bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perception of primary health professionals about Female Genital Mutilation: from healthcare to intercultural competence
Authors: Kaplan-Marcusan Adriana , Torán-Monserrat Pere , Moreno-Navarro Juana , Fàbregas Ma Jose Castany , Muñoz-Ortiz Laura 
Published: January 2009

Abstract

Background
The practice of Female Genital Mutilation (FGM), a deeply-rooted tradition in 28 countries in Sub-Saharan Africa, carries important negative consequences for the health and quality of life of women and children. Migratory movements have brought this harmful traditional practice to our medical offices, with the subsequent conflicts related to how to approach this healthcare problem, involving not only a purely healthcare-related event but also questions of an ethical, cultural identity and human rights nature.

Methods
The aim of this study was to analyse the perceptions, degree of knowledge, attitudes and practices of the primary healthcare professionals in relation to FGM. A transversal, descriptive study was performed with a self-administered questionnaire to family physicians, paediatricians, nurses, midwives and gynaecologists. Trends towards changes in the two periods studied (2001 and 2004) were analysed.

Results
A total of 225 (80%) professionals answered the questionnaire in 2001 and 184 (62%) in 2004. Sixteen percent declared detection of some case in 2004, rising three-fold from the number reported in 2001. Eighteen percent stated that they had no interest in FGM. Less than 40% correctly identified the typology, while less than 30% knew the countries in which the practice is carried out and 82% normally attended patients from these countries.

Conclusion
Female genital mutilations are present in primary healthcare medical offices with paediatricians and gynaecologists having the closest contact with the problem. Preventive measures should be designed as should sensitization to promote stands against these practices.
The consequence of fetal ethanol exposure and adolescent odor re-exposure on the response to ethanol odor in adolescent and adult rats
Authors: Eade Amber M , Sheehe Paul R , Molina Juan C , Spear Norman E , Youngentob Lisa M , Youngentob Steven L 
Published: January 2009

Abstract

Background
An epidemiologic predictive relationship exists between fetal ethanol exposure and the likelihood for adolescent use. Further, an inverse relationship exists between the age of first experience and the probability of adult abuse. Whether and how the combined effects of prenatal and adolescent ethanol experiences contribute to this progressive pattern remains unknown. Fetal ethanol exposure directly changes the odor attributes of ethanol important for both ethanol odor preference behavior and ethanol flavor perception. These effects persist only to adolescence. Here we tested whether adolescent ethanol odor re-exposure: (Experiment 1) augments the fetal effect on the adolescent behavioral response to ethanol odor; and/or (Experiment 2) perpetuates previously observed adolescent behavioral and neurophysiological responses into adulthood.

Methods
Pregnant rats received either an ethanol or control liquid diet. Progeny (observers) experienced ethanol odor in adolescence via social interaction with a peer (demonstrators) that received an intragastric infusion of either 1.5 g/kg ethanol or water. Social interactions were scored for the frequency that observers followed their demonstrator. Whole-body plethysmography evaluated the unconditioned behavioral response of observers to ethanol odor in adolescence (P37) or adulthood (P90). The olfactory epithelium of adults was also examined for its neural response to five odorants, including ethanol.

Results
Experiment 1: Relative to fetal or adolescent exposure alone, adolescent re-exposure enhanced the behavioral response to ethanol odor in P37 animals. Compared to animals with no ethanol experience, rats receiving a single experience (fetal or adolescent) show an enhanced, yet equivalent, ethanol odor response. Fetal ethanol experience also increased olfactory-guided following of an intoxicated peer. Experiment 2: Combined exposure yielded persistence of the behavioral effects only in adult females. We found no evidence for persistence of neurophysiological effects in either sex.

Conclusion
Fetal ethanol exposure influences adolescent re-exposure, in part, by promoting interactions with intoxicated peers. Re-exposure subsequently enhances ethanol odor responsivity during a key developmental transition point for emergent abuse patterns. While persistence of behavioral effects occurred in females, the level of re-exposure necessary to uniformly yield persistence in both sexes remains unknown. Nonetheless, these results highlight an important relationship between fetal and adolescent experiences that appears essential to the progressive pattern of developing ethanol abuse.
Policy on the rebound: trends and causes of delayed discharges in the NHS
Authors: Godden S , McCoy D , Pollock AM 
Published: January 2009

Summary Objectives The Community Care (Delayed Discharges, etc.) Act, 2003 was aimed at reducing the number of patients whose discharge from hospital was delayed, incorporating financial incentives based on a model from Sweden. The Act permitted NHS hospital trusts to charge local authority Social Service Departments for delays they were deemed responsible for and was accompanied by grants aimed at supporting improvements in the transfer of care. This study aims to assess how far the subsequent reduction in delays has been due to the operation of the Act, and to evaluate the extent that the legislation increased efficiency across health and social care. Design Analysis and interpretation of a range of official routine health statistics plus unpublished performance data. Setting Data on patients delayed in hospital in England from 2001–2002 to 2006–2007 and trends in hospital activity. Main outcome measures Trend analysis of health statistics and performance data relating to delayed discharges and other relevant indicators. Results Althought there has been an overall reduction in delayed discharges, this trend predates the implementation of the Act. Overall, bed- days lost to delayed discharges accounted for only a small proportion of all bed-days – 1.6% in 2006–2007, and over the period studied the causes of the majority of delays were attributed to the NHS (68%). Conclusions These findings indicate lttle evidence to support the policy of charging social services to improve public sector efficiency. The focus on reducing delays should be set in the context of the wider health economy. There are a number of pressures to reduce the time patients spend in hospital including fewer beds and increasing numbers of admissions, plus a rise in emergency readmission rates is noted. There are few good data available to monitor the impact of earlier discharge, such as on the quality and availability of post-discharge care.
Should according ISO 15189 accredited medical laboratories be monitored by the federal state authorities?1
Authors: Lehnigk Katharina , Steinhorst Andreas 
Published: January 2009

Abstract
The new guideline for quality assurance in medical laboratories (RiLi-BÄK 2008; Richtlinie der Bundesärztekammer zur Qualitätssicherung laboratoriumsmedizinischer Untersuchungen) describe in part A basic standards for quality assurance and quality management, which have to be implemented by all medical laboratories in Germany. Specific requirements are listed in part B. However, legal regulations can only be effective if compliance with these regulations is controlled.
Dipl.-Biol Katharina Lehnigk offers the opinion that the obligation of state authorities to survey medical laboratories also applies to laboratories which are voluntarily accredited according to the European Standard ISO 15189. The state has to take care that the compliance with regulations is guaranteed. A transfer of survey obligations from state authorities to other institutions including accreditation bodies may be conceivable.
Dr. Andreas Steinhorst from the accreditation body DACH (Deutsche Akkreditierungsstelle Chemie) reasons that state authorities should have confidence in the accreditation rules of ISO 15189 and therefore a surveillance of laboratories which have an accreditation according to ISO 15189 is not necessary. This holds particularly true since the standards of ISO 15189 have been partly adopted by the RiLi-BÄK 2008. However, the European Standard ISO 15189 is much more comprehensive than part A of the RiLi-BÄK 2008.
Charles Ives and “Our National Malady”
Authors: Sherwood Gayle 
Published: January 2009

Abstract
In his psychoanalytical biography of Ives, Charles Ives: “My Father's Song,” Stuart Feder convincingly argued that Ives's health breakdowns in 1906 and 1918 were the result of emotional and psychological factors rather than a physical heart condition. But the Freudian approach and terminology employed by Feder were unknown in American in 1906 and had not been fully accepted even by 1918. Therefore, how would an American doctor in 1906 have diagnosed Ives's “condition”? A careful examination of key events in Ives's life between 1902 and 1908, and a close reading of his correspondence indicate that he may have been recognized as neurasthenic. Ives's neurasthenia locates his identity by nationality, ethnicity, gender, economic and social class, education, profession, environment, and lifestyle. As a result, his artistic values and character traits emerge as remarkably typical of his country, culture, and time.
“Fam'd Handel Breathing, tho' Transformed to Stone”: The Composer as Monument
Authors: Aspden Suzanne 
Published: January 2009

Abstract
L. F. Roubiliac carved two full-length statues of Handel, in 1738 and 1762. Although designed for quite different settings—a public pleasure garden and Westminster Abbey—the two sculptures have notable congruencies: both were sited in spaces critical for national self-definition, and both reflected aspects of the composer's public persona. This article explores the delineation of Handel's image in these statues and reproductions of them, and explicates their role in a broader attempt to define the nation through its heroes. Handel's possible involvement in fostering his status as a “British worthy” is suggested both through circumstances of the effigies' production and through his onstage performance, particularly in Alexander's Feast.
“One Says That One Weeps, but One Does Not Weep”: Sensible, Grotesque, and Mechanical Embodiments in Boccherini's Chamber Music
Authors: Guin Elisabeth Le 
Published: January 2009

Abstract
The structural coherence and teleology emblematic of eighteenth-century Classicism are not strong features in the music of Luigi Boccherini (1743–1805). His posthumous reputation has suffered a great deal as a result. But regarded through the lens of performance—the sensations and images involved in its bodily presentation—his music evokes a different eighteenth century characterized by urgent, even volatile, inquiries into the nature of the self.
In this article I use contemporary theories of embodiment as articulated by Gasparo Angiolini and other creators of pantomime dance—a tradition to which Boccherini had considerable exposure—in order to address the heart of Boccherini's oeuvre, the chamber music for strings, in regard to its characteristic presentations of sensibilité through extreme repetitiveness and a hyperattention to details of dynamics and articulation; of the grotesque through bizarre timbres and registral excesses; and of Newtonian mechanistic philosophy through gestural enactments of rapidity and rigidity. These presentations often distance and ironize the performer, particularly in regard to virtuosity. I argue that they make thereby a sophisticated contribution to the central Enlightenment tension between subjectivity and appearance so memorably articulated in Diderot's “Paradoxe sur le Comédien.”
Rameau's Imaginary Monsters: Knowledge, Theory, and Chromaticism in Hippolyte et Aricie
Authors: Dill Charles 
Published: January 2009

Abstract
In recent years, historians have begun studying the compromises and semiotic slippages underlying Enlightenment thought, what writers of the time characterized as, among other things, monstrosities. Monsters failed to conform to a perceived natural order and as such became models for discussing everything from the limits of knowledge to departures from generic practices. Taking advantage of both this critical trope and the presence of monsters in Rameau's Hippolyte et Aricie (1733), the present essay describes Rameau's struggles with instrumental reason in his theorization of the chromatic genus. The composer marked the climactic moment in act 4 of the opera with what is surely the most striking progression in the performed version, a chromatic modulation that captures the characters' shock and registers the monster's supernatural presence. During the same period, he experimented theoretically with numerous descriptions of the chromatic progression, as both an ordinary and an extraordinary property of music. Working as composer and theorist, then, Rameau let chromaticism occupy varied epistemological positions in his work, which in turn allows us to observe him dealing with the limitations of his theoretical system and musical representation.
Orality, Literacy, and the Early Notation of the Office Hymns
Authors: Boynton Susan 
Published: January 2009

Abstract
This article takes the early notation of the Office hymns as the framework for a new investigation of orality and literacy in musical notation. Of all chant genres, hymns remained an oral tradition the longest, and the notation of entire hymn repertories was apparently rare before 1100. As a repertory of melodies hardly written down before the eleventh century, the hymns offer an opportunity to study the initial recording of an oral tradition at a time when other chant genres were increasingly notated. The variety of approaches to notating both entire hymn repertories and individual hymns in the sources up to the early twelfth century signals the increasing reliance on writing, as well as the dynamic interaction between orality and literacy, that characterizes monastic textual production in the eleventh century. The article places the notation of hymns in the context of their important role in monastic education and proposes an analogy between hymnaries and monastic customaries.
Aaron Copland and the Popular Front
Authors: Crist Elizabeth B. 
Published: January 2009

Abstract
In the early 1930s Aaron Copland began to compose in an accessible idiom he described as “imposed simplicity.” Many works written within this style, including El Salón México, the Fanfare for the Common Man, and the Third Symphony, have come to epitomize a nostalgic Americanism and sentimental populism. Yet the relatively simple surface of Copland's music belies a complex aesthetic ideology that owes to a tradition of progressive politics in the context of the Popular Front.
Recent revisionist historiography understands the Front as a cultural force extending from the late 1920s through the war years and advocating a social-democratic politics, reform of corporate capitalism, and multiethnic solidarity. These ideals can be read in the aesthetic ideology of Copland's music of the same era. El Salón México (1932), for example, draws upon working-class ethnic culture to mount a critique of industrial modernism, while the Third Symphony (1946) and its hommage to the “common man” evoke a radical populism to project a progressive vision of social justice. In contrast to portrayals of the composer as merely sympathetic to the cultural forces of depression and war, Copland was a politically engaged and ideologically aligned artist working within what historian Michael Denning has called “the cultural front.”
Growth and Survival of Larval and Juvenile Gila Chub at Different Temperatures
Authors: Schultz Andrew A , Bonar Scott A 
Published: January 2009

Abstract
The information needed to effectively culture imperiled native fishes for recovery efforts is lacking for certain species, yet it is critical for proper management and conservation. Culture techniques and requirements are virtually unknown for Gila chub Gila intermedia, a species federally listed as endangered. We tested the effect of four different water temperatures on the growth, survival, and overt health and appearance of larval (20, 24, 28, and 32°C) and two sizes of juvenile Gila chub (20, 23, 26, and 29°C). Growth of larvae was highest at 28°C and lowest at 32°C, whereas survival of larvae was highest at 24°C and lowest at 20°C. Spinal deformities were common for larvae reared at 32°C but generally uncommon for those reared at lower temperatures. Although growth of small (32–49 mm total length) and large (52–72 mm) juveniles generally increased with temperature, the differences were not statistically significant. In any experiment testing small and large juveniles, survival was 100% and no external abnormalities were noted. Water temperatures from 20°C to 28°C appear suitable for rearing larval Gila chub, temperatures from 24°C to 28°C being optimal. Water temperatures from 20°C to 29°C appear suitable for rearing juvenile Gila chub.
Estimating the Ratio of Hatchery‐Produced to Wild Adult Steelhead on the Spawning Grounds using Scale Pattern Analyses
Authors: Dauer M. B. , Seamons T. R. , Hauser L. , Quinn T. P. , Naish K. A. 
Published: January 2009

AbstractHatcheries produce Pacific salmon and trout Oncorhynchus spp. for many purposes, including fishery enhancement. The genetic integrity of wild populations spawning near such hatcheries may depend on the efficacy of their spatial or temporal separation from hatchery fish. We describe a simple, novel approach based on the examination of scales from an iteroparous species, steelhead O. mykiss, to evaluate whether the ratio of hatchery‐produced adults to wild adults on the spawning grounds met recommended levels. In this river, migrating steelhead are diverted into the hatchery by a weir. Hatchery‐produced fish are manually spawned and killed in the hatchery, whereas wild fish are passed over the weir and allowed to spawn naturally upstream from the hatchery. Therefore, in principle, all hatchery‐produced adults should be captured at the hatchery on their first spawning migration. However, scales from 8.3% (58 of 699) of female and 2.6% (22 of 844) of male hatchery‐produced steelhead adults showed evidence of previous spawning migrations. Although this frequency was lower than the incidence of repeat spawning by wild fish (males, 11.0%; females, 20.3%), these records nevertheless indicated significant reproductive opportunities in the wild for hatchery‐produced fish. Combining these frequencies of repeat spawning with estimates of the survival and numbers of wild fish, we modeled the ratio of hatchery to wild fish on the spawning grounds using data from eight return years. This ratio exceeded the recommended levels under all reasonable scenarios modeled (14.7‐89.6% hatchery fish). Combined with evidence of spatial and temporal overlap, our data suggest that unless changes are made to increase the capture efficiency of adults at Washington State's Forks Creek Hatchery and similar hatcheries relying on segregated stocks, the risks of genetic introgression and ecological interactions with wild steelhead populations will remain high.
Indications, Extent, and Benefits of Pelvic Lymph Node Dissection for Patients with Bladder and Prostate Cancer
Authors: Thurairaja Ramesh , Studer Urs E. , Burkhard Fiona C. 
Published: January 2009

Learning Objectives
Evaluate all patients undergoing radical pelvic surgery to determine whether they should have pelvic lymph node dissection. Determine to what extent a pelvic lymph node dissection should be performed and analyze the risks involved. Based on best practices, assess whether pelvic lymph node dissection is beneficial for staging and prognosis.
This article is available for continuing medical education credit at CME.TheOncologist.com.
Chronic Idiopathic Thrombocytopenic Purpura: Mechanisms of Pathogenesis
Authors: Gernsheimer Terry 
Published: January 2009

Abstract
The mechanism of idiopathic (autoimmune) thrombocytopenic purpura (ITP) has historically been attributed to platelet autoantibody production and the resultant platelet destruction. More recent evidence suggests a multifactorial pathogenesis. A complex picture of the immune processes involved in autoimmunity has emerged over the last decade with the identification and characterization of immunoregulatory elements (receptors, cytokines, and other signaling molecules) and cell trafficking patterns. An understanding of the interplay of cellular and humoral immune responses in the breakdown of self-tolerance has brought to light unrecognized mechanisms of the autoimmune destruction of platelets in ITP and potential targets for future therapeutic advances. The failure of the bone marrow to maximally increase platelet production also appears to play an important role in the thrombocytopenia of ITP. Treatment strategies targeting the thrombopoietin receptor to increase platelet production are a promising new approach to the management of ITP.
Sorafenib in Unresectable Hepatocellular Carcinoma from Mild to Advanced Stage Liver Cirrhosis
Authors: Pinter Matthias , Sieghart Wolfgang , Graziadei Ivo , Vogel Wolfgang , Maieron Andreas , Königsberg Robert , Weissmann Adalbert , Kornek Gabriela , Plank Christina , Peck-Radosavljevic Markus 
Published: January 2009

Abstract

Background.
Few data are available on the safety and efficacy of sorafenib in patients with multifocal hepatocellular carcinoma (HCC) and advanced liver cirrhosis.

Methods.
Between May 2006 and December 2007, we treated 59 patients (Child-Pugh class A/B/C, 26/23/10) with unresectable HCC with sorafenib (daily target dose, 400 mg twice daily). Data were collected retrospectively. Survival curves were calculated via the Kaplan–Meier method.

Results.
One patient (Child-Pugh class B) had a partial response, 14 patients (Child-Pugh class A/B/C, 5/7/2) had stable disease, and 32 patients (Child-Pugh class A/B/C, 15/11/6) had progressive disease; 12 patients were not evaluable because they had no follow-up radiologic evaluation. In the intention-to-treat group, the median time to progression and overall survival (OS) time were 2.8 months (range, 1.4–6.5 months) and 6.5 months (range, 0.4–17.4 months), respectively. Well-preserved liver function and lower Barcelona Clinic Liver Cancer stage were associated with a longer OS time on univariate analysis. There were four severe gastrointestinal bleedings (grade 4–5; Child-Pugh class B/C, 2/2). Most drug-related side effects were low grade and manageable irrespective of liver function.

Conclusions.
Sorafenib is effective and safe in patients with multifocal HCC and Child-Pugh class A cirrhosis. Survival in Child-Pugh class B patients is significantly less than in Child-Pugh class A patients, warranting a prospective randomized trial with a placebo group. Child-Pugh class C patients have a limited life expectancy despite sorafenib treatment because of their severe underlying disease and derive little benefit from sorafenib treatment.