bluuebunny/crossref_metadata_2025 huggingface dataset:
Ten-Year Survival After First-Ever Stroke in the Perth Community Stroke Study
Authors: Hardie Kate , Hankey Graeme J. , Jamrozik Konrad , Broadhurst Robyn J. , Anderson Craig
Published: July 2003

Background and Purpose—

Very few studies have provided information regarding long-term prognosis after stroke. We aimed to determine the absolute and relative survival over 10 years among patients with first-ever stroke from a population-based study in Perth, Western Australia.

Methods—

For a 12-month period beginning February 1989, all individuals with a suspected acute stroke or transient ischemic attack who were resident in a geographically defined and representative region of Perth, Western Australia, were registered prospectively and assessed according to standardized diagnostic criteria. Patients with a definite first-ever stroke were followed up prospectively at 4 months, 12 months, 5 years, and 10 years after the index event.

Results—

A total of 251 patients with first-ever stroke were registered, and 244 (97%) were followed up at 10 years, by which time 197 (79%; 95% confidence interval [CI], 74 to 84) had died. The major causes of death were the direct effects of the initial stroke (27%; 95% CI, 21 to 33) and cardiovascular disease (26%; 95% CI, 20 to 32). Among 1-year survivors of stroke, the average annual case fatality was 4.8%, which was 2.3 (95% CI, 1.9 to 2.7) times greater than for the general population of the same age and sex.

Conclusions—

One in 5 patients with first-ever stroke survived to 10 years. The average annual case fatality was 4.8% between years 1 and 10 after stroke, which was twice that expected for the general population. Vascular disease is the major cause of death among long-term survivors of stroke.
Selection of Acute Ischemic Stroke Patients for Intra-Arterial Thrombolysis With Pro-Urokinase by Using ASPECTS
Authors: Hill Michael D. , Rowley Howard A. , Adler Felix , Eliasziw Michael , Furlan Anthony , Higashida Randall T. , Wechsler Lawrence R. , Roberts Heidi C. , Dillon William P. , Fischbein Nancy J. , Firszt Carolyn M. , Schulz Gregory A. , Buchan Alastair M.
Published: July 2003

Background—

Previous studies have suggested that baseline computed tomographic (CT) scans might be a useful tool for selecting particular ischemic stroke patients who would benefit from thrombolysis. The aim of the present study was to assess whether the baseline CT scan, assessed with the Alberta Stroke Program Early CT Score (ASPECTS), could identify ischemic stroke patients who might particularly benefit from intra-arterial thrombolysis of middle cerebral artery occlusion.

Methods—

Baseline and 24-hour follow-up CT scans of patients randomized within 6 hours of symptoms to intra-arterial thrombolysis with recombinant pro-urokinase or control in the PROACT-II study were retrospectively scored by using ASPECTS. Patients were stratified into those with ASPECTS >7 or ≤7. Independent functional outcome at 90 days was compared between the 2 strata according to treatment assignment.

Results—

The analysis included 154 patients with angiographically confirmed middle cerebral artery occlusion. The unadjusted risk ratio of an independent functional outcome, in favor of treatment, in the ASPECTS >7 group was 5.0 (95% confidence interval [CI], 1.3 to 19.2) compared with 1.0 (95% CI, 0.6 to 1.9) in the ASPECTS ≤7 group. After adjustment for baseline characteristics, the risk ratio in the ASPECTS score >7 was 3.2 (95% CI, 1.2 to 9.1). Similar favorable treatment effects were observed when secondary outcomes were used, but these did not reach statistical significance.

Conclusions—

Ischemic stroke patients with a baseline ASPECTS >7 were 3 times more likely to have an independent functional outcome with thrombolytic treatment compared with control. Patients with a baseline ASPECTS ≤7 were less likely to benefit from treatment. This observation suggests that ASPECTS can be both a useful clinical tool and an important method of baseline risk stratification in future clinical trials of acute stroke therapy.
Ethnic Differences in Markers of Thrombophilia
Authors: Jerrard-Dunne Paula , Evans Andrew , McGovern Rory , Hajat Cother , Kalra Lalit , Rudd Anthony G. , Wolfe Charles D. , Markus Hugh S.
Published: July 2003

Background and Purpose—

The role of hypercoagulable states in the pathogenesis of ischemic stroke in black subjects is not known, and data on normal reference ranges in black populations are lacking. This study estimated ethnic-specific reference ranges in a community population to determine the prevalence of thrombophilic states in a multiethnic stroke population.

Methods—

Free protein S, protein C, antithrombin III, activated protein C resistance, IgG anticardiolipin antibodies, and lupus anticoagulant were determined in 130 consecutive ischemic stroke cases ≤65 years of age (50 black Caribbeans, 30 black Africans, 50 whites) and 130 community controls.

Results—

Black African controls had significantly lower protein S (
P
<0.001) and protein C (
P
=0.049) and a trend toward lower antithrombin III (
P
=0.056) levels compared with white controls. Black Caribbean and African controls had higher diluted Russell’s viper venom time ratios compared with whites (
P
=0.001,
P
<0.001). Using ethnic-specific reference ranges, 8 controls (6.3%) and 11 cases (8.5%) had thrombophilia abnormalities (odds ratio [OR], 1.39; 95% confidence interval [CI], 0.54 to 3.57;
P
=0.50). ORs were 0.96 (95% CI, 0.18 to 4.99;
P
=0.96) for whites, 1.57 (95% CI, 0.41 to 5.94;
P
=0.51) for black Caribbeans, and 2.07 (95% CI, 0.18 to 24.2;
P
=0.95) for black Africans.

Conclusions—

Failure to account for ethnic differences in the normal reference ranges for thrombophilia markers may lead to inappropriate diagnosis and investigation of hypercoagulable states in black individuals. Protein S and protein C deficiencies and lupus anticoagulant may contribute to stroke risk in a minority of black cases, but they are unlikely to be major contributors to the excess stroke risk seen in young individuals of African and African-Caribbean descent.
Sport, Politics and the Engaged Historian
Authors: Guttmann Allen
Published: July 2003

Historiography on the intersection of sport and politics is a vast field within which six major areas can be identified. 1. German, Italian and — to a lesser extent — Japanese historians have written extensively about the role of sports under fascist regimes. 2. There have also been numerous efforts to analyse the role of sport in communist societies (as well as considerable attention to `workers' sports' in the 1920s and 1930s). 3. Many historians have dealt with sport and the politics of race and ethnicity (especially, but not exclusively, in South Africa, the USA, Australia and Ireland). 4. European and American historians have also written extensively and with considerable passion about the politics of gender discrimination. 5. The Olympic Games, which their founder intended to be a political force, have been a fifth focus of historical scrutiny. 6. A small but prolific group of French and German neo-Marxist historians and sociologists have argued that modern sports are a mirror image of capitalist institutions and are, therefore, inherently repressive. These are all areas of intense and intensive historical attention.
`With Political Pakistan in the Offing...': Football and Communal Politics in South Asia, 1887-1947
Authors: Dimeo Paul
Published: July 2003

This article examines the relationship between football and communal politics in India between 1887 and 1947. It argues that, while cricket was the outlet for communal antagonisms in Bombay and Delhi, it was football that played this role in Calcutta. Given the scale of violence in the 1930s and 1940s and the enormity of its consequences in terms of both political upheaval and genocide, the contribution made by sports clubs to help focus these divisions is a very important — if often ignored — element in South Asian history.
Projecting the Nation through Sport and Culture: Ireland, Aonach Tailteann and the Irish Free State, 1924-32
Authors: Cronin Mike
Published: July 2003

This article explores the attempt by the newly-independent Irish state to stage a major sporting and cultural event, Aonach Tailteann, in the 1920s and 1930s. The event has to be understood in the context of a new nation trying to promote itself on the world stage by defining, through sporting and cultural happenings, those ideals which the state would embrace. The article reveals that, despite the high idealism of Aonach Tailteann, the whole event was hamstrung by the financial realities of statehood and the problematics caused by a long-neglected national economy. Such financial conservatism also demonstrates that the state, while built on the ideals of revolutionary Sinn Féin, was loath actively to support such an explicit recognition of cultural revivalism. The article also illustrates a central problem that would dog the whole lifetime of the Free State: whether or not to champion traditionalism in the face of cultural and political modernism.
Soviet Sport and Transnational Mass Culture in the 1930s
Authors: Keys Barbara
Published: July 2003

As an international system of competitive, achievement-oriented sport developed into one of the interwar period's most potent carriers of transnational mass culture, the Soviet Union initially chose not to participate. Ideologically hostile toward capitalist internationalism and suspicious of international cultural influences, the Soviet regime instead attempted to create an alternative international system of `proletarian sport' that eschewed record-seeking and individualism. In the 1930s, however, the political benefits of participation in `capitalist' sport (including the opportunity to influence foreign public opinion and to project images of national power) drew the Soviet Union into participation. Although `capitalist' sport was modified in the Soviet context, a reciprocal `sportification' of Soviet physical culture also occurred, as the process of cultural transfer embedded the Soviet Union in transnational cultural flows that sometimes served to subvert Soviet ideology.
Icons of Liberty or Objects of Desire? American Women Olympians and the Politics of Consumption
Authors: Dyreson Mark
Published: July 2003

The 1920s witnessed both an explosion in sporting opportunities and the first exercise of national suffrage for women in the USA. Some commentators, including several women athletes, claimed that women's incursions into the formerly male domains of highly-competitive athletics were even more important than their hard-fought victory which won them the right to vote. Female athletes were hailed as symbols of the `new woman's' political and social liberties. For the first time in American history, women's athletic performances became part of the struggle to define national identity in international sporting arenas. At the same time the media treated women athletes as sexually-appealing commodities and marketed them to mass audiences. In the burgeoning American consumer culture of the early twentieth century, female athletic stars served paradoxically as emblems of new political freedoms and traditional objects of male desires.
`Turned into Taxpayers': Paraplegia, Rehabilitation and Sport at Stoke Mandeville, 1944-56
Authors: Anderson Julie
Published: July 2003

This article explores the links between rehabilitation practices and the aims of successive postwar British governments between 1944 and 1956. It focuses on the work at Stoke Mandeville Hospital in Aylesbury where rehabilitation centred around sporting activity. While games and sport were important at the hospital, they were seen more as a means to an end outside the gates of the institution. The focus for the state was labour and the article argues that the process of rehabilitation through sport was informed by the demands of central government and the desire to reduce the economic burden of numbers of permanently disabled people.
Hitting Apartheid for Six? The Politics of the South African Sports Boycott
Authors: Booth Douglas
Published: July 2003

In the political struggle against apartheid, protesters and opponents of the South African regime adopted a range of strategies and tactics, including a boycott of sport. This article analyses and evaluates the effectiveness and significance of the sports boycott that passed through various stages with respect to objectives and goals. Boycotters initially sought to deracialize South African sport. By the early 1980s, the sports boycott was one of a raft of resistance strategies aimed at forcing the South African regime to abandon apartheid; by the end of that decade, supporters advocated the boycott as a strategy to build non-racial democratic sporting structures that would assist the transition to a post-apartheid society. While proponents insist that the boycott contributed directly to the abandonment of apartheid, this article suggests that the contribution was more indirect, that the deracialization of sport in the mid-1970s (under the impetus of the boycott) may have had a greater impact on the discarding of racial ideology in South Africa than commentators have thus far admitted.
Evidence-Based Guidelines for Treating Bipolar Disorder: Recommendations from the British Association for Psychopharmacology
Authors: Goodwin G. M.
Published: July 2003

The British Association for Psychopharmacology guidelines specify the scope and target of treatment for bipolar disorder. They are based explicitly on the available evidence and presented, similar to previous Clinical Practice guidelines, as recommendations to aid clinical decision-making for practitioners. They may also serve as a source of information for patients and carers. The recommendations are presented together with a more detailed review of the available evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from participants and interested parties. The strength of supporting evidence was rated. The guidelines cover the diagnosis of bipolar disorder, clinical management and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment.
GABA-Ergic Drugs: Exit Stage Left, Enter Stage Right
Authors: Ashton Heather , Young Allan H.
Published: July 2003

Drugs that enhance γ-aminobutyric acid (GABA) activity by interacting at post-synaptic GABAA receptors have long been used as hypnotics, sedatives, tranquillizers and anticonvulsants. In this category, benzodiazepines rapidly gained pride of place, replacing barbiturates and becoming the most commonly prescribed of all drugs in the Western world in the 1970s. However, problems such as dependence and withdrawal reactions became apparent in the 1980s, and it seemed that the usefulness of drugs with this mode of action was limited. Recently, focus has shifted to a new group of drugs with GABA-ergic actions mediated through various mechanisms not directly involving the GABAA receptor. These drugs include gabapentin, vigabatrin, tiagabine, lamotrigine, pregabalin and others. Although originally developed as anticonvulsants for epilepsy, they appear to have wider applications for use in affective disorders, especially bipolar depression, anxiety disorders and pain conditions. The current information on the properties and therapeutic potential of this new generation of GABA-ergic drugs is reviewed. It remains to be seen whether long-term use leads to tolerance, dependence and withdrawal or discontinuation reactions.
The Effect of Emotional Stress on the Primary Humoral Immunity of Rats
Authors: Shao Feng , Lin Wenjuan , Wang Weiwen , Washington Welton Craig , Zheng Li
Published: July 2003

The effect of exposure to emotional stress on humoral immune function after injection with ovalbumin, a novel antigen, was studied in adult male Wistar rats. Emotional stress was induced by randomly giving empty water bottles to rats trained to drink water at set times. The results showed that emotional stress induced the decrease in spleen weight and specific immunoglobulin G antibody level to ovalbumin, and increased levels of epinephrine, norepinephrine and corticosterone. A decrease of antibody levels correlated negatively with an increase in plasma norepinephrine levels. These findings suggest that emotional stress can modulate immune function, and that sympathetic nervous system may be involved in this immunomodulation.
Effects of Gabapentin on Anxiety Induced by Simulated Public Speaking
Authors: Quevedo Joao , Barichello Tatiana , Izquierdo Ivan , Vianna Monica R. M. , de-Paris Fernanda , Busnello Joao V. , Kapczinski Flavio , Sant'Anna Marcia K.
Published: July 2003

The effects of gabapentin, 400 mg and 800 mg, on anxiety induced by simulated public speaking (SPS) were investigated. Thirty-two normal male volunteers (aged 17-30 years) had their anxiety and mood evaluated by self-scales [Visual Analogue Mood Scale (VAMS) and Profile of Mood State (POMS)] during the SPS procedure. Physiological measures (heart rate and blood pressure) were taken. Treatment with gabapentin at 800 mg attenuated the anxiety of subjects that had a decrease on the VAMS item calm-excite. In addition, volunteers that received gabapentin at 400 mg and 800 mg showed a decrease in the hostility score in POMS. Our results suggest, in agreement with other studies, an anxiolytic potential to gabapentin.
Reboxetine Promotes Social Bonding in Healthy Volunteers
Authors: Tse Wai S. , Bond Alyson J.
Published: July 2003

Reboxetine is a novel antidepressant with a selective action on noradrenaline. In addition to its efficacy in depression, it has been found to improve social adaptation. The objective of this study was to assess the specific social behavioural effects of reboxetine which might be associated with social adaptation. Ten pairs of healthy volunteers took part in a randomized double-blind, crossover study of 2 weeks treatment with reboxetine (4 mg b.d.) and placebo with a 2-week washout period. In each pair, one person (subject) took the tablets and the other (flatmate) received no treatment. On the last day of each treatment period, the subjects socially interacted with a stranger (a confederate behaving as a responsive person) in a stranger-dyadic social interaction paradigm. After the interaction, subjects played the Mixed-Motive game, which measures cooperative behaviour and communication, with the confederate. Subjects read a short story before and after the social interaction. The flatmates evaluated the social behaviour of the subjects before and at the end of the two treatment periods. On reboxetine, the subjects were rated to be significantly more agreeable and cooperative (passive participant) and less submissive by their flatmates. They showed significantly less eye contact with the confederate in the social interaction paradigm and gave significantly fewer helplessness messages during the game. They spoke faster on the reading task after the social interaction. This study provides evidence that reboxetine increases cooperative social behaviour and increases social drive, which might be important for social adaptation.
REM Sleep Effects as a Biomarker for the Effects of Antidepressants in Healthy Volunteers
Authors: Rijnbeek B. , de Visser S. J. , Franson K. L. , Cohen A. F. , van Gerven J. M. A.
Published: July 2003

The potential use of rapid eye movement (REM) sleep effects as a biomarker for the therapeutic effects of antidepressants in healthy volunteers is reviewed. A literature search was performed to select studies investigating the effects of antidepressants on REM sleep. To assess the specificity of REM sleep effects as a biomarker, the effects of other central nervous system drugs on REM sleep were also investigated. A significant REM sleep reduction was shown for 16 of 21 investigated antidepressants after single-dose (mean reduction 34.1%) and for 11/13 drugs after multiple-dose administration (mean reduction 29.2%). The median increase in REM latency was approximatety 60% after single- or multiple-dose administration. REM sleep effects were linearly normalized to therapeutic doses, by dividing the REM sleep effect by the investigated dose and multiplying by the therapeutic dose. Normalized REM sleep effects were highly variable (range -27.0% to 81.8% for REM sleep; range -17.0% to 266.3% for REM latency) and demonstrated no relationship with relevant pharmacological properties of the investigated drugs. No quantifiable dose-response relationship could be constructed after single and multiple dose administration. REM sleep effects were not specific for antidepressants. Benzodiazepines, for example, caused an average dose normalized REM sleep reduction of 8.7% and a median 8.6% increase of REM latency. This review demonstrates that although REM sleep effects occur with most of the antidepressants, it is by itself of limited value as a biomarker for antidepressant action. The specificity for antidepressants is limited, and it does not show a quantitative dose-response relationship to antidepressant agents. This is at least partly due to the complex relationships between drug pharmacokinetics and the variable time course of REM and other sleep stages throughout the night. Models that take these complex relationships into account may provide more comprehensive and quantifiable results.
Menstrual Cycle Effects on Hypothalamic Dopamine Receptor Function in Women with a History of Puerperal Bipolar Disorder
Authors: Wieck A. , Davies R. A. , Hirst A. D. , Brown N. , Papadopoulos A. , Marks M. N. , Checkley S. A. , Kumar R. C. , Campbell I. C.
Published: July 2003

Neuroendocrine challenge tests of hypothalamic dopamine receptor function in the early postpartum period suggest that the sensitivity of these receptors is increased in women with a history of bipolar disorder after childbirth. We tested the hypothesis that, in women predisposed to bipolar disorder in the puerperium, hypothalamic dopamine receptor function is more sensitive to changes in circulating ovarian hormone concentrations than in women without such histories. Eight fully recovered and drug-free women who had had at least one episode of bipolar illness following childbirth were compared with nine normal controls. Growth hormone (GH) responses to apomorphine (APO 0.005 mg s.c.) were measured in the early follicular phase, when plasma concentrations of ovarian hormones are low, and in the mid-luteal phase, when they are relatively high. The recovered bipolar subjects and the controls did not differ from each other in their follicular and midluteal oestrogen and progesterone concentrations. In the midluteal phase, both groups had increased oestrogen and progesterone levels. The recovered bipolar subjects did not differ from controls in baseline concentrations of GH in either of the menstrual phases. The APO-GH responses of the two groups did not differ in the follicular phase, but in the midluteal phase, when female sex steroids are relatively increased, the recovered group had significantly enhanced APO-GH responses [MANOVA for repeated measures: (i) area under the curve, group by phase effect: p < 0.04; (ii) GH peak rise after APO, group by phase effect: p < 0.056] and the responses were not related to concurrent measures of mood. The results of this small study of women predisposed to bipolar disorder in the puerperium shows an increased dopaminergic receptor sensitivity in the luteal phase of the menstrual cycle. It suggests that their dopaminergic systems have increased sensitivity to changes in circulating female sex steroids. This may be aetiologically relevant to the pathogenesis of puerperal bipolar disorder.
Differential Effect of Quetiapine on Depressive Symptoms in Patients with Partially Responsive Schizophrenia
Authors: Emsley Robin A. , Buckley Peter , Jones A. Martin , Greenwood Michael R.
Published: July 2003

While atypical antipsychotics appear to be effective in reducing depressive symptoms in the acute phase of schizophrenia, little is known about their efficacy in patients with ongoing symptoms. The present study assessed whether quetiapine (Seroquel®) is more effective than haloperidol in treating depressive symptoms in patients with persistent positive symptoms, and investigated whether this effect is independent, or secondary to, reductions in other symptoms such as positive, negative or extrapyramidal symptoms. Patients with schizophrenia and a history of partial refractoriness to conventional antipsychotics who had not responded to 4 weeks of fluphenazine treatment (20 mg/day) were randomized to receive either quetiapine (600 mg/day) or haloperidol (20 mg/day) for a further 8 weeks. Change in the Positive and Negative Syndrome Scale depression factor score from baseline to endpoint was calculated and path analyses were performed on data from 269 patients. Quetiapine produced a greater reduction in depressive scores than haloperidol (-1.60 versus -0.54; p = 0.006). The path analyses indicated that this was a direct effect on depressive symptoms. These findings extend the evidence for an antidepressant effect for the novel antipsychotics in schizophrenia, and suggest that this is not limited to acutely psychotic patients.
The Relationship between Serotonergic Function and the Psychopathy Checklist: Screening Version
Authors: Dolan Mairead C. , Anderson Ian M.
Published: July 2003

Reduced serotonergic (5-HT) neurotransmission has been reported in impulsive and aggressive personality disordered and offender samples. What is not clear is the relationship between 5-HT function and the North American construct of psychopathy assessed using the Psychopathy Checklist and its derivatives, which emphasizes the core interpersonal/affective as well as behavioural components of this syndrome. Fifty-one DSM-III-R personality disordered offenders who had a dynamic assessment of 5-HT function (prolactin response to 30 mg d-fenfluramine challenge) were rated on the Psychopathy Checklist: Screening Version based on interview and file data. The Psychopathy Checklist: Screening Version (PCL: SV) mean score in the sample was similar to other reports in European forensic samples. A three-factor structure best explained the PCL: SV data: arrogant/deceitful, callous-unemotional and impulsive-antisocial behaviour factors. 5-HT function did not correlate with psychopathy as a unidimensional phenomenon. The impulsive-antisocial component correlates negatively with 5-HT function while the arrogant/deceitful component correlates positively with 5-HT. In line with previous research findings, impulsive-antisocial conduct shows an inverse relationship with 5-HT function. Arrogant/deceitful traits correlate positively with 5-HT function and may be an adaptive component of psychopathy.
Patterns of Antipsychotic and Anticholinergic Prescribing for Hospital Inpatients
Authors: Paton Carol , Duffett Richard , Harrington Maria , Lelliott Paul , Okocha Chike , Sensky Tom
Published: July 2003

The development of atypical antipsychotics has not only given the prescriber more options, but also increased the complexity of decision making. We examined current prescribing practice for antipsychotic and anticholinergic drugs, which involved a 1-day census of all antipsychotic and anticholinergic drugs prescribed for 4191 inpatients in 49 UK mental health services. Eighty-five percent of inpatients were prescribed antipsychotics, 48% of whom were prescribed more than one. Atypical antipsychotics were widely prescribed and combined with typicals in over 60% of cases. Large doses of antipsychotics were frequently prescribed `as required'. The dose administered was always much less than the dose prescribed and nothing at all was administered against 79% of prescriptions. Antipsychotic prescribing often deviates from recommended practice. Nursing staff have considerable discretion to administer large doses of antipsychotics on an `as required' basis.
The Pharmacological Treatment of Bipolar Affective Disorder: Practice Is Improving but Could Still be Better
Authors: Lloyd Adrian J. , Harrison C. Louise , Ferrier I. Nicol , Young Allan H.
Published: July 2003

Pharmacological treatment of bipolar affective disorder was examined by case note review of 120 subjects under the care of four hospitals in the North-East of England and compared with that recommended in published consensus opinions and also with the findings of previous surveys. Although the only comparison available is with other geographical regions, it appears that lithium use has remained relatively constant in recent years (53% in this sample). The use of anticonvulsants (62%) was greater than in previous studies, as was use of mood stabilizers in combination (37% overall, 53% in rapid cycling subjects). Antidepressant use was found in 23% of subjects. Eleven percent of subjects taking antidepressants were not prescribed a mood stabilizer and 43% of antidepressants prescribed were tricyclics, possibly increasing the risk of switching to mania. Fifteen percent had no mood stabilizer and antipsychotic use was almost equally split between typical and atypical drugs. Practice in the population studied is nearer than treatment described in previous work to that suggested in the literature. This may result from either, or most probably a combination of, the local availability of a specialist mood disorder service and evolution of overall prescribing practice. However, it still falls short in a number of respects of such recommendations as exist and this requires further examination and monitoring.
Serum Clozapine Levels: A Review of Their Clinical Utility
Authors: Greenwood-Smith Catherine , Lubman Dan I. , Castle David J.
Published: July 2003

Therapeutic drug monitoring (TDM) is frequently utilized in the treatment of psychiatric conditions, but its clinical application concerning the use of clozapine is unclear. We present three case reports of patients taking clozapine, review the relevant literature, and propose guidelines to aid the clinical use of TDM of clozapine. Due to its complex metabolism, there are significant inter- and intra-individual variations in clozapine serum levels, for a given dose. However, the range of serum levels that corresponds with toxicity remains unclear. Although central nervous system side-effects may correlate with serum level, many adverse effects of clozapine appear to be unrelated, including haematological and cardiac events. There are numerous clinically significant interactions between clozapine and other substances, including prescribed medications, nicotine and caffeine. TDM of clozapine may be of clinical value in certain situations, such as poor clinical response; signs of toxicity; onset of seizures; changes in concurrent medication, caffeine or nicotine; liver disease; and suspected non-compliance. The current literature does not support the routine testing of serum clozapine levels in everyday clinical practice.
Levetiracetam in the Treatment of Rapid Cycling Bipolar Disorder
Authors: Bräunig Peter , Krüger Stephanie
Published: July 2003

Levetiracetam (LEV) is a novel anticonvulsant that is currently investigated in bipolar disorder. It may be useful in the treatment of refractory and complicated cases, in which conventional mood stabilizers are not effective. We report two cases of rapid cycling bipolar disorder in which the add-on of LEV to a conventional treatment regimen improved symptoms of depression, as well as those of mania/mixed mania, and disrupted the severe rapid cycling pattern.
Globalizing Development in Tanzania
Authors: Green Maia
Published: July 2003

This article explores the social processes through which projects and programmes in international development become standardized in the context of global social policies. The striking similarity in development projects in diverse settings occurs despite the introduction of participatory planning methodologies which are intended to constitute the mechanism through which beneficiaries can become involved in the design and implementations of interventions which affect them. An anthropological account of stakeholder workshops in the development sector of Tanzania shows how the workshops facilitated by those defining themselves as development professionals create the social space of projects as envisioned in documentation and how the management models which inform development planning create development, not as failure as other anthropological accounts would have it, but as success in relation to the achievement of their planned objectives.
Scarcity and the Emergence of Fundamentalist Ecology
Authors: Shantz Jeffrey
Published: July 2003

This article discusses the emergence of fundamentalist environmentalism in the mid-1980s. Fundamentalist versions of ecology, exemplified most notably by the theory of `deep ecology' and the social movement Earth First!, have mistakenly proposed social scarcity as a means to overcome natural scarcity. This confusion has led fundamentalist ecologists away from an analysis of the power relations which underlie social inequality and the destruction of nature. Instead, fundamentalist ecologists offer neo-Malthusian and anti-worker perspectives that shift responsibility for ecological crises away from capitalist structures of inequality and towards personal consumption practices. Failure to understand the materiality of ecological destruction and its connection to social relations has made it difficult for radical ecology to build alliances with other social movements.
The Concept of Europe as an Idée-force
Authors: Llobera Josep R.
Published: July 2003

This article considers the formation of the European Union at the level of ideas over a long period of time. The title responds to Fouillée's concept of idée-force as applied to the development of the concept of Europe. First, Edgar Morin's theory of Europe is presented. The author emphasizes the ambiguity of the concept. The idea of two models of Europe has existed for a long time. The next stage is to show the different concepts of Europe that existed in the 1940s and how, in spite of optimistic visions of a European future, the creation of unity was a rather slow process, focusing successively on the economic, legal and political dimensions, but only superficially on the cultural level. The following step shows that the proposition enunciated by Cris Shore - that the European Union is becoming a superstate and a supernation - is incorrect; by examining the European audio-visual dimension one can easily conclude that the pace of unification is extremely slow. Finally, it is suggested that national and European identity are not the same type of discursive practice.
NGO Legitimacy
Authors: Lister Sarah
Published: July 2003

The legitimacy of non-governmental organizations (NGOs) is poorly theorized in development studies literature, where it is usually seen as dependent on accountability, performance and representativeness. This `technical' approach masks deeper questions about legitimacy - for whom, for what, and how it is created. This article applies an institutional perspective from organizational theory to the analysis of NGOs. The approach emphasizes the multifaceted nature of legitimacy and the effect of organizational environments and dominant cognitive models on organizational forms and activities. The article presents legitimacy as socially constructed and raises questions about issues of power in the attribution of legitimacy. The article concludes by considering how analysis may be taken beyond institutional approaches and the contribution that can be made by anthropological perspectives, particularly an understanding of the role of discourses.
Citizens of Towns, Citizens of Nations
Authors: Stack Trevor
Published: July 2003

This article finds a disjuncture between the practices associated with being a citizen of a town and those associated with being a citizen of a nation. The practices on which it focuses are the knowing of a town's history and the knowing of a nation's history. It looks at how townspeople in west Mexico talked about the history of their town, Tapalpa, in relation to how they talked about Mexico's history. In principle, the knowing of Tapalpa's history was linked to the knowing of Mexico's history. In practice, there was a disjuncture such that townspeople could aspire only to a mimetic role in the knowing of Mexico's history. The article concludes by suggesting that this was typical of the relation between being a citizen of Tapalpa and being a citizen of Mexico.
Beat Mexico
Authors: Campbell Howard
Published: July 2003

The literary turn in anthropology has provoked an examination of the textual bases of ethnography and sought alternative models for ethnographic writing in works of fiction. This article contributes to this literature through an analysis of the works and lives in Mexico of members of the Beat generation, mainly Jack Kerouac, William Burroughs and Hal Chase. Comparing Bohemia and anthropology, I discuss the limitations and strengths of Beat writings about Mexico. I suggest that, despite many flaws, Bohemia continues to be a rich source of ideas for ethnography, both as fieldwork and literature.
“If You're Light You're Alright”
Authors: HUNTER MARGARET L.
Published: July 2003

This article uses two national survey data sets to analyze the effects of skin color on life outcomes for African American and Mexican American women. Using a historical framework of European colonialism and slavery, this article explains how skin color hierarchies were established and are maintained. The concept of social capital is used to explain how beauty, defined through light skin, works as capital and as a stratifying agent for women on the dimensions of education, income, and spousal status. The analysis shows that light skin predicts higher educational attainment for both groups of women. Light skin directly predicts higher personal earnings for African American women and indirectly affects personal earnings for Mexican American women. Light skin predicts higher spousal status for African American women but not for Mexican American women.
Men's Talk About “Women's Matters”
Authors: AGADJANIAN VICTOR
Published: July 2003

The place of men in reproductive and contraceptive changes and the role of informal social interaction in these processes have become central themes in recent research on fertility change in sub-Saharan Africa and other developing regions. These two themes, however, have been treated separately in the literature, and this study bridges them by examining men's informal communication on family planning matters through a gender lens. This analysis, based on qualitative data collected in Greater Maputo, Mozambique, indicates that although men's communication on these matters is limited in comparison to women's communication, it nonetheless plays an important role in the formation of men's reproductive and contraceptive attitudes and preferences. Gender ideology emerges as a powerful delimiter of men's communication circles and of the information transmitted in those circles. The author argues that gender barriers in peer communication affect individuals' perceptions of reproductive and contraceptive matters and their corresponding preferences and decisions.
Gender and the Politics of Needs
Authors: NOONAN RITA K.
Published: July 2003

This study examines the ways in which gendered definitions of social provision in Costa Rica have created gaps in national health care programs that women's organizations are currently (and successfully) addressing. More specifically, I highlight how women's organizations are key actors in the politics of needs interpretation, wherein definitions of health needs are contested by policy makers, doctors, and women themselves. I argue that women's health organizations have begun to broaden and politicize health needs by including domestic violence in national debates. Using interviews and organizational histories of six grassroots health organizations, I find that these groups have been successful, in large part, because they framed their concerns in ways that were convincing to politicians and national health care bureaucrats.
Smiling Women and Fighting Men
Authors: FODOR ÉVA
Published: July 2003

The gendered assumptions embedded in the construction of the rational individual are well established in Western feminist thought but inapplicable to describe societies operating on different principles, such as East European state socialism. This article identifies the communist subject as the building block of communist political ideology and argues that this formulation was no less male biased than its counterpart, the rational individual under liberal capitalism. In state socialist Hungary this male bias came to be expressed differently: Women were integrated into society through membership in a social group perceived as relatively homogeneous regarding interests and obligations and with gender-specific qualities and privileges. These qualities were considered inferior to men's since women—because of household responsibilities—were not capable of total devotion to the communist party. The author explores this construction of the female communist subject through a content analysis of classified materials from the archives of the Hungarian Socialist Workers' Party.
Race Discourses and Antiracist Practices in a Local Women's Movement
Authors: ZAJICEK ANNA M.
Published: July 2003

Increasingly, feminist scholars examine how the stability of racial hierarchies is maintained through discourse. This article explores the importance of race discourse in the construction of white women's accounts explaining their race politics. Specifically, the author examines the connections between race discourse and politics as they emerged in interviews with white women involved in a local women's movement between 1972 and 1999. The interviews revealed five discursive strategies women used to talk about race and the movement's antiracist practices. In addition, one of the most important contributions of this study is the evidence it provides of the relationship between the discursive construction of an “invisible white self” and the broader structure of power relations.
Building power asymmetries in girls' interaction
Authors: Harness Goodwin Marjorie
Published: July 2003

This study, based on three years of ethnographic research (and over 60 hours of videotaped interaction) in a Southern California elementary school, investigates how enduring asymmetrical relationships among females in a multicultural peer group are built in moment-to-moment interaction. By exploring how relations of power, based on forms of opposition, bullying, and exclusion, are both built interactively and commented upon in female groups, I call into question the generalizability of accounts of female same-sex talk which focus exclusively on cooperative or polite interactive practices. I employ both ethnographically grounded observations and the methodology of conversation analysis to analyze practices for building power asymmetry in naturally occurring same-sex female talk during play and at lunch.
Legal institutions, nonspeaking recipiency and participants' orientations
Authors: Ehrlich Susan
Published: July 2003

In this article, I explore the question of what constitutes a participant's orientation to gender within conversation analysis (CA), suggesting that CA's notion of participant orientation may be too narrow and restrictive to adequately capture the significance of gender as an organizing principle of institutions. The data that I analyze are drawn from legal settings, specifically a Canadian criminal trial dealing with sexual assault. Significant to an investigation of talk-in-interaction in such contexts is the fact that participants' orientations to the talk are not only discernible in the talk's local sequential properties but also in the (nonlocal) assessments and judgments of the nonspeaking recipients, the jury or judge. Indeed, a turn-by-turn analysis of these proceedings shows that conversational participants were not explicitly orienting to gender, but rather were orienting to the type of trial they were involved in (i.e., a sexual assault trial) and to the positioning of the accused as a possible agent of sexual acts of aggression. Nonetheless, orientations to or understandings of gender were made explicit in the judge's decision and thus seemed extremely significant to the outcome of the court's proceedings.
Gender orientations to outward appearance in Japanese conversation: a study in grammar and interaction
Authors: Tanaka Hiroko , Fukushima Mihoko
Published: July 2003

This article employs `grammar and interaction' — a new strand of conversation analysis — to contribute to the debate concerning the utility of conversation analysis for feminist research by exploring methods for making gender orientations accessible for analysis. We examine mixed-sex conversations in Japanese, in which participants discuss each other's outward appearance in general, and body weight in particular. We propose that certain `breaches' of conversational organization can usefully be explained in terms of a possibly competing, normative `gender constraint' involving orientations towards a man's expanded rights to topicalize, assess, demand and dictate standards of women's outward appearance. It is further suggested that this constraint may cut across a plethora of rudimentary organizations of conversation. The proposed constraint is shown to be oriented to or resisted by participants through the contingent mobilization of grammatical, prosodic and semantic resources to constitute themselves and others as `men' or `women' vis-à-vis this constraint.
Towards understanding gender and talk-in-interaction
Authors: Weatheral Ann
Published: July 2003

Feminist language researchers typically assume that gender is relevant to any interaction. Conversation analysis offers an interesting challenge for feminists to show how and that the pervasiveness of gender is achieved in talk-in-interaction. The aim of this article is to make a step towards understanding the interactional mechanisms underling the omnirelevance of gender in daily life. The present study draws upon the practices and principles of conversation analysis, particularly the notions of repair and membership categorization devices, to examine recordings of children's interactions. Evidence that supports the claim that the organization of repair may be implicated in the (re)production of gender is presented.
What can conversation analysis contribute to feminist methodology? Putting reflexivity into practice
Authors: Speer Susan A.
Published: July 2003

This article uses conversation analysis to explore an issue central to the design and delivery of feminist research: the relationship between researcher and researched, and specifically, the impact of the former on the latter. A guiding principle of much feminist research is that it should be respondent-centred, allowing participants to set the agenda and define what is important in their own terms. Though not advocated as an explicitly feminist method, one technique deemed to be ideally suited to this end is the use of prompts as stimulus materials. In this article, I revisit data from my own research in which picture prompts were used to derive gender talk. Rather than treat prompts as facilitators of talk in which the respondents set the priorities, I demonstrate how the activity of showing a prompt itself requires work on the part of the moderator. I argue that even where the researcher tries to minimize her impact on the data collection process — as in this case through the use of prompts — that she is still influential and the data is thereby always an interactional product. Although many feminists acknowledge this, and advocate the importance of a reflexive orientation to our data collection practices, I suggest that most feminists do not, as yet, possess the analytic skills to do this reflexivity well. I consider the implications of this analysis for the way feminists and other researchers derive and analyse gender talk, and conceive of the relationship between the researcher and those researched.