bluuebunny/crossref_metadata_2025 huggingface dataset:
Nocturia and associated morbidity in a Danish population of men and women aged 60–80 years
Authors: Bing Mette H. , Moller Lars A. , Jennum Poul , Mortensen Svend , Lose Gunner
Published: June 2008

OBJECTIVE

To evaluate the association between nocturia and medical diseases, medication, urinary incontinence (UI), recurrent cystitis, smoking, alcohol, parity, hysterectomy, pelvic organ prolapse surgery, UI surgery, and prostate surgery.

SUBJECTS AND METHODS

The previously validated questionnaire the Nocturia, Nocturnal Enuresis and Sleep‐interruption Questionnaire was sent to 2000 women and 2000 men aged 60, 65, 70, 75, and 80 years. The population was selected at random from The Danish Civil Registration System.

RESULTS

Using multiple logistic regressions UI and age were significantly associated with nocturia irrespective of severity. Nocturia of ≥1 voids was significantly associated with body mass index (BMI), hypertension, and smoking; and nocturia of ≥2 voids with gender, BMI, diabetes and recurrent cystitis, as well as between nocturia of ≥3 voids and gender, lung disease, diabetes, use of diuretics and recurrent cystitis. Summarising the associations in an ordinal regression analysis UI (odds ratio (OR) 2.17, 95% CI 1.76–2.68), recurrent cystitis (OR 1.97, 95% CI 1.30–2.97) and diabetes (OR 1.89, 95% CI 1.32–1.65) had the strongest associations with nocturia.

CONCLUSIONS

Our results show that various disorders are associated with nocturia. However, the associations are strongly dependent on the severity of the nocturia.
An adjustable continence therapy device for treating incontinence after prostatectomy: a minimum 2‐year follow‐up
Authors: Gilling Peter J. , Bell Deborah F. , Wilson Liam C. , Westenberg Andre M. , Reuther Rana , Fraundorfer Mark R.
Published: June 2008

OBJECTIVE

To evaluate the efficacy and safety of the ProACTTM (Uromedica, Inc., MN, USA) balloon device, an alternative for the surgical management of incontinence after prostatectomy.

PATIENTS AND METHODS

The initial patients who received this device at our institution were evaluated, using urodynamics at baseline and at 6 months. Perioperative variables were recorded and pad usage, volume adjustments, an estimate of Incontinence Quality of Life (I‐QoL) and adverse events were recorded at baseline, and 1, 3, 6, 12 and 24 months after surgery.

RESULTS

In all, 37 patients were treated on this protocol between November 2001 and March 2005. Of these, 30 had had radical prostatectomy and seven holmium laser enucleation of the prostate. The mean (range) pad usage decreased from 2.81  (1–12) at baseline to 0.7 (0–4) pads at 24 months, and the I‐QOL increased from 49.7 (4.5–77) to 81.3 (13.6–100) over the same period. At 24 months, 62% of 34 men were pad‐free and 81% required one pad or less. Bilateral explantation was required in three patients (11%) for infection (one) and balloon migration (two). All other adverse events were mild and transient.

CONCLUSIONS

The ProACT balloon device is an acceptable therapy for the surgical management of incontinence after prostatectomy.
Does topical haemostatic agent have an adverse effect on the function of the prostatic neurovascular bundle?
Authors: Zeltser Ilia , Dugi Daniel , Gupta Amit , Park Sangtae , Kabbani Wareef , Cadeddu Jeffrey
Published: June 2008

OBJECTIVE

To assess the functional and histological effects of a bovine thrombin topical haemostatic agent used clinically to aid in surgical haemostasis (FloSealTM, Baxter International Inc., Deerfield, IL, USA) on the cavernous nerves in a canine model of survival, as there are concerns that the fibrotic/inflammatory response to this product could affect neural function.

MATERIALS AND METHODS

In phase I, nine adult male dogs had the bilateral neurovascular bundles (NVBs) dissected. A small intravenous catheter placed directly into the erectile bodies of the penis was used to record the intracorporal pressure (ICP). Erection was induced by electrical stimulation of the NVB on each side. After intraoperative randomization to treatment or control, 5 mL of FloSeal was unilaterally applied along the NVB on the treatment side. In phase II, after 2 weeks of survival, both control and treatment NVB were again dissected and re‐stimulated to produce an erectile response. The mean arterial pressure and ICP were recorded. The prostate and the NVBs were then removed for histological analysis.

RESULTS

All dogs achieved erections after electrical stimulation on both the control and treatment side. There was no statistically significant difference in absolute ICP, pressure increase from baseline or systemic pressure after stimulating the NVB on the treatment side between phases I and II. Histological analysis showed a giant‐cell reaction around the FloSeal granules and mild focal perineural oedema, but the cavernous nerves were otherwise normal in appearance.

CONCLUSION

In this short‐term functional study, FloSeal did not adversely affect cavernous nerve function, measured as the erectile response to electrical stimulation. We found no evidence contraindicating its use during radical prostatectomy.
Peroperative transrectal ultrasonography‐guided bladder neck dissection eases the learning of robot‐assisted laparoscopic prostatectomy
Authors: Van Der Poel Henk G. , De Blok Willem , Bex Axel , Meinhardt Willem , Horenblas Simon
Published: June 2008

OBJECTIVE

To study the role of peroperative transrectal ultrasonography (peTRUS) for the dissection of the bladder neck during robot‐assisted laparoscopic prostatectomy (RALP).

PATIENTS AND METHODS

Integrated peTRUS in the da Vinci S system (Intuitive Surgical, Sunnyvale, CA, USA) was used for bladder neck identification and dissection in the initial 80 patients with clinically localized prostate cancer operated by two urologists. The clinical and pathological results were compared with the initial 80 patients who had RALP with no peTRUS. The location of positive margins was recorded.

RESULTS

The operative duration, blood loss, hospital stay, catheter dependency, clinical and pathological T‐stage and Gleason sum score were no different between the groups. The prostate‐specific antigen level at time of diagnosis was slightly higher for patients in the peTRUS group. Basal surgical margins (bladder neck and basal areas of both prostate lobes) were positive for tumour in 9.1% and 2.3% of patients treated without and with peTRUS, respectively (P = 0.001). Although the use of peTRUS improved the basal margin rate in the initial 30 patients in each group, it did not in the last 30 in each group, when the urologist’s experience apparently improved. In a multivariate analysis the use of peTRUS and pathological T‐stage were the best predictors of basal margin status. Pad use at 6 months after surgery was similar for both groups.

CONCLUSION

peTRUS during RALP decreased the positive surgical margin rate at the base of the prostate during the initial experience of RALP.
Safety and efficacy of glargine compared with NPH insulin for the treatment of Type 2 diabetes: a meta‐analysis of randomized controlled trials
Authors: Bazzano L. A. , Lee L. J. , Shi L. , Reynolds K. , Jackson J. A. , Fonseca V.
Published: June 2008

Aims  We systematically analysed evidence from randomized controlled trials (RCTs) examining the safety and efficacy of neutral protamine Hagedorn (NPH) insulin and glargine in the management of adults with Type 2 diabetes.

Methods   Studies were identified by searching medline (1966–March 2007), embase (1974–2007), American Diabetes Association abstract database and the Cochrane Central Register of Controlled Trials using Medical Subject Headings (MeSH) diabetes mellitus, Type 2, insulin, insulin isophane, hypoglycaemic agents and the keywords glargine and NPH. Data on study design, participants, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), body weight and hypoglycaemia were independently abstracted by two investigators using a standardized protocol.

Results  Data from a total of 4385 participants in 12 RCTs were pooled using a random‐effects model. The mean net change (95% confidence interval) for FPG, HbA1c and body weight for patients treated with NPH insulin as compared with glargine was 0.21 mmol/l (−0.02 to 0.45), 0.08% (−0.04 to 0.21) and −0.33 kg (−0.61 to −0.06), respectively, with negative values favouring NPH and positive values favouring glargine. More participants experienced symptomatic and nocturnal hypoglycaemia on NPH than glargine, but there was no significant difference in confirmed or severe episodes.

Conclusions  We identified no difference in glucose‐lowering between insulin glargine and NPH insulin, but less patient‐reported hypoglycaemia with glargine and slightly less weight gain with NPH in adults with Type 2 diabetes.
Treatment of chronic diabetic foot ulcers with bemiparin: a randomized, triple‐blind, placebo‐controlled, clinical trial
Authors: Rullan M. , Cerdà L. , Frontera G. , Masmiquel L. , Llobera J.
Published: June 2008

Aims To assess the efficacy and safety of bemiparin in the treatment of chronic diabetic foot ulcers.

Methods A triple‐blind, parallel, randomized, placebo‐controlled trial. Patients aged > 8 years, with diabetes for at least 3 years, and with a foot ulcer persisting for > 3 months were selected from 39 Spanish centres. Bemiparin 3500 IU/day for 10 days, followed by 2500 IU/day for up to 3 months plus standard care for ulcers, was compared with placebo plus standard care for ulcers for 3 months. The primary efficacy end‐point was ulcer improvement, defined as an objective decrease in ulcer area of ≥ 50%, measured by digital photography and ImageJ software, and/or any decrease in Wagner's ulcer grade at 3 months.

Results Ulcer improvement rates were 70.3% (26 of 37 patients) in the bemiparin group and 45.5% (15 of 33 patients) in the placebo group [absolute difference 24.8; 95% confidence interval (CI) 2.3, 47.3;P = 0.035] (number needed to treat 4; 95% CI 2, 43). Complete healing rates at 3 months were similar in both groups (35.1% vs. 33.3%;P = 0.874), as were the number of adverse events.

Conclusions Bemiparin is more effective than placebo in the management of diabetic foot ulcers and has few side‐effects.
Prevalence and reasons for insulin refusal in Bangladeshi patients with poorly controlled Type 2 diabetes in East London
Authors: Khan H. , Lasker S. S. , Chowdhury T. A.
Published: June 2008

Aims  To determine the prevalence and reasons for refusal to commence insulin in Bangladeshi patients with Type 2 diabetes.

Methods  A survey of 212 Bangladeshi patients seen in a hospital diabetes unit, with poor glycaemic control (HbA1c≥ 8.0%) on maximum oral glucose‐lowering therapy, in whom insulin was deemed necessary. Patients who refused insulin were invited to attend focus groups. Data were analysed by thematic content analysis using the constant comparative method.

Results  Of 212 patients offered insulin, 122 (57.5%) commenced insulin immediately, 47 (22.1%) started insulin within 6 months and 43 (20.3%) refused to commence insulin despite repeated counselling. Thirty‐six (83.7%) of those who refused insulin agreed to participate in focus groups. Reasons for insulin refusal included: disease severity—perceptions that requirement for insulin was an indicator of a more serious stage of their condition; insulin leading to premature death—common suggestion that commencing insulin led to early death; loss of control—including fear of hypoglycaemia, weight gain, loss of independence and reliance on others to give insulin or look for signs of hypoglycaemia; lack of perception of benefits—poor perception of the benefits of improved glycaemic control on quality of life and cardiovascular risk; needle anxiety—a significant proportion of subjects conveyed concern over frequent injections.

Conclusions  Insulin refusal is common in Bangladeshi subjects with Type 2 diabetes and poor glycaemic control. A number of factors contribute to this, and methods to overcome the barriers to insulin therapy need to be sought.
Nursing concept analysis in North America: state of the art
Authors: Weaver Kathryn , Mitcham Carl
Published: June 2008

Abstract The strength of a discipline is reflected in the development of a set of concepts relevant to its practice domain. As an evolving professional discipline, nursing requires further development in this respect. Over the past two decades in North America there have emerged three different approaches to concept analysis in nursing scholarship: Wilsonian‐derived, evolutionary, and pragmatic utility. The present paper compares and contrasts these three methods of concept in terms of purpose, procedures, philosophical underpinnings, limitations, guidance for researchers, and ability to contribute to nursing knowledge and disciplinary advancement. This work extends prior criticisms of concept analysis methods, especially as formulated by Morse and colleagues, by promoting further critical discussion regarding the direction and effectiveness of nursing efforts to meet the basic needs of disciplinary development. Its central thesis is that nursing concept analysis must advance beyond the Wilsonian‐derived methods of Walker and Avant by devoting greater attention to understanding the domain of concepts to be analysed and deriving features from these contexts.
LABELLING CHARACTERISTICS AND DEMAND FOR RETAIL GROCERY PRODUCTS IN AUSTRALIA*
Authors: JENSEN PAUL H. , WEBSTER ELIZABETH
Published: June 2008

This paper examines whether labelling characteristics affect short‐run demand for manufactured foods in Australia. We estimate the effect of common labelling characteristics on demand using data from 92 brands in 12 product categories from major supermarket stores across Australia over the period 2002 to 2005. We find that certain characteristics – such as whether the product is made from recycled materials, certified as being Australian‐made, is a private label product, is health‐conscious or supports a charity – have a positive effect on demand. However, being an environmentally‐friendly good had a negative impact on demand as did products which offer the chance to win a prize and uncertified Australian‐made goods.
BANK MERGERS AND ACQUISITIONS – AN EVALUATION OF THE ‘FOUR PILLARS’ POLICY IN AUSTRALIA*
Authors: WU SU
Published: June 2008

This paper examines the efficiency consequences of bank mergers and acquisitions with particular reference to the ‘four pillars’ policy preventing mergers among the four major banks. Using data envelopment analysis, the technical efficiencies of banks operating in Australia over the period from 1983 to 2001 are estimated. A second‐stage regression is used to evaluate ex‐post efficiency performance of banks involved in mergers and acquisitions. The empirical results demonstrate that for the time being mergers among the four major banks may result in much poorer efficiency performance in the merging banks and the banking sector.
MIXED INDUSTRIAL STRUCTURE AND SHORT‐RUN FISCAL MULTIPLIER
Authors: CENSOLO ROBERTO , COLOMBO CATERINA
Published: June 2008

Existing studies on the fiscal multiplier under imperfect competition assume a symmetric market structure with identical firms. This paper examines the fiscal policy implications of introducing a multisectoral economy, where a composite commodity is offered in many varieties within a market of monopolistic competition and a homogeneous good is produced in a perfectly competitive environment. Within the context of this mixed industrial structure we show that the size of the short‐run multiplier crucially depends on the composition of public expenditure chosen by the government.
ARE LABOUR FORCE PARTICIPATION RATES NON‐STATIONARY? EVIDENCE FROM 130 YEARS FOR G7 COUNTRIES*
Authors: MADSEN JAKOB , MISHRA VINOD , SMYTH RUSSELL
Published: June 2008

This paper applies a unit root test with a non‐linear threshold to examine whether labour force participation rates are mean reverting for G7 countries using annual data over a 130 year period. We find some evidence of mean reversion for just over half the sample; however, this result is sensitive to regime shifts. We also examine whether the labour force participation rate is trend reverting through employing a lagrange multiplier (LM) unit root test with one and two structural breaks in the intercept and slope. The LM unit root test provides no additional evidence in support of stationarity. On the basis of the unit root tests for mean reversion we conclude that there is at best mixed evidence that long‐term changes in unemployment rates translate into long‐term changes in employment rates and that the unemployment rate is a useful indicator of joblessness.
IS THE BALANCING ITEM FOR AUSTRALIA SUSTAINABLE? EVIDENCE FROM A THRESHOLD AUTOREGRESSIVE MODEL WITH AN AUTOREGRESSIVE UNIT ROOT
Authors: MISHRA VINOD , SMYTH RUSSELL , TANG TUCK CHEONG
Published: June 2008

This article applies an unrestricted two‐regime threshold autoregressive (TAR) model with an autoregressive unit root to examine the sustainability of the balancing item of the balance of payments for Australia from the first quarter 1960 to the second quarter 2006. The main finding is that the balancing item of the balance of payments in Australia is characterised by a non‐linear, but stationary, series meaning that the balancing item is sustainable. This result implies that short‐run volatility in the balancing item has no effect on the reliability of reporting of the balancing item in the long‐run.
MENTAL HEALTH AND LIFE SATISFACTION OF YOUNG AUSTRALIANS: THE ROLE OF FAMILY BACKGROUND*
Authors: ULKER AYDOGAN
Published: June 2008

This paper uses the Household, Income and Labour Dynamics in Australia Survey to investigate the factors that influence young Australians’ mental health and life satisfaction, with an emphasis upon the role of family background. It also explores male and female differences concerning those background effects. The results indicate a particularly significant negative association between parental divorce and well‐being, and suggest that the timing of divorce matters. Distinguishing the samples by gender shows that this relationship remains significant only for females. Past living arrangements consistently turn out to be statistically insignificant whether the sample used is the total, males or females. The current living arrangements, however, appear to be significantly associated with both mental health and life satisfaction of males. Adding potentially confounding characteristics to our basic regression, which includes only the family background variables, suggests that some of the ‘aggregate’ effects of family background might work indirectly through the mediating variables such as education or lifestyles, though most of them remain direct. Among those, marital status, education, labour market experience and lifestyles seem to be the major factors explaining the dispersion in well‐being of young Australians. Income and wealth, on the other hand, have only a minor impact.
Empirical Bayes Confidence Intervals for Means of Natural Exponential Family‐Quadratic Variance Function Distributions with Application to Small Area Estimation
Authors: GHOSH MALAY , MAITI TAPABRATA
Published: June 2008

Abstract. The paper develops empirical Bayes (EB) confidence intervals for population means with distributions belonging to the natural exponential family‐quadratic variance function (NEF‐QVF) family when the sample size for a particular population is moderate or large. The basis for such development is to find an interval centred around the posterior mean which meets the target coverage probability asymptotically, and then show that the difference between the coverage probabilities of the Bayes and EB intervals is negligible up to a certain order. The approach taken is Edgeworth expansion so that the sample sizes from the different populations need not be significantly large. The proposed intervals meet the target coverage probabilities asymptotically, and are easy to construct. We illustrate use of these intervals in the context of small area estimation both through real and simulated data. The proposed intervals are different from the bootstrap intervals. The latter can be applied quite generally, but the order of accuracy of these intervals in meeting the desired coverage probability is unknown.
Control Variates for the Metropolis–Hastings Algorithm
Authors: HAMMER HUGO , TJELMELAND HÅKON
Published: June 2008

Abstract. We propose new control variates for variance reduction in estimation of mean values using the Metropolis–Hastings algorithm. Traditionally, states that are rejected in the Metropolis–Hastings algorithm are simply ignored, which intuitively seems to be a waste of information. We present a setting for construction of zero mean control variates for general target and proposal distributions and develop ideas for the standard Metropolis–Hastings and reversible jump algorithms. We give results for three simulation examples. We get best results for variates that are functions of the current statexand the proposaly, but we also consider variates that in addition are functions of the Metropolis–Hastings acceptance/rejection decision. The variance reduction achieved varies depending on the target distribution and proposal mechanisms used. In simulation experiments, we typically achieve relative variance reductions between 15% and 35%.
Simplex Mixed‐Effects Models for Longitudinal Proportional Data
Authors: QIU ZHENGUO , SONG PETER X.‐K. , TAN MING
Published: June 2008

Abstract. Continuous proportional outcomes are collected from many practical studies, where responses are confined within the unit interval (0,1). Utilizing Barndorff‐Nielsen and Jørgensen's simplex distribution, we propose a new type of generalized linear mixed‐effects model for longitudinal proportional data, where the expected value of proportion is directly modelled through a logit function of fixed and random effects. We establish statistical inference along the lines of Breslow and Clayton's penalized quasi‐likelihood (PQL) and restricted maximum likelihood (REML) in the proposed model. We derive the PQL/REML using the high‐order multivariate Laplace approximation, which gives satisfactory estimation of the model parameters. The proposed model and inference are illustrated by simulation studies and a data example. The simulation studies conclude that the fourth order approximate PQL/REML performs satisfactorily. The data example shows that Aitchison's technique of the normal linear mixed model for logit‐transformed proportional outcomes is not robust against outliers.
Scales of exception: Experiments with knowledge and sheer life in tropical Southeast Asia
Authors: Ong Aihwa
Published: June 2008

New political spaces, I suggest, are generated by varied strategies that govern populations in and through multiple scales of exception. I identify biopolitical assemblages as a space of inquiry into the situated play of exceptions that territorializes different kinds of value. Scales of exception are produced when a neoliberal logic of economic growth articulates biopolitical problems of population security. Neoliberal and biopolitical decisions not only focus on accumulating values in space, but also anticipate the value of currently devalued spaces. By invoking exceptions, states alternately favour neoliberal or biopolitical values, thus investing spaces with different kinds of value. The interplay of biopolitical and neoliberal logics and the resulting configuration of scales of exception are well illustrated in Southeast Asia in an age of pandemics. In Singapore, a technomedical hub assembles networks for capturing knowledge capital and property rights, configuring an ecology of expertise. This is a site of scientific prowess in a region increasingly viewed as a space of ‘third world’ exception to global health norms. In Indonesia, health crises have prompted a logic of ethical sensibility to basic human survival whereby political leaders invoke bio‐sovereignty, configuring a national scale of ethical exception that challenges the global power of biocapital and the World Health Organization over the supply of vaccines. In contrast to approaches that foreground spaces of capital accumulation, I attend to diverse logics that differently valorize scales of exception, thus giving visibility to situated mechanisms that animate and mutate political cartography.
The politics of the possible: Making urban life in Phnom Penh
Authors: Simone AbdouMaliq
Published: June 2008

Phnom Penh, ‘re‐entering’ urban history as it did just some three decades ago becomes an important arena in which to focus on the intensifying contestation of rights, practices and development trajectories related to city making. Far from being comprehensively marginalized by emerging urban economies, residents with limited economic means, through their configurations of space, social relations and infrastructure continuously attempt to construct the conditions that enable the city to act as a flexible resource for the viable organization of their everyday lives. These issues are taken up in an analysis of some of the ways in which residents of a large low income housing tract, popularly dubbed ‘Building’, in the Bassac River neighbourhood collaborate to maximize their access to resources and opportunity.
Land use/cover changes in the war‐ravaged Jaffna Peninsula, Sri Lanka, 1984–early 2004
Authors: Suthakar K. , Bui Elisabeth N.
Published: June 2008

Temporal and spatial information on land use/cover is a prerequisite for effective planning decisions in the context of social and economic development. Satellite remote sensing data have become increasingly important in the study of land use/cover changes. This paper uses multitemporal satellite data to measure and spatially characterize land use/cover changes in the Jaffna Peninsula, northern Sri Lanka over the two decades from 1984 to early 2004 in terms of potential drivers. Over this period, the Jaffna Peninsula has been impacted severely by armed conflict between the government of Sri Lanka and the Liberation Tigers of Tamil Eelam. A postclassification method is used to compare land use/cover classes from satellite images using Geographical Information Systems (GIS) to analyze the spatial pattern of land use/cover changes over the study period. Results indicate that the land use/cover pattern has been very dynamic since early the 1980s, showing a remarkable decrease in agricultural land use and concomitant increase in non‐agricultural land uses. The ethnic conflict and its consequences, particularly large‐scale population migrations, have been the main driving forces for such land use/cover changes in the Jaffna Peninsula. The results of this study are not only important in aiding efforts to reconstruct this area after decades of physical and socioeconomic devastation, but should also prompt similarly urgent studies in other inaccessible war‐torn areas of the world.
The failure of colonial ‘distancing’: Changing representations of the 2005–06 chikungunya epidemic in Réunion, France
Authors: Weinstein Philip , Ravi Srilata
Published: June 2008

In 2005–06, the Indian Ocean island of Réunion, an overseas department of France, experienced a massive epidemic of the mosquito‐borne viral infection chikungunya. Public health authorities in metropolitan France were arguably slow to react, and we explore their representations and management of the epidemic in the context of tropicality and colonial discourse. We analyse official reports on the epidemic from the bulletins of the Institut de Veillance Sanitaire (Institute for Health Surveillance) for changes in representations of risk posed by chikungunya to metropolitan France, in the emphasis on control measures for the epidemic and in descriptions of chikungunya case symptomatologies, and compare these with parallel representations of another epidemic, flu, already known in metropolitan France. Our findings illustrate that official responses to chikungunya at the beginning of the epidemic are suggestive of a centred tropicality: there is no perceived risk to metropolitan France because of its nontropical climate; thus, there is no justification for costly control measures for a disease inevitable in the tropics; and therefore the symptoms of French nationals in overseas departments in the tropics can be described in detached terms so as to generate knowledge about the disease. However, this ‘distancing’ fails with the perceived risk to metropolitan France towards the end of the epidemic in late 2006, when representations are more consistent with a decentred tropicality: the concept of a protective metropolitan French climate is abandoned; the need for a whole‐of‐society involvement in control measures is accepted; and symptoms are described using more inclusive language. Similar changes are not found in official reports on the flu epidemic.
Contending with unequal and privileged access to natural resources and land in the Okavango Delta, Botswana
Authors: Mbaiwa Joseph E. , Ngwenya Barbara N. , Kgathi Donald L.
Published: June 2008

This paper reviews how state policy and regulatory instruments, including protected area alienations and concessions, have altered or denied the access to land and natural livelihood resources of the indigenous Basarwa and minority subsistence‐oriented communities in the Okavango Delta (OD) in Botswana. Drawing on field research and guided by a sustainable rural livelihoods framework, the paper provides an overview of key institutional interventions – in particular the setting up of the Moremi Game Reserve, Wildlife Conservation Policy, Tourism Policy, Agricultural Development Policy and the erection of veterinary fences – that have served to privilege a foreign‐owned and dominated commercialized wildlife and nature tourism sector and the export‐oriented beef industry in the OD. The officially sanctioned barriers to customary and usufructory rights and access, and the non‐recognition of historically embedded traditional land uses have decimated already marginalized resource‐based subsistence livelihoods, and precipitated intergroup conflicts over preferential rights and access to resources and opportunities, notably wildlife, non‐timber veld products, agriculture and community‐based tourism schemes. Such outcomes, moreover, will have consequences for the longer‐term sustainability of the OD both as a socioeconomic resource base and as a natural ecosystem.
Traditional intramontane mobility in Garhwal Himalaya: A survey of subsistence practices in the Pindar basin, Uttaranchal
Authors: Sati Vishwambhar Prasad
Published: June 2008

This paper looks at the key resource interactions driving the current trend in intramontane mobility as a traditional subsistence practice in the Garhwal Himalaya region of Uttaranchal, India. For hundreds of years, the natural resource based mid‐altitude villages in the Pindar River basin hinged on the annual summer migration to highland pastures. Where self‐sufficiency has been obtained through an environmentally embedded tradition of crop and livestock farming, highland forests and alpine pastures continue to provide the human and animal requirements of fuelwood and fodder, as well as the forest products defining traditional diets and cottage industry. The paper reports the data from a rapid appraisal survey of resources obtained by households in selected mid‐altitude villages from the seven highland locations that have sustained the centuries‐old subsistence culture of the Pindar basin. While livestock have been the crucial link in a forest/fodder–manure–cultivation chain that has necessitated households' dependence on highland pastures and forests, over the last four decades there has been a decline in the numbers engaged in livestock raising and, concomitantly, the annual migration to summer pastures. Instead, there is a trend towards increased cultivation of cash crops and forest resource collection in the traditional highland encampment areas.
The Structure of Parent–Child Dyadic Synchrony in Toddlerhood and Children's Communication Competence and Self‐control
Authors: Lindsey Eric W. , Cremeens Penny R. , Colwell Malinda J. , Caldera Yvonne M.
Published: June 2008

The aim of the present investigation was to examine parent–child synchrony and its link to children's communicative competence and self‐control. Data were collected from 80 families with toddler age children (41 girls, 39 boys) during a laboratory assessment. Five components of parent–child dyadic synchrony were assessed during a semi‐structured parent–child play activity at 18 months. Assessments of children's communicative competence and self‐control were obtained at 36 months. Results indicated that parent–child synchrony, shared positive affect, and mutual compliance were highly intercorrelated components of dyadic synchrony. Moreover, children from highly synchronous parent–child dyads displayed more communicative competence and more self‐controlled behavior. Mother–child mutual compliance and father–child shared positive affect were particularly significant contributors to children's self control. The associations between synchrony and child developmental adjustment remained significant after controlling for individual child and parent behavior. Developmental implications and suggestions for future research are discussed.
Behavioral and Cognitive Readiness for School: Cross‐domain Associations for Children Attending Head Start
Authors: Bierman Karen L. , Torres Marcela M. , Domitrovich Celene E. , Welsh Janet A. , Gest Scott D.
Published: June 2008

Utilizing a diverse sample of 356 four‐year‐old children attending Head Start, this study examined the degree to which behavioral aspects of school readiness, including classroom participation, prosocial behavior, and aggression control were related to direct assessments of child cognitive readiness (academic knowledge, executive function skills) at the start of the prekindergarten year. Classroom participation and prosocial behavior each accounted for unique variance in cognitive readiness. Aggressive behavior, in contrast, was not correlated with academic knowledge, and was associated with low levels of executive function skills. In multiple regressions, aggressive behavior paradoxically enhanced the prediction of child cognitive readiness. Profile analyses strengthened the conclusion that the promotion of competencies associated with classroom participation and prosocial behavior may be particularly critical to cognitive readiness in prekindergarten. Implications are discussed for developmental models of school readiness and preschool classroom practice.
Temperament and the Development of Conscience: The Moderating Role of Effortful Control
Authors: Stifter Cynthia A. , Cipriano Elizabeth , Conway Anne , Kelleher Rachael
Published: June 2008

In this longitudinal study we examined whether two components of effortful control, behavioral control, and executive function moderated the relation between temperament and conscience development. Temperament was assessed when participants were two years of age, and three temperament groups were formed: inhibited, exuberant, and low reactive. At 4.5 years of age, children's behavioral control and executive function were assessed. Moral behavior, emotionality during an empathy film, and false‐belief understanding were measured at 5.5 years of age as components of conscience. Results indicate that inhibited children may benefit most from higher levels of effortful control. Inhibited children with higher levels of behavioral control performed better on false‐belief understanding tasks whereas inhibited children who scored higher on executive function tests reported less emotional response to the evocative film. Finally, as a group, inhibited children exhibited more moral behavior than exuberant and low reactive children.
Effect of gender and highly active antiretroviral therapy on HIV‐related pulmonary arterial hypertension: results of the HIV–HEART Study
Authors: Reinsch N , Buhr C , Krings P , Kaelsch H , Kahlert P , Konorza T , Neumann T , Erbel R ,   on behalf of the Competence Network of Heart Failure
Published: June 2008

Background

Idiopathic pulmonary arterial hypertension (PAH) is a rare disease. HIV‐infected patients exhibit a considerably higher rate of development of this condition compared to the general population.

Methods

This cross‐sectional study of 802 (83.4% male; age 44.3±10.3 years) HIV‐positive patients aimed to evaluate the male‐to‐female ratio in HIV‐related PAH and to elucidate whether PAH is more likely to occur in patients receiving highly active antiretroviral therapy (HAART) than in HIV‐treatment‐naïve patients. All patients were examined by Doppler echocardiography to estimate systolic pulmonary arterial pressure (sPAP). Manifest PAH was defined as sPAP >35 mmHg at rest in combination with symptoms of dyspnoea.

Results

A total of 38 (4.7%) patients were diagnosed with elevated sPAP >35 mmHg. Fourteen (1.7%; 11 male) of these patients presented with symptoms of dyspnoea, resulting in a male‐to‐female ratio of manifest HIV‐associated PAH of 1:1.4. Patients with symptoms of dyspnoea and sPAP>35 mmHg were more likely to receive HAART (13/14 patients).

Conclusions

In HIV patients, sPAP occurs more frequently than has been reported previously; the condition is possibly associated with HAART. Furthermore, HIV‐positive females exhibit a higher prevalence of HIV‐related PAH (HIV–PAH) than HIV‐positive males.
Bacterial pneumonia in HIV‐infected patients: use of the pneumonia severity index and impact of current management on incidence, aetiology and outcome
Authors: Curran A , Falcó V , Crespo M , Martinez X , Ribera E , Villar del Saz S , Imaz A , Coma E , Ferrer A , Pahissa A
Published: June 2008

Objectives

Despite a recent decrease, bacterial pneumonia (BP) is still the most common admission diagnosis in HIV patients. We analyse BP incidence, characteristics and prevention measures.

Methods

Observational study of all patients hospitalized for BP in a tertiary hospital in Barcelona, Spain, from January 2000 to December 2005. Demographic and HIV‐related data, BP risk factors, characteristics of BP and outcomes are analysed.

Results

One hundred and eighty‐six BP episodes in 161 patients were included; patients were mainly male (73.7%) and intravenous drug users (73.7%). A decrease in BP incidence was seen during the study period, especially in vaccinated patients. The most commonly isolated microorganism was Streptococcus pneumoniae (31.7%), followed by Legionella pneumophila (5.9%). Legionella pneumophila was more likely in patients with undetectable viral load, higher CD4 cell counts or prior vaccination. Highly active antiretroviral therapy, cotrimoxazole prophylaxis and pneumococcal vaccination did not have a significant influence on bacteraemia rate, in‐hospital complications or BP mortality. High Pneumonia Severity Index (PSI) predicted mortality accurately [relative risk 15.2, 95% confidence interval 3.2–71.7; P=0.001]. Mortality was 9.1%, but was significantly higher in patients with CD4 counts under 200 cells/μL (P=0.022).

Conclusions

A decline in BP incidence was seen during the study period. Combining CD4 cell count and PSI score could become a good strategy in deciding which patients have to be hospitalized.
RNA amplification of the HIV‐1 Pol and env regions on dried serum and plasma spots
Authors: Dachraoui R , Brand D , Brunet S , Barin F , Plantier J‐C
Published: June 2008

Background

Dried sample spots have molecular applications, but few data are available on conditions of HIV‐1 RNA amplification.

Objectives

To determine the impact of (i) the sample type (plasma or serum), (ii) various storage periods, (iii) transfer at ambient temperature of the dried spots via postal mail, and (iv) two different methods of elution–extraction, to amplify partial pol and env genes with a view to both phylogenic and resistance analyses.

Methods

Fourteen samples (dried plasma spot and dried serum spot) from seven patients were stored at 20–25 °C for 2, 5 and 7 days. Two extraction buffers were tested on these samples, followed by reverse transcriptase‐polymerase chain reaction (RT‐PCR) on pol and env genes. Sixteen spots from eight other patients were sent by postal mail at ambient temperature between two laboratories, and were analysed at both sites.

Results

We observed no influence of the 2–7 day storage period, whatever the sample type and viral load, but the choice of the extraction procedure is a critical step. Analysis of the mailed spots resulted in a good agreement between the two laboratories.

Conclusions

This study shows that amplification of HIV‐1 RNA on spots is possible in various conditions by different operators and using appropriate reagents. This finding could be particularly useful for large‐scale molecular and resistance epidemiological studies in resource‐rich and resource‐limited countries alike.
Social and economic hardship among people living with HIV in London
Authors: Ibrahim F , Anderson J , Bukutu C , Elford J
Published: June 2008

Objectives

To examine the social and economic circumstances of people living with HIV in London.

Methods

Between June 2004 and June 2005, 1687 people living with HIV (73% response) receiving treatment and care in north‐east London National Health Service out‐patient clinics completed a confidential, self‐administered questionnaire. The questionnaire sought information on employment, income, education, residency status in the UK and housing.

Results

In total, 1604 respondents were included in the analysis: Black African heterosexual women (n=480) and men (224); White (646) and ethnic minority (i.e. non‐White) homosexual men (112); White heterosexual men (64) and women (39); and Black Caribbean heterosexual women (26) and men (13). Black African heterosexual men and women consistently reported more difficulties than any other group in relation to employment, income, housing and residency status. Half the Black African heterosexual men (46.8%) and women (51.2%) reported insecure residency status in the UK, significantly more than any other group (P<0.001). Just under half the respondents (46.6%) were employed at the time of the survey; Black African heterosexual women (35.3%) and men (45.4%) were less likely to be employed than White (57.6%) or ethnic minority (53.7%) homosexual men (P<0.001). Forty per cent of Black African heterosexual men and women, 22.9% of ethnic minority homosexual men and 9.6% of White homosexual men did not have enough money to cover their basic needs (P<0.001).

Conclusions

In this study of people living with HIV in London, a substantial number faced social and economic hardship, particularly Black African and other ethnic minority respondents. Our findings provide further evidence that in London HIV is associated with poverty, particularly among migrant and ethnic minority populations.
Genotypic antiretroviral drug resistance testing at low viral loads in the UK
Authors: Cane PA , Kaye S , Smit E , Tilston P , Kirk S , Shepherd J , Hopkins M , Zhang H , Geretti AM
Published: June 2008

Background

Antiretroviral drug resistance testing is recommended in HIV‐1 infected patients failing therapy in order to inform treatment selection. Although guidelines and test manufacturers recommend a viral load of at least 500–1000 HIV‐1 RNA copies/mL for genotypic resistance testing to be performed, prompt management of virological failure could benefit from testing at lower viral load levels.

Methods

Laboratories undertaking genotypic resistance testing were asked to provide figures for the number of resistance tests undertaken at viral loads <2000 copies/mL, the success rates of such tests and the extent of resistance detected, all stratified for viral load levels.

Results

Of the replies received, most laboratories were attempting resistance testing at viral loads below the recommended guidelines, with variable success and outcomes.

Conclusions

This audit of current practice in the UK for undertaking genotypic resistance tests at viral loads <1000 copies/mL highlights the widespread use of such testing outside the British HIV Association guidelines.
Increased basal‐ganglia activation performing a non‐dystonia‐related task in focal dystonia
Authors: Obermann M. , Yaldizli O. , De Greiff A. , Konczak J. , Lachenmayer M. L. , Tumczak F. , Buhl A. R. , Putzki N. , Vollmer‐Haase J. , Gizewski E. R. , Diener H.‐C. , Maschke M.
Published: June 2008

Background and purpose:  We tried to determine whether altered sensorimotor cortex and basal‐ganglia activation in blepharospasm (BSP) and cervical dystonia (CD) are restricted to areas directly responsible for the innervation of dystonic muscles, or whether impairment in focal dystonia reaches beyond these direct associations supporting a more global disturbance of sensory and motor control in focal dystonia.

Methods:  Twenty patients with focal dystonia (11 BSP, 9 CD) and 14 healthy controls were investigated with functional magnetic resonance imaging (fMRI) performing a simple grip force forearm contraction task.

Results:  BSP and CD patients and healthy controls showed similar activation in the pre‐motor, primary motor and primary sensory cortex, whilst basal‐ganglia activation was increased in BSP and CD with related activation patterns compared with controls. BSP patients had increased activation in the thalamus, caudate nucleus, putamen and lateral globus pallidus, whilst CD patients showed increased activation in the caudate nucleus, putamen and thalamus. No differences in applied grip force were detected between groups.

Conclusions:  In both, BSP and CD, increased basal‐ganglia activation could be demonstrated in a task not primarily involving the dystonic musculature affected by these disorders. Comparable activation changes may also indicate a common pathway in the pathophysiology in BSP and CD.
Electrophysiological assessment of visual function in patients with non‐arteritic ischaemic optic neuropathy
Authors: Parisi V. , Gallinaro G. , Ziccardi L. , Coppola G.
Published: June 2008

Background and purpose:  Our study aims to evaluate retinal function and neural conduction in post‐retinal visual pathways of patients with non‐arteritic ischaemic optic neuropathy (NION).

Methods:  Twenty patients (mean age: 63.7 ± 5.96 year) with NION and 20 age‐similar control subjects were enrolled. Simultaneous recording of pattern electroretinograms (PERGs) and visual evoked potentials (VEPs), and Log of minimum angle resolution (MAR) visual acuity (VA) were assessed in NION patients and controls.

Results:  Significantly (anova, P < 0.01) abnormal PERG and VEP responses, delayed retinocortical time (RCT, difference between VEP P100 and PERG P50 implicit times), and reduced VA were found in NION patients with respect to control subjects. The delay in RCT was not significantly (Pearson’s test, P > 0.01) correlated with the PERG impairment. The reduction in VA was significantly (Pearson’s test, P < 0.01) correlated to the increase in VEP P100 implicit time and RCT, whereas no correlations (P > 0.01) were found with PERG abnormalities.

Conclusions:  Non‐arteritic ischaemic optic neuropathy patients with a reduction in VA may present two different, unrelated impairments: a dysfunction of the inner retinal layer (abnormal PERG) and abnormal post‐retinal neural conduction (abnormal VEP and RCT). The reduction in VA seems to be related to the post‐retinal impairment and seems to be independent from the retinal dysfunction.