bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated control of wheel drive—brake torque for vehicle-handling enhancement
Authors: Ghike C , Shim T , Asgari J
Published: February 2009

Wheel torque control is an effective means of improving vehicle handling and stability. Brake-based electronic stability programs which intervene in extreme situations to regulate vehicle behaviour are the most common form of wheel torque control. With the advent of advanced driveline technologies, wheel torque control can also be achieved by the differential distribution of available drive torque to all four wheels. Similarly, in combined cornering and braking manoeuvres, the applied brake input can be differentially distributed to regulate vehicle handling. This paper proposes an integrated scheme for wheel torque control that combines differential drive or brake torque distribution with the emergency braking control to regulate the vehicle yaw rate and side-slip angle. A wheel torque controller was developed using a non-linear predictive control theory, an eight-degrees-of-freedom vehicle model, and non-linear tyre models. The simulated vehicle responses show improved vehicle-handling performance.
Fault correction of an airflow signal in a gasoline engine system using a neural fuzzy scheme and genetic algorithm
Authors: Chen P-C
Published: February 2009

This study presents an airflow correction system for correcting the fault of an airflow signal of a gasoline engine. The correction system consists of a fuzzy-model-based airflow estimation system and an airflow-monitoring system. The airflow estimation system estimates the normal airflow based on fuzzy neural networks and trained using the steepest-descent method and back-propagation algorithm. The airflow-monitoring system corrects the fault airflow signal according to the correction law. In order to raise the training performance, a genetic algorithm is used to search the learning rates and initial consequent gains of the fuzzy neural networks. The estimated results indicate that using a genetic algorithm certainly improves the performance of normal airflow estimation. The corrected results indicate that the airflow correction system can provide a feasible means of carrying out airflow fault correction in gasoline engine systems.
A reliability analysis method using binary decision diagrams in phased mission planning
Authors: Prescott D R , Remenyte-Prescott R , Reed S , Andrews J D , Downes C G
Published: February 2009

The use of autonomous systems is becoming increasingly common in many fields. A significant example of this is the ambition to deploy unmanned aerial vehicles (UAVs) for both civil and military applications. In order for autonomous systems such as these to operate effectively, they must be capable of making decisions regarding the appropriate future course of their mission responding to changes in circumstance in as short a time as possible. The systems will typically perform phased missions and, owing to the uncertain nature of the environments in which the systems operate, the mission objectives may be subject to change at short notice. The ability to evaluate the different possible mission configurations is crucial in making the right decision about the mission tasks that should be performed in order to give the highest possible probability of mission success.

Because binary decision diagrams (BDDs) may be quickly and accurately quantified to give measures of the system reliability it is anticipated that they are the most appropriate analysis tools to form the basis of a reliability-based prognostics methodology. The current paper presents a new BDD-based approach for phased mission analysis, which seeks to take advantage of the proven fast analysis characteristics of the BDD and enhance it in ways that are suited to the demands of a decision-making capability for autonomous systems. The BDD approach presented allows BDDs representing the failure causes in the different phases of a mission to be constructed quickly by treating component failures in different phases of the mission as separate variables. This allows flexibility when building mission phase failure BDDs because a global variable ordering scheme is not required. An alternative representation of component states in time intervals allows the dependencies to be efficiently dealt with during the quantification process. Nodes in the BDD can represent components with any number of failure modes or factors external to the system that could affect its behaviour, such as the weather. Path simplification rules and quantification rules are developed that allow the calculation of phase failure probabilities for this new BDD approach. The proposed method provides a phased mission analysis technique that allows the rapid construction of reliability models for phased missions and, with the use of BDDs, rapid quantification.
The Philippines 2004 measles campaign: a success story towards elimination
Authors: Sobel Howard , Ducusin Joyce , De Quiroz Maricel , Cabotaje Myrna , Olivé Jean-Marc
Published: February 2009

Prior to the 2004 Philippines Measles Follow up Elimination Campaign, measles caused an estimated 6000 deaths among Filipino children. After the campaign, cases and deaths decreased by 96.4% and 99.2%, respectively. The Nationwide Rapid Coverage Assessments, with an extensive system of feedback, was the prime factor in reaching the under-immunized areas.
Unusual presentations of Salmonella Typhi infections in children
Authors: Mittal Sumit , Saxena Ajit , Garg Pankaj
Published: February 2009

We report on three children with Salmonella typhi presenting with fever and urticaria, thrombocytopenic purpura and meningitis. We suggest that clinicians should consider S. typhi infection as a diagnosis even when the presenting features are more typical of other illnesses.
A review of the epidemiology of cancers at the University Teaching Hospital, Lusaka, Zambia
Authors: Bowa K , Wood C , Chao A , Chintu C , Mudenda V , Chikwenya M
Published: February 2009

This is a retrospective study based on pathology reports of specimens reviewed at the University Teaching Hospital (UTH) pathology laboratory in Lusaka, Zambia, from January 1997 to December 2005. UTH is the main reference hospital in Zambia and has a catchment area covering 1.3 million people. The most common cancer among men was Kaposi's sarcoma followed by cancer of the eye, soft tissue sarcomas and cancer of the prostate. The most common cancer among women was cancer of the cervix, followed by cancer of the eye, cancer of the breast and Kaposi's sarcoma. Non-Hodgkin's lymphoma is the fifth most common cancer in both men and women. There has been a significant change in the pattern of malignancies at the UTH over the last 20 years, with an increase in Kaposi's sarcoma, cancer of the cervix and cancer of the eye.
Re-emerging chloramphenicol sensitivity and emerging low level ciprofloxacin resistance among Salmonella enterica serotype typhi isolates in North India
Authors: Gupta Varsha , Kaur Jaspal , Kaistha Neelam
Published: February 2009

Ciprofloxacin has become the antibiotic of choice for the treatment of typhoid fever with the emergence and worldwide spread of Salmonella enterica typhi strains resistant to chloramphenicol. However, the rampant use of ciprofloxacin gradually led to an increase in its minimum inhibitory concentration against S. enterica typhi. This threatened its therapeutic efficacy and resulted in the re-emergence of chloramphenicol-sensitive S. enterica typhi strains.
Fine needle aspiration cytology in the diagnosis of abdominal TB: a review of 92 cases
Authors: Handa Uma , Garg Sukant , Mohan Harsh
Published: February 2009

During a period of eight years (1999–2006), 92 cases of abdominal TB were diagnosed by fine needle aspiration cytology (FNAC). Based on our findings, FNAC is a simple, fast, accurate and inexpensive diagnostic procedure for cases of suspected abdominal TB.
Disseminated Cysticercosis
Authors: Basu Gopal , Surekha Viggeswarpu , Ganesh Alka
Published: February 2009

Cysticercosis is a common public health problem in the Tropics. However, disseminated cysticercosis is rare. We report a patient with chronic liver disease and seizures, in whom a simple plain radiographic examination helped in narrowing down the differential diagnosis to disseminated cysticercosis. The diagnosis was confirmed by serum cysticercal antibody enzyme-linked immunosorbent assay (ELISA) and computerized tomography of the brain.
The eunuch patient
Authors: Mukhopadhyay Amita , Chowdhury Ritam
Published: February 2009

Eunuchs in India, commonly known as ‘Hirjas’, are under-represented and marginalized. They rarelyaccess conventional health-provider systems due to mistrust and fear of censure. This is the story of Asha, who was brave enough to approach a community medicine resident in a municipal hospital for medical aid and counselling, and how she brought home the message that every patient deserves dignity and respect.
Delusional parasitosis over dermatological morbidity: diagnostic and therapeutic challenges
Authors: Suganthan Jonas S , Rajkumar Anto P , Jagannath C , Pulimood Susanne A , Jacob K S
Published: February 2009

Delusional parasitosis is a rare psycho-dermatological disorder that lacks standard management guidelines. We report a case of an elderly woman with long standing multiple dermatological illnesses who later developed delusional parasitosis. We highlight the pertinent diagnostic and therapeutic challenges. We support multidisciplinary collaborative care combining effective pharmacotherapy with efficient non-pharmacological measures.
Improving glycaemic control in African diabetic patients on insulin: a resource-free approach
Authors: Gill Geoffrey V , Gebrekidan Atakilt , English Patrick J , Tesfaye Solomon
Published: February 2009

In the resource-poor areas of the tropics, diabetic patients requiring insulin are often treated with once-daily injections of intermediate-acting insulin. Glycaemic control on this regime is usually poor. We trialled a simple change to twice-daily insulin (same total daily dose, two-thirds given in morning, and one-third in evening) in a group of 20 Ethiopian diabetic patients treated in this way. Nurse support and contact, and self-glucose monitoring were not available. After three months, the haemoglobin Alc (HbAlc) had improved from 10.5 ± 1.8 to 8.0 ± 1.5% (P < 0.001). No improvement occurred in the 20 control patients who remained on once-daily insulin. Among the twice-daily insulin group there was a small increase in weight and mild hypoglycaemic episodes. However, all patients were very satisfied and wished to continue the new system. We conclude that a simple change from once- to twice-daily insulin, without monitoring or support, can lead to a significant improvement in the overall glycaemic control, and is suitable for resource-limited tropical countries.
The pattern of epilepsy in a rural African hospital – an approach adapted to local circumstances
Authors: Winkler Andrea Sylvia , Schaffert Matthias , Schmutzhard Erich
Published: February 2009

The classification of epilepsy, which represents the commonest neurological disorder throughout the developing world, has been difficult due to lack of diagnostic tools. Adapted to the circumstances of an epilepsy clinic in northern Tanzania, we grouped people with epilepsy (PWE) according to an adjusted version of the International Classification of Epileptic Seizures with the main groups being: generalized types of seizures (206 PWE) divided into those starting within (147 PWE) and those starting outside (59 PWE) a specific age range (6–25 years); and partial types of seizures (102 PWE) with subgroups of generalized seizures with diffuse brain damage (41 PWE), those with predominantly focal signs (60 PWE) and complex partial seizures (1 PWE). Clinical implications are discussed.
Late-stage HIV/AIDS among children: the missing diagnosis of a preventable disease
Authors: Gouveia Josiana , Souza Edvaldo , Falbo Ana
Published: February 2009

We studied 126 malnourished children who had been admitted to the Instituto Materno Infantil Professor Fernando Figueira (IMIP) hospital. Nine (7.1%) had confirmation of HIV infection and all fulfilled the AIDS-defining criteria – all had been infected through mother-to-child transmission. Only one HIV-infected mother had been screened for HIV infection during prenatal care. There is, therefore, a need to increase HIV testing in all malnourished patients, especially when routine screening for HIV infection during prenatal care is not automatically undertaken.
Chikungunya in West Bengal, India
Authors: Bandyopadhyay Bhaswati , Pramanik N , Rajyasree De , Mukherjee D , Neogi D K , Hati A K
Published: February 2009

Fever of unknown origin broke out in several districts of West Bengal, from August 2007 to December 2007. The cases were suffering from high fever, severe joint pain lasting for several weeks after clinical cure and appearance of skin rashes. Patients’ sera were collected at least five days after fever and were analyzed to detect specific IgM antibodies. A total of 800 patients were investigated and 321 (40.13%) were found to be reactive for Chikungunya antibodies. Of the patients, 66% were male. Predominant signs and symptoms observed in the sero-positive cases were fever (100%), arthralgia (96%) and diffuse erythematous skin rash (94%). Of the patients, 3% had haemorrhagic manifestations. Re-emerging Chikungunya virus spread in epidemic form in several districts of West Bengal after a gap of four decades.
Newer methods over the conventional diagnostic tests for tuberculous meningitis: do they really help?
Authors: Baveja C P , Gumma Vidyanidhi , Manisha Jain , Choudhary Monica , Talukdar B , Sharma V K
Published: February 2009

Rapid diagnosis of tuberculous meningitis (TBM) is crucial as the disease outcome depends on the stage at which the treatment is initiated. The reliability of the available tests has not been established; thus, the present study was conducted to evaluate the conventional diagnostic tests as compared to the newer methods. Cerebrospinal fluid was collected from 100 children, and analyzed for various biochemical and cytological tests. The samples were subjected to Ziehl-Neelsen (Z-N) staining, Lowenstein-Jensen (L-J) culture, BACTEC culture and polymerase chain reaction (PCR). Twenty-two patients could be identified as definitive TBM based on the demonstration of Mycobacterium tuberculosis by BACTEC culture and PCR. Of these 22 cases, Z-N staining was positive in only two and L-J culture in six cases. Both the BACTEC culture and PCR had 100% agreement in the diagnosis of TBM. However, BACTEC culture could be a better diagnostic test as drug sensitivity can also be performed by this method.
Rectal bezoars due to pumpkin seeds
Authors: Mirza Mohammad Salman , Al-Wahibi Khalifa , Baloch Shafiq , Al-Qadhi Hani
Published: February 2009

Rectal bezoars commonly occur due to seeds, especially in children living in countries south of the Mediterranean and in the Middle-East. Dried seeds are considered a delicacy and consumed widely. Inadequate chewing or hastily eating without removing the hull may lead to their impaction as bezoars, which may require manual removal under general anaesthesia.
Louse-borne relapsing fever in Ethiopian children: experience of a rural hospital
Authors: Ramos Jose Manuel , Malmierca Eduardo , Reyes Francisco , Tesfamariam Abraham
Published: February 2009

We describe the epidemiological and clinical aspects of louse-borne relapsing fever (LBRF) in a series of children attending in a rural hospital in Ethiopia during 1997–2007. From a total of 249 cases of LBRF, 154 (61.4%) were children (> 15 years). The most frequent symptoms were: fever, headache, dizziness and musculoskeletal pains. The overall case fatality rate was 2.4 (10% for patients < 1.1 years; 3.4% for 1.1 to 4.0 years; and 0% >4.0 years [ P = 0.05]). The mortality in children was less than in adults (13.2%) ( P = 0.003).
Barriers experienced by parents of children with clubfoot deformity attending specialised clinics in Uganda
Authors: Kazibwe Herman , Struthers Patricia
Published: February 2009

Clubfoot is a congenital structural impairment that, if untreated or inadequately treated, leads to deformity. Effective management is dependent on the compliance of parents to the treatment for clubfoot. A cross-sectional descriptive survey using a questionnaire identified the barriers parents encounter in bringing their children for treatment during the plaster-casting stage of managing clubfoot at the Talipes Clinics at Mbarara Regional Hospital and Mulago Hospital in Uganda. A total of 167 parents participated in the study. Ninety percent of the parents had attended weekly clinics with 67% indicating that they did not know about clubfoot and its treatment. The study found a significant association between compliance and transport costs ( P = 0.014); distance travelled ( P = 0.005); and family support ( P = 0.028). Other barriers highlighted include the need to improve the communication skills between clinicians offering treatment to children with clubfoot and their parents. Informed parents could assist with compliance to treatment.
Retroperitoneal necrotizing fasciitis – when a simple procedure turns ugly
Authors: Alvi Abdul , Shamsi Ghina
Published: February 2009

We present a case series of patients who underwent simple perianal procedures outside this hospital but developed postoperative and life-threatening retroperitoneal necrotizing fasciitis. With a high index of clinical suspicion and radiological imaging, we were able to establish earlier diagnosis. Resuscitation, the use of intravenous broad-spectrum antibiotics, aggressive surgical debridement and continuous organ support were essential in achieving a positive outcome in both of these patients.
The use of boluses of propofol for the management of severe tetanus in a child
Authors: Petitjeans Fabrice , Turc Jean , Coulet Olivier , Puidupin Marc , Eve Olivier , Benois Alain
Published: February 2009

Tetanus is endemic in many developing countries. Although propofol has been proposed for sedation in tetanus, the routine use of this drug has not been clearly documented in published reports. A few studies have reported its beneficial effects but no randomized studies are available. We describe the case of a five-year-old boy who presented with severe tetanus in East Africa. The antispastic therapy consisted of benzodiazepine infusion with the addition of titrated boluses of propofol. Intubation and mechanical ventilation were avoided.
Incremental Network Optimization: Theory and Algorithms
Authors: Şeref Onur , Ahuja Ravindra K. , Orlin James B.
Published: February 2009

In an incremental optimization problem, we are given a feasible solution x0 of an optimization problem P, and we want to make an incremental change in x0 that will result in the greatest improvement in the objective function. In this paper, we study the incremental optimization versions of six well-known network problems. We present a strongly polynomial algorithm for the incremental minimum spanning tree problem. We show that the incremental minimum cost flow problem and the incremental maximum flow problem can be solved in polynomial time using Lagrangian relaxation. We consider two versions of the incremental minimum shortest path problem, where increments are measured via arc inclusions and arc exclusions. We present a strongly polynomial time solution for the arc inclusion version and show that the arc exclusion version is NP-complete. We show that the incremental minimum cut problem is NP-complete and that the incremental minimum assignment problem reduces to the minimum exact matching problem, for which a randomized polynomial time algorithm is known.
Medical Respite Care for Homeless People: A Growing National Phenomenon
Authors: Zerger Suzanne , Doblin Bruce , Thompson Lisa
Published: February 2009

The first known respite care facilities for homeless people emerged in the mid-1980s, but recent trends in health systems and services have driven their rapid proliferation across the country within the past decade. This report is the first attempt to describe these respite programs comprehensively.
Community Responses to Diabetes and Mental Health Care for the Uninsured Population in Michigan
Authors: Dalton Vanessa K. , Jacobson Peter D. , Konig Madeleine , Holman Peter P.
Published: February 2009

Objective . To examine how the safety net in Michigan is responding to the health care needs of their uninsured population with diabetes and/or mental illness.
Methods . We used a multiple-site case study design. Data were collected through interviews of key informants in five Michigan communities. Analytic patterns and themes were identified, and compared across communities and by organizational type.
Results . Informants reported they are managing to meet the needs of uninsured diabetics but are having great difficulty caring for the uninsured with mental illness. Specialty care for diabetes is obtainable, but is resource-intensive. Mental health services available for uninsured patients are severely limited. The presence of a county health plan (CHP) appears insufficient to improve access, especially to mental health services.
Conclusions . The safety net for Michigan’s uninsured population with diabetes and mental illness is weak. Processes including referrals and care coordination are of poor quality in some communities. The value of integrating mental health services into primary care should be examined.
The Feasibility of Mothers Accepting Health Advice from their Adolescent Daughters
Authors: Mosavel M.
Published: February 2009

The influence of mothers on the health behaviors of their adolescent daughters has been well established; however, little work has focused on the potential of daughters to influence the health behaviors of their mothers. To assess the feasibility of mothers accepting cancer advice from their daughters, 12 focus groups were conducted with 75 African American and Hispanic mothers from inner-city neighborhoods in a Midwestern city in the United States. By means of the focus groups, researchers investigated whether mothers would allow their adolescent daughters to give them health advice and the extent to which cultural norms would affect if, and how, mothers listen to such advice. This study illustrates the potential of daughter-initiated health advice and identifies the cultural challenges associated with it. The results suggest that health promotion programs aimed at the mother might involve adolescent daughters as influential opinion leaders within the family.
Toward a Smoke-free Harlem: Engaging Families, Agencies, and Community-based Programs
Authors: Northridge Mary E. , Scott Gwendolyn , Swaner Rachel , Northridge Jennifer L. , Jean-Louis Betina , Klihr-Beall Sandra , Vaughn Rubiahna L. , Pradier Yvonne J. , Vaughan Roger D. , Hayes Roger , Caraballo Ralph S.
Published: February 2009

The aim of this collaborative public health study was to engage families, agencies, and programs in reducing secondhand smoke exposure in Central Harlem, New York City. Baseline interviews (n = 657) and focus groups (n = 4) were conducted with adult members of households with children who had asthma and asthma-like symptoms in the Harlem Children’s Zone Asthma Initiative. The interviews concerned the prevalence and determinants of exposure of enrolled children to secondhand smoke. Key findings were that participants: (1) were generally aware of the hazards of secondhand smoke; (2) used strategies to reduce exposure to secondhand smoke in their homes; (3) believed that outdoor pollutants are sometimes just as bad for the health of their children as secondhand smoke; and (4) used smoking to provide stress relief and help diffuse otherwise volatile situations in their homes. The Harlem Smoke-Free Home Campaign was launched in October 2007 based in part on these findings.
Racial Distribution of Patient Population and Family Physician Endorsed Importance of Screening Patients for Inherited Predisposition to Cancer
Authors: Gramling Robert , Clarke Jennifer , Simmons Emma
Published: February 2009

Uptake of genetic testing is higher among racial majority versus minority patients for reasons that remain unclear. Primary care physicians represent the front line of screening for inherited cancer risk. We surveyed family physicians enrolled in the Massachusetts Practice Based Research Network to assess whether their attitudes about cancer-predictive genetic testing related to the race of their patients. Among the 65 physicians who responded (91.5% response rate), those whose practices had higher proportions of White patients were more likely to strongly endorse the value of screening for inherited cancer risk (OR adj 3.18, 95% CI 1.05, 9.66). These findings, though limited by use of a small convenience sample, suggest that clinical attention to screening for genetic cancer risk is greater in practices serving fewer racial minority patients. More research is necessary to confirm these findings and to determine whether these factors affect disparities in genetic testing and health outcomes.
Medical Mistrust and Less Satisfaction With Health Care Among Native Americans Presenting for Cancer Treatment
Authors: Guadagnolo B. Ashleigh , Cina Kristin , Helbig Petra , Molloy Kevin , Reiner Mary , Cook E. Francis , Petereit Daniel G.
Published: February 2009

Purpose . To assess barriers to cancer care among Native Americans, whose health outcomes compare unfavorably with those of the general U.S. population.
Methods and patients . We undertook a comparative community-based participatory research project in which newly-diagnosed cancer patients were prospectively surveyed using novel scales for medical mistrust and satisfaction with health care. Socio-demographic information was obtained. Mean scale scores for mistrust and satisfaction were analyzed by race. Multivariable models were used to adjust for income, education level, and distance lived from cancer care institute.
Results . Participation refusal rate was 38%. Of 165 eligible patients, 52 were Native American and 113 where non-Hispanic White. Native Americans expressed significantly higher levels of mistrust (p =.0001) and lower levels of satisfaction (p = .0001) with health care than Whites. In multivariable analyses, race was the only factor found to be significantly predictive of higher mistrust and lower satisfaction scores.
Conclusion . Native Americans exhibit higher medical mistrust and lower satisfaction with health care.
Demographic and Socioeconomic Predictors of Melanoma Prognosis in the United States
Authors: Eide Melody J. , Weinstock Martin A. , Clark Melissa A.
Published: February 2009

Studies suggest sociodemographic factors may influence melanoma prognosis. Our objective was to quantify sociodemographic predictors of U.S. melanoma. Data from 17,702 melanoma cases reported to the Surveillance Epidemiology and End Results (SEER) program from 1988–1993 were merged with sociodemographic data (1990 U.S. Census). Regression analysis was used to model prognosis: melanoma mortality to incidence ratio. Prognosis was significantly associated with neighborhood racial heterogeneity, education and income. Melanoma patients who resided in areas with higher education (OR 0.4, 95% CI 0.3–0.5), more White residents (OR 0.7, 95% CI 0.5–0.8), or higher incomes (OR 0.4, 95% CI 0.2–0.5) were less likely to have poor prognosis. Education explained 3.3 times more variance than race and 1.9 times more than income. Sociodemographic factors were associated with stage and tumor thickness. Neighborhood sociodemographic variables were predictive of melanoma prognosis, and suggest an important direction for targeting public health efforts to reach those in at-risk communities.
Universal Health Insurance for Children
Authors: Hughes Dana , Kreger Mary , Sabherwal Simran , Powell Darci , Sargent Katherine
Published: February 2009

Large and increasing numbers of Americans lack health insurance. While children have recently fared better than adults, millions still lack coverage, and thus experience difficulty obtaining acute and preventive care during a critical period of growth and development. This situation has both short and long-term social and economic implications, including higher health care costs for episodic and end-stage treatment, loss of productivity, and rising-insurance costs to businesses. This paper describes past and current efforts to extend health insurance to children and explores options for achieving universal coverage among children. Specifically, it describes the challenges associated with the financing and delivery of the American health care system, outlines public policy approaches to covering children historically, presents the current status of health insurance for low-income children, and offers options for achieving universal health insurance for children.
“It’s a toss up between my hearing, my heart, and my hip”: Prioritizing and Accommodating Multiple Morbidities by Vulnerable Older Adults
Authors: Schoenberg Nancy E. , Leach Corinne , Edwards William
Published: February 2009

Nearly three quarters of older adults have multiple morbidities (MM). This study investigated which morbidities older adults prioritize, why, and how they accommodate these conditions, focusing on elders with two or more chronic conditions and low socioeconomic status.
Methods . In-depth interviews were conducted with 41 older adults (most being African American women from the southeastern U.S., with two or more chronic illnesses).
Results . Many participants reported worrying most about their heart disease, diabetes, and disability/mobility problems, and about their synergistic effects. Many worried that MMs might tip them into a downward spiral. Participants spent the most time and money on arthritis and diabetes. Few received help; when they did, relatives assisted with arthritis/mobility, diabetes, and effects of stroke.
Discussion . Enhanced formal care coordination, increased use of technological innovations, and understanding elders’ priorities are necessary to improve self-care/management and quality of life.
Cancer Screening Practices among Physicians Serving Chinese Immigrants
Authors: Aragones Abraham , Trinh-Shevrin Chau , Gany Francesca
Published: February 2009

Chinese immigrants in the United States are broadly affected by cancer health disparities. We examined the cancer screening attitudes and practices of physicians serving Chinese immigrants in the New York City (NYC) area by mailing a cancer screening survey, based on current guidelines, to a random sample of physicians serving this population. Fifty three physicians (44%) completed the survey. Seventy-two percent reported following the guidelines for breast cancer, 35% for cervical cancer screening, and 45% for all colorectal cancer screening tests. Sixty-eight percent of physicians were satisfied with their current rates of cancer screening with their Chinese immigrant patient population. Physicians serving the Chinese community in NYC follow cancer screening guidelines inadequately. Cancer screening rates in this population could likely be increased by interventions that target physicians and improve awareness of guidelines and recommended best practices.
Overweight among Refugee Children after Arrival in the United States
Authors: Hervey Katrina , Vargas Delfino , Klesges Lisa , Fischer Philip R. , Trippel Sally , Juhn Young J.
Published: February 2009

We determined the impact of 69 African refugee children’s arrival age and weight on subsequent weight gain by following BMI of refugee children. During 6–24 months after arrival in the U.S., 57% of underweight children became normal weight, whereas only 2% of normal weight children moved to the next higher weight category (p<.001). Children with overweight or those at-risk for overweight on arrival were more likely to be overweight on follow-up than were children who were not at risk or overweight on arrival (OR 18.9, 95% CI 3.2–112) Despite the tendency of catch-up weight gain of children underweight at arrival, BMI at arrival did not predict the slope of BMI change over time. Children who are overweight at arrival are more likely to remain at risk of overweight. The younger cohort experienced an increase in BMI at a slower rate than the older cohorts.
Healthy Colon, Healthy Life ( Ruột Lành, Sống Khỏe ): Patient and Physician Factors Associated with Colorectal Cancer Screening Among Vietnamese Americans in a County Medical Care System
Authors: Walsh Judith , Nguyen Tung , Nguyen Lamkieu , Pasick Rena , McPhee Stephen J.
Published: February 2009

Objective . To examine factors associated with colorectal cancer (CRC) screening among Vietnamese Americans.
Methods . Telephone survey of Vietnamese aged 50–79 receiving primary care at participating clinics.
Results . Among 808 participants, 53% were up to date (UTD) with fecal occult blood test (FOBT), 19% were UTD with sigmoidoscopy, 28% were UTD with colonoscopy. Females were more likely to be UTD with FOBT (OR 1.4, 95% CI 1.02, 1.93). Individuals in the U.S. for less than 15 years were less likely than others to be UTD with any CRC screening (OR 0.65, 95% CI 0.44, 0.96). Patients of female physicians were more likely to be UTD with sigmoidoscopy or colonoscopy (OR 1.72, 95% CI 1.15, 2.57). Ethnicity and language concordance were not associated with screening.
Conclusions . Many Vietnamese people are not receiving CRC screening. Women and patients of female physicians receive more screening.
Cultural Constructs, Stage of Change, and Adherence to Mammography among Low-Income African American Women
Authors: Steele-Moses Susan K. , Russell Kathleen M. , Kreuter Matthew , Monahan Patrick , Bourff Sara , Champion Victoria L.
Published: February 2009

The purpose of this study was to explore the predictive relationships between cultural belief and stage of change and mammography adherence in low-income Midwestern African American urban women (N = 321). Secondary analysis of questionnaire data measuring religiosity, racial pride, family collectivism, future and present time orientation, and stage of mammography screening adoption was conducted. Religiosity (OR = 1.12; p = .002) and future time orientation (OR = 1.12; p = .05) predicted mammography adherence with a positive association, while present time orientation (OR = 0.91; p = .05) was significantly negatively associated. Religiosity (OR = 1.11; p = .002) and future time orientation (OR = 1.12; p = .05) were positive predictions of stage progression, whereas present time orientation (OR = 0.90; p = .03) had a significant negative relationship. By identifying cultural variables that are related to mammography adherence in African American women, mammography-promoting interventions can be more effectively tailored.
Pasa la Voz : Using Peer Driven Interventions to Increase Latinas’ Access to and Utilization of HIV Prevention and Testing Services
Authors: Ramos Rebecca L. , Green Nancy Lorenza , Shulman Lawrence C.
Published: February 2009

Promotoras along the U.S.-Mexico border in the role of animadoras (motivators) used a chain referral strategy called Pasa la Voz (Spread the Word). Latinas at high to moderate risk of HIV infection became better informed about prevention, accessed prevention services, and referred other at-risk Latinas for services.
Defining Contemporary Forms of Slavery: Updating a Venerable NGO
Authors: Welch Claude E.
Published: February 2009

The London-based NGO Anti-Slavery was founded in 1839. For almost all its history, it remained a small group, working primarily through informal links to British parliamentarians. Pressure from the group made a significant though indirect impact on the 1926 League of Nations Slavery Convention and the 1956 United Nations Supplementary Convention. Anti-Slavery’s focus has shifted from chattel slavery to contemporary forms of slavery, which remain poorly defined in international law. This article examines both the evolution of Anti-Slavery and the League’s and United Nations failure to establish an effective monitoring group, which Anti-Slavery has consistently pressed for, albeit unsuccessfully.
Within Reach of the State: Prosecuting Atrocities in Africa
Authors: Fiss Owen
Published: February 2009

Human rights trials now abound in Africa. These trials are being conducted almost exclusively by international tribunals, most notably the International Criminal Court, without—so this article maintains—proper regard for the power and duty of national courts to protect their citizens from human rights abuses. Not every atrocity calls for an international tribunal.
Reconstructing Masculinities: The Disarmament, Demobilization, and Reintegration of Former Combatants in Colombia
Authors: Theidon Kimberly
Published: February 2009

A key component of peace processes and post-conflict reconstruction is the disarmament, demobilization, and reintegration (DDR) of ex-combatants. I argue that DDR programs imply multiple transitions: from the combatants who lay down their weapons, to the governments that seek an end to armed conflict, to the communities that receive—or reject—these demobilized fighters. At each level, these transitions imply a complex equation between the demands of peace and the clamor for justice. However, traditional approaches to DDR have focused on military and security objectives, which have resulted in these programs being developed in relative isolation from the field of transitional justice and its concerns with historical clarification, justice, reparations, and reconciliation. Drawing upon my research with former combatants in Colombia, I argue that successful reintegration not only requires fusing the processes and goals of DDR programs with transitional justice measures, but that both DDR and transitional justice require a gendered analysis that includes an examination of the salient links between weapons, masculinities, and violence. Constructing certain forms of masculinity is not incidental to militarism: rather, it is essential to its maintenance. What might it mean to “add gender” to DDR and transitional justice processes if one defined gender to include men and masculinities, thus making these forms of identity visible and a focus of research and intervention? I explore how one might “add gender” to the DDR program in Colombia as one step toward successful reintegration, peace-building, and sustainable social change.
Context, Timing and the Dynamics of Transitional Justice: A Historical Perspective
Authors: Fletcher Laurel E. , Weinstein Harvey M. , Rowen Jamie
Published: February 2009

Legal process is invoked by supporters of transitional justice as necessary if not a precondition for societies affected by mass violence to transition into a new period of peace and stability. In this paper, we question the presumption that trials and/or truth commissions should be an early response to initiating a transitional justice process. We conducted a multi-factorial, qualitative analysis of seven case studies in countries impacted by mass violence and repression—Argentina, Cambodia, Guatemala, Timor-Leste, Northern Ireland, Sierra Leone, and South Africa. What emerges is a fuller appreciation of the dynamic system in which transitional justice interventions occur. Each system component may influence the outcome of these interventions. We offer principles that can guide institutional development, scholarship, and policy prescriptions in the area of transitional justice.
Transnational and Domestic Processes in the Definition of Human Rights Policies in Mexico
Authors: Muñoz Alejandro Anaya
Published: February 2009

This article elaborates a theoretically oriented account of recent changes in the foreign and domestic human rights policies of the Mexican government. Referring to two different frameworks offered by international relations literature (the “boomerang-spiral” model and the “locking in” argument), the article shows that the changes in Mexico’s human rights policies are best explained by taking into consideration transnational and domestic processes. Pressure and rhetorical entrapment, generated by the activism of a transnational advocacy network, the political preferences of newly elected democratic leaders, and the role played by national decision makers are key explanatory factors that complement each other in this case study.
Misreading Muslim History
Authors: Filali-Ansary Abdou
Published: February 2009

A review of The West and Islam: Religion and Political Thought in World History by Antony Black.
Debating the Color Revolutions: What Are We Trying to Explain?
Authors: Silitski Vitali
Published: February 2009

Abstract:
What were the color revolutions? The phrase encompasses a set of political changes across the postcommunist world that can be divided into three categories: transformative elections, “electoral revolutions” as such, and “postelectoral” popular uprisings. Electoral transitions varied dramatically with regard to the significance of the opposition’s actual victory in elections, the size of the crowds that turned out in the streets in support of the opposition, the geopolitical context of the transitions, and the long-term consequences of these electoral revolutions for the countries where they occurred. In seeking to explain these events, diffusion and structure need not be viewed as mutually exclusive causal variables. Indeed, diffusion, working in different structural and cultural contexts, has produced diverse political outcomes.

Change may be caused more by the frailty of the regime than the strength of the opposition, but in such cases the outcome is often less democratic.
Hong Kong’s Democrats Hold Their Own
Authors: Sing Ming
Published: February 2009

In September 2008, pandemocrats retained the voters’ support during the Legislative Council election. Beijing’s interferences with the elections, though less blatant than those of 2004, unmistakably cast doubt on its sincerity to implement democracy in Hong Kong by 2020. In 2008, Beijing promoted a new wave of pro-Beijing professionals with a stronger and more independent image. The sudden rise and stunning electoral victories of the Social Democrats, who are hallmarked by civil disobedience on behalf of democratic and social reforms, reflect a deepening sense of public despair about the futility of the current political system, and a proliferating radicalism.

A decade after the handover of their city to China, Hong Kong’s “pandemocrats” remain able to stand their ground at the ballot box.
Can Cuba Change? Ferment in Civil Society
Authors: Gershman Carl , Gutierrez Orlando
Published: February 2009

Abstract:
Despite the apparent stability of the Castro dictatorship, an internal movement of civic resistance has gradually been gaining strength in Cuba. Opposition organizations as the Varela Project and the Women in White have undertaken important initiatives, and some 3,000 actions of protest and non-cooperation take place every year, mostly in the provinces of eastern and central Cuba. Alienated youth, marginalized non-whites, and oppressed workers represent three potentially explosive sources of cleavage and discontent. By reviving the democratic nationalism associated with the tradition of José Martí, the Cuban movement will be an important factor shaping the future of the country.

The opposition within Cuba has become more diverse as well as more unified, and the regime, despite its enduring capacity for repression, is showing signs of underlying weakness.
Is Democracy Possible?
Authors: Gilley Bruce
Published: February 2009

Anti-democratic thought is enjoying a resurgence with new claims of citizen incompetence, ignorance, and irrationality. While these claims have a long pedigree, they have become more widely held in a democratic age. They point to important insights concerning the limits of popular rule, although they are often based on misunderstandings or simple errors. Those that are valid are in any case already reflected in the institutions of democratic countries, especially those of the United States, where the claims are mostly made. The overstatement of these claims reminds us that democracy is not just possible, but also necessary.

While the belief in democracy has spread around the world, it has begun to crumble in some of the West’s finest academic institutions.
Paraguay: The Unraveling of One-Party Rule
Authors: Abente-Brun Diego
Published: February 2009

How did the Colorado Party lose its iron grip on power? Fernando Lugo’s victory, ending six decades of Colorado Party rule, marked the twelfth time since the beginning of the third wave of democratization that a hegemonic-party regime was transformed into a fully competitive one allowing a transfer of power. Recent scholarship has shed considerable light on why and how hegemonic parties remain in power year after year as well as what factors precipitate the end to their dominance. These studies have revealed that, far from being idiosyncratic oddities, hegemonic-party regimes have been a persistent, if marginal, phenomenon during the twentieth century.

Fernando Lugo’s victory in the 2008 presidential election ended 61 years of one-party rule in Paraguay. How did the Colorado Party lose power?
Debating the Color Revolutions: Popular Autocrats
Authors: Dimitrov Martin K.
Published: February 2009

Abstract:
Levels of regime strength and links to the West help to explain authoritarian breakdown, but the ruler’s popularity also matters.
Debating the Color Revolutions: Getting Real About “Real Causes”
Authors: Bunce Valerie , Wolchik Sharon
Published: February 2009

Abstract:
Way is correct that structural factors make competitive regimes more or less vulnerable, but he ignores the durability of even very weak regimes. In the color revolutions, defeat occurred because of the formation of a united opposition; collaboration among oppositions, civil society groups and international democracy promoters; ambitious campaigns to win public support, register new voters, and get out the vote; and widespread use of vote monitors. Thanks to such innovations, voters selected the opposition rather than staying home or supporting the regime, and very close elections in Ukraine, Serbia and Slovakia tilted in the favor of the opposition.

Structure agency, and process all are critical in explaining the uneven pattern of electoral change in postcommunist Europe and Eurasia.
Ferment in Civil Society
Authors: Gershman Carl , Gutierrez Orlando
Published: February 2009

Abstract:
Despite the apparent stability of the Castro dictatorship, an internal movement of civic resistance has gradually been gaining strength in Cuba. Opposition organizations as the Varela Project and the Women in White have undertaken important initiatives, and some 3,000 actions of protest and non-cooperation take place every year, mostly in the provinces of eastern and central Cuba. Alienated youth, marginalized non-whites, and oppressed workers represent three potentially explosive sources of cleavage and discontent. By reviving the democratic nationalism associated with the tradition of José Martí, the Cuban movement will be an important factor shaping the future of the country.

The opposition within Cuba has become more diverse as well as more unified, and the regime, despite its enduring capacity for repression, is showing signs of underlying weakness.