bluuebunny/crossref_metadata_2025_split huggingface dataset:
The costs of not treating hepatitis C virus infection in injecting drug users in New Zealand
Authors: SHEERIN IAN G. , GREEN F. TERRI , SELLMAN J. DOUGLAS 
Published: October 2003

AbstractThis paper estimates future health service costs of the current practice in New Zealand of not funding treatment of hepatitis C virus (HCV) infections. Costs are estimated separately for Māaori and non‐Māaori, male and female IDUs. Markov modelling is used to track the infection and progression of HCV to severe liver disease and death, and accumulated costs are estimated for the life of the cohort. Upper and lower estimates of costs are calculated based on different assumptions of the rate of progression of HCV to more severe liver disease. Costs are estimated at $24.6 million per 1000 non‐Māaori men IDUs (discounted at 3%), under progression assumptions based on liver clinic studies, compared with $10.3 million per 1000 using lower rates of progression based on community studies. Similarly, corresponding costs for non‐Māaori women are estimated at $27.6 million and $11.2 million per 1000 IDUs. Costs for women are higher because their greater life expectancy is associated with more cases of liver cirrhosis (LC) at older ages. Future costs for Māaori are lower than non‐Māaori, because Māaori are more likely to die at younger ages and hence fewer progress to more advanced liver disease. The current situation in New Zealand of not treating HCV infections will result in considerable future costs as some people with HCV progress to more severe liver disease. Provisional estimates are that the accumulated costs of HCV‐related liver disease for all IDUs currently infected will be between $166 million at lower rates of disease progression (discounted at 3%) to $400 million at upper rates. Some of the associated morbidity and mortality could have been avoided if the HCV infections had been treated.
Obstacles to carrying out brief intervention for heavy drinkers in primary health care: a focus group study
Authors: AALTO MAURI , PEKURI PETTERI , SEPPÄ KAIJA 
Published: October 2003

AbstractThe objective of this study was to identify possible obstacles to carrying out competent early identification and brief intervention (EIBI) of heavy drinkers in primary health care. Qualitative focus group discussion method study applying the deductive framework approach. Six focus groups involving 18 general practitioners and 19 nurses were recruited from primary health care of the City of Tampere, Finland. Possible obstacles are: (1) confusion regarding the content of early‐phase heavy drinking, (2) lack of self‐efficacy among primary health care professionals, (3) sense of lacking time needed for carrying out brief intervention, (4) not having simple guidelines for brief intervention, (5) sense of difficulty in identifying of early‐phase heavy drinkers, and (6) uncertainty about the justification for initiating discussion on alcohol issues with patients. The main actions to be taken to promote brief intervention are to educate professionals about the content of early‐phase heavy drinking and to produce directing, but not excessively demanding guidelines for carrying out EIBI. Probably successful personal experiences carrying out EIBI can improve professionals' self‐efficacy and give to them final justification for discussion alcohol issues with their patients.
In‐patient benzodiazepine withdrawal: comparison of fixed and symptom‐triggered taper methods
Authors: MCGREGOR CATHERINE , MACHIN ALISON , WHITE JASON M. 
Published: October 2003

AbstractFixed and symptom‐triggered taper methods during in‐patient benzodiazepine withdrawal treatment were compared using a randomized controlled design. Forty‐four benzodiazepine users seeking in‐patient withdrawal treatment at two substance use treatment clinics in Adelaide, Australia were recruited. Measurements included the Severity of Dependence Scale and the SF–36. A scale comprising six items from the Clinical Institute Withdrawal Assessment Scale—Benzodiazepines (CIWA‐B) was used to measure withdrawal symptoms. Participants were randomized to receive a fixed diazepam tapering regime or diazepam only in response to withdrawal symptoms (symptom‐triggered group). Results showed that there were no significant differences between treatment groups in terms of withdrawal severity, duration of in‐patient treatment, amount of diazepam administered, treatment attrition and benzodiazepine use at follow‐up. Both groups showed a reduction in benzodiazepine dosage of 86% over the first 8 days which was maintained at 1 month post‐discharge. Although there were improvements in some subscales of the SF–36 between baseline and follow‐up, values were significantly below age‐matched norms at both time‐points. This study showed that benzodiazepine users entering treatment have relatively poor health and that symptom‐triggered taper methods incorporating flexible dosing and flexible treatment duration are as effective as fixed dose taper methods for in‐patient benzodiazepine withdrawal treatment.
Aftercare attendance and post‐treatment functioning of severely substance dependent residential treatment clients
Authors: SANNIBALE C. , HURKETT P. , VAN DEN BOSSCHE E. , O'CONNOR D. , ZADOR D. , CAPUS C. , GREGORY K. , MCKENZIE M. 
Published: October 2003

AbstractThe present study evaluated the impact of a structured aftercare programme following residential treatment for severe alcohol and/or heroin dependent clients. Over 17 months, 77 participants were recruited to the study and allocated randomly to either a structured aftercare (SA) programme or to unstructured aftercare (UA) of crisis counselling on request. Independent clinicians interviewed participants and collaterals, at 4–month (median) intervals, for 12 months following residential treatment. SA compared to UA was associated with a fourfold increase in aftercare attendance and one‐third the rate of uncontrolled principal substance use at follow‐up. Participants who attended either type of aftercare relapsed a median of 134 days later than those who attended no aftercare. Overall, 23% of monitored participants remained abstinent throughout, 21% maintained controlled substance use and 56% relapsed, within a median of 36 days following residential treatment. The only significant predictor of days to relapse, controlling for age, was pretreatment use of additional substances. Participants with pretreatment additional substance use relapsed a median of 192 days earlier than those who had used no other substances. The degree of agreement between participant self‐reports and collateral reports was fair‐to–moderate and moderate among collaterals. Intention‐to–treat analyses revealed significant and clinically meaningful reductions in substance use in this sample of severely dependent residential treatment clients. The generalizability of these results is limited because of significant differences in age and presenting substance between the study sample and other clients admitted to the service during the study. This latter group of younger, male, heroin‐dependent clients with polydrug use who refuse opioid pharmacotherapy, are more likely to drop out of treatment or relapse early following treatment and continue to present a challenge to treatment services.
Pharmacotherapies to enhance smoking cessation during pregnancy
Authors: ONCKEN C. A. , KRANZLER H. R. 
Published: October 2003

AbstractSmoking during pregnancy is a significant public health concern. Maternal smoking increases the risk of spontaneous abortion, low birth weight, premature delivery, sudden infant death syndrome and learning and behavioral problems in the offspring. Unfortunately, the majority of pregnant women do not quit smoking during pregnancy. Although pharmacotherapy may improve smoking cessation rates in pregnancy, very few studies exist that have studied the safety and efficacy of medications to treat pregnant smokers. This article reviews the available safety and efficacy data for the use in pregnancy of the five first‐line therapies and two second‐line therapies that are recommended for smoking cessation in non‐pregnant smokers. Other promising nicotine replacement therapies are also reviewed. Ultimately, the choice whether to use pharmacotherapy for smoking cessation should be made jointly by the pregnant smoker and her health care provider. This article reviews factors that may be considered when prescribing pharmacotherapy to pregnant smokers (i.e. the role of behavioral counseling, identification of appropriate patients, potential advantages and disadvantages of each of the pharmacotherapies, proposed monitoring strategies, dose and duration and goals of treatment). More research regarding the safety and efficacy of pharmacotherapy during pregnancy is needed to define the risk/benefit profile of each medication for use in smoking cessation in pregnant women.
Review of bupropion for smoking cessation
Authors: RICHMOND ROBYN , ZWAR NICHOLAS 
Published: October 2003

AbstractThe advent of bupropion hydrochloride sustained release (Zyban) has heralded a major change in the options available for smoking cessation pharmacotherapy. Bupropion is a selective re‐uptake inhibitor of dopamine and noradrenalin which prevents or reduces cravings and other features of nicotine withdrawal. Bupropion is a useful oral and non‐nicotine form of pharmacotherapy for smoking cessation. For this review a total of 221 papers were reviewed plus poster presentations. This review examines in detail original clinical trials on efficacy, categorised according to whether they were acute treatment trials in healthy smokers; studies in specific populations such as people with depression, chronic obstructive pulmonary disease (COPD) or cardiovascular disease; or relapse prevention studies. Overall, these studies in varying populations comprising over four thousand subjects, showed bupropion consistently produces a positive effect on smoking cessation outcomes. The evidence highlights the major public health role that bupropion has in smoking cessation. The methodological issues of published clinical trials reporting one year outcomes were examined in detail including: completeness of follow‐up; loss to follow‐up; intention to treat analysis; blindness of assessment; and validation of smoking status. The review discusses contraindications, adverse effects, dose and overdose, addictive potential, and the role of bupropion in reducing cessation‐related weight gain. Bupropion combined with or compared to other pharmacotherapies (nicotine patch; nortriptyline) is considered. Impressive evidence exists for the use of bupropion in smoking cessation among difficult patients who are hard‐core smokers such as those with cardiovascular disease, chronic obstructive pulmonary disease (COPD) and depression. Bupropion reduces withdrawal symptoms as well as weight gain and is effective for smoking cessation for people with and without a history of depression or alcoholism. Serious side effects of bupropion use are rare. The major safety issue with bupropion is risk of seizures (estimated at approximately 0.1%) and it should not be prescribed to patients with a current seizure disorder or any history of seizures. In clinical trials of bupropion for smoking cessation no seizures were reported. Allergic reactions occur at a rate of approximately 3% and minor adverse effects are common including dry mouth and insomnia.
A pilot study of a computer‐assisted cell‐phone interview (CACI) methodology to survey respondents in households without telephones about alcohol use
Authors: WILKINS CHRIS , CASSWELL SALLY , BARNES HELEN MOEWAKA , PLEDGER MEGAN 
Published: October 2003

AbstractAn intrinsic drawback with the use of a computer‐assisted telephone interview (CATI) survey methodology is that people who live in households without a connected landline telephone are excluded from the survey sample. This paper presents a pilot of the feasibility of a computer‐assisted cell‐phone interview (CACI) methodology designed to survey people living in households without a telephone about alcohol use and be compatible with a larger telephone based alcohol sample. The CACI method was found to be an efficient and cost competitive method to reach non‐telephone households. Telephone ownership was found to make a difference to the typical occasion amount of alcohol consumed, with respondents from households without telephones drinking significantly more than those with telephones even when consumption levels were controlled for socio‐economic status. Although high levels of telephone ownership in the general population mean these differences may not have any impact on population alcohol measures they may be important in sub‐populations where telephone ownership is lower.
Understanding Capitalism: Crises and Passive Revolutions
Authors: Li Xing , Hersh Jacques 
Published: October 2003

This article has two objectives: First, it attempts to provide a framework for understanding capitalism's resilient adaptability through analysing the roles of liberal democracy and ecological environmentalism. Both are conceptualised as capitalism's passive revolutions in response to emerging crises – processes of constituting and reconstituting conditions for production and reproduction. Liberal democracy is seen as a political restructuring strategy aimed at producing social control with less coercive measures as well as depolitising social contradictions and economic crises. Ecological environmentalism is argued to be capitalism's ecological restructuring attempt at the economic level in order to rescue an economic system at an impasse and to resolve the contradictions between production relations/forces and the externalities of production. Second, the article aims to conduct a critical analysis of what are considered to be passive revolutions taking place within capitalism in order to uncover their hidden mystifications, contradictions and distortions in the promotion of certain policies, practices, values, cognitions and symbols which are considered to be supportive of the existing capitalist political and economic system. The working assumption is that, due to capitalism's modus operandi which is primarily based on capital accumulation, democratic principles and environmental concerns will eventually have to submit to this inherent imperative.
Selenium in municipal wells in the Irapuato City — spectrofluorimetric determination with 2,3-diaminonaphthalene
Authors: Wróbel K. K. , López-de-Alba P.L. , Wróbel Z. K. , López-Martínez L. , Villagómez L.E. Pantoja 
Published: October 2003

Abstract
A chromatographic procedure with spectrofluorimetric detection (λ = 257 nm, λ = 548 nm) is proposed in this work for Se determination in well water after formation of a piazselenol compound. The low detection limit obtained (15 ng·l-1 ) enabled minimisation of the sample size and, consequently, smaller amounts of reagents were needed. Selenium content was confirmed using standard reference material. The proposed procedure was applied for the determination of Se in municipal wells in Irapuato city (Lerma-Chapala basin) and the obtained results showed that 52.5% of the analysed wells contained amounts higher than the limit 10 μg·l-1 of selenium as recommended by the World Health Organisation for drinking water. The high selenium levels were found only in the wells of the city of Irapuato (concentration range 12 – 223 μg l-1 ), not in the wells in other cities of the State of Guanajuato. No contamination by other trace elements (arsenic, cadmium, chromium, iron, manganese, lead) was found in Irapuato wells.
Factors limiting phytoplankton productivity in 49 shallow reservoirs of North Côte d'Ivoire (West Africa)
Authors: Arfi R. , Bouvy M. , Cecchi P. , Pagnao M. , Thomas S. 
Published: October 2003

Abstract
Several hundred ranching reservoirs are scattered in North Côte d'Ivoire, where they have an increasing economical importance as water resources during the dry season. To obtain a synoptic view of their limnological characteristics and to identify key factors limiting algal productivity, 49 of these shallow reservoirs were sampled once in 1997 at the end of the dry season. They showed low conductivity (range 40-230 µS cm-1 ) and low pH (range 5.1-7.3), and lakes deeper than 2 m were stratified. Most lakes had low nutrient concentrations (median: 0.09, 3.49 and 0.44 µM, for NO3-N, NH4-N and PO4-P, respectively). They were very turbid, with most of Secchi depths ranging between 0.1 and 0.4 m, and had high seston weights (median, 45 mg l-1). Many lakes had high chlorophyll concentrations (median, 106 µg l-1 ), and some of them featured algal blooms, while many lakes had primary production value &lt;1000 mg C m-2 d-1. Algae of size &gt;10 µm represented about 50 percent of the chlorophyll biomass and phytoplankton production. Classification on hydrological and particle data identified five groups based on depth, turbidity and productivity. During the dry season, the initial nutrient pulse linked to the annual flood is exhausted. At this time of the year, phytoplankton production was nitrate limited in some lakes, while in some others, phosphorus was limiting. Deep sites (&gt;2 m) were less turbid and less productive than shallow ones (&lt;2 m). In shallow unstratified lakes showing a nutrient-rich bottom layer, easy vertical mixing allow a regular enhancement of the algal productivity. In deeper and stratified lakes, nutrient enrichment only occurs when high intensity winds induce vertical mixing, and their productivity is directly related to these episodic nutrient pulses.
Comparison of fish and macroinvertebrate bioassessments from South Carolina coastal plain streams
Authors: Paller Michael H. 
Published: October 2003

Abstract
Stream bioassessments are usually based on a single taxonomic assemblage, often fishes or macroinvertebrates, with the assumption that this assemblage is representative of ecological conditions. However, ecological and physiological differences between taxonomic groups may result in different assessment results. In this study, concurrent fish and macroinvertebrate bioassessments from South Carolina coastal plain streams were compared on the basis of precision, sensitivity, accuracy, and agreement. Multimetric indices used in this comparison were a modified Index of Biotic Integrity based on electrofishing data and a benthic macroinvertebrate multimetric index based on data collected with Hester-Dendy artificial substrates. Benthic macroinvertebrates were also collected from natural substrates for comparative purposes. The Index of Biotic Integrity was more precise than the HesterDendy multimetric index but the average difference between disturbed and reference sites was greater for the latter resulting in equal sensitivity (i.e., ability to measure disturbance in relation to index variability). The two indices were significantly correlated (r=0.62, p &lt;0.001), but agreement between them was weak for slightly and moderately disturbed sites. Analysis of species richness and abundance data indicated that fish and macroinvertebrates responded differently to some disturbances regardless of whether macroinvertebates were collected from HesterDendy samplers or natural substrates. Disagreement between macroinvertebrate and fish assessments at moderately disturbed sites indicated that biological condition could not always be adequately evaluated from a single taxonomic group. Identification of disturbed sites was most accurate when based on both indices suggesting that future research should emphasize cost-effective sampling and integration of information from multiple taxonomic groups.
Sediment elutriate toxicity testing with embryos of sea urchin (Paracentrotus lividus)
Authors: Marin M.G. , Da Ros L. , Moschino V. , Campesan G. 
Published: October 2003

Abstract
Several laboratory conditions for preparing and testing of elutriates from sediments of industrial and urban contaminated areas of the Lagoon of Venice (Italy) were assessed in experiments using embryos of the sea urchin Paracentrotus lividus.
Elutriates were obtained by mixing of aerated offshore sea water and fresh aliquots of sediments (5, 20, 200 g l-1) for four hours. Sediments were then allowed to settle for 12 hours, the supernatant was filtered (at 1 µm) and subsequently tested, undiluted and diluted, at ratios of 1:4 and 1:10. Each diluted sample was again tested after further filtering at 0.45 µm.
Bioassays were carried out on embryos from post-fertilisation to the pluteus stage. The following parameters were observed: survival, frequency of developmental stages, and embryonic growth. The latter was most sensitive to varying experimental conditions, as the length of the skeletal somatic rods of plutei decreased significantly with increasing sediment concentration. Percent survival was slightly reduced in non-diluted and non-filtered treatments only. The frequency of developmental stages was always significantly different in 200 g l -1 elutriates 24 hours after fertilisation.
In bioassays, no direct relationship was observed between sediment concentrations in elutriates and toxic effects, fitting the contamination levels revealed by chemical analysis of elutriates.
When short mixing times were used, the most convenient sediment:water ratio was 1:4 (without further dilution or filtering) which more clearly showed the different degrees of toxicity among sediments.
The elutriate bioassay with lividus embryos is proposed as a rapid and highly sensitive approach for monitoring sediment toxicity in water-column organisms.
Residues of chlorinated hydrocarbons, polycyclic aromatic hydrocarbons and polychlorinated biphenyls in some marine organisms in Lake Temsah, Suez Canal, Egypt
Authors: Ahmed Mohamed Tawfic , Loutfy Naglaa , Youssof Y. , El Shiekh E. , Eissa I. A 
Published: October 2003

Abstract
Lake Temsah is the end point where some municipal, agricultural and industrial wastewaters are discharged. The lake is connected to the Suez Canal where large volumes of petroleum oil are passed from producing countries in the Arab Gulf to Europe and North America. The lake is the main source of fish for the area of Ismailia and a recreational site where the tourism industry thrives. Recently, numerous complaints have been made about the level of pollution in the lake which affects to a significant extent fishing and tourism industries. In the present study, residues of some chlorinated hydrocarbon pesticides, polycyclic aromatic hydrocarbons and polychlorinated biphenyls were monitored in some of the lake's organisms. Mullet (Mugil cephalus, usually living in the water column), crab (Lupa pelagcus, an intertidal organism) and a bivalve (Ruditapes decussata, a benthic sedentary organism) were selected as representatives of various strata of the lake ecosystem. Residues of an endosulfan, DDE, Dieldrin, heptachlor epoxide and Dicofol were detected. Aroclor residues were not seen. Endosulfan had the highest detected concentration of all organochlorines: concentrations were 24.1, 52.3, 124.8, and 65.6 µg kg−1 in fish skin, fish gills, fish muscles and bivalves respectively. DDE was the most frequent detected organochlorine, detected in all samples, while Dieldrin was only detected in bivalves and crab. The concentration of polycyclic aromatic hydrocarbons was lowest in fish skin, 2.7 µg kg−1, and highest in bivalves, 48.9 µg kg−1. Fluorine and anthracene were the most frequently detected polycyclic aromatic hydrocarbons compounds, while acenaphthene was the least detected. The highest concentrations of organochlorines and polycyclic aromatic hydrocarbons, 108 and 48.9 µg kg−1, respectively, were detected in bivalves. Bivalves also had the widest spectrum of detected organochlorines and polycyclic aromatic hydrocarbons. All tested organisms showed a higher ability to accumulate organochlorines in comparison to polycyclic aromatic hydrocarbons. Results also showed some indications that factors other than fat content may have some influence on the accumulation of persistent contaminants in biological tissues.