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Double-edged Sword (double-edged + sword)
Selected AbstractsChronic lung disease: oxygen dogma revisitedACTA PAEDIATRICA, Issue 2 2001O D Saugstad Since the discovery of retrolental fibroplasia, and the role of oxygen in its development, oxygen has been considered a double-edged sword in neonatal medicine, the utmost care being exercised in order not to give too much oxygen (1). However, the important observation that hypoxaemia might induce pulmonary vasoconstriction (2) and airway constriction (3) in infants at risk for bronchopulmonary dysplasia has resulted in only a minor upward adjustment of oxygen supplementation in many neonatal units. Since oxygen toxicity has long been linked not only to retinopathy of prematurity but also to bronchopulmonary dysplasia (4), it is relevant to ask whether an increased FiO2 might have any detrimental effects on babies. [source] Brazil's Bolsa Família: A Double-Edged Sword?DEVELOPMENT AND CHANGE, Issue 5 2008Anthony Hall ABSTRACT In common with most Latin American countries, as governments embrace safety nets to attack poverty, conditional cash transfer (CCT) programmes have become part of mainstream social policy in Brazil. Under president Fernando Henrique Cardoso (1995,2002), and especially since Luiz Inácio Lula da Silva took office in 2003, targeted assistance in education, health and nutrition, now united under Bolsa Família, have expanded rapidly to benefit forty-four million (24 per cent of the total population), absorbing almost two-fifths of the social assistance budget earmarked for the poorest sectors. Despite its operational problems, Bolsa Família appears to have been effective in providing short-term relief to some of the most deprived groups in Brazil. Yet it could prove to be a double-edged sword. There is a risk that, due to its popularity among both the poor and Brazil's politicians, Bolsa Família could greatly increase patronage in the distribution of economic and social benefits and induce a strong dependence on government handouts. There are also early signs that it may be contributing to a reduction in social spending in key sectors such as education, housing and basic sanitation, possibly undermining the country's future social and economic development. [source] Multiple pathology and tails of disability: Space,time structure of disability in longevityGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2003Satoru Matsushita Disability and the resulting lowered quality of life are serious issues accompanying increased longevity. Curiously, despite its potential contribution to aging theory, complete statistical and etiological structures of this common and unwelcome aging phenotype before death have not been well identified. Another neglected issue in aging and disability is the principles of phylogenesis and morphogenesis, which contemporary life science invariably starts with. In the present review these two related subjects are addressed, with an introduction of an analysis on patients and published data. Statistically rigorous log,normal and normal distributions distinguish disability for its duration and age-wise distribution, respectively. Multiple pathology and diverse effects of various endogenous diseases on disability are confirmed. The robust long-tailed log,normal distribution for various phases of disability validates the fact that patients in disability undergo series of stochastic subprocesses of many independent endogenous diseases until death. For 60% of patients, the log,normal distribution is mimicked by a random walk model. Diseases of core organs are major causes of the long tails. A declining force of natural selection after reproduction and trade-off of life history through pleiotropy of the genes are considered to be the roots of aging. The attenuated selection pressure and the resulting decrease of genetic constraints produce an increased opportunity for chance and stochastics. Elucidated stochastic behaviors of disability underscore the key role of chance in aging. Evolutionary modifications in the development of the structure tend to favor developmentally later stages first. Distal parts are developmentally last, therefore most subject to modification. The rate of molecular evolution of the genes is also found to be relatively slow at the core and rapid at the edge of cells and organs. Therefore, systems at the core must be relatively slow and inactive to comply with pleiotropy and trade-offs in comparison with systems at the edge. Hence, against flat and probabilistic aging, the core organs must be moulded to be more robust with a lower threshold for dysfunction, to age relatively slowly, and should have less of a disease quota in aging. The principle of core protective aging assures possibilities not only to reduce disability but also to accomplish the Third Age as well. Finally, it must also be acknowledged that the principle is a double-edged sword. Paradoxically, the developed biological and societal organization provides protection for the injured core, and so develops long tails of disability. The principle of core protective aging re-emphasizes the key role of prevention in order to reduce the amount of disability. [source] Distant warriors, distant peace workers?GLOBAL NETWORKS, Issue 4 2008Multiple diaspora roles in Sri Lanka's violent conflict Abstract This article provides a critical, empirically based analysis of the multiple ways in which diaspora communities participate in transnational politics related to their war-affected former home countries. The case of Sri Lanka , and the Tamil and Sinhalese diasporas in the West , is used to illustrate how contemporary armed conflicts are increasingly waged in an international arena. Active diaspora groups have enabled an extension of nationalist mobilization, hostilities and polarization across the globe. Diaspora actors take part in propaganda work and fundraising in support of the belligerent parties in Sri Lanka, while the polarization between Sinhalese and Tamils is to a large extent replicated in the diaspora. However, there are also examples of diaspora groups that challenge war and militarism, for instance by calling for non-violent conflict resolution, condemning atrocities by both sides, and engaging in cross-ethnic dialogue. The article also argues that diaspora engagement in reconstruction of war-torn areas can be a double-edged sword, as it can reproduce , or reduce , grievances and inequalities that fuel the conflict. By discussing the many ways in which diasporas engage in homeland politics, the article challenges simplified understandings of diasporas as either,warriors'or,peace workers' in relation to their homeland conflicts. [source] Machine Politics and Democracy: The Deinstitutionalization of the Argentine Party System1GOVERNMENT AND OPPOSITION, Issue 4 2008Gerardo Scherlis This article contends that intra-party dynamics based on particularistic exchanges constitute a double-edged sword for a political system. On the one hand, they provide party leaders with strategic flexibility, which can be essential for their party stability and for the governability of the political system. On the other hand, in permitting office holders to switch policies whenever they consider fit, these dynamics render governments unpredictable and unaccountable in partisan terms, thus debasing the quality of democratic representation. The hypothesis is illustrated by recent Argentine political development. [source] Structure and biology of complement protein C3, a connecting link between innate and acquired immunityIMMUNOLOGICAL REVIEWS, Issue 1 2001Arvind Sahu Summary: Complement protein C3 is a central molecule in the complement system whose activation is essential for all the important functions performed by this system. After four decades of research it is now well established that C3 functions like a double-edged sword: on the one hand it promotes phagocytosis, supports local inflammatory responses against pathogens, and instructs the adaptive immune response to select the appropriate antigens for a humoral response; on the other hand its unregulated activation leads to host cell damage. In addition, its interactions with the proteins of foreign pathogens may provide a mechanism by which these microorganisms evade complement attack. Therefore, a clear knowledge of the molecule and its interactions at the molecular level not only may allow the rational design of molecular adjuvants but may also lead to the development of complement inhibitors and new therapeutic agents against infectious diseases. A.S. is a Wellcome Trust Overseas Senior Research Fellow in Biomedical Science in India. This research was supported by National Institutes of Health grants AI 30040, GM 56698, HL28220, and AI 48487. [source] Life and death within germinal centres: a double-edged swordIMMUNOLOGY, Issue 2 2002Liliana Guzman-Rojas Summary Within germinal centres, B lymphocytes are destined to die by apoptosis via Fas signalling, unless they are positively rescued by antigen and by signals initiated by CD40,CD154 interactions. Thus, while the germinal centre microenvironment can become a virtual graveyard for most B lymphocytes that fail to bind antigen with high affinity, it concomitantly provides the necessary stimuli for the survival of cells that successfully accomplish affinity maturation. Such dichotomy in the physiology of germinal centre reaction that results in survival of the functional B-cell repertoire and the elimination of abnormal cells, dictates the fate towards B-cell homeostasis or disease. Consequently, the death and survival-signalling arms within germinal centres predominantly reside on the timely and controlled expression of Fas and its ligand (FasL), and CD40 and CD154, respectively. In keeping with this notion, lymphoproliferation or deficient immunity are documented landmarks of inactivation of either the Fas/FasL or CD40/CD154 signalling pathways. The present review considers two different scenarios in the control of B-cell survival and death within germinal centres. The first is an idealistic scenario, in which a discriminatory and co-ordinate signalling initiated by the CD40/CD154 and Fas/FasL pairs, respectively, leads the rescue of the functional B-cell repertoire and the elimination of the abnormal phenotype. The second is a gloomy scenario in which both the lack and the hyperexpression of either receptor/ligand pairs, are seen as equally deleterious. [source] The family vacation: a double-edged swordINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 4 2003Nancy Chesworth No abstract is available for this article. [source] "Peace Is the Concern of Every Mother": Communist and Social Democratic Women's Antiwar Activism in British Columbia, 1948,1960PEACE & CHANGE, Issue 4 2010Brian T. Thorn This article discusses the antiwar activism of Canadian women within two left-wing political movements: the revolutionary Communist Party of Canada and the social democratic Co-Operative Commonwealth Federation. The piece focuses on the period from 1948 to 1960, which is often seen as a time of retreat for the feminist movement in North America. This article engages in a critical dialogue with the concept of "maternalism," the notion that women had a special responsibility to speak out against wars and international conflicts that threatened the lives of the world's children and the husbands, brothers, and sons who would be killed in future wars. Maternalist ideology represented a double-edged sword for these left-wing women and for feminism. On one hand, it offered them a route into radical protest against war and capitalism. On the other hand, in its portrayal of women as "natural" wives and mothers, maternalism, at least in the short term, failed to advance women's equality. Nonetheless, this article concludes that, given the conservative context of the time, maternalism was a useful strategy for the left as well as for feminism. [source] Salvage Surgery for Patients With Recurrent Squamous Cell Carcinoma of the Upper Aerodigestive Tract: When Do the Ends Justify the Means?,THE LARYNGOSCOPE, Issue S93 2000W. Jarrard Goodwin Jr. MD Abstract Objectives/Hypotheses: Salvage surgery is widely viewed as a "double-edged sword." It is the best option for many patients with recurrent cancer of the upper aerodigestive tract, especially when original therapy included irradiation, yet it may provide only modest benefit at high personal cost to the patient. The stakes are high because alternatives are of limited value. The primary objective of this study was to fully assess the value of salvage surgical procedures in the treatment of local and regional recurrence. The following hypotheses were developed to focus the study design and data analysis. 1) The efficacy of salvage surgery correlates recurrent stage, recurrent site, and time to presalvage recurrence. 2) The economic and noneconomic costs of salvage surgery increase with higher recurrent stage. 3) Information relating the value of salvage surgery to recurrent stage and recurrent site will be useful to these patients and the physicians who treat them. Study Design: Two complimentary methods of investigation were used: a meta-analysis of the published literature and a prospective observational study of patients undergoing salvage surgery for recurrent cancer of the upper aerodigestive tract. Methods: The meta-analysis combined 32 published reports to obtain an estimate of average treatment effect for salvage surgery with regard to survival, disease-free survival, surgical complications, and operative mortality. The prospective observational study included detailed data in 109 patients who underwent salvage surgery. In addition to parameters studied in the meta-analysis, we obtained baseline and interval quality of life data (Functional Living Index for Cancer [FLIC] scores), baseline and interval performance status evaluations (Performance Status Scale for Head and Neck Cancer Patients [PSS head and neck scores]), length of hospital stay, and hospital and physician charges, and related this data primarily to recurrent stage, recurrent site, and time to presalvage recurrence. Results: The weighted average of 5-year survival in the meta-analysis was 39% in 1,080 patients from 28 different institutions. In the prospective study, median disease-free survival was 17.9 months in 109 patients, and this correlated strongly with recurrent stage, weakly with recurrent site, and not at all with time to presalvage recurrence. Noneconomic costs for patients and economic costs correlated with recurrent stage, but not with site. Baseline FLIC and PSS head and neck scores correlated with recurrent stage, but not with site. After salvage surgery the percentage of patients reaching or exceeding baseline was 51% for FLIC scores, and this differed significantly with recurrent stage. Postoperative interval "success" in PSS head and neck subscale scores for diet and eating in public also correlated with recurrent stage. Conclusions: Overall, the expected efficacy for salvage surgery in patients with recurrent head and neck cancer was surprisingly good, but success was limited and costs were great in stage III and, especially, in stage IV recurrences. A strong correlation of efficacy and noneconomic costs with recurrent stage allowed the creation of expectation profiles that may be useful to patients. Additional systematic clinical research is needed to improve results. In the end, the decision to undergo salvage surgery should be a personal choice made by the patient after honest and compassionate discussion with his or her surgeon. [source] Corporate Governance in China,Is Economic Growth Potential Hindered by Guanxi?BUSINESS AND SOCIETY REVIEW, Issue 4 2005UDO C. BRAENDLE Despite the opening of the market and partial privatization of state-owned companies in China, the state still represents the controlling shareholder in larger companies. By analyzing the weaknesses of Chinese corporate governance we illustrate the framework for harmful corruption. China is characterized by a weak legal system and strong influences of traditions such as guanxi. In this article we analyze the influence of guanxi on the Chinese corporate governance system. We find that guanxi is in general a double-edged sword, but business-to-government guanxi in particular can harm the weak Chinese corporate governance system and hamper its further economic development and growth. [source] La dialectique de la surveillance et le nouveau régime d'assurancemédicaments au QuébecCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 2 2003Christian Boudreau Sommaire: Les travaux sur la surveillance ont surtout mis en évidence le pouvoir administratif croissant des organisations modernes, principalement 1'État et I'entreprise privée. La présente étude prend le contre-pied de ces travaux. Elle montre que certains systèmes de surveillance, en particulier les banques de données de la Régie de I'assurance-maladie du Québec, peuvent contribuer à la transparence et a I'imputabilité des décisions gouvemementales lors de l'élaboration et de la mise en euvre des politiques publiques. C'est le cas du nouveau régime d'assurance-médicaments au Québec qui, par sa transparence, a permis à des agents de la société civile d'exercer à leur tour une surveillance sur 1'État. Comme I'indique notre étude, l'éitat peut être à la fois un puissant agent de surveillance et un agent étroitement surveillé et publiquement imputable. L'étude montre aussi que la surveillance peut être une arme à double tranchant non seulement pour les dirigeants de I'État, mais aussi pour les agents sociaux qui leur résistent, d'oú l'importance d'être vigilant dans le déploiement de la surveillance. Abstract: Work undertaken on monitoring activities has, for the most part, highlighted the increasing administrative authority of modern organizations, mainly that of the government and of private corporations. This study takes the opposing view of such work. It shows that monitoring systems, more specifically the Régie de l'assurance-maladie du Québec databases, can contribute to the transparency and accountability of government decisions in developing and implementing public policies. Such is the case with the new Prescription Drug Insurance Plan in Quebec, the transparency of which afforded civil-society officials the opportunity to monitor the government. As the study shows, the government can be both a powerful monitoring agent and a closely monitored and publicly accountable one. The study also shows that monitoring can be a double-edged sword, not only for government officials but also for social-agency officials who stand up to them, hence the importance of exercising great care when performing monitoring activities. [source] Role of iron in carcinogenesis: Cancer as a ferrotoxic diseaseCANCER SCIENCE, Issue 1 2009Shinya Toyokuni Iron is abundant universally. During the evolutionary processes, humans have selected iron as a carrier of oxygen inside the body. However, iron works as a double-edged sword, and its excess is a risk for cancer, presumably via generation of reactive oxygen species. Thus far, pathological conditions such as hemochromatosis, chronic viral hepatitis B and C, exposure to asbestos fibers, as well as endometriosis have been recognized as iron overload-associated risks for human cancer. Indeed, iron is carcinogenic in animal experiments. These reports unexpectedly revealed that there are target genes in iron-induced carcinogenesis and that iron-catalyzed oxidative DNA damage is not random in vivo. Several iron transporters and hepcidin, a peptide hormone regulating iron metabolism, were discovered in the past decade. Furthermore, a recent epidemiological study reported that iron reduction by phlebotomy decreased cancer risk in the apparently normal population. These results warrant reconsideration of the role of iron in carcinogenesis and suggest that fine control of body iron stores would be a wise strategy for cancer prevention. (Cancer Sci 2009; 100: 9,16) [source] | ||||||||||||||||