bluuebunny/crossref_metadata_2025_split huggingface dataset:
Video-Assisted Vein Harvest: A Single Institution's Experience of 103 Peripheral Bypass Cases
Authors: Voellinger David C. , Jordan William D. 
Published: June 2007

Traditional harvesting of the greater saphenous vein (GSV) has meant a long, continuous incision with the potential for increased morbidity, pain, and hospital stay. The authors have used a minimally invasive video-assisted technique in an attempt to reduce these complications. In this report, they retrospectively analyze a series of 103 cases of videoassisted saphenous vein harvests for vascular bypass procedures. All patients from September 1994 to May 1997 who underwent video-assisted saphenous vein harvest were reviewed for vein harvest time, hospital length of stay, surgical complications, graft patency, and clinical outcome. Operative technique used limited incisions, video-assisted dissection, and two different subcutaneous retractors-endoplastic (Type I) (Snowden Pencer, Tucker, GA) and endosaphenous (Type II) (Ethicon Endosurgery, Cincinnati, OH). Ninety-six patients underwent 103 operations for lower and upper extremity vascular disease. For all patients, the average time of vein removal was 0.74 cm vein/minute operative time, for procedures with the Type I retractor 0.63 cm vein/minute, for procedures with the Type II retractor 1.07 cm vein/minute (p≤0.0001). Postoperative length of stay (LOS) averaged 7.7 days (median 5 days) for all patients and was longer between patients with rest pain (6.4 days) and tissue loss (10.1 days) vs claudicants (4.4 days) (p<0.05), between patients with tibioperoneal anastomoses (10.0 days) vs patients with popliteal anastomoses (6.0 days) (p<0.05), and between Type I patients (8.3 days) and Type II patients (6.9 days) (p=0.03). Nine wound complications occurred (8.7%), two of which (1.9%) were directly related to the video-assisted technique. Cumulative graft patency was 84% ±9% after 18 months. According to the International Society for Cardiovascular Surgery reporting standards for lower extremity occlusive disease, patient outcome averaged +2.03 for all patients, and was improved between patients with claudication (+2.82) vs patients with rest pain (+1.50) (p<0.05) and between Type II patients (+2.36) vs Type I patients (+1.64) (p=0.01). Video-assisted saphenous vein harvest can be accomplished with low morbidity and provides a satisfactory conduit. The patients had a short postoperative LOS, a satisfactory wound complication rate, and a good operative outcome. The Type II saphenous vein retractor decreased operative time, shortened hospital LOS, and improved outcome.
Impaired Endothelium-Dependent Dilatation Precedes Early Arterial Wall Change in Symptom-Free Smokers
Authors: Labropoulos Nicos , Webb K. Michael , Mansour M. Ashraf , Kang Steven S. , Baker William H. 
Published: June 2007

Smoking is one of the known risk factors associated with atherosclerosis. Endothelial cell dysfunction is an early event in the development of atherosclerosis, and diminished nitric oxide production has been found to be a marker of this dysfunction. The aim of this study was to investigate the effect of smoking on the endothelial function before the development of early atherosclerotic wall changes. Twenty symptom-free smokers (> 10 cigarettes per day) and 22 symptom-free, ageand sex-matched volunteers were included into the study. Subjects with diabetes, hypertension, a known history of cardiovascular disease, or those who had a plaque (isolated irregular luminal lesion > 1.5 mm thick) or an intima-media thickness > 0.8 mm in the carotid bifurcation were excluded. By means of high-resolution ultrasound, the diameter of the brachial artery at rest, during reactive hyperemia (endothelium-dependent dilatation), and after sublingual glycerin trinitrate (endothelium-independent dilatation; five controls and five smokers) were measured. All the tests were performed with acclimatized subjects in the supine position. The entire test was recorded on super VHS video. Diameter measurements (average diameter of five cardiac cycles), incident with the R wave on the electrocardiogram, were taken from the near to far wall. Reproducibility measurements in eight subjects (five volunteers and three smokers) showed a coefficient of variation ranging from 1.6% to 3.2% for intraobserver and 1.8% to 3.9% for interobserver variability. Brachial artery endothelium-dependent dilatation was present in all the symptom-free volunteers (10.8 ±3.4%, range 3.4 to 18.2) and reduced or abolished in smokers (3.5 ± 2.9%, range 0 to 7.6; p > 0.001). Glycerin trinitrate induced comparable dilatation in both smokers and controls, indicating that the dysfunction is endothelium dependent. Endothelial dysfunction is present prior to arterial wall changes in smokers, suggesting early arterial damage.
Insights in the Development of Primary Venous Reflux
Authors: Labropoulos Nicos , Giannoukas Athanasios D. , Stavridis George , Bailey David , Glenville Brian , Nicolaides Andrew N. 
Published: June 2007

Purpose: The relation between vein wall fibrosis and presence of primary venous reflux was investigated. Methods: Twenty-eight limbs of 27 patients undergoing coronary bypass surgery without history of superficial or deep venous thrombosis and without clinical evidence of varicose veins were subjected preoperative ultrasonic investigation of the long saphenous vein (LSV) and its tributaries in order to detect presence of reflux. Histologic examination of vein specimens, harvested perioperatively from premarked sites of the LSV (ankle, knee, and midthigh) and its tributaries, was carried out. The specimens were classified according to the fibrotic content of the wall on histology as normal, mildly, moderately, and severely affected. Results: Sixteen limbs (57%) had reflux. Saphenofemoral junction (SFJ) incompetence alone was not seen, and this always was present in association with an incompetent LSV (3/16, 19%). Reflux was equally distributed (37.5%) in the above(6/16) and belowknee (6/16) segments, whereas in three limbs it was present throughout the LSV. Fibrosis was seen in the majority of the specimens taken from the LSV (62/65, 95%) and its tributaries (21/32, 66%), irrespective of the presence or absence of reflux. Different grades of fibrosis were found on histology in different sites of the same vein. Conclusions: Venous wall fibrosis very often exists in the absence of reflux and venous insufficiency occurs at any segment of the LSV with minor involvement of the SFJ. Thus, primary venous reflux seems to be a locally developing process.
Flow-Mediated Dilation in Lower-Extremity Vein Grafts
Authors: Smith Bruce M. , Ellahham Samer , Stanford Jon L. , Kohlman-Trigoboff Debra , Tupas-Habib Maria T. , Molina Hector 
Published: June 2007

Autogenous vein bypasses manifest a substantial late stenosis and occlusion rate due, at least in part, to the hostile conditions of the arterial milieu. The present study was undertaken to evaluate flow-mediated dilation (FMD)-a putative measure of endothelial health and, potentially, long-term function-in chronically implanted vein grafts performed for critical lower-extremity ischemia. Eleven patients, four men, seven women (mean age: 64 ±14 years; range: 30 to 81 years), with saphenous vein bypasses performed for critical lower-extremity ischemia a mean of 346 ±457 days previously (range: 47 to 1640 days), had their grafts studied in the resting state, following 5 minutes' tourniquet application to produce hyperemia, and following administration of nitroglycerin. Baseline and maximal postischemic brachial artery and vein graft diameters were determined ultrasonographically. An Atherosclerosis Risk Score (ARS) was calculated by assigning one point for each of six established risk factors for atherosclerosis (smoking, diabetes, hypertension, hypercholesterolemia, male gender, and age >60 years). Vein graft flow and diameter increased significantly with hyperemia (20% ±23%; p=0.04, and 3% ±3%; p=0.01 by paired t-test, respectively). Mean ARS was 3.6 ±1.2 (range: 2 to 5). FMD in vein grafts correlated inversely with ARS (r=-0.66, p=0.03). Seven of the 11 vein grafts demonstrated FMD >1% of baseline diameter. No differences were observed between the seven patients with “reacting” grafts and four with “non-reacting” grafts except in the mean ARS (2.9 ±0.9 vs. 4.3 ±0.5, respectively, p=0.05) and in the frequency of diabetes (33% vs. 100%; p=0.05). Chronically implanted saphenous vein grafts performed for limb-threatening ischemia exhibit FMD. FMD in vein grafts appears to be influenced adversely by concurrent atherosclerotic risk factors, and is reduced compared to FMD reported in other vessels.
Anglicans Gathering for God's Mission: A Missiological Ecclesiology for the Anglican Communion
Authors: Douglas Ian T. 
Published: June 2007

ABSTRACTThese are difficult times for the Anglican Communion. The crisis in global Anglicanism is not so much over human sexuality but rather over questions of identity and authority. Some church leaders are advocating structural and canonical solutions to maintain the integrity of the Anglican Communion. A missiological perspective, however, sees communion as a gift from God fostered through relationships in mission across difference. The Decade of Evangelism and pan-Anglican efforts to address international debt and the HIV/AIDS pandemic are examples of communion in mission relationships. A missiological ecclesiology for the Anglican Communion will lift up, celebrate, and encourage more meaningful relationships in God's mission. The Anglican Congresses of 1908, 1954 and 1963 are expressions of such a missiological ecclesiology. The proposed 2008 Anglican Congress or Gathering will unite and foster a deeper sense of communion across Anglicanism through enlivened mission relationships.
An Unfortunate Lex Orandi? Some Comments on Episcopacy Envisioned in the 1979 ECUSA Ordinal
Authors: Spinks Bryan D. 
Published: June 2007

ABSTRACTSince the Anglican Church has neither a teaching Magisterium of the Roman model, nor a binding Confession of Faith as in some Lutheran and Reformed traditions, it has become commonplace to invoke the dictum Lex orandi, Lex credendi and claim that Anglican doctrine is enshrined in its liturgy. This of course may have made some sense when all Anglican Prayer Books had not wandered far from the 1662, or even 1637/1764 texts, but it becomes much more problematic today, when, even with ‘guidelines’ issued by the International Anglican Liturgical Consultation (which have only the authority a Province wishes to give them), Provincial liturgies grow further and further away from any common prayer texts. This is particularly pertinent in an ecumenical context with regard to the Anglican understanding of its threefold ministry. The Preface to the Ordinal (1550, 1552 and 1662) stated: ‘It is evident unto all men diligently reading the Holy Scriptures and ancient authors that from the Apostles' time there have been these orders of Ministers in Christ's Church, Bishops, Priests and Deacons’.
Essentialism and Anti-Essentialism in Feminist Philosophy
Authors: Stone Alison 
Published: June 2007

AbstractThis article revisits the ethical and political questions raised by feminist debates over essentialism, the belief that there are properties essential to women and which all women share. Feminists’ widespread rejection of essentialism has threatened to undermine feminist politics. Re-evaluating two responses to this problem—‘strategic’ essentialism and Iris Marion Young’s idea that women are an internally diverse ‘series’—I argue that both unsatisfactorily retain essentialism as a descriptive claim about the social reality of women’s lives. I argue instead that women have a ‘ genealogy’: women always acquire femininity by appropriating and reworking existing cultural interpretations of femininity, so that all women become situated within a history of overlapping chains of interpretation. Because all women are located within this complex history, they are identifiable as belonging to a determinate social group, despite sharing no common understanding or experience of femininity. The idea that women have a genealogy thus reconciles anti-essentialism with feminist politics.
Politics and the Economist-King: Is Rational Choice Theory the Science of Choice?
Authors: Landemore HÉlÈne 
Published: June 2007

AbstractThis article is another unapologetic contribution to ‘the gentle art of rational choice bashing’. The debate over rational choice theory (RCT) may appear to have tired out; yet RCT is as dominant in political sciences as ever. The reason is that critics typically take aim at the symptoms of RCT’s failings, rather than their root cause: RCT’s very ambition of being the ‘science of choice’. In this article I argue that RCT fails twice, first as a science ofchoiceand then as ascienceof choice. Both failures suggest that political sciences need an epistemologic (re)conversion away from the Platonic ideal of a deductive and universal science of choice toward a more inductive and pluralist paradigm. While advocates of RCT rightly insist that ‘you can’t beat something with nothing’, I take their advice, with a grain of salt: in order for alternatives to appear, the frame of references needs to be modified. I draw a few perspectives for the political sciences.
The Integration of Immigrants
Authors: Carens Joseph 
Published: June 2007

AbstractThis paper considers normative questions about the integration of legally resident immigrants into contemporary liberal democratic states. First, I ask to what extent immigrants should enjoy the same rights as citizens and on what terms they should have access to citizenship itself. I defend two general principles: (1) differential treatment requires justi.cation; (2) the longer immigrants have lived in the receiving society, the stronger their claim to equal rights and eventually to full citizenship. Second, I explore additional forms of economic, cultural, social, and political integration. I argue that the integration of immigrants depends upon a process of mutual, but asymmetrical adaptation and that it is precisely because the immigrants have to adapt more that the receiving society bears a greater responsibility to take steps to promote equality between the immigrants and the existing population.
Evidence of cultural hybridity in responses to epilepsy among Pakistani Muslims living in the UK
Authors: Small Neil , Ismail Hanif , Rhodes Penny , Wright John 
Published: June 2007

Objectives: To examine how people from Bradford's Pakistani Muslim community experience living with epilepsy. Specifically, the paper addresses social interactions and negotiations with care providers and considers how different understandings of epilepsy are integrated. Methods: Interviews were conducted with a sample of Bradford's Pakistani Muslim community ( n=20). Interviews were analysed to identify themes and significant areas of shared concern. Results: This paper identifies popular, professional and folk sectors contributing to an individual's `health system'. Where sectors overlap, zones of hybridity are created: that is, a person might simultaneously seek help from a doctor and from a religious healer, or might offer explanations for seizures that include neurological and spiritual components. Discussion: While there are many similarities between the experiences of these minority ethnic community members and published work on the lived experience of epilepsy in other communities, there are also important differences that service providers need to recognize and respond to. Differences include forms of cultural expression and specific language needs. Improving communication between professionals and persons with epilepsy needs to be prioritized.
Cognitive—behavioural stress management with HIV-positive homosexual men: mechanisms of sustained reductions in depressive symptoms
Authors: Carrico Adam W. , Antoni Michael H. , Weaver Kathryn E. , Lechner Suzanne C. , Schneiderman Neil 
Published: June 2007

Background: We examined the sustained efficacy of a group-based cognitive—behavioural stress management (CBSM) intervention in comparison to a modified wait-list control condition on measures of mood, coping and social support in mildly symptomatic HIV-positive homosexual and bisexual men. Participants were recruited largely during the era prior to highly active antiretroviral therapy (HAART; 1992—1997). Methods: Men were randomized to either a 10-week, group-based CBSM intervention ( n=83) or a psycho-educational seminar group ( n=46). All participants completed a battery of psychosocial questionnaires administered by a research assistant at baseline, immediately following the 10-week CBSM intervention period, and at a 6-month follow-up. Results: Men in the CBSM group maintained previously observed effects on depressive symptoms and perceived social support. These sustained effects of CBSM on depressive symptoms were mediated by 10-week increases in cognitive coping (i.e. positive reframing). Discussion: CBSM appears to be a potentially efficacious treatment that reduces and maintains lower levels of depressive symptoms and enhances social support in HIV-positive homosexual and bisexual men. In particular, changes in positive reframing during the 10-week intervention period remain a crucial factor contributing to sustained reductions in depressive symptoms.
Service providers' reflections on the affective domain and its influence on decision-making about treatments for chronic pain
Authors: Brown Cary A. 
Published: June 2007

Objectives: This study sought to explore why service providers, working within the complex area of chronic pain, do not believe that the affective domain influences their decision-making about treatments. Methods: These results were extrapolated from a larger multistage study based on a series of iterative postal questionnaires. Stage 1 of the large study identified, via postal survey, what treatment components service providers identified as `important'. In stage 2, a constructivist framework was used to develop an iterative Delphi questionnaire to explore service providers' rationale for these choices. Stage 3 also employed a Delphi process and asked participants to reflect on their previous comments. Stages 2 and 3 used postal questionnaires and summary reports from preceding rounds for background information. Results: Most service providers clearly felt that `affect' and `self-image' had little influence on their decision-making compared to `coherence' and `purposiveness'. This report presents the findings of the Stage 3 questionnaire, in which participants were asked to reflect and comment on this low level of endorsement for the influence of affect and self-image. Seven themes emerged from the coded data: professionalism, self-protection, affect and experience, lack of reflective skills, ethos of altruism, lack of understanding, and model of practice. Analysis of these themes indicates a tension between what service providers feel they should do and what they actually do. Discussion: Service providers felt that affect and self-image had little influence on their decision-making. However, there is growing evidence in the literature to suggest that it is not possible, or preferable, to divorce emotion from the clinical encounter. Chronic illnesses are complex systems that do not respond optimally to linear problem-solving. Access to a wide range of information, including the affective domain, is important for effective decision-making.
Depressive symptoms, intrusive thoughts, sleep quality and sexual quality of life in women co-infected with human immunodeficiency virus and human papillomavirus
Authors: Rose Rachel C. , Peake Michele R. , Ennis Nicole , Pereira Deidre B. , Antoni Michael H. 
Published: June 2007

Background: Women infected with human immunodeficiency virus (HIV) experience major challenges and often report marked decreases in sexual functioning and quality of life (QOL). HIV-infected women also face challenges concerned with other commonly observed concomitant sexually transmitted organisms, such as human papillomavirus (HPV), which may further affect sexual QOL. Despite advances made in understanding factors that predict sexual functioning and QOL in men with HIV, relatively little is understood about the role of behavioural and emotional factors in women.Methods: As a preliminary inquiry into this question, this study related depressive symptoms, AIDS-related intrusive thoughts and sleep quality with sexual QOL reports in 21 HIV+HPV+women.Results: We found that depressive symptoms, intrusive thoughts and sleep quality individually predicted poorer sexual QOL. Further analyses suggested that depression mediated the relationship between intrusive thoughts and sexual QOL.Discussion: Implications for further work and clinical interventions to address depressive symptoms in this population are discussed.
Pain management in sickle cell disease
Authors: Booker Matthew J. , Blethyn Kate L. , Wright Christine J. , Greenfield Sheila M. 
Published: June 2007

Objectives: Sickle cell disease (SCD) is an inherited blood disorder characterized by recurrent `crisis' pain, which is the most common reason for repeated hospital admission. The nature of this pain, however, is poorly understood, and the pain is often sub-optimally managed. Methods: A focus group format, interpreted using thematic analysis, was used to gain a greater understanding of the barriers that SCD patients face in managing their pain and their perceptions of the treatment that they receive from healthcare professionals. Results: Key issues emerging from the focus groups that adversely affected participants' pain management included: feeling isolated by their experience of `crisis' pain, not being listened to, and limitations to social support networks. Specific issues relating to seeking medical care included lack of understanding about SCD by non-specialist clinicians, feelings of being low priority due to the `invisible' nature of their pain, and feeling mistrusted by medical staff when seeking analgesia. Discussion: Feelings of isolation may drive maladaptive coping strategies and manifest in anger, aggression and active avoidance of service use. Suggested service improvements include the active targeting of isolated individuals in the form of pain discussion groups or self-help groups, and greater provision of specialised services.
Researching chronic childhood illness: the example of childhood cancer
Authors: Dixon-Woods Mary , Young Bridget , Ross Emma 
Published: June 2007

Objectives: To provide an overview of issues raised by conducting research in the area of chronic childhood illness, using the example of childhood cancer. Methods: This literature review used informal methods. Results: Children with cancer and their families may participate in a wide variety of studies in different research traditions, including social science studies, epidemiological, biological and genetic research, and clinical trials. Different concerns about research participation have been raised in these different contexts. Sociological debate has tended to characterize exclusion from research as a manifestation of assumptions of poor competence on the part of children, and to see inclusion in research as a means of restoring proper balance in power relations and giving children a voice. The ethical imperative within clinical research, on the other hand, has been in favour of protection of individuals from risk or direct harm. Lack of consensus on issues such as the status of children's consent for research participation persists, in part because debates have taken place within rather than across disciplinary boundaries, and in part because of a tendency to debate issues as ethical principles in an empirical vacuum. The lack of research on the experiences and views of those asked to take part in childhood cancer research is striking. Discussion: It is important that debates about the involvement of children in research are informed by high-quality social science research and by interdisciplinary dialogue.