bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the determinants and age and gender differences in the acceptance of mobile learning
Authors: Wang Yi‐Shun , Wu Ming‐Cheng , Wang Hsiu‐Yuan
Published: February 2008

With the proliferation of mobile computing technology, mobile learning (m‐learning) will play a vital role in the rapidly growing electronic learning market. M‐learning is the delivery of learning to students anytime and anywhere through the use of wireless Internet and mobile devices. However, acceptance of m‐learning by individuals is critical to the successful implementation of m‐learning systems. Thus, there is a need to research the factors that affect user intention to use m‐learning. Based on the unified theory of acceptance and use of technology (UTAUT), which integrates elements across eight models of information technology use, this study was to investigate the determinants of m‐learning acceptance and to discover if there exist either age or gender differences in the acceptance of m‐learning, or both. Data collected from 330 respondents in Taiwan were tested against the research model using the structural equation modelling approach. The results indicate that performance expectancy, effort expectancy, social influence, perceived playfulness, and self‐management of learning were all significant determinants of behavioural intention to use m‐learning. We also found that age differences moderate the effects of effort expectancy and social influence on m‐learning use intention, and that gender differences moderate the effects of social influence and self‐management of learning on m‐learning use intention. These findings provide several important implications for m‐learning acceptance, in terms of both research and practice.
Reassessing the Role of Anxiety in Vote Choice
Authors: Ladd Jonathan McDonald , Lenz Gabriel S.
Published: February 2008

Much recent political psychology scholarship has examined the role of anxiety in vote choice. This work generally argues that anxiety affects vote choice indirectly by causing citizens to more thoroughly search for and process political information. This indirect effect of anxiety leads citizens to rely less on heuristics, such as party, and more on substantive information, such as policy positions. The most prominent example of this scholarship is the Affective Intelligence (AI) theory of emotions. In this paper, we use cross‐sectional and panel survey data to test AI against two simpler alternatives: (1) that emotions directly influence candidate evaluations and (2) that candidate evaluations directly influence emotions. We first show that these simpler alternatives can produce the complex, cross‐sectional interactions that provide the principal support for AI. Then, using panel data to better assess causal direction, we find little support for AI, some evidence that emotions directly influence candidate evaluations, and strong evidence that candidate evaluations directly influence emotions. Scholars, we conclude, should be hesitant to abandon these simpler explanations in favor of AI.
Simple and Globally Convergent Methods for Accelerating the Convergence of Any EM Algorithm
Authors: VARADHAN RAVI , ROLAND CHRISTOPHE
Published: February 2008

Abstract.  The expectation‐maximization (EM) algorithm is a popular approach for obtaining maximum likelihood estimates in incomplete data problems because of its simplicity and stability (e.g. monotonic increase of likelihood). However, in many applications the stability of EM is attained at the expense of slow, linear convergence. We have developed a new class of iterative schemes, called squared iterative methods (SQUAREM), to accelerate EM, without compromising on simplicity and stability. SQUAREM generally achieves superlinear convergence in problems with a large fraction of missing information. Globally convergent schemes are easily obtained by viewing SQUAREM as a continuation of EM. SQUAREM is especially attractive in high‐dimensional problems, and in problems where model‐specific analytic insights are not available. SQUAREM can be readily implemented as an ‘off‐the‐shelf’ accelerator of any EM‐type algorithm, as it only requires the EM parameter updating. We present four examples to demonstrate the effectiveness of SQUAREM. A general‐purpose implementation (written in R) is available.
Likelihood Ratio Testing for Hidden Markov Models Under Non‐standard Conditions
Authors: DANNEMANN JÖRN , HOLZMANN HAJO
Published: February 2008

Abstract.  In practical applications, when testing parametric restrictions for hidden Markov models (HMMs), one frequently encounters non‐standard situations such as testing for zero entries in the transition matrix, one‐sided tests for the parameters of the transition matrix or for the components of the stationary distribution of the underlying Markov chain, or testing boundary restrictions on the parameters of the state‐dependent distributions. In this paper, we briefly discuss how the relevant asymptotic distribution theory for the likelihood ratio test (LRT) when the true parameter is on the boundary extends from the independent and identically distributed situation to HMMs. Then we concentrate on discussing a number of relevant examples. The finite‐sample performance of the LRT in such situations is investigated in a simulation study. An application to series of epileptic seizure counts concludes the paper.
‘Southern‐style’ National Health Services? Recent Reforms and Trends in Spain and Greece
Authors: Petmesidou Maria , Guillén Ana M.
Published: February 2008

This article analyses recent changes in the Greek and Spanish national health services. The aim is to assess how the period of austerity and further recovery during the 1990s and early 2000s impacted on them in terms of equity and efficiency. This is of interest because of the closeness in time between the universalizing reform laws and the arrival of the conditions for economic convergence established in the Maastricht Treaty. The analysis is also attractive because it deals with the transformation of already mature health insurance systems into national health services, a transformation that is novel in European welfare history. The article addresses the questions of whether austerity has hindered full implementation of the reform laws enacted in the early to mid‐1980s, examining reform trajectories and financing and expenditure trends. Furthermore, it considers the impact on access, understood in terms of population coverage, the array of services provided, waiting lists, and territorial inequalities. Finally, it discusses the introduction of new managerial formulas and attempts at enhancing efficiency. The concluding section states that divergent trajectories have occurred, thus rendering the definition of a ‘Southern model of health care’ difficult. It also provides explanations of the trajectories followed in both national cases and informs on prospects for the future.
Gender Pay Differentials in Portugal: Contributions to the Employment Policy Debate in the European Union
Authors: González Pilar , Santos Luis Delfim , Santos Maria Clementina
Published: February 2008

Since the implementation of the European Employment Strategy in the 1990s, the issue of gender gaps in the European Union labour markets has been granted a high profile. The Portuguese labour market has performed well on various indicators relating to gender equality, namely, participation and employment rates. Nevertheless, a persistent pay gap remains despite the recent evolution of the labour market, especially concerning the average education level of workers. This article investigates the main factors explaining the gender pay gap across two decades and the way those factors perform along time. We also discuss the means of closing the gap in the context of the European Employment Strategy, considering the lessons from other member states. We used wage decomposition techniques to analyse the relative importance of differences in the productive characteristics of workers, differences in the way men and women are distributed among jobs and the relative importance of discrimination practices. Our findings suggest that most of the pay gap is due to discrimination practices. Individual action by economic agents is insufficient to solve the persistent pay gap. Social partners must incorporate this issue within collective bargaining in order to construct an adequate strategy for reducing the gap, which can only be done by engaging men and women, employees and employers.
Activation and Local Welfare in Italy: Trends and Issues
Authors: Bifulco Lavinia , Bricocoli Massimo , Monteleone Raffaele
Published: February 2008

This article deals with the development of local welfare in Italy and is grounded on a research project focusing on activation as a main feature of change in Italian social policies. Along with decentralization processes, many Italian regions have been acting as policy laboratories, developing and testing very different approaches according to their political attitude. On the one hand this results in a fragmented policy landscape which is difficult to recompose, and, moreover, in growing inequalities in the Italian welfare system. On the other hand, it opens opportunities for experimentation on institutional and organizational structures on a regional scale, creating a variety of practices for research and policy analysis. In the article we first describe the main trends in national social policies, with a specific focus on the dynamics of change referring to activation. We will then focus on a pilot programme which is aiming at the promotion and implementation of innovative practices in health and social care services in Friuli‐Venezia Giulia, a region in which there is a significant orientation towards enhancing social citizenship and enforcing the central position of the public actor. We investigate how the dynamics of territorialization and personalization, implied by the programme, trigger specific logics and practices of activation. Finally, referring to this case study, we propose an analytical overview of some relevant issues in the development of ‘local active welfare’ in Italy.
On the Existence and Uniqueness of Pure‐Strategy Nash Equilibrium in Asymmetric Rent‐Seeking Contests
Authors: YAMAZAKI TAKESHI
Published: February 2008

There can be three types of heterogeneity among players in a rent‐seeking contest. First, effectiveness of player's effort on the winning probabilities may differ among players. Secondly, players may evaluate the rent or prize of the rent‐seeking contest differently. Thirdly, players may face different financial constraints. This article proves under standard assumptions in the literature that there exists a unique pure‐strategy Nash equilibrium in a general asymmetric rent‐seeking contest with these three types of heterogeneity among players.
PHILOSOPHY AND THE STUDY OF ITS HISTORY
Authors: MELNYK ANDREW
Published: February 2008

Abstract: This article's goal is to outline one approach to providing a principled answer to the question of what is the proper relationship between philosophy and the study of philosophy's history, a question arising, for example, in the design of a curriculum for graduate students. This approach requires empirical investigation of philosophizing past and present, and thus takes philosophy as an object of study in something like the way that contemporary (naturalistic) philosophy of science takes science as an object of study. This approach also requires articulating a sense in which philosophy might make, or might have made, progress.
Effects of Changes in Incomes and Practice Circumstances on Physicians' Decisions to Treat Charity and Medicaid Patients
Authors: CUNNINGHAM PETER J. , HADLEY JACK
Published: February 2008

Context: The decline over the past decade in the percentage of physicians providing care to charity and Medicaid patients has been attributed to both financial pressure and the changing practice environment. Policymakers should be concerned about these trends, since private physicians are a major source of medical care for low‐income persons. This study examines how changes in physicians' practice income, ownership, and size affect their decisions to stop or start treating charity care and Medicaid patients.

Methods: This study uses panel data from four rounds of the Community Tracking Study Physician Survey. The dependent variables are the likelihood of physicians' (1) dropping charity care, (2) starting to provide charity care, (3) no longer accepting new Medicaid patients, and (4) starting to accept new Medicaid patients. The primary independent variables are changes in physicians' practice income, ownership, and practice type/size. Multivariate analysis controls for the effects of other physician practice characteristics, health policies, and health care market factors.

Findings: A decline in physicians' income increased the likelihood that a physician would stop accepting new Medicaid patients but had no effect on his or her decision to provide charity care. Those physicians who switched from being owners to employees or from small to larger practices were more likely to drop charity care and to start accepting Medicaid patients, and physicians who made the opposite practice changes did the reverse.

Conclusions: Changes in their income and practice arrangements make physicians less willing to accept Medicaid and uninsured patients. Moreover, physicians moving into different practice arrangements treat charity and Medicaid patients as substitutes rather than as similar types of patients. To reverse these trends, policymakers should consider raising Medicaid reimbursement rates and subsidizing organizations that encourage private physicians to provide charity care.
Health Research Funding Agencies' Support and Promotion of Knowledge Translation: An International Study
Authors: TETROE JACQUELINE M. , GRAHAM IAN D. , FOY ROBBIE , ROBINSON NICOLE , ECCLES MARTIN P. , WENSING MICHEL , DURIEUX PIERRE , LÉGARÉ FRANCE , NIELSON CAMILLA PALMHØJ , ADILY ARMITA , WARD JEANETTE E. , PORTER CASSANDRA , SHEA BEVERLEY , GRIMSHAW JEREMY M.
Published: February 2008

Context: The process of knowledge translation (KT) in health research depends on the activities of a wide range of actors, including health professionals, researchers, the public, policymakers, and research funders. Little is known, however, about health research funding agencies' support and promotion of KT. Our team asked thirty‐three agencies from Australia, Canada, France, the Netherlands, Scandinavia, the United Kingdom, and the United States about their role in promoting the results of the research they fund.

Methods: Semistructured interviews were conducted with a sample of key informants from applied health funding agencies identified by the investigators. The interviews were supplemented with information from the agencies' websites. The final coding was derived from an iterative thematic analysis.

Findings: There was a lack of clarity between agencies as to what is meant by KT and how it is operationalized. Agencies also varied in their degree of engagement in this process. The agencies' abilities to create a pull for research findings; to engage in linkage and exchange between agencies, researchers, and decision makers; and to push results to various audiences differed as well. Finally, the evaluation of the effectiveness of KT strategies remains a methodological challenge.

Conclusions: Funding agencies need to think about both their conceptual framework and their operational definition of KT, so that it is clear what is and what is not considered to be KT, and adjust their funding opportunities and activities accordingly. While we have cataloged the range of knowledge translation activities conducted across these agencies, little is known about their effectiveness and so a greater emphasis on evaluation is needed. It would appear that “best practice” for funding agencies is an elusive concept depending on the particular agency's size, context, mandate, financial considerations, and governance structure.
PSYCHOLOGICAL CONTINUITY, FISSION, AND THE NON‐BRANCHING CONSTRAINT
Authors: FRANCESCOTTI ROBERT
Published: February 2008

Abstract: Those who endorse the Psychological Continuity Approach (PCA) to analyzing personal identity need to impose a non‐branching constraint to get the intuitively correct result that in the case of fission, one person becomes two. With the help of Brueckner's (2005) discussion, it is shown here that the sort of non‐branching clause that allows proponents of PCA to provide sufficient conditions for being the same person actually runs contrary to the very spirit of their theory. The problem is first presented in connection with perdurantist versions of PCA. The difficulty is then shown to apply to endurantist versions as well.
The Value of Relationship Lending: Small Banks in an Era of Consolidation
Authors: Bongini Paola , Di Battista Maria Luisa , Zavarrone Emma
Published: February 2008

Consolidation in the banking industry has caused concern about the survival of small banks. Empirical evidence, however, shows that small banks are performing better than larger banks in terms of loan growth and profitability. This paper investigates the determinants of such unexpected superior performance; in particular we posit that peculiarities of small banks, like their ability to lever on relationship lending, are good explanatory variables of their recent loan growth.
Measurement of family impact of skin disease: further validation of the Family Dermatology Life Quality Index (FDLQI)
Authors: Basra MKA , Edmunds O , Salek MS , Finlay AY
Published: February 2008

Aim  To adapt the Impact on Family scale (IOF), originally developed for families of children with chronic illnesses, for use in families of adult patients and to examine the convergent validity of the Family Dermatology Life Quality Index (FDLQI) by comparing it with the adapted version of the IOF scale.

Methods  Adult family members of patients with different skin diseases attending the out‐patients clinic of a secondary referral centre completed the FDLQI and the adapted version of the IOF scale, whereas patients completed the Dermatology Life Quality Index (DLQI).

Results  A total of 50 patients and 50 family members/partners participated in the study. The mean scores for the three instruments were as follows: FDLQI = 6.0 (SD = 6.4, median = 4); IOF scale = 27.9 (SD = 8.2, median = 29); DLQI = 5.4 (SD = 5.6, median = 3). There was no difference between male and female participants in the mean scores of any of the three instruments. The FDLQI demonstrated high internal consistency (Cronbach's α = 0.91). Factor analysis revealed the presence of one factor structure underlying the items of the FDLQI, which explained 55.8% of the total variance. The IOF scale also showed a high internal consistency (Cronbach's α = 0.89). The results of factor analysis revealed one dominant factor and three weaker factors, which together explained 72% of the total variance. The convergent validity of the FDLQI was demonstrated by a highly significant positive correlation between the mean FDLQI and the IOF scale scores (rs = 0.61, P < 0.0001). All the items of the FDLQI also had significant correlations with the mean total IOF scale scores (P < 0.05).

Conclusions  The results of this study have demonstrated that with minor modifications IOF scale, which was originally developed for families of children suffering from chronic illnesses, can also be used in families of adult dermatology patients. The study has also provided further evidence of the validity of the newly developed FDLQI.
Commitment in Age-Gap Heterosexual Romantic Relationships: A Test of Evolutionary and Socio-Cultural Predictions
Authors: Lehmiller Justin J. , Christopher R. Agnew
Published: February 2008

Little research has addressed age-gap romantic relationships (romantic involvements characterized by substantial age differences between partners). Drawing on evolutionary and socio-cultural perspectives, the present study examined normative beliefs and commitment processes among heterosexual women involved in age-gap and age-concordant relationships. Results indicated that woman-older partners were the most satisfied with and committed to their relationships, relative to woman-younger and similarly aged partners, consistent with socio-cultural predictions. Additional analyses revealed that satisfaction, alternatives, investments, and normative beliefs accounted for differing degrees of variance in the prediction of commitment among age-gap and similarly aged partners, with greater explained variance among partners of similar ages. Thus, among female heterosexual age-gap partners, factors beyond traditional predictors of commitment may be important in understanding the maintenance of these relationships.
Recent Currents in the Nineteenth‐Century American Maritime History
Authors: Raffety Matthew
Published: February 2008

Despite a substantial amount of scholarship in new and exciting directions, some scholars are concerned that the field of nineteenth‐century U.S. Maritime history is becoming too fragmented to function as a coherent field. The ‘new maritime history’ of the late 1960s has ushered in a host of new approaches to the lives, labor, and politics of American seamen. Scholars examining the gender identity, labor, ideology, legal status, literary portrayals, nationalism, multiculturalism, and racial and cultural identities of seafarers have created a dynamic, if at times confusing and atomized portrait of American seafarers in the nineteenth century. Nevertheless, despite the myriad of approaches and specialties within the literature, ranging including piracy, mutiny, shipbuilding, whaling, fishing, and packet ships, scholars do agree that the maritime setting was crucial to the national development and sense of self for the United States during nineteenth century, and the maritime history of the United States needs to be integrated more completely into the larger national story and transnational stories.
South Africa's Soviet Connection1
Authors: Filatova Irina
Published: February 2008

To outward appearance at least, South Africa and the Soviet Union did not enjoy close relations during most of the 20th century. Diplomatic relations existed on paper between the Boer republics and Russia during the Anglo‐Boer war but they ended when the republics lost their independence. During the 1920s and 1930s trade was negligible, and the new high point in mutual interest and relations came only during the Second World War, when Soviet diplomatic or trade missions opened in Johannesburg, Pretoria and Cape Town. This official relationship was broken by the National Party government in 1956, and was re‐established only in the early 1990s, after the collapse of the Soviet Union and the end of apartheid. Diplomatic relations were, however, just the tip of the iceberg. The Soviet Union maintained a close connection with the Communist Party of South Africa (CPSA) and, later on, with both the African National Congress (ANC) and the South African Communist Party (SACP), the CPSA's successor. This article attempts to assess the extent and importance of this connection, and its influence on South Africa's transition to democracy and on the political players in today's South Africa.
Effectiveness of an Exercise Support Program in Reducing the Severity of Postnatal Depression in Taiwanese Women
Authors: Heh Shu‐Shya , Huang Lian‐Hua , Ho Shiao‐Ming , Fu Yu‐Ying , Wang Li‐Lin
Published: February 2008

ABSTRACT:  Background:
Depression during the perinatal period should be identified as early as possible to avoid negative effects on the new family. The purpose of this study was to examine the effectiveness of an exercise support program on reducing psychological morbidity after childbirth.
Methods:
A controlled trial was conducted in a regional hospital in Taipei, Taiwan. Eighty primiparas with an Edinburgh Postnatal Depression Scale (EPDS) score above 10 at 4 weeks postpartum agreed to participate. They were allocated alternately to an intervention (to receive exercise support) and control group (to receive standard care) at 6 weeks postpartum. The exercise support consisted of 1 hour per week at the hospital and two sessions at home for 3 months. Sixty‐three primiparas finished the exercise support program. The main outcome measure was the EPDS score at 5 months postpartum.
Results:
Women who received the exercise support program were less likely to have high depression scores after childbirth when compared with the control group.
Conclusions:
The exercise support program given to postpartum women appeared to benefit their psychological well‐being. This promising finding should be tested in a well‐designed randomized controlled trial. (BIRTH 35:1 March 2008)
Transfers in Planned Home Births Related to Midwife Availability and Continuity: A Nationwide Population‐Based Study
Authors: Lindgren Helena E. , Hildingsson Ingegerd M. , Christensson Kyllike , Rådestad Ingela J.
Published: February 2008

ABSTRACT:  Background:
Planning a home birth does not necessarily mean that the birth will take place successfully at home. The object of this study was to describe reasons and risk factors for transfer to hospital during or shortly after a planned home birth.
Methods:
A nationwide study including all women who had given birth at home in Sweden between January 1, 1992, and July 31, 2005. A total of 735 women had given birth to 1,038 children. One questionnaire for each planned home birth was sent to the women. Of the 1,038 questionnaires, 1,025 were returned. Reasons for transfer and obstetric, socioeconomic, and care‐related risk factors for being transferred were measured using logistic regression.
Results:
Women were transferred in 12.5 percent of the planned home births. Transfers were more common among primiparas compared with multiparas (relative risk [RR] 2.5; 95% CI 1.8–3.5). Failure to progress and unavailability of the chosen midwife at the onset of labor were the reasons for 46 and 14 percent of transfers, respectively. For primiparas, the risk was four times greater if a midwife other than the one who carried out the prenatal checkups assisted at the birth (RR 4.4; 95% CI 2.1–9.5). A pregnancy exceeding 42 weeks increased the risk of transfer for both primiparas (RR 3.0; 95% CI 1.1–9.4) and multiparas (RR 3.4; 95% CI 1.3–9.0).
Conclusions:
The most common reasons for transfer to hospital during or shortly after delivery were failure to progress followed by the midwife’s unavailability at the onset of labor. Primiparas whose midwife for checkups during pregnancy was different from the one who assisted at the home birth were at increased risk of being transferred. (BIRTH 35:1 March 2008)
Asymptomatic Atherosclerosis and Hypertension in Nondiabetic Patients With Chronic Kidney Disease
Authors: Ekart Robert , Hojs Radovan , Bevc Sebastjan , Balon Breda Pečovnik
Published: February 2008

Abstract:  Atherosclerosis is accelerated in dialysis patients, but less is known about asymptomatic atherosclerosis and major risk factors in patients with different stages of chronic kidney disease (CKD). We compared intima media thickness (IMT) and plaque occurrence in the carotid arteries in 104 nondiabetic patients (stages 1–5 of CKD; mean age: 51.6 years) with those in 40 healthy control subjects. The IMT values (0.69 vs. 0.59 mm; P < 0.002) were higher in patients. More patients had plaques (46.2 vs. 17.5%; P < 0.002), and number of plaques was higher (P < 0.003). Negative correlation between IMT (P < 0.0001), presence of plaques (P < 0.0001), their number (P < 0.040), and chromium 51‐labeled ethylenediaminetetraacetate (51Cr‐EDTA) clearance were found in patients. With multiple regression analysis, relationship between IMT and 51Cr‐EDTA clearance (P < 0.001) and presence of hypertension (P < 0.001) was found. Nondiabetic patients with CKD showed advanced atherosclerosis and IMT, plaque occurrence, and number increased directly with the level of renal dysfunction. Another important risk factor was hypertension.
A Tissue‐engineered Stomach Shows Presence of Proton Pump and G‐cells in a Rat Model, Resulting in Improved Anemia Following Total Gastrectomy
Authors: Maemura Tomoyuki , Shin Michael , Kinoshita Manabu , Majima Takashi , Ishihara Masayuki , Saitoh Daizoh , Ichikura Takashi
Published: February 2008

Abstract:  Despite advances in surgical reconstruction, total gastrectomy still is accompanied by various complications, especially chronic ones, such as pernicious anemia, resulting in refractory malnutrition. As an alternative approach, we have proposed a tissue‐engineered stomach as a replacement of the native stomach. This study aimed to assess the secretory functions of a tissue‐engineered stomach in a rat model and the nutritional status of the recipients over an extended time period. Stomach epithelial organoid units were isolated from neonatal rats and seeded onto biodegradable polymers. These constructs were implanted into the omenta of adult recipient rats. After 3 weeks, cyst‐like structures had formed, henceforth referred to as tissue‐engineered stomachs. The recipient stomachs were resected and replaced by their tissue‐engineered counterparts. At 24 weeks after implantation, the secretory function of the tissue‐engineered stomach was evaluated using immunohistochemical staining. The hemoglobin levels and nutritional status of the recipients were compared with a control group that had undergone a simple Roux‐en‐Y reconstruction following total gastrectomy. Recipient rats tolerated the tissue‐engineered stomachs well. X‐ray examination using barium as contrast showed no bowel stenosis. Staining for proton pump α‐subunit and gastrin demonstrated the existence of parietal cells and G‐cells in the neogastric mucosa, respectively, suggesting secretory functions. The treatment group showed significantly higher hemoglobin levels than the control group, although no differences in the body weight change, total protein, or cholesterol levels were observed between the two groups. A tissue‐engineered stomach has the potential to function as a food reservoir following total gastrectomy. It is conjectured that replacement with a tissue‐engineered stomach might restore the proton pump parietal cells and G‐cells, and thereby improve anemia after a total gastrectomy in a rat model.
ANALYSIS OF ANCIENT DNA FROM FOSSIL CORALLINES (CORALLINALES, RHODOPHYTA)1
Authors: Hughey Jeffery R. , Braga Juan C. , Aguirre Julio , Woelkerling William J. , Webster Jody M.
Published: February 2008

The field of molecular paleontology has recently made significant contributions to anthropology and biology. Hundreds of ancient DNA studies have been published, but none has targeted fossil coralline algae. Using regions of the SSU gene, we analyzed rDNA from fossil coralline algae of varying ages and states of preservation from Spain, Papua New Guinea (PNG), and the Great Barrier Reef (GBR). Specimens from PNG, GBR, and some localities from Spain did not contain endogenous ancient DNA. Reproducible sequence data were obtained from specimens ∼550 years old from near Cadiz, Spain, and from rocky‐shore deposits in Carboneras, Almeria Province of Spain (∼78,000 years before present [YBP]). Based on BLAST searches and a phylogenetic analysis of sequences, an undescribed coralline alga belonging to the Melobesioideae was discovered in the Carboneras material as well as the following coralline genera: Jania, Lithophyllum, Lithothamnion, Mesophyllum, and Phymatolithon. DNA from fleshy brown and red macroalgae was also discovered in the specimens from Carboneras. The coralline algae identified using molecular techniques were in agreement with those based on morphological methods. The identified taxa are common in the present‐day southeastern Spain littoral zone. Amino acid racemization, concentration ratios, and specific concentrations failed to show a correlation between biomolecular preservation and PCR amplification success. Results suggest that molecular investigations on fossil algae, although limited by technical difficulties, are feasible. Validity of our results was established using authentication criteria and a self‐critical approach to compliance.
Minority Disparities in Disability Between Medicare Beneficiaries
Authors: Ciol Marcia A. , Shumway‐Cook Anne , Hoffman Jeanne M. , Yorkston Kathryn M. , Dudgeon Brian J. , Chan Leighton
Published: February 2008

OBJECTIVES: To examine racial and ethnic disparities in mobility limitation, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) in older adults enrolled in Medicare.

DESIGN: Longitudinal national survey.

PARTICIPANTS: Community‐dwelling respondents in the Medicare Current Beneficiaries Survey from 1992 to 2004 (10,180–16,788 respondents per year).

MEASUREMENTS: Disability‐related outcomes included mobility limitation, difficulty in six ADLs and six IADLs. Explanatory variables included age, sex, racial or ethnic group, living situation, and income level.

RESULTS: From 1992 to 2004, proportions of Medicare beneficiaries with mobility limitations were stable across racial and ethnic groups, improving slightly for ADLs and IADLs. Blacks reported more limitations in all three disability‐related measures. In a longitudinal analysis, the probability of developing mobility limitation was consistently higher for blacks, followed by white Hispanics, white non‐Hispanics, and Asians, after adjusting for age, sex, socioeconomic status, and living situation. For ADL and IADL difficulties, the number of reported difficulties increased with age for all ethnic and racial groups. At approximately age 75, Asians and white Hispanics reported difficulties with much higher numbers of ADLs and IADLs than the other groups.

CONCLUSION: Across all ethnic and racial groups, self‐reported disability has declined in the past decade, but even after adjusting for age, sex, socioeconomic status, and living situation, racial and ethnic disparities in disability outcomes persist. Race and ethnicity may influence the reporting of disability, potentially affecting measures of prevalence. Further research is needed to understand whether these differences are a result of perceptions related to disablement or true differences in disability between racial and ethnic groups.
Muscle Endurance in Elderly Nursing Home Residents Is Related to Fatigue Perception, Mobility, and Circulating Tumor Necrosis Factor‐Alpha, Interleukin‐6, and Heat Shock Protein 70
Authors: Bautmans Ivan , Njemini Rose , Predom Heidi , Lemper Jean‐Claude , Mets Tony
Published: February 2008

OBJECTIVES: To explore the relationships between muscle endurance and circulating interleukin (IL)‐6, tumor necrosis factor alpha (TNF‐α), and heat shock protein (Hsp)70 in nursing home residents and to assess how muscle endurance relates to self‐perceived fatigue and mobility.

DESIGN: Exploratory study.

SETTING: Three nursing homes of the Foundation for Psychogeriatrics (Brussels, Belgium).

PARTICIPANTS: Seventy‐seven residents (53 female and 24 male, mean age 81 ± 8).

MEASUREMENTS: Participants were assessed for muscle endurance (fatigue resistance and grip work); perceived fatigue (visual analogue scale for fatigue); fatigue during daily activities (Mobility‐Tiredness Scale); effect of fatigue on quality of life (World Health Organization Quality Of Life questionnaire); mobility (Tinetti Test & Elderly Mobility Scale (EMS)); and circulating IL‐6, TNF‐α, and Hsp70.

RESULTS: Residents with better fatigue resistance reported less self‐perceived tiredness (P<.05). Similar trends were observed for fatigue during daily activities and for the extent to which fatigue bothered subjects. Higher grip work was associated with less self‐perceived fatigue on all fatigue scales (P<.01). Fatigue resistance and grip work were positively related to balance and basic mobility (all P<.01; trend for relationship between fatigue resistance and EMS). Subjects with high IL‐6 and Hsp70 showed significantly worse fatigue resistance (P=.007) and muscle work (P=.045) than those with high IL‐6 and low Hsp70. In male residents, higher TNF‐α was related to worse fatigue resistance and grip work (P<.05).

CONCLUSION: Elderly nursing home residents complaining of fatigue need to be taken seriously, because they show worse muscle endurance, which is related to poorer mobility. Inflammatory processes involving TNF‐α and the interaction between IL‐6 and Hsp70 are related to poorer muscle endurance in these patients.
Creation and Testing of the Geriatric Self‐Efficacy Index for Urinary Incontinence
Authors: Tannenbaum Cara , Brouillette Judith , Korner‐Bitensky Nicol , Dumoulin Chantale , Corcos Jacques , Tu Le Mai , Lemieux Marie‐Claude , Ouellet Stephane , Valiquette Luc
Published: February 2008

OBJECTIVES: To report on the content development, construct validity, and reliability testing of the Geriatric Self‐Efficacy Index for Urinary Incontinence (GSE‐UI).

DESIGN: Prospective cohort study.

SETTING: Six UI outpatient clinics in Quebec, Canada.

PARTICIPANTS: Community‐dwelling incontinent men and women aged 65 and older.

MEASUREMENTS: Thirty‐eight items were generated using a literature search and interdisciplinary panel of experts. Item reduction was achieved through field‐testing with 75 older men and women with UI attending an information session. The final 20‐item draft, measuring older adults' level of confidence in preventing urine loss, was administered to a new group of consecutive patients 1 week before and at the time of their first visit to the UI clinic to enable evaluation of test–retest reliability. A 3‐day voiding diary, quantifying the frequency of UI, and the Incontinence Quality of Life questionnaire were used to test construct validity.

RESULTS: One hundred sixteen of 300 eligible patients (39%) participated (mean age±standard deviation 74±6, range 65–87). The GSE‐UI items showed normal distributions and no ceiling effects. Self‐efficacy scores ranged from 16 to 193 (mean 104±41, possible range 0–200) and correlated positively with quality of life scores (r=0.7, P<.001) and negatively with UI severity (r=−0.4, P<.001). Internal consistency for the GSE‐UI was 0.94 (Cronbach alpha). Initial test–retest reliability of the 20 items using intraclass correlations ranged from 0.50 to 0.86.

CONCLUSION: The GSE‐UI will enable measurement of whether a person's confidence in their ability to prevent urine loss is an important mechanism contributing to improvements in UI.
Can Counseling and Support Reduce Burden and Depressive Symptoms in Caregivers of People with Alzheimer's Disease During the Transition to Institutionalization? Results from the New York University Caregiver Intervention Study
Authors: Gaugler Joseph E. , Roth David L. , Haley William E. , Mittelman Mary S.
Published: February 2008

OBJECTIVES: To determine whether counseling and support reduce the burden and depressive symptoms of spouse caregivers of patients with Alzheimer's disease (AD) during the transition to institutionalization.

DESIGN: A randomized, controlled trial of an enhanced counseling and support program for spouse caregivers of persons with AD. Structured interviews were conducted with spouse caregivers at baseline, every 4 months during Year 1, and every 6 months thereafter for up to 16 years.

SETTING: Outpatient research clinic in the New York City metropolitan area.

PARTICIPANTS: Referred volunteer sample of 406 spouse caregivers of community‐dwelling patients with AD enrolled over a 9.5‐year period.

INTERVENTION: Enhanced counseling and support consisting of six sessions of individual and family counseling, support group participation, and continuous availability of ad hoc telephone counseling.

MEASUREMENTS: Outcome measures included burden (modified Zarit Burden Interview) and depressive symptoms (Geriatric Depression Scale).

RESULTS: Burden and depressive symptoms were significantly lower for caregivers in the treatment group than for controls receiving usual care at the time of and after institutionalization. Nursing home admission itself significantly reduced burden and depressive symptoms in the intervention and control groups.

CONCLUSION: Institutionalization alone can reduce caregiver burden and depressive symptoms, but enhanced counseling provides additional long‐term benefits. The results offer some of the first clinical evidence of the benefits of enhanced counseling during the transition to institutionalization for caregivers of people with AD.
Subtypes of Disability in Older Persons over the Course of Nearly 8 Years
Authors: Gill Thomas M. , Guo Zhenchao , Allore Heather G.
Published: February 2008

OBJECTIVES: To characterize distinct and clinically meaningful subtypes of disability, defined based on the number and duration of disability episodes, and to determine whether the incidence of these disability subtypes differ according to age, sex, or physical frailty.

DESIGN: Prospective cohort study.

SETTING: Greater New Haven, Connecticut.

PARTICIPANTS: Seven hundred fifty‐four community‐living residents aged 70 and older and initially nondisabled in four essential activities of daily living.

MEASUREMENTS: Disability was assessed during monthly telephone interviews for nearly 8 years; physical frailty was assessed during comprehensive home‐based assessments at 18‐month intervals. The incidence of five disability subtypes was determined within the context of the 18‐month intervals in participants who were nondisabled at the start of the interval: transient, short‐term, long‐term, recurrent, and unstable.

RESULTS: Incident disability was observed in 29.8% of the 18‐month intervals. The most common subtypes were transient disability (9.7% of all intervals), defined as a single disability episode lasting only 1 month, and long‐term disability (6.9%), defined as one or more disability episodes, with at least one lasting 6 or more months. Approximately one‐quarter (24.7%) of all participants had two or more intervals with an incident disability subtype. Although there were no sex differences in the incidence rates for any of the subtypes, differences in rates were observed for each subtype according to age and physical frailty, with only one exception, and were especially large for long‐term disability.

CONCLUSION: The mechanisms underlying the different disability subtypes may differ. Additional research is warranted to evaluate the natural history, risk factors, and prognosis of the five disability subtypes.
Activity Restriction Induced by Fear of Falling and Objective and Subjective Measures of Physical Function: A Prospective Cohort Study
Authors: Deshpande Nandini , Metter E. Jeffrey , Lauretani Fulvio , Bandinelli Stefania , Guralnik Jack , Ferrucci Luigi
Published: February 2008

OBJECTIVES: To examine whether activity restriction specifically induced by fear of falling (FF) contributes to greater risk of disability and decline in physical function.

DESIGN: Prospective cohort study.

SETTING: Population‐based older cohort.

PARTICIPANTS: Six hundred seventy‐three community‐living elderly (≥65) participants in the Invecchiare in Chianti Study who reported FF.

MEASUREMENTS: FF, fear‐induced activity restriction, cognition, depressive symptoms, comorbidities, smoking history, and demographic factors were assessed at baseline. Disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) and performance on the Short Performance Physical Battery (SPPB) were evaluated at baseline and at the 3‐year follow‐up.

RESULTS: One‐quarter (25.5%) of participants did not report any activity restriction, 59.6% reported moderate activity restriction (restriction or avoidance of <3 activities), and 14.9% reported severe activity restriction (restriction or avoidance of ≥3 activities). The severe restriction group reported significantly higher IADL disability and worse SPPB scores than the no restriction and moderate restriction groups. Severe activity restriction was a significant independent predictor of worsening ADL disability and accelerated decline in lower extremity performance on SPPB over the 3‐year follow‐up. Severe and moderate activity restriction were independent predictors of worsening IADL disability. Results were consistent even after adjusting for multiple potential confounders.

CONCLUSION: In an elderly population, activity restriction associated with FF is an independent predictor of decline in physical function. Future intervention studies in geriatric preventive care should directly address risk factors associated with FF and activity restriction to substantiate long‐term effects on physical abilities and autonomy of older persons.
Abdominal Crisis in the Horse: A Comparison of Pre‐Surgical Evaluation With Surgical Findings and Results
Authors: ADAMS STEPHEN B. , McILWRAITH C. WAYNE
Published: February 2008

The results of preoperative examination, surgical intervention and the outcome of 50 cases of acute abdominal crisis in the horse are presented. Pre‐surgical parameters discussed in this correlative study include duration of the condition prior to sergery, pulse rate, packed cell volume (PCV), abdominal distention, intestinal motility and tympany, rectal findings, reflux of fluid after passage of a nasogastric tube, and abdominal paracentesis. A retrospective study was performed to evaluate the usefulness of each clinical parameter in deciding that a case was surgical, arriving at a specific pre‐surgical diagnosis, and in giving a prognosis. Rectal examination was the single most useful diagnostic tool. Reflux of gastric fluid through the nasogastric tube usually indicated obstruction of the small intestine.
Simultaneous Bilateral Mastectomy in the Dog
Authors: BARTELS KENNETH E. , FERGUSON H. RODNEY , GILLETTE EDWARD L , FERGUSON HARRY L
Published: February 2008

Current reports advise against attempting simultaneous bilateral mastectomy in the dog. However, total mastectomy may be the most logical treatment for all dogs with mammary tumors in view of newer evidence suggesting a multicentric origin for this disease. A surgical technique for simultaneous bilateral mastectomy was evaluated in 22 dogs with mammary tumors. The procedure was successfully performed in selected patients and healing occurred without serious complications. The technique, rationale, and recommendations for use of this procedure are presented.
Evaluation of Cervical Spinal Fusion as a Treatment in the Equine “Wobbler” Syndrome
Authors: WAGNER PAMELA C. , GRANT BARRIE D. , BAGBY GEORGE W. , GALLINA ANTHONY M. , SANDE RONALD D. , RATZLAFF MARC
Published: February 2008

Cervical vertebral interbody fusion was performed on 30 horses affected with cervical vertebral malformation (CVM) or “wobbles” to assess the efficacy of the surgery in either preventing progression of or reversing the neurologic deficit induced by the syndrome. Evaluation of each horse prior to surgery included clinical, radiographic, neurologic, and laboratory examination. Subjects ranged from 3 months to 8 years of age, and included 22 males and 8 females of various breeds. Three normal horses were included as controls. The Cloward method of cervical fusion was used to achieve stabilization at the affected vertebral articulation. Horses were reexamined 3 months after surgery. Clinical improvement was seen in 90% (27 of 30) of the cases. Four horses were returned to training, which had been interrupted by onset of symptoms. Seven were returned to owners as breeding animals. Twelve horses were kept for long‐term studies. Seven horses were sacrificed to examine the surgical site. In 6 of the 7 horses on which necropsy was performed, the most severe histologic lesion in the spinal cord could be predicted from lesions seen radiographically. The spinal cords of control animals were normal. Osseous fusion was dependent on the completeness of removal of disc fibrocartilage during surgery. We conclude that clinical improvement in some horses affected with CVM can be achieved by cervical fusion.