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Terms modified by Doubtful Selected AbstractsGranulite facies thermal aureoles and metastable amphibolite facies assemblages adjacent to the Western Fiordland Orthogneiss in southwest Fiordland, New ZealandJOURNAL OF METAMORPHIC GEOLOGY, Issue 5 2009A. H. ALLIBONE Abstract In southwest New Zealand, a suite of felsic diorite intrusions known as the Western Fiordland Orthogneiss (WFO) were emplaced into the mid to deep crust and partially recrystallized to high- P (12 kbar) granulite facies assemblages. This study focuses on the southern most pluton within the WFO suite (Malaspina Pluton) between Doubtful and Dusky sounds. New mapping shows intrusive contacts between the Malaspina Pluton and adjacent Palaeozoic metasedimentary country rocks with a thermal aureole ,200,1000 m wide adjacent to the Malaspina Pluton in the surrounding rocks. Thermobarometry on assemblages in the aureole indicates that the Malaspina Pluton intruded the adjacent amphibolite facies rocks while they were at depths of 10,14 kbar. Similar P,T conditions are recorded in high- P granulite facies assemblages developed locally throughout the Malaspina Pluton. Palaeozoic rocks more than ,200,1000 m from the Malaspina Pluton retain medium -P mid-amphibolite facies assemblages, despite having been subjected to pressures of 10,14 kbar for > 5 Myr. These observations contradict previous interpretations of the WFO Malaspina Pluton as the lower plate of a metamorphic core complex, everywhere separated from the metasedimentary rocks by a regional-scale extensional shear zone (Doubtful Sound Shear Zone). Slow reaction kinetics, lack of available H2O, lack of widespread penetrative deformation, and cooling of the Malaspina Pluton thermal anomaly within c. 3,4 Myr likely prevented recrystallization of mid amphibolite facies assemblages outside the thermal aureole. If not for the evidence within the thermal aureole, there would be little to suggest that gneissic rocks which underlie several 100 km2 of southwest New Zealand had experienced metamorphic pressures of 10,14 kbar. Similar high- P metamorphic events may therefore be more common than presently recognized. [source] Patch testing with components of water-based metalworking fluids: results of a multicentre study with a second seriesCONTACT DERMATITIS, Issue 6 2006Johannes Geier Background:, Although many allergens in metalworking fluids (MWF) are identified, there are still some MWF components, which are not sufficiently investigated concerning their sensitizing properties. Objectives:, To investigate sensitization to 10 frequently used MWF components, which are not part of the established MWF test series, in metalworkers with suspected occupational dermatitis due to MWF. Patients/Methods:, Oleyl alcohol, myristyl alcohol, dimethylolurea, 4,4,-methylenebis morpholine, imazalil, 1-amino-2-propanol (monoisopropanolamine; MIPA), 2-amino-2-ethyl-1,3-propanediol (AEPD), 2,5-bis(n-octyldithio)-1,3,4-thiadiazole, zinc alkyl dithiophosphate and dibenzyl disulfide have been patch tested in 144 patients. Results:, 7 patients reacted positively to the formaldehyde releaser 4,4,-methylenebis morpholine, and 6 of these patients also reacted to formaldehyde and/or other formaldehyde releasers. 4 patients reacted positively to myristyl alcohol tested at 10% petrolatum (pet.). Additionally, 20 doubtful or irritant reactions occurred. 1 patient each reacted positively to oleyl alcohol, MIPA, and AEPD. None of the other test substances mentioned above elicited any clear-cut positive reaction. Patch testing with well-known MWF allergens showed proportions of positive reactions, which were comparable to those from other studies, e.g. 11% to monoethanolamine, 8% to colophonium and 3%,5% to various preservatives. Conclusions:, 4,4,-methylenebis morpholine may be an important MWF allergen, although clinical relevance could not be stated definitely in every case. Myristyl alcohol should not be patch tested at 10% pet., but at a lesser concentration, due to irritant properties. [source] Skin-sensitizing and irritant properties of propylene glycolCONTACT DERMATITIS, Issue 5 2005Data analysis of a multicentre surveillance network (IVDK, review of the literature In the several publications reviewed in this article, propylene glycol (PG; 1,2-propylene glycol) is described as a very weak contact sensitizer, if at all. However, particular exposures to PG-containing products might be associated with an elevated risk of sensitization. To identify such exposures, we analysed patch test data of 45 138 patients who have been tested with 20% PG in water between 1992 and 2002. Out of these, 1044 patients (2.3%) tested positively, 1083 showed a doubtful, follicular or erythematous reaction (2.4%) and 271 explicit irritant reactions (0.6%). This profile of patch test reactions is indicative of a slightly irritant preparation, and thus, many of the ,weak positive' reactions must probably be interpreted as false positive. No private or occupational exposures associated with an increased risk of PG sensitization were identified, except for lower leg dermatitis. Therefore, according to our patch test data, PG seems to exhibit very low sensitization potential, and the risk for sensitization to PG on uncompromised skin seems to be very low. [source] Resource Accessibility and Vulnerability in Andhra Pradesh: Caste and Non-Caste InfluencesDEVELOPMENT AND CHANGE, Issue 4 2007Lee Bosher ABSTRACT Coastal Andhra Pradesh in southern India is prone to tropical cyclones. Access to key resources can reduce the vulnerability of the local population to both large-scale disasters, such as cyclones, and to the sort of small-scale crises that affect their everyday lives. This article uses primary fieldwork to present a resource accessibility vulnerability index for over 300 respondents. The index indicates that caste is the key factor in determining who has assets, who can access public facilities, who has political connections and who has supportive social networks. The ,lower' castes (which tend to be the poorest) are marginalized to the extent that they lack access to assets, public facilities and opportunities to improve their plight. However, the research also indicates that the poor and powerless lower castes are able to utilize informal social networks to bolster their resilience, typically by women's participation with CBOs and NGOs. Nevertheless it is doubtful whether this extra social capital counterbalances the overall results which show that , despite decades of counteractions by government , caste remains a dominant variable affecting the vulnerability of the people of coastal Andhra Pradesh to the hazards that they face. [source] Why insulin sensitizers but not secretagogues should be retained when initiating insulin in type 2 diabetesDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 1 2008Philip Raskin Abstract The stringent targets set for HbA1c levels in type 2 diabetes are currently achieved by fewer than half the patients in the United States. Failure to manage hyperglycaemia in the early stages of disease results in progressive loss of ,-cell function, which ultimately necessitates the initiation of insulin therapy. At this point, choices have to be made on whether to continue oral anti-diabetic drug therapy and, if so, with which agent(s). Historically, sulfonylureas have been the mainstay of oral anti-diabetic drug therapy; however, their long-term efficacy in patients with depleted ,-cell capacity is doubtful, and other classes of oral anti-diabetic drugs, notably the insulin sensitizers, may prove more reliable. These agents (metformin and thiazolidinediones) appear to provide various benefits over and above sustained glycaemic control, which may variably include reduced loss of ,-cell function as well as improvements to cardiovascular risk factors, morbidity, and mortality. Metformin also limits weight gain associated with insulin therapy. This manuscript presents the case that when insulin therapy is initiated it should be tailored to individual needs through combination with one or more insulin sensitizers rather than a secretagogue. Copyright © 2007 John Wiley & Sons, Ltd. [source] Preventing Type 2 diabetes and the dysmetabolic syndrome in the real world: a realistic viewDIABETIC MEDICINE, Issue 9 2003P. Zimmet The last two decades have seen an explosive increase in the number of people with diabetes globally. There is now an urgent need for strategies to prevent the emerging global epidemic. Several recent successful intervention studies, both lifestyle and pharmacological, targeting subjects with impaired glucose tolerance (IGT) have stimulated enthusiasm for prevention of Type 2 diabetes. Lifestyle interventions reduced the incidence of diabetes by over 50% in the Finnish Diabetes Prevention Study and the Diabetes Prevention Program. Can the findings of these two studies be applied globally? Underpinning the enthusiasm, there needs to be a realistic approach to interventions in both developed and developing nations, and in ethnic groups where a better understanding of the socio-economic, cultural and demographic issues and perceptions surrounding chronic diseases such as diabetes is required. Whether the strategies used in these two studies can be translated into a ,real world' scenario is doubtful. In practice, it is more than likely that a number of strategies will be needed to compliment the lifestyle approach. These will include pharmacological approaches with metformin, acarbose and other agents used to treat diabetes and its complications, currently under investigation. Longer-term follow-up studies will also clarify whether both lifestyle and pharmacological interventions actually prevent Type 2 diabetes, or merely delay its onset. [source] Unilateral Intracarotid Amobarbital Procedure for Language LateralizationEPILEPSIA, Issue 11 2005Jörg Wellmer Summary:,Purpose: The determination of language dominance as part of the presurgical workup of patients with pharmacoresistant epilepsies has experienced fundamental changes. With the introduction of noninvasive functional magnetic resonance imaging (fMRI), the number of patients receiving intracarotid amobarbital procedures (IAPs) for assessment of language dominance has decreased considerably. However, recent studies show that because of methodologic limitations of fMRI, IAP remains an important tool for language lateralization. The current study examines whether unilateral instead of bilateral IAP is an adequate way to apply IAP with reduced invasiveness. Methods: We retrospectively examine the predictive value of unilateral IAP for the results of bilateral IAP based on a sample of 75 patients with various types of language dominance. Target parameters are the prediction of the language-dominant hemisphere and the identification of patients with atypical language dominance. For language assessment based on unilateral IAP, we introduce the measure hemispheric language capacity (HLC). Results: Unilateral IAP performed on the side of intended surgery quantifies language capacity contralateral to the intended surgery. It detects atypical (bilateral or right) language dominance in the majority of patients. Experience with a separate series of 107 patients requiring presurgical language lateralization shows that in >80%, bilateral IAPs are redundant. Conclusions: Unilateral IAP is principally sufficient for language lateralization in the presurgical evaluation of patients with pharmacoresistant epilepsies. Necessity of bilateral IAP is restricted to few indications (e.g., callosotomy). In times of noninvasive language lateralization, we propose unilateral IAP as the method of choice for the verification of doubtful (bilateral) fMRI activation patterns. [source] Effect of degree of fluid saturation on transport coefficients in disturbed soilsEUROPEAN JOURNAL OF SOIL SCIENCE, Issue 1 2004A. Tuli Summary To improve the predictive capability of transport models in soils we need experimental data that improve their understanding of properties at the scale of pores, including the effect of degree of fluid saturation. All transport occurs in the same soil pore space, so that one may intuitively expect a link between the different transport coefficients and key geometrical characteristics of the pores such as tortuosity and connectivity, and pore-size distribution. To understand the combined effects of pore geometry and pore-size distribution better, we measured the effect of degree of water saturation on hydraulic conductivity and bulk soil electrical conductivity, and of degree of air saturation on air conductivity and gaseous diffusion for a fine sand and a sandy loam soil. To all measured data were fitted a general transport model that includes both pore geometry and pore-size distribution parameters. The results show that both pore geometry and pore-size distribution determine the functional relations between degree of saturation, hydraulic conductivity and air conductivity. The control of pore size on convective transport is more for soils with a wider pore-size distribution. However, the relative contribution of pore-size distribution is much larger for the unsaturated hydraulic conductivity than for gaseous phase transport. For the other transport coefficients, their saturation dependency could be described solely by the pore-geometry term. The contribution of the latter to transport was much larger for transport in the air phase than in the water phase, supporting the view that connectivity dominates gaseous transport. Although the relation between effective fluid saturation and all four relative transport coefficients for the sand could be described by a single functional relation, the presence of a universal relationship between fluid saturation and transport for all soils is doubtful. [source] ,Over the Pond and Across the Water': Developing the Field of ,Gendered Organizations'GENDER, WORK & ORGANISATION, Issue 3 2002Patricia Yancey Martin This article is concerned with the development of gendered organizations as a field of study. It begins by exploring some of the factors that militate against integrating organization studies and gender studies and gendered organizations scholarship over national/continental divides. Increasingly doubtful about whether traditional (mainstream and critical) organization theories will or can adequately address gender, we contend that scholars of gendered organizations should ,strike out' on our/their own, ,boldly going' into unfamiliar territory to create new, innovative theories, concepts and ideas. We make various suggestions about possible future directions for theorizing and research. [source] Christa Wolf's Kassandra and Medea: Continuity and ChangeGERMAN LIFE AND LETTERS, Issue 1 2004Helen Bridge When Christa Wolf's Medea: Stimmen appeared in 1996, some critics accused the work of being little more than a pale repetition of the earlier Kassandra project. This paper argues that, while broad continuities in Wolf's concerns are obvious, the shift from monologue in Kassandra to a polyphony of voices in Medea is symptomatic of subtle, yet important shifts in her approach to myth and her understanding of history. Although Wolf's archaeological understanding of myth and the problems this raises remain unchanged, the focus has shifted from the effects myth has on the individual to the human needs which give rise to it. The more psychological exploration of myth in Medea reveals interesting shifts in Wolf's understanding of the individual's role in history. In Kassandra, just as we assume that individuals exercise sovereign control over the myths they circulate, so we have the impression that history results from human agency in accordance with the will of those in power. In Medea, Wolf seems more doubtful about the ability of individuals to control events, even those they have caused. The idea of a coherent historical development, albeit a negative one, which is central to the Kassandra project, is absent from the later work. [source] Does Administrative Corporatism Promote Trust and Deliberation?GOVERNANCE, Issue 4 2002Perola Öberg How corporatist arrangements actually work has not been empirically demonstrated, despite the theoretical focus on interest intermediation. This article investigates whether corporatism affects trust and deliberation in state activities, using Swedish public administration as a case study. First, it is doubtful that corporatism directly promotes trust among citizens, but it very likely promotes trust within and between the represented organizations. Second, interest,group representation cannot be understood as a process of strict delivering of positions adopted in advance. Preferences are often transformed in discussions where other interests are involved. Furthermore, the case investigated here shows that the decision,making process within a corporatist arrangement resembles deliberation, rather than negotiations between "contesting interests." [source] Hematological malignancies in the island of Sardinia, 1974,1993: age and sex distributions and temporal changes in incidenceHEMATOLOGICAL ONCOLOGY, Issue 3 2004G. Broccia Abstract We have collected, by an active retrospective survey, all the cases of hematologic malignancies (HM) newly diagnosed during the time period 1974,1993 in the resident population of Sardinia. Diagnosis was deemed valid, after consultation of clinical records, in more than 90% of the 7264 collected cases. The number of newly diagnosed cases by year more than doubled during the 20-year period investigated. This striking increase can be only partially accounted for by ageing of population. Indeed, age-specific and age-adjusted rates of most of HM increased during this period, although Hodgkin Disease (HD), Chronic Myeloid Leukemia (CML) and Acute Lymphoblastic Leukemia (ALL) were notable exceptions. The observed increase in rates is likely, in a large part, to be fictitious, due to easier access to a health care system, which in the meantime, improved its diagnostic efficiency. This was particularly evident for Chronic Lymphocytic Leukemia (CLL), Multiple Myeloma (MM) and some others myelo- and lympho-proliferative disorders, but its relevance declined after 1984,1989. A likely true increase in occurrence was evidenced for Non-Hodgkin Lymphomas (NHL) and similarly, although to a lesser extent and more doubtful, for Myelodysplasias (MDS) and Acute Myeloid Leukemia (AML). At the end of the studied period each type of HM presented age and sex distributions and age-adjusted rates that show only minor differences from those reported for other western countries. No argument emerged to suggest that any genetic peculiarities of the Sardinian population might have affected the occurrence of HM. The confounding effects of improved diagnostic efficiency have prevented a reliable assessment of influence on incidences of environmental and socio-economic changes that, in relatively recent times, have occurred in Sardinia. Copyright © 2005 John Wiley & Sons, Ltd. [source] Present and future therapeutic strategies for idiopathic oligozoospermiaINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 6 2000Dimitrios A. Adamopoulos The effectiveness of medical treatment for idiopathic oligozoospermia (IO) has been at best doubtful until now and a logical consequence of this unsatisfactory situation has been the partial displacement of this approach by assisted reproduction techniques. This state of affairs has resulted from insufficient investigation, inappropriately designed clinical trials and consistent disregard for the principles of evidence-based medicine. Protocol-related shortcomings and wrong interpretation of the data available have also been some of the all too frequent problems encountered in this therapeutic approach. In this rather misty situation, it appears that, of the therapeutic agents used so far, follicle stimulating hormone (FSH) (mainly FSH-secretagogues) may exert some beneficial effects on a number of biological endpoints related to spermatogenesis and sperm maturation. The short and medium term prospects of medical treatment for IO rest mainly with improvement of investigative procedures to a higher degree of sophistication, with emphasis placed on identifying the causes rather than the results of dysfunction so that a better selection of candidates can be made. Moreover, the introduction of prognostic indices for evaluation of the beneficial effects of a therapeutic agent may be of paramount importance. Finally, a better assessment of the preparations available and, possibly, the introduction of new more specific agents may also be an important step forward in this field. This type of large-scale effort should not be left to individual investigators or special centres working independently, but it may come under the auspices of a central regulating agency so that undisputed results from large, multicentre and uniform studies might be obtained, if medical treatment is to remain a good option. In this context, it may also be emphasized that andrology's main task should always be to treat the male with the problem rather than his healthy female partner, whenever this is possible. [source] Correcting misconceptions about the development of social work in China: a response to Hutchings and TaylorINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 1 2008Cunfu Jia Hutchings and Taylor, in their article entitled ,Defining the profession? Exploring an international definition of social work in the China context'[International Journal of Social Welfare 16: 381,389], no doubt had good intentions in offering their account of the development of social work in China, as the opening and concluding sections of the article show. Within the text, however, their critique of contemporary social work in China is, in my opinion, unfair in relation to, among other things, (i) the undemocratic nature of the Chinese political system, which they say hinders the development of social work in China; (ii) the ideology of the Communist Party, the government, and traditional Chinese culture, which they say are at odds with Western social work's value system and methodology; thus concluding that (iii) it is doubtful whether social work development in China could integrate with that of the international community. In this response, I comment on (i) the information base of the authors; (ii) the disconnection between their conceptualisation and historical facts; and (iii) their use of the international definition of social work. [source] Democratic demand for a social Europe?INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 2 2005Preferences of the European citizenry Within the literature on European integration there is a widespread assumption that Europe is in need of intensified and more effective supranational social policy cooperation. However, on the political level it is doubtful whether such measures are welcomed by the national electorates. This article addresses this issue empirically by asking whether there is public demand for promoting greater European welfare policy cooperation and what are the determinants of such a demand. The data source used is the Eurobarometer survey 2000. A number of hypotheses dealing with socio-structural differences, the effects of welfare regime types, the subjective evaluation of the integration process and the role of identity will be scrutinised. Overall, the results indicate that at the attitudinal ,grass root' level there is no unequivocal support for a European welfare responsibility and that some fundamental cleavages are present. It is the regional and cultural aspects, especially, which turn out to be having an effect and to be influencing future political conflicts. A common European welfare arrangement, therefore, cannot be regarded as a solution to the problems the European Union is facing; rather it will raise new and severe problems of finding social and political support. [source] How to Cut the Seigniorage Cake into Fair Shares in an Enlarged EMUJCMS: JOURNAL OF COMMON MARKET STUDIES, Issue 5 2007JØRGEN DRUD HANSEN The European Central Bank redistributes each year seigniorage from issuing euro notes to the National Central Banks of the euro countries. The key for this redistribution is, from 2008, based on the respective GDP and population proportions of the euro countries. Applying the distribution formula to the new EU countries from central and eastern Europe seems to give these countries a large net benefit compared with the seigniorage they bring in, i.e. their share of currency in circulation. However, as argued in this article, currency demand in the new EU member countries is expected to increase relative to the present group of euro countries , especially after gaining membership in the EMU because of integration of the financial markets and, in the longer term, catching-up growth. Hence, it is doubtful whether a large unintended redistribution of seigniorage to the benefit of acceding EMU countries will materialize in the future. [source] Hunting for large carnivore conservationJOURNAL OF APPLIED ECOLOGY, Issue 6 2009Adrian Treves Summary 1. Carnivores are difficult to conserve because of direct and indirect competition with people. Public hunts are increasingly proposed to support carnivore conservation. This article reviews scientific evidence for the effectiveness of public hunts of large carnivores in attaining three common policy goals: stable carnivore populations, preventing conflict with carnivores (property damage and competition over game) and building public support for carnivore conservation. 2. Sustainable exploitation of stable wildlife populations has a solid, scientific foundation but the theory and its predictions must be adapted to complex patterns of carnivore behavioural ecology and population dynamics that demand years of landscape-level monitoring to understand fully. 3. A review of the evidence that hunting prevents property damage or reduces competition for game reveals large gaps in our understanding. Reducing the number of large carnivores to protect hunters' quarry species seems straightforward but we still know little about behavioural and ecological responses of the contested prey and sympatric meso-predators. For reducing property damage, the direct effect , numerical reduction in problematic individual carnivores , presents numerous obstacles, whereas the indirect effect , behavioural avoidance of humans by hunted carnivores , holds more promise. 4. Scientific measures of public support for carnivore-hunting policies are almost completely lacking, particularly measures of attitudes among hunters before and after controversial wildlife is designated as legal game species. Moreover, illegal killing of carnivores does not appear to diminish if they are designated as game. 5.Synthesis and applications. Sustainable hunting to maintain stable populations is well understood in theory but complex life histories of carnivores, and behavioural changes of hunters and the carnivores they stalk may result in unsustainable mortality for carnivores. The direct impact of hunting on carnivore damage to property is unclear and even doubtful given the inability or unwillingness of hunters to remove specific individuals selectively. However, hunters may indirectly deter carnivores from people and their property. The assumption that hunters will steward carnivores simply because they have in the past helped conserve other game species requires more study as preliminary results suggest it is incorrect. Policy-makers may achieve support for policy if they mesh utilitarian and preservationist values held by the general public. A number of opposed hypotheses should be disentangled before researchers confidently inform policy on sustainable hunting to prevent conflicts and build public support for carnivore conservation. [source] Public sector institutions, politics and outsourcing: Reforming the provision of primary healthcare in Punjab, PakistanJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 4 2010Iram A. Khan Abstract Lodhran/Rahim Yar Khan (RYK) model of primary healthcare is a home-grown experiment in Pakistan. The model envisaged transferring the management of primary healthcare facilities to a public sector NGO. The paper finds that through the re-alignment of interest groups, the model was replicated in several other districts of the province. It also examines the evolution of stakeholders' behaviour, interest, position and influence in its implementation over a period of time. The study concludes that sustainability of the model remains doubtful unless public sector health bureaucracy is restructured and made to work effectively. Copyright © 2009 John Wiley & Sons, Ltd. [source] Formation of clinopyroxene + spinel and amphibole + spinel symplectites in coronitic gabbros from the Sierra de San Luis (Argentina): a key to post-magmatic evolutionJOURNAL OF METAMORPHIC GEOLOGY, Issue 7 2008G. CRUCIANI Abstract The El Arenal metagabbros preserve coronitic shells of orthopyroxene ± Fe-oxide around olivine, as well as three different types of symplectite consisting of amphibole + spinel, clinopyroxene + spinel and, more rarely, orthopyroxene + spinel. The textural features of the metagabbros can be explained by the breakdown of the olivine + plagioclase pair, producing orthopyroxene coronas and clinopyroxene + spinel symplectites, followed by the formation of amphibole + spinel symplectites, reflecting a decrease in temperature and, possibly, an increase in water activity with respect to the previous stage. The metagabbros underwent a complex P,T history consisting of an igneous stage followed by cooling in granulite, amphibolite and greenschist facies conditions. Although the P,T conditions of emplacement of the igneous protolith are still doubtful, the magmatic assemblage suggests that igneous crystallization occurred at a pressure lower than 6 kbar and at 900,1100 °C. Granulitic P,T conditions have been estimated at about 900 °C and 7,8 kbar combining conventional thermobarometry and pseudosection analysis. Pseudosection calculation has also shown that the formation of the amphibole + spinel symplectite could have been favoured by an increase in water activity during the amphibolite stage, as the temperature of formation of this symplectite strongly depends on aH2O (<740 °C for aH2O = 0.5; <790 °C for aH2O = 1). Furthermore, but not pervasive, re-equilibration under greenschist facies P,T conditions is documented by retrograde epidote and chlorite. The resulting counterclockwise P,T path consists of progressive, nearly isobaric cooling from the igneous stage down to the granulite, amphibolite and greenschist stage. [source] What can we do about acute extrapyramidal symptoms?JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2000R. Gray RN BSC (HONS) Antipsychotic drugs are the most effective treatment for psychotic disorders such as schizophrenia. However, they are known to cause a range of side-effects including acute extrapyramidal symptoms (EPS) that are both distressing and disabling. Mental health nurses play a critical role in both the detection and the management of these symptoms. A review of the literature was conducted to identify strategies for managing acute EPS. Despite a widely held belief that EPS are associated with noncompliance with medication, the data to support this hypothesis are weak. Although akathisia may negatively affect the treatment outcome, there was little evidence to suggest that parkinsonism or dystonia do. Whilst the use of anticholinergic medication may be helpful in treating acute parkinsonism and dystonia they were associated with their own side-effects and the benefit of long-term prophylactic treatment is doubtful. The literature suggests that logical prescribing and rapid detection and management of acute EPS will result in a substantial reduction in the incidence of these disabling side-effects. [source] Neo-Hymesian linguistic ethnography in the United KingdomJOURNAL OF SOCIOLINGUISTICS, Issue 5 2007Ben Rampton This paper describes the development of ,linguistic ethnography' in Britain over the last 5,15 years. British anthropology tends to overlook language, and instead, the U.K. Linguistic Ethnography Forum (LEF) has emerged from socio- and applied linguistics, bringing together a number of formative traditions (inter alia, Interactional Sociolinguistics, New Literacy Studies and Critical Discourse Analysis). The career paths and the institutional positions of LEF participants make their ethnography more a matter of getting analytic distance on what's close-at-hand than a process of getting familiar with the strange. When linked with post-structuralism more generally, this ,from-inside-outwards' trajectory produces analytic sensibilities tuned to discourse analysis as a method, doubtful about ,comprehensive' and ,exotic' ethnography, and well disposed to practical/political intervention. LE sits comfortably in the much broader shift from mono- to inter-disciplinarity in British higher education, though the inter-disciplinary environment makes it hard to take the relationship between linguistics and ethnography for granted. [source] Whistles, bells, and cogs in machines: Thomas Huxley and epiphenomenalismJOURNAL OF THE HISTORY OF THE BEHAVIORAL SCIENCES, Issue 3 2010John Greenwood In this paper I try to shed some historical light upon the doctrine of epiphenomenalism, by focusing on the version of epiphenomenalism championed by Thomas Huxley, which is often treated as a classic statement of the doctrine. I argue that it is doubtful if Huxley held any form of metaphysical epiphenomenalism, and that he held a more limited form of empirical epiphenomenalism with respect to consciousness but not with respect to mentality per se. Contrary to what is conventionally supposed, Huxley's empirical epiphenomenalism with respect to consciousness was not simply based upon the demonstration of the neurophysiological basis of conscious mentality, or derived from the extension of mechanistic and reflexive principles of explanation to encompass all forms of animal and human behavior, but was based upon the demonstration of purposive and coordinated animal and human behavior in the absence of consciousness. Given Huxley's own treatment of mentality, his characterization of animals and humans as "conscious automata" was not well chosen. © 2010 Wiley Periodicals, Inc. [source] Sensitization to petrolatum: an unusual cause of false-positive drug patch-testsALLERGY, Issue 9 2004G. Ulrich We report on an unexpected sensitization to petrolatum diagnosed with the occurrence of multiple nonrelevant and false-positive drug patch-tests performed while investigating a patient suffering from many cutaneous adverse drug reactions. All the positive drug patch-tests were prepared with GILBERT® vaseline. This petrolatum reaction is positive as it was tested with five other brands of petrolatums a few months later. As the same petrolatums, but from different batches were tested, patch-tests with GILBERT® petrolatum were doubtful, while other petrolatums were positive. White petrolatum is a mixture of semisolid hydrocarbons of the methane series. The sensitizing impurities of petrolatum are polycyclic aromatic hydrocarbons, e.g. phenanthrene derivatives. The purity of petrolatum depends on both the petroleum stock and on the production and packaging methods. Even if rare, contact sensitization to petrolatum can disturb the interpretation of drug patch-tests. It is necessary in the interpretation of drug patch-tests to test both in petrolatum and other vehicles and with all the different petrolatums used in preparing the material for drug patch-tests. So, it is essential to advise the patients sensitized to petrolatum to remove all the topical drugs, such as all the cosmetics, which contain petrolatum in their formulation. [source] Pallidopyramidal disease: A misnomer?,MOVEMENT DISORDERS, Issue 9 2010Martin W.I.M. Horstink MD Abstract The combination of recessive early-onset parkinsonism and pyramidal tract signs caused by pallidopyramidal degeneration is known as pallidopyramidal disease or syndrome (PPD/S). We investigated whether patients diagnosed as Davison's PPD/S showed any definite proof of pyramidal and pallidal involvement, without findings suggestive of other nosological entities. Since Davison's original description, 15 other PPD/S cases have been reported, yet all lack proof of pyramidal or pallidal degeneration. Because of the dopa-responsiveness in all patients subsequent to Davison's report, we argue that these patients probably suffered from early-onset nigral parkinsonism or dopa-responsive dsystonia, rather than pallidal parkinsonism; in such cases, the presumed pyramidal Babinski could be a pseudobabinski ("striatal toe"). Secondary pallidopyramidal syndromes do occur, for example, in multiple system atrophy or Wilson's disease, but in these patients additional findings indicate diseases other than Davison's PPD/S. We conclude that the existence of PPD/S as a distinct clinico-pathological nosological entity, as proposed by Davison, is doubtful. In cases reported as Davison's PPD/S, the description "pallidopyramidal" seems to be a misnomer. © 2010 Movement Disorder Society [source] Intraoperative loading attenuates nausea and vomiting of tramadol patient-controlled analgesia. (Show-Chwan Memorial Hospital, Changhua, Taiwan) Can J Anaesth 2000;47:968,973.PAIN PRACTICE, Issue 2 2001Wei-Wu Pang Sixty adult patients scheduled for elective abdominal surgery were enrolled into this prospective, randomized, double-blinded study. The patients were anesthetized in a similar manner. At the beginning of wound closure, the patients were randomly allocated to receive tramadol (Group 1) or normal saline (Group 2). Pain control and adverse effect assessments were done in the PACU and every 6 h for 48 h post drug by an independent observer. The loading dose was 290 ± 45 mg in Group 1 and 315 ± 148 mg in Group 2. In PACU, more nausea and vomiting both in terms of incidence and severity were observed in patients with postoperative loading than in those with intraoperative loading of tramadol. Conclude that administering the loading dose of tramadol during surgery decreases the nausea and vomiting associated with a high dose of tramadol and improves the quality of tramadol PCA in the relief of postoperative pain. Comment by Lian-Kah Ti, M.D. The clinical application and conclusions of this study have to be questioned. It was not surprising that a loading dose of tramadol could effectively be given intraoperatively. What was surprising was that the authors chose not to give any analgesics either preoperatively or intraoperatively for relatively major surgery in an older population, potentially risking morbidity. Indeed, analgesics were withheld in the control group until the patients were extubated, awake, responsive, and complained of pain. Another source of concern was the large loading dose used. Based on their own experience, the authors gave doses of 300 mg of tramadol, which far exceeded the maximum recommended single dose of 100 mg as stated in the manufacturer's instruction for use. The authors did not report any intraoperative hemodynamic consequences from the loading dose, although they noted that the amount of isoflurane required was decreased. The authors concluded that the decreased nausea and vomiting seen in the patients receiving tramadol intraoperatively resulted from the patients being anesthetized at the point when peak plasma levels were achieved. An alternative explanation could be that the patients in the control group had greater postoperative pain (initial VAS of 5.9), and that pain itself resulted in the increased nausea and vomiting. Therefore, the value of this study is doubtful. [source] Klimapolitik: Kyoto-Protokoll und Emissionshandel für CO2 -Zertifikate in der EU1PERSPEKTIVEN DER WIRTSCHAFTSPOLITIK, Issue 3 2005Wolfgang Ströbele Also every economist knows that the institutional conditions and the rules of the game are important. This basic idea stood behind the introduction of a CO2 -emissions trading system within the European Community starting in 2005. Since the starting point is the Kyoto-protocol with its subset of relevant states involved and the rules agreed upon there, one must ask whether the EU CO2-trading system is really an instrument that helps to reach the Kyoto goals more efficiently. A positive answer to this question is very doubtful. The new European subsystem is only valid for CO2 while Kyoto knows six greenhouse gases, the EU trading periods are 2005,2007 and 2008,2012 while Kyoto is only relevant for the second period, the integration with all flexible instruments of Kyoto is not guaranteed from the beginning. The plants involved are power plants and plants with high energy intensity. Since the technological levels of these plants are rather similar in Europe, the difference in marginal abatement cost will not be large enough to offset the rather high transaction cost of the special EU system. Furthermore, the heating systems and small scale plants of industry are not included in the trading system. The same holds true for traffic, households and the service sector. Drawing a borderline between CO2 -policy there and the trading activities will cause inefficiencies. If CO2 -prices are high, the main incentive of the trading system will be a large shift from domestic production to production abroad without any CO2 -restrictions. Leakage-effects will then be dominant. With low CO2 -prices the special European bureaucratic system will not create enough efficiency gains to cover the trading system's cost. [source] Modelling binary mixtures of herbicides in populations resistant to one of the components: evaluation for resistance managementPEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 2 2009Bertrand Jacquemin Abstract BACKGROUND: Herbicide mixtures are commonly proposed to delay the selection of herbicide resistance in susceptible populations (called the SM strategy). However, in practice, herbicide mixtures are often used when resistance to one of the two active ingredients has already been detected in the targeted population (called the RM strategy). It is doubtful whether such a practice can select against resistance, as the corresponding selection pressure is still exerted. As a consequence, the effect of mixtures on the evolution of an already detected resistance to one of the herbicides in the combination remains largely unexplored. In the present work, a simple model was developed to explore further the necessary and sufficient conditions under which a binary RM strategy might stabilise or even reduce resistance frequency. RESULTS: Covering the hypothetical largest range of parameters, 39% of 9000 random simulations attest that the RM strategy might theoretically reduce resistance frequency. When strong enough, high genetic cost of resistance, negative cross-resistance between the herbicides associated in the mixture and reduced selection differential between resistant and susceptible plants can counterbalance the resistance advantage to one of the two applied herbicides. However, the required conditions for an RM strategy to ensure resistance containment in natural conditions seldom overlap with experimental parameter estimates given in the literature. CONCLUSION: It is concluded that the sufficient conditions for an RM strategy to be effective would rarely be encountered. As a consequence, the strategy of formulating mixtures with herbicides for which resistance has already been detected should be avoided. Copyright © 2008 Society of Chemical Industry [source] WORSHIPPING AN UNKNOWN GODRATIO, Issue 4 2006Anthony Kenny This paper examines the religious tradition of ,negative theology', and argues that it is doubtful whether it leaves room for belief in God at all. Three theologians belonging in different degrees to this tradition are discussed, namely John Scotus Eriugena, Anselm of Canterbury and Nicolas of Cusa, and it is argued that all three, in maintaining the ineffability of God, reach positions that are in effect forms of agnosticism. There is a paradox here: if God is inconceivable, is it not self-refuting to talk about him at all, even to state his inconceivability? The final part of the paper examines the work of the nineteenth-century poet Arthur Hugh Clough, two of whose poems, Hymnos Aumnos, and Qui Laborat Orat, explore the paradox of talking about the inconceivable Godhead. Clough gives eloquent expression to the idea that leaving God unnamed is not equivalent to disowning him. There is room for a devout agnosticism. [source] On the correlations between the polyhedron eccentricity parameters and the bond-valence sums for the cations with one lone electron pairACTA CRYSTALLOGRAPHICA SECTION B, Issue 4 2008Vasyl Sidey Applicability of the Wang,Liebau polyhedron eccentricity parameter in the bond-valence model [Wang & Liebau (2007). Acta Cryst. B63, 216,228] has been found to be doubtful: the correlations between the values of the polyhedron eccentricity parameters and the bond-valence sums calculated for the cations with one lone electron pair are probably an artifact of the poorly determined bond-valence parameters. [source] A critical evaluation of the Braak staging scheme for Parkinson's disease,ANNALS OF NEUROLOGY, Issue 5 2008Robert E. Burke MD Braak and colleagues have proposed that, within the central nervous system, Parkinson's disease (PD) begins as a synucleinopathy in nondopaminergic structures of the lower brainstem or in the olfactory bulb. The brainstem synucleinopathy is postulated to progress rostrally to affect the substantia nigra and cause parkinsonism at a later stage of the disease. In the context of a diagnosis of PD, made from current clinical criteria, the pattern of lower brainstem involvement accompanying mesencephalic synucleinopathy is often observed. However, outside of that context, the patterns of synucleinopathy that Braak described are often not observed, particularly in dementia with Lewy bodies and when synucleinopathy occurs in the absence of neurological manifestations. The concept that lower brainstem synucleinopathy represents "early PD" rests on the supposition that it has a substantial likelihood of progressing within the human lifetime to involve the mesencephalon, and thereby cause the substantia nigra pathology and clinical parkinsonism that have heretofore defined the disease. However, the predictive validity of this concept is doubtful, based on numerous observations made in populations of aged individuals who, despite the absence of neurological signs, have brain synucleinopathy ranging up to Braak stages 4 to 6 at postmortem. Furthermore, there is no relation between Braak stage and the clinical severity of PD. We conclude that the relation between patterns of abnormal synuclein immunostaining in the human brain and the disease entity now recognized as PD remains to be determined. Ann Neurol 2008;64:485,491 [source] | |||||||||||||||||||||||||||||||||||||