bluuebunny/crossref_metadata_2025_split huggingface dataset:
Education for safe motherhood: a Save the Mothers' advocacy initiative
Authors: Chamberlain Jean , Watt Susan 
Published: October 2008

PurposeThe provision of and access to healthcare for pregnant women is a complicated labyrinth of social and health‐related issues. The purpose of this paper is to discuss a new approach by the Save the Mothers organization to stimulate changes leading to safer and healthier pregnancies for Ugandan women using a Master of Public Health Leadership (MPHL) as the mechanism for education, advocacy, and network development.Design/methodology/approachSave the Mothers developed and supports a modular, post‐graduate, multi‐disciplinary MPHL. This training is designed to develop public health leaders who create transformative local projects and networks of professionals advocating for safe motherhood and consequent decreased child mortality.FindingsStudents and graduates have begun to change the conditions in Uganda for women and children by promoting safe motherhood practices and policies. Examples include a journalist, a politician, a social worker, and a school principal who have brought the issues into their spheres of influence and practice. Measurement of the impact of this approach is ongoing.Practical implicationsThis program provides a locally based, culturally appropriate approach to change, which could be adapted to a variety of other locales and development issues. This program permits practicing professionals to remain employed while undertaking advanced training, establishes the implementation of local projects, and links a graduate university program with diverse community leaders.Originality/valueThis unique approach within Africa may be a model for the development of multidisciplinary, education‐based initiatives to change conditions in developing countries using existing expertise and stimulating effective advancement through safe motherhood networks.
Assessing the capacity to produce health personnel in Rwanda
Authors: Dussault Gilles , Codjia Laurence , Kantengwga Kathy , Tulenko Kate 
Published: October 2008

PurposeThe purpose of this paper is to present the results of a study to assess the capacity of a poor country to scale‐up its production of health workers.Design/methodology/approachThe assessment consisted of a survey of institutions training doctors, nurses and technicians in Rwanda. Data on student intake, teaching staff, infrastructures and equipment were collected directly from the institutions by questionnaire administered in person. Data for the qualitative assessment of current and future capacity of production were collected by interviews.FindingsPhysical capacity in terms of classrooms and dormitories was generally good, except at the Faculty of Medicine. Laboratories and libraries were considered inadequate everywhere. Few national teachers hold a PhD and dependence on foreign trainers is high. Nursing teachers' training is also insufficient, particularly in pedagogy. As trainers are young, providing them with additional training should be easier. All institutions reported insufficient budgets. Managerial competencies are not developed. There is no licensing mechanism to ensure quality maintenance.Research limitations/implicationsThere is no validated data base on training institutions and the research had to rely on self‐reported statistics and other information.Practical implicationsA rapid increase in the production of health personnel would be difficult in the current conditions. Production strengthening should involve stakeholders from training institutions, and include measures to motivate and retain trainers, and to improve the quality of training.Originality/valueThe authors are not aware of similar studies in low income countries. Their methodology can be of interest to researchers and policy‐makers who do not have access to baseline data.
The human development index as a criterion for optimal planning
Authors: Engineer Merwan , King Ian , Roy Nilanjana 
Published: October 2008

PurposeThe human development index (HDI) and gender‐related development index (GDI) have become accepted as leading measures for ranking human well being in different countries. The purpose of this paper is to identify the planning policies that improve these indices and to also suggest modifications to the indices that yield more sensible policies.Design/methodology/approach – This paper solves the first‐best welfare problem in which the planner maximizes a development index subject to resource constraints.Findings – Planning strategies that maximize the HDI tend towards minimizing consumption and maximizing expenditures on education and health. Interestingly, such strategies also tend towards equitable allocations, even though inequality aversion is not modelled in the HDI. The paper shows that the GDI generates optimal plans with similar properties, and determine when the GDI and HDI generate consistent optimal plans. A problematic feature of the optimal plans is that the income component in the HDI (or GDI) does not play its intended role of securing resources for a decent standard of living. Rather, it acts to distort the allocation between health and education expenditure. The paper argues that it is better to drop income from the index. Alternatively, the paper considers net income, income net of education and health expenditures, as indicating capabilities not already reflected in the index. Finally, it compares how the modified indices and the HDI rank countries.Originality/value – The paper is believed to be the first to integrate development indices into national development planning.
Open economy inflation targeting arrangements and monetary policy rules
Authors: Cavoli Tony , Rajan Ramkishen S. 
Published: October 2008

PurposeThe purpose of this paper is to explore whether India is a suitable candidate for an inflation targeting regime. It begins by placing India's monetary policy actions in a broader context by discussing whether the Reserve Bank of India (RBI) should shift from its current policy of heavily managed exchange rates to one involving greater currency flexibility. If the latter is chosen, the selection of inflation targeting would appear an appropriate one.Design/methodology/approachThis paper has analytical, empirical and policy dimensions. Given the recent history of exchange rate centered policy in India, a discussion of the role of the exchange rate is needed. This is presented by the use of an analytical model where we examine how inflation targeting might work with the exchange rate. Then the decision rule from the model (a monetary policy rule (MPR)) is adapted for empirical testing and is estimated to investigate whether an MPR that follows inflation targeting can work for India.FindingsThere is some evidence to suggest that the RBI follows an MPR quite inadvertently. The MPR (interest rates) tends to react to current inflation, but there is no evidence that it reacts to forecasts of inflation. Additionally, interest rates do not react at all to the exchange rate.Originality/valueThe RBI's operating policy framework and whether it should adopt an inflation targeting arrangement is a highly topical issue that has attracted a great deal of attention in policy discussions in India. Very few papers broach this topic systematically and combine the analytical and empirical considerations.
Long‐term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment
Authors: Haggerty Kevin P. , Skinner Martie , Fleming Charles B. , Gainey Randy R. , Catalano Richard F. 
Published: October 2008

ABSTRACTAims  This study examines the efficacy of the Focus on Families project (currently called Families Facing the Future), a preventive intervention to reduce substance use disorders among children in families with a parent in methadone treatment.Design  One hundred and thirty families were assigned randomly to a methadone clinic treatment‐as‐usual control condition or treatment‐as‐usual plus the Focus on Families intervention between 1991 and 1993.Setting  Participants were recruited from two methadone clinics in the Pacific Northwest.Participants  This study examines the development of substance use disorders among the 177 children (56.84% male) involved in the program using data from a long‐term follow‐up in 2005, when these participants ranged in age from 15 to 29 years.Intervention  The intervention was delivered through group parent‐training workshops at the methadone clinics and through individualized home‐based services. The intervention taught parenting skills and skills for avoiding relapse to drug abuse.Measurements  At long‐term follow‐up, substance use disorders were measured by the Composite International Diagnostic Interview (CIDI). Survival analyses were used to assess intervention versus control differences in the hazard of developing substance use disorders.Findings  Overall, intervention and control participants did not differ significantly in risk of developing substance use disorders. However, there was evidence of a significant difference in intervention effect by gender. There was a significant reduction in the risk of developing a substance use disorder for intervention group males compared to control group males (hazard ratio = 0.53, P = 0.03), while intervention versus control differences among females were non‐significant and favored the control condition.Conclusions  Results from this study suggest that helping parents in recovery focus on both reducing their drug use and improving their parenting skills may have long‐term effects on reducing substance use disorders among their male children. However, the overall long‐term benefits of this program are not supported by the results for female children.
Early‐onset depressive disorders predict the use of addictive substances in adolescence: a prospective study of adolescent Finnish twins
Authors: Sihvola Elina , Rose Richard J. , Dick Danielle M. , Pulkkinen Lea , Marttunen Mauri , Kaprio Jaakko 
Published: October 2008

ABSTRACTAims  To explore the developmental relationships between early‐onset depressive disorders and later use of addictive substances.Design, setting and participants  A sample of 1545 adolescent twins was drawn from a prospective, longitudinal study of Finnish adolescent twins with baseline assessments at age 14 years and follow‐up at age 17.5 years.Measurements  At baseline, DSM‐IV diagnoses were assessed with a professionally administered adolescent version of Semi‐Structured Assessment for Genetics of Alcoholism (C‐SSAGA‐A). At follow‐up, substance use outcomes were assessed via self‐reported questionnaire.Findings  Early‐onset depressive disorders predicted daily smoking [odds ratio (OR) 2.29, 95% confidence interval (CI) 1.49–3.50, P < 0.001], smokeless tobacco use (OR = 2.00, 95% CI 1.32–3.04, P = 0.001), frequent illicit drug use (OR = 4.71, 95% CI 1.95–11.37, P = 0.001), frequent alcohol use (OR = 2.02, 95% CI 1.04–3.92, P = 0.037) and recurrent intoxication (OR = 1.83, 95% CI 1.18–2.85, P = 0.007) 3 years later. ORs remained significant after adjustment for comorbidity and exclusion of baseline users. In within‐family analysis of depression‐discordant co‐twins (analyses that control for shared genetic and familial background factors), early‐onset depressive disorders at age 14 predicted significantly frequent use of smokeless tobacco and alcohol at age 17.5.Conclusions  Our results suggest important predictive associations between early‐onset depressive disorders and addictive substance use, and these associations appear to be independent of shared familial influences.
Review article: intra‐oesophageal impedance monitoring for the assessment of bolus transit and gastro‐oesophageal reflux
Authors: CONCHILLO J. M. , SMOUT A. J. 
Published: October 2008

SummaryBackground  Intra‐oesophageal impedance monitoring can be used to assess the clearance of a swallowed bolus (oesophageal transit) and to detect gastro‐oesophageal reflux independent of its acidity.Aim  To discuss the clinical application of the impedance technique for the assessment of bolus transit and gastro‐oesophageal reflux.Methods  Review of the literature on intra‐oesophageal impedance monitoring of bolus transit and gastro‐oesophageal reflux.Results  Using impedance criteria, normal oesophageal bolus clearance can be defined as complete clearance of at least 80% of liquid boluses and at least 70% of viscous boluses. Impedance recording identifies oesophageal function abnormalities in non‐obstructive dysphagia patients and in patients with postfundoplication dysphagia. The impedance technique seems to be less suitable for the most severe end of the dysphagia spectrum like achalasia. Intra‐oesophageal impedance monitoring detects reflux events independent of the pH of the refluxate, which allows identification of non‐acid reflux episodes. In addition, use of impedance monitoring enables assessment of the composition (liquid, gas, mixed) and proximal extent of the refluxate. Combined impedance–pH monitoring is more accurate than pH alone for the detection of both acid and weakly acidic reflux. Furthermore, addition of impedance monitoring to pH increases the yield of symptom association analysis both in patients off and on proton pump inhibitor therapy.Conclusions  Intra‐oesophageal impedance monitoring is a feasible technique for the assessment of bolus transit and gastro‐oesophageal reflux. Combined impedance–manometry provides clinically important information about oesophageal function abnormalities and combined impedance–pH monitoring identifies the relationship between symptoms and all types of reflux events regarding acidity and composition.
Small bowel polyps and tumours: endoscopic detection and treatment by double‐balloon enteroscopy
Authors: FRY L. C. , NEUMANN H. , KUESTER D. , KUHN R. , BELLUTTI M. , MALFERTHEINER P. , MONKEMULLER K. 
Published: October 2008

SummaryBackground  Double‐balloon enteroscopy has allowed us not only to inspect deeply the small bowel but also to carry out interventions for diseases of the small bowel.Aim  To evaluate the utility of double‐balloon enteroscopy for the diagnosis and therapy of these lesions.Methods  All patients undergoing double‐balloon enteroscopy for evaluation of small bowel polyps and tumours during a 3.75‐year period at a university referral hospital were studied. The types of polyps and tumours as well as endoscopic technique of removal, surgery and complications were documented.Results  The incidence of small bowel polyps and tumours in‐patients undergoing DBE was 9.6%. A total of 40 double‐balloon enteroscopy procedures were performed in 29 patients [13 female (44.8%), mean age 51 years, range 22–74]. The following lesions were found most frequently: adenomas in familial adenomatous polyposis syndrome, n = 8; hamartomas, n = 4 (Peutz‐Jeghers and Cronkhite Canada syndromes), jejunal adenocarcinoma n = 5, neuroendocrine tumour n = 4 and others n = 6.Conclusions  The incidence of small bowel tumours in those in‐patients who were undergoing double‐balloon enteroscopy was 10%. Double‐balloon enteroscopy is useful for the diagnosis and treatment of small bowel polyps and tumours.
TACI‐Ig prevents the development of airway hyperresponsiveness in a murine model of asthma
Authors: Bilsborough J. , Chadwick E. , Mudri S. , Ye X. , Henderson W. R. , Waggie K. , Hebb L. , Shin J. , Rixon M. , Gross J. A. , Dillon S. R. 
Published: October 2008

SummaryBackground
Increased levels of serum IgE are associated with greater asthma prevalence and disease severity. IgE depletion using an anti‐IgE monoclonal antibody has met with success in the treatment of moderate‐to‐severe and severe persistent allergic asthma.Objective
To test whether B cell‐targeted therapy is a more effective treatment for airway hyperresponsiveness (AHR) in a murine model compared with IgE‐depletion.Methods
We delivered soluble mTACI‐Ig, a receptor for the B cell survival factors BLyS (B Lymphocyte Stimulator) and APRIL (A PRoliferation‐Inducing Ligand), or anti‐IgE to allergen‐sensitized mice before airway challenge with allergen.Results
mTACI‐Ig treatment reduced circulating mature B cell levels in the blood, while anti‐IgE treatment had no effect on B cell counts. Both mTACI‐Ig and anti‐IgE decreased the levels of total and allergen‐specific IgE in the serum. Histopathologic analysis of lungs showed a reduction in disease severity scores for both treatment groups, but results were more pronounced in mTACI‐Ig‐treated mice. Neutrophil and eosinophil numbers in the bronchoalveolar lavage (BAL) were significantly reduced following mTACI‐Ig treatment, but not after anti‐IgE delivery. BLyS and APRIL blockade also resulted in a significant decrease in IL‐4 and eotaxin mRNA and IL‐4 and KC protein levels in total lung homogenates and BAL fluid, respectively. Finally, mTACI‐Ig treatment was more effective than anti‐IgE treatment in reducing AHR to inhaled antigen.Conclusions
Our data demonstrate that delivery of mTACI‐Ig is a more effective treatment than anti‐IgE mAb in a murine model of AHR.
The Dawn Phenomenon Is Related To Overnight Growth Hormone Release In Adolescent Diabetics
Authors: Edge J. A. , Matthews D. R. , Dunger D. B. 
Published: October 2008

SUMMARYWe have investigated the relation between nocturnal insulin requirements and nocturnal growth hormone (GH) release in 26 diabetic adolescents at various puberty stages and have examined the effect of nocturnal GH suppression on pre‐breakfast insulin requirement. In all the studies, euglycaemia was maintained overnight using a computer‐calculated variable‐rate insulin infusion, and 15‐min blood samples were collected for GH assay. During initial clamp studies, insulin infusion rates were greater from 0500–0800 h (15.22 ± 0.95 mU/kg/h, mean ± SEM) than from 0100–0400 h (12.42 ± 0.84 mU/kg/h, P < 0.001). The increase in insulin infusion rate correlated with mean overnight GH concentration (r = 0.68, P < 0.001), and was maximal at puberty stage 3 in both sexes. In seven of the subjects, a second identical clamp was performed following administration of 100 mg oral pirenzepine. During these studies, mean overnight GH levels were reduced by 11–85%, from 17.6 ± 1.6 to 7.5 ± 2.2 mU/l; P < 0.01. Insulin requirements were not significantly different between the periods 0100–0400 and 0500–0800 h during these studies, and the reduction in pre‐breakfast (0500–0800 h) insulin requirement when compared with the baseline studies correlated with the fall in GH secretion (r, = 0.82, P < 0.01). The dawn increase in insulin requirement in adolescents with IDDM is related to the overnight GH secretion during puberty, and pre‐breakfast insulin requirement can be reduced by suppressing nocturnal GH release.
Tsh Secretion In Cushing's Syndrome: Relation To Glucocorticoid Excess, Diabetes, Goitre, And The ‘Sick Euthyroid Syndrome’
Authors: Benker Georg , Raida Martin , Olbricht Thomas , Wagner Richard , Reinhardt Walter , Reinwein Dankwart 
Published: October 2008

SUMMARYThyrotrophin (TSH) secretion was studied in 63 patients with Cushing's syndrome (53 patients with pituitary dependent Cushing's disease, eight with adrenocortical tumours, and two with the ectopic ACTH syndrome). Prior to treatment, TSH response to 200 μg of TRH intravenously was significantly decreased compared to controls; TSH response was ‘flat’ (increment < 2 mU/l) in 34 patients (54%). Patients with a flat response to TRH had significantly higher morning and midnight cortisol levels than patients with a TSH response of 2 mU/l and more; this was not due to differences in serum thyroid hormone levels. Basal TSH, TSH increment after TRH, and stimulated TSH value, but not serum triiodothyronine, were correlated with cortisol measurements (0800 h serum cortisol, midnight cortisol, and urinary free corticoid excretion). After exclusion of 40 patients with additional disease (severe systemic disease, diabetes mellitus, or goitre), cortisol ‐ TSH correlations were even more pronounced (r = ‐0.73 for midnight cortisol and stimulated TSH levels), while in the patients with additional complications, these correlations were slight or absent. Successful treatment in 20 patients was associated with a rise in thyroid hormone levels and the TSH response to TRH. These results indicate that (1) the corticoid excess but not serum T3 is the principal factor regulating TSH secretion in Cushing's syndrome, (2) a totally flat response to TRH is rare, and (3) TSH suppression and lower than normal serum thyroid hormone levels are reversible after treatment. Since factors like severe systemic disease, diabetes mellitus and goitre also affect TSH secretion, they tend to obscure the statistically significant correlations between cortisol excess and TSH secretion.
Quantification of individual phosphorus species in sediment: a sequential conversion and extraction method
Authors: Oxmann J. F. , Pham Q. H. , Lara R. J. 
Published: October 2008

SummaryCommon sequential phosphorus (P) extraction methods are not specific to particular chemical species and have several limitations. This work presents the first chemical method for quantification of individual mineral and sorbed P species. It was developed by combining a conversion technique with a sequential extraction procedure. Mangrove sediments with different characteristics were incubated in pH‐adjusted 0.01 M CaCl2 with and without reference material additions of octacalcium phosphate (Ca8H2(PO4)6·5H2O; OCP), hydroxyapatite (Ca5(PO4)3OH), strengite (FePO4·2H2O) or variscite (AlPO4·2H2O). The changes in soluble phosphate concentration were measured in the supernatant solution, while pH‐induced variations in P composition were determined by subsequent sequential extraction of the sediments. Dissolved phosphate concentration was controlled by adsorption below pH 7.8. Above this pH, soluble phosphate concentration was governed by OCP, which was qualitatively determined by plotting the experimental values of pH + pH2PO4 and pH – 0.5 pCa on a solubility diagram including the isotherms of known crystalline phosphate compounds. In contrast to the often‐predicted slow dissolution rate of crystalline phosphates in soils or sediments, drastic changes in P composition by dissolution, precipitation and adsorption processes were detected after 7 days. These were mainly not observed indirectly by changes in dissolved phosphate through adsorption effects, but were determined quantitatively by subsequent sequential extraction, thus enabling the quantification of individual species. Evaluation of the method was performed by standard addition experiments. Besides P species quantification, the method provides the means for other applications, such as the determination of P mineral dissolution kinetics in soils and sediments, the prediction of P composition in changing environmental settings and the refinement of theoretical models of phosphate solubility in soil and sedimentary environments.
Neutrophil mobilization and clearance in the bone marrow
Authors: Furze Rebecca C. , Rankin Sara M. 
Published: October 2008

SummaryThe bone marrow is the site of neutrophil production, a process that is regulated by the cytokine granulocyte colony‐stimulating factor (G‐CSF). Mature neutrophils are continually released into the circulation, with an estimated 1011 neutrophils exiting the bone marrow daily under basal conditions. These leucocytes have a short half‐life in the blood of ∼6·5 hr, and are subsequently destroyed in the spleen, liver and indeed the bone marrow itself. Additionally, mature neutrophils are retained in the bone marrow by the stromal cell‐derived factor (SDF‐1α)/chemokine (C‐X‐C motif) receptor 4 (CXCR4) chemokine axis and form the bone marrow reserve. Following infection or inflammatory insult, neutrophil release from the bone marrow reserve is substantially elevated and this process is mediated by the co‐ordinated actions of cytokines and chemokines. In this review we discuss the factors and molecular mechanisms regulating the neutrophil mobilization and consider the mechanisms and functional significance of neutrophil clearance via the bone marrow.