bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and regulation of the gastric H+/K+‐ATPase in the rat heart
Authors: Beisvag V. , Falck G. , Loennechen J. P. , Qvigstad G. , Jynge P. , Skomedal T. , Osnes J.‐B. , Sandvik A. K. , Ellingsen Ø.
Published: November 2003

Previous reports indicate that H+/K+‐adenosine triphosphatase (ATPase) might be expressed in the heart.

Aims:  The objectives of the present study were to explore the presence of H+/K+‐ATPase protein and gene expression in the rat heart and to investigate whether the enzyme could contribute to potassium transport across the sarcolemma.

Methods and results:  We performed reverse transcription‐polymerase chain reaction (RT‐PCR) on mRNA from myocardium and isolated cardiomyocytes using primers specific for the gastric H+/K+‐ATPase α‐subunit. The PCR products were sequenced and the predicted gastric H+/K+‐ATPase sequence was verified. Western blots from myocardium detected a 34‐kDa band and a 94‐kDa band, indicating the β‐subunit and α‐subunit of the gastric H+/K+‐ATPase, respectively. Immunocytochemistry detected significant immunoreactivity of the β‐subunit in cardiomyocytes. H+/K+‐ATPase‐dependent potassium transport was assessed by 86Rb+‐uptake in isolated cardiomyocytes. Both ouabain and the selective H+/K+‐ATPase inhibitor Schering 28080 reduced 86Rb+‐uptake at maximum specific inhibition, by 70 and 25%, respectively; the effects were additive. Competitive RT‐PCR analysis indicated a significant upregulation of the myocardial H+/K+‐ATPase in heart failure after myocardial infarction.

Conclusion:  The gastric isoform of H+/K+‐ATPase is expressed in rat cardiac myocytes, both at transcript and protein levels. Functional studies indicate that the enzyme could contribute to potassium and pHi regulation in cardiomyocytes.
Management-Based Regulation: Prescribing Private Management to Achieve Public Goals
Authors: Coglianese Cary , Lazer David
Published: November 2003

We analyze a little-studied regulatory approach that we call management-based regulation. Management-based regulation directs regulated organizations to engage in a planning process that aims toward the achievement of public goals, offering firms flexibility in how they achieve public goals. In this article, we develop a framework for assessing conditions for using management-based regulation as opposed to the more traditional technology-based or performance-based regulation. Drawing on case studies of management-based regulation in the areas of food safety, industrial safety, and environmental protection, we show how management-based regulation can be an effective strategy when regulated entities are heterogeneous and regulatory outputs are relatively difficult to monitor. In addition to analyzing conditions for the use of management-based regulation, we assess the range of choices regulators confront in designing management-based regulations. We conclude that management-based regulation requires a far more complex intertwining of the public and private sectors than is typical of other forms of regulation, owing to regulators’ need to intervene at multiple stages of the production process as well as to the degree of ambiguity over what constitutes “good management.”
How Green Was My Valley? An Examination of Tournament Theory as a Governance Mechanism in Silicon Valley Law Firms
Authors: Price Bruce M.
Published: November 2003

The tournament model is a widely used mechanism to control opportunistic behavior by associates in law firms. However, this mechanism can only operate in certain economic (and social) circumstances. When those circumstances do not exist, the model breaks down, and with it the ability to control opportunism in the absence of some alternative mechanism. Prior research has not investigated whether the utilization of a tournament model prevents the opportunistic behaviors identified as grabbing, leaving, and shirking. In order to test the limits of the tournament model, it is necessary to find particular historical moments when the economic environment radically challenges assumptions/premises of the model. The dot-com bubble in Silicon Valley provides precisely such a time and place. This article demonstrates limits to the applicability of tournament theory. Those limits are to be found in the economic environment in circumstances in which: (1) exogenous reward structures offer many multiples of internal rewards; (2) demonstrably high short-term rewards outside the firm starkly contrast with the delayed long-term rewards inside the firm; (3) the managerial strata reduce their emphasis on long-term recruiting of potential partners in favor of short-term productivity by young associates; and (4) firms develop departmental leverage ratios in excess of their capacity to monitor, mentor, and train recruits.
Precedent, Parity, and Racial Discrimination: A Federal/State Comparison of the Impact of Brown v. Board of Education
Authors: Romero David W. , Sanders Romero Francine
Published: November 2003

Questions regarding Brown v. Board of Education's short-term effect remain unanswered, particularly its comparative impact on federal district courts and state supreme courts. We test this through an analysis of racial discrimination cases in those venues in the twenty-year period bifurcated by the decision in May 1954. Our findings suggest that while federal district courts and state courts were similarly unresponsive to discrimination claims before that date, Brown exerted a significant impact on district court decisions but had little influence at the state level. Furthermore, a third pattern was found in federal appellate courts, where discrimination claims had a high likelihood of pro-minority decisions even before the Supreme Court directive.
Jurisprudential Regimes and Supreme Court Decisionmaking: The Lemon Regime and Establishment Clause Cases
Authors: Kritzer Herbert M. , Richards Mark J.
Published: November 2003

In this research note, we apply the construct of jurisprudential regimes as described in our recent article in American Political Science Review to the area of Establishment Clause jurisprudence. We hypothesize that Lemon v. Kurtzman represented a jurisprudential regime in the Supreme Court's decisionmaking in this area of law. Our analysis shows that the predictors of the Court's decisions in the two periods differed in ways that are very consistent with the types of changes one would expect the hypothesized regime shift to produce.
E‐mail me your thoughts: digital communication and narrative writing
Authors: Merchant Guy
Published: November 2003

The use of ICT for communicating with those not physically present in the classroom can add a new dimension to literacy work. This study illustrates how the interactive nature of e‐mail opens new possibilities for young writers, enriching the curricular emphasis on genres and forms, and expanding children's horizons by encouraging them to write in new ways for new audiences. The paper reports on a study into the use of e‐mail as a means of providing support for classroom writing projects at Key Stage 2. These projects, with pupils in the 7–10 age range, focused on two popular narrative genres: sword and sorcery adventures, and sci‐fi stories. The research shows how digital communication can be used to enrich print‐based literacy whilst at the same time providing a creative exploration of new forms of interactive written discourse on screen.
Lifting the flaps on information: purpose and play in non‐fiction texts
Authors: Smith Vivienne
Published: November 2003

Books with flaps comprise a small, but recognisable sub‐genre of non‐fiction texts for children. Whilst they are popular with young readers, they sit unhappily within an educational discourse of non‐fiction that is dominated by notions of information retrieval and genre theory. This article considers the purpose and function of flaps in a number of texts and proposes that the best of these books provide pertinent lessons for readers about the nature of ‘information’, and about the playful nature of reading itself.
Thinking aloud: children's interactions with text
Authors: Sainsbury Marian
Published: November 2003

This article describes a small‐scale exploratory study in which young children were taught to think aloud as they read, revealing some of their thought processes as they made sense of the text. The children spontaneously made predictions, adjusted their understanding, entered imaginatively into the characters' feelings and related their reading to events in their own experience. They had difficulty, though, in appreciating a surprise ending. The think‐aloud method proved fruitful for research purposes and could offer valuable insights to teachers.
Does Sexual Harassment Training Change Attitudes? A View from the Federal Level*
Authors: Antecol Heather , Cobb‐clark Deborah
Published: November 2003

Objective. Employment‐related sexual harassment imposes large costs on both workers and their employers and many organizations have responded by implementing formal policies, grievance procedures, or training programs. However, limited evaluation of these interventions leaves us knowing very little about their impact. Our goal is to add to this limited empirical literature by analyzing the relationship between sexual harassment training and employees' views about what behaviors in fact constitute sexual harassment.

Method. We use probit analysis and data drawn from the U.S. Merit Systems Protection Board (USMSPB) of the U.S. federal government to determine—separately by gender—the impact of sexual harassment training on the propensity of workers to define specific unwanted sexual behaviors in the workplace as forms of sexual harassment.

Results. We find that sexual harassment training is associated with an increased probability—particularly for men—of considering unwanted sexual gestures, remarks, touching, and pressure for dates to be a form of sexual harassment. We also find that the proportion of agency staff receiving training is positively related to the propensity that an individual employee has a definition of sexual harassment that includes these forms of unwanted sexual behavior.

Conclusions. Our results suggest that sexual harassment training programs may be useful in leading workers to be more sensitive to the issue of sexual harassment. Widespread training within the agency has an effect over and above that attributable to the individual's receipt of training itself and training appears to be particularly successful in clarifying men's views about the “gray” area generated by unwanted sexual behavior originating with co‐workers rather than supervisors.
Campaign Finance Laws and the Competition for Spending in Gubernatorial Elections*
Authors: Bardwell Kedron
Published: November 2003

Objective. The diversity of campaign finance laws in the U.S. states allows the effects of these reforms to be measured. I investigate the impact of contribution limits and public financing on campaign spending in gubernatorial elections.

Methods. I conduct a multivariate regression analysis of general election spending in races for governor from 1980 to 2000. I analyze levels of spending per voter, as well as challengers' share of total spending.

Results. State contribution limits do not hold down overall spending. Candidate acceptance of public funding and spending limits reduces spending by incumbent governors more than it reduces that of challengers. As for challengers' share of spending, I find that public funding programs improve challengers' ability to match incumbents' spending dollar for dollar.

Conclusions. State programs that offer public funding to candidates effectively favor challengers. This points to the potential of these reforms to make federal elections more competitive.
The Impact of Structural Reform on County Government Service Provision*
Authors: Benton J. Edwin
Published: November 2003

Objective. This study examines the effect that county government structure has on county spending in an environment of rapid population growth. In particular, it looks at the consequence of changing from a traditional commission noncharter form to an appointed administrator/elected executive commission type with a home rule charter.

Methods. This study uses a pooled time‐series design to analyze the spending behavior of seven rapid‐growth counties in Florida that adopted a modernized structure between 1980 and 1990.

Results. The findings indicate that changing the form of county government leads to a statistically significant increase in total spending as well as for spending for traditional and regional services.

Conclusions. In addition to the theoretical implications for studying government structural impacts, there are practical implications for county officials in rapidly growing areas who view the adoption of modernized structures as a means to facilitate the expansion of current services and/or the addition of new services.
Job Skill and Black Male Wage Discrimination*
Authors: Coleman Major G.
Published: November 2003

Objective. Debate over the causes of wage inequality have raised suggestions that, rather than discrimination, skill differences may be the reason for racial wage disparities. The purpose of this research is to examine what impact on‐the‐job skill differences have on wage inequality.

Method. I regress the log wage onto race and a measure of skill. The Multi‐City Study of Urban Inequality Employer Survey is particularly useful in this analysis because it contains the employer's evaluation of the worker's relative skill against other workers.

Result. When white and black men have the same employer's competitive performance rating, rather than decreasing racial wage differences, the differences actually increase.

Conclusion. The wage gap is not a skills gap, but evidence of racial discrimination in the labor market.
Acclimation Effects and Separate Opinion Writing in the U.S. Courts of Appeals*
Authors: Hettinger Virginia A. , Lindquist Stefanie A. , Martinek Wendy L.
Published: November 2003

Objective. This article investigates the existence of a freshman effect on separate opinion authorship on the U.S. Courts of Appeals. First, we evaluate the extent to which freshman judges demonstrate unique behavior with respect to writing concurring and dissenting opinions. Second, we examine the potential for background factors to condition any freshman effect.

Methods. Individual judges' decisions to author separate opinions, drawn from the Courts of Appeals Database (1960 to 1988), are modeled as a function of a host of individual‐ and circuit‐level factors, including the freshman status of the judge.

Results. After controlling for alternative explanations, we find that freshman judges on the courts of appeals are less likely to author concurring and dissenting opinions. Prior federal or appellate court experience, however, does not appear to condition the freshman effect.

Conclusion. Freshman circuit court judges experience significant acclimation effects following their elevation to the federal appellate bench.
Governing Nature: The Re‐Regulation of Resources, Land‐Use Planning, and Nature Conservation*
Authors: Jonas Andrew E. G. , Bridge Gavin
Published: November 2003

The ongoing neoliberalization of local and regional economies is contributing to quite profound changes in the ways resources, land uses, and nature are managed. Consider in this regard the changing role of the state1 within North America and Europe. For a good part of the 20th century, state intervention in land‐use planning, resource management, and nature conservation was motivated primarily by national development goals, including a desire to ensure the territorial‐economic integrity of the nation state. Although there is always variation within countries resulting from such factors as the uneven spatial distribution of natural resources, the variety of arrangements for allocating powers and responsibilities among territorial units of government, and different cultural attitudes toward nature, there was nonetheless a discernible trend toward the nationalization (Europe) or federalization (United States) of resource management, land‐use planning, and nature conservation. At the very least, in most countries the state played a strong coordinating, regulatory, and financial role in relation to the management of nature within its territory.
Changing Local Modes of Economic and Environmental Governance in England: A Tale of Two Areas*
Authors: Jonas Andrew E. G. , Gibbs David C.
Published: November 2003

Objectives. Using an urban regime theory approach, the article aims to investigate the degree to which environmental policy in England is devolved to the local level of the state and integrates with local economic governance.

Methods. Intensive case study research was undertaken in two local areas of the eastern region of England having divergent economic growth trajectories. Methods included analysis of local media and documentation from local and regional organizations, and 30 primary interviews with strategic local actors.

Results. The Cambridge Subregion area is experiencing pressures of economic development, creating conflict around the Green Belt and contested meanings of sustainable development. In Waveney—a declining area in search of growth—local groups have struggled to manage local economic regeneration in an environmentally sustainable manner. Both areas have witnessed new territorial‐institutional developments in relation to environmental policy making, with limited evidence of policy integration at the subregional scale.

Conclusion. Despite the emphasis on local policy integration through sustainable development, the relationship between the economy and the environment in England is a focus of conflict and new territorial‐institutional developments. Urban regime theory needs to broaden its focus to include the full variety of interests in local environmental policy and the mechanisms producing new territorial scales of economic and environmental governance.
The Effect of Negative Campaign Advertising on Vote Choice: The Mediating Influence of Gender*
Authors: King James D. , McConnell Jason B.
Published: November 2003

Objective. Some studies of negative campaign advertising's impact argue that a backlash or “boomerang effect” exists. However, the appropriate conceptualization of a boomerang effect might not be an immediate backlash against the sponsor but a delayed response that comes after repeated exposure to negative campaign advertisements.

Method. We conducted an experiment using a variation of the pretest‐posttest control group design in which treatment groups were exposed to varying numbers of negative campaign advertisements.

Results. There is a parabolic effect of repeated exposure to negative advertisements that is gender specific. Among women, the sponsor initially benefits from an enhanced image but suffers a decline in image when the voters become overexposed to negative advertisements.

Conclusion. A reconceptualization of the “boomerang effect” of negative campaign advertising is in order.
The Changing Structure of Structural Assimilation: White‐Collar Mexican Ethnicity and the Significance of Ethnic Identity Professional Organizations*
Authors: Macias Thomas
Published: November 2003

Objective.This article examines the experience of ethnicity among third‐plus generation Mexican‐American professionals at the workplace and through participation in ethnic identity professional organizations.

Methods.A total of 25 face‐to‐face interviews were conducted in the San Jose, California metro area. Interviewees were initially recruited from two ethnic identity professional organizations.

Results.The predicted confluence of acculturation with structural assimilation is supported by the responses of Mexican‐American professionals who acknowledge the social pressure to conform to dominant culture expectations. However, changes in the structure of structural assimilation since 1965 related to the emergence of identity politics have meant integration into society's dominant institutions no longer requires the exchange of ethnic for professional identities.

Conclusions.Ethnic identity professional organizations provide a key source of ethnic networking for Mexican‐American professionals who typically find themselves in work settings with low levels of minority representation.
Identity Politics Among Arab‐American Women*
Authors: Marshall Susan E. , Ghazal Read Jen'nan
Published: November 2003

Objective.Identity politics has dominated contemporary analyses of protest movements. Although multiple identities are commonplace, progress in delineating their empirical relationship has been slow. This article examines the relationships among ethnic and religious identities and feminist orientations among Arab‐American women, a group that bridges multiple cultural identities. The primary research question is whether ethnic and religious identities undermine feminism in this population or whether multiple identities are mutually supportive.

Methods.Using data from a national mail survey of Arab‐American women, regression analyses examine the separate effects of various dimensions of ethnic and religious identity on women's feminist orientations.

Results.Arab political identity is positively associated with feminism while religious and feminist identities are inversely related. The effects of ethnic cultural identity and Muslim affiliation are negligible.

Conclusions.This study finds a complex pattern of relationships among multiple identities and underscores the underlying political dynamic linking group identities.
The Family and the Internet: The Israeli Case*
Authors: Mesch Gustavo S.
Published: November 2003

Objective. The goal of this study was to explore the relationship between Internet connection and frequency of adolescents' daily use and family time and the perceived quality of relations between adolescents and their parents.

Methods. Data from the 2000 National Youth Survey conducted in Israel by the Minerva Center for Youth Studies were used.

Results. The findings show that frequency of Internet use is negatively related to adolescents' perception of the quality of family relationships. This negative relationship is not explained by a reduction of the time that parents and adolescents' share.

Conclusions. It is possible that high frequency of Internet use by adolescents, particularly when it is not being used for learning purposes, creates intergenerational conflicts. This possibility should be explored in future studies.
The Corrosive Effect of Acculturation: How Mexican Americans Lose Political Trust*
Authors: Michelson Melissa R.
Published: November 2003

Objective.Existing research establishes that political trust is not only an important determinant of individual political behavior and government effectiveness, but may also measure the health of civic society. This article looks specifically at trust among Latinos of Mexican descent, demonstrating that acculturation is corrosive of political trust.

Methods.Logit and ordered logit models are used to simultaneously test two theories of acculturation—classic assimilation theory and ethnic competition theory. Data come from the Latino National Political Survey (LNPS).

Results.Support is found for both modes of acculturation.

Conclusions.Although the results do not conclusively side with one particular mode of acculturation, they consistently show that acculturation is corrosive of political trust. Latinos of Mexican descent become more cynical about American government as they incorporate into or are exposed to mainstream American culture, and as they become more aware of or concerned about racism and discrimination.
Raising Considerations: Public Opinion and the Fair Application of the Death Penalty*
Authors: Murray Gregg R.
Published: November 2003

Objectives. A major justification for capital punishment is its perceived public support, yet common measures of public opinion do not capture the complexity of death penalty attitudes. This research, first, examines the stability of attitudes regarding the fair application of the death penalty when those attitudes are expressed within the context of an enlarged pool of considerations about its administration and, second, evaluates the directional effect of the considerations on those attitudes.

Methods. Data from a national telephone survey that capture the complexity of these attitudes are analyzed using ordered probit estimation.

Results. These results indicate substantial instability in attitudes regarding the fair application of capital punishment given the context of more pertinent considerations. Furthermore, within this context respondents tend to indicate that the death penalty is less fairly applied.

Conclusion. The justification for capital punishment may rest on oversimplified conceptions of attitudes toward the death penalty and its application.
The Benefits and Threats of PBB: An Assessment of Modern Reform
Authors: Smith James Fielding
Published: November 2003

PBB is more vulnerable to threats from fraud, falsification, and misrepresentation than were previous budgeting systems Vulnerability grows from complexity, dependence on performance data, year‐to‐year changes in strategic focus, and the great expansion of the numbers of kinds of specialists involved in the process It appears to grow out of PBB's widely recognized benefits Transparency has been put forward as the primary protective device against threats to PBB; however, this has problems with both definition and operationalization. The fix may be a number of coordinated measures, most importantly the inculcation of sound ethical standards throughout an organization using PBB
Analyzing How Local Governments Establish Service Priorities
Authors: Franklin Aimee L. , Carberry‐George Brandi
Published: November 2003

Resource limitations and increasing citizen expectations are causing decisionmakers to reexamine existing approaches to establishing priorities in the funding of governmental services. Using local governments as a contextual example, this article investigates the decision making processes used by Texas cities The research seeks to understand the role different budgetary frameworks, i.e., incremental, performance and community values, play in resource allocation. Factors such as the budget sequence, the participants and the reference sources are considered to better understand local budget deliberations. This research indicates that a mixed or hybrid framework (any combination of the incremental, performance and community values approaches) dominates decision making in Texas cities. That is, most cities attempt to incorporate the politicalness of incrementalism, the results orientation of the performance framework, and the utility maximization desired under the community values framework. Results from this research indicate that Texas cities are moving away from a single framework orientation as a rule and are incorporating more rational and participative aspects into their budget process. This refutes common wisdom on this topic and suggests a more complicated approach to decision making that emphasizes the injection of more objective performance‐related data, as well as the subjective perceptions of non‐traditionally dominant participant groups.
Turning Up the Heat: The Impact of Electric Utility Competition on K–12 Education Funding in Ohio
Authors: Fleeter Howard B.
Published: November 2003

Ohio, like many states, is currently‐considering deregulation of the retail electric power industry. This issue is made more complex in Ohio because structural change in the delivery of electric power is also likely to have a negative effect on state and local government revenues. This effect occurs because of three main forces: the elimination of differential property tax treatment of utilities relative to general businesses, the likely decrease in state electricity excise tax revenues as a result of falling power prices and administrative difficulty in taxing out of state providers, and the potential for stranded costs to diminish the taxable value of electric generating equipment. This article provides an overview of these issues and a brief analysis of the extent to which these problems will be shared by other states. The article then demonstrates the impact of deregulation‐induced tax changes on both state and local school district revenues in Ohio and concludes with a discussion of how the state's ability to insulate local governments from these adverse fiscal effects is made both more imperative and more difficult by a recent Supreme Court Ruling on school funding Finally, the issues discussed in the article are placed in a more general context of the challenges of adjusting tax policy to changing circumstances
The long‐term impact of torture on the mental health of war‐wounded refugees: findings and implications for nursing programmes
Authors: Hermansson Ann‐Charlotte , Timpka Toomas , Thyberg Mikael
Published: November 2003

Today, nurses from many disciplines are expected to provide nursing care to refugees severely traumatized in war and conflict. The general aim of this study was to explore the long‐term impact of torture on the mental health of war‐wounded refugees. The study group consisted of 22 tortured and 22 nontortured male refugees who had been injured in war. Standardized interview schedules, exploring different background characteristics, and three instruments for assessment of mental health were used: the Hopkins Symptom Checklist, the Post Traumatic Symptom Scale and a well‐being scale. The prevalence of psychiatric symptoms was high in both groups. However, there were no significant differences in mental health between the tortured and the nontortured refugees. The patterns of associations between background characteristics and mental health were different in the two groups. The strongest associations with lower level of mental health were higher education in the tortured group and unemployment in the nontortured group. Methodological difficulties in research on sequelae of prolonged traumatization remain. Further studies within the caring sciences can broaden the present understanding of the impact of torture and other war traumas.
Prediction of 3‐yr cadaveric graft survival based on pre‐transplant variables in a large national dataset
Authors: Goldfarb‐Rumyantzev Alexander S , Scandling John D , Pappas Lisa , Smout Randall J , Horn Susan
Published: November 2003

Abstract:Pre‐ and post‐transplant predictive factors of graft survival for optimal and expanded criteria grafts have been studied in the past. The goal of our study was to evaluate the recent large set of United Network of Organ Sharing records (1990–1998) to generate a prediction algorithm of 3‐yr graft survival based on pre‐transplant variables alone. The dataset of patients with end‐stage renal disease and cadaveric kidney or kidney–pancreas transplantation (1990–1998) used in the study consisted of 37 407 records. Logistic regression (LM) and a tree‐based model (TBM) were used to identify predictors of 3‐yr allograft survival and to generate prediction algorithm. Donor and recipient demographic characteristics (age, race, and gender) and body mass index showed non‐linear, while human leukocyte antigen match showed strong linear relationships with 3‐yr graft survival. Prediction of the probability of graft survival from the model, achieved a good match with the observed survival of the separate dataset, with a correlation ofr = 0.998 for LM andr = 0.984 for TBM. The positive predictive value (PV) of allograft survival with LM and TBM was 76.0% and the negative PV was 63 and 53.8% for LM and TBM, respectively. Both LM and the TBM can potentially be used in clinical practice for long‐term prediction of kidney allograft survival based on pre‐transplant variables.
Mini incision live donor nephrectomy: an optimal approach for the developing countries
Authors: Kumar A , Tripathi DM , Srivastava A
Published: November 2003

Abstract: Objective: Laparoscopic donor nephrectomy (LD) is rapidly gaining popularity, however, this may not be affordable by donors in many developing countries because of its high cost. We describe our mini flank incision (MD) donor nephrectomy technique and its outcome.

Methods: A 7–10‐cm subcostal rib sparing transverse incision was given 2 cm lateral to the tip of the 12th rib, towards the lateral border of rectus muscle. All dissections were performed with help of long retractors and instruments, vessels were transfixed and cut. In last 45 cases, vessels were clipped with Liga or Weck clips. Donors and recipients outcome was analysed.

Result: From January 2000 to December 2002 a total of 148 patients underwent donor nephrectomy by mini incision technique. Mean patient age was 44.8 ± 7.3 yr (range 20–70 yr). Nephrectomies were performed in 115 patients on the left side and in 33 cases on the right side. The mean incision length was 9.1 ± 1.8 cm (range 7–10 cm). Mean operative time was 105 ± 10.5 min (70–130 min). Mean analgesic (Tramadol) requirement was 205 ± 52 mg; postoperative hospital stay was 2.2 ± 0.5 d. Twelve per cent patients developed fever and 4% had superficial wound infection in postoperative period. Three patients required blood transfusion. Mean convalescence period was 22 ± 2.8 d.

Conclusion: Extrapleural, extraperitoneal, subcostal mini incisions live donor nephrectomy is a relatively safe procedure with low morbidity. This technique has a shorter hospital stay, early convalescence and better cosmesis. It is cost‐effective and is an ideal substitute for the developing country.
Efficacy of combined lamivudine and adefovir dipivoxil treatment for severe HBV graft reinfection after living donor liver transplantation
Authors: Beckebaum Susanne , Malagó Massimo , Dirsch Olaf , Cicinnati Vito R , Trippler Martin , Pietro Lampertico  , Lama Nicole , Treichel Ulrich , Gerken Guido , Broelsch Christoph E
Published: November 2003

Abstract: Resistance to lamivudine and hyperimmune globulin (HBIG) may cause severe graft reinfection with progression to fulminant hepatic failure in liver transplant recipients. In this report, we describe the clinical course of a patient with perinatally acquired chronic hepatitis B virus (HBV) infection and hepatocellular carcinoma who developed severe fibrosing cholestatic hepatitis after living donor liver transplantation because of the emergence of lamivudine and HBIG‐resistant chronic hepatitis B. Immunohistochemistry demonstrated that more than 30% of hepatocytes stained positively for hepatitis B core antigen. Hepatitis B virus sequence analysis revealed several mutations in the polymerase gene (L528M, M552I, M552V) as well as in the surface gene region encoding the immunogenic major hydrophilic loop of the small surface protein (G130N, M133T, D144G). The amino acid exchange at codon 144 has already been described to escape neutralization by HBIG. Combined treatment with lamivudine and adefovir dipivoxil (ADV) was associated with a dramatic biochemical, virological and clinical response with resolution of jaundice, ascites, peripheral edema and pleural effusions. Serum bilirubin normalized, HBV DNA levels significantly decreased and liver biopsy was remarkable for the absence of viral protein. These results indicate that ADV may provide a sustained rescue treatment for aggressive courses of HBV graft reinfection in liver transplant recipients.
Frequency of the HFE C282Y and H63D mutations in Danish patients with clinical haemochromatosis initially diagnosed by phenotypic methods
Authors: Milman Nils , Koefoed Pernille , Pedersen Palle , Nielsen Finn Cilius , Eiberg Hans
Published: November 2003

Abstract: Aim: To assess the frequency of the C282Y and H63D mutations on the HFE gene in Danish patients with clinical hereditary haemochromatosis initially diagnosed by phenotypic methods.

Methods: In the period 1950–1985, an epidemiological survey in Denmark identified 179 patients with clinical idiopathic haemochromatosis diagnosed by phenotypic methods (serum transferrin saturation, serum ferritin, liver biopsy and mobilisable body iron stores). In 32 unrelated patients, frozen blood samples were available for genetic analysis. In a subsequent series of 26 unrelated Danish patients, a phenotypic diagnosis of clinical idiopathic haemochromatosis was made before blood samples were taken for HFE genotyping. The total series consisted of 58 patients (40 men and 18 women) with a median age of 60 yrs (range 18–74). HFE genotyping was performed by the polymerase chain reaction (PCR) technique.

Results: Among the patients, 55 of 58 (94.8%) were C282Y/C282Y homozygous. One 63‐year‐old woman (1.7%) was compound C282Y/H63D heterozygous. Two women (3.4%), aged 42 and 43 yrs were negative for both the C282Y and the H63D mutation.

Conclusion: In the Danish population, homozygosity for the C282Y mutation appears to be the prevailing cause of clinically overt genetic haemochromatosis. This finding has implications both for the evaluation of patients with iron overload disorders and for the strategy in future population screening surveys.
Neonatal end‐of‐life care in Sweden
Authors: Lundqvist Anita , Nilstun Tore , Dykes Anna‐Karin
Published: November 2003

• A survey was carried out of Swedish neonatal end‐of‐life regarding practice before birth, at birth, during dying and after death using a descriptive questionnaire with close‐ended questions and individual comments

• The practice in 32 of 38 neonatal units, as described by the head nurse or the registered nurses, was largely similar. Respectful treatment of both the neonate and the parents during neonatal end‐of‐life care was indicated

• Differences were found in pre‐natal care concerning the information about the risks of pre‐term birth, the opportunity for parents to view a pre‐term neonate and meet its family, as well as a social worker

• Practice directly after birth was also different. A little less than half of the units answered that they gave a description of the seriously ill neonate to the parents before the first visit to the ward

• Practice during dying indicated that only a few units permitted the neonate to die at home
An audit of post‐operative nausea and vomiting, following cardiac surgery: scope of the problem
Authors: Mace Lisa
Published: November 2003

• Post‐operative nausea and vomiting is a major problem for patients following cardiac surgery

• The literature in this area identifies that there are a number of individual patient and post‐operative factors which increase the risk of post‐operative nausea and vomiting, including female gender, non‐smoker, age, use of opioids, pain and anxiety

• An audit involving 200 patients, who had undergone cardiac surgery was implemented to assess/evaluate the incidence of nausea and vomiting for this patient group

• Data collected included information relating to nausea and vomiting, pain, consumption of morphine and other individual patient variables

• The results suggest that nausea and vomiting, is experienced by a large number of patients after cardiac surgery (67%), with the majority suffering on the first day after surgery. The duration of nausea and vomiting for most is short, but for a significant number (7%) it can last up to one‐quarter of their initial post‐operative course

• The paper discusses key implications for practice arising from this project
Designing a grounded theory study: some practicalities
Authors: McCallin Antoinette M
Published: November 2003

• Grounded theory is an interpretative research methodology frequently used by social science researchers seeking to discover the underlying social processes shaping interaction. The methodology is useful to create knowledge about the behavioural patterns of a group

• The aim of this paper was to discuss some practical issues that the prospective grounded theory researcher planning a small‐scale project may consider

• Discussion focuses on the basic premises, choosing a version of grounded theory, the research problem, the purpose of study, the research question and the place of the literature in a study

• The specific skills required of the grounded theory researcher are considered and some cautions are exercised

• The paper may assist student researchers in a critical care setting and may be of interest to their supervisors and experienced grounded theory researchers
Removing chest drains – a critical reflection of a complex clinical decision
Authors: Riley Marie E
Published: November 2003

• Decision‐making is a fundamental element of nursing work (Boblin‐Cummings et al., 1999; Berggren and Severinsson, 2000; Bucknall, 2000) which fluctuates according to experience, location and personal boundaries

• Nursing judgements are said to portray the nature of nursing knowledge and practice (Thompson, 1999; Buckingham and Adams, 2000a) and can affect others either favourably or adversely (Gordon et al., 1994), with Buckingham and Adams (2000a) emphasizing the benefits to be gained from understanding the process, including improved clinical effectiveness and self‐knowledge

• It is said that all decisions are made in one of two ways – hypothetico‐deductively or intuitively (Dowie and Elstein, 1988; Thompson, 1999; Buckingham and Adams, 2000a) – although different titles are used interchangeably for the same modes. Both of these modalities are examined

• Hypothetico‐deductive reasoning entails exposure to information before and during the patient encounter. These data are grouped and used to generate a hypothesis or possible diagnosis

• The second stance in decision‐making is founded upon intuition and closely associated with expertise

• The presence of chest drains after cardiothoracic surgery is known to cause severe pain, thereby interfering with respiratory mechanics and the ability to take part in physiotherapy exercises (Owen and Gould, 1997; Fox et al., 1999; Charnock and Evans, 2001; Lazzara, 2002)

• This work therefore aims to examine the decision‐making processes in relation to the prompt removal of chest drains by analysing the options available and the skills required to utilize them effectively
Developmental regulation of cation pumps in skeletal and cardiac muscle
Authors: DAUNCEY M. J. , HARRISON A. P.
Published: November 2003

The prenatal and early postnatal periods are critical stages during which long‐term development can be affected. For example, retardation of growth during these periods is closely linked to the occurrence of adult degenerative diseases. Appropriate development of muscle is essential for numerous functions, including movement, posture, thermogenesis, breathing and maintenance of the circulation. Defects in normal muscle development could thus impair any of these functions in the neonate and may also have long‐term consequences for the health of the individual.

Central to normal muscle structure and function is the appropriate development not only of the sarcomeric proteins but also of the sarcolemma, transverse‐tubules, sarcoplasmic reticulum and associated membrane‐bound ATPases. Long‐term regulation of these ATPases is by changes in their concentration, whereas short‐term regulation is mediated by alterations in enzyme activity. This review focuses on changes in total concentrations of Na+, K+‐ and Ca2+‐ATPases during prenatal and postnatal life, in functionally diverse muscles of mammalian species born at different stages of maturity. Both these cation pumps belong to multigene families and changes in relative abundance of their specific isoforms are also considered because they may have important consequences for contractile performance during distinct stages of development. Finally, potential regulatory mechanisms which alter markedly during normal ontogeny are discussed. These include intrinsic factors such as hormones and contractile activity, extrinsic factors such as nutrition and environmental temperature, and interactions between these variables which are known to be especially important during postnatal development.
Effect of intracellular and extracellular ion changes on E–C coupling and skeletal muscle fatigue
Authors: FITTS R. H. , BALOG E. M.
Published: November 2003

The causative factors in muscle fatigue are multiple, and vary depending on the intensity and duration of the exercise, the fibre type composition of the muscle, and the individual's degree of fitness. Regardless of the aetiology, fatigue is characterized by the inability to maintain the required power output, and the decline in power can be attributed to a reduced force and velocity. Following high‐intensity exercise, peak force has been shown to recover biphasically with an initial rapid (2 min) recovery followed by a slower (50 min) return to the pre‐fatigued condition. The resting membrane potential depolarizes by 10–15 mV, while the action potential overshoot declines by a similar magnitude. Following high‐frequency stimulation of the frog semitendinous muscle, we observed intracellular potassium [K+]i decrease from 142±5 to 97±8 mm, while sodium [Na+]i rose from 16±1 to 49±6 mm. The [K+]i loss was similar to that observed in fatigued mouse and human skeletal muscle, which suggests that there may be a limit to which [K+]i can decrease before the associated depolarization begins to limit the action potential frequency. Fibre depolarization to ‐60 mV (a value observed in some cells) caused a significant reduction in the t‐tubular charge movement, and the extent of the decline was inversely related to the concentration of extracellular Ca2+. A decrease in intracellular pH (pHi) to 6.0 was observed, and it has been suggested by some that low pH may disrupt E–C coupling by directly inhibiting the SR Ca2+ release channel. However, Lamb et al. (1992) observed that low pH had no effect on Ca2+ release, and we found low pHi to have no effect on t‐tubular charge movement (Q) or the Q vs. Vm relationship. The Ca2+ released from the SR plays three important roles in the regulation of E–C coupling. As Ca2+ rises, it binds to the inner surface of the t‐tubular charge sensor to increase charge (Qγ) and thus Ca2+ release, it opens SR Ca2+ channels that are not voltage‐regulated, and as [Ca2+]i increases further it feeds back to close the same channels. The late stages of fatigue have been shown to be in part caused by a reduced SR Ca2+ release. The exact cause of the reduced release is unknown, but the mechanism appears to involve a direct inhibition of the SR Ca2+ channel.
Mechanisms underlying changes of tetanic [Ca2+]i and force in skeletal muscle
Authors: WESTERBLAD H. , ALLEN D. G.
Published: November 2003

Force development in skeletal muscle is driven by an increase in myoplasmic free [Ca2+] ([Ca2+]i) due to Ca2+ release from the sarcoplasmic reticulum (SR). The magnitude of [Ca2+]i elevation during stimulation depends on: (a) the rate of Ca2+ release from the SR, (b) the rate of Ca2+ uptake by the SR, and (c) the myoplasmic Ca2+ buffering. We have used fluorescent Ca2+ indicators to measure [Ca2+]i in intact, single fibres from mouse and Xenopus muscles under conditions where one or more of the above factors are changed. The following interventions resulted in increased tetanic [Ca2+]i: β‐adrenergic stimulation, which potentiates the SR Ca2+ release; application of 2,5‐di(tert‐butyl)‐1,4‐benzohydroquinone, which inhibits SR Ca2+ pumps; application of caffeine, which facilitates SR Ca2+ release and inhibits SR Ca2+ uptake; early fatigue, where the rate of SR Ca2+ uptake is reduced; acidosis, which reduces both the myoplasmic Ca2+ buffering and the rate of SR Ca2+ uptake. Reduced tetanic [Ca2+]i was observed in late fatigue, due to reduced SR Ca2+ release, and in alkalosis, due to increased myoplasmic Ca2+ buffering. Force is monotonically related to [Ca2+]i, but depends also on the myofibrillar Ca2+ sensitivity and the maximum force cross‐bridges can produce. This is clearly illustrated by changes of intracellular pH where, despite a lower tetanic [Ca2+]i, tetanic force is higher in alkalosis than acidosis due to increases of myofibrillar Ca2+ sensitivity and maximum cross‐bridge force.