt Cory P.
Published: April 2004

6F-Polyimides with a phenylethynyl endcap (HFPE) were fabricated into carbon fiber composites using the standard polymerization of monomer reactant (PMR) approach via the ester/acid route. T650-35/HFPE carbon fiber composites were evaluated against the corresponding T650-35/PMR-II-50 composites with nadic endcap at 315-370 °C (600-700 °F) for their physical and mechanical properties as well as thermo-oxidative stability. In addition, concentrated HFPE monomer solutions were infused into stitched AS4 and T650-35 preforms and their mechanical properties were compared with those of the commercial BMI-5270 composites from cryogenic temperature to 343 °C (650 °F). The stitched HFPE composites out-performed BMI-5270 composites in terms of property retention at elevated temperature and microcrack resistance during thermal cycling from −54 to 288 °C (−65 to 550 °F). The stitched composites also showed more resistance toward blistering and delamination than conventional laminate composites during a rapid heating rate simulating launch and re-entry of reusable launch vehicles (RLV).