bluuebunny/crossref_metadata_2025 huggingface dataset:
Essential strategies for achieving durable population-based maternal and child health services
Authors: Akukwe C. , Nowell A.H.
Published: September 2007

Essential strategies; maternal and child health; population-based; worldwide
Against women: are we looking after our General Practitioners? GPs' views of the 1990 part-time contract
Authors: Littlewood Jenny , Beer Naomi , Lazou Elizabeth , Webb Enid , Saunders Mary
Published: September 2007

A postal survey was conducted looking at the roles and experiences of General Practitioners on part-time contracts. This involved their perception of the attitudes of their colleagues and patients to their part-time status, and the consequences of these for their professional development.

Of the 130 General Practitioners with part-time contracts in the one Regional Health Authority that was being surveyed 77.7% responded; 74.3% of the respondents were women. Of the women General Practitioners who responded to this particular question, the predominant age-bands were 31-40 years [41.4% (41)] and 41-50 [19.2% (19)], whilst male General Practitioners were more evenly spread across the age bands. The results showed that the majority of General Practitioners took up part-time contracts to enable them to look after their dependants, though a sizeable minority wished for free time or to relieve stress from a full-time contract. Forty percent said that they felt excluded from decision making about continuity of patient care and practice policy. Just under forty percent also stated that their workload was excessive in comparison with their full-time counterparts. Further, many expressed the opinion that they were financially penalised. The cost effective correlation between the increased availability of General Practitioners (particularly women) for patient care, and the costly medical education and training of such General Practitioners not being 'wasted' for several years was also noted together for the need for ongoing (or continual) medical education and training.

The findings of this survey suggest there are many unresolved issues involved in satisfactory part-time contracting arrangements for General Practitioners. This particularly affects women General Practitioners. Whilst the RCP policy statement addresses education and training for general practice, the question of not losing out in relation to training opportunities and promotion is not addressed. The unresolved effects of the intra-professional differences in opportunities may affect the inter-professional functioning of the primary health care team and ultimately continuity and quality of care for patients.
The impact of water supplies and sanitation on growth in Chinese children
Authors: Cheung Y.B.
Published: September 2007

In many developing countries, improvement in water supplies has not been supplemented by improvement in sanitation facilities. Moreover, health education is rarely included in environmental hygiene programmes. Community health workers need to know if water supplies and sanitation have independent or complementary effects on health. This study analysed the weight data of 1,045 Chinese children aged 60 months or below. Regression models with interaction terms were tested against a model with main effects only. There was no evidence of interaction between water supplies and sanitation measures. The results show that water supplies and toilet facilities had independent associations with growth. Improved water source (P=0.01) and flush-toilet (P=0.06) were found positively associated with the children's weight. Presence of excreta in the home had a negative, but not statistically significant, association with weight.
Hospital transformation and organisational learning
Authors: Ho W.
Published: September 2007

Kwong Wah Hospital was founded by the charity organisation Tung Wah Group of Hospitals some 88 years ago, with management transfer to the Hong Kong Hospital Authority in 1991. Capitalising both from the traditional caring culture of its founder, as well as opportunities in the new management environment, the hospital has scored remarkable successes in service quality, community partnership, organisational effectiveness, and staff development. Underpinning these transformations were Structure, Process, People, and Culture strategies. The learning imperative is heavily mandated for the success of each of these strands of development. Indeed, the embodiment of a learning organisation culture provides the impetus in sustaining the change momentum, towards achieving the Vision of becoming a 'Most Preferred Hospital' in Hong Kong.
Review: HMG CoA reductase inhibitors and renoprotection: the weight of the evidence
Authors: Romayne Kurukulasuriya L. , Athappan Ganesh , Saab Georges , Whaley Connell Adam , Sowers James R.
Published: September 2007

Dyslipidemia and the contributions of oxidized low-density lipoproteins (ox-LDL) are independent cardiovascular risk factors. There is growing evidence that dyslipidemia contributes not only to cardiovascular disease but also to the progressive decline of renal function in diabetic and non-diabetic kidney disease. Ox-LDL, by generating inflammation and oxidative stress, contributes to a pro-atherogenic mileu and leads to endothelial dysfunction, subsequent glomerular filtration barrier damage, and progressive renal injury. Chronic kidney disease (CKD), in turn, induces deleterious effects on lipid metabolism. Therefore, by inhibiting cholesterol synthesis and reducing ox-LDL, HMG CoA reductase inhibitors (statins) are attractive therapeutic options to preserve renal function. Current evidence demonstrates a reduction in cardiovascular risk and improved renal outcomes especially in patients with mild to moderate impairment of renal function. Evidence supports a beneficial role of statins thought to extend beyond their lipid-lowering effect, referred to as pleiotropic actions. These actions include modulatory effects on inflammation, oxidative stress and thrombosis, derived from their ability to prevent the formation of isoprenoid intermediates involved in cellular signaling, posttranslational modification of proteins and cellular function. This translates to potential reductions in the rate of decline in GFR in CKD and adverse effects of type 2 diabetes mellitus in the kidney. This review examines the role of statins for reno-protection as well as cardiovascular benefit in patients with CKD.
Review: Hypertension and the cardiometabolic syndrome in Chile: a review of concepts and consequences for the developing world
Authors: Margozzini P. , Rigotti A. , Ferreccio C. , Quezada N. , Garrido M. , Valdés G.
Published: September 2007

We review some recent developments regarding the concept of cardiometabolic syndrome and its relation with hypertension and overall cardiovascular disease risk. We emphasize how this new clinical entity has helped to understand multimorbidity in chronic diseases. This concept has important consequences for individual patient treatment as well as public health policy. The challenge derived from cardiovascular disease and other chronic conditions is increasing worldwide, but the highest burden is located in the developing world. Thus, new and cost-effective approaches are needed for diseases that are mainly occurring in the poorest and less educated populations. We illustrate this situation analyzing hypertension and cardiometabolic syndrome data derived from a recent national health survey in Chile.
Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years
Authors: Syrjala Karen L. , Kurland Brenda F. , Abrams Janet R. , Sanders Jean E. , Heiman Julia R.
Published: September 2007

This prospective study evaluated sexual function through 5 years after myeloablative allogeneic hematopoietic cell transplantation (HCT) for cancer to determine sexual function recovery and residual problems. Adults completed measures before HCT (N = 161), with survivors followed at 6 months and at 1, 2, 3, and 5 years. At 5 years case-matched controls also completed assessments. Analyses indicated that men and women differed in rates of being sexually active across time (P < .001) and in overall sexual function (P < .001). Both sexes declined in sexual activity rates and sexual function from before HCT to 6 months afterward (P ≤ .05). Activity rates recovered for men by 1 year (74%) and for women by 2 years (55%). Men improved from their 6-month nadir in sexual function by 2 years (P = .02), whereas women did not improve by 5 years (P = .17). Both male and female survivors were below controls in rates of sexual activity and sexual function at 5 years. Most women reported sexual problems (80% of survivors vs 61% of controls, P = .11); in contrast for men 46% of survivors versus 21% of controls (P = .05) reported problems. Thus, despite some recovery, sexual dysfunction remained a major problem for men and women after HCT. Aggressive efforts are needed to treat these deficits.
Enterococcal colonization of infants in a neonatal intensive care unit: associated predictors, risk factors and seasonal patterns
Authors: Hufnagel Markus , Liese Cathrin , Loescher Claudia , Kunze Mirjam , Proempeler Heinrich , Berner Reinhard , Krueger Marcus
Published: September 2007

Background

During and shortly after birth, newborn infants are colonized with enterococci. This study analyzes predictors for early enterococcal colonization of infants in a neonatal intensive care unit and describes risk factors associated with multidrugresistant enterococci colonization and its seasonal patterns.

Methods

Over a 12-month period, we performed a prospective epidemiological study in 274 infants admitted to a neonatal intensive care unit. On the first day of life, we compared infants with enterococcal isolates detected in meconium or body cultures to those without. We then tested the association of enterococcal colonization with peripartal predictors/risk factors by using bivariate and multivariate statistical methods.

Results

Twenty-three percent of the infants were colonized with enterococci. The three most common enterococcal species wereE. faecium(48% of isolates),E. casseliflavus(25%) andE. faecalis(13%). Fifty-seven percent of the enterococci found were resistant to three of five antibiotic classes, but no vancomycin-resistant isolates were observed. During winter/spring months, the number of enterococci and multidrug-resistant enterococci were higher than in summer/fall months (p = 0.002 and p < 0.0001, respectively). With respect to enterococcal colonization on the first day of life, predictors were prematurity (p = 0.043) and low birth weight (p = 0.011). With respect to colonization with multidrug-resistant enterococci, risk factors were prematurity (p = 0.0006), low birth weight (p < 0.0001) and prepartal antibiotic treatment (p = 0.019). Using logistic regression, we determined that gestational age was the only parameter significantly correlated with multidrug-resistant enterococci colonization. No infection with enterococci or multidrugresistant enterococci in the infants was detected. The outcome of infants with and without enterococcal colonization was the same with respect to death, necrotizing enterocolitis, intracerebral hemorrhage and bronchopulmonary dysplasia.

Conclusion

In neonatal intensive care units, an infant's susceptibility to early colonization with enterococci in general, and his or her risk for colonization with multidrug-resistant enterococci in particular, is increased in preterm newborns, especially during the winter/spring months. The prepartal use of antibiotics with no known activity against enterococci appears to increase the risk for colonization with multidrug-resistant enterococci.
In vivo transcriptional targeting into the retinal vasculature using recombinant baculovirus carrying the human flt-1 promoter
Authors: Luz-Madrigal Agustín , Clapp Carmen , Aranda Jorge , Vaca Luis
Published: September 2007

Background

Endothelial cells are a target for gene therapy because they are implicated in a number of vascular diseases. Recombinant baculovirus have emerged as novel gene delivery vectors. However, there is no information available concerning the use of endothelial-specific promoters in the context of the baculovirus genome. In the present study, we have generated a recombinant baculovirus containing the human flt-1 promoter (BacFLT-GFP) driving the expression of the green fluorescent protein. Transcriptional gene targeting was analyzed in vitro in different mammalian cell lines and in vivo in adult rat retinal vasculature.

Results

BacFLT-GFP evoked the highest levels of expression in the endothelial cell line BUVEC-E6E7-1, similar to those reached by recombinant baculovirus carrying the CMV promoter (112% relative to BacCMV-GFP, n = 4). Interestingly, BacFLT-GFP directed high levels of expression in rat glioma C6 and in human glioblastoma CH235 cells (34.78% and 47.86% relative to BacCMV-GFP, respectively). Histone deacetylase inhibitors such as butyrate or trichostatin A enhanced the transcriptional activity of both BacCMV-GFP and BacFLT-GFP. Thus, in this study histone deacetylation appears to be a central mechanism for the silencing of baculovirus, independently of the promoter utilized. In vivo transcriptional targeting was demonstrated in adult rat retinal vasculature by intravitreal delivery of BacFLT-GFP and immunohistochemical staining with von Willebrand factor (vWF). Analysis by fluorescence microscopy and deconvolved three-dimensional confocal microscopy of retinal whole mounts obtained after 3 days of baculovirus injection showed that most GFP-expressing cells localized to the inner limiting membrane (ILM) and ganglion cell layer (GCL) and colocalize with vWF (70%, n = 10) in blood vessels, confirming the endothelial phenotype of the transduced cells.

Conclusion

Taken together, our results indicate that the restricted expression in endothelial cells mediated by the flt-1 promoter is not affected by the context of the baculovirus genome and demonstrate the potential of using recombinant baculovirus for transcriptional targeted gene expression into the eye vasculature.
High-dose antipsychotic medication
Authors: Mackay A.V.P.
Published: September 2007

The dopamine hypothesis for the mode of action of antipsychotic drugs has been with us for some 30 years and has, by and large, withstood the test of time. It simply states that antipsychotic drugs owe their therapeutic effects to an ability to block central dopamine receptors. This has given us a working and testable explanation for the effects of these drugs and it has prompted the synthesis of new agents. While so-called antipsychotic drugs (otherwise known as neuroleptics or major tranquillisers) are known to be effective in schizophrenia and related psychoses, mania, and the agitation associated with severe depressive illness or organic disorder, this paper is only concerned with the pharmacotherapy of schizophrenia.
Management of difficult personality disorder patients
Authors: Norton Kingsley
Published: September 2007

‘…therapy often becomes part of the problem rather than vice versa’. George Lockwood, 1992

Ten per cent of the general adult population have a diagnosable personality disorder (Zimmerman & Coryell, 1990) and in 4% this is clinically severe (Tyrer, 1988). The clinical management of such patients may be difficult. However, much clinical difficulty is generated by interpersonal aspects deriving from the particular interaction of the patient and psychiatrist involved and the respective roles they play.
Pharmacotherapy for anxiety disorders: using the available drugs
Authors: Tyrer P.
Published: September 2007

The treatment of anxiety is one of the more contentious issues in therapeutics. It is also one of the most important, as pathological anxiety is such a common symptom in the population. The recent Office of Population Censuses and Surveys survey of psychiatric morbidity indicated that one in eight of all those interviewed had an anxiety disorder of sufficient severity to receive a formal diagnostic label in the week before interview (Meltzer et al, 1994). Clearly, only a proportion of these should be treated with drugs, and selection for pharmacotherapy is one of the more difficult issues in clinical practice. It is a matter of some concern that changes in the National Health Service are increasingly shifting the onus of responsibility for treatment from the psychiatrist to the general practitioner. As a consequence, it behoves both disciplines to keep liaison active, so that best practice can be maintained from whatever source it is being provided.
Management of chronic pain
Authors: Tyrer Stephen P.
Published: September 2007

Until 50 years ago chronic pain was not considered to be a medical condition that required special evaluation and treatment facilities. Pain was considered to be an indicator of tissue damage and appropriate medical or surgical treatment was prescribed for this. The many patients who had continuing pain because of the results of disease or trauma or because acute treatment was unable to relieve the condition were not seen as suffering from a recognised pathological entity. It was not until a doctor, Sicilian-born John J. Bonica, had to pay his debts as a medical student through wrestling professionally, and later suffered persistent pain as a result, that chronic pain became a recognised condition in its own right. Bonica started a pain clinic in Tacoma, Washington State, in 1949 and wrote the first textbook on pain treatment, The Management of Pain, in 1953. There are now 2000–3000 pain clinics in the USA and almost 5000 worldwide.
Burden of care in the home: issues for community management
Authors: Vaddadi Krishna S.
Published: September 2007

The number of beds available in the UK for the treatment of mental illness has fallen by over two-thirds since its peak in the mid-1950s. There is a worldwide trend of closure of large mental hospitals and integration of services for the mentally ill in their own local community. Community surveys have shown that an overwhelming majority of mentally ill people are treated in primary care or by specialists, but without being admitted to a hospital. This is now the preferred clinical practice (Shepherd et al, 1981).
Case study: Head injury
Authors: Matthews Helen
Published: September 2007

This study is presented to encourage recognition of the contribution mental health practitioners can make to the care of head-injured people.
Commentary: Head injury
Authors: Perini Anthony
Published: September 2007

It has been estimated that every year 8 per 100 000 of the population suffer severe head injury, 18 per 100 000 suffer moderate head injury and 250–300 per 100 000 suffer mild head injury (Medical Disability Society, 1988). It is likely that 100–150 per 100 000 of the population have significant disability as the result of head injury (Department of Health, 1994).
Life expectation in organic brain disease
Authors: Jolley David , Baxter David
Published: September 2007

The purpose of this review is to outline current knowledge on the life expectation of people suffering from organic brain disease, the techniques available for describing and comparing life expectation in populations, factors which are associated with longer and shorter life expectation, and the causes of death among patients with this condition.
Pharmacological treatment of the newly diagnosed patient with schizophrenia
Authors: Travis Michael J. , Kerwin Robert W.
Published: September 2007

The early treatment of newly diagnosed schizophrenia has ramifications for the future psychiatric and social well-being of the patient. Changes in care structures and care delivery mechanisms, in addition to financial constraints and outcome targets, provide an additional incentive to ensuring that any intervention is both successful and cost-effective.
Spurious childhood psychosis induced by schizophrenia in the parent
Authors: Aldridge Steve , Tagg Gill
Published: September 2007

We describe the case of a child presenting with what initially appeared as a pervasive developmental disorder (ICD F84.1) associated with, and in our view, induced by, schizophrenic illness in the mother. Important issues are raised for both adult and child psychiatry, in particular that the failure of the Mental Health Act (1983) to address the mother's needs adequately, left the child vulnerable to her untreated illness.
Management of people with schizophrenia in primary care
Authors: Kendrick Tony
Published: September 2007

In 1961 Parkes and his colleagues followed 100 people with schizophrenia for a year after their discharge from hospitals in south London and found that the general practitioner (GP) was the professional most frequently in contact with people. Only 56% attended as psychiatric out-patients, most being seen fewer than five times in the year, while 70% were in regular contact with their GPs, and when problems developed it was usually the GP who was involved first (Parkes et al, 1962).
Cycles of abuse: a case study
Authors: Bailey Susan
Published: September 2007

This study is presented to encourage recognition and early intervention with cycles of physical, sexual and emotional abuse, both within institutions (whether the family, hospital, residential care, residential schools or penal institutions) or within the community at large.
Management of adult sex offenders
Authors: Holloway Josanne
Published: September 2007

The true incidence and prevalence of sexual abuse against children is difficult to ascertain. Differing sampling methods, definitions of sexual abuse and methods of information-gathering have a significant effect on the rates reported. General population studies (Morrison et al, 1994) in the USA and Europe reveal a rate between 0.7 and 1.83 per 1000 children. Data from prevalence studies (Morrison et al, 1994) highlight large differences, with rates varying from 7 to 62%; meanwhile, only between 2 and 17% of sexual assaults are reported to the police. Many of the reported offenders are not prosecuted because of difficulties with the child's statement. Some offenders are cautioned, others are charged with specimen charges or have their charges downgraded. Despite an increase in the reporting of sexual offences since the 1970s, they account for only approximately 3% of all offenders on probation and 8% of male offenders in prison even though the number and length of prison sentences for sex offenders has increased since the 1970s. Convicted female offenders remain a very small group with only 23 convicted female sex offenders in custody in 1989.
Treatment compliance in schizophrenia
Authors: Buchanan Alec
Published: September 2007

There is a myth that people with mental disorders comply poorly with treatment. In fact, psychiatric patients are no more likely than patients in other medical specialities to go against the advice of their doctor. However, it is easy to find instances where psychotropic medication is refused by the supposed beneficiary. The value of neuroleptic treatment in schizophrenia is now widely accepted, and failure to take such treatment is associated with relapse. Relapse may endanger the patient and other people. Despite this, people with schizophrenia frequently fail to take their treatment. One-third of patients leaving a general adult psychiatry ward can be expected to be non-compliant within two years (Buchanan, 1992).
Cognitive therapy for the treatment of delusions
Authors: Turkington Douglas , Siddle Ronald
Published: September 2007

Traditionally, delusions have been viewed as false, unshakeable beliefs which arise out of internal morbid processes and are out of keeping with a person's educational and cultural background (Hamilton, 1978). Primary delusions appear to arise without understandable cause, and secondary delusions appear more understandable in relation to the prevailing affective state or cultural climate (Sims, 1995), for example. However, during the cognitive therapy process we would expect that even primary delusions might become more understandable as the patient's life history and belief profile are gradually disclosed.
Understanding the importance of oral health in psychiatric patients
Authors: Cormac Irene , Jenkins Philip
Published: September 2007

Dental disease and psychiatric illness are among the most prevalent health problems in the Western world. While the dental needs of mentally ill people are similar in type to those in the general population (Markette et al, 1975) there is some evidence that patients suffering from mental illness are more vulnerable to dental neglect and poor oral health (Stiefel et al, 1990; Armstrong, 1994). Sims (1987) reports that physical health problems are more common in psychiatric patients. They seem to be poorly recognised by psychiatrists, and oral health is no exception (Hede, 1995). Oral health is an important aspect of quality of life which affects eating, comfort, speech, appearance and social acceptance (Nordenram et al, 1994).
New classes of antidepressant drugs
Authors: Scott Allan I. F.
Published: September 2007

The January 1997 issue of this journal contained four reviews that compared tricyclic antidepressants with selective serotonin reuptake inhibitors (SSRIs) and other newer antidepressants in terms of their pharmacology (Palazidou, 1997), adverse effects, potential drug interactions and toxicity (Henry, 1997), efficacy in the prevention of relapse and recurrence (Edwards, 1997), and findings from meta-analyses (Anderson, 1997). In July 1997 reboxetine was promoted as the first selective noradrenaline reuptake inhibitor (NARI), and in October of the same year mirtazapine was promoted as the first noradrenergic and specific serotonergic antidepressant (NaSSA). Milnacipran is presently being registered by the manufacturers, after which it will be the second antidepressant drug promoted as a specific serotonin and noradrenaline reuptake inhibitor (SNRI).
Duties of psychiatrists: treat the patient or protect the public?
Authors: Adshead Gwen
Published: September 2007

In this paper I will be discussing the professional duties of psychiatrists. I will argue that there is an ethical tension at the heart of psychiatric practice – between the psychiatrist's professional duties to his or her patient, and what professional duties there might be to protect public safety. It may be of some comfort to clinicians to know that this tension has exercised the best minds for centuries, including thinkers such as Marcus Aurelius nearly 800 years ago (Spruit, 1998).
Randomized Phase II Study of Erlotinib Combined With Bevacizumab Compared With Bevacizumab Alone in Metastatic Renal Cell Cancer
Authors: Bukowski Ronald M. , Kabbinavar Fairooz F. , Figlin Robert A. , Flaherty Keith , Srinivas Sandy , Vaishampayan Ulka , Drabkin Harry A. , Dutcher Janice , Ryba Sarah , Xia Qi , Scappaticci Frank A. , McDermott David
Published: September 2007

Purpose

Bevacizumab (Bev) has clinical activity in advanced renal cell carcinoma (RCC), and, when combined with erlotinib (Erl), has shown encouraging objective response rate (ORR) and progression-free survival (PFS). We performed a phase II, randomized, double-blind, multicenter, placebo-controlled trial to assess whether Erl provides additional clinical benefit with regard to PFS and ORR when combined with Bev in first-line treatment of metastatic RCC.

Patients and Methods

One hundred four patients received intravenous Bev (10 mg/kg) every 2 weeks in combination with oral Erl (150 mg) or placebo daily. Patients were treated until progression or toxicity.

Results

A landmark analysis was performed 9 months after enrollment was completed (median follow-up, 9.8 months). Sixty-five patients had discontinued therapy; time to study discontinuation did not differ between the two treatment groups. The median PFS was 9.9 months (Bev + Erl [B+E]) versus 8.5 months (Bev; hazard ratio = 0.86; 95% CI, 0.5 to 1.49; P = .58). ORR (complete plus partial) was 14% (B+E) versus 13% (Bev). One complete response occurred in the B+E group. Median survival was 20 months for B+E but not reached for Bev. The most common grade 3/4 adverse events (> 5% of patients) were hypertension, rash, proteinuria, diarrhea, and hemorrhage. One treatment-related death occurred on study (GI perforation, B+E group).

Conclusion

The addition of Erl to Bev was well tolerated, but did not provide additional clinical benefit compared with Bev alone. Bev has encouraging clinical activity for previously untreated metastatic RCC patients.
A nucleolar targeting signal in PML-I addresses PML to nucleolar caps in stressed or senescent cells
Authors: Condemine Wilfried , Takahashi Yuki , Le Bras Morgane , de Thé Hugues
Published: September 2007

The promyelocytic leukemia (PML) tumour suppressor is the organiser of PML nuclear bodies, which are domains the precise functions of which are still disputed. We show that upon several types of stress, endogenous PML proteins form nucleolar caps and eventually engulf nucleolar components. Only two specific PML splice variants (PML-I and PML-IV) are efficiently targeted to the nucleolus and the abundant PML-I isoform is required for the targeting of endogenous PML proteins to this organelle. We identified a nucleolar targeting domain within the evolutionarily conserved C-terminus of PML-I. This domain contains a predicted exonuclease III fold essential for the targeting of the PML-I C-terminus to nucleolar fibrillar centres. Furthermore, spontaneous or oncogene retrieval-induced senescence is associated with the formation of very large PML nuclear bodies that initially contain nucleolar components. Later, poly-ubiquitin conjugates are found on the outer shell or within most of these senescence-associated PML bodies. Thus, unexpectedly, the scarcely studied PML-I isoform links PML bodies, nucleolus, senescence and proteolysis.
Honor Thy Sister: Selfhood, Gender, and Agency in Palestinian Culture
Authors: Baxter Diane
Published: September 2007

In this article, I examine the ideology of honor among West Bank Palestinians most particularly as it relates to sexuality and gender relations within families. I contend that the iconic Arab and Palestinian subject of the ideal, gendered, connected self—a central concept that undergirds most representations of honor—elides the significance of the individual and obscures the rights and strengths of women and the obligations, vulnerabilities, and anxieties of men. Beyond a critique of representations of honor, subjectivities, and patriarchy, I suggest that ideological-culturally-based explanatory models of behavior favor coherency over ambivalence and untidiness. In terms of honor and the subjectivities that inform it, such explanations have led to an over-reliance on resistance as a method of analyzing "anomalies." I argue that for Palestinian women and men, subjectivity and agency are achieved within and are a reflection of structural, ideological, and experiential configurations, rather than as resistances to them.
Cultural Clientelism and Brokerage Networks in Early Modern Florence and Rome: New Correspondence between the Barberini and Michelangelo Buonarroti the Younger*
Authors: Cole Janie
Published: September 2007

This study draws on the unpublished correspondence between Michelangelo Buonarroti the Younger, a Florentine poet and grandnephew of the artist, and the Barberini family, in an attempt to examine the wider concepts of cultural clientelism and brokerage networks in the early modern process of cultural dissemination (in the areas of literature, music, theater, painting, architecture, and science) in Florence and Rome. Reconsidering the definition and role of a Seicento cultural broker added to the traditional model of patron and client, it analyzes Michelangelo the Younger’s activity as broker, patron-broker, and broker-client in connection with such significant figures as Maffeo Barberini (the future Urban VIII), Galileo, and the painter Lodovico Cigoli, exploring the ways in which these roles supported his personal commitment to promote his family’s social status and revealing the fluidity of roles in the patronage system. By obtaining Barberini patronage for his theatrical works and public recognition of the mythology of his illustrious forebear, Buonarroti’s cultural brokerage supported these dynastic ambitions. Spanning nearly half a century, this archival documentation casts new light on a little-known, but significant, area of Italian social relations and suggests directions for further research on other Seicento cultural brokers and new definitions for a broader concept of cultural brokerage in early modern Italy.
RACK1, a PKC Targeting Protein, Is Exclusively Localized to Basal Airway Epithelial Cells
Authors: Slager Rebecca E. , DeVasure Jane M. , Pavlik Jaqueline A. , Sisson Joseph H. , Wyatt Todd A.
Published: September 2007

The novel isoform of protein kinase C (PKC), PKC∊, is an important regulator of ciliated cell function in airway epithelial cells, including cilia motility and detachment of ciliated cells after environmental insult. However, the mechanism of PKC∊ signaling in the airways and the potential role of the PKC∊-interacting protein, receptor for activated C kinase 1 (RACK1), has not been widely explored. We used immunohistochemistry and Western blot analysis to show that RACK1 is localized exclusively to basal, non-ciliated (and non-goblet) bovine and human bronchial epithelial cells. Our immunohistochemistry experiments used the basal body marker pericentrin, a marker for cilia, β-tubulin, and an airway goblet cell marker, MUC5AC, to confirm that RACK1 was excluded from differentiated airway cell subtypes and is only expressed in the basal cells. These results suggest that PKC∊ signaling in the basal airway cell may involve RACK1; however, PKC∊ regulation in ciliated cells uses RACK1-independent pathways.
A global and efficient multi-objective auto-calibration and uncertainty estimation method for water quality catchment models
Authors: van Griensven A. , Meixner T.
Published: September 2007

Catchment water quality models have many parameters, several output variables and a complex structure leading to multiple minima in the objective function. General uncertainty/optimization methods based on random sampling (e.g. GLUE) or local methods (e.g. PEST) are often not applicable for theoretical or practical reasons. This paper presents “ParaSol”, a method that performs optimization and uncertainty analysis for complex models such as distributed water quality models. Optimization is done by adapting the Shuffled Complex Evolution algorithm (SCE-UA) to account for multi-objective problems and for large numbers of parameters. The simulations performed by the SCE-UA are used further for uncertainty analysis and thereby focus the uncertainty analysis on solutions near the optimum/optima. Two methods have been developed that select “good” results out of these simulations based on an objective threshold. The first method is based on χ2 statistics to delineate the confidence regions around the optimum/optima and the second method uses Bayesian statistics to define high probability regions. The ParaSol method was applied to a simple bucket model and to a Soil and Water Assessment Tool (SWAT) model of Honey Creek, OH, USA. The bucket model case showed the success of the method in finding the minimum and the applicability of the statistics under importance sampling. Both cases showed that the confidence regions are very small when the χ2 statistics are used and even smaller when using the Bayesian statistics. By comparing the ParaSol uncertainty results to those derived from 500,000 Monte Carlo simulations it was shown that the SCE-UA sampling used for ParaSol was more effective and efficient, as none of the Monte Carlo samples were close to the minimum or even within the confidence region defined by ParaSol.
Evaluation of advanced treatment technologies for the elimination of pharmaceutical compounds
Authors: Baumgarten S. , Schröder H.Fr. , Charwath C. , Lange M. , Beier S. , Pinnekamp J.
Published: September 2007

Pharmaceuticals and their metabolites have developed as ecotoxicologically relevant micropollutants in the aquatic environment. During conventional biological wastewater treatment they are eliminated insufficiently and therefore reach surface waters via discharges. They are either partially or completely non-biodegradable and/or hardly eliminable by activated sludge adsorption because they often have polar structures. Membrane bioreactor treatment (MBR) was applied to pre-treat wastewater containing pharmaceutical compounds, e.g., antibiotics like floxacins and their synthetic precursor compounds. Our objectives were to eliminate these persistent target compounds from wastewater prior to discharge into receiving waters. Therefore an advanced treatment applying MBR combined with different chemical and physicochemical processes was performed. The addition of powdered activated carbon (PAC), nano filtration (NF), reverse osmosis (UO) or ozone (O3) and O3/UV were applied to MBR permeate spiked with the selected target compounds. Treatment efficiency was assessed using conventional inorganic and organic chemical analyses besides advanced physicochemical methods like liquid chromatography coupled with mass and tandem mass spectrometry (LC-MS and –MS-MS).
Treatment of toilet wastewater for reuse in a membrane bioreactor
Authors: Boehler M. , Joss A. , Buetzer S. , Holzapfel M. , Mooser H. , Siegrist H.
Published: September 2007

Toilet wastewater is treated and reused on site at Europe's highest membrane bioreactor (MBR), located in a cable car mountain station in the ski resort of Zermatt. Negative impacts on the sensitive mountain environment are minimised by reusing close to 100% of the treated wastewater for toilet flushing. Besides 100% nitrogen removal, 80% of phosphorus was also eliminated. This paper presents operational results, optimisations of sludge management, decoloration and long-term maintenance of biomass in the very low-loaded summer season. From a global view the experiences and results of the project are of great importance, proposing a solution to a problem existing 100-fold in the Alps as well as in arid regions all over the world: reducing water consumption for sanitation by reuse.
Reducing micropollutants with source control: substance flow analysis of 212 pharmaceuticals in faeces and urine
Authors: Lienert J. , Bürki T. , Escher B.I.
Published: September 2007

Pharmaceuticals in the aquatic environment are raising concern. It is expected that many anthropogenic pharmaceuticals are largely excreted via urine; a popular argument for introducing urine source separation. However, to date, this assumption lacks verification. We close this gap with quantitative screening of official pharmaceutical data. We analysed the excretion pathways of 212 pharmaceuticals' active ingredients (AI), equalling 1,409 products. On average, 64% (±27%) of each AI was excreted via urine, and 35% (±26%) via faeces. In urine, 42% (±28%) of each AI was excreted as metabolites. However, these numbers need cautious interpretation. We found an extreme variability (1) between different therapeutic groups, (2) within some groups and (3) sometimes even between products of the same AI. We discuss various therapeutic groups and include Swiss sales' quantities. For instance, urine source separation could very effectively remove the highly sold and non-degradable x-ray contrast media: 94% (±4%) are excreted via urine. However, for different pharmaceuticals belonging to cytostatics, excretion via urine was 6–98%. Because of such large variability we advise caution to introduce the still imperfect urine separation technology solely because of pharmaceuticals. Nonetheless, together with other good arguments for this innovation, removal of pharmaceuticals is a welcome side effect.
A pilot assessment of water, sanitation, hygiene and home-based care services for people living with HIV/AIDS in rural and peri-urban communities in South Africa
Authors: Potgieter N. , Koekemoer R. , Jagals P.
Published: September 2007

A short-term assessment of water, sanitation, hygiene and home-based care services in two rural and two peri-urban communities in South Africa was made using specially designed questionnaires. The results from this assessment indicated the shortcomings of various sections in the service provision to people affected and living with HIV/AIDS in South Africa. This paper is a summarised version of the assessment and aims to give an indication of the inadequacies of some of these services.
Characterisation and biological treatment of greywater
Authors: Hernández Leal L. , Zeeman G. , Temmink H. , Buisman C.
Published: September 2007

Characterisation of greywater was conducted in two different greywater streams in the Netherlands (Groningen and Sneek). The concentrations of macropollutants and nutrients measured were very different in both streams; in particular the COD was 425 mg/L in Groningen's water whereas in Sneek it was 1,583 mg/L.

The aerobic treatment of greywater in a fed-batch reactor led to a 90% removal of COD at different organic loading rates. Anaerobically, the removal reached 40% COD removal on average, the possible reason being the high amount of surfactants present in the influent.
EU demonstration project for separate discharge and treatment of urine, faeces and greywater – Part II: Cost comparison of different sanitation systems
Authors: Oldenburg M. , Peter-Fröhlich A. , Dlabacs C. , Pawlowski L. , Bonhomme A.
Published: September 2007

The experience from the EU demonstration project was used for a cost analysis of different sanitation systems with regard to nutrient recycling. The analysis was made for an existing residential area, for which the different sanitation systems have been applied. The cost calculations were made for a lifetime of 50 years. The multiple sewer systems cause higher investment costs, mainly for the installation of the additional facilities; the investment costs for the treatment are lower. The cost analysis did not prove lower costs for the new sanitation concepts in this special case in comparison with the conventional system. Economic benefits are demonstrated for the operation costs. The result will be reinforced by the consideration of an increase of the energy costs. The revenues for the nutrient related products have only a very small impact on the result.
Flow cytometry analysis of single‐strand DNA damage in neuroblastoma cell lines using the F7‐26 monoclonal antibody
Authors: Grigoryan Rita S. , Yang Bo , Keshelava Nino , Barnhart Jerry R. , Reynolds C. Patrick
Published: September 2007

The F7‐26 monoclonal antibody (Mab) has been reported to be specific for single‐strand DNA damage (ssDNA) and to also identify cells in apoptosis. We carriedout studies to determine if F7‐26 binding measured by flow cytometry was able to specifically identify exogenous ssDNA as opposed to DNA damage from apoptosis. Neuroblastoma cells were treated with melphalan (L‐PAM), fenretinide, 4‐hydroperoxycyclophosphamide (4‐HC) ± pan‐caspase inhibitor BOC‐d‐fmk, topotecan or with 10Gy γ radiation ± hydrogen peroxide (H2O2) and fixed immediately postradiation. Cytotoxicity was measured by DIMSCAN digital imaging fluorescence assay. The degree of ssDNA damage was analyzed by flow cytometry using Mab F7‐26, with DNA visualized by propidium iodide counterstaining. Flow cytometry was used to measure apoptosis detected by terminal deoxynucleotidyltransferase (TUNEL) assay and reactive oxygen species (ROS) by carboxy‐dichlorofluorescein diacetate. Irradiated and immediately fixed neuroblastoma cells showed increased ssDNA, but not apoptosis by TUNEL (TUNEL‐negative). 4‐HC or L‐PAM ± BOC‐d‐fmk increased ssDNA (F7‐26‐positive), but BOC‐d‐fmk prevented TUNEL staining. Fenretinide increased apoptosis by TUNEL but not ssDNA damage detected with F7‐26. Enhanced ssDNA in neuroblastoma cells treated with radiation + H2O2 was associated with increased ROS. Topotecan increased both ssDNA and cytotoxicity in 4‐HC‐treated cells. These data demonstrate that Mab F7‐26 recognized ssDNA due to exogenous DNA damage, rather than apoptosis. This assay should be useful to characterize the mechanism of action of antineoplastic drugs. © 2007 International Society for Analytical Cytology
Identification of candidate secreted factors involved in trigeminal placode induction
Authors: McCabe Kathryn L. , Shiau Celia E. , Bronner‐Fraser Marianne
Published: September 2007

Cranial ectodermal placodes are critical for normal development of the peripheral nervous system of the head. However, many aspects of the molecular and tissue interactions involved in their induction have yet to be elucidated. The trigeminal placode is induced by an unidentified secreted factor(s) from the dorsal neural tube. To determine candidates that may be involved in this induction process, we have performed reverse transcriptase‐polymerase chain reaction (RT‐PCR) and whole‐mount in situ hybridization to screen for receptors expressed by uninduced presumptive trigeminal level ectoderm. We have found that receptors for fibroblast growth factors, insulin‐like growth factors, platelet‐derived growth factors, Sonic hedgehog, the transforming growth factor‐beta superfamily, and Wnts all are expressed in patterns consistent with a role in trigeminal placode formation. This RT‐PCR screen for candidate receptors expressed in presumptive trigeminal ectoderm is the first systematic screen to identify potential interactions underlying induction of the trigeminal placode and represents a critical step for understanding this complex process. Developmental Dynamics 236:2925–2935, 2007. © 2007 Wiley‐Liss, Inc.
Metabolism of trans and conjugated fatty acids
Authors: Chardigny Jean‐Michel , Clouet Pierre , Combe Nicole , Quignard‐Boulangé Annie , Schmitt Bernard , Lagarde Michel , Léger Claude‐Louis
Published: September 2007

Trans fatty acids (FA) enter all the metabolic pathways of bioconversion, oxidation and lipid storage and are incorporated into all tissues. They also interfere with the polyunsaturated FA metabolic pathways. Among trans FA, major attention is paid to elaidic and vaccenic acids. The latter is bioconverted into rumenic acid, a conjugated linoleic acid (CLA) isomer, through the Δ9 desaturase pathway. Considering CLA isomers, they are also bioconverted by desaturases and the elongation pathway, but the significance of this conversion is not fully understood. This review considers these different aspects, with particular attention to human data.
Factors influencing the fatty acid determination in fats and oils using Fourier transform near‐infrared spectroscopy
Authors: Azizian Hormoz , Kramer John K. G. , Winsborough Suzanna
Published: September 2007

Fourier transform near‐infrared (FT‐NIR) technology is matrix dependent and thus highly dependent on factors that influence the absorption spectra. Ignoring these factors during the development of FT‐NIR models will affect the accuracy and reliability of the classification of fats and oils and the determination of their fatty acid (FA) composition. Four factors were studied: the temperature at which samples are scanned, differences in FA chain length and number of double bonds, and the presence of non‐triacylglycerol components. The results showed that an increase in the recording temperature decreased the absorption peak intensity, but not the position. FT‐NIR spectral differences were linked to variations in molecular vibrations resulting from the number of carbon atoms or double bonds in the FA. The FT‐NIR method could clearly differentiate between chain lengths from 10:0 to 18:0 and numbers of double bonds from zero (18:0) to three (18:3). Contaminants in triacylglycerols altered the FT‐NIR spectra, resulting in increased errors in the FA content. An increased concentration of β‐sitosterol in triolein decreased or increased the observed contents of cis9‐18:1 and cis11‐18:1, respectively. An FT‐NIR model adjusted for the phytosterol content corrected this discrepancy. The revised FT‐NIR model was successfully used to provide the accurate FA compositions of commercial sunflower oils.