bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous Quantitative EEG Monitoring in Hemispheric Stroke Patients Using the Brain Symmetry Index
Authors: van Putten Michel J.A.M. , Tavy Dénes L.J.
Published: October 2004

Background and Purpose—

There is increased awareness that continuous brain monitoring might benefit neurological patients, because it may allow detection of derangement of brain function in a possible reversible state, allowing early intervention. Here, we explore if quantitative continuous electroencephalography (cEEG) monitoring is technically feasible and possibly clinically relevant in patients with acute ischemic hemispheric stroke.

Materials—

Twenty-one consecutive patients with an acute hemispheric stroke were monitored in our stroke unit, using cEEG for 12 to 24 hours on the day of admission. EEGs were quantified using a particular measure for symmetry, the brain symmetry index (BSI). This measure was subsequently correlated with the clinical condition of the patient using the National Institute of Health Stroke Scale (NIHSS).

Results—

cEEG was technically feasible. We found a most satisfying positive correlation between the BSI and the NIHSS, with ρ≈0.86 (
P
<0.01).

Conclusions—

Technically, cEEG monitoring posed no major problems. It was found that the BSI correlates satisfactorily with the clinical neurological condition of our stroke patients. This suggests that the BSI can be used as a measure to monitor possible changes of brain function in this patient category.
Oxidative Stress Affects the Integrin-Linked Kinase Signaling Pathway After Transient Focal Cerebral Ischemia
Authors: Saito Atsushi , Hayashi Takeshi , Okuno Shuzo , Nishi Tatsuro , Chan Pak H.
Published: October 2004

Background and Purpose—

The integrin-linked kinase (ILK) signaling pathway contributes to regulation of cellular adhesion, migration, and differentiation, and to apoptotic cell death after a variety of cell death stimuli. We have reported that overexpression of copper/zinc superoxide dismutase (SOD1) reduces apoptotic cell death by promoting the phosphatidylinositol 3-kinase (PI3-K)/Akt survival pathway after transient focal cerebral ischemia (tFCI). However, the role of the ILK pathway after tFCI and the role of oxygen free radicals in regulation of apoptosis remain unclear.

Methods—

To clarify these issues, we used an in vivo tFCI model with SOD1 transgenic mice and wild-type mice. We administered the PI3-K inhibitor, LY294002, into mouse brains after tFCI and examined the role of PI3-K in the ILK pathway and expression of the ILK/Akt complex by immunohistochemistry, Western blot analysis, and coimmunoprecipitation.

Results—

A transient increase in ILK was detected early after tFCI and was prevented by treatment with LY294002, but promoted by SOD1. Coimmunoprecipitation revealed that the direct reaction of ILK/Akt transiently increased concurrent with the increase in ILK after tFCI. Moreover, the ILK/Akt complex was prevented by LY294002, but promoted by SOD1.

Conclusions—

These results suggest that the ILK pathway mediated by PI3-K is affected by tFCI and by SOD1.
Inflammatory Gene Load Is Associated With Enhanced Inflammation and Early Carotid Atherosclerosis in Smokers
Authors: Jerrard-Dunne Paula , Sitzer Matthias , Risley Paul , Buehler Alexandra , von Kegler Stefan , Markus Hugh S.
Published: October 2004

Background and Purpose—

Smoking acts as a pro-inflammatory stimulus. Inflammation may provide a key mechanism by which smoking causes atherosclerosis. If so, then the degree to which an individual mounts an inflammatory response is likely to influence atherosclerosis severity. This study examined the impact of inflammatory gene polymorphisms and gene–smoking interactions on common carotid artery intima-media thickness (IMT), a measure of early atherosclerosis.

Methods—

In a community population (n=1000), mean IMT was determined using ultrasound. This population was genotyped for 6 polymorphisms in 4 inflammatory genes:
IL-6-174
,
IL-6-572
, and
IL-6-597
;
IL-1-β-31
;
IL-1 receptor antagonist VNTR
and
CD14-159.
Serum IL-6 levels were measured in the first 500 subjects. Genotypes/haplotypes associated with higher IL-6 levels were designated “inflammatory haplotypes.” A gene load score was calculated, in which 2 represented individuals homozygous for ≥2 inflammatory genotypes/haplotypes and 0 was homozygous for none.

Results—

Increasing gene load of inflammatory genotypes was associated with a linear increase in serum IL-6 levels (
P
=0.018) and increased carotid artery IMT (
P
=0.003). There was a significant interaction between gene load and smoking status on carotid IMT (
P
for interaction=0.002). Specifically, in smokers, carriers of inflammatory haplotypes had significantly increased age- and sex-adjusted IMT (
IL-6-174C/IL-6-572G/IL-6-597A
,
P
=0.005;
IL-1-β-31T/IL-1RN*2
,
P
=0.04;
CD14-159CC
,
P
=0.028).

Conclusions—

These findings support the hypothesis that inflammation and cytokine responses provide a key mechanism by which smoking causes atherogenesis. Secondly, they highlight the importance of gene–environment, and gene–gene–environment interactions in the pathogenesis of atherosclerosis.
Neurotoxicity of Intra-arterial Papaverine Preserved with Chlorobutanol Used for the Treatment of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage
Authors: Smith Wade S. , Dowd Christopher F. , Johnston S. Claiborne , Ko Nerissa U. , DeArmond Stephen J. , Dillon William P. , Setty Deepa , Lawton Michael T. , Young William L. , Higashida Randall T. , Halbach Van V.
Published: October 2004

Background and Purpose—

Papaverine is used to vasodilate cerebral arteries undergoing vasospasm from subarachnoid hemorrhage. However, papaverine inhibits cellular respiration in vitro and could cause neurotoxicity in humans.

Methods—

We studied 5 consecutive patients with cerebral vasospasm who were treated with intra-arterial papaverine preserved with chlorobutanol and imaged with MRI fluid-attenuated inversion recovery and diffusion-weighted imaging after treatment. One patient had histological analysis of the brain at autopsy.

Results—

All 5 patients exhibited marked neurological decline immediately after treatment, and this was sustained through hospital discharge. In all cases, MRI images showed selective gray matter–only signal changes within the vascular territory treated with papaverine. Histological analysis of 1 case brought to autopsy showed selective injury to islands of neurons with relative sparing of white matter.

Conclusions—

Intra-arterial delivery of papaverine preserved with chlorobutanol into vasospastic anterior cerebral arteries may result in marked neurological deterioration with selective gray matter changes on MRI imaging. This effect is consistent with a permanent toxic effect to human brain. It is unclear whether this toxicity is caused by papaverine or chlorobutanol, and its use in the treatment of cerebral vasospasm should be reserved for cases without alternatives.
Stroke Incidence and 30-Day Case-Fatality in a Suburb of Tbilisi
Authors: Tsiskaridze Alexander , Djibuti Mamuka , van Melle Guy , Lomidze Giorgi , Apridonidze Sophia , Gauarashvili Iana , Piechowski-Jóźwiak Bartłomiej , Shakarishvili Roman , Bogousslavsky Julien
Published: October 2004

Background and Purpose—

Although stroke is one of the main public health problems worldwide, no study of stroke incidence has been performed in Georgia, and therefore, a population-based registry was established to determine the incidence and case-fatality rates of first-ever stroke.

Methods—

We identified all first-ever strokes between November 2000 and July 2003 in a defined population of 51 246 residents in the Sanzona suburb of Tbilisi, the capital of Georgia, using overlapping sources of information and standard diagnostic criteria.

Results—

A total of 233 first-ever strokes occurred during the study period. The crude annual incidence rate was 165 (95% CI, 145 to 188) per 100 000 residents. The corresponding rate adjusted to the standard “world” population was 103 (95% CI, 89 to 117). In terms of stroke subtype, the crude annual incidence rate per 100 000 inhabitants was 89 (95% CI, 74 to 106) for ischemic stroke, 44 (95% CI, 34 to 57) for intracerebral hemorrhage, 16 (95% CI, 10 to 25) for subarachnoidal hemorrhage, and 16 (95% CI, 10 to 25) for unspecified stroke, and the corresponding case-fatality rates at 1 month were 19.2%, 48.4%, 47.8%, and 69.6%.

Conclusion—

The overall stroke incidence rate in an urban population of Georgia is comparable to those reported in developed countries. As for the stroke subtypes, there is an excess of hemorrhagic strokes compared with other registries. Geographical and lifestyle variations may explain these findings, whereas inadequacy of the stroke care system in Georgia might contribute to the high case-fatality.
Faster Is Better
Authors: Lamontagne Anouk , Fung Joyce
Published: October 2004

Background and Purpose—

The instantaneous adaptations to speed and load changes during overground locomotion have major implications for mobility after stroke. We examined the extent to which stroke subjects could increase their overground walking speed with respect to speed and unloading changes.

Methods—

Twelve subjects with a unilateral stroke were evaluated while walking overground full weight bearing (FWB) or with body weight support (BWS) at preferred or fast speed. On the basis of their preferred walking speed, subjects were classified as high (≥45 cm/s) or low functioning (<45 cm/s). Gait speed, temporal distance factors (TDFs), as well as movements and muscle activation of the lower limbs were measured and compared across the conditions.

Results—

FWB-Fast condition induced marked (165%) increment in gait speed in all subjects. BWS at preferred speed induced faster speeds in low- but not the high-functioning subjects, whereas combined BWS and fast walking yielded further speed increments in the high-functioning subjects. Fast walking was associated with bilateral increases in joint excursion and muscle activation, as well as improved symmetry in some TDFs. BWS favored a hip flexion strategy in early swing while decreasing limb circumduction.

Conclusions—

This study shows that stroke subjects can increase substantially their walking speed without deleterious effects. Fast walking induces marked speed-related improvements in body and limb kinematics and muscle activation patterns. BWS during overground walking also increases gait speed, but to a lesser extent and only in low-functioning subjects. The combination of BWS with fast speed produces the greatest increments in walking speed in all subjects.
Scanning Laser Doppler Flowmetry Shows Reduced Retinal Capillary Blood Flow in CADASIL
Authors: Harju Mika , Tuominen Susanna , Summanen Paula , Viitanen Matti , Pöyhönen Minna , Nikoskelainen Eeva , Kalimo Hannu , Kivelä Tero
Published: October 2004

Background and Purpose—

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a progressive systemic nonatherosclerotic angiopathy which causes ischemic strokes and vascular subcortical dementia. A cross-sectional study was performed to examine the retinal vascular caliber and blood flow in CADASIL.

Methods—

Scanning laser Doppler flowmetry was used in a case–control study (11 patients and controls) of peripapillary retinal circulation. Automated full-field perfusion image analysis was used to analyze the flow data. Retinal vessel calibers were measured from retinal images acquired with scanning laser ophthalmoscopy. The caliber of the superior and inferior temporal retinal artery and vein were measured 1 and 2 mm from the disc rim, and the mean values were used for analysis.

Results—

Retinal capillary peak systolic flow (mean, 249 versus 311 arbitrary unit [AU];
P
=0.072) was lower, and mean capillary flow (mean, 184 versus 224 AU;
P
=0.12) and minimum diastolic flow (mean, 105 versus 132 AU;
P
=0.16) tended to be lower in patients than in controls. No significant difference in the calibers of proximal retinal arteries (mean, 104 versus108 μm) and veins (mean, 150 versus 145 μm) was found between the patients and controls.

Conclusions—

Retinal capillary blood flow is mild to moderately reduced in CADASIL but that does not appear to cause major ischemic injury. Such reduction is analogous to that in the cerebral cortex in CADASIL patients with which retina appears to share its relative sparing from severe arterial ischemic tissue damage.
Are There Genetic Influences on Sporadic Brain Arteriovenous Malformations?
Authors: Young William L. , Yang Guo-Yuan
Published: October 2004

The genesis of brain arteriovenous malformations remains enigmatic. We reviewed some pathways involving inflammatory and angiogenic signals that are amenable to the study of genetic single-nucleotide polymorphisms associated with the sporadic disease. Such study can yield insights into arteriovenous malformation pathogenesis and suggest possible fruitful approaches to developing medical therapy. Moreover, single-nucleotide polymorphisms identification would provide targets for risk stratification for planning clinical trials and eventually guiding management.
Gene Transfer of Extracellular Superoxide Dismutase Failed to Prevent Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage
Authors: Yamaguchi Mitsuo , Zhou Changman , Heistad Donald D. , Watanabe Yoshimasa , Zhang John H.
Published: October 2004

Background and Purpose—

We examined the therapeutic effect of human extracellular superoxide dismutase (ECSOD) gene transfer in the prevention of delayed cerebral vasospasm after experimental subarachnoid hemorrhage (SAH) because it was reported ECSOD relieved early-stage vasospasm.

Methods—

Twenty mongrel dogs were divided randomly into 4 groups to serve as control, SAH, SAH+adenovirus ECSOD (AdECSOD), and SAH+no transgene (AdBglII) groups, respectively. An established canine double-hemorrhage model of SAH was used by injecting autologous arterial blood into the cisterna magna on day 0 and day 2. Angiography was performed at day 0 and day 7. Clinical behavior, cerebrospinal fluid (CSF) ECSOD activity, CSF leukocyte count, morphology, and human ECSOD expression (RT-PCR) in the basilar arteries were evaluated.

Results—

Severe vasospasm was obtained in SAH, SAH+AdECSOD, and SAH+AdBglII gene–transferred dogs, and the residual diameters of the basilar artery were 41±1%, 39±4%, and 49±4%, respectively. Increased CSF activity of ECSOD was obtained in SAH+AdECSOD (162±23 U/mL) when compared with SAH (26±2) and SAH+AdBglII (25±3) dogs. RT-PCR confirmed successful gene transfer in the basilar arteries from SAH+AdECSOD dogs. Increased leukocyte counts were observed in the CSF and in the subarachnoid space, especially in SAH+AdECSOD and SAH+AdBglII dogs.

Conclusions—

Gene transfer of human ECSOD failed to prevent delayed cerebral vasospasm.
Re-Evaluating the Finnish Workplace Development Programme: Evidence from Two Projects in the Municipal Sector
Authors: Payne Jonathan
Published: October 2004

Academics from a variety of disciplines have recently begun to consider the role that public policy might play in developing better forms of work organization that expand employees’ opportunities to exercise skill and discretion in their jobs. The article explores these questions through an examination of the Finnish Workplace Development Programme, often regarded as a form of public policy intervention, par excellence, explicitly aimed at improving work organization. Drawing upon interviews with key stakeholders and experts involved with the programme, together with two case studies of development projects in the municipal sector, it considers how successful the programme has been in its attempt to develop ‘the better job’.
Diversity Management in a Danish Context: Towards a Multicultural or Segregated Working Life?
Authors: Kamp Annette , Hagedorn-Rasmussen Peter
Published: October 2004

Since diversity management was introduced in Europe in the late 1990s, it has been debated whether this new concept would act as a catalyst of organizational change in favour of underprivileged groups. This article argues that diversity management is interpreted in a specific societal and organizational context, and indicates how strong institutions make their impact on Danish versions of diversity management. On the basis of a case study of the implementation of diversity management in a specific organization, the authors analyse how discourses of diversity management and corporate social responsibility are combined. The study suggests that this version of diversity management potentially leads to changes in the positions of ethnic minorities, primarily in the form of assimilation, as it maintains a focus on the sameness of people, not on the value of difference or otherness.
No Claim, No Pain? The Privatization of Dispute Resolution in Britain
Authors: Colling Trevor
Published: October 2004

This article explores current strains within the Employment Tribunal Service (ETS) in Britain. These should be seen as consequences of the ‘nationalization’ of employment rights; the assumption by the state of the principal roles and costs involved in dispute resolution, displacing joint regulation by employers and trade unions. The predominant policy response to the escalating demand for tribunal hearings can be characterized as ‘privatization’, in that dispute resolution is capped as far as possible at the level of the .rm and access to external adjudication is reduced. Where external adjudication proceeds, it does so in ‘private’; and roles are passed increasingly from public bodies and authorities to private organizations. Speci.cally, the article examines the ACAS Arbitration Scheme, the growth of privately provided alternative dispute resolution (ADR) and the provisions of the Employment Act 2002. Their likely consequences for the accessibility, formality, speed and expense of justice are considered.
Privatization in Portugal: Employee Owners or Just Happy Employees?
Authors: Ramos Luís Moura , Martins Rita
Published: October 2004

The aim of this article is to evaluate the impact of measures designed to enhance employee ownership in the context of the Portuguese privatization process. The authors seek to quantify the advantages offered to employees in the bundle of special conditions they were entitled to, using data from 60 privatization operations between 1989 and 1999. The risky decision to buy shares in their own firms sometimes enabled employees to make a good investment, when stock market activity permitted it. In other cases, in spite of the breadth of the potential benets offered to encourage employees, the results associated with these investments were actually negative.
The Press and the Politics of Marginal Voices: Narratives of the Experiences of the Ogoni of Nigeria
Authors: Adebanwi Wale
Published: October 2004

Given its place in the vortex of power relations in Nigeria, the Nigerian press has nurtured and/or subverted, promoted and/or combated the legitimacy of hegemonic power-blocs and state in their relationship with minority (marginal) ethnic groups. The role of the press in this context has become more crucial since the struggle of the minority ethnic groups gained a new impetus in the 1980s and 1990s Nigeria, linked as it was to a global resurgence of the drive towards self-determination and the attendant nationalist struggles. This article use the case of the Ogoni ethnic group in the oil-rich region of Nigeria to examine how newspapers and news magazines use narratives to interrupt and intervene in the process of dominant discourses and practices that subordinate relatively powerless minorities. Against the backdrop of narrative theory, the article provides empirical evidence of the centrality of narratives in the mobilization or de-mobilization of marginal intervention in the socio-economic and political life of the centrein the African postcolony.
Political talk radio and democratic participation: caller perspectives on Election Call
Authors: Ross Karen
Published: October 2004

There has been much recent discussion about the changing nature of ‘the public sphere’ with the relatively new genre of reality TV being viewed as a space in which the public can at least perform, if not always engage in meaningful debate. This article considers the perspectives of callers to a political talk show - Election Call- in terms of why they call in, what they think about their interactions with politicians and how they regard the programme’s potential to constitute a public sphere. It also looks at the gendered aspects of caller experiences and beliefs in order to tease out whether gender has any influence on the public’s practice of politics. Election Callis a BBC production, which has been broadcasting since 1974, going out simultaneously on radio and TV (and the web for 2001), in the days immediately preceding the British general election. I argue that while callers mostly felt very positive about the experience of appearing on the show and having the opportunity to put their point of view, and believed that Election Callfulfils an important democratic function, they were much more negative in their assessment of their interactions with politicians, believing that it continues to be difficult to get a straight answer out of those elected to serve and represent us.
Cultural industries in the Digital Age: some provisional conclusions
Authors: Bustamante Enrique
Published: October 2004

This is an empirical study based on US and European experiences and their applicability to Spanish reality. It is based on a number of sectoral analyses. The article aims to discuss the transformations of the cultural industries, their adaptation to the Digital Age and the new system of communication and culture that is shaping up in the most developed countries. It is argued that although the changes ushered in by the widespread adoption of digital technologies have been profound, we have to see current transformations in relation to the continuing weight of traditional media and organizational structures. There is a major challenge for communications policy in balancing the needs for public services agaisnt the pressures of commercialism.
CCTV ‘dialogue’ = speaking + listening: a case analysis of a prestigious CCTV talk show series Dialogue
Authors: Zhong Yong
Published: October 2004

This article discusses the findings of a case study of a talk show in the Dialogueseries, produced and screened by China Central Television. On the surface, the talk show is much more sophisticated in form and presentation, more inclusive in terms of topics and speakers and more enthusiastic about generating dialogue than past talk shows on Chinese television. However, through a textual analysis of aspects of the talk show ranging from formal characteristics, to its content, to its narrative structure, the case study finds that, under the camouflage of greater sophistication, the ‘dialogue’ staged by the talk show is a deceptive game as it is a reinvented one-way passage of messages from the center to the periphery, from the speakers to the listeners, from the instructors to the pupils and then to the pupils of the pupils. On the basis of the analysis, there is insufficient evidence to substantiate claims that Chinese television, represented by the Dialogueseries, is liberalized or democratized as a viewer-friendly participatory mass medium.
The reinforcement of tellability in Greek television eyewitnessing
Authors: Makri-Tsilipakou Marianthi
Published: October 2004

Greek television news broadcasts routinely incorporate large chunks of livetransmissions, consisting of on-the-scene reporters interviewing eyewitnesses to emerging news, which are often trivial but always audience-involving. Although the tellabilityof such stories seems to be a priori warranted, tellers regularly employ a number of reinforcing strategies which construct their accounts as newsworthy and credible. Some of these strategies are of the usual narrativekind; others seem to be television-oriented - often mixing mundanewith institutional, creating an intermediatetype of talk - seldom failing, however, to display the speaker’s cultural competence and medium-awareness in terms of the overall structural design and verbal shape of their contributions.
Marking the boundaries of the ‘normal’ in televised sports: the play-by-play of race
Authors: Bruce Toni
Published: October 2004

Despite an emerging body of research on race and representation in televised sport, little is known about commentator practices and understandings, particularly in relation to the construction of racial difference. Based on interviews and analysis of commentary, the results of this study point to a complex interaction between embedded racist ideologies and media practices specific to live basketball coverage. Taken together, and despite the conscious intentions of commentators, these interactions appear to contribute to an ongoing ‘Othering’ of African Americans and men of color and the normalization of dominant white cultural understandings of difference.
Public Opinion in Puerto Rico on Alcohol Control Policies
Authors: Harwood Eileen M. , Bernat Debra H. , Lenk Kathleen M. , Jo Vázquez Mary , Wagenaar Alexander C.
Published: October 2004

This article discusses the first study to assess public opinion of alcohol policies in Puerto Rico. In 2001, a telephone survey of 514 adults on the island assessed levels of support for 20 alcohol control policies covering five domains: (a) raising alcohol taxes, (b) restricting alcohol consumption in public places, (c) punishing adult providers of alcohol, (d) restricting youth access to alcohol, and (e) restricting marketing of alcohol. Results show high-level support for all alcohol policies, especially for restrictions on alcohol consumption in public places (93% to 95% support) and increases in alcohol taxes earmarked for alcohol treatment, prevention, and education (92% support). Multiple regression analyses reveal older respondents, compared to younger respondents, and respondents reporting lower levels of alcohol consumption were more supportive of alcohol control policies. Results demonstrate a willingness in Puerto Rico to consider public policy solutions to social and health problems associated with drinking.
Reliability and Validity of the Beck Depression and Anxiety Inventories in Caucasian Americans and Latinos
Authors: Contreras Sandra , Fernandez Senaida , Malcarne Vanessa L. , Ingram Rick E. , Vaccarino Vivian Ruiz
Published: October 2004

Although the Beck Depression Inventory and Beck Anxiety Inventory are two of the most widely used instruments for assessing depressive and anxious symptoms in both clinical and nonclinical populations, their cross-cultural reliability and validity have yet to be fully established. In this study, 2,703 Caucasian American and 1,110 Latino college students completed both measures. For each measure, exploratory factor analysis with promax rotation, conducted separately by ethnic group, revealed similar factor structures across groups. For both groups, and both instruments, factor analysis yielded highly similar two-factor solutions. Reliability, as evidenced by internal consistency coefficients, was good; all alphas exceeded .82. On both measures, Latino students scored significantly higher than Caucasian American students on total scores and women scored significantly higher than men. These results support the reliability, validity, and cultural equivalence of these measures of depressive and anxious symptomatology for use with Caucasian American and acculturated Latino younger college students.
Identifying Risk for Onset of Major Depressive Episodes in Low-Income Latinas During Pregnancy and Postpartum
Authors: Le Huynh-Nhu , Muñoz Ricardo F. , Soto Jose A. , Delucchi Kevin L. , Ippen Chandra Ghosh
Published: October 2004

This study aimed to identify subgroups of pregnant women at imminent (1 year) risk for major depressive episodes. Participants were 84 low-income, predominantly Mexican women using public sector obstetrics services who participated in monthly interviews during pregnancy and up to 6 months postpartum. Participants were designated a priori as “more vulnerable” or “less vulnerable” to future perinatal depression based on evidence of mood regulation problems defined as (a) a self-reported history of major depressive episodes, (MDE) and/or (b) high current depressive symptom scores on a continuous depression scale. Two definitions of a major depressive episode based on meeting 2 or 3 DSM-IV MDE criteria, were used to measure the incidence of a new major depressive episode. Results suggest that more vulnerable groups (i.e., with the greatest mood regulation problems) had a higher incidence of major depressive episodes than less vulnerable groups. Implications for screening and developing preventive interventions for postpartum depression are discussed.
Risk for HIV Infection Among Adolescents in the Border City of Tijuana, Mexico
Authors: Martinez-Donate Ana P. , Blumberg Elaine J. , Hovell Melbourne F. , Sipan Carol L. , Zellner Jennifer A. , Hughes Suzanne
Published: October 2004

Previous studies have suggested high rates of HIV infection and other sexually transmitted infections in theU.S.–Mexico border region. However, no information is available on the risk for HIV infection among Mexican adolescents living in this geographic area. This study examines the prevalence of HIV risk practices and psychosocial correlates among 370 high school students in the border city of Tijuana, Mexico, by gender and age group. The results indicate substantial risk for HIV infection among Tijuana youth due to unprotected sexual practices, lifetime rates of pregnancy and sexually transmitted infections, and needle-sharing practices, mostly related to tattooing and body piercing. These findings suggest the need for HIV prevention programs for Tijuana adolescents. These programs must be culturally sensitive and tailored to meet the needs of the different age and gender groups in this region.
Comparing Two Methods to Obtain Blood Specimens From Pediatric Central Venous Catheters
Authors: Barton Sharon Jackson , Chase Teresa , Latham Barbara , Rayens Mary Kay
Published: October 2004

The purpose of this study was to test agreement in blood values obtained from a discard method and a push-pull method in samples from central venous catheters in pediatric patients. The discard method causes blood loss beyond what is necessary for blood testing and increases potential for infection each time the central venous catheter is entered. Twenty-eight children ranging in age from 6 months to 12 years were enrolled in the study. A research protocol was developed to pair the 2 methods of blood collection for each sample. The Bland-Altman method was used to test agreement on each blood value for each paired sample. Of the 438 pairs of measured blood values, 420 (95.9%) fell within the limits of agreement. Nurses reported no difficulty in using the push-pull technique to obtain any samples. The push-pull method of obtaining blood specimens from pediatric central venous catheters should be considered. It can eliminate blood loss through discard and can reduce infection because it reduces the number of times a catheter is entered.
Weight Gain and Height Velocity in Young Children 1 Year Following Bone Marrow Transplant: A Single Institution Study
Authors: Rodgers Cheryl
Published: October 2004

The nutritional and growth effects on children following a bone marrow transplant (BMT) have not been well documented. The purpose of this study was to describe the growth patterns of young children during the first year following BMT. A retrospective chart review was used to examine the nutritional status of 25 young children, 1 to 6 years of age, who received an allogeneic BMT. Nutritional data were reviewed prior to BMT and at 3, 6, 9, and 12 months following BMT. The mean weight gain was 2.5 kg with a median weight gain of 2.3 kg (range, -1.2 to 9.4 kg). The mean height gain was 7 cm with a median height gain of 7.4 cm (range, 1.2 to 16.8 cm). Growth related to gender, age, and incidence of infection was similar to the overall average; however, children with graft-versus-host disease revealed poor weight and height gain. Nurses must learn to recognize patients at nutritional risk and intervene when necessary. More research is needed to address specific nutritional needs of the pediatric BMT patient.
Pediatric Oncology Professionals’ Perceptions of Information Needs of Adolescent Patients With Cancer
Authors: Bradlyn Andrew S. , Kato Pamela M. , Beale Ivan L. , Cole Steve
Published: October 2004

In contrast to the extensive research on the information needs of older patients with cancer, the question of what information is most relevant for adolescents seems to have been addressed in only one published study. The aim of the present study was to update and extend the sole previous survey of oncology professionals’ views about the information needs of adolescent patients. This was achieved by including professionals other than physicians, by structuring the questionnaire to show whether perceived information needs were different for the time of diagnosis versus during treatment, and by differentiating between the 6 cancer diagnoses most commonly affecting adolescents. Fifteen hundred surveys were distributed to pediatric cancer professionals, and 556 valid returns were analyzed. The main finding was that information was considered more important to provide during treatment than at the time of diagnosis. Also, medical information topics were generally considered more essential than psychological topics. The magnitude of this difference was influenced to a small extent by professional discipline, gender, age and experience of respondent, and whether the information was being given at diagnosis or during treatment. It is notable that whereas respondents generally were confident in their ability to communicate information, physicians rated themselves as better communicators at the time of diagnosis than during treatment.
Defining Social Capital for Nursing: Experiences of Family Caregivers of Children with Chronic Conditions
Authors: Looman Wendy Sue
Published: October 2004

The purpose of this descriptive study was to describe the multidimensional nature of social capital as experienced by parental caregivers of children with special health care needs (CSHCN). Social capital is defined broadly as an investment in relationships. To define social capital more fully in the context of families of CSHCN, a structural definition was developed through a thematic analysis of focus-group discussions with parents. Twenty-three parents of CSHCN participated in focus groups that were audiotaped and transcribed for data analysis by the researcher. Thematic analysis of data was guided by van Kaam’s four-phase phenomenological method: extraction of descriptive expressions, identification of dimensions, intuitive categorization of expressions, and identification of common elements. Implications for practice include the importance of reframing social support as an outcome of social interactions and focusing on social capital to facilitate a contextual assessment of support for families and CSHCN.
Surviving Breast Cancer and Living with Lymphedema: Resiliency among Women in the Context of Their Families
Authors: Radina M. Elise , Armer Jane M.
Published: October 2004

This study involves secondary analysis of an existing qualitative dataset (in-depth interviews with survivors [n = 6] and health professionals [n = 2], observations of a support group [n = 3], and field notes). Based on previous findings from this dataset, new questions arose regarding why only some of post–breast cancer lymphedema women who were interviewed appeared resilient within the context of their families. In the present study, we reinvestigate this dataset using the resiliency model of family stress, adjustment, and adaptation to guide our investigation via the construction of an a priori template used in analyses. Three stressors are identified that contribute to the vulnerability of these women. Resiliency in the women is characterized as adjustment, adaptation, or crisis. The present findings provide a foundation for assisting women with lymphedema and their families and underscore practitioners’ need to serve the patient and the family.
Family-Based Interventions for Childhood Obesity: A Review
Authors: Berry Diane , Sheehan Rebecca , Heschel Rhonda , Knafl Kathleen , Melkus Gail , Grey Margaret
Published: October 2004

The purpose of this article is to critically evaluate the evidence related to family-based interventions designed to treat childhood obesity. A MEDLINE, PSYCLIT, and CINAHL search identified articles published between January 1980 and January 2004 relating to family-based interventions. Thirteen studies were included, and all of the interventions used nutrition education, exercise, and behavioral interventions, including behavioral modification, behavioral therapy, or problem solving. Behavioral modification interventions targeted children and parents together or separately and were reported to be successful in improving weight-loss outcomes in both parents and children. Behavioral therapy interventions targeting children and parents together or the parents of children separately improved weight outcomes. Problem-solving interventions that targeted parents of children showed improved weight outcomes for their children. However, when problem solving was used with both parents and children together or children alone, weight outcomes did not improve. A majority of the studies have some methodological weaknesses.
Student Perspectives on the George Mason University 12th Annual Washington Health Policy Summer Institute
Authors: Yoho Mary J. , Sridaromont Kathryn , Ho Tuong-Vi , Decker Sharon
Published: October 2004

As an elective course for their PhD in nursing program, four doctoral students participated in the June 2004 12th annual George Mason University (GMU) Washington Health Policy Institute. This unique educational offering included presentations and interaction with nursing and health policy leaders and discussion of health policy issues with legislators. Participants were able to incorporate newly acquired health policy skills into their current professional nursing roles and stay connected with other like-minded colleagues who attended the Summer Health Policy Institute. They left believing that they can positively affect current health policy issues by taking an informed, proactive stance and supporting political action committees. Their nursing expertise and knowledge of patients makes them important players in the health policy-making arena. The GMU Washington Health Policy Institute proved to be a premier policy learning experience. It provided these nurses with the opportunity to learn from and network with leading health policy experts.
Transformational Leadership and Hospital Restructuring: A Descriptive Study
Authors: Gullo Shirna Rena , Gerstle David S.
Published: October 2004

This article reports on a descriptive study conducted in late 2002 on the impact of middle nurse managers’ transformational leadership characteristics on hospital registered nurses’ sense of empowerment and job satisfaction during a hospital restructuring. The purpose of this study was to determine whether middle nurse managers’ transformational leadership behaviors were related to an increase in job satisfaction and empowerment of staff RNs in a nursing service department undergoing restructuring. This study utilized a descriptive correlational design with convenience sampling. It was conducted from July to October 2002 in an acute care, for-profit hospital in the southeastern United States. The sample included full-time, part-time, and PRN staff registered nurses who were employed at this facility for at least 1 year. The instruments used to collect data were a demographic questionnaire, the Multifactor Leadership Questionnaire, the Organizational Job Satisfaction Scale, and the Reciprocal Empowerment Scale.
Transforming Nurses’ Work Environments to Improve Patient Safety: The Institute of Medicine Recommendations
Authors: Page Ann E. K.
Published: October 2004

In early 2004, the Institute of Medicine released the report Keeping Patients Safe— Transforming the Work Environment of Nurses, commissioned by the Agency for Healthcare Research and Quality as part of its initiative to determine the causes of medical errors and develop models to decrease their occurrence and severity. The study’s analysis of evidence from health services research, behavioral and organizational research on work and workforce effectiveness, human factors analysis and engineering, studies of organizational disasters and their evolutions, and studies of high-risk industries with low accident rates identified mechanisms for improving patient safety within all health care organizations that employ nurses. This article presents the report’s recommendations and conceptual framework, which together provide a blueprint that all nurses—clinicians, educators, managers, researchers, and policy experts—can use to create and follow a patient safety agenda throughout the U.S. health care system.
Supreme Court Ruling May Revive the National Patients’ Rights Movement
Authors: Jennings Carole P.
Published: October 2004

The June 21, 2004 Supreme Court decision ruling that state efforts to enforce “patient rights,” with the subsequent right to sue health plans in state court, were unconstitutional. This Policy Highlight discusses the finding and the implications for state legislatures that have passed patient rights legislation. This decision could potentially affect the 130 million HMO participants receiving coverage from employees. The Court further ruled that patients could sue their health plans over coverage decisions only in federal court, and damages would be limited to the cost of the denied coverage. Some speculate that this decision may revive the “national patients’ rights movement.”
A Voice for the People: A Nurse’s Reflections on her Role as an Elected State Representative
Authors: Hall-Long Bethany A.
Published: October 2004

This article presents a case follow-up of a nurse’s election and experiences as a Delaware State Representative. Public policy affects all aspects of the nursing profession. It is important that nurses be part of this process. Political strategies, policy definitions, and tips are shared for other nurses. All elections are different, but there is value in examining the process of this case to add to nurses’ political knowledge and experiences.
Immune regulatory activity of CD34+ progenitor cells: evidence for a deletion-based mechanism mediated by TNF-α
Authors: Gur Hilit , Krauthgamer Rita , Bachar-Lustig Esther , Katchman Helena , Arbel-Goren Rinat , Berrebi Alain , Klein Tirza , Nagler Arnon , Tabilio Antonio , Martelli Massimo F. , Reisner Yair
Published: October 2004

Previous studies suggest that cells within the CD34+ hematopoietic stem cell compartment are endowed with immune regulatory activity. Furthermore, it is possible to expand the human regulatory cells upon short-term culture of purified CD34+ cells with an early-acting cytokine cocktail. We now show that addition of anti-CD28, anti-CD2, interleukin-2 (IL-2), anti–IL-10, or IL-12 to the bulk mixed lymphocyte reaction (MLR) cannot reverse the inhibitory activity of the CD34+ cells, ruling out anergy-based mechanisms or mechanisms involving Th1-Th2 skewing. Furthermore, phenotyping of cells present after addition of CD34+ cells to the bulk MLR ruled out potential induction of plasmacytoid dendritic precursors, known to be endowed with regulatory activity. In contrast, the inhibitory activity of CD34+ cells could be reversed by adding the caspase inhibitor BD-FMK to the bulk MLR, indicating a deletion-based mechanism. The deletion can be inhibited by anti–tumor necrosis factor-α (anti–TNF-α) and not by anti–transforming growth factor-β (anti–TGF-β), suggesting a potential role for TNF-α in the regulatory activity of CD34+ cells.
Ephrin B2 expression in Kaposi sarcoma is induced by human herpesvirus type 8: phenotype switch from venous to arterial endothelium
Authors: Masood Rizwan , Xia Guangbin , Smith D. Lynne , Scalia Piergips , Still Jonathan G. , Tulpule Anil , Gill Parkash S.
Published: October 2004

Kaposi sarcoma (KS) is an angioproliferative tumor derived from endothelial cells in which tumor cells form aberrant vascular structures. Ephrin B2 and ephrin B4 (EphB4) are artery- and vein-specific proteins, respectively, with critical roles in vessel maturation. We investigated whether the disorganized KS vasculature was due to unbalanced expression of ephrin B2 and EphB4. Secondly, we wished to determine if human herpesvirus type 8 (HHV-8), the viral agent associated with KS, regulates ephrin B2 and EphB4. An arterial phenotype was observed in KS tissue and cell lines, as shown by abundant expression of ephrin B2 with little or no EphB4. Infection of venous endothelial cells with HHV-8 resulted in a phenotype switch from EphB4 to ephrin B2, similar to that seen with vascular endothelial growth factor (VEGF). The HHV-8 effect on ephrin B2 expression was reproduced with the HHV-8-specific viral G-protein-coupled receptor. We also showed that ephrin B2 expression is required for KS cell viability by knock down with siRNA. KS is the first example of a human tumor with a predominantly arterial phenotype. This predominance can be attributed to expression of HHV-8 proteins and their downstream effects. Ephrin B2 is thus an important novel factor in KS biology and a potential target for therapy.
Fibromodulin as a novel tumor-associated antigen (TAA) in chronic lymphocytic leukemia (CLL), which allows expansion of specific CD8+ autologous T lymphocytes
Authors: Mayr Christine , Bund Dagmar , Schlee Martin , Moosmann Andreas , Kofler David M. , Hallek Michael , Wendtner Clemens-Martin
Published: October 2004

Fibromodulin (FMOD) was shown to be highly overexpressed in chronic lymphocytic leukemia (CLL) cells compared with normal B lymphocytes by gene expression profiling. Therefore FMOD might serve as potential tumor-associated antigen (TAA) in CLL, enabling expansion of FMOD-specific T cells. In CLL samples derived from 16 different patients, high expression of FMOD by real-time reverse transcriptase–polymerase chain reaction (RT-PCR) was detectable in contrast to normal B lymphocytes. We used unpulsed native CLL cells and CD40 ligand (CD40L)–stimulated CLL cells as antigen-presenting cells (APCs) to expand autologous T cells from 13 patients. The number of T cells during 4 weeks of in vitro culture increased 2- to 3.5-fold and the number of T cells recognizing FMOD peptides bound to HLA-A2 dimers increased 10-fold. The expanded T cells also were able to secrete interferon-γ (IFN-γ) upon recognition of the antigen demonstrated by IFN-γ ELISPOT assays. T cells not only recognized HLA-A2–binding FMOD peptides presented by transporter-associated with antigen-processing (TAP)–deficient T2 cells, but also FMOD overexpressing autologous CLL cells in an HLA-A2–restricted manner. In summary, FMOD was shown for the first time to be naturally processed and presented as TAA in primary CLL cells, enabling the expansion of autologous tumor-specific T cells.