bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Participation Incentives on the Composition of National Health Surveys
Authors: Moyer Anne , Brown Margaret
Published: September 2008

Our understanding of health attitudes and behaviors often relies on national surveys. This study examined how the composition of the Health Information National Trends Survey was influenced by participation incentives. Younger respondents who had had cancer were the least likely to report that a lack of incentive would dissuade them from participating. The group receiving no incentive had the smallest proportion of individuals with cancer. However, there was no relationship between incentive group and family history of cancer, age, or income. Overall, incentives appear to be a sensible way to motivate survey participation.
How Do You Feel?
Authors: Juth Vanessa , Smyth Joshua M. , Santuzzi Alecia M.
Published: September 2008

Self-esteem has been demonstrated to predict health and well-being in a number of samples and domains using retrospective reports, but little is known about the effect of self-esteem in daily life. A community sample with asthma ( n = 97) or rheumatoid arthritis ( n = 31) completed a self-esteem measure and collected Ecological Momentary Assessment (EMA) data 5x/day for one week using a palmtop computer. Low self-esteem predicted more negative affect, less positive affect, greater stress severity, and greater symptom severity in daily life. Naturalistic exploration of mechanisms relating self-esteem to physiological and/or psychological components in illness may clarify causal relationships and inform theoretical models of self-care, well-being, and disease management.
Patient Empowerment in Clinical Genetics Services
Authors: McAllister Marion , Payne Katherine , MacLeod Rhona , Nicholls Stuart , Dian Donnai  , Davies Linda
Published: September 2008

Outcome measurement in clinical genetics is problematic because the patient benefits are difficult to measure. The aim in this qualitative grounded theory study was to develop a theoretical framework describing the patient benefits from using clinical genetics services. Seven focus groups and 19 interviews were conducted with patients, patient group representatives, and health professionals. Data analysis resulted in construction of a model of empowerment summarizing the patient benefits from using clinical genetics services. Empowerment is similar to the concept of perceived personal control (PPC), and a measure of PPC has been developed for use in evaluations of clinical genetics services. However, empowerment includes some benefits not captured by PPC related to empowerment of other at risk relatives, and future generations.
Adolescents Who Intend to Change Multiple Health Behaviours Choose Greater Exposure to an Internet-delivered Intervention
Authors: Crutzen Rik , de Nooijer Jascha , Candel Math J.J.M. , de Vries Nanne K.
Published: September 2008

Despite a growth of Internet-delivered interventions, exposure rates to such interventions are still low. In total, 35,104 adolescents participated in the E-MOVO project: an Internet-delivered lifestyle intervention aimed at multiple health behaviours. By means of multilevel analyses, we demonstrated the relationship between intention to change behaviour and adolescents' exposure to E-MOVO's functionalities. There was a clustering of intention to change risk taking behaviours in an unhealthy way and energy balance-related behaviours in a healthy way. This should be taken into account with the design of Internet-delivered interventions.
An Investigation of the Effects of Music on Anxiety and Pain Perception in Patients Undergoing Haemodialysis Treatment
Authors: Pothoulaki M. , MacDonald R.A.R. , Flowers P. , Stamataki E. , Filiopoulos V. , Stamatiadis D. , Stathakis Ch. P.
Published: September 2008

This study aimed to investigate the effects of preferred music listening on anxiety and pain perception in patients undergoing haemodialysis. A two group experimental design was used. Sixty people diagnosed with end stage renal failure undergoing haemodialysis treatment participated in this study. Preferred music listening was applied as an intervention. Anxiety and pain were measured pre-test and post-test. The control group scored significantly higher in state anxiety than the experimental group and experienced significantly higher pain intensity in post-test phase. Findings provide experimental evidence to support the effectiveness of preferred music listening in medical settings.
Applying an Extended Model of the Theory of Planned Behaviour to Breast Self-examination
Authors: Mason Tania E. , White Katherine M.
Published: September 2008

Few studies have examined the predictors of breast self-examination in younger women, where it is the primary method for the early detection of breast cancer. Female college students ( N = 253, aged 17 to 50 years) completed items related to breast self-examination assessing theory of planned behaviour (TPB) constructs (intentions, attitude, subjective norm, perceived behavioural control), social influence variables of self-identity and group norm, and demographic characteristics. One month later, breast self-examination behaviour was assessed. Results supported this application of the TPB model and highlight the importance of group norms for strategies to increase breast self-examination in younger women.
Eating Disorders Patients' Views on Their Disorders and on an Outpatient Service
Authors: Reid Marie , Burr Jennifer , Williams Sarah , Hammersley Richard
Published: September 2008

The objective of the study was to determine sufferers' views of outpatient treatment for eating disorders and provide practical recommendations for treatment practice. Twenty NHS outpatients participated in semi-structured interviews, which were subjected to thematic analysis. Respondents expressed ambivalence about whether their eating disorder is a way of exerting control or a disorder that controls them and this leads to them seeking treatment. Sufferers preferred a practical and sensitive approach and began to rely on treatment for recovery. Treatment needs to facilitate sufferers' need for control by striking a balance between practical and empathetic approaches that both involve patients in treatment decisions and give authoritative guidance.
Changes of midazolam pharmacokinetics in Wistar rats treated with lipopolysaccharide: relationship between total CYP and CYP3A2
Authors: Kato Ryuji , Yamashita Satoshi , Moriguchi Jun , Nakagawa Machiko , Tsukura Yuri , Uchida Kagehiro , Amano Fumio , Hirotani Yoshihiko , Ijiri Yoshio , Tanaka Kazuhiko
Published: September 2008

It has been reported that infection interferes with drug metabolism, resulting in changes in pharmacokinetics. In this study, we investigated the effects of lipopolysaccharide (LPS) on hepatic total cytochrome P450 (CYP), CYP3A2, and CYP2C11 contents in a transient, LPS-induced, endotoxemia model of rats. In addition, to assess the effects on CYP3A2 activities, the pharmacokinetics of midazolam (CYP3A2 substrate) and 1-OH-midazolam (metabolite of midazolam) were investigated. Hepatic total CYP contents were significantly low until day 3 ( P < 0.05) but returned to the control level on day 5. Hepatic CYP3A2 contents were significantly decreased on day 1 until day 5 ( P < 0.05) but returned to the control level on day 7. Hepatic CYP2C11 contents were continuously low until day 7, and lowest on day 3. The AUC of 1-OH-midazolam was significantly decreased on day 1 after LPS administration ( P < 0.01). In conclusion, LPS (5 mg/kg) challenge decreased hepatic total CYP, CYP3A2, and CYP2C11 contents and also decreased the activities of hepatic CYP3A2. It took at least 7 days for hepatic total CYP and CYP3A2 to recover to control levels, and it was suggested that the changes of hepatic total CYP contents might correlate with those of hepatic CYP3A2 contents and activities. Additionally, it is shown that their changes might reflect the recovery process from inflammation.
Review: Systemic and uteroplacental renin—angiotensin system in normal and pre-eclamptic pregnancies
Authors: Anton Lauren , Brosnihan K. Bridget
Published: September 2008

Pregnancy is characterized by an increase in many of the different components of the circulating renin—angiotensin system (RAS). However, the physiological mechanisms of stimulated RAS activity during pregnancy are unknown. Even less understood is how this system may be altered in pre-eclampsia, a hypertensive disorder of pregnancy. Additional studies have shown the presence of a local tissue specific RAS in the uteroplacental unit of normal and pre-eclamptic pregnancies. Differences in normal pregnant and pre-eclamptic RAS component regulation may provide insight into the mechanisms responsible for the clinical pathological features of pre-eclampsia. Specifically, this review summarizes the key findings in the circulating and uteroplacental RAS in normal and pre-eclamptic pregnancies.
Review: Genetics of diabetic nephropathy
Authors: Maeda Shiro
Published: September 2008

Genetic susceptibility has been proposed as an important factor for the development and progression of diabetic nephropathy, and research efforts have been invested worldwide to identify the susceptibility gene for diabetic nephropathy. Although, several candidate genes were shown to be associated with the disease, the results were not always consistent; most of the genes conferring susceptibility to diabetic nephropathy remain to be identified. Recent development of the single nucleotide polymorphism (SNP) typing technology and collation of information on linkage disequilibrium in the human genome have facilitated genome-wide association studies (GWASs) for investigating novel disease-susceptibility genes across the entire human genome. GWASs are considered a powerful and promising approach and are expected to be useful for identifying convincing susceptibility genes for several common diseases; however, to date, these studies have not been able to completely cover the entire human genome.
Novel Fabrication of ZnO Film-coated Carbon Nanotube Arrays in Modified AAO Membrane
Authors: Yu Kailu , Wang Wenhua , Luo Taigang
Published: September 2008

The AAO membrane was modified by immersion within Zn(NO3)2 solution. Zinc-containing film would be formed over the inner surfaces of membrane. Using this as template, ZnO film-coated carbon nanotube arrays were fabricated in plasma-enhanced CVD.
Non-Statistical Based Robust Identification of a Lightly Damped Flexible Beam Using Kautz Orthonormal Basis Functions
Authors: Esmaeilsabzali Hadi , Montazeri Allahyar , Poshtan Javad , Jahedmotlagh Mohammadreza
Published: September 2008

Robust identification of a lightly damped flexible beam with parametric and non-parametric uncertainties is presented; however, the main concern is about non-parametric uncertainties which are high-frequency high-amplitude unmodeled dynamics. Our approach is based on worst-case estimation theory in which uncertainties are assumed to be unknown but bounded and produces so-called hard bounds on model errors. Based on this theory, two methods named “Set Member-sip” and “Model Error Modeling” has been applied. We have also examined two outbounding algorithms (ellipsoidal and parallelotopic) to solve the Set Membership identification problem. In order to properly deal with high-amplitude non-parametric uncertainties, the proposed methods are compared. It is shown that the combination of Set Membership approach with Model Error Modeling technique will result in superior identification in that it can better handle high-frequency high-amplitude non-parametric uncertainties. For each method the mode obtained and its associated uncertainty bound is mapped to the frequency plane so that it can be utilised by robust controller design methods such as H∞.
Spatial Attenuation of Sound in a Rectangular Enclosure under Active Control of Sound Transmission through an Elastically Supported Flexible Panel
Authors: Lau Siu-Kit , Tang Shiu-Keung
Published: September 2008

The present research involved a numerical analysis of the influence of the rotational and translational flexibilities of sound-transmitting panel edges in a two-dimensional cavity-panel system on the transmitted sound field under active control. We considered full coupling between the panel and the enclosed acoustic space. Visualisation of the sound field and a normalised impedance-mobility approach were used to investigate the performances of global and local control of the enclosed sound field and to overcome the limitations involved in assessing the attenuation of acoustic potential energy. The present results suggest that the optimal global control of the enclosed sound field is not attained under potential energy control. Good global and local performance is obtained using an acoustic control source at high eigen-frequencies. In terms of global and local performance, a high degree of translational flexibility of the panel edge yields better active control that a high degree of rotational flexibility.
A Parametric Shape Grammar of the Traditional Malay Long-Roof Type Houses
Authors: Said Suzana , Embi Mohamed R.
Published: September 2008

A parametric shape grammar of the traditional Malay houses (TMH) built in the past century is presented. The grammar, which consists of rules for generating the form and structure of TMH, is derived from simple geometric representations of the houses. The rules first derive the basic unit structures that form the shapes of the TMH. Nine basic shapes have been identified that form the main vocabulary elements of the grammar. Parameterized polygons and lines define each basic shape. Ranges of values assigned to the variables describing the parameterized polygons and lines are presented. The shape addition rules are used to characterize the compositional aspects of TMH style. Evidences of these basic shapes or their combinations have been documented by previous researchers and are used as a way of explaining the built forms of the TMH. The scope of the study is currently limited to the original TMH of the bumbung panjang (long roof) type in which the key features of the houses are easily discernible from the side view.
Parametric Variations of Palladio's Villa Rotonda
Authors: Park Hyoung-June
Published: September 2008

A computational tool for the study of proportional balance is introduced as an apparatus for investigating Andrea Palladio's design of Villa Almerico, more familiarly known as Villa Rotonda, in the second book of his Quattro Libri dell'Architettura. The objective of this investigation of Villa Rotonda is to find a novel outcome from the morphological transformations of the villa, where the transformations are generated from parametric variations of the villa while maximizing its proportional balance. The outcome confirms Palladio's mastery of proportional treatments of his design of Villa Rotonda and shows various morphological descendants evolved from the original design. It suggests a new way of employing a parametric geometry in the formal study of a classical building and its stylistic evolution.
“World-Menace”: National Reproduction and Public Health in Katherine Mayo’s Mother India
Authors: Nadkarni Asha
Published: September 2008

U.S. journalist Katherine Mayo's Mother India sparked protests and debates across three continents when it was published in 1927. An imperialist polemic against Indian self-rule thinly disguised as a journalistic exposé, Mother India claimed to reveal “the truth about the sex life, child marriages, hygiene, cruelty, religious customs, of one-sixth of the world's population.” Mayo's muckraking journalism thus set out to dispel U.S. fascination with Indian culture and Hindu spirituality, exploiting Indian subaltern female suffering to justify both the continued British rule of India and the continued exclusion of Indians from U.S. citizenship. Through readings of Mother India and Mayo’s other writings, this essay suggests that Mayo maps the domestic issue of immigration onto the international terrain of imperialism to solidify a nativist nationalism. She draws on the scientific language of public health to argue that in a new era of global circulation of goods and bodies the United States must strengthen its borders to protect itself from the threat of disease Indian bodies contain. Imagining India as embodying a specifically sexual threat that must be kept in check, Mayo thus fashions a peculiarly U.S. version of imperial containment to segregate populations and police behaviors. By putting reproduction at the center of the question of sovereignty, however, she troubles reproductive practices at home as well as in India: her argument against Indian sovereignty ultimately rebounds upon U.S. women who similarly fail to fulfill their reproductive duties. Mayo's transnational optic thus reveals a United States in peril that can only be saved by a radically isolationist stance.
“The Birth of a European Public”: Migration, Postnationality, and Race in the Uniting of Europe
Authors: El-Tayeb Fatima
Published: September 2008

Europe appears to be in a unique position in this post-cold war, post 9/11 world, both with regard to its internal reconstruction and to its potential role in current world politics. At a time when the "post-national," "the end of the nation-state," have become buzzwords within academic and non-academic discourses of globalization, the European Union appears as the first supranational system fit for the 21st Century. The quest for an European identity however, seems to have fallen way behind the process of creating a common legal and economic system. While changes in national laws and the introduction of the Euro passed relatively smoothly, the rejection of a European constitution in a number of national plebiscites lead to renewed debates, a search for an existing “European consciousness” able to hold the Union together. All too often however, these debates devolve into an assessment of what, or rather who, is certainly not European. Migration in particular gains a central position here by functioning both as a threat uniting the beleaguered European nations and as a trope shifting the focus away from Europe’s unresolved identity crisis.
In this essay, I briefly analyze discourses on the continent’s future and past as they pertain to memory, identity, and migration. In order to do so, I will trace some of the complicated interactions resulting from the simultaneous construction of a European space, both materially and discursively, in the contemporary global landscape and of a normative European historical memory. My starting point is the notion of an emerging European “public space” and its role in creating a common continental identity. I focus on two recent incidents of what could be defined as the emergence of a “transnational” European public: the widespread protests against the Iraq war in the spring of 2003 and the “riots” in the French banlieus in the winter of 2005. Both events also place the European public within the discursive space of two dominant tropes of current global politics, “the war on terror” and “the clash of civilizations,” tied to renewed attempts to create transatlantic Western unity.
I will approach the events at the center of my analysis partly by way of their assessment by two of Europe’s foremost “public intellectuals,” Juergen Habermas and Jean Baudrillard. Habermas’ reflection on the meaning of the Western European resistance to the Iraq war and Baudrillard’s view of the uprising on the margins of French society can be seen as emblematic of two versions of post-war Europe – one in which the European Union stands for the successful construction of a civil society out of the ruins left behind by World War II, the other documenting the failure of this attempt. Ultimately however, I will argue, both interpretations are failing to place Europe’s post-war history in a global context as they remain caught up in an outdated, solipsistic perspective that continues to place racialized migrant and minority populations outside of the limits of “Europe.”
The Immigrant Rights Movement on the Net: Between “Web 2.0” and Comunicación Popular
Authors: Costanza-Chock Sasha
Published: September 2008

Independent media makers, social justice organizations, and everyday people are self-documenting the current wave of immigrant rights mobilizations. Some of this self-documentation of struggles is circulated through appropriated corporate space on commercial sites like YouTube and Myspace. While movement media does find broader audiences via these spaces, media activists, cultural workers, and social movements need to develop a clear shared critique of online corporate media, as well as a stronger autonomous communication infrastructure, built in tandem with existing autonomous communication infrastructure, tools and networks.
“Citizenship Matters”: Lessons from the Irish Citizenship Referendum
Authors: Mancini J. M. , Finlay Graham
Published: September 2008

In 2004, by constitutional referendum, Ireland revoked the automatic right to citizenship by territorial birth (jus soli). This event is of great significance in Europe, where consequently there is no longer a single nation that grants unrestricted territorial birthright citizenship to people born within its borders, and also represents a trend toward the revocation of jus soli within nations governed by the common law tradition. But the Irish Citizenship Referendum also invites comparative analysis with the United States, where jus soli is protected by the Fourteenth Amendment, due both to the historical and contemporary links between the two nations and the presence of contemporary pressures to undermine jus soli in the United States that are similar to those that resulted in the Irish Citizenship Referendum. In this article, we discuss both the importance of U.S. practice for the normative discussions surrounding the removal of jus soli as an automatic qualification for citizenship in Ireland, and the importance of the Irish debates as an example for the historical and normative investigation of the foundations of citizenship in the United States, especially in the field of American studies. In particular, we propose that the Irish Citizenship Referendum illuminates the need to reconsider the relationship between restrictionism in immigration and in citizenship, often cast in American Studies as a direct relationship. The Irish case shows that a successful campaign for limits on access to citizenship was made in the absence of policies limiting immigration. One of the purposes and effects of citizenship restriction in a context of increased immigration, we propose, is the creation of a dual and unequal workforce. For this reason, we argue that the elimination of jus soli as a basis for citizenship was unjustified in the Irish case, despite the popular pressures on Irish politicians, and that the pressure being placed on U.S. politicians to undermine jus soli should be consciously resisted.
Unskilled Labor Migration and the Illegality Spiral: Chinese, European, and Mexican Indocumentados in the United States, 1882–2007
Authors: Sadowski-Smith Claudia
Published: September 2008

This article explores the historical production of immigrant illegality in the United States as a set of interrelated yet distinct racial projects. The passage of nineteenth and twentieth century immigration legislation, which instituted requirements for immigrant identification, transformed unskilled labor movements from China and Europe into unauthorized or improperly documented immigration. This illegality was differently racialized. Excluded as a group, Chinese entrants became wholesale associated with illegality. In contrast, though it far surpassed the numbers of unauthorized entrants from China, European illegal movement was quickly forgotten. Unauthorized immigration from China and Europe were met with tightened immigration law and enforcement. Set in motion by the regulation of Chinese and European immigration, this “spiral of illegality” created the context for the transformation of Mexican laborers into indocumentados in the twentieth century and continues to shape the conditions under which twenty-first century immigrants arrive and live in the United States. While Mexican nationals have been the largest group to have arrived undocumented in the United States, today they constitute about half of the undocumented population, which hails from everywhere in the world, including nations in Asia and Europe. Recognition of such intersections among undocumented immigrant groups questions widespread assumptions about the existence of sharp distinctions between contemporary and historical immigration, and it also contributes to emerging forms of cross-ethnic activism for immigrant rights that complicate notions of indocumentados as nationals of one particular country.
Sacred Signified: The Semiotics of Statues in the Greek Magical Papyri
Authors: Haluszka Adria
Published: September 2008

This paper explores the spells of the Greek Magical Papyri in which the creation of divine images are described and suggests that there is little evidence for formal animation rituals, per se, and that the core rituals of the papyri exhibit a less specific, more fluid approach to statues. This fluid approach can be understood best if we approach the statues as what Charles Peirce called indices, that is, if we approach the statues as objects that point to the divine without necessarily enunciating a specific relationship between the physical statue and the god it represented. An attempt to understand these spells and their statues using this semiotic model allows for a wider range of interpretations regarding interactions with the sacred that are not limited to statue animation alone.
Single Combat and the Aeneid
Authors: Martino John
Published: September 2008

This paper explores the significance of key martial scenes depicted in the latter books of the Aeneid by examining connections between the republican tradition of monomachy, the impact of Augustus’s sweeping reforms, and the probable meaning of Vergil’s single-combat depictions. In concentrating upon the sacral dimension of these connections, it is argued that Vergil sought to convey a sense of the religious (and socio-political) chaos of his era through an enigmatic treatment of the spolia opima tradition.
Depression and College Stress Among University Undergraduates: Do Mattering and Self-Esteem Make a Difference?
Authors: Dixon Sarah K. , Kurpius Sharon E. Robinson
Published: September 2008

Depression and college stress, major concerns among undergraduates, are potentially related to self-esteem and mattering. This study investigated the interrelationships among these four variables. Participants included college students (199 males and 256 females) between the ages of 18 and 23. Significant sex differences were found with women reporting greater depression, college stress, and mattering. Sex, self-esteem, and mattering accounted for 13.8% and 39.4% of the variance in stress and depression, respectively. Accounting for 49.1% of the variance, the full model including sex, self-esteem, and mattering enhanced the ability of stress to predict depression. All of the study hypotheses were supported.
Subjective Experiences in Activity Involvement and Perceptions of Growth in a Sample of First-Year Female University Students
Authors: Busseri Michael A. , Rose-Krasnor Linda
Published: September 2008

We examined subjective experiences in activities and perceptions of growth in a sample of first-year female university students (N = 196; age range = 17 to 19 years old, M = 18.48, SD = 0.53; the most common ethnic affiliations were British Isles, 51% of respondents, Canadian, 34%, French, 14%, and German, 8%). Students described 4 activities, rated their subjective experiences in each activity on 8 dimensions, and evaluated the impact of their involvement using scales created by the authors for the present study. Subjective experiences were generally positive across dimensions for 7 activity categories. For each activity type, 5 dimensions of subjective experience (enjoyment, competence, importance, commitment, control) loaded onto a "psychological engagement" factor. Positive experiences in activities were associated with more positive perceptions of activity-related growth. Differences between dimensions of subjective experiences, activity types, and domains of growth are explored, as well as implications for student affairs professionals.
Understanding the Epistemology of Ethnic Identity Development in Multiethnic College Students
Authors: Chaudhari Prema , Pizzolato Jane Elizabeth
Published: September 2008

We examined the nuances of multiethnic identity in 22 self-identifying mixed ethnic college students ranging from 17 years of age to 27 years of age via semistructured interviews. Majority of the sample was predominantly female. The participants were recruited from two institutions in a metropolitan area of the Eastern United States. Results suggest an expansion of the definition of situational identity (Renn, 2000) and a triplaned understanding of ethnic identity development and assessment in relation to epistemology for this population.
Basil and Gregory’s Sermons on Usury: Credit Where Credit Is Due
Authors: Ihssen Brenda Llewellyn
Published: September 2008

Significant features in St. Gregory of Nyssa’s sermon Contra usurarios indicate that the younger brother of St. Basil the Great did not merely imitate the latter’s earlier contribution on the destructive and corrosive nature of usury. Gregory’s homily has an internal integrity that sets it apart from Basil’s Homilia in psalmum 14 . Though they used common themes when writing about usury—theft, falsehood, anxiety, enslavement, heavenly usury, and the natural world—Basil and Gregory approached these themes differently, were inspired and influenced by different Scripture and philosophy, and had different motives.
Epiphanius of Salamis, the Kollyridians, and the Early Dormition Narratives: The Cult of the Virgin in the Fourth Century
Authors: Shoemaker Stephen J.
Published: September 2008

The so-called Kollyridians of Epiphanius’s Panarion are commonly regarded in modern scholarship as a group of Christian goddess worshipers who believed in the Virgin Mary’s divinity. Yet a careful reading of Epiphanius’s account, with close attention to his rhetoric, suggests instead that the Kollyridians merely were offering Mary a kind of veneration that during the late fourth century was increasingly directed toward Christian saints. The Six Books apocryphon, an early Dormition narrative from the fourth century, enjoins on its readers ritual practices almost identical with what Epiphanius ascribes to the Kollyridians, yet without any indication of belief in Mary’s divinity. Comparison of this apocryphon with Epiphanius’s description of the Kollyridians further suggests that the Kollyridian rituals do not necessarily amount to goddess worship or belief in Mary’s divinity. Moreover, such comparison reveals that Epiphanius probably knew the Six Books apocryphon, either directly or indirectly, and his account of the Kollyridians likely responds in part to its early Dormition traditions.
The Prayer of the Apostle Paul in the Context of Nag Hammadi Codex I
Authors: Kaler Michael
Published: September 2008

The first and perhaps most famous of the Nag Hammadi codices, first known as the “Jung Codex,” contains five gnostic writings, including the well-known “Gospel of Truth.” While most of the individual texts contained in Codex I have been studied intensively, less attention has been paid to the composition and logic of the codex as a whole, despite the fact that paleographical analysis shows that the contents of the codex were carefully chosen and carefully arranged. Particularly interesting is the role played by a brief prayer, ascribed to the apostle Paul, which the compiler of the codex used as an introduction to this collection of esoteric literature. In the hopes of contributing to the illumination of the logic underlying the compiler’s choice and arrangement of her material, in this presentation I will show why this prayer is such an appropriate introduction to the codex as a whole, and how it prefigures and subtly hints at the themes to be addressed in the other texts.
Revisiting the Allegory/Typology Distinction: The Case of Origen
Authors: Martens Peter W.
Published: September 2008

There is a significant debate in Origenian scholarship today about the allegory/typology distinction. Some scholars accept the demarcation between these two forms of nonliteral scriptural interpretation, whereas others reject it. In this paper I seek to determine whether, or to what extent, the allegory/typology distinction is valid for study of this prominent early Christian exegete. My article unfolds in three steps. First, I canvass the last sixty years of scholarship that insists upon this distinction and determine where consensus has been reached, as well as where disagreement still exists; next, I turn to Origen’s own writings and assess how he used and defined the Greek terms that stand behind “allegory” and “typology”; in the third section I explore if there was in Origen’s writings a distinction that resembled what most scholars today intend to invoke when they speak of allegory and typology. In my conclusion I contend that the literature’s allegory/typology distinction is of mixed value. I propose ways to salvage what is important in this distinction and dispense with what is problematic.
Debriefing and Accountability in Deceptive Research
Authors: Miller Franklin G. , Gluck John P. , Wendler David
Published: September 2008

Debriefing is a standard ethical requirement for human research involving the use of deception. Little systematic attention, however, has been devoted to explaining the ethical significance of debriefing and the specific ethical functions that it serves. In this article, we develop an account of debriefing as a tool of moral accountability for the prima facie wrong of deception. Specifically, we contend that debriefing should include a responsibility to promote transparency by explaining the deception and its rationale, to provide an apology to subjects for infringing the principle of respect for persons, and to offer subjects an opportunity to withdraw their data. We also present recommendations concerning the discussion of deception in scientific articles reporting the results of research using deception.
Moral Accountability and Debriefing
Authors: Benham Bryan
Published: September 2008

What is the ethical significance of debriefing in deceptive research? The standard view of debriefing is that it serves to disclose the deception to the participant and is a means of evaluating and mitigating potential harms that may have resulted from involvement in the research. However, as the article by Miller, Gluck, and Wendler in this issue of the Kennedy Institute of Ethics Journal points out, there has been little systematic attention to the ethics of debriefing, particularly with regard to the role of debriefing in addressing the prima facie moral wrong of deception itself. They argue that in addition to mitigating the harms of deception, debriefing should include an apology to participants for being deceived. In the current paper, I argue that an apology is not morally obligatory in most research contexts. Debriefing should be considered an opportunity to further define the researcher-participant relationship without the need to be remorseful about the research practice.
Quality of life measures in pediatric cardiology
Authors: Berkes Andrea , Mogyorósy Gábor
Published: September 2008

Az utóbbi néhány évtizedben ugrásszerű fejlődést mutató gyermek-szívsebészeti, illetve -kardiológiai ellátás területén napjainkban joggal merül fel az igény a kezelés eredményességének betegszempontú elemzésére. Az életminőség-mérésekkel kapcsolatos szakmai elvárások, illetve azok felhasználási lehetőségei gyakran ismeretlenek a gyakorló orvosok számára. A gyermekkori mérések számos nehézsége, a korrekt vizsgálatok alacsonyabb száma miatt ez különösen igaz a gyermekgyógyászat területére.
Cél:
A gyermekkardiológia területén zajló életminőség-mérésekkel szemben támasztott alapvető szakmai elvárások és az eddigi vizsgálatok eredményeinek klinikai szempontú ismertetése.
Módszer:
Irodalmi áttekintés felnőtt-, illetve gyermekkorú, szívfejlődési rendellenességgel született vegyes populációs és speciális betegcsoportok körében végzett életminőség-mérésekről, a vizsgálatok fő eredményeinek és alapvető módszertani jellemzőinek bemutatásával.
Következtetés:
Az eddigi vizsgálatok eredményei szerint az életminőség-méréseknek helye van a gyermekkardiológiai ellátásban. Megfelelően kivitelezett mérésekkel a gondozás színvonala javítható.
Postoperative application of amphotericin B nasal spray in chronic rhinosinusitis with nasal polyposis. Can recidive polyposis be prevented?
Authors: Gerlinger Imre , Fittler András , Mayer Anna , Patzkó Ágnes , Fónay Fruzsina , Pytel József , Botz Lajos
Published: September 2008

A krónikus rhinosinusitis (KRS) a felnőttpopuláció 1–4%-át érintő, jelentős életminőség-romlást okozó idült, multifaktoriális, gyakran orrpolipképződéssel járó, etiológiáját illetően azonban pontosan nem tisztázott megbetegedés. Az elmúlt évtizedben felmerült, hogy az orrüregi nyálkahártya jellegzetes eozinofil sejtes beszűrődését okozó megbetegedésnek az orrüregi nyákban található gombák elleni fokozott – nem IgE típusú klasszikus allergiás – immunválasz a kiváltó oka.Célkitűzés:Ha igaz ez a feltételezés, akkor kézenfekvőnek tűnik, hogy az endoszkópos orrpolypectomiákat követően megfelelő ideig és koncentrációban adott amphotericin B-tartalmú orrspray kedvező hatású lehet a betegek számára, akár csökkentve a recidívák számát.Módszer:A feltételezés igazolá­sára a szerzők 33 beteg bevonásával prospektív, randomizált, placebokontrollált, kettős vak klinikai tanulmányt végeztek. A tanulmányt végül 30 beteg fejezte be. A 2005. november 1-je és 2006. október 1-je között orrpolyposissal endoszkópos műtétre került betegek egyik csoportja (A csoport, 14 beteg) egy évig 5 mg/ml koncentrációjú amphotericin B-tartalmú orrsprayt kapott, míg a placebo­csoport (B csoport, 16 beteg) hatóanyag nélküli orrsprayt. Az eredmények értékeléséhez a módosított Lund–Mackay-féle CT-értékelő pontrendszert, a tüneti változásokat vizsgáló pontrendszert (SNAQ-11), életminőségtesztet és endoszkópos kiértékelést végeztek. A műtétek előtt és a műtéteket követően egy évvel elvégzett vizsgálatok eredményeit SPSS 14.0 for Windows program segítségével értékelték.Eredmények:Az A csoport betegeinek CT-értékelő pontrendszere egy év elteltével jelentős szórást mutatott, a javulás jelei nélkül. A B csoportban a CT-értékelő pontrendszere enyhe javulást mutatott, azonban ez az A csoporttal összehasonlítva nem volt szignifikáns (p = 0,052). A tüneti változásokat vizsgáló pontrendszer (SNAQ-11), valamint az életminőségteszt mindkét betegcsoportban lényeges javulást mutatott, a két tesztben a változások mértékét összehasonlítva azonban egyik betegcsoport javára sem találtak szignifikáns különbséget. Az endoszkópos lelet az amphotericin B-csoport javára mutatott mérsékelt javulást 12 hónappal a műtéteket követően.Következtetések:A szerzők megállapítják, hogy az orrpolyposis miatt operált betegekben az amphotericin B-tartalmú orrcsepp egy évig történő adása nem okoz szignifikáns változást a CT-pontszámok, a klinikai tünetek, valamint az életminőség vonatkozásában. A betegek endoszkópos követése során az amphotericin B-csoportban észlelt kedvezőbb kép a klinikai tünetek javulásában nem nyilvánult meg. A szerzők a tanulmány eredményeiből levont tanulságok tükrében tárgyalják a gombaelméletről rendelkezésre álló eddigi ismeretanyagot. Kritikusan elemzik az elmúlt években publikált 7, ellentmondásos konklúziót mutató klinikai tanulmány tapasztalatait is.
Diclofenac/orphenadrin as a combined analgetic in post-operative relief of pain
Authors: Borsodi Marianna , Nagy Edina , Darvas Katalin
Published: September 2008

A szerzők a kombinált, nemszteroid gyulladásgátló diclofenac- és centrális izomrelaxáns orphenadrintartalmú infúzió és a tramadolium chloratum hatásosságát, biztonságosságát és tolerálhatóságát hasonlították össze kis és közepes műtéteket követően, a posztoperatív fájdalomcsillapítás során. A vizsgálat nyílt, csoport- és önkontrollos, prospektív, randomizált, IV. fázisú klinikai vizsgálat volt. A bevont 60 beteg összesen 74 napon át kapott fájdalomcsillapítót. A betegeket három csoportba sorolták: a diclo­fenac-orphenadrint kapó
A
(
n
= 19), a tramadolt kapó
B
(
n
= 30) és a diclofenac-orphenadrint és tramadolt is kapó
C
(
n
= 11) csoportba. A kapott adatokat statisztikailag elemezték. A fájdalomcsillapítók hatásának megítéléséhez a vizuális analóg skálát (VAS) használták. A VAS-értékek a kezelés hatására mindhárom csoportban mind nyugalomban (–2,5, –3,7, –3,0), mind mozgásban (–3,0, –3,8, –3,4) szignifikánsan (
p
< 0,001) csökkentek, tehát mindhárom csoportban hatásos volt a fájdalomcsillapítás. Ezt a keringési paraméterek elemzése is alátámasztotta. A kezelés végén mind a betegek, mind az orvosok szignifikánsan (
p
< 0,05, illetve
p
 < 0,01) kedvezőbbnek ítélték a hatásosságot a csak diclofenac-orphenadrin infúziót kapó
A
csoportban. Az alkalmazott fájdalomcsillapítók mennyiségét elemezve a
C
csoportban kiegészítésként adott tramadol mennyisége szignifikánsan alacsonyabb volt a csak tramadolt kapó
B
csoporthoz képest (
B:
87,5 mg,
C:
61,5 mg,
p
< 0,01), azaz a diclofenac-orphenadrin infúzió a tramadol fájdalomcsillapító hatását erősítette. A kezelés elején és végén mért laboratóriumi paraméterek a fiziológiás értékhatárokon belül voltak, mellékhatásként összesen 3 esetben észleltek hányingert, illetve hányást. Mindezek alapján a diclofenac-orphenadrin infúziót a kis és középkategóriájú műtétek utáni fájdalomcsillapításban hatásos, biztonságos, kényelmesen adagolható és jól kombinálható fájdalomcsillapítónak tartják.
A change of attitude in lipidology, achievement of target levels. What comes next?
Authors: Márk László , Dani Győző , Kiss Zoltán , Katona András
Published: September 2008

A cardiovascularis prevenció egyik legnagyobb feladata a szív- és érrendszeri események rizikójának minimalizálása a lipidcélértékek elérésével. Ennek fontosságát sugallják a nagy betegszámú klinikai vizsgálatok összefoglaló értékelésével készült metaanalízisek és a mindennapi orvosi tevékenységet meghatározó terápiás irányelvek. A célértékek elérésének jelentőségét gyakran hangsúlyozzuk, mégis nagy a távolság az elmélet és a napi gyakorlat között. A szerzők irodalmi adatok és saját vizsgálati eredményeik alapján hasonlítják össze a célértékek elérésének arányát és elemzik a továbblépés lehetőségeit.A CÉL program 2004-ben, 2005-ben és 2006-ban mérte fel az összkoleszterin-célértékek elérésének arányát a családorvosok több mint 10 ezer betegében. Az arány 3 év alatt 12%-ról 30%-ra nőtt. A REALITY vizsgálat magyar eredményei szerint 2004-ben az összkoleszterin-célértéket elérők aránya 21% volt, és 3 év alatt 27%-ra nőtt. Ezen önmagában igen alacsony javulási arányhoz hozzátartozik az is, hogy 2007-ben, amikor a betegek alig több mint egynegyede volt célértéken, a családorvosok 87%-a és a szakorvosok 56%-a beletörődött ebbe, és nem tervezett további változtatást a célértéket el nem érők kezelésében.A gyulai megyei kórház kardiológiai profilú belgyógyászati osztályán végzett felmérések azt igazolják, hogy az ismerten érbetegek életkilátásait bizonyítottan javító aszpirin, béta-blokkolók, ACE-gátlók és statinok alkalmazási gyakorisága az irányelvek következetes alkalmazásának és az odafigyelésnek köszönhetően 7 év alatt javult, és ma már mind a négy csoportban 90% fölött van. Ugyanakkor az LDL-koleszterin-célértékeket 2007 decemberében, illetve 2008 januárjában a nagy kockázatú betegek 37%-a, az igen nagy kockázatúak 18%-a érte el. Az, hogy az utóbbi csoportban csak a betegek 21%-a részesült kombinált lipidcsökkentő kezelésben, jelzi, hogy ezen arány javítása lehet a továbblépés egyik útja. Nagy hangsúlyt kell helyezni a célértékek elérésének vizsgálatára és az alkalmazott terápia folyamatos újraértékelésére, különösen a nagy és az igen nagy cardiovascularis kockázatú betegek esetében, mert ők nyerhetnek ezzel a legtöbbet.
Some recent ethical dilemmas of randomized controlled clinical trials
Authors: Kovács József
Published: September 2008

A randomizált kontrollcsoportos klinikai (RKK) vizsgálatok, amelyek ma az orvostudományi kutatás „arany standardját” jelentik, éppen egyre nagyobb elterjedtségük miatt az etikai viták kereszttüzében állnak. Vita folyt és folyik arról, hogy mennyi haszna lehet a betegnek ilyen kutatásokban részt venni, s még ha haszna származhat is belőle, nem félrevezetés-e az ilyen kutatásokat terápiásnak nevezni. Vita folyt arról, hogy etikailag mikor fogadható el egy RKK elkezdése, elfogadható-e és mikor a betegek-kutatási alanyok random módon történő beosztása az egyes kutatási csoportokba, s mikor fogadható el a placebokontroll használata. Az is vita tárgya volt, hogy hogyan kell értelmezni a Helsinki Deklarációban szereplő „legjobb eljárás” fogalmát. A cikk megkísérli áttekinteni ezen újabb viták tanulságait.
Polymorphisms of the Toll-like receptor 4 gene and their potential role in infectious diseases and chronic inflammatory disorders
Authors: Reismann Péter , Rácz Károly , Tulassay Zsolt
Published: September 2008

A Toll-like receptor-4 a természetes immunválasz egyik központi mediátora. Fő ligandja a Gram-negatív baktériumok lipopoliszacharidja, de emellett más molekulák is kötődnek a receptorhoz, mint például a hősokkprotein-60, az oxidált alacsony denzitású lipoprotein és a fibronektin. A receptor aktivációja a proinflammatorikuscitokin-szint növekedésével jár. Az elmúlt évek kutatási eredményei kimutatták, hogy a Toll-like receptor-4 a fertőző ágensek elleni immunválaszon kívül olyan krónikus gyulladásos reakcióval járó egyéb betegségekben is részt vehet, mint például az atherosclerosis, a diabetes mellitus vagy a gyulladásos bélbetegségek. A közlemény bemutatja a receptorral kapcsolatos újabb ismereteket, a receptor gyakori koszegregációs polimorfizmusait, valamint a polimorfizmusok különböző megbetegedésekre gyakorolt hatását.
New therapy for atrial fibrillation: pulmonary vein isolation by cryoballoon ablation
Authors: Földesi Csaba , Kardos Attila , Mihálcz Attila , Som Zoltán , Hódi Gabriella , Andréka Péter , Szili-Török Tamás
Published: September 2008

A pitvarfibrilláció a leggyakoribb tartós szívritmuszavar, amelynek prevalenciája az utóbbi évtizedekben egyre nőtt és így népegészségügyi problémává vált. Az antiaritmiásgyógyszer-választék bővülése ellenére a pitvarfibrilláció farmakoterápiájának továbbra is jelentős korlátai vannak. Mindezek miatt egyre nagyobb hangsúlyt kaptak a nem gyógyszeres megszüntetést és ritmusmegőrzést célzó technikai fejlesztések, köztük a legnagyobb fejlődést és perspektívát mutató transzkatéteres ablatiós technikák, amelyekhez energiaforrásként jellemzően rádiófrekvenciás energiát használunk. Az ablatiós technikától és a nem elhanyagolható interperszonális különbségektől függően (mind az operatőr, mind a beteg oldaláról) a rádiófrekvenciás ablatio alkalmazása esetén olyan, potenciálisan életveszélyes szövődményektől is kell tartani, mint a tüdővénák stenosisa, illetve atriooesophagealis fisztula kialakulása. A cryoablatio a transzkatéteres ablatio olyan speciális formája, amely nem égetéssel, hanem fagyasztással szünteti meg az aritmiaszubsztrátot. A cryoballonos ablatio során a tüdővénákat átmenetileg ballonnal okkludáljuk, majd a vénaszájadék körkörös fagyasztása révén érhető el a tüdővéna komplett izolációja, amely a paroxizmális pitvarfibrilláció ablatiós kezelésének sarokköve. A cryoballonos ablatióval a rádiófrekvenciás ablatióval megegyező tartós aritmiamentesség érhető el megnövekedett biztonságosság mellett. Intézetünkben hazánkban elsőként végeztünk cryoballonos ablatiót paroxizmális pitvarfibrillációban szenvedő betegeken. Az ennek kapcsán közölt jelen összefoglalóval szeretnénk felhívni a figyelmet e módszer előnyeire, amely viszonylagos egyszerűségével lehetővé teheti, hogy a jövőben e beavatkozás gyorsan és széles körben elterjedjen.