bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stoma formation for functional bowel disease
Authors: Harris R. P. , Daly K. J. , Jones L. S. , Kiff E. S. 
Published: June 2004

AbstractObjective  To assess the results of stoma formation for functional bowel disease.Methods  A retrospective study of the indications for and complications of stoma formation in this group. A quality of life questionnaire was sent to the group.Results  A very small proportion of patients with functional bowel disease have a stoma formed (< 1%). Stoma formation is often associated with problems requiring further operations. Their QOL is reported as poor and is improved upon by stoma formation. Most patients with a temporary stoma elected to keep it rather than suffer their previous problems.Conclusion  Some patients with functional bowel disease can be successfully managed by stoma formation. Their treatment is difficult, emotionally demanding and labour‐intensive.
‘Paper Clinics’– a model for improving delivery of outpatient colorectal services
Authors: Porrett T. R. C. , Lunniss P. J. 
Published: June 2004

AbstractObjectives  The overburdening of colorectal out‐patient clinics necessarily leads to delays in time from referral to consultation and subsequent clinic attendance. This study aimed to ascertain the feasibility of ‘paper clinic’ follow‐up rather than all patients receiving a routine follow‐up appointment following investigation. A more efficient outpatient follow‐up process should reduce unnecessary follow‐up, thereby facilitating the speedy investigation and diagnosis of patients through changes in clinic profiles.Methods  From August 2001 all patients seen in the outpatient clinic of one (part time) Consultant colorectal surgeon, who required investigation, were prospectively recorded on a ‘paper clinic’ form. These patients were given the necessary test request forms but were not given a further outpatient appointment. The results of the investigations were reviewed, together with the patients' medical records at a formal fortnightly ‘paper clinic’ session carried out by the Consultant and Nurse Consultant, and a treatment plan derived. Patients then followed one of 5 follow‐up pathways and were notified in writing with a copy to their GP.Results  During a 24‐month period a total of 897 patients were reviewed using the ‘paper clinic’ follow‐up system. Of these, 285 (31.8%) patients were discharged without further follow‐up. In a given 3‐month period when the clinic was well established, 152 patients were reviewed, of whom 27% were discharged from follow‐up, 17% received SOS appointments, 13% required further investigation (and consequently were returned to ‘paper clinic’ follow‐up), and 7% received Nurse led follow‐up. In this 3‐month period 64% of patients reviewed by ‘paper clinic’ follow‐up did not return to Surgical Outpatient's and 12% received a Surgical Outpatient appointment for review.Conclusion  ‘Paper clinic’ follow‐up is an effective and feasible follow‐up alternative, resulting in a major decrease in outpatient follow‐up burden. This has allowed the redesign of the outpatient clinic profile allowing for an increase in new urgent slots, and more rapid clinic follow up review of those patients who need it. Re‐design and rationalization of existing services can result in considerable service improvement. Expanding clinics should not be considered the only option when faced with capacity and demand issues.
EU Enlargement and the Portuguese Economy
Authors: Crespo Nuno , Fontoura Maria Paula , Barry Frank 
Published: June 2004

The main focus of the present paper is on the emerging and likely future trade effects of enlargement. Though our particular concern is with Portugal, we set the scene by comparing the trade structures of the 10 countries of Central and Eastern Europe (i.e. the eight CEE accession states plus Bulgaria and Romania) – including an analysis of the individual cases of the Czech Republic, Hungary and Poland – with those of the EU15 as a whole, and with those of the 4 EU cohesion countries.The elimination of trade barriers between incumbents and accession states will have two trade‐related effects on EU incumbents: an increase in bilateral flows with the CEEC and a shift effect as the CEEC displace some incumbent exports to EU markets. The first effect is likely to be strongest for those incumbents for which there is a strong overlap between their export structure and the import structure of the CEEC. Portugal emerges as one of the economies with the least overlap.The displacement effect, we conclude, is likely to be particularly strong in the case of Portugal, given the high degree of similarity between Portuguese exports and those of the CEEC. Portugal appears to be ‘being squeezed from below’ in that, for the majority of its traditional export sectors, the CEEC became progressively more competitive during the second half of the 1990's.Portuguese specialisation was increasingly confined to low‐technology, low‐added‐value sectors with declining demand, as strong FDI inflows to the CEEC led to an increasing preponderance of more dynamic sectors in their export structures. Thus, Portugal is also being squeezed from above. This suggests that there may be substantial industrial disruption, in response to which labour‐market flexibility and dynamic entrepreneurial response is crucial. Intersectoral mobility is generally easier the more highly educated the workforce – an indicator on which Portugal scores poorly. The Portuguese labour market, however, displays a high degree of flexibility, consistent with its long lasting low rate of unemployment. Continued flexibility will help minimise these likely adjustment costs.Besides the trade and industry effects, other topics considered in the paper include the implications of enlargement for Portugal's ability to attract FDI, the likely consequences for Portugal of inward migration from the CEEC to the EU, and the implications of enlargement for Portugal's budgetary relations with the rest of the EU.
Prospects for Ireland in an Enlarged EU
Authors: Barry Frank 
Published: June 2004

The CEEC share of Irish exports has grown fivefold since transition began, with export sales expanding in all sectors. Even at current income levels there remains scope for a further doubling of exports, and trade will grow even more substantially if accession facilitates the CEEC in converging more rapidly on EU living standards.Most analyses predict that the EU15 sectors that face the greatest threats of enlargement‐induced disruption are Food and Textiles, Clothing and Footwear. In the case of Irish Food Processing, however, the prognosis of the present paper is positive since Irish agricultural output differs quite strongly from that of the CEE economies. The adjustment costs associated with industrial dispution, furthermore, are highest in economies with rigid labour markets, whereas the flexibility of the Irish labour market seems to have improved substantially over the last decade or so.Outward FDI from Ireland has grown strongly over the Celtic Tiger era, and Irish multinational firms have been reasonably active in acquiring companies in their sectors in Cental and Eastern Europe. The main worry for Ireland is that the more successful accession states may divert FDI inflows away from Ireland. Micro‐level analysis of the conditions pertaining in some of Ireland's most important foreign‐dominated sectors – information technology, pharma‐chem and instrument engineering – suggests that these threats may be overstated. The leading CEE economies, rather than drawing FDI away from Ireland, may instead contribute to the further development of EU‐wide production networks, making the networks themselves more competitive as global players.The net cost to Ireland of agreements already reached on the financing of enlargement is quite manageable. The cost to Ireland would escalate dramatically, however, if costs and benefits were to be redistributed within the EU in line with current income levels, entailing a substantial transformation of the CAP transfer mechanism.
Enlargement and the European Geography of the Information Technology Sector
Authors: Barry Frank , Curran Declan 
Published: June 2004

The information technology sector in Europe, comprising the production of computer hardware and software, is disproportionately located on the continent's western periphery. The vast bulk of computers sold in Europe in the 1990s were assembled either in Ireland or Scotland, while Ireland also accounted for over 40 per cent of all packaged software and 60 per cent of all business software sold in Europe. As the sector in both these locations is largely foreign owned, the question arises as to whether EU enlargement might impact on the geography of the sector by diverting information technology FDI from the western to the new eastern periphery. This issue is explored in the present paper by analysis of five individual sub‐segments: computer assembly and electronic components, R&D, mass‐market packaged software and the remainder of the software sector.The paper deems it likely that computer assembly operations will continue the shift seen in recent years from Ireland and Scotland to Central and Eastern Europe. The production of electronic components such as microchips represents a growing share of activity in most EU locations as well as in the CEE countries. Analysis suggests that this pattern of geographically‐dispersed growth will resume once the consequences of the collapse of the high‐tech bubble are played out.The distribution of R&D activity across Europe and globally is also considered unlikely to be much affected by enlargement. As for software, as long as localisation activities remain important, Ireland – the EU location in which most of this activity is carried out – seems set to be able to compete strongly, given the attractiveness of its English‐language environment and other attributes to the young continental Europeans upon which this activity relies. Most software services remain largely non‐tradable however. This sector will grow in the accession states as computer penetration rates converge on the EU average, but without displacing activity from the incumbent EU member states. For firms already competing in the tradable niche software segment, on the other hand, enlargement cannot but be beneficial because of its impact on the size of the market into which they sell.
Transnational Families: Memories and Narratives
Authors: Chamberlain Mary , Leydesdorff Selma 
Published: June 2004

AbstractThis introduction to a special issue of the journal explores not only the role of memory and narratives in understanding gender and transnational families, but suggests how such families use and understand their memories to construct coherent narratives of the self and kin. In common with renewed thinking about the multifaceted nature of migration, the complexities of the process, and the continuing dialogue that migration establishes between the old and the new, the past and the present, those who engage with oral history/life story methods are increasingly aware that such data provide a ‘value added’ to rich empirical detail. These methods reveal the use of memory and its role in the continuing emotional adjustments in which most transnational experience is embroiled. They show how the multi‐layering of memory, language and narratives are indicators of the ways in which culture shapes recall and recounting. Families themselves become sites of belonging, part of the imaginary unity through which a transnational family may seek its identity. Equally, oral histories can tease out ways in which gender differences impact on, or are impacted by, transnational lives. The introduction situates the subsequent articles within a brief overview of oral history and migration.
Celebrating Ourselves: The Family Reunion Rituals of African‐Caribbean Transnational Families
Authors: Sutton Constance R. 
Published: June 2004

AbstractIn the past decade, family reunions have become an important ritualized event among Afro‐Caribbean transnational migrants. Dispersed across a large number of North Atlantic countries, Afro‐Caribbeans have turned to organizing events specifically designed to reunite kinfolk. The rituals constitute a celebration of family as a distinct social group with a kin‐based, lineage‐like identity. Re‐creating kin ties among those spread across different nations and transmitting kin‐based connections to their offspring are the main incentives for holding these rituals. In this article I describe three different recent family reunions, one held in Barbados, one in Grenada, and one in Trinidad and Barbados. I analyse the specific forms these rituals take, relate their differences from the social positioning of the core members of the kin groups and discuss the signifying practices of the reunions for maintaining Caribbean family connections in the diaspora. Finally, I raise questions about how the kin‐based identities constructed in the reunion rituals intersect with race/class, ethnic and national identities.
Soa's Version: Ironic Form and Content in The Self‐Account of A Transnational métisse Narrator
Authors: Walsh Andrew 
Published: June 2004

AbstractIn this article I explore the links between the form and content of narratives collected from a young Malagasy/French woman, named Soa, who has recently moved from Madagascar to France. Soa's self‐account is riddled with stories that point out the ambiguities inherent in her experience of life as a woman with feet, and obligations, in two worlds at once. Rather than indicating her confusion or uncertainty, it is argued here that these stories, and the form in which they are presented, indicate the sort of ironic stance that may well be the prerogative of transnational, millionétisse narrators like Soa.
The Quest for Family and The Mobility of Modernity in Narratives of Postwar British Emigration
Authors: Hammerton James 
Published: June 2004

AbstractIn this article I focus on ways in which the postwar generation of British migrants to Canada and Australia construct their stories as epic struggles with family themes of both loss and triumph at the centre. While, during the postwar years, there is among some migrants evidence of the emergence of a more adaptable, sojourning ‘mobility of modernity’, most life stories told by the migrants suggest a more traditional pattern in which family themes dominate. In these narratives postwar migrants structure their accounts along traditional ‘epic story’ lines reminiscent of Oscar Handlin's long superseded thesis about dislocation in the old country, alienation in the new and ultimate triumph over material and cultural obstacles. But the ‘epic’ quality of these stories is deeply attached to family themes; the disruption of family networks and attempts to rescue the old or create new ones are central to the way the migration experience determines the structuring of life memories. The very act of migration focuses attention on its impact on kinship. The predominantly urban, nuclear family form of postwar British migration does contrast sharply with more traditional rural patterns based on extended family movements and ‘chain migration’. But British migrants' emphasis on the ‘quest for family’ and the refashioning of migrant identity in their narratives underlines the coexistence of traditional themes within countervailing trends towards the mobility of modernity.
Recycled Odyssey: Creating Transnational Families in The Greek Diaspora
Authors: Panagakos Anastasia N. 
Published: June 2004

AbstractIn this article I explore the types of transnational families forged by Greek Canadian women through cycles of migration between Canada and Greece. The focus is on how transmigrant women search for a spouse and heterosexual lifestyle embodied within a seemingly ‘authentic’ Greek experience. This recycled odyssey in which the women negotiate systems of gender and ethnic identification between two different social milieux highlights how parental guidance, class tensions and representations of gender and sexuality (re)form the Greek transnational family. These conflicts, and their resolutions, indicate how the ties of transnational families are negotiated to accommodate competing notions of sexuality, femininity, filial piety, parental investment and economic responsibility. Such cases are poorly documented since it is assumed that ‘white’ ethnic groups in North America are more assimilated. However, given the forces that drive transnationalism — such as global capital, cheap travel, telecommunications and European integration — belonging to an imagined community has different implications than it did in the past.
‘Aprendemos A Convivir’: Conjugal Relations, Co‐parenting, and Family Life Among Ecuadorian Transnational Migrants in New York and The Ecuadorian Andes
Authors: Pribilsky Jason 
Published: June 2004

AbstractThe aim of this article is to examine conjugal relations, co‐parenting and family life among Ecuadorian transnational migrants in New York and the Azuayo‐ Cañari highlands of Ecuador. It counters two commonly‐held views of transmigration. Officials and academics often stress the negative impacts of male migration to the USA, arguing that it leads to spousal abandonment. In addition, studies of gender in transnational relationships generally concentrate on women's experiences and lack a more nuanced understanding of men's lives in migration. Based on interviews with both male migrants in New York and women in Ecuador, this research focuses instead on how intact couples work to redefine roles, relationships and family life; how they learn to live side‐by‐side (aprender a convivir). The article begins with an account of men's adjustment to single life in the city, which is then juxtaposed to women's experiences in the sending villages. The main section presents a narrative of one couple, revealing how they handle remittances, communication, child‐raising and their own relationship. Their experiences highlight the tensions and problems faced by young couples starting to form their own autonomous households in a setting increasingly different from that of previous generations. But, despite hardships, such couples often state that their relationship improved after migration.
Off‐Label Prescribing of Drugs in Specialty Headache Practice
Authors: Loder Elizabeth W. , Biondi David M. 
Published: June 2004

Objective.—To assess the extent of off‐label prescribing in specialty headache practice.Methods.—A prospective record was kept of all prescriptions written during a 30‐day period in a tertiary care headache program affiliated with two teaching hospitals. Each drug was categorized as “on‐label,” defined as approved by the FDA for a headache or general pain indication, and used in accordance with label instructions, or “off‐label,” defined as any use of a drug not covered in the FDA‐approved package insert.Results.—A total of 379 prescriptions were written during a 30‐day period. One hundred and seventy‐eight prescriptions (47%) met the criteria for off‐label use. In all, 23 categories of off‐label treatment were prescribed during the study, but just 4 accounted for over half of all off‐label prescriptions: newer antiepileptic drugs such as topiramate and lamotrigine (each accounted for n = 26, 15% of off‐label prescriptions), newer antidepressants, especially venlafaxine (n = 27; 15% of off‐label prescriptions), and botulinum toxin type A (n = 13; 7% of off‐label prescriptions).Two hundred and one prescriptions met criteria for on‐label use. The largest percentages of prescriptions written for approved, on‐label indications were for triptans (n = 74; 37% of on‐label prescriptions), and nonsteroidal anti‐inflammatory drugs (n = 64; 32% of on‐label prescriptions).Conclusions.—Off‐label prescribing is common in the specialty management of headache conditions. We conclude that it is within the current standard of care, and an integral part of practice, to use off‐label medications in the treatment of complex headache conditions.
Severe Vascular Events in Migraine Patients
Authors: Velentgas Priscilla , Cole J. Alexander , Mo Jingping , Sikes Carolyn R. , Walker Alexander M. 
Published: June 2004

Objective.—To estimate rates of vascular events in relation to dispensing of triptans and ergot alkaloids among migraineurs, and to compare these rates with those of nonmigraineurs.Context.—It has been speculated that the use of triptans or ergot alkaloid drugs might increase risk of ischemic events through vasoconstriction.Design.—A retrospective cohort study of 130,411 migraineurs and 130,411 age‐, sex‐, and health plan‐matched nonmigraineurs who were members of UnitedHealthcare during 1995 through 1999. The data source for this study was Ingenix's research database containing pharmacy and medical claims for UnitedHealthcare members, and the National Death Index.Main Outcome Measures.—Incidence of cardiovascular and cerebrovascular events and mortality.Results.—Migraineurs and nonmigraineurs had identical rates of myocardial infarction: 1.4 per 1000 person‐years. Migraineurs were 67% more likely to suffer a stroke than nonmigraineurs (adjusted relative risk [RR] 1.67, 95% confidence interval [CI] 1.31–2.13), and had higher rates of unstable angina and transient ischemic attacks. There was no increase in risk of myocardial infarction with current (adjusted RR 0.80, 95% CI 0.58–1.11) or recent (adjusted RR 1.15, 95% CI 0.71–1.87) triptan use. Neither current (adjusted RR 0.90, 95% CI 0.64–1.26) nor recent (adjusted RR 0.84, 95% CI 0.46–1.55) triptan use was associated with risk of stroke. Current users of ergot alkaloids were somewhat more likely to have a stroke than other migraineurs (adjusted RR 1.49, 95% CI 0.93–2.41), but there was no dose‐response relationship.Conclusions.—Use of triptans is not associated with increased risk of any ischemic events, including myocardial infarction and stroke, or mortality. Consistent with previous studies, migraineurs in general have an elevated risk of stroke, but not myocardial infarction, compared with nonmigraineurs.