bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychoeducation Program for Chinese Family Carers of Members With Schizophrenia
Authors: Cheng Lai-Yu , Chan Sally
Published: July 2005

The purpose of this study was to evaluate the effectiveness of a psychoeducation program for Chinese family carers of members with schizophrenia in Hong Kong. The participants consisted of 64 carers of clients with schizophrenia who were recruited from a local mental hospital and randomly assigned to the experimental and control arm (32 each). The experimental group received a psychoeducation program developed and implemented by mental health nurses based on Atkinson and Coia’s framework. The control group received routine care. The outcome measures were family burden, self-efficacy, and perception of social support. The findings showed that the experimental group had more improvement on their perception of burden of care (t = 5.25, p< .01), self-efficacy (t = -7.16, p< .01), and social support (t= -5.61, p < .01). This study supports psychoeducation as an effective nursing intervention for Chinese family carers.
Self-Care of Women Growing Older With HIV and/or AIDS
Authors: Plach Sandra K. , Stevens Patricia E. , Keigher Sharon
Published: July 2005

The purpose of this report is to describe the ways older women living with HIV perceive of and practice self-care. Data are taken from a culturally diverse subsample of 9 women age 50 years or older who participated in a larger longitudinal qualitative study of women who were HIV infected. During a period of 2 years, 10 semistructured narrative interviews were conducted with each of the 9 participants to gain an in-depth understanding of their experiences with symptom management, adherence to medical regimens, reduction of HIV risk, access to health care and social services, and personal efforts to maintain their health. Transcribed data were managed using Nvivo software and analyzed using multistaged narrative analysis. Findings suggest that mature women living with HIV integrate actions to maintain bodily comfort and improve physical well-being with actions that champion and conserve the existential self. Excerpts from their interviews illustrate this dialectical understanding of self-care.
Prospective Budgeting for Home Care
Authors: Greene Vernon L.
Published: July 2005

Objective: To provide a model for prospective budgeting for home care that is plausible, coherent, flexible, and sufficiently tractable that it can serve as a template for practical decision making and to clarify what would be the data requirements and statistical framework to calibrate the model.Methods: Methods used are standard risk-neutral expected value theory, cost benefit analysis, and the conditional logistic probability model.Results: A simple but effective prospective budgeting model that provides analytic scaffolding for a practical decision support system for home care case managers, consultants, and program evaluators that can improve program equity, efficiency, and effectiveness.Discussion: The author criticizes the well-known Titration Budgeting Model of Weissert, Chernew, and Hirth in terms of its logical and operational problems but then goes on to develop a framework within which the goals of the titration model can be met and home care resources can be more efficiently allocated.
Geriatric Interdisciplinary Team Training Program
Authors: Fulmer Terry , Hyer Kathryn , Flaherty Ellen , Mezey Mathy , Whitelaw Nancy , Jacobs M. Orry , Luchi Robert , Hansen Jennie Chin , Evans Denis A. , Cassel Christine , Kotthoff-Burrell Ernestine , Kane Robert , Pfeiffer Eric
Published: July 2005

Geriatric interdisciplinary team training has long been a goal in health education with little progress. In 1997, the John A. Hartford Foundation funded eight programs nationally to create Geriatric Interdisciplinary Team Training (GITT) programs. Faculty trained 1,341 health professions students. The results of the evaluation, including presentation of new measures developed to assess interdisciplinary knowledge, are presented, and the implications of the program as a model of interdisciplinary education are discussed. Evaluation data from 537 student trainees are presented. At posttest, GITT trainees demonstrated improvement on all measures of attitudinal change, no change on the geriatric care planning measure, and a change in some of the questions on the test of team dynamics that varied by discipline. Changes were greatest for all the attitudinal measures with the self-reported Team Skills Scale indicating the most significant change—a change that is significant across medicine, nursing, and social work trainees.
Death in Wartime
Authors: Zelizer Barbie
Published: July 2005

This article addresses the formulaic dependence of the news media on images of people facing impending death. Considering one example of this depiction—U.S. journalism’s photographic coverage of the killing of the Taliban by the Northern Alliance during the war on Afghanistan, the article traces its strategic appearance and recycling across the U.S. news media and shows how the beatings and deaths of the Taliban were depicted in ways that fell short of journalism’s proclaimed objective of fully documenting the events of the war. The article argues that in so doing, U.S. journalism failed to raise certain questions about the nature of the alliance between the United States and its allies on Afghanistan’s northern front.
Women and Crisis Reporting
Authors: Sutcliffe John B. , Lee Martha F. , Soderlund Walter C.
Published: July 2005

This article examines U.S. network television news coverage of seven political/military crises occurring in the Caribbean Basin. It first documents the extent to which women are involved in covering these crises. In line with existing research, women are found to be underrepresented in all major aspects of on-air media coverage. The article then explores the impact of this under representation on the actual content of media reporting. There is, at the very least, a possibility that those doing the reporting affect the content of the report, as well as who is chosen as a news source, either on-camera and/or quoted. The article examines this question using the technique of “paired comparisons”;specifically, it compares news stories dealing with four of the crises filed from the same location, on the same day, by male and female reporters representing at least two networks. The major finding of this research is that while there are subtle differences in the way in which male and female reporters frame stories, there is a broad consistency in male and female reporting. It is the case, however, that female anchors and reporters are slightly more likely to use female sources in their stories.
The Rest of the Story
Authors: Winett Liana Blas , Lawrence Regina G.
Published: July 2005

The 2001 anthrax attacks brought public health into the media spotlight in away unmatched since the AIDS epidemic of the 1980s. This moment presented Americans with opportunities to better understand the strengths and weaknesses of the nation’s public health infrastructure, as well as to better understand the political and policy backgrounds against which this infrastructure operates. The authors systematically examined how thoroughly this underlying political context was covered by two major U.S. news papers: the New York Times, widely considered the nation’s paper of record; and the Atlanta Journal-Constitution, the home newspaper of the Centers for Disease Control and Prevention (CDC).In particular, the authors explored whether and how these news sources drew connections between political decision making and functioning of the CDC. They conducted quantitative and qualitative analysis of 157 news articles, supplemented by interviews with four reporters and one editor close to the story. Political context was included inconsistently and in sometimes strikingly different ways by the two newspapers, and lines of accountability extending beyond the CDC itself were not clearly traced. The authors theorize that these patterns in coverage of political context reflect the nature of reporting on public health issues; the different relationships of the two papers to the CDC; and the unwillingness of key public health sources to articulate certain claims in the heat of the crisis.
A Comparison of Educational Methods to Improve NSAID Knowledge and Use of a Medication List in an Elderly Population
Authors: Gates Brian J. , Setter Stephen M. , Corbett Cynthia F. , Baker Danial E.
Published: July 2005

The objective of this study is to compare the effectiveness of pharmacist-provided individualized education with standardized video education for(a) improving patient understanding of gastropathy caused by nonsteroidal anti-inflammatory drugs (NSAIDs) and (b) stimulating the use of a medication list. Home care patients were assessed and then randomized to receive either video education or a tailored intervention from a home care pharmacist. Patients in the tailored group were more likely to keep an updated list (p = .033) and utilize it before purchasing over-the-counter medications (p = .043). Tailored education may be more effective than standardized video education for changing behaviors related to NSAID-induced gastropathy.
Choosing Home Health as a Specialty and Successfully Transitioning Into Home Health Nursing Practice
Authors: Hartung Sheila Q.
Published: July 2005

This article describes components of a qualitative research study that investigated the process of how acute care nurses successfully transition into home health nursing practice. The sequences of activities in choosing home health as a specialty to practice and the phases of successful transition from acute care practice to home health practice are described. The sequence of activities and phases of successful transition were developed and grounded in the practice of 14 home health nurses. Implications for home health nursing practice, administration, and education are discussed.
Death, Grief, and the Home Health Worker: A Systems Approach
Authors: Weeber Stan C.
Published: July 2005

As the burden of long-term care shifts from nursing homes to home-based care, home health workers are increasingly likely to serve an older clientele susceptible to chronic disease and death. A significant occupational stressor in such cases is a lack of knowledge about what constitutes professionally appropriate interaction with dying patients and their families. Utilizing social systems theory and findings from the sociology of death and dying, this article provides information helpful to workers dealing with such cases. There is discussion of the stages of grief for the dying patient and for survivors, the difference between normal and abnormal grief, how to lessen the symptoms of grief, the art of condolence, and the special topic of children and grief. The article concludes with six recommended strategies for workers to cope with the problems of death, dying, and grief within the real-life social system in which they work and live.
Doing Organization Development in Complex Systems: The Case at a Large U.S. Research, Land-Grant University
Authors: McLean Gary N.
Published: July 2005

The problem and the solution.Doing organization development in a university is similar to doing such work in any complex organization or system. It becomes even more difficult when the expertise to conduct such work resides within the university. This article presents examples of such work that failed at a large, Midwestern, research, land-grant university. A review of the available history of organization development efforts at the university follows the detailed cases with analysis based on the Organization Development Process Model, with reference to the E and O theories of change. Recommendations that, if followed, might have resulted in different outcomes are then presented.
The Evolution of Organization Development at Cornell University: Strategies for Improving Performance and Building Capacity
Authors: Warzynski Chester C.
Published: July 2005

The problem and the solution. Beer and Nohria propose that there is an inherent tension between organizational strategies designed to improve economic performance (Theory E) and organizational strategies designed to build organizational capacity (Theory O). They argue that the most effective approach to change integrates the two theories along six dimensions: goals, leadership, focus, process, rewards, and use of consultants. This article assesses the efficacy of the Beer and Nohria hypothesis in explaining organizational change by examining four senior leadership initiatives at Cornell University during the past decade and the organizational development strategies that emerged to support them. The article concludes with some lessons learned and the observation that an evolutionary approach to organizational development may provide a useful model for other universities.
The Impact of Unexpected Leadership Changes and Budget Crisis on Change Initiatives at a Land-Grant University
Authors: Latta Gail F. , Myers Nancy F.
Published: July 2005

The problem and the solution. One of the greatest challenges to successful organization development is managing the impact of unexpected events on planned institutional change initiatives. Too often, in the face of crises, organizational development efforts are put on autopilot and attention is shifted away from identified objectives to the immediate problem at hand. This article examines three organizational change initiatives undertaken at a Midwestern land-grant university during the period 2000 to 2004. Along with planned change, the authors examine the impact of unexpected budget cuts and leadership turnover, which threatened to derail the change initiatives. From this case study, they elucidate some of the unique challenges for implementing change strategies in institutions of higher education and the particular challenges posed by the emergence of unanticipated circumstances.
The Center for Organizational Development and Leadership at Rutgers University: A Case Study
Authors: Ruben Brent D.
Published: July 2005

The problem and the solution. Although colleges and universities are highly regarded for academics, they are also broadly criticized for inefficiency, indifference to external constituencies, and resistance to change. Helping institutions address the underlying causes of these problems while maintaining the commitment to academic excellence is the fundamental challenge facing organizational development programs in higher education. This article provides a brief case study of one such effort: the Rutgers University Program for Organizational Development and Leadership.
The Effectiveness of an Interactive Small Group Diabetes Intervention in Improving Knowledge, Feeling of Control, and Behavior
Authors: Garrett Nancy , Hageman Christine M. , Sibley Shalamar D. , Davern Michael , Berger Mary , Brunzell Carol , Malecha Karen , Richards Steven W.
Published: July 2005

The objective of this study is to evaluate the effectiveness of a small group intervention in improving knowledge, feeling of control, and behaviors related to self-management of diabetes. The intervention includes educational content on diabetes self-management as well as discussion of attitudes, feelings, and motivations about living with diabetes. The authors randomized volunteers into an intervention group that participated in the small-group learning activity and a control group that received a diabetes self-care book. A survey was conducted by telephone before and after each intervention and the difference in change over time between the groups was assessed for each outcome. Compared to the control group, participants in the small-group activity reported significant changes on all three outcomes adjusting for demographic differences between the groups. Because facilitating the learning session does not require clinically trained personnel, this type of intervention could broaden the resources available to people with diabetes.
Assessing HIV Prevention Provider Knowledge of Behavior Science Theory: Building on Existing Intuitive Experience
Authors: Gandelman Alice A. , Vogan Stacy A. , Dolcini M. Margaret
Published: July 2005

Behavioral science theory is recommended as a basis for prevention programs, yet many STD/HIV prevention providers have little academic background in this area and see no relevance of theory to their work. This study assessed STD/HIV prevention providers’ intuitive insight about behaviors. Comparisons of behavioral determinants from providers “common sense” theories with determinants identified in formal theories are made through the use of Theoretical Domains, a teaching tool designed to enhance the understanding and use of behavioral science in planning and implementing interventions. Understanding how to effectively apply behavior change concepts, combined with prevention providers’ basic, intuitive knowledge can enhance understanding, communication, and skills exchange between providers and researchers. Building capacity in local communities begins with a participatory process of community members, prevention providers, and researchers working together as equal partners. Better translation of research into practice using theory-based interventions will benefit the field of STD/HIV prevention.
Fostering Youth Leadership to Address Workplace and Community Environmental Health Issues: A University-School-Community Partnership
Authors: Delp Linda , Brown Marianne , Domenzain Alejandra
Published: July 2005

Many communities of color are disproportionately exposed to workplace and community environmental hazards. This article presents the results of a pilot project designed by a university-school-community partnership to develop youth leadership to confront these exposures. Using a popular empowerment education approach, students applied peer education, research, and organizing skills learned in the classroom to community-based internships in a service-learning model. Evaluation results from pretests and posttests, focus groups, and in-depth interviews demonstrated that students shared what they learned about young workers’ rights and environmental justice with family and friends. They developed a critical analysis of environmental inequities, created a citywide youth coalition that advocates around legal, educational, and environmental issues affecting youth, and implemented campaigns to enforce child labor laws and to prevent school construction on contaminated land. This multifaceted model can serve as an important foundation to develop youth leaders to influence environmental policies in a variety of communities.
Conditioning with 8-Gy total body irradiation and fludarabine for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia
Authors: Stelljes Matthias , Bornhauser Martin , Kroger Matthias , Beyer Joerg , Sauerland Maria C. , Heinecke Achim , Berning Bjorna , Scheffold Christian , Silling Gerda , Buchner Thomas , Neubauer Andreas , Fauser Axel A. , Ehninger Gerhard , Berdel Wolfgang E. , Kienast Joachim ,   for the Cooperative German Transplant Study Group
Published: July 2005

Seventy-one patients with acute myeloid leukemia (AML), most of them (63/71) considered ineligible for conventional allogeneic hematopoietic stem cell transplantation (HSCT), were enrolled into a phase 2 study on reduced-intensity myeloablative conditioning with fractionated 8-Gy total body irradiation (TBI) and fludarabine (120 mg/m2). Patients received mobilized peripheral blood stem cells (n = 68) or bone marrow (n = 3) from siblings (n = 39) or unrelated donors (n = 32). Thirty-six patients received a transplant in complete remission (CR) and 35 had untreated or refractory disease (non-CR). Median patient age was 51 years (range, 20-66 years). Sustained engraftment was attained in all evaluable patients. With a median follow-up of 25.9 months (range, 3.7-61.2 months) in surviving patients, probabilities of overall survival for patients who received a transplant in CR and non-CR were 81% and 21% at 2 years, respectively. Relapse-free survival rates were 78% and 16%. The cumulative incidence of nonrelapse mortality (NRM) in CR patients was 8% at 2 years and beyond but amounted to 37% at 2 years in non-CR patients. Outcome data in this poor-risk population indicate that allogeneic HSCT from related or unrelated donors with 8-Gy TBI/fludarabine conditioning is feasible with low NRM and preserved antileukemic activity in AML patients in first or later CR.
CD4+CD25+ regulatory T-cell lines from human cord blood have functional and molecular properties of T-cell anergy
Authors: Li Lequn , Godfrey Wayne R. , Porter Stephen B. , Ge Ying , June Carle H. , Blazar Bruce R. , Boussiotis Vassiliki A.
Published: July 2005

CD4+CD25+ regulatory T cells (Tregs) are essential negative regulators of immune responses. Here, we examined the signaling properties of human Tregs, using CD4+CD25+ Treg and CD4+CD25– control (Tcont) cell lines generated from cord blood. Treg cell lines were markedly hyporesponsive to stimulation with dendritic cells and with anti-CD3/CD28–coated beads. Hyporesponsiveness was reversed by exogenous interleukin-2 (IL-2). T-cell receptor (TCR)–CD3/CD28–mediated activation of Rap1 and Akt was retained in Tregs, but activation of Ras, mitogenactivated protein kinase 1/2 (MEK1/2), and extracellular signal-regulated kinase 1/2 (Erk1/2) was impaired. Tregs were blocked from cell cycle progression due to decrease of cyclin E and cyclin A and increase of p27kip1 (p27kip cyclin dependent kinase inhibitor). IL-2 induced sustained increase of cyclin E and cyclin A and prevented up-regulation of p27kip1. Tregs had high susceptibility to apoptosis that was reversed by IL-2, which correlated with activation of Erk1/2, up-regulation of Bcl-xL (B-cell CLL/lymphoma 2-like nuclear gene encoding mitochondrial protein, transcript variant 2), and phosphorylation of Bad (Bcl2 antagonist of cell death) at Ser112. Thus, Tregs share biochemical characteristics of anergy, including abortive activation of Ras-MEK-Erk, increased activation of Rap1, and increased expression of p27kip1. In addition, our results indicate that TCR–CD3/CD28–mediated and IL-2 receptor–mediated signals converge at the level of MEK-Erk kinases to regulate Treg survival and expansion and suggest that manipulation of the MEK-Erk axis may represent a novel strategy for Treg expansion for immunotherapy.
Exhaled volatile organic compounds in patients with non-small cell lung cancer: cross sectional and nested short-term follow-up study
Authors: Poli Diana , Carbognani Paolo , Corradi Massimo , Goldoni Matteo , Acampa Olga , Balbi Bruno , Bianchi Luca , Rusca Michele , Mutti Antonio
Published: July 2005

Background

Non-invasive diagnostic strategies aimed at identifying biomarkers of lung cancer are of great interest for early cancer detection. The aim of this study was to set up a new method for identifying and quantifying volatile organic compounds (VOCs) in exhaled air of patients with non-small cells lung cancer (NSCLC), by comparing the levels with those obtained from healthy smokers and non-smokers, and patients with chronic obstructive pulmonary disease. The VOC collection and analyses were repeated three weeks after the NSCLC patients underwent lung surgery.

Methods

The subjects' breath was collected in a Teflon® bulb that traps the last portion of single slow vital capacity. The 13 VOCs selected for this study were concentrated using a solid phase microextraction technique and subsequently analysed by means of gas cromatography/mass spectrometry.

Results

The levels of the selected VOCs ranged from 10-12 M for styrene to 10-9 M for isoprene. None of VOCs alone discriminated the study groups, and so it was not possible to identify one single chemical compound as a specific lung cancer biomarker. However, multinomial logistic regression analysis showed that VOC profile can correctly classify about 80 % of cases. Only isoprene and decane levels significantly decreased after surgery.

Conclusion

As the combination of the 13 VOCs allowed the correct classification of the cases into groups, together with conventional diagnostic approaches, VOC analysis could be used as a complementary test for the early diagnosis of lung cancer. Its possible use in the follow-up of operated patients cannot be recommended on the basis of the results of our short-term nested study.
Diverse spatial, temporal, and sexual expression of recently duplicated androgen-binding protein genes in Mus musculus
Authors: Laukaitis Christina M , Dlouhy Stephen R , Emes Richard D , Ponting Chris P , Karn Robert C
Published: July 2005

Background

The genes for salivary androgen-binding protein (ABP) subunits have been evolving rapidly in ancestors of the house mouse Mus musculus, as evidenced both by recent and extensive gene duplication and by high ratios of nonsynonymous to synonymous nucleotide substitution rates. This makes ABP an appropriate model system with which to investigate how recent adaptive evolution of paralogous genes results in functional innovation (neofunctionalization).

Results

It was our goal to find evidence for the expression of as many of the Abp paralogues in the mouse genome as possible. We observed expression of six Abpa paralogues and five Abpbg paralogues in ten glands and other organs located predominantly in the head and neck (olfactory lobe of the brain, three salivary glands, lacrimal gland, Harderian gland, vomeronasal organ, and major olfactory epithelium). These Abp paralogues differed dramatically in their specific expression in these different glands and in their sexual dimorphism of expression. We also studied the appearance of expression in both late-stage embryos and postnatal animals prior to puberty and found significantly different timing of the onset of expression among the various paralogues.

Conclusion

The multiple changes in the spatial expression profile of these genes resulting in various combinations of expression in glands and other organs in the head and face of the mouse strongly suggest that neofunctionalization of these genes, driven by adaptive evolution, has occurred following duplication. The extensive diversification in expression of this family of proteins provides two lines of evidence for a pheromonal role for ABP: 1) different patterns of Abpa/Abpbg expression in different glands; and 2) sexual dimorphism in the expression of the paralogues in a subset of those glands. These expression patterns differ dramatically among various glands that are located almost exclusively in the head and neck, where the sensory organs are located. Since mice are nocturnal, it is expected that they will make extensive use of olfactory as opposed to visual cues. The glands expressing Abp paralogues produce secretions (lacrimal and salivary) or detect odors (MOE and VNO) and thus it appears highly likely that ABP proteins play a role in olfactory communication.
Variation in transcriptional regulation of cyclin dependent kinase inhibitor p21waf1/cip1 among human bronchogenic carcinomas
Authors: Harr Michael W , Graves Timothy G , Crawford Erin L , Warner Kristy A , Reed Cheryl AM , Willey James C
Published: July 2005

Background

Cell proliferation control depends in part on the carefully ordered regulation of transcription factors. The p53 homolog p73, contributes to this control by directly upregulating the cyclin dependent kinase inhibitor, p21waf1/cip1. E2F1, an inducer of cell proliferation, directly upregulates p73 and in some systems upregulates p21 directly. Because of its central role in controlling cell proliferation, upregulation of p21 has been explored as a modality for treating bronchogenic carcinoma (BC). Improved understanding of p21 transcriptional regulation will facilitate identification of BC tissues that are responsive to p21-directed therapies. Toward this goal, we investigated the role that E2F1 and p73 each play in the transcriptional regulation of p21.

Results

Among BC samples (N = 21) p21 transcript abundance (TA) levels varied over two orders of magnitude with values ranging from 400 to 120,000 (in units of molecules/106 molecules β-actin). The p21 values in many BC were high compared to those observed in normal bronchial epithelial cells (BEC) (N = 18). Among all BC samples, there was no correlation between E2F1 and p21 TA but there was positive correlation between E2F1 and p73α (p < 0.001) TA. Among BC cell lines with inactivated p53 and wild type p73 (N = 7) there was positive correlation between p73α and p21 TA (p < 0.05). Additionally, in a BC cell line in which both p53 and p73 were inactivated (H1155), E2F1 TA level was high (50,000), but p21 TA level was low (470). Transiently expressed exogenous p73α in the BC cell line Calu-1, was associated with a significant (p < 0.05) 90% increase in p21 TA and a 20% reduction in E2F1 TA. siRNA mediated reduction of p73 TA in the N417 BC cell line was associated with a significant reduction in p21 TA level (p < 0.01).

Conclusion

p21 TA levels vary considerably among BC patients which may be attributable to 1) genetic alterations in Rb and p53 and 2) variation in TA levels of upstream transcription factors E2F1 and p73. Here we provide evidence that p73 upregulates p21 TA in BC tissues and upregulated p21 TA may result from E2F1 upregulation of p73 but not from E2F1 directly.
To quell obesity, who should regulate food marketing to children?
Authors: Kelly Ben
Published: July 2005

The global hegemony of the United States in the production and marketing of food, while a marvel of economic success, has contributed to the epidemic of obesity that is particularly afflicting children. So far the U.S. government has declined to regulate the aggressive ways in which food producers market high-energy, low-nutrition foods to young people. That public-health responsibility has been left to an industry-created scheme of self-regulation that is deeply flawed; there is a compelling need for government involvement. The issue is certain to be raised by health advocates at a U.S. Federal Trade Commission meeting in mid-July to discuss the self-regulatory approach, but the outlook for remedies to emerge from the meeting is not encouraging.
Safety lessons from aviation
Authors: Higton Phil
Published: July 2005

Thirty years ago the world of Commercial Aviation provided a challenging environment. In my early flying days, aircraft accidents were not unusual, flying was seen as a risky business and those who took part, either as a provider or passenger, appeared grudgingly willing to accept the hazards involved. A reduction in the level of risk was sought in technological advances, greater knowledge of physics and science, and access to higher levels of skill through simulation, practice and experience. While these measures did have an impact, the expected safety dividend was not realized. The most experienced, technically competent individuals with the best equipment featured far too regularly in the accident statistics. We had to look at the human element, the impact of flaws or characteristics of the human condition. We call this area Human Factors. My paper describes the concept of Human Factors, its establishment as a key safety tool in aviation and the impact of this on my working life.
Manufacturers’ approaches in the development of intelligent multilevel safety systems to assist perfusionists during cardiopulmonary bypass
Authors: Kriewall Timothy J
Published: July 2005

How safe is safe? The design intent of perfusion safety systems is to offer maximum flexibility, low-cost and fail-safe features. While easily said, these requirements are difficult to deliver in a perfusion world where standardization is uncommon. This paper reviews the challenges all manufacturers face as they strive to offer the ultimate in safety, keeping the price affordable for the technology deployed and the usability common sense for the perfusionist using the equipment. As microprocessors are able to assist designers in providing intelligent, multilevel safety systems, care must be taken during the design process to balance technological ability with intuitive use. In the final analysis, however, it is the perfusionist who is the primary safety system, and the technology is his or her backup.
Quality of life change and response shift in patients admitted to palliative care units: a pilot study
Authors: Echteld Michael A , Deliens Luc , Ooms Marcel E , Ribbe Miel W , van der Wal Gerrit
Published: July 2005

This pilot study was carried out to determine to what extent patients admitted to palliative care units (PCUs) in The Netherlands maintained good levels of individual quality of life (QoL), and to what extent response shift - a measure of adaptation - influenced QoL at the end of life. Two components of response shift were measured: reconceptualization (exchanging important areas of life) and value change (changing the perceived importance of important areas of life). Twenty patients admitted to PCUs were interviewed at one week, three weeks, and five weeks after admission. Results show that individual QoL was high and remained stable over the three measurement points. The individual QoL of patients who did not reconceptualize or did not change values was higher than the individual QoL of patients who did. The current pilot data need to be corroborated with data from additional respondents.
The development of a questionnaire to assess the attitudes of older people to end-of-life issues (AEOLI)
Authors: Catt Susan , Blanchard Martin , Addington-Hall Julia , Zis Maria , Blizard Bob , King Michael
Published: July 2005

Objectives: To develop an end-of-life attitudes questionnaire for use in a large communitybased sample of older people. Design: Nominal groups and standardization of questions. Participants: Eighteen older people, ten academics and five specialist palliative care health professionals were involved in nominal groups. Thirty older people took part in initial pilot work and a further 50 were involved in reliability testing. Results: A 27-item attitudes of older people to end-of-life issues (AEOLI) questionnaire. Discussion: In modern times, death and dying predominantly occurs among older people and yet we know very little about older people’s attitudes to end-of-life care. The AEOLI questionnaire can be used in large scale surveys to elicit attitudes on end-of life issues considered important by older people and health care professionals.
Existential issues do not necessarily result in existential suffering: lessons from cancer patients in Israel
Authors: Blinderman Craig D , Cherny Nathan I
Published: July 2005

Existential distress has been recognized as a source of suffering for oncology patients. This study focusses on existential issues and coping mechanisms of a unique culturally diverse Jewish/Middle Eastern oncology population. A qualitative assessment of 40 patients with advanced cancer was undertaken through an interview process addressing the following themes: autonomy, dignity/body image, social isolation, coping mechanisms, guilt/past disappointments, spiritual health, meaning, hope and death/dying. The findings of this study indicate that existential concerns are endemic in this patient population, but that significant distress is relatively uncommon. Early palliative measures, family support, effective coping strategies, and religious belief systems may influence the way patients with advanced cancer deal with existential concerns.
Menopausal Hot Flashes and Development of Cognitive Impairment
Authors: RATKA ANNA
Published: July 2005

Abstract: Hot flashes have a negative influence on the quality of life in hypogonadal women. There seem to be many regulators of hot flashes that add to the complexity of these profound vasomotor symptoms. In this papaper, focus is placed on selected factors that may be involved in the relationship between hot flashes and cognitive status. During the hypogonadal state, the brain becomes relatively deprived of glucose. Hot flashes were found to be associated with transient inadequacies in brain levels of glucose. Neuroglucopenia was shown to initiate a cascade of immediate and delayed reactions leading to neuronal damage. Estrogen is known to diminish neuroglucopenia. In a pilot study on postmenopausal women, it was observed that cognitive performance of women who reported having hot flashes during their menopausal years was better than in women who did not experience hot flashes. It is hypothesized that a hot flash triggers a counterregulatory mechanism of the central nervous system to the insufficiency of glucose delivery to the brain and may have a beneficial effect on cognitive health in postmenopausal women. Possible therapeutic implications of this hypothesis are discussed in the light of current knowledge.
Development of 17α‐Estradiol as a Neuroprotective Therapeutic Agent: Rationale and Results from a Phase I Clinical Study
Authors: DYKENS JAMES A. , MOOS WALTER H. , HOWELL NEIL
Published: July 2005

Abstract: 17α‐estradiol (17α‐E2) differs from its isomer, the potent feminizing hormone 17β‐estradiol (17β‐E2), only in the stereochemistry at one carbon, but this is sufficient to render it at least 200‐fold less active as a transactivating hormone. Despite its meager hormonal activity, 17α‐E2 is as potent as 17β‐E2 in protecting a wide variety of cell types, including primary neurons, from a diverse array of lethal and etiologically relevant stressors, including amyloid toxicity, serum withdrawal, oxidative stress, excitotoxicity, and mitochondrial inhibition, among others. Moreover, both estradiol isomers have shown efficacy in animal models of stroke, Alzheimer's disease (AD), and Parkinson's disease (PD). Data from many labs have yielded a mechanistic model in which 17α‐E2 intercalates into cell membranes, where it terminates lipid peroxidation chain reactions, thereby preserving membrane integrity, and where it in turn is redox cycled by glutathione or by NADPH through enzymatic coupling. Maintaining membrane integrity is critical to mitochondrial function, where loss of impermeability of the inner membrane initiates both necrotic and apoptotic pathways. Thus, by serving as a mitoprotectant, 17α‐E2 forestalls cell death and could correspondingly provide therapeutic benefit in a host of degenerative diseases, including AD, PD, Friedreich's ataxia, and amyotrophic lateral sclerosis, while at the same time circumventing the common adverse effects elicited by more hormonally active analogues. Positive safety and pharmacokinetic data from a successful phase I clinical study with oral 17α‐E2 (sodium sulfate conjugate) are presented here, and several options for its future clinical assessment are discussed.
A Systematic Review of Clinical Trials of Hormone Therapy on Cognitive Function: Effects of Age at Initiation and Progestin Use
Authors: MAKI PAULINE M.
Published: July 2005

Abstract: The putative protective effects of hormone therapy (HT) have been cast in doubt by recent findings from the Women's Health Initiative Memory Study showing an increase in dementia and an increased likelihood of impaired cognitive status in women initiating HT after age 65. To explore the external generalizability of those findings to younger postmenopausal women, the medical literature was surveyed for randomized, double‐blind, placebo‐controlled trials of treatment with either estrogen alone or estrogen plus a progestin on neuropsychological test performance. Findings from trials in younger women (<65 years) are presented separately from those in older women (≥65 years). This review finds little support for beneficial cognitive effects in older women of estrogen alone or in combination with progestin. However, evidence from younger women suggests potential beneficial effects in select cognitive domains, particularly among symptomatic women and recently menopausal women, and scant evidence of harm. There is a dearth of studies of the cognitive effects of estrogen plus progestin in younger women. Future studies systematically exploring the effect of age and progestin use are needed to better characterize the effects of HT on cognition in younger women. Without firm evidence of benefit to younger women, it is prudent to caution early postmenopausal women about the cognitive risks observed in WHI, recognizing the low likelihood of dementia at that age.
Estradiol Prevents Neural Tau Hyperphosphorylation Characteristic of Alzheimer's Disease
Authors: ALVAREZ‐DE‐LA‐ROSA MARGARITA , SILVA IVALDO , NILSEN JON , PÉREZ M. M. , GARCÍA‐SEGURA LUIS MIGUEL , ÁVILA JESÚS , NAFTOLIN FREDERICK
Published: July 2005

Abstract: Alzheimer's disease (AD) is three times more prevalent in women than men, and epidemiological studies have shown that estrogen replacement in aging women forestalls the onset of AD. Hyperphosphorylation of the tau protein that forms the neurofibrillary tangles found in AD brains might be responsible for the breakdown of microtubules in affected neurons. The mechanisms by which tau protein is phosphorylated in the AD brain are not fully understood. Using a human neuroblastoma cell line (SH‐SY5Y) and primary cultures of newborn male or female rat cerebral cortical neurons, we investigated the effect of 17β‐estradiol on tau protein expression and phosphorylation. We found that estradiol increased total tau and induced dephosphorylation at the proline‐directed site of themolecule. Further, estradiol prevented okadaic acid‐induced hyperphosphorylation of tau in both proline‐ and non‐proline‐directed sites, and antiestrogens blocked this effect. To our knowledge, this is the first report of an effect of estradiol on naturally occurring and induced tau phosphorylation. This assumes special significance because the estrogen action was found to be sexually dimorphic in rat cortical neurons and differentiation‐sensitive in human neuroblastoma cells.
Neurosteroids and Female Reproduction: Estrogen Increases 3β-HSD mRNA and Activity in Rat Hypothalamus
Authors: Soma K. K. , Sinchak K. , Lakhter A. , Schlinger B. A. , Micevych P. E.
Published: July 2005

A central event in mammalian reproduction is the LH surge that induces ovulation and corpus luteum formation. Typically, the LH surge is initiated in ovariectomized rats by sequential treatment with estrogen and progesterone (PROG). The traditional explanation for this paradigm is that estrogen induces PROG receptors (PR) that are activated by exogenous PROG. Recent evidence suggests that whereas exogenous estrogen is necessary, exogenous PROG is not. In ovariectomized-adrenalectomized rats, estrogen treatment increases hypothalamic PROG levels before an LH surge. This estrogen-induced LH surge was blocked by an inhibitor of 3β-hydroxysteroid dehydrogenase/Δ5-Δ4 isomerase (3β-HSD), the proximal enzyme for PROG synthesis. These data indicate that estrogen induces de novo synthesis of PROG from cholesterol in the hypothalamus, which initiates the LH surge. The mechanism(s) by which estrogen up-regulates neuro-PROG is unknown. We investigated whether estrogen increases 1) mRNA levels for several proteins involved in PROG synthesis and/or 2) activity of 3β-HSD in the hypothalamus. In ovariectomized-adrenalectomized rats, estrogen treatment increased 3β-HSD mRNA in the hypothalamus, as measured by relative quantitative RT-PCR. The mRNAs for other proteins involved in steroid synthesis (sterol carrier protein 2, steroidogenic acute regulatory protein, and P450 side chain cleavage) were detectable in hypothalamus but not affected by estrogen. In a biochemical assay, estrogen treatment also increased 3β-HSD activity. These data support the hypothesis that PROG is a neurosteroid, produced locally in the hypothalamus from cholesterol, which functions in the estrogen positive-feedback mechanism driving the LH surge.
Use of mixed dyes in photogalvanic cells for solar energy conversion and storage: EDTA-methylene blue and thionine system
Authors: Gangotri K. M. , Lal C
Published: July 2005

The photogalvanic effect was studied in a photogalvanic cell containing Ethylene-diaminetetra-acetic acid as reductant and methylene blue and thionine as photosensitizers. The photopotential and photocurrent generated were 752.0 mV and 90.0 μA, respectively. The observed conversion efficiency was 0.43 per cent and the maximum output of cell was 67.68 μW. The photogalvanic cell can be used for 30 min in the dark. The effects of different parameters on electrical output of the cell were observed, and a mechanism for the generation of photocurrent in photogalvanic cells has also been proposed.
Numerical study of bluff-body non-premixed flame structures using laminar flamelet model
Authors: Hossain M , Malalasekera W
Published: July 2005

A laminar flamelet model is applied for bluff-body stabilized flames to study the flow field, mixing pattern, and the flame structure at two different velocities. The k - ɛ turbulence model is applied for accounting the turbulence fluctuations. It is found that the recirculation zone dominates the near field, while the far field structure is similar to the jet flow. The intermediate neck zone is the intense mixing region. The computation shows that the fuel jet velocity has significant effect on the structure of the flow field, which in turn has significant effect on the combustion characteristics. The laminar flamelet model is found to be adequate for simulating the temperature and the flame composition inside the recirculation zone. The flamelet model has, however, failed to account for the local extinction in the neck zone. Possible limitation of the laminar flamelet model to predict the local extinction is discussed.
Correlations for the discharge coefficient of rotating orifices based on the incidence angle
Authors: Idris A , Pullen K. R.
Published: July 2005

The flow through rotating orifices is of interest to the designer of machines incorporating such features. The designer often requires a set of correlations which can be used to check out preliminary designs and converge on a solution prior to attempting detailed and expansive analysis. The correlations given in this paper are based on the incidence angle, i, of the flow into the orifice and they allow the discharge coefficient for rotating orifices to be estimated for as many conditions and geometries as possible. The approach adopted is to group the parameters that affect the discharge coefficient to i = 0° (Reynolds number, orifice chamfer and radius, L/d ratio, pressure ratio, and pumping effect) and i ≠ 0° (rotation of the disc, preswirl, cross-flow, and the angle of inclination of the orifice). The effect of each parameter on the discharge coefficient can easily be observed when using this method. Furthermore, the method can predict the discharge coefficient for systems that have various parameters that are combined together. There is a good agreement between the correlations and the experimental results and the available data on rotating orifices in the open literature. The correlations also agree with various combinations run in computational fluid dynamics (CFD). The approach adopted in this paper, which is based on the incidence angle, can assist designers to find the combination of geometric and flow parameters that gives the best discharge coefficient for rotating orifices.
A Web-based mobile asthma management system
Authors: Lee Hye-Ran , Yoo Sun K , Jung Seok-Myung , Kwon Na-Young , Hong Chein-Soo
Published: July 2005

Continuous recording of daily symptoms constitutes an effective means of managing asthma patients. Daily management reduces the costs associated with hospitalization and improves the quality of patient care. We have implemented a Web-based mobile asthma management system. We used a pocket PC, mobile phone and desktop computer. The recorded items and individualized prescriptions were structured using Extensible Markup Language (XML) DTD (Data Type Definition). The mobile Web form was automatically adjusted to fit the different display resolutions of the terminal devices. The system provided reliable exchange of all relevant information between a doctor and the asthma patient using wireless mobile transmission. Email and Short Messaging Service (SMS) were used to send messages to patients, for example in the case of an automatically determined patient alert. Patients could obtain customized instructions according to their daily personal symptoms, peak expiratory flow (PEF), medications and activity restriction. The daily graph of PEF and the graphs of symptoms and medication were particularly useful for asthma patient control and self-awareness of the progress of the disease.