bluuebunny/crossref_metadata_2025 huggingface dataset:
Insolubilia and the Fallacy Secundum Quid et Simpliciter
Authors: Read Stephen , Novaes Catarina Dutilh
Published: May 2008

Thomas Bradwardine makes much of the fact that his solution to the insolubles is in accordance with Aristotle's diagnosis of the fallacy in the Liar paradox as that of secundum quid et simpliciter. Paul Spade, however, claims that this invocation of Aristotle by Bradwardine is purely "honorary" in order to confer specious respectability on his analysis and give it a spurious weight of authority. Our answer to Spade follows Bradwardine's response to the problem of revenge: any proposition saying of itself that it is false says more than does Bradwardine's proposition saying of it that it is false, and so follows from that other proposition only in respect of part of what it says, and not simpliciter.
The Mother Tongue and Bilingual Hysteria: Translation Metaphors in Tsitsi Dangarembga's Nervous Conditions
Authors: Thompson Katrina Daly
Published: May 2008

Approaching Tsitsi Dangarembga's 1988 novel Nervous Conditions as an extended metaphor of translation, the article analyses the complementary relationship between the two female cousins, Nyasha and Tambu, by examining the complex ways in which they situate themselves in relation to language and culture. The comparison between Nyasha and Tambu is anchored in translation theory and psychoanalysis, while highlighting the Shona linguistic undercurrent present in the text of the novel. In examining Tambu, it pursues the question of translation (both literal and figurative) and the parallels between the female subject's relation to language, on the one hand, and to the maternal, on the other. Nyasha's relationship to language, on the other hand, is read through psychoanalytic theories of polylingualism: her inability to locate her own identity with regards to language and culture eventually leads to anorexic hysteria.
Claire Harris's “Where the Sky Is a Pitiful Tent”: How Two Women Respond after Witnessing Political Torture
Authors: Blumenthal Anna S.
Published: May 2008

In her long poem “Where the Sky Is a Pitiful Tent”, Claire Harris juxtaposes quoted prose passages from I, Rigoberta Menchu to an imagined account, in poetry, of a woman's loss by murder of her rebel husband. Although Harris's topic in “Sky” is a dominant group's use of torture to control a resistant victimized group, the poet is primarily interested in the effects of such brutality on the rhetorical choices made by the two victimized women speakers, each of whom is recovering her voice in the aftermath of traumatic experience. In her two speakers Harris dramatizes the contrasting ways of knowing and speaking that Belenky, Clinchy, Goldberger and Tarule in Women's Ways of Knowing identify as “separate knowing” and “connected knowing”. They define the first of these approaches as “detached,” “public” and “disinterested”, the second as personal, “empathic”, “imaginative” and emotionally aware; both perceptual methods correspond to contrasting rhetorical purposes and methods. Harris shows that though each speaker recovers an authoritative voice, each voice reveals both surprising strengths and rhetorical effectiveness as well as a tendency for omissions and distortions resulting from self-protective instincts and from the limitations intrinsic to particular genres. Irony and paradox abound, as Harris dramatizes her two speakers' isolation as well as their mutual dependence: full awareness requires rhetorical and generic inclusiveness.
Croyances et transcendances: variations en modes mineurs
Authors: Lamine Anne-Sophie
Published: May 2008

L'auteure discute du traitement de la croyance dans les écrits de trois auteurs: Albert Piette, Thomas Luckmann et Georg Simmel, en les confrontant à diverses études empiriques qui font apparaître des paradoxes sur l'intensité et la spécificité des croyances religieuses. Elle montre comment leurs approches conceptuelles permettent de prendre en compte la croyance comme modalité choisie, à la fois importante et partielle, et la continuité entre croyances religieuses et croyances non-religieuses.
Débats autour de la sécularisation, la "guerre des genres'' et le clivage entre qualitatif et quantitatif
Authors: Stolz Jörg
Published: May 2008

Les trois contributions de Pollack, Woodhead et Lamine proposent, chacune à leur manière, un état des lieux original sur la question: Pollack présente et confronte la théorie de l'individualisation à la théorie du marché et de la sécularisation. Woodhead, quant à elle, propose une théorie de la sécularisation basée sur une perspective de genre et Lamine, enfin, se focalise sur les complexités de la micro-croyance. L'auteur évalue les points forts et les points faibles de ces trois approches. De façon intéressante, on peut regarder ces trois auteurs comme des représentants de trois paradigmes très différents (et partiellement en conflit) sur le religieux et la sécularisation. L'auteur ouvre, en conclusion, une discussion sur une possible compatibilité et intégration de ces paradigmes entre eux.
La vitalité religieuse contemporaine: entre régulation des corps et réappropriation de l'espace public
Authors: Bastian Jean-Pierre
Published: May 2008

Dans la lignée de Foucault, L. Segato analyse les vitalités religieuses contemporaines comme un mode de régulation des corps par une dynamique de concurrence entre organisations religieuses et Etat dans le contexte de la mondialisation. Par ailleurs, M. Koenig privilégie le processus d'intégration européenne pour avancer l'idée que les modalités juridiques européennes redonnent aux acteurs religieux une légitimation dans l'espace public qui leur accorde une nouvelle vitalité. En critiquant ces deux perspectives, l'auteur propose de situer la vitalité religieuse contemporaine dans la capacité de la religion à créer des sujets, c'est-à-dire des acteurs collectifs qui émergent à l'insu des régulations juridiques et politiques nationales, aussi bien en Europe qu'aux périphéries de l'Occident.
On the Shifting Nature of Religion during the Ongoing Post-Communist Transformation in Russia, Belarus and Ukraine
Authors: Titarenko Larissa
Published: May 2008

The author discusses the issues of religiosity in Belarus, Ukraine and especially Russia raised by Irena Borowik in her articles in Social Compass: the revival of religiosity after the breakdown of the Soviet Union, the mixed nature of contemporary beliefs and religious practices among the post-Soviet population, and specific features of the Russian Orthodox Church, its relationship with the state and its current problems. The author combines empirical data on religiosity in Russia, Belarus and Ukraine with the particular historical circumstances of this region that made it possible to apply the theoretical framework of such theories as post-communist trauma, modernization and multiple modernities.
Secularization as Conflict
Authors: Wohlrab-Sahr Monika , Schmidt-Lux Thomas , Karstein Uta
Published: May 2008

With reference to the religious and ideological changes in the GDR we opt for a specific approach to the analysis of secularization processes that goes beyond the conceptualization of the East German secularization process as mere repression. Based on research among East German families, our argument is that an important element of this process was the successful introduction of an interpretational frame that constructs a non-reconcilable conflict between politics and religion, as well as between science and religion. Our hypothesis is that the success of the secularization process in the GDR is closely interrelated with this conflictive framework. Our data indicate three levels of this conflict: about membership, world interpretation and ethics. These conflicts did not remain on the level of repression alone, but acquired subjective plausibility for much of the population. Consequently our approach is based on a general theory of conflict; it is historically grounded; and it takes its starting point from the perspectives of laypersons in the religious-ideological field.
Closing Ranks: Religion, Society and Politics Today
Authors: Segato Rita Laura
Published: May 2008

The consequences of identity politics in patterning religious experience and affiliation today, described here as an aspect of a new territoriality, are vast in many fields. The functional relation existing between a new territoriality defined by network, biopolitics as a form of control and the spectacularization (i.e., the visible nature) of identities greatly affects the field of religion today. In this new territorial environment, networks suffocate internal dissidence on doctrinal and theological matters, and in facing the outside world they stress their unity by means of the management of bodies, placing a premium on exterior signs of belonging.
Mapping Urban Poverty for Local Governance in an Indian Mega-City: The Case of Delhi
Authors: Baud Isa , Sridharan N. , Pfeffer Karin
Published: May 2008

The article maps urban poverty, using the `livelihoods assets framework' to develop a new index of multiple deprivation, examining the implications for area and sector targeting by policy-makers. This article deals with the index and the results for Delhi. The study maps: the spatial concentration of poverty; the diversity of deprivation at ward level; whether poverty is concentrated in slums; and correlations between voting patterns and poverty levels. The index uses census data disaggregated to electoral-ward level for multicriteria analysis, through GIS. Results show that hotspots of poverty are diverse in character, but are not concentrated in slum areas, with strong implications for policy-making and poverty studies methodology. These results suggest that the new index allows better insight into poverty with better targeting possibilities for policy-makers.
Building Social Capital in Hong Kong by Institutionalising Participation: Potential and Limitations
Authors: Wong Sam
Published: May 2008

This paper draws on ethnographic research in Hong Kong to question the effectiveness of Elinor Ostrom's `design principles' in providing solutions to social divisions by social capital building and institutionalised participation. It challenges the strategic and instrumental assumptions of human motivations for not adequately considering moral concerns, a sense of commitment and the right way of doing things in social cooperation. The tendency to formalise the process of participation, by authority building, rule enforcement and threat of sanction, plays down the role of informal institutions in mediating modes of interactions. The practices of good governance can undermine the already-limited social capital of poor people. This paper concludes by offering the `agency—institutions—structures' framework in analysing social capital.
The Measurement of Energy Expenditure
Authors: Branson Richard D. , Johannigman Jay A.
Published: May 2008

Proper nutrition support depends upon the clinician's ability to estimate the patient's energy expenditure. The accuracy of estimation is inversely proportional to the severity of the patient's illness. This fact has spurred academic and industry groups to pursue the measurement of energy expenditure. Harris and Benedict used indirect calorimetry to develop their now‐famous equation nearly 100 years ago. The concept of indirect calorimetry is simple; if you know the concentration of inspired gases and expired gases, along with the flow, you can determine the amount of a gas consumed or produced. The complexity and expense of indirect calorimeters suggest that this simple concept is technically challenging. Because we desire to know the energy expenditure of the most critically ill patients, indirect calorimetry is further confounded by the presence of oxygen and mechanical ventilation. This paper will discuss the myriad of variables and obstacles that complicate the measurement of energy expenditure and will suggest methods to avoid or overcome them.
Update on Immunosuppressive Drugs Used in Solid‐Organ Transplantation and Their Nutrition Implications
Authors: McPartland Kenneth J. , Pomposelli James J.
Published: May 2008

The success of solid organ transplantation rests heavily on the major advances in immunosuppressive therapy. The early years of organ transplantation were plagued with high failure rates and frequent eipsodes of acute rejection. With the introduction of improved immunosuppressive agents, successful organ transplantation has become the norm. The emphasis of immunosuppressive therapy has shifted from preventing rejection to balancing acceptable rates of rejection with moderation in adverse effects of the immunosuppressive agents. Among the many possible adverse effects of immunosuppressive therapy is the potential for these agents to affect the nutrition status of the transplant recipient. Given the fact that many patients undergoing transplantation are catabolic and nutritionally vulnerable, it is particularly important for those involved in the care of these patients to be familiar with the nutrition implications of immunosuppressive drugs. In this article, we review the different classes of immunosuppressive medications used in transplantation and emphasize their interactions with the nutrition status of the transplant recipient.
Effectiveness of The Triple P Positive Parenting Program on Behavioral Problems in Children
Authors: de Graaf Ireen , Speetjens Paula , Smit Filip , de Wolff Marianne , Tavecchio Louis
Published: May 2008

The Triple P Positive Parenting Program is a multilevel parenting program to prevent and offer treatment for severe behavioral, emotional, and developmental problems in children. The aim of this meta-analysis is to assess the effectiveness of Triple P Level 4 interventions in the management of behavioral problems in children by pooling the evidence from relevant literature that included Level 4 Triple P interventions. Level 4 intervention is indicated if the child has multiple behavior problems in a variety of settings and there are clear deficits in parenting skills. Results indicate that Level 4 of Triple P interventions reduced disruptive behaviors in children. These improvements were maintained well over time, with further improvements in long-term follow-up. These effects support the widespread adoption and implementation of Triple P that is taking place in an increasing number of countries in quite diverse cultural contexts around the world.
Accuracy of methods to estimate ionized and “corrected” serum calcium concentrations in critically ill multiple trauma patients receiving specialized nutrition support
Authors: Dickerson RN , Alexander KH , Minard G , Croce MA , Brown RO
Published: May 2008

BACKGROUND: The purpose of this study was to determine the accuracy of 22 published methods to estimate serum ionized calcium (iCa) and “corrected” total serum calcium (totCa) concentrations in critically ill, multiple trauma patients. Seven of these formulas estimated iCa and 15 were directed toward predicting a “corrected” totCa. METHODS: Adult patients admitted to the trauma intensive care unit who received specialized nutrition support were consecutively recruited for study. Patients who received blood products, i.v. calcium, or therapeutic doses of heparin within 24 hours before the laboratory measurements or had a history of cancer, bone disease, parathyroid disease, hyperphosphatemia (> or = 6 mg/dL), hyperbilirubinemia (> 3.5 mg/dL), or renal failure requiring dialysis were excluded. The 22 published methods were analyzed for sensitivity, specificity, percentage false negatives, and percentage false positives for predicting hypocalcemia or hypercalcemia. RESULTS: One hundred patients were studied 4.9 +/‐ 3.3 days postinjury and were receiving enteral nutrition (n = 81), parenteral nutrition (n = 18), or both (n = 1) at the time of study. Twenty‐one patients were hypocalcemic (iCa < or = 1.12 mmol/L) and 6 were hypercalcemic (iCa > or = 1.32 mmol/L). The mean sensitivity of the 22 methods for assessing hypocalcemia was 25% +/‐ 32% and the specificity was 90% +/‐ 18%. Although the average percentage of false positives for assessing hypocalcemia was 10% +/‐ 18%, the mean percentage of false negatives was inordinately high at 75% +/‐ 32%. The most common method for determination of “corrected” totCa concentration [“corrected” calcium = totCa + (0.8 x (4‐serum albumin concentration))] had a sensitivity of only 5%. The McLean‐Hastings nomogram method, the most common method for estimating serum iCa concentration, had a sensitivity of 67% but unfortunately also had a significant false‐positive rate of 27%. Serum totCa correlated modestly with iCa (r2 =.334, p <.001). Those patients with a serum albumin < or = 2 g/dL (n = 43) had a significantly higher prevalence of hypocalcemia than those with a higher serum albumin concentration (37% incidence of hypocalcemia vs 10%, respectively, p <.002). CONCLUSIONS: Aberrations in calcium homeostasis are frequent (27%) in postresuscitative critically ill multiple trauma patients. Methods for predicting hypocalcemia lack sensitivity and are often associated with an unacceptable rate of false negatives. Predictive methods for estimating ionized or corrected serum concentrations should not be used. Direct measurement of serum iCa concentration is indicated for assessing calcium status for this population.
Home Parenteral Nutrition Support in Adults: Experience of a Medical Center in Asia
Authors: Wang Ming‐Yang , Wu Ming‐Hsun , Hsieh Der‐Yirng , Lin Lie‐Jane , Lee Po‐Huang , Chen Wei‐Jao , Lin Ming‐Tsan
Published: May 2008

Background: Parenteral nutrition (PN) support is mandatory in patients with gut failure. Short bowel syndrome is a term used for symptoms and pathophysiological disorders brought about by the removal or malfunction of a large portion of the small bowel. Inflammatory bowel disease, vascular disease, and malignancy are the most common causes of short bowel syndrome in adults. There are many complications associated with chronic use of PN. Cholestasis, nutrient deficiency, small bowel bacterial overgrowth, and catheter‐related infections were noted in these patients. Due to the various etiologies, we tried to find the optimal method to manage these patients. Methods: We reviewed all patients over 16 years old, from 1989 to 2002, who required home PN support for at least 30 days. Charts were reviewed to obtain information regarding demographics, nutrition management, outcome, and complications related to PN. Survival was estimated by using the Kaplan‐Meier method. The association of survival with primary disease, length of small bowel, age, and gender was assessed by proportional hazard regression analysis. Results: There were 31 patients who needed home PN support during this period, 14 male and 17 female. The average age was 55 (median age, 53; range, 28–88); the average period of PN administration was 19 months (median, 7; range, 1–115 months). The most common indications for home PN were alimentary tract obstruction and short bowel syndrome. Most deaths were related to their original diseases and catheter‐related sepsis. Malignant diseases were a major indication for home PN (HPN). However, 20% of these patients with incurable diseases lived longer than 1 year. The disease patterns were different from those in western societies. Most patients had malignancies and vascular insults in our series. There was much less inflammatory bowel disease in our patients than in western countries; catheter‐related infections were frequent and caused 25% of mortality. Conclusions: HPN is very important to patients with intestinal failure or who are waiting for recovery from temporal intestine insufficiency. Even in malignant diseases, a significant number of patients survived for> 1 year with treatment of HPN. Most complications related to their underlying diseases and associated infections. Improving patient education and treatment might improve the prognosis of these patients and expand the application of this technique to help more patients with small intestine failure.
Psychological Aspects of Artificial Feeding in Cancer Patients
Authors: Peteet John R. , Medeiros Cynthia , Slavin Leslie , Walsh‐Burke Katherine
Published: May 2008

Anorexia and weight loss are major physical and psychological problems for patients with cancer, and nutritional support has become an increasingly important part of cancer treatment. Reports discussing the psychological aspects of parenteral feeding have emphasized the importance of the nature of the underlying illness, but special problems surrounding the use of artificial feeding in patients with cancer have not been described. Patterns of emotional response to artificial feeding in such patients are most directly influenced by two interacting sets of variables: the diagnosis and prognosis of cancer, and personality characteristics of patients and family members involved. Typically, management problems result when demoralized patients respond to artificial feeding by becoming more passive, when independent patients struggle over artificial feeding in order to maintain a sense of control, or when anxious patients or families express fears about dying in the form of extreme preoccupation with eating and maintaining weight. An understanding of these patterns has specific implications for improving the patient's cooperation and quality of life.
Effect of Nutritional Support on Weaning Patients Off Mechanical Ventilators
Authors: Bassili Hosni R. , Deitel Mervyn
Published: May 2008

The provision of adequate nutritional support to ventilator patients (VP), although important, is still overlooked in many hospitals. All VP in our intensive care unit from July 1977 to June 1979 were reviewed; only those who were on ventilators for 3 or more days (range 3–25) were included, but those ventilated after cardiac arrest with possible brainstem damage were excluded. Group A included 33 VP (22 surgical, 11 medical) who received a protein‐free, energy‐deficient routine IV diet (1650 kJ/day as dextrose in water or electrolyte solution); group B had 14 VP who received nutritional support as TPN or nasogastric tube feeding (8300–12600 kJ/day with optimum nitrogen). In group A, 18 (54.5%) of the 33 VP were able to be weaned off the ventilator compared to 13 (92.8%) of the 14 VP in group B (p < 0.05). Of medical VP, 10 (90.9%) of 11 in group A were weaned compared with 3 (100%) of 3 in group B (not significant). However, of surgical VP, only 8 (36.3%) of 22 in group A were able to be weaned off mechanical ventilation compared with 10 (90.9%) of 11 in group B (p < 0.01); this was likely highly significant in surgical patients because of greater metabolic demand for wound healing and more severe sepsis.
Primary Taste Thresholds in Children with Leukemia Undergoing Marrow Transplantation
Authors: Barale Karen , Aker Saundra N. , Martinsen Charlene S.
Published: May 2008

Taste threshold for the four basic tastes were determined to assess taste impairment in 11 children with acute leukemia undergoing marrow transplantation and in 20 normal children. Thresholds were measured on admission, 2 days, and 45 days after transplant using the Up‐Down Staircase method. No significant difference was noted between patients at admission and the control group for sweet, bitter, or salt. There was a significant difference between patients and controls for the sour threshold (p = 0.006). Patient threshold values on day 2 and day 45 posttransplant were compared with admission values. No significant differences were seen, except for the salt threshold which was increased at day 2 posttransplant when compared with the admission values.

We conclude that only minor changes in taste thresholds were demonstrated in this study. These changes probably do not account for abnormal food tastes reported by patients.
Severe Acute Metabolic Acidosis (Acute Beriberi): An Avoidable Complication of Total Parenteral Nutrition
Authors: Velez Robert J. , Myers Bert , Guber Myles S.
Published: May 2008

Total parenteral nutrition is one of the most important recent advances in medicine. The delivery of total parenteral nutrition, however, can be associated with a broad spectrum of complications ranging from mechanical (catheter related) to metabolic. We have recently seen a previously unreported complication of total parenteral nutrition ‐ three patients maintained on total parenteral nutrition, who did not receive vitamins and experienced the acute onset of life‐threatening metabolic acidosis with pH values as low as 6.70. All responded promptly and completely to the administration of intravenous thiamine, and thus were probably examples of acute beriberi. Acute beriberi is a well‐documented syndrome which usually occurs in nutritionally compromised individuals outside the hospital setting who lack thiamine in their diet. Without thiamine, glucose cannot enter the Krebs cycle in order to be completely oxidized for energy production and therefore, accumulates as lactic acid. This lactic acidosis is refractory to any treatment except thiamine and will result in cardiovascular collapse if the vitamin is not administered. (Journal of Parenteral and Enteral Nutrition 9:216–219, 1985)
Response to Total Parenteral Nutrition in the Extremely Malnourished Patient
Authors: Starker Paul M. , Lasala Patrick A. , Forse R. Armour , Askanazi Jeffrey , Elwyn David H. , Kinney John M.
Published: May 2008

Changes in serum albumin levels and body weight are often used as indicators of the efficiency of a nutritional support regimen. Patients with moderate nutritional depletion demonstrate two distinct patterns of response during refeeding. The first is characterized by a decrease in the previously expanded extracellular fluid space with a rise in serum albumin and a loss of weight and the second by continued fluid retention with weight gain and no rise in serum albumin concentration. The second pattern has been observed in patients with ongoing stress such as infection. This study examines severely malnourished patients with no apparent inflammatory complications and demonstrates that this group responds to nutritional support in a pattern similar to that seen in the stressed patient. Eight patients with profound malnutrition were studied during the 1st week of nutritional support. Nitrogen balance was measured and the findings confirmed that all patients were anabolic. Sodium balances were used as an indicator of changes in the extracellular fluid compartment. Body weight and serum albumin were assessed daily. Body weight increased from 59 ± 4 to 62 ± 4% of normal (p < 0.01) while serum albumin changed insignificantly (3.00 ± 0.27 to 2.85 ± 0.23 g/100 ml, NS) during the initial week of an adequate nutritional support regimen (nitrogen balance was + 21.0 ± 4.3 g, p < 0.05). These changes were associated with a positive sodium balance (+215 ± 20 mEq, p < 0.05). These data confirm that some extremely malnourished patients do not experience a diuresis during the initial phase of nutritional support but rather may retain water and increase body weight. This study also emphasizes that a failure of albumin to rise is not a reflection of poor nitrogen balance but rather a reflection of sodium retention. (Journal of Parenteral and Enteral Nutrition 9:300–302, 1985)
Beneficial Effects of Fasting and Low Carbohydrate Diet in D‐Lactic Acidosis Associated with Short‐Bowel Syndrome
Authors: Ramakrishnan Thiruvengadam , Stokes Perry
Published: May 2008

A case of D‐lactic acidosis in an 18‐yr‐old man with a short bowel is reported. The diagnosis, suspected on clinical grounds, was confirmed by serum and urine levels of D‐lactate. Our studies revealed that an ad libitum diet was associated with elevated D‐lactate levels and “nothing per oral” and 10% carbohydrate diet regimens caused a drop in D‐lactate levels. We recommend npo and low carbohydrate diet as preferred alternatives to antibiotics in some patients with D‐lactic acidosis. The literature is reviewed. (Journal of Parenteral and Enteral Nutrition 9:361–363, 1985)
Infection Control during Parenteral Nutrition Therapy
Authors: Williams Walter W.
Published: May 2008

Parenteral nutrition therapy can achieve an anabolic state in patients who are unable to maintain normal nitrogen balance; however, it may be associated with infectious complications. Infections may be related to contamination of the cannula and the cannula wound, of the infusate, or of other parts of the parenteral nutrition system. A variety of microorganisms has been associated with these infections. The exact mechanisms that initiate cannula‐related infection are poorly understood. Susceptibility of the host, the method and site of cannula insertion, colonization of parenteral nutrition cannulas, use of parenteral nutrition systems for multiple purposes, cannula material, and other factors may all play some role. Controlling infections depend on many factors, including quality control processes to ensure sterility of parenteral nutrition solutions, attention to aseptic technique during cannula insertion, procedures to prevent in‐use contamination, proper care of the cannula insertion site, and proper management of other parts of the parenteral nutrition system. In addition, infectious complications appear to be reduced by an organized team that follows infection control protocols. Many facets of parenteral nutrition therapy are based on data from uncontrolled clinical investigations. Well‐designed, controlled clinical trials may provide data that will further minimize the risks associated with parenteral nutrition therapy. (Journal of Parenteral and Enteral Nutrition 9: 735–746, 1985)
Effect of Intravenous L‐Carnitine on Growth Parameters and Fat Metabolism during Parenteral Nutrition in Neonates
Authors: Helms Richard A. , Mauer Elizabeth C. , Hay William W. , Christensen Michael L. , Storm Michael C.
Published: May 2008

To determine whether intravenous carnitine can improve nutritional indices, neonates requiring parenteral nutrition were randomized into carnitine treatment (n = 23) and control (n = 20) groups. Observed plasma lipid indices, carnitine and nitrogen balances, and plasma carnitine concentrations were not different in the prestudy period. Under standardized, steady‐state conditions, 0.5 g/kg Intralipid was administered intravenously over 2 hr prior to carnitine administration, after infants received 7 days of 50 μmol/kg/day, and after a second 7 days of 100 μmol/kg/day of continuous intravenous L‐carnitine as part of parenteral nutrition. Triglyceride (TGY), free fatty acid (FFA), acetoacetate (AA), β‐hydroxybutyrate (BOB), and plasma carnitine concentrations were measured prior to and at 2, 4, and 6 hr after the initiation of the lipid bolus. Twenty‐four‐hour urine collections for nitrogen and carnitine balance were obtained on days 7 and 14. Neonates receiving carnitine had significantly greater concentrations of plasma carnitine on days 7 and 14 (p < 0.001). Greater nitrogen (p < 0.05) and carnitine (p < 0.001) balances and weight gain (week 2, p < 0.05) were found in the carnitine‐supplemented group when compared with controls. On day 14, (BOB + AA)/ FFA ratios were significantly higher (p < 0.05), and peak TGY concentrations and 6‐hr FFA concentrations were significantly lower (p < 0.05) in the treatment group. Carnitine supplementation was associated with modest increases in growth and nitrogen accretion possibly by enhancing the neonate's ability to utilize exogenous fat for energy. (Journal of Parenteral and Enteral Nutrition 14:448–453, 1990)
Parenteral Infusion of Long‐ and Medium‐Chain Triglycerides and Reticuloendothelial System Function in Man
Authors: Jensen Gordon L. , Mascioli Edward A. , Seidner Douglas L. , Istfan Nawfal W. , Domnitch Amy M. , Selleck Kelley , Babayan Vigen K. , Blackburn George L. , Bistrian Bruce R.
Published: May 2008

Previous study demonstrated that patients who received total parenteral nutrition (TPN) with standard intermittent infusion of long chain triglyceride (LCT) at 0.13 g kg−1hr−1 over 10 hr for each of three days showed a significant decline in 99Tc‐sulfur colloid (TSC) clearance rate by the reticuloendothelial system (RES). The present studies evaluated eight patients who received the same total lipid dose of LCT infused continuously as in a three‐in‐one admixture, and another nine patients receiving the same amount of fat as a medium chain triglyceride (MCT)/LCT (75%/25%) emulsion intermittently over 10 hr at 0.13 g kg−1hr−1 for three consecutive days. Patients were given continuous total parenteral nutrition (TPN) comprised of protein, 1.5 g kg−1day−1, and dextrose, 4.5 g kg‐1day‐l. RES function was examined by measuring the clearance rates of intravenously injected TSC while receiving TPN containing only protein and dextrose, and again after three days of fat infusion. Mean (±SEM) clearance rate constants before and after continuous LCT infusion were 0.38 ± 0.09 and 0.41 ± 0.08 min−1, respectively, while those before and after intermittent MCT/LCT infusion were 0.50 ± 0.18 and 0.73 ±‐ 0.24 min−1, respectively. In contrast to intermittent LCT infusion, the administration of continuous LCT or an intermittent MCT/LCT mixture does not impair TSC clearance by the RES. These findings suggest that condensing the daily period of LCT infusion at standard dosage may exceed the rate of metabolic utilization, resulting in increased fat removal and diminished TSC uptake by the RES. The provision of fat principally as MCT or by a continuous mode of administration may enable adequate metabolism of lipid emulsion without RES dysfunction, and so may be of particular benefit in critically ill or septic patients. (Journal of Parenteral and Enteral Nutrition 14: 467–471, 1990)
Energy‐Enriched Hospital Food to Improve Energy Intake in Elderly Patients
Authors: Ödlund Olin Ann , Österberg Pernilla , Hådell Karin , Armyr Irene , Jerström Stina , Ljungqvist Olle
Published: May 2008

Background: It was hypothesized that energy intake in hospitalized elderly patients could be improved by increasing the density of energy of the food and that the volume of food actually consumed, even with a higher energy content than the normal, would not change with servings of high energy‐dense hospital food. Methods: Thirty‐six elderly patients (52 to 96 years) of both sexes, long‐term treated at two comparable wards, participated in this study. The patients were given 6 weeks of regular hospital food (RHF, 1670 kcal/d, 7.0 MJ) and 6 weeks of high‐energy food (HE, 2520 kcal/d, 10.5 MJ). The volume of food was kept constant. A crossover study design was used. Food intake, energy intake, body weight, and modified functional condition (Norton scale) were measured. Results: Regardless of type of food (RHF or HE) and time of day (lunch or dinner), the food portion size (volume of food) intake was the same, approximately 80% of the portions consumed. HE led to a 40% increase in energy intake (from 25 ± 1 during RHF to 35 ± 2 kcal/kg/d, p <.0001), which resulted in a 3.4% increase in body weight (p <.001) after 3 weeks of HE. Only minimal changes in functional condition were found. The cost of HE was substantially lower (‐85%) than any other mean available for improvement of energy intake. Conclusions: A significant increase in energy intake can be achieved by higher energy density in regular hospital food and that HE does not cause a decrease in the volume of the food consumed. These findings suggest that it is the volume of food rather than the energy that limits voluntary energy intake of hospital food in elderly hospitalized patients. (Journal of Parenteral and Enteral Nutrition 20:93–97, 1996)
Risk of Symptomatic Central Venous Thrombotic Complications in AIDS Patients Receiving Home Parenteral Nutrition
Authors: Duerksen Donald R. , Ahmad Arif , Doweiko John , Bistrian Bruce R. , Mascioli Edward A.
Published: May 2008

Background: The acquired immunodeficiency syndrome (AIDS) is frequently complicated by malnutrition that may require parenteral nutritional support. In a non‐AIDS population with long‐term indwelling central venous catheters, low‐dose warfarin therapy has been shown to prevent venous thrombosis. The purpose of this study was to determine the incidence of symptomatic central venous thrombosis in AIDS patients receiving home parenteral nutrition. The incidence of thrombosis on low‐dose warfarin was compared with no prophylactic therapy. Methods: A retrospective review of 47 malnourished AIDS patients started on home parenteral nutrition was performed. None of the patients had a prior history of venous thrombosis. During this period, 9 of 47 patients were treated with low‐dose warfarin therapy. The incidence of clinical and radiologic venous thrombosis was compared in these two groups. Results: Forty‐seven patients were treated with parenteral nutrition for 296 patients‐months. The rate of central venous thrombosis in patients receiving warfarin (0.016 thromboses per patient‐month) was no different from those patients on no prophylactic therapy (0.009 thromboses per patient‐month). The most common abnormality in coagulation observed in the entire group during follow‐up was thrombocytopenia occurring in 66% of patients. Sixty percent of patients received medications that could interfere with platelet function. Conclusions: We conclude that routine thrombosis prophylaxis with low‐dose warfarin may not be justified in malnourished AIDS patients receiving home parenteral nutrition. Prospective clinical trials are needed to determine the risks and benefits of prophylactic warfarin therapy in this group of patients. (Journal of Parenteral and Enteral Nutrition 20:302–305, 1996)
The Social Representation of Entrepreneurs in the French Press
Authors: Radu Miruna , Redien-Collot Renaud
Published: May 2008

The purpose of this article is to question the foundations and structure of entrepreneurs' social representation in the French press. Social representations are the result of a perceptive and cognitive construction of reality, which transforms social objects (people, contexts, situations) into symbolic categories (values, beliefs, ideologies), therefore providing a collective significant system for the regulation of cognitions and actions (Ljunggren and Alsos, 2001).Within the consensual reality through which the social world is created and experienced, the press can be emphasized as an entrepreneurial `Greek chorus' (Kets deVries, 2000) playing a key role in the diffusion and transformation of entrepreneurial culture at the local and national levels.We conducted a discourse analysis of 962 articles, from 2001 to 2005, in order to study the press's potential impact on entrepreneurial desirability and feasibility beliefs.We identified three main categories of discourses — the legitimacy discourse, the normativity discourse, and the accessibility discourse, which may impact readers' desirability and feasibility beliefs. This is the first attempt to assess the role of the public discourse in fuelling entrepreneurial intentions in the French context.
Selective Mobility into Self-employment in Post-socialist Transition
Authors: Saar Ellu , Unt Marge
Published: May 2008

On the one hand, a self-employed worker may be a successful business owner exploiting new opportunities.At the other extreme, self-employed may be refugees from poverty and unemployment with few resources and few opportunities to earn high incomes. In this article, we address the question about importance of the `pull' and `push' factors into self-employment drawing upon the experience of post-socialist Estonia.The article uses data from various sources (quantitative as well as qualitative).We conclude that the crucial mechanism at play may have been selective mobility into self-employment. At the beginning of the 1990s less educated workers who were working in primary and secondary sectors moved into self-employment more or less for lack of choice. Most more educated self-employed who started their business in the first half of the 1990s moved out from self-employment and became managers in firms belonging to the state or other employers.As reforms progressed, the type of people who were moving into self-employment changed.
A Conceptualization of the Determinants of Small Business Website Adoption
Authors: Simmons Geoff , Armstrong Gillian A. , Durkin Mark G.
Published: May 2008

As evidence mounts on the importance of small businesses and the opportunities presented by website adoption globally, it becomes important to understand the key issues that determine website adoption. However, the extant literature relating to small business website adoption is fragmented and fails to provide an understanding of what determines adoption.Therefore the key contribution of this article to current knowledge is the development of a conceptualization, supported by the literature, that will provide an interpretation of what determines small business website adoption. Critically, this is the first article to incorporate the important role that the small business marketing context plays within Internet technology adoption. The article develops nine hypotheses, which relate to the critical interactions and integration, within and between four determinant groupings underpinning the conceptualization.The nine hypotheses will guide and direct future research towards generating an empirically based understanding of what determines small business website adoption.
Lung cancer, caring for the caregivers. A qualitative study of providing pro-active social support targeted to the carers of patients with lung cancer
Authors: Ryan PJ , Howell V , Jones J , Hardy EJ
Published: May 2008

Introduction: Carers of patients with lung cancer often have a short time to access the support they require. The Macmillan Carers Project (MCP) was set up to provide non-clinical social support targeted in the community to the carers of patients with lung cancer and this study describes its evaluation. Methods: Prospective case study using interviews with the carers, project workers and health and social care professionals to obtain qualitative data for thematic analysis. 81 patients’ carers received support from the MCP; 20 carers, 2 MCP workers and their manager and 10 other professionals (chest consultant physician, lung cancer clinical nurse specialist, GP, four Macmillan nurses, hospice social worker and two community social workers) were interviewed. Results: Patients were predominantly male (62%), mean age 71 years and carers were predominantly female (70%) mean age 63 years. Carers identified the MCP as providing emotional support, more time, practical help, financial advice, information and back-up for a myriad of problems. Although there was some overlap with other services, the MCP was valued by carers and professionals as filling a gap in social care. Conclusions: The unique aspect of this study was support targeted to the carers of a single cancer site (lung) rather than generic cancer support. As lung cancer may progress rapidly, patients and their carers have a short time to gather new information, access services and adjust to their new circumstances and roles. By focusing on the needs of carers from the time of lung cancer diagnosis, we have shown that the MCP was a valued additional service, well received by carers, patients and professionals.
The evolution of hyperprolactinaemia as an entity in psychiatric patients
Authors: Kohen Dora , Wildgust Hiram Joseph
Published: May 2008

This paper explores chronologically the evolution of raised prolactin levels as an entity in psychiatric patients. Menstrual problems were described in patients with schizophrenia prior to the introduction of antipsychotic medication, but galactorrhoea and gynaecomastia were not commonly seen until the advent of antipsychotics. Following the introduction of antipsychotic medication single case reports of patients with galactorrhoea and gynaecomastia appeared. These were followed by a collection of case reports and the process reached today's data of laboratory defined rates of prolactin and sexual side effects. The paper also reviews the emerging research linking hyperprolactinaemia with increased risk of osteoporosis and possibly breast cancer. An overarching thread which runs throughout these publications, is the paucity of clinical research, which has only recently begun to be addressed.
The MERITO Study: a multicentre trial of the analgesic effect and tolerability of normal-release oral morphine during ‘titration phase’ in patients with cancer pain
Authors: De Conno F , Ripamonti C , Fagnoni E , Brunelli C , Luzzani M , Maltoni M , Arcuri E , Bertetto O ,   on behalf of MERITO Study Group
Published: May 2008

Adequate and rapid pain control is one of the main goals of cancer pain treatment. The objective of this study was to assess the effect and tolerability of oral normal-release morphine during the initial phase of treatment in patients with moderate-to-severe cancer pain. Consecutive patients naïve to strong opioids received normal-release morphine 5 or 10 mg every 4 h during the titration phase (first 5 days), depending on previous analgesic therapy. Pain intensity was assessed using an 11-point Numerical Rating Scale (0–10), and data were recorded in a patient-compiled diary. The primary endpoint was the proportion of time with pain control (a reduction of at least 50% with respect to the baseline pain score) during the titration phase. A total of 159 consecutive patients (102 men; mean age 65 years) with cancer-related pain were enrolled. Pain control was observed for 75% (95% CI 70–80) of the follow-up period in the intent-to-treat population. Overall, 50% and 75% of patients achieved pain control within 8 and 24 h after starting normal-release morphine therapy respectively. The mean pain score was 7.63 points at baseline, and decreased to 2.43 and 1.67 points (both P < 0.001) at days 3 and 5 respectively. The most commonly reported adverse events were somnolence (24% of patients), constipation (22%), vomiting (13%), nausea (10%) and confusion (7%). Normal-release morphine results in rapid and satisfactory pain control, and is well tolerated, during the strong-opioid titration phase in patients with moderate-to-severe cancer pain.
Categorical prevalence and severity of hyperprolactinaemia in two UK cohorts of patients with severe mental illness during treatment with antipsychotics
Authors: Bushe Chris , Yeomans David , Floyd Tamsin , Smith Shubulade M
Published: May 2008

Hyperprolactinaemia may be associated with hidden longer-term consequences, such as osteoporosis, bone fractures, pituitary tumours and breast cancer. Prolactin data from clinical trials is not always reported in a categorical manner and does not always allow the risk of hyperprolactinaemia to be evaluated for specific patient cohorts. Patients participating in a physical health management programme in the UK for severe mental illness patients — the Well-being Support Programme — had prolactin measurements made regardless of symptoms. Prolactin data from the complete cohort of 178 patients receiving antipsychotics in Leeds and London are reported. Hyperprolactinaemia was measured in 33.1% but more commonly in females than males (47.3% and 17.6%) and was associated with all antipsychotics except clozapine. The highest prevalence rates were found in amisulpride (n=20) 89%, risperidone long-acting intramuscular injection (LAIM) 67% (n=6) and risperidone (n=30) 55% used as antipsychotic monotherapy. Clinically Significant hyperprolactinaemia (>1000 mIU/L ~47 ng/ml) was measured in 15.8% of patients, predominantly in females. Levels >2000 mIU/L ~95 ng/ml in 6.2% of the complete cohort. Clinicians may wish to add prolactin measurement to the routine laboratory parameters currently measured for some antipsychotics and should be advised of the potential longer-term consequences of hidden hyperprolactinaemia.
Medical Works of the Medieval Period from India and Central Asia
Authors: Haidar Mansura
Published: May 2008

Medical sciences have developed in India from time immemorial. This paper presents a detailed outlook of the development of these techniques in medieval India and Indo-Central Asia. The different authors, works and techniques of that time are recalled and compared in order to provide an overall view of this barely known tradition.