bluuebunny/crossref_metadata_2025 huggingface dataset:
POLYBIUS AND THE EVIDENCE FOR PERIPHRASTIC ΟΙ ΠΕΡΙ ΤΙΝΑ
Authors: Gorman Robert
Published: May 2003

The current view about the construction oι περι + acc. nominis proprii is subject to doubt. The most thorough investigation of the phrase maintains that in narrative prose of the Hellenistic and Roman period the periphrastic use (i.e., oι περι τινα as the equivalent of the proper name alone) is common when περι governs two or more names, but unevidenced if the preposition has only one object. The pattern is said to have been already fully formed when it first appeared in the Histories of Polybius. The evidence from that author, however, does not support this view. Each of the passages offered as clear examples of periphrasis admits of a more plausible interpretation. For some, the context makes clear that Polybius has in mind specific referents for the phrase which cannot then be periphrastic. In other passages the phrase belongs to one of several types recognizable according to Polybian usage, whose details tell against the periphrastic interpretation. Thus, oι περι X and oι περι X και Y are indistinct with respect to this usage and there is no certain instance of periphrastic o περ τινα in the Histories, the work with which this idiom is perhaps most closely identified.
"THE USE OF SUNDAY FOR MEETINGS OF BELIEVERS IN THE NEW TESTAMENT": A RESPONSE
Authors: Young Norman
Published: May 2003

S. R. Llewelyn's recent study on Sunday in the NT attempts to prove that first-century Christians were regularly meeting together on the first day of the week. His available evidence is sparse, and his conclusions lack cogent support. His effort to demonstrate that the offering in 1 Cor. 16:2 was in a Christian assembly falls short of proof. Likewise his argument that Acts 20:7 proves that Christians assembled to celebrate the Eucharist on Sunday is not coercive. Finally the inference that Rev. 1:10 points to Sunday as a time of regular Christian assembly is more than the language of the text warrants.
Subpopulations at increased risk of adverse health outcomes from air pollution
Authors: Annesi-Maesano I. , Agabiti N. , Pistelli R. , Couilliot M‐F. , Forastiere F.
Published: May 2003

Epidemiological research to identify subpopulations with enhanced susceptibility to air pollution is still at an early stage.

From the available studies, there is evidence that both “endogenous” and “exogenous” factors contribute to individual susceptibility. Females and the elderly are at an increased risk of pollution-related diseases. Moreover, some chronic clinical conditions seem to be good candidates for identifying the “frail” populations: chronic obstructive pulmonary disease including asthma, coronary heart diseases, congestive heart failure, and heart rhythm disorders.

It seems clear that epidemiological research on susceptibility in the future should investigate the underlying biological and physiological mechanisms, in addition to the environmental and toxicological effects.
Particulate air pollution and hospital admissions for cardiorespiratory diseases: are the elderly at greater risk?
Authors: Anderson H.R. , Atkinson R.W. , Bremner S.A. , Marston L.
Published: May 2003

A systematic literature review suggests that particulate air pollution is associated with daily admissions for both respiratory and cardiac diseases in people aged >65 yrs.

A model of acute effects is proposed which shows how admissions can be brought forward by a relatively short period of time as well as events being added that would not have happened at all except for air pollution. A model of the effects of air pollution on chronic disease is proposed that provides the background of long-term vulnerability upon which the increased short-term vulnerability is superimposed.

A study of daily hospital admissions in London shows that for respiratory disease the relative risks of admission associated with particles reduce with increasing age, while for cardiac disease, there is no trend. When the attributable risk is estimated using baseline admission rates for respiratory disease, it is children who have the highest attributable risk, followed by the elderly.

For cardiac disease there is a steep increase in attributable risk with age, reflecting the dominant influence of baseline risks. The attributable risk for cardiovascular disease in the elderly is considerably greater than for respiratory disease, due to higher baseline admission rates.
Questionnaires, spirometry and PEF monitoring in epidemiological studies on elderly respiratory patients
Authors: Bellia V. , Pistelli F. , Giannini D. , Scichilone N. , Catalano F. , Spatafora M. , Hopps R. , Carrozzi L. , Baldacci S. , Di Pede F. , Paggiaro P. , Viegi G.
Published: May 2003

Questionnaires are the most used subjective instrument of measurement in respiratory epidemiology. The standardisation of the questionnaires aims to limit bias by maximising validity and reliability, and comparability. Within the European Union project BIOMED1, a compendium of respiratory standard questionnaires (CORSQ) was developed for adults covering 18 topics from general information to early life events, through environmental risk factors and respiratory symptoms and diseases.

Reliable spirometry data needs a rigorous quality control programme, as in the “Salute Respiratoria nell'Anziano” (Sa.R.A.) project, Italian for “Respiratory Health in the Elderly”. Reproducibility rates were 95.8% for forced expiratory volume in one second (FEV1). Male sex and age were independent risk factors for a poorer reproducibility, as well as cognitive and physical impairment (shorter 6‐min walking distance) and lower educational level for a poorer acceptability. Reference values for people aged 65–85 yrs have been produced; these results suggest that the effect of aging should be corrected for physical and mental disability. A revision of interpretative strategies included in current guidelines is needed.

Peak expiratory flow monitoring has several methodological problems: reliability and sensitivity of the measurement in order to detect changes in airway calibre; compliance with long-term monitoring; choice of the best variability index; difference between asthmatic and nonasthmatic subjects; age-related differences. Despite these methodological problems, peak expiratory flow monitoring has been successfully used in the evaluation of the effects of air pollution in normal and asthmatic subjects, and in the elderly.
Air pollution and mortality in the Netherlands: are the elderly more at risk?
Authors: Fischer P. , Hoek G. , Brunekreef B. , Verhoeff A. , van Wijnen J.
Published: May 2003

The association between daily mortality and short-term variations in the ambient levels of ozone (O3), black smoke (BS), sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and particulate matter was studied in the Netherlands.

Daily total and cause-specific mortality counts (cardiovascular, chronic obstructive pulmonary disease (COPD) and pneumonia), air quality, temperature, relative humidity and influenza data were obtained from 1986–1994. The relationship between daily mortality and air pollution was modelled using Poisson regression analysis. All pollution mortality associations were adjusted for potential confounding due to long-term trends, seasonal trends, influenza epidemics, ambient temperature, ambient relative humidity, day of the week and holidays, using generalised additive models.

Statistically significant associations were mostly found in the elderly, that is the age categories of 65–74 and ≥75 yrs for the pollutants PM10(particles with a 50% cut-off aerodynamic diameter of 10 µm), BS, SO2, NO2and CO. This may partly be due to a better precision of relative risk (RR) estimates for the larger numbers of deaths in these age groups. Significant associations for those <65 yrs were found for O3(total and COPD mortality), PM10(pneumonia), NO2(pneumonia) and CO (pneumonia).

RR estimates for deaths between 45–65 yrs tended to be smaller than those in >65 yrs, with the exception of ozone; for cardiovascular mortality the RR for PM10, O3and CO were similar in these age groups.

In conclusion, larger relative risks for air pollution were mostly found in the elderly except for ozone and for death-cause pneumonia which showed larger relative risk in younger age groups.
Case-crossover design in air pollution epidemiology
Authors: Jaakkola J.J.K.
Published: May 2003

The case-crossover design was developed to study the effects of transient, short-term exposures on the risk of acute events, such as myocardial infarction, in the early 1990s. This paper illustrates how the principles of case-crossover design are related to the principles of crossover and case-control designs and stipulates the possibilities of case-crossover design in air pollution epidemiology.

In the case-crossover design, the study population consists of subjects who have experienced an episode of the health outcome of interest. Similar to a crossover study, each subject serves as his or her own control. As in a matched case-control study, the inference is based on a comparison of exposure distribution rather than the risk of disease. The case-crossover study is most suitable for studying relations with the following characteristics: 1) the individual exposure varies within short time intervals; 2) the disease has abrupt onset and short latency for detection; and 3) the induction period is short.

Case-crossover design allows use of routinely monitored air pollution information and at the same time makes it possible to study individuals rather than days as the unit of observation. Case-crossover design is amenable for studying the effects of varying short-term air pollution exposure on health outcomes with an abrupt onset, such as myocardial infarction or asthma attack.
Epidemiological aspects and early detection of chronic obstructive airway diseases in the elderly
Authors: Lundbäck B. , Gulsvik A. , Albers M. , Bakke P. , Rönmark E. , van den Boom G. , Brøgger J. , Larsson L‐G. , Welle I. , van Weel C. , Omenaas E.
Published: May 2003

The burdens of chronic obstructive airway diseases among the elderly in Europe, and worldwide, are increasing. Although asthma is common in all ages, the main airway disease affecting the elderly is chronic obstructive pulmonary disease (COPD). The aim of this paper is to review the prevalence and incidence of COPD on the basis of population studies. As the prevalence estimates of asthma are probably well known, only the incidence and remission of asthma will be discussed. The underdiagnosis of obstructive airway diseases is huge. A Dutch programme for early detection of obstructive airway disease among the elderly has, thus, been included in the presentation.

A prerequisite for fighting COPD is to acquire data on illnesses and death. COPD has only recently been defined by cut-off points of spirometric outcomes, which is why measures of the prevalence of COPD have been distorted by use of a large number of different diagnostic terms and lung function criteria. The prevalence of clinically-relevant COPD has been estimated in several community studies to 4–6% in adult population samples, with a considerable increase by age, particularly among smokers. The incidence of COPD not only increases heavily with age and smoking, but also occupational exposure to dust, gas and damp. Precise estimates of the incidence of COPD or spirometric airflow limitation are not available.

Demographic changes will result in a further substantial increase of chronic obstructive airway disorders, mainly chronic obstructive pulmonary disease, among the elderly. The increasing burden of chronic obstructive pulmonary disease has to come to the awareness of the public, governments, health authorities, and industry.
Health impact assessment of air pollution: providing further evidence for public health action
Authors: Martuzzi M. , Krzyzanowski M. , Bertollini R.
Published: May 2003

Many epidemiological studies have demonstrated the importance of air pollution as a risk factor and characterised dose-response relationships between health endpoints and pollutants.

The association between particulate matter (PM) and health is generally regarded as causal, and a nonthreshold linear relationship with, for example, mortality and hospital admission has been observed in several settings.

The ubiquitous PM air pollution is likely to have a large overall impact on human health, even if risks are relatively small. There have recently been a large number of papers reporting quantitative estimations of the health impact of PM on health, as measured by the proportion of excess events that are attributable to PM exposures in the general population, mainly in industrialised countries. For example, in the eight largest Italian cities it has been estimated that concentrations beyond 30 µg·m−3are responsible for about 3,500 extra deaths per year. A similar study has been carried out for France, Austria and Switzerland.

These evaluations fill a knowledge gap between the laboratory and clinical studies on the pathophysiological mechanisms, the epidemiological research on the nature and strength of the association at the population level, and the risk management needs for developing appropriate preventive policies.

Some limitations in the methodology deserve further research, however health impact assessment type studies are informative and effective tools of communication with the general public and policy makers.
The need for a focus on air pollution research in the elderly
Authors: Sandström T. , Frew A.J. , Svartengren M. , Viegi G.
Published: May 2003

During recent years an increasing focus has been directed towards the adverse health effects associated with ambient air pollution. Elderly people appear to be particularly susceptible to the adverse effects involving the respiratory and cardiovascular systems, resulting in symptoms, exacerbations of disease and even mortality.

From an epidemiological point of view it is essential to obtain a more detailed description and identification of factors associated with these health effects. Novel study designs are needed with complementary exposure and biomedical characterisation. Long-term prospective studies are required. A better understanding of the pathophysiological mechanisms is considered important and requires an interaction between epidemiological and mechanistic studies in elderly individuals with or without complementary diseases that put in them especially at risk.

Generally a synergy between complementary disciplines is warranted to move this important research area forward, also includingin vitromodels of cell responses in the elderly, animal models of diseases of the elderly, together with controlled air pollution exposure studies identifying health-related events and mechanisms.

The generation of an understanding of air pollution effects in the elderly, at an elevated level, is a prerequisite to substantially reducing the adverse health effects of this population group. At local, national and European Union levels, some steps have been taken to support the research in this area. A major focus on the adverse air pollution effects in the elderly requires a long-term commitment that still remains to be established.
Influence of passive leg elevation on the right ventricular function in anaesthetized coronary patients
Authors: Bertolissi Massimo , Broi Ugo Da , Soldano Franca , Bassi Flavio
Published: May 2003

Introduction

The aim of the present study was to evaluate the haemodynamic effects of passive leg elevation on the right ventricular function in two groups of patients, one with a normal right ventricular ejection fraction (RVEF) and one with a reduced RVEF.

Methods

Twenty coronary patients undergoing elective coronary artery bypass grafting surgery were studied by a RVEF pulmonary artery catheter. The haemodynamic data reported were collected before the induction of anaesthesia (time point 1), just before (time point 2) and 1 min (time point 3) after the legs were simultaneously raised at 60°, and 1 min after the legs were lowered (time point 4). The patients were divided into two groups: group A, with preinduction RVEF > 45%; and group B, with preinduction RVEF < 40%.

Results

In group A (n = 10), at time point 3 compared with time point 2, the heart rate significantly decreased (from 75 ± 10 to 66 ± 7 beats/min). The right ventricular end diastolic volume index (from 105 ± 17 to 133 ± 29 ml/m2), the right ventricular end systolic volume index (from 61 ± 13 to 77 ± 24 ml/m2), the systolic systemic arterial/right ventricular pressure gradient (from 93 ± 24 to 113 ± 22 mmHg) and the diastolic systemic arterial/right ventricular pressure gradient (from 58 ± 11 to 66 ± 12 mmHg) significantly increased. Also in group A, the cardiac index did not significantly increase (from 3.28 ± 0.6 to 3.62 ± 0.6 l/min/m2), the RVEF was unchanged, and the right ventricular end diastolic volume/pressure ratio (RVED V/P) did not significantly decrease (from 48 ± 26 to 37 ± 13 ml/mmHg). In group B (n = 6) at the same time, the heart rate (from 72 ± 15 to 66 ± 12 beats/min), the right ventricular end diastolic volume index (from 171 ± 50 to 142 ± 32 ml/m2) and the RVED V/P (from 71 ± 24 to 39 ± 7 ml/mmHg) significantly decreased. The cardiac index and the diastolic systemic arterial/right ventricular pressure gradient were unchanged in group B, while the RVEF and the systolic systemic arterial/right ventricular pressure gradient did not significantly increase, and the right ventricular end-systolic volume index did not significantly decrease. All results are expressed as mean ± standard deviation.

Conclusions

We conclude that passive leg elevation caused a worse condition in the right ventricle of group B because, with stable values of cardiac index, of systolic systemic arterial/right ventricular pressure gradient and of diastolic systemic arterial/right ventricular pressure gradient (which supply oxygen), the RVED V/P (to which oxygen consumption is inversely related) markedly decreased. This is as opposed to group A, where the cardiac index, the systolic systemic arterial/right ventricular pressure gradient and the diastolic systemic arterial/right ventricular pressure gradient increased, and the RVED V/P slightly decreased. Passive leg elevation must therefore be performed cautiously in coronary patients with a reduced RVEF.
Case report: Severe mercuric sulphate poisoning treated with 2,3-dimercaptopropane-1-sulphonate and haemodiafiltration
Authors: Dargan Paul I , Giles Lucy J , Wallace Craig I , House Ivan M , Thomson Alison H , Beale Richard J , Jones Alison L
Published: May 2003

Introduction

Inorganic mercury poisoning is uncommon, but when it occurs it can result in severe, life-threatening features and acute renal failure. Previous reports on the use of extracorporeal procedures such as haemodialysis and haemoperfusion have shown no significant removal of mercury. We report here the successful use of the chelating agent 2,3-dimercaptopropane-1-sulphonate (DMPS), together with continuous veno-venous haemodiafiltration (CVVHDF), in a patient with severe inorganic mercury poisoning.

Case report

A 40-year-old man presented with haematemesis after ingestion of 1 g mercuric sulphate and rapidly deteriorated in the emergency department, requiring intubation and ventilation. His initial blood mercury was 15 580 μg/l. At 4.5 hours after ingestion he was started on DMPS. He rapidly developed acute renal failure and so he was started on CVVHDF for renal support and in an attempt to improve mercury clearance; CVVHDF was continued for 14 days.

Methods

Regular ultradialysate and pre- and post-filtrate blood samples were taken and in addition all ultradialysate generated was collected to determine its mercury content.

Results

The total amount of mercury in the ultrafiltrate was 127 mg (12.7% of the ingested dose). The sieving coefficient ranged from 0.13 at 30-hours to 0.02 at 210-hours after ingestion. He developed no neurological features and was discharged from hospital on day 50. Five months after discharge from hospital he remained asymptomatic, with normal creatinine clearance.

Discussion

We describe a patient with severe inorganic mercury poisoning in whom full recovery occurred with the early use of the chelating agent DMPS and CVVHDF. There was removal of a significant amount of mercury by CVVHDF.

Conclusion

We feel that CVVHDF should be considered in patients with inorganic mercury poisoning, particularly those who develop acute renal failure, together with meticulous supportive care and adequate doses of chelation therapy with DMPS.
The Bair Hugger patient warming system in prolonged vascular surgery: an infection risk?
Authors: Huang Joseph KC , Shah Elizabeth F , Vinodkumar Narayanan , Hegarty MA , Greatorex Robert A
Published: May 2003

Introduction

Use of the Bair Hugger forced-air patient warming system during prolonged abdominal vascular surgery may lead to increased bacterial contamination of the surgical field by mobilization of the patient's skin flora.

Methods

This possibility was studied by analyzing bacterial content in air and wound specimens collected during surgery in 16 patients undergoing abdominal vascular prosthetic graft insertion procedure, using the Bair Hugger patient warming system. The bacterial colony counts from the beginning and the end of surgery were compared, and the data analyzed using the Wilcoxon matched pairs test.

Results

The results showed not only that there was no increase in bacterial counts at the study sites, but also that there was a decrease (P < 0.01) in air bacterial content around the patient and in the operating theatre after prolonged use of the patient warmer. No wound or graft infections occurred.

Conclusion

The use of this warming system does not lead to increased bacterial contamination of the operating theatre atmosphere, and it is unlikely to affect the surgical field adversely.
Multivariate analysis of risk factors for QT prolongation following subarachnoid hemorrhage
Authors: Fukui Shinji , Katoh Hiroshi , Tsuzuki Nobusuke , Ishihara Shoichiro , Otani Naoki , Ooigawa Hidetoshi , Toyooka Terushige , Ohnuki Akira , Miyazawa Takahito , Nawashiro Hiroshi , Shima Katsuji
Published: May 2003

Background

Subarachnoid hemorrhage (SAH) often causes a prolongation of the corrected QT (QTc) interval during the acute phase. The aim of the present study was to examine independent risk factors for QTc prolongation in patients with SAH by means of multivariate analysis.

Method

We studied 100 patients who were admitted within 24 hours after onset of SAH. Standard 12-lead electrocardiography (ECG) was performed immediately after admission. QT intervals were measured from the ECG and were corrected for heart rate using the Bazett formula. We measured serum levels of sodium, potassium, calcium, adrenaline (epinephrine), noradrenaline (norepinephrine), dopamine, antidiuretic hormone, and glucose.

Results

The average QTc interval was 466 ± 46 ms. Patients were categorized into two groups based on the QTc interval, with a cutoff line of 470 ms. Univariate analyses showed significant relations between categories of QTc interval, and sex and serum concentrations of potassium, calcium, or glucose. Multivariate analyses showed that female sex and hypokalemia were independent risk factors for severe QTc prolongation. Hypokalemia (<3.5 mmol/l) was associated with a relative risk of 4.53 for severe QTc prolongation as compared with normokalemia, while the relative risk associated with female sex was 4.45 as compared with male sex. There was a significant inverse correlation between serum potassium levels and QTc intervals among female patients.

Conclusion

These findings suggest that female sex and hypokalemia are independent risk factors for severe QTc prolongation in patients with SAH.
Haplotypic analysis of the TNF locus by association efficiency and entropy
Authors: Ackerman Hans , Usen Stanley , Mott Richard , Richardson Anna , Sisay-Joof Fatoumatta , Katundu Pauline , Taylor Terrie , Ward Ryk , Molyneux Malcolm , Pinder Margaret , Kwiatkowski Dominic P
Published: May 2003

Background

To understand the causal basis of TNF associations with disease, it is necessary to understand the haplotypic structure of this locus. We genotyped 12 single-nucleotide polymorphisms (SNPs) distributed over 4.3 kilobases in 296 healthy, unrelated Gambian and Malawian adults. We generated 592 high-quality haplotypes by integrating family- and population-based reconstruction methods.

Results

We found 32 different haplotypes, of which 13 were shared between the two populations. Both populations were haplotypically diverse (gene diversity = 0.80, Gambia; 0.85, Malawi) and significantly differentiated (p < 10-5 by exact test). More than a quarter of marker pairs showed evidence of intragenic recombination (29% Gambia; 27% Malawi). We applied two new methods of analyzing haplotypic data: association efficiency analysis (AEA), which describes the ability of each SNP to detect every other SNP in a case-control scenario; and the entropy maximization method (EMM), which selects the subset of SNPs that most effectively dissects the underlying haplotypic structure. AEA revealed that many SNPs in TNF are poor markers of each other. The EMM showed that 8 of 12 SNPs (Gambia) and 7 of 12 SNPs (Malawi) are required to describe 95% of the haplotypic diversity.

Conclusions

The TNF locus in the Gambian and Malawi sample is haplotypically diverse and has a rich history of intragenic recombination. As a consequence, a large proportion of TNF SNPs must be typed to detect a disease-modifying SNP at this locus. The most informative subset of SNPs to genotype differs between the two populations.
Analysis and functional classification of transcripts from the nematode Meloidogyne incognita
Authors: McCarter James P , Dautova Mitreva Makedonka , Martin John , Dante Mike , Wylie Todd , Rao Uma , Pape Deana , Bowers Yvette , Theising Brenda , Murphy Claire V , Kloek Andrew P , Chiapelli Brandi J , Clifton Sandra W , Bird David Mck , Waterston Robert H
Published: May 2003

Background

Plant parasitic nematodes are major pathogens of most crops. Molecular characterization of these species as well as the development of new techniques for control can benefit from genomic approaches. As an entrée to characterizing plant parasitic nematode genomes, we analyzed 5,700 expressed sequence tags (ESTs) from second-stage larvae (L2) of the root-knot nematode Meloidogyne incognita.

Results

From these, 1,625 EST clusters were formed and classified by function using the Gene Ontology (GO) hierarchy and the Kyoto KEGG database. L2 larvae, which represent the infective stage of the life cycle before plant invasion, express a diverse array of ligand-binding proteins and abundant cytoskeletal proteins. L2 are structurally similar to Caenorhabditis elegans dauer larva and the presence of transcripts encoding glyoxylate pathway enzymes in the M. incognita clusters suggests that root-knot nematode larvae metabolize lipid stores while in search of a host. Homology to other species was observed in 79% of translated cluster sequences, with the C. elegans genome providing more information than any other source. In addition to identifying putative nematode-specific and Tylenchida-specific genes, sequencing revealed previously uncharacterized horizontal gene transfer candidates in Meloidogyne with high identity to rhizobacterial genes including homologs of nodL acetyltransferase and novel cellulases.

Conclusions

With sequencing from plant parasitic nematodes accelerating, the approaches to transcript characterization described here can be applied to more extensive datasets and also provide a foundation for more complex genome analyses.
MatchMiner: a tool for batch navigation among gene and gene product identifiers
Authors: Bussey Kimberly J , Kane David , Sunshine Margot , Narasimhan Sudar , Nishizuka Satoshi , Reinhold William C , Zeeberg Barry , Ajay  , Weinstein John N
Published: May 2003

MatchMiner is a freely available program package for batch navigation among gene and gene product identifier types commonly encountered in microarray studies and other forms of 'omic' research. The user inputs a list of gene identifiers and then uses the Merge function to find the overlap with a second list of identifiers of either the same or a different type or uses the LookUp function to find corresponding identifiers.
Using scenarios to evaluate a professional development programme for teaching staff
Authors: Wren Yvonne
Published: May 2003

The need for professional development for both teachers and speech and language therapists working with children with speech, language and communication needs has been highlighted in recent publications. Less attention has been given to how such training should be evaluated. This paper describes the use of scenarios to evaluate a professional development programme for teaching staff, offered by speech and language therapists. The benefits and limitations of using this approach over other methods are discussed.
Patterns of interaction between children with physical disabilities using augmentative and alternative communication systems and their peers
Authors: Clarke Michael , Kirton Andrea
Published: May 2003

Developing peer relationships in school is an essential part of growing up. Many children who have little or no functional speech are provided with augmentative and alternative communication (AAC) systems such as speech synthesizers and books and charts of symbols/pictures/words. Such children face many barriers to communication and to developing peer relationships. To date there exists little understanding of the characteristics of interaction between children using AAC and their speaking peers. This paper reports findings from an analysis of interactions between 12 children with physical disabilities using AAC systems and their speaking peers in school. Analysis identifies the primary structures, functions, and modes of communication used by both partners in one-to-one conversation.
The vowel house: a cognitive approach to vowels for literacy and speech
Authors: Reid Jennifer
Published: May 2003

Awareness of consonants and vowels is a fundamental literacy skill. In English, there is a highly complex relationship between written and spoken vowels. Children with language impairment may display significant difficulties in acquiring adequate phonological processing skills for vowels, with serious consequences for their acquisition of literacy. A framework based on phonetic features of vowels but incorporating links to written vowel patterns is presented. This has proved useful for improving children's phonological awareness of vowels, for literacy teaching, and also for targeting persisting spoken vowel production difficulties. The framework has been specifically devised for the vowels of Scottish English, but it may be adapted for other varieties of English.
Using augmentative and alternative communication approaches to promote participation of preschoolers during book reading: a pilot study
Authors: Trudeau Natacha , Cleave Patricia L. , Woelk Elizabeth J.
Published: May 2003

Literacy development is important, especially for individuals using augmentative and alternative communication (AAC). Early exposure to reading and writing through joint book reading is important in this development. This article describes a project examining the impact of an interactive book reading programme on four preschool-aged children and their mothers. Two of the children were typically developing and two relied on nonverbal communication means. The program used AAC techniques and adaptations to promote the participation of all children. The children's participation was examined in the group and during book reading in the home before and after the group programme.
Exploring early years professionals' knowledge about speech and language and development and impairment
Authors: Letts Carolyn , Hall Elaine
Published: May 2003

This paper reports findings of a questionnaire study that was carried out in the North East of England. It reports early years professionals' need for training, levels of confidence, and the accuracy of their judgements regarding children's speech and language. Variations in confidence and accuracy of judgement are analysed to explore the effects of different professional training and the kinds of setting in which early years practitioners work. Findings are discussed in the context of increasing demands on early years staff both to identify language difficulties and to work more closely with other professionals to support children with special needs.
Fluoride-induced apoptosis in human epithelial lung cells (A549 cells): role of different G protein-linked signal systems
Authors: Refsnes Magne , Schwarze Per E , Holme Jørn A , Laêg Marit
Published: May 2003

In the present study, possible mechanisms involved in fluoride-induced apoptosis in a human epithelial lung cell line (A549) were examined. Sodium fluoride (NaF) induced apoptosis in the A549 cells, with a maximum at 5-7.5 mM after 20 hours of exposure. The number of cells with plasma membrane damage (PI-positive cells) increased moderately up to 5 mM, but markedly at 7.5 mM. Deferoxamine (an Al3chelator) almost completely prevented these NaF-induced responses, which may suggest a role for G protein activation. The apoptotic effect was partially reduced by the PKA inhibitor H89. NaF induced a weak but sustained increase in PKC activity, whereas the PKC activator TPA induced a transient effect. TPA, which enhanced the NaF-induced PKC activity, was not apoptotic when added alone, but facilitated the NaFinduced apoptosis and the increase in PI-positive cells. PKC downregulation induced by TPA pretreatment almost completely prevented the NaF-induced apoptosis and the increase in PI-positive cells. Pretreatment with the PKC inhibitor GF109203X, which abolished the PKC activity after 3 hours, enhanced the NaF-induced apoptosis. KN93 (a CaM kinase II inhibitor) and W7 (a calmodulin inhibitor) seem to reduce the apoptotic effect of NaF, whereas BAPTA-AM (a Ca2chelator) was without effect. The tyrosine kinase inhibitor genistein also markedly reduced the NaF-induced apoptosis, whereas the PI-3 kinase inhibitor wortmannin augmented the response. In conclusion, the present results suggest that NaF induces an apoptotic effect and an increase in PI-positive A549 cells via similar mechanisms, involving PKC, PKA, tyrosine kinase and Ca2linked enzymes, whereas PI-3 kinase seems to exert a counteracting effect.
Protective role of ascorbic acid and a-tocopherol on arsenic-induced microsomal dysfunctions
Authors: Ramanathan K , Shila S , Kumaran S , Panneerselvam C
Published: May 2003

Arsenic, a naturally occurring element, is present in food, soil, air and water. All human populations are exposed to arsenic and its compounds through occupational or environmental processes. Since arsenic compounds have been shown to exert their toxicity chiefly by generating reactive oxygen species, we have evaluated the effect of ascorbic acid and a-tocopherol on oxidative damage, antioxidant status and on xenobiotic metabolizing systems in arsenic-exposed rat liver and kidney microsomes. Arsenic exposure increases oxidative damage to lipids and proteins and decreases the levels of antioxidants and the activities of xenobiotic metabolizing enzymes. Coadministration of ascorbic acid and a-tocopherol to arsenic-exposed rats resulted in a reduction in the levels of lipid peroxidation, protein carbonyls and hydrogen peroxide and an elevation in the levels of reduced glutathione, ascorbic acid and a-tocopherol. Ascorbic acid and a-tocopherol treatment decreases the activity of haem oxygenase, whereas it increases the levels/ activity of cytochrome P450, cytochrome b5 and NADPH-cytochrome P450 reductase in arsenic-intoxicated rats. The results of this study provide evidence that ascorbic acid and a-tocopherol supplementation can improve the arsenic-induced altered microsomal functions in liver and kidney.
A comparative study on the gastroduodenal tolerance of different antianaemic preparations
Authors: Gastearena M A Idoate , Gil A G , Azqueta A , Coronel M P , Gimeno M
Published: May 2003

The most significant adverse effect of repeated oral administration of iron-containing antianaemic preparations is the gastroduodenal toxicity, attributable to a direct toxic effect of iron on the glandular epithelium. To assess gastroduodenal mucosal damage and the potential protective effect of different antianaemic preparations, a study was carried out to compare the gastroduodenal toxicity caused by three different types of antianaemic drugs in normal and anaemic rats administered at repeated therapeutic doses. Histological damage to the gastroduodenal mucosa was evaluated using light and electron microscopy. In both normal and anaemic rats, pathological changes were less marked in animals treated with ferrimannitol-ovoalbumin (TM/ FMOA) than in those treated with iron protein succinylate or ferrous sulphate. Electron microscopic studies of duodenal mucosa in normal rats treated with iron protein succinylate and ferrous sulphate confirmed a severe ultrastructural alteration, whereas no changes were detected in animals treated with TM/FMOA. In anaemic rats, slight duodenal ultrastructural changes were noted with all three types of treatment. The effectiveness of the preparations in resolving the anaemia was similar in the three groups. It was concluded that TM/FMOA exerts a protective effect against the toxicity normally observed of the iron in other formulations in normal and anaemic rats, which was attributed to the fact that administration of iron bound to a protein core allows for gradual release of iron.
Potential adverse interaction between aspirin and Lisinopril in hypertensive rats
Authors: Dubey K , Balani D K , Pillai K K
Published: May 2003

The potential clinical effect of aspirin (ASA) in patients treated with angiotensin converting enzyme (ACE) inhibitors is debatable. Several studies have suggested that ASA attenuates the beneficial effects of ACE inhibitors in hypertension, congestive heart failure (CHF) or coronary artery disease (CAD) and have questioned the safety of using ASA concomitantly with these agents. The present study aims to investigate the possible interaction between ASA and ACE inhibitor in hypertensive rats. Hypertension was induced in adult male Wistar rats using Methylprednisolone (MP) 20 mg/kg per week s.c. for 2 weeks. The systolic blood pressure (SBP) was measured by noninvasive BP technique. The effect of Lisinopril (LS) 15 mg/kg per day and that of combination of LS and ASA; 100 and 25 mg/kg per day p.o. was studied on hypertension induced by glucocorticoid. Concurrent ASA treatment with LS did not hinder the hypotensive effect of LS at either dose. However ASA 100 mg/kg per day caused mortality in animals and produced massive cardiac necrosis and renal damage as evident from histopathology. Treatment with ASA 25 mg/kg per day caused lower mortality with variable effects on cardiac and renal tissues. These results indicate that ASA attenuates the beneficial effects of ACE inhibitor on survival in hypertensive rats and this effect was more pronounced at higher dose of ASA.
Correlation of lead and cadmium in human seminal plasma with seminal vesicle and prostatic markers
Authors: Pant N , Banerjee A K , Pandey S , Mathur N , Saxena D K , Srivastava S P
Published: May 2003

The objective of this study was to investigate the correlation between lead and cadmium with seminal vesicle and prostatic markers. Semen samples categorized into fertile and infertile were evaluated for the presence of lead and cadmium and biochemical markers in the seminal plasma. Associations between lead and fructose, acid phosphatase and g-glutamyl transpeptidase (g-GT) were observed. However, no such relationships were noticed for cadmium. It is concluded that lead may be one of the pollutants indirectly affecting semen quality by altering the functions of accessory sex glands.
The effects of aflatoxin B1 on the development of kwashiorkor in mice
Authors: Kocabas Can Naci , Coşkun Turgay , Yurdakök Murat , HazwrogÆlu Rwfkw
Published: May 2003

Seventy Swiss albino mice (6-week-old male) were selected for the investigation into aflatoxin B1's role in the cause of kwashiorkor. The mice were divided randomly into four groups. They were grouped within each group by being fed either low or normal protein level diets supplemented with very small amounts of aflatoxin B1 (0.5 mg/day). The control groups were fed aflatoxin B1-free diets containing either normal or low protein levels. All groups were monitored for 7 weeks. The increase in body weight was found to be low in groups I and II, given diets contaminated with aflatoxin B1. Although groups II and IV, which were given low dietary protein, showed remarkable decreases in serum total protein and albumin levels (group II: total protein 4.1±-0.1 g/dL, albumin 2.6±-0.8 g/dL and group IV: total protein 4.6±-1.3 g/dL, albumin 2.8±-0.82 g/dL) when compared with the groups fed a normal dietary protein level (group I: total protein 5.9±-1.3 g/dL, albumin 3.4±-0.7 g/dL and group III: total protein 5.4±-1.6 g/dL, albumin 3.5±-1.2 g/dL; P B-0.05). The statistical difference between these two groups was found not to be significant (P -0.05). However, decreases in total protein and albumin levels were a little more prominent in group II. In addition, histopatological changes of the liver was remarkable in the group fed a low protein diet and aflatoxin B1 when compared with the group fed only a low protein diet and no aflatoxin B1. More significantly, however, was the increase in liver weight in both groups fed a low protein diet (groups II and IV). Our conclusion is that aflatoxin B1 could not have contributed to the development of kwashiorkor.
Safeguarding Being: a bioethical principle for genetic nursing care
Authors: Giarelli Ellen
Published: May 2003

This philosophical inquiry examines the nature of the technology of genetic predisposition testing and its relation to patients as whole persons. The bioethical principles of nonmaleficence, beneficence, autonomy and justice are judged insufficient to resolve issues associated with use. A new principle of ‘sustained being’, drawn from philosophical propositions of Pellegrino, is suggested. The new principle is suited to an evolving practice and is compatible with consequentialist, deontological and relational ethics theories. The notion of ‘taking care’ is related to nursing in genetic health care to form a standard of conduct and a moral imperative to ‘safeguard being’.
Do Nurses Exercise Power in Basic Care Situations?
Authors: Palviainen Piia , Hietala Minna , Routasalo Pirkko , Suominen Tarja , Hupli Maija
Published: May 2003

Power is a matter of authority and control. It can be wielded either consciously or unconsciously, and it can be either overt or latent. Using a structured questionnaire, this study set out to describe nurses’ opinions about the exercise of power in basic care situations in both acute and long-term care. The questionnaire was organized into four categories in which items concerned: power in obligatory daily activities; power in activities necessitated by obligatory activities; power in voluntary activities; and power in activities that take into account the patient’s characteristics. The samples consisted of 228 nurses from five medical and surgical wards of district hospitals, and 233 nurses from five geriatric units of a community health centre and from one nursing home in Finland. The final response rate was 65% (acute care 76%; long-term care 55%). Data analysis was based on statistical methods. The results showed that, in the nurses’ own opinion, negative power is exercised only in certain situations and in the patient’s best interest, when for instance there are concerns that something may happen to the patient.
Ethical Dilemmas Related to the HIV-Positive Person in the Workplace
Authors: Botes Annatjie , Otto Marianne
Published: May 2003

This study’s objectives were: (1) to describe and explore the ethical dilemmas surrounding the HIV-positive person in the workplace in South Africa; and (2) to describe the Rational Interaction for Moral Sensitivity (RIMS) approach as a possible mechanism for solving these ethical dilemmas.

A qualitative, exploratory and descriptive research design was used. The target populations were HIV-positive employees and occupational health nurses working for a South African company. Data collected through individual HIV-positive employee interviews and occupational health nurse workgroups were analysed. The ethical dilemmas were conceptualized and described within the theoretical framework of the principles of ethics, namely, autonomy, beneficence, justice and confidentiality. To elicit a solution to the dilemmas, the data were recontextualized using the RIMS approach, a group decision-making strategy designed for the business environment.
Moral Stress: synthesis of a concept
Authors: Lützén Kim , Cronqvist Agneta , Magnusson Annabella , Andersson Lars
Published: May 2003

The aim of this article is to describe the synthesis of the concept of moral stress and to attempt to identify its preconditions. Qualitative data from two independent studies on professional issues in nursing were analysed from a hypothetical-deductive approach. The findings indicate that moral stress is independent of context-given specific preconditions: (1) nurses are morally sensitive to the patient’s vulnerability; (2) nurses experience external factors preventing them from doing what is best for the patient; and (3) nurses feel that they have no control over the specific situation. The findings from this analysis are supported by recent research on stress in the workplace but differ in that the imperatives directing work are moral in nature. Stress researchers have found that persons who experience that they have no control over their work situation and at the same time experience high demands may be prone to cardiovascular diseases. An important question raised by this study is whether moral stress should be recognized as a health risk in nursing. Further research is required in order to generate intervention models to prevent or deal with moral stress.
What puzzles teachers in Rio de Janeiro, and what keeps them going?
Authors: Lyra Isolina , Fish Solange , Braga Walewska
Published: May 2003

This paper focuses on the key mechanism of ‘puzzling’ in EP, and the crucial issue of sustainability (see Allwright, this issue, Sections IV.2 and V.2), in the context of volunteer teacher development work (Section VII.2).

Having taken part, initially as participating teachers and now as ‘multipliers’, in Exploratory Practice (EP) meetings held in the city of Rio de Janeiro since 1997, we decided to investigate the puzzles presented by teachers from state and private schools as well as from language courses, in order to gain a general idea of their concerns and to better plan our future EP meetings. We grouped the puzzles into six emerging categories: motivation, anxiety, teaching, institutional lack of interest, discipline (or behaviour), and Exploratory Practice itself.

This grouping gave us an interesting picture of the teachers’ concerns and led us to investigate further by interviewing nine of the teachers involved. We found that these interviews also gave us insight into the extent to which sustainability, one of the main principles of EP, is being achieved at present and how EP is related to teachers’ lives.

The whole process of investigation and reflection led us to the understanding that EP is as important to those teachers as it is to ourselves, for it helped each one of us to sense considerable improvement in the quality of our lives.