bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoperative Microemboli and Low Middle Cerebral Artery Blood Flow Velocity Are Additive in Predicting Development of Cerebral Ischemic Events After Carotid Endarterectomy
Authors: Ogasawara Kuniaki , Suga Yasunori , Sasaki Makoto , Chida Kohei , Kobayashi Masakazu , Yoshida Kenji , Otawara Yasunari , Ogawa Akira
Published: August 2008

Background and Purpose—

Microemboli generated during dissection of the carotid arteries in patients undergoing carotid endarterectomy result in postoperative cerebral ischemic events. The purpose of this study was to determine whether these events correlate with middle cerebral artery blood flow velocity.

Methods—

One hundred sixty-three patients with ipsilateral internal carotid artery stenosis (>70%) underwent carotid endarterectomy under transcranial Doppler monitoring of mean blood flow velocity and microembolic signals in the ipsilateral middle cerebral artery.

Results—

Logistic regression analysis of several variables demonstrated that only middle cerebral artery mean blood flow velocity during carotid dissection was significantly associated with new postoperative neurological deficits in patients with microembolic signals during carotid dissection (95% CI, 1.069 to 1.528;
P
=0.0072). The combination of low middle cerebral artery mean blood flow velocity (≤28 cm/s) and microembolic signals ≥10 during carotid dissection resulted in improved specificity and positive predictive value for the development of new postoperative neurological deficits when compared with either criterion used alone.

Conclusions—

Intraoperative microemboli and low middle cerebral artery mean blood flow velocity are additive in predicting the development of cerebral ischemic events after carotid endarterectomy.
Assessment of the Contribution of the External Carotid Artery to Brain Perfusion in Patients With Internal Carotid Artery Occlusion
Authors: van Laar Peter Jan , van der Grond Jeroen , Bremmer Jochem P. , Klijn Catharina J.M. , Hendrikse Jeroen
Published: August 2008

Background and Purpose—

The purpose of this study was to prospectively investigate the contribution of the ipsilateral external carotid artery (ECA) to cerebral perfusion in patients with internal carotid artery occlusion.

Methods—

Institutional Review Board approval and informed consent were obtained. Thirty functionally independent patients (24 men, 6 women; mean age, 63 years) with an angiographically proven unilateral internal carotid artery occlusion and transient or minor disabling ischemic attacks ipsilateral to the side of the internal carotid artery occlusion were included. Grading of ECA collateral flow was performed with intraarterial digital subtraction angiography. The contribution of the ECA to regional cerebral blood flow was assessed with selective arterial spin labeling MRI. Differences in regional cerebral blood flow were analyzed with Student
t
test.

Results—

Twenty percent of the patients had ECA Grade 0 collateral flow (no filling of ophthalmic artery), 20% Grade 1 (filling of carotid siphon), and 60% Grade 2 (filling of anterior and/or middle cerebral artery) as demonstrated on digital subtraction angiography. Although in the Grade 1 group, the ECA supplied a smaller region of the brain compared with the Grade 2 group, the mean regional cerebral blood flow of the perfusion territory supplied by the ECA is similar (
P
=0.70) in the Grade 1 group (mean±SD 57±16 mL/min/100 g) and the Grade 2 group (60±12 mL/min/100g).

Conclusion—

In patients with symptomatic internal carotid artery occlusion, focal brain regions may strongly depend on the contribution to cerebral perfusion of the ECA ipsilateral to the side of the internal carotid artery occlusion, even in patients with limited ECA collateral supply as demonstrated on digital subtraction angiography.
Higher ABCD
2
Score Predicts Patients Most Likely to Have True Transient Ischemic Attack
Authors: Josephson S. Andrew , Sidney Stephen , Pham Trinh N. , Bernstein Allan L. , Johnston S. Claiborne
Published: August 2008

Background and Purpose—

Some patients diagnosed with transient ischemic attack (TIA) in the emergency department may actually have alternative diagnoses such as seizure, migraine, or other nonvascular spells. The ABCD
2
score has been shown to predict subsequent risk of stroke in patients with TIA diagnosed by emergency physicians, but perhaps high ABCD
2
scores simply separate those patients with true TIA from those with alternative diagnoses. We investigated this hypothesis in a cohort of patients with TIA identified in the emergency department whose records were reviewed by an expert neurologist.

Methods—

Among patients diagnosed by emergency physicians with TIA in 16 hospitals in the Kaiser-Permanente Medical Care Plan over a 1-year period ending February 1998 (before publication of prediction rules), an expert neurologist reviewed all records for those in which the diagnosis of TIA was considered questionable by a medical records analyst and determined whether the spell was likely to represent a true TIA. Subsequent strokes within 90 days were identified. ABCD
2
scores were calculated for all patients and 2-sided Cochrane-Armitage trend tests were used to assess subsequent risk of stroke.

Results—

Of the 713 patients reviewed by the expert neurologist, 642 (90%) were judged to likely have experienced a true TIA. Ninety-day stroke risk was 24% (95% CI, 20% to 27%) in the group judged to have experienced a true TIA and 1.4% (0% to 7.6%) in the group judged to not have a true TIA (
P
<0.0001). ABCD
2
scores were higher in those judged to have a true TIA compared with others (
P
=0.0001). In the group judged to have a true TIA, 90-day stroke risk increased as ABCD
2
score increased (
P
<0.0001); there was no relationship between ABCD
2
score and stroke risk in those judged unlikely to have had a TIA (
P
=0.73).

Conclusions—

Among patients diagnosed by emergency department physicians with TIA, higher ABCD
2
score was associated with a greater likelihood that the diagnosis was confirmed on expert review. The predictive power of the ABCD
2
model is therefore partially explained by identification of those patients likely to have experienced a true TIA, an important aspect of the score when used by nonneurologists. However, higher ABCD
2
scores still remained predictive of 90-day stroke rate in the group of patients judged to have a true TIA by an expert neurologist.
Safety Profile of Transcranial Near-Infrared Laser Therapy Administered in Combination With Thrombolytic Therapy to Embolized Rabbits
Authors: Lapchak Paul A. , Han Moon-Ku , Salgado Karmen F. , Streeter Jackson , Zivin Justin A.
Published: August 2008

Background and Purpose—

Transcranial near-infrared laser therapy (TLT) is currently under investigation in a pivotal clinical trial that excludes thrombolytic therapy. To determine if combining tissue plasminogen activator (tPA; Alteplase) and TLT is safe, this study assessed the safety profile of TLT administered alone and in combination with Alteplase. The purpose for this study is to determine if the combination of TLT and thrombolysis should be investigated further in a human clinical trial.

Methods—

We determined whether postembolization treatment with TLT in the absence or presence of tPA would affect measures of hemorrhage or survival after large clot embolism-induced strokes in New Zealand white rabbits.

Results—

TLT did not significantly alter hemorrhage incidence after embolization, but there was a trend for a modest reduction of hemorrhage volume (by 65%) in the TLT-treated group compared with controls. Intravenous administration of tPA, using an optimized dosing regimen, significantly increased hemorrhage incidence by 160%. The tPA-induced increase in hemorrhage incidence was not significantly affected by TLT, although there was a 30% decrease in hemorrhage incidence in combination-treated rabbits. There was no effect of TLT on hemorrhage volume measured in tPA-treated rabbits and no effect of any treatment on 24-hour survival rate.

Conclusion—

In the embolism model, TLT administration did not affect the tPA-induced increase in hemorrhage incidence. TLT may be administered safely either alone or in combination with tPA because neither treatment affected hemorrhage incidence or volume. Our results support the study of TLT in combination with Alteplase in patients with stroke.
Excess Salt Causes Cerebral Neuronal Apoptosis and Inflammation in Stroke-Prone Hypertensive Rats Through Angiotensin II-Induced NADPH Oxidase Activation
Authors: Yamamoto Eiichiro , Tamamaki Nobuaki , Nakamura Taishi , Kataoka Keiichiro , Tokutomi Yoshiko , Dong Yi-Fei , Fukuda Masaya , Matsuba Shinji , Ogawa Hisao , Kim-Mitsuyama Shokei
Published: August 2008

Background and Purpose—

The precise mechanism of salt-induced brain injury is unclear. We examined the detailed causative role of angiotensin II and NADPH oxidase in salt-accelerated brain injury of stroke-prone spontaneously hypertensive rats (SHRSP).

Methods—

We examined the effect of salt loading on brain reactive oxygen species (ROS), inflammation, and apoptosis in SHRSP. Salt-loaded SHRSP were given vehicle, valsartan (an angiotensin AT1 receptor blocker), or hydralazine to compare their efficacy on brain injury. We also examined the efficacy of apocynin (a NADPH oxidase inhibitor) on brain injury of salt-loaded SHRSP.

Results—

Cerebral NADPH oxidase activity and ROS in SHRSP were already increased at 1 week after salt loading followed by the significant increase in ED-1-positive cells and neuronal apoptosis. Thus, cerebral NADPH oxidase activation preceded cerebral inflammation and neuronal apoptosis. Despite comparable hypotensive effects between valsartan and hydralazine in salt-loaded SHRSP, valsartan reduced cerebral NADPH oxidase activity and ROS more than hydralazine being accompanied by more prevention of stroke by valsartan than hydralazine. Valsartan, but not hydralazine, prevented neuronal apoptosis, being associated with the suppression of apoptosis signal-regulating kinase 1 activation by valsartan. Moreover, cerebral inflammation was also prevented by valsartan more than hydralazine, being associated with more suppression of monocyte chemotactic protein-1 and tumor necrosis factor-α expressions by valsartan. Thus, angiotensin II was directly involved in salt-induced neuronal NADPH oxidase activation, ROS, apoptosis, and inflammation in SHRSP. Apocynin attenuated the enhancement of ROS, cerebral inflammation, neuronal apoptosis, and apoptosis signal-regulating kinase 1 activation and prevented stroke in salt-loaded SHRSP, indicating the causative role of cerebral NADPH oxidase in salt-induced brain injury.

Conclusion—

We obtained the evidence that excess salt, through ROS produced by angiotensin II-activated NADPH oxidase, caused cerebral neuronal apoptosis and inflammation as well as stroke in SHRSP.
Supratentorial Regions of Acute Ischemia Associated With Clinically Important Swallowing Disorders
Authors: Gonzalez-Fernandez Marlis , Kleinman Jonathan T. , Ky Paul K.S. , Palmer Jeffrey B. , Hillis Argye E.
Published: August 2008

Background and Purpose—

Dysphagia is a common problem after stroke associated with significant morbidity and mortality. Except for patients with brain stem strokes, particularly lateral medullary strokes, it is difficult to predict which cases are likely to develop swallowing dysfunction based on their neuroimaging. Clear models of swallowing control and integration of cortico-bulbar input have not been defined and the role of subcortical structures is unclear. The purpose of this study was to identify supratentorial regions of interest (ROIs) that might be related to clinically important dysphagia in acute stroke patients, focusing on subcortical structures.

Methods—

We studied 29 acute supratentorial ischemic stroke cases admitted to our institution between 2001 and 2005 diagnoses with first ischemic stroke and without history of swallowing dysfunction. Subjects had MRI within 24 hours. Cases were defined as those subjects who were diagnosed as dysphagic after clinical evaluation by a speech language pathologist (SLP) and whose dysphagia was considered clinically significant, ie, requiring treatment by diet modification. Controls were defined as those patients who: (1) passed the stroke unit’s dysphagia screening, (2) had a clinical evaluation by SLP that did not result in a diagnosis of dysphagia or diet modifications, or (3) had no documented evidence of dysphagia evaluation or treatment during hospitalization and were discharged on a regular diet. A trained technician, blinded to case-control status, examined 12 ROIs for dysfunctional tissue in diffusion and perfusion-weighted images. The odds ratio (OR) of dysphagia was calculated for each ROI. Logistic regression models were used to adjust for stroke severity (NIHSS) and volume.

Results—

Analysis of data on 14 cases and 15 controls demonstrated significant differences in the unadjusted odds of dysphagia for the following ROIs: (1) primary somatosensory, motor, and motor supplementary areas (PSSM; OR=10,
P
=0.009); (2) orbitofrontal cortex (OFC; OR=6.5,
P
=0.04); (3) putamen, caudate, basal ganglia (PCBG; OR=5.33,
P
=0.047); and (4) internal capsule (IC; OR=26;
P
=0.005). Nonsignificant differences were found in the insula and temporopolar cortex. Adjusted OR of dysphagia for subjects with strokes affecting the IC was 17.8 (
P
=0.03). Adjusted odds ratios for the PSSM, OFC, and PCBG were not statistically significant.

Conclusion—

Significantly increased odds of dysphagia were found in subjects with IC involvement. Other supratentorial areas that may be associated with dysphagia include the PSSM, OFC, and PCBG. Analysis of additional areas was limited by the number of subjects in our sample. Future studies with larger sample size are feasible and will contribute to the development of a full swallowing control model.
Aneurysm Growth Occurs at Region of Low Wall Shear Stress
Authors: Boussel Loic , Rayz Vitaliy , McCulloch Charles , Martin Alastair , Acevedo-Bolton Gabriel , Lawton Michael , Higashida Randall , Smith Wade S. , Young William L. , Saloner David
Published: August 2008

Background and Purpose—

Evolution of intracranial aneurysmal disease is known to be related to hemodynamic forces acting on the vessel wall. Low wall shear stress (WSS) has been reported to have a negative effect on endothelial cells normal physiology and may be an important contributor to local remodeling of the arterial wall and to aneurysm growth and rupture.

Methods—

Seven patient-specific models of intracranial aneurysms were constructed using MR angiography data acquired at two different time points (mean 16.4±7.4 months between the two time points). Numeric simulations of the flow in the baseline geometries were performed to compute WSS distributions. The lumenal geometries constructed from the two time points were manually coregistered, and the radial displacement of the wall was calculated on a pixel-by-pixel basis. This displacement, corresponding to the local growth of the aneurysm, was compared to the time-averaged wall shear stress (WSS
TA
) through the cardiac cycle at that location. For statistical analysis, radial displacement was considered to be significant if it was larger than half of the MR pixel resolution (0.3 mm).

Results—

Mean WSS
TA
values obtained for the areas with a displacement smaller and greater than 0.3 mm were 2.55±3.6 and 0.76±1.5 Pa, respectively (
P
<0.001). A linear correlation analysis demonstrated a significant relationship between WSS
TA
and surface displacement (
P
<0.001).

Conclusions—

These results indicate that aneurysm growth is likely to occur in regions where the endothelial layer lining the vessel wall is exposed to abnormally low wall shear stress.
Predictors of Time From Hospital Arrival to Initial Brain-Imaging Among Suspected Stroke Patients
Authors: Rose Kathryn M. , Rosamond Wayne D. , Huston Sara L. , Murphy Carol V. , Tegeler Charles H.
Published: August 2008

Background and Purpose—

We examined patient demographic and hospital characteristics and clinical predictors of delay time from hospital arrival until CT among 20 374 patients enrolled in the North Carolina Collaborative Stroke Registry (January 2005 to April 2008).

Methods—

Delay time was log-transformed in linear regression analyses and dichotomized (≤25 minutes, >25 minutes) in logistic regression analyses to correspond to a 1999 National Institute of Neurological Disorders and Stroke guideline.

Results—

In multiple linear regression analyses, prehospital delay time, mode of transport, race, gender, presumptive diagnosis, time of day of arrival, weekday versus weekend arrival, and hospital type (defined by Joint Commission Primary Stroke Center certification and teaching status) were significantly associated with CT delay. In analyses of 3549 patients arriving within 2 hours of symptom onset, time of day of arrival and weekday versus weekend arrival were no longer significant. Among patients arriving within 2 hours of symptom onset, the strongest independent predictors of meeting the National Institute of Neurological Disorders and Stroke (NINDS) guideline were arrival by emergency medical services versus other modes of transportation (odds ratio, 95% CI=2.3 [1.9, 2.8]) and a presumptive diagnosis of transient ischemic attack versus unspecified stroke type (odds ratio, 95% CI=0.4 [0.3, 0.5]).

Conclusions—

Most patients do not arrive to the hospital in a timely manner and cannot be considered for time-dependent therapies. Among those that do, disparities exist in time to receipt of CT scan, suggesting room for improvement in hospital-level stroke systems of care.
Reducing Death and Disability From Stroke
Authors: Goldstein Larry B.
Published: August 2008

Governmental actions affect our lives and the lives of our fellow citizens in a variety of ways. This is certainly true for both the conduct of biomedical research and the provision of medical care. Governmental policy-makers require accurate information upon which to base their decisions. Stroke researchers and clinicians are uniquely suited to provide the facts, figures and statistics to help these officials weigh alternative options, and need to become actively involved in the advocacy efforts of their professional organizations. Although written from the perspective of the United States, the issues raised are relevant throughout the world.
Preparation, Characterization and Conductivity Study of Polypyrrole-Pillared Clay Nanocomposites
Authors: Shakoor Abdul , Anwar Hafeez , Rizvi Tasneem Zahra
Published: August 2008

Polypyrrole-aluminum pillared montmorillonite (PPy-Al-PMMT) clay composites were prepared by in-situ polymerization of pyrrole in aqueous dispersion of aluminum pillared montmorillonite (Al-PMMT) clay using FeCl3.6H 2O as an oxidant. Various composite samples with varying amounts of (Al-PMMT) clay from 0.2 wt% to about 25 wt% were prepared and were characterized by using scanning electron microscopy (SEM) and X-ray diffraction (XRD). XRD results revealed that for very low concentration of Al-PMMT, PPy was intercalated in the interlamellar region of PMMT replacing the aluminum pillars. With the increase of Al-PMMT concentration above 1 wt% the level of intercalation decreased. Room temperature DC conductivity of PPy-Al-PMMT composites was measured using standard Four Point Probe technique and AC conductivity was measured in the frequency range 100 Hz to 1 MHz. using an LCR meter. DC conductivity values slightly increased with the increase of clay content in the samples due to the effect of intercalation of PPy in the interlamellar galleries of PMMT. For upto 1% Al-PMMT the DC conductivity increased rapidly with Al-PMMT content but for higher concentrations this increase was not so rapid. AC conductivities of the (PPy-Al-PMMT) clay composites were considerably high as compared to the AC conductivity of pure PPy and this also increased with the content of Al-PMMT in the composites. At low frequencies the AC conductivities of pure PPy and its composites remained constant with the increase of frequency and increased rapidly with the increase of frequency at high frequencies. The slope of frequency dependence curves at high frequencies did not change with the Al-PMMT content and was found to be the same in pure PPy as well as in all the composite samples studied. The onset of rapid increase of AC conductivity, however, shifted to a higher frequency value on addition of Al-PMMT in PPy.
The Effect of Nanoscaled-Layered Silicates on Thermal Conductivity of Nanocomposites based on HDPE and PP
Authors: Mohaddespour Ahmad , Abolghasemi Hossein , Ahmadi S. Javad
Published: August 2008

Organically-modified montmorillonite (OMT) is added in the HDPE and PP matrices into which PEG and PPG are used as a compatibilizer to investigate the behavior of thermal conductivity for polymer/clay nanocomposites. The results indicate that the thermal conductivity of all nanocomposites increases with temperature. Clay incorporation also increases the thermal conductivity. HDPE and PP nanocomposites with 5wt% of clay content show the augmentation of 19 and 23% for thermal conductivity at 20°C with respect to their pure polymers. Mathematical modeling of nanocomposite sheets reveals that the addition of clay into the HDPE and PP matrices up to 10wt%, under the current circumstances of this study, and increase in temperature up to 50°C do not significantly affect the temperature distributions.
Optimal Design of Composite Stiffened Panel with Cohesive Elements using Micro-Genetic Algorithm
Authors: Kim Soo-Hyun , Kim Chun-Gon
Published: August 2008

A postbuckling analysis for composite stiffened structures is a representative nonlinear analysis, but is difficult to obtain analysis results and a lengthy computational time is required. In this study, an accurate and realistic postbuckling model for a stiffened composite panel is made, and optimization module is studied. In order to predict the realistic behavior in the postbuckling region, cohesive elements were introduced to the analysis model to account for skin-stiffener debonding. The global behaviors and failure loads of the analysis results were found to be similar to the experimental results. Based on this analysis model, the optimal layer design of a composite stiffened panel up to postbuckling failure was performed using micro genetic algorithm. The optimized result showed a higher maximum failure load in the postbuckling region.
Cure-induced Normal Force Development in Unfilled and Filled Epoxy Resins
Authors: Harsch Margit , Herzog Florian , Karger-Kocsis Jozsef
Published: August 2008

The present study is devoted to assessing the development of normal force (Fn) in a bisphenol A-type epoxy resin (EP) with (about 50wt%) and without filler when cured by anhydride under isothermal conditions, however, at various temperatures (T=75 up to 150°C). The evoking Fn was measured in a plate—plate rheometer capable of following the contraction of the cross-linking EP. Supplementary information on the conversion, glass transition temperature, and gel time was received from differential scanning calorimetry (DSC) and oscillatory rheological measurements. Up to gelation no Fn was detected. Between gelation and vitrification the normal force rate (dFn/dt) proved to be constant at a given temperature and followed an exponential function as a function of temperature. F n plotted as a function of conversion confirmed that its onset is linked with the gelation. The buildup of Fn after gelation remained independent of the curing temperature in a given conversion range. At higher conversion, however, the Fn values measured in low temperature isothermal tests became higher than at high temperature tests due to the earlier onset of vitrification in the former case. The results were basically similar for both the neat and filled EPs except that the gelation and vitrification transitions were less sharp for the filled compared to the unfilled EP version.
Normalization of Shear Test Data for Rate-independent Compressible Fabrics
Authors: Harrison P. , Wiggers J. , Long A.C.
Published: August 2008

This article describes a method of using both picture frame (PF) and bias extension (BE) tests together to characterize accurately the trellis shearing resistance of engineering fabrics under low in-plane tension conditions. Automated image analysis software has been developed to reduce the amount of laborious manual analysis required to interpret BE data accurately. Normalization methods for both PF and BE tests on rate-independent compressible fabrics are presented. Normalization of PF test results is relatively straightforward while normalization of BE test results for direct comparison with PF data is more complicated. The normalization method uses a number of simple assumptions to account for the nonuniform shear strain field induced across BE samples during testing. Normalized results from BE tests on samples of different aspect ratios are compared and provide validation of the theory.
Dielectric and Piezoelectric Properties of 2—2 Cement Based Piezoelectric Composite
Authors: Huang Shifeng  , Xu Dongyu  , Cheng Xin  , Jiang Minhua
Published: August 2008

Cement-based piezoelectric composites with 2—2 connectivity were fabricated from lead magnesium niobate—lead zirconate—lead titanate (PMN) and sulfoaluminate cement by a dice-and-fill technique. The influences of PMN volume fraction and frequency on the piezoelectric and dielectric properties of the composite were analyzed. The results indicated that with increasing the PMN volume fraction, both the piezoelectric strain factor d33 and the relative dielectric factor εr of the composite increased, while the piezoelectric voltage factor g33 decreased. The dielectric resonance peaks, antiresonance absorption peaks, and the dielectric loss peaks of the composites commonly appeared around 200 kHz. With increasing the PMN volume fraction, both the dielectric resonance peaks value and the antiresonance absorption peaks value increased, while the dielectric loss peaks value decreased. At the high frequency zone, the relative dielectric factor εr and dielectric loss tan δ of the composite changed smoothly with increasing frequency.
An Exploratory Investigation of Frequently Cited Articles From the Early Childhood Intervention Literature, 1994 to 2005
Authors: Pool Juli Lull , Macy Marisa , Bells McManus Suzanne , Noh Jina
Published: August 2008

The authors explored frequently cited articles across four peer-reviewed journals in early intervention (EI) and early childhood special education (ECSE). The Social Sciences Citation Index was used to examine journal articles from 1994 to 2005 in Early Childhood Research Quarterly, Infants and Young Children, the Journal of Early Intervention, and Topics in Early Childhood Special Education. Results for the most frequently cited EI and ECSE journal articles are reported.
Domination in a Scientific Field
Authors: Wei Hong
Published: August 2008

This paper applies Bourdieu's theory of the scientific field to examine the sources of authority, reasons for conflict, and group dynamics in an isotope lab at a Chinese university. After 7 months of participant observation and non-structured interviews, I found that theoretical capital and technological capital are both used in the isotope lab. While both are associated with scientific authority, it was theoretical capital that determined lab members' social authority. Dominant and subordinate members of the lab applied different strategies to advance their interests. Conflicts of interest induced competition between the holders of theoretical and technological capital, which in turn caused interpersonal conflict. The specificity of the field of geoscience determines the relative power of technological and theoretical capital, and the low autonomy of the scientific field in China strengthens that hierarchy. I find that this hierarchy of scientific capital in the broader field can have a considerable impact on the social construction of experimental results in the local settings.
Transgenes and Transgressions: Scientific Dissent as Heterogeneous Practice
Authors: Delborne Jason A.
Published: August 2008

Although scholars in science and technology studies have explored many dynamics and consequences of scientific controversy, no coherent theory of scientific dissent has emerged. This paper proposes the elements of such a framework, based on understanding scientific dissent as a set of heterogeneous practices. I use the controversy over the presence of transgenic DNA in Mexican maize in the early 2000s to point to a processual model of scientific dissent. `Contrarian science' includes knowledge claims that challenge the dominant scientific trajectory, but need not necessarily lead to dissent. `Impedance' represents efforts to undermine the credibility of contrarian science (or contrarian scientists) and may originate within or outside of the scientific community. In the face of impedance, contrarian scientists may become dissenters. The actions of the scientist at the center of the case study, Professor Ignacio Chapela of the University of California, Berkeley, demonstrate particular practices of scientific dissent, ranging from `agonistic engagement' to `dissident science'. These practices speak not only to functional strategies of winning scientific debate, but also to attempts to reconfigure relations among scientists, publics, institutions, and politics that order knowledge production.
Exploring the Influence of the Regulatory Survey Process on Nursing Home Administrator Job Satisfaction and Job Seeking
Authors: Holecek Terry , Dellmann-Jenkins Mary , Curry Dale
Published: August 2008

Nursing home administrators’ retention rate continues to be a serious problem. One factor potentially affecting administrator turnover that has received minimal research attention is the nursing home regulatory process. Using a random start systematic sample of 135 nursing home administrators, this study explores whether regulatory process perceptions, survey performance (number of deficiency citations on last survey), and demographic or facility variables are associated with job satisfaction and job seeking. Multivariate analyses revealed three main findings: (a) an overall positive perception of the survey process was a significant predictor of administrator job satisfaction and job seeking, (b) survey performance outcomes were not related to administrator job satisfaction, and (c) administrator job seeking was associated with perception of the survey process, performance outcomes, and four factors identified in prior research on staff turnover (type of facility, job tenure, salary, and job satisfaction). Results reinforce ongoing initiatives on retaining quality nursing home leadership.
Perceived Discrimination, Perceived Stress, and Mental and Physical Health Among Mexican-Origin Adults
Authors: Flores Elena , Tschann Jeanne M. , Dimas Juanita M. , Bachen Elizabeth A. , Pasch Lauri A. , de Groat Cynthia L.
Published: August 2008

This study provided a test of the minority status stress model by examining whether perceived discrimination would directly affect health outcomes even when perceived stress was taken into account among 215 Mexican-origin adults. Perceived discrimination predicted depression and poorer general health, and marginally predicted health symptoms, when perceived stress was taken into account. Perceived stress predicted depression and poorer general health while controlling for the effects of perceived discrimination. The influence of perceived discrimination on general health was greater for men than women, and the effect of perceived stress on depression was greater for women than men. Results provide evidence that discrimination is a source of chronic stress above and beyond perceived stress, and the accumulation of these two sources of stress is detrimental to mental and physical health. Findings suggest that mental health and health practitioners need to assess for the effects of discrimination as a stressor along with perceived stress.
The Impact of No Child Left Behind on Teachers' Writing Instruction
Authors: McCarthey Sarah J.
Published: August 2008

The study uses Foucault's framework of governmentality to understand the impact of No Child Left Behind (NCLB) on teachers' writing instruction and attitudes toward writing in high- and low-income schools. Using interviews and observations of 18 teachers, the study identified four themes: emphasis on testing, curricular effects, awareness of lower-achieving students, and concerns for English language learners. While teachers shared concerns in those areas, there were differences in how teachers from high- and low-income schools experienced the impact of NCLB on their writing instruction. The study suggests that NCLB has affected teacher morale as well as the nature and amount of writing instruction, but that school contexts figure into teachers' instruction. The example of one teacher from a low-income school demonstrates the potential for teachers to resist the coercive aspects of NCLB through their writing instruction.
Subclinical Mastitis Is Common Among Ghanaian Women Lactating 3 to 4 Months Postpartum
Authors: Aryeetey Richmond N. O. , Marquis Grace S. , Timms Leo , Lartey Anna , Brakohiapa Lucy
Published: August 2008

Subclinical mastitis (SCM) is an asymptomatic inflammation of mammary tissue and has been associated with lactation failure, suboptimal growth in early infancy, and increased risk of mother-to-child transmission of HIV via breast milk. A rapid survey was carried out to determine the prevalence of SCM among lactating Ghanaian women between 3 and 4 months postpartum. Bilateral breast milk samples were obtained from 117 lactating women in Manya Krobo, Ghana and analyzed for sodium (Na) and potassium (K). An elevated sodium/potassium ratio (Na/K) above 1.0 was considered indicative of SCM. Overall, SCM prevalence was observed among 45.3% of the women. About 30% of the women had unilateral SCM. Na/K was associated with maternal age. The high SCM prevalence in Manya Krobo suggests the need for lactation support to reduce SCM and the risk of poor infant outcomes. J Hum Lact. 24(3):263-267.
Effects of Instituting the “BEST Program” (Breast Milk Early Saves Trouble) in a Level III NICU
Authors: Montgomery Dianne , Schmutz Nancy , Baer Vickie L. , Rogerson Renee , Wheeler Rachael , Rowley Anna-Marie , Lambert Diane K. , Christensen Robert D.
Published: August 2008

A program is developed to increase the use of breast milk during the first week, for patients < 2 kg birth weight. This is termed the “BEST program,” using the acronym “Breast milk Early Saves Trouble.” An analysis of feeding practices and outcomes during the 12 months before versus the 12 months after implementing this program was conducted. Demographic features of the patients in the 2 periods were similar. In the “Before Intervention” period, 33% received human milk exclusively in the first 7 feeding days; 50% in the “Intervention” period ( P = .009). In the Before Intervention period, 74% received some breast milk; 82% in the Intervention group ( P = .046). Banked human milk increased from 2% to 33% of patients ( P ≥ .001), and a trend was seen in more mothers who initially wanted to bottle-feed but subsequently changed to breastfeeding ( P = .08). A trend was also seen in more infants discharged home breastfeeding ( P = .09). J Hum Lact. 24(3):248-251.
Case Report of Methicillin-Resistant Staphylococcus aureus (MRSA) Mastitis With Abscess Formation in a Breastfeeding Woman
Authors: Wilson-Clay Barbara
Published: August 2008

An afebrile woman with persistent nonhealing nipples and low-grade intermittent breast pain was diagnosed at 9 weeks postpartum with a methicillin-resistant Staphylococcus aureus infection of the left breast with abscess formation. Unilateral weaning allowed partial lactation to continue. J Hum Lact. 24(3):326-329.
Prevalence Ratio of HTLV-1 in Nursing Mothers From the State of Paraíba, Northeastern Brazil
Authors: Pimenta Flávia C. F. , Kashima Haddad Simone , de Medeiros João G. , Costa Maria José C. , Diniz Margareth F. M. , Fernandes Melina P. , de Araújo Lenisio B. , Pombo-de-Oliveira Maria S.
Published: August 2008

The human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus known as a direct causal agent of a malignant disease. The vertical route of HTLV transmission is the most frequent pathway of the virus contamination. This study was performed to determine the prevalence ratio of HTLV-1 infection among nursing women. From January 2004 to January 2005, blood samples from 1033 nursing mothers from Paraíba, Brazil were evaluated for HTLV antibodies by ELISA and HTLV-1 viral particles confirmed by polymerase chain reaction (PCR). HTLV antibodies were detected in 7 women. The overall seroprevalence ratio was 0.68% and HTLV-1 viral sequences were confirmed by PCR in 2 women. These preliminary data suggest that HTLV screening should be introduced as a mandatory test before breastfeeding and breast milk donation in Paraíba, Brazil. Additionally, counseling programs would help reduce the prevalence ratio of HTLV-1 infected individuals in this Brazilian region. J Hum Lact. 24(3):289-292.
Are US Mothers Meeting the Healthy People 2010 Breastfeeding Targets for Initiation, Duration, and Exclusivity? The 2003 and 2004 National Immunization Surveys
Authors: Forste Renata , Hoffmann John P.
Published: August 2008

Using data from the National Immunization Surveys (2003 and 2004), the authors model the influence of child, maternal, and state- or metropolitan-level factors on the initiation, duration, and exclusivity of breastfeeding to determine the characteristics of groups meeting the Healthy People 2010 targets. Analyses indicate that only children of college graduates meet the targets for breastfeeding at initiation, 6 months, and 12 months; no groups meet the target for exclusive breastfeeding. Results indicate a low prevalence of breastfeeding among children of single mothers, less educated mothers, participants in the Women, Children, and Infants program, and those living in nonwestern states and in areas of high newborn risk. Hispanic children, children of college graduates, and children living in the West consistently have higher odds of breastfeeding. Only the prevalence of breastfeeding early postpartum is near the Healthy People 2010 target of 75%, the percentages for 6 or 12 months and exclusive breastfeeding are well below. J Hum Lact. 24(3):278-288.
An Analysis of Infant Feeding Content Found Within the Hong Kong Print Media
Authors: Dodgson Joan E. , Tarrant Marie , Thompson Jackie T. , Young Branda
Published: August 2008

Worldwide public media greatly affect women's decisions about infant feeding and may not reflect evidence-based practices. The aims of this research were to (1) describe the characteristics of printed articles having infant-feeding content, (2) describe this thematic content, and (3) compare the thematic content found in groupings based on media type and language (English and Chinese). Four Chinese-language newspapers, the English-language newspaper, and 3 bilingual parenting magazines were analyzed. A multiphase qualitative and quantitative content analysis found 5 themes (social context, mothers' information, effects on baby, the value of breast milk, and the utility of formula). Significant differences were found based on media type and language. Although breastfeeding was usually positively framed in all the media, Chinese media had more inaccurate information. Through this analysis, areas where actions could be taken to improve the quality of information about infant feeding received by the public have been identified. J Hum Lact. 24(3):317-325.
The Breastfeeding Mother and the Pediatrician
Authors: Geraghty Sheela R. , Riddle Sarah W. , Shaikh Ulfat
Published: August 2008

An estimated 70% of mothers in the United States initiate breastfeeding annually. Mothers often discuss breastfeeding problems with their infant's pediatrician. Pediatricians may feel unsure about their role when assisting the nonpatient, breastfeeding mother. By having practical solutions and support systems in place to anticipate and tend to breastfeeding mothers' needs, pediatricians can be instrumental in preventing early weaning. The purpose of this article is to provide practical suggestions to outpatient-based pediatric health care providers when assisting the breastfeeding dyad. J Hum Lact. 24(2):335-339.
John Paul II's Call for a Renewed Theology of Being: Just What Did He Mean, and How Can We Respond?*
Authors: Hemming Laurence Paul
Published: August 2008

In this article I explore the contemporary relationship of theology to philosophy through the call for a `renewed philosophy of being' by Pope John Paul II. I argue that in fact three understandings of being appear in this call: the first, phenomenological , appears as the bringing to description of the situation of contemporary nihilism, exemplified by Nietzsche both in his published works and his Nachlaß ; the second, metaphysical , can be understood as the moralistic voice taken up by contemporary theologians in addressing philosophy. This voice, I argue, is the voicing of the subjectivity of the (Cartesian) subject, and can be understood as the unfolding of the being-historical of the subject, explained in Martin Heidegger's use of the term `history of being' or Seinsgeschichte . This voice arises out of the `modernity' of the eighteenth century up to the present: it is a voice of extreme nihilism, but expressing itself as an imperative — not what `is', but what `should be'. This voice is also to be found in John Paul II. The third understanding is a possibility only arising out of the extreme nihilism encountered in the first two understandings of being. This understanding makes possible the genuine asking of the `question of being', the Seinsfrage , also laid out by Heidegger. As such, the question of being, when genuinely asked, alters the human comportment to God. Inasmuch as being presses in on man through a lack, an emptiness, that reasserts the fundamental orientation toward the future that unfolds from out of the being of beings, so the region of concealment and the withdrawal of the nihilating of the nothing, which is the region proper to divinity, can be understood and seen all over again.
Appeals to the Bible in Ecotheology and Environmental Ethics: a Typology of Hermeneutical Stances*
Authors: Horrell David G. , Hunt Cherryl , Southgate Christopher
Published: August 2008

This article surveys and classifies the kinds of appeal to the Bible made in recent theological discussions of ecology and environmental ethics. These are, first, readings of `recovery', followed by two types of readings of `resistance'. The first of these modes of resistance entails the exercise of suspicion against the text, a willingness to resist it given a commitment to a particular (ethical) reading perspective. The second, by contrast, entails a resistance to the contemporary ethical agenda, given a perceived commitment to the Bible. This initial typology and the various reading strategies surveyed are then subjected to criticism, as part of an attempt to begin to develop an ecological hermeneutic, a hermeneutic which operates between recovery and resistance with an approach that may be labelled `revision', `reformation' or `reconfiguration'.
Miracles and Moral Culpability: How To Murder Your Parishioners and Get Away With It*
Authors: Luck Morgan
Published: August 2008

I argue that there exists a proportional relationship between degrees of moral culpability and degrees of probability, where the more an agent believes her actions will result in certain consequences, the more morally culpable she is for these consequences. I assert that this degree of probability is necessarily diminished by the existence of active supernatural powers. Consequently, agents who believe in such powers are less morally culpable than agents who do not.
Persons in Community in the Theology of Rowan Williams: Issues Arising With the Use of Sociology in Christian Moral Reasoning
Authors: Moseley Carys
Published: August 2008

Rowan Williams's theological-moral reasoning regarding the formation of personal identities in relation to gender, familial and communal ties is analysed in an article review of his book Lost Icons. This is his most sustained essay in theological social criticism, and was intended for the general public beyond academic theology. Williams exposes Christian moral reasoning on these issues to forms of secular critique whilst simultaneously using theological and historical strategies from liberal Anglo-Catholicism. His argumentation is subjected to theological and social-scientific scrutiny. The article calls for closer attention to debates within secular feminism and social research concerning the formation of adult men and women in relation to the wider post-Christian society. Links are made from Williams's thought in Lost Icons to underlying patterns in his academic theological output.
Forgetting the Land
Authors: Rodwell John S.
Published: August 2008

A three-year project funded by the M. B. Reckitt Trust is aiming to provide a theological critique of the sustainability process. This paper, based on the Reckitt Lecture given at the close of the first year of the work, outlines findings from a case study in the post-industrial landscape of South Yorkshire. Working with statutory and voluntary social, economic and environmental agencies and the Christian faith communities there, it explores how `sustainability' is interpreted, whether a spiritual perspective is represented in the sustainability process and whether notions of `belonging' and `place' figure in the quest to secure the future of the area. The wider significance of the findings is discussed.
Urban Sprawl: Using a Game to Sensitize Stakeholders to the Interdependencies Among Actors’ Preferences
Authors: Reckien Diana , Eisenack Klaus
Published: August 2008

This article introduces QuAG, a role-playing game, to enhance understanding of urban development through a social simulation. The participants represent actors of city development, divided into moving (e.g., residents, industry, retail) and nonmoving actors (e.g., planners, politicians). Development is performed by the relocation of actors between urban and suburban areas depending on the regions’ attractiveness and the actors’ preferences. An area’s attractiveness varies with the location changes of actors and the manipulation by planners. The game is based on a qualitative computer model with similar rules and elements. The role-play was effective in two ways: it sensitized participants to the interdependencies among actors and their contribution to a region’s attractiveness and made the computer model more tangible to them. If a similar impact of the planning measures in the game can be expected in the real world, the effects of investments can provide strong incentives for the movers.
Treatment Preferences of Overweight Youth and Their Parents in Western Canada
Authors: Holt Nicholas L. , Moylan Beverly A. , Spence John C. , Lenk Julie M. , Sehn Zoë L. , Ball Geoff D. C.
Published: August 2008

The purpose of this study was to examine the family environment and assess treatment preferences among overweight youth and their parents. Data were collected via 41 interviews with parents and children from the wait-list of a weight management clinic and analyzed using grounded theory methodology. Framed around an ecological framework, findings ranged from proximal family issues to more distal policy issues. At the family level, parents attempted to influence their children's lifestyle behaviors by using contradictory and inconsistent strategies that reflected extremes of leniency and control. There was resistance to reducing screen time because participants thought that it was important for the children's social lives. Participants desired better help from health care professionals, requested family-centered treatment, expressed a desire for increased social support, and needed policy/ program-level changes to assist their weight management efforts. These findings offer insight into the complexity of individual, familial, and environmental factors that impact both behavior change and health services delivery in pediatric weight management.