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Kinds of Fell Terms modified by Fell Selected AbstractsThe birth process initiates an acute phase reaction in the fetus-newborn infantACTA PAEDIATRICA, Issue 9 2000G Marchini Our goal was to investigate whether the normal birth process stimulated an acute phase response in healthy infants with physiological changes in the circulating levels of acute phase cytokines and acute phase proteins. We also monitored body temperature, body weight and behavioural state in order to investigate if clinical signs of acute phase reaction were present. We made cross-sectional measurements of interleukin-1,, interleukin-6, C-reactive protein, serum amyloid A, procalcitonin, prealbumin, body weight, body temperature and the duration of the sleeping period during the first four postnatal days. We found an increase in interleukin-6 (p < 0.001) during the first day, followed by an increase in C-reactive protein, serum amyloid A and procalcitonin on the second postnatal day (p < 0.01). The level of prealbumin fell after birth and reached its lowest value at 3 d of age (p < 0,001). Interleukin-l p remained unchanged. The duration of the sleeping period was longer during the first day (p < 0.01). There was an increase in body temperature during the first day (p < 0.01). Maximal weight loss was during the first 2 d. Conclusions: The normal birth process and extra-uterine adaptation stimulates an acute phase reaction in the newborn infant with a release of interleukin-6 and acute phase proteins and a depression of prealbumin. This reaction, as the body's first line inflammatory defence system, probably affects the infant's behaviour, nutritional state as well as the regulation of body temperature. [source] Cerebral oxygenation decreases but does not impair performance during self-paced, strenuous exerciseACTA PHYSIOLOGICA, Issue 4 2010F. Billaut Abstract Aim:, The reduction in cerebral oxygenation (Cox) is associated with the cessation of exercise during constant work rate and incremental tests to exhaustion. Yet in exercises of this nature, ecological validity is limited due to work rate being either fully or partly dictated by the protocol, and it is unknown whether cerebral deoxygenation also occurs during self-paced exercise. Here, we investigated the cerebral haemodynamics during a 5-km running time trial in trained runners. Methods:, Rating of perceived exertion (RPE) and surface electromyogram (EMG) of lower limb muscles were recorded every 0.5 km. Changes in Cox (prefrontal lobe) were monitored via near-infrared spectroscopy through concentration changes in oxy- and deoxyhaemoglobin (,[O2Hb], ,[HHb]). Changes in total Hb were calculated (,[THb] = ,[O2Hb] + ,[HHb]) and used as an index of change in regional blood volume. Results:, During the trial, RPE increased from 6.6 ± 0.6 to 19.1 ± 0.7 indicating maximal exertion. Cox rose from baseline to 2.5 km (,,[O2Hb], ,,[HHb], ,,[THb]), remained constant between 2.5 and 4.5 km, and fell from 4.5 to 5 km (,,[O2Hb], ,,[HHb], ,,[THb]). Interestingly, the drop in Cox at the end of the trial coincided with a final end spurt in treadmill speed and concomitant increase in skeletal muscle recruitment (as revealed by higher lower limb EMG). Conclusion:, Results confirm the large tolerance for change in Cox during exercise at sea level, yet further indicate that, in conditions of self-selected work rate, cerebral deoxygenation remains within a range that does not hinder strenuous exercise performance. [source] Incorporating Uncertainty into Demographic Modeling: Application to Shark Populations and Their ConservationCONSERVATION BIOLOGY, Issue 4 2002Enric Cortés I used age-structured life tables and Leslie matrices based on a prebreeding survey and a yearly time step applied only to females to model the demography of 41 populations from 38 species of sharks representing four orders and nine families. I used Monte Carlo simulation to reflect uncertainty in the estimates of demographic traits and to calculate population statistics and elasticities for these populations; I used correlation analysis to identify the demographic traits that explained most of the variation in population growth rates ( , ). The populations I examined fell along a continuum of life-history characteristics that can be linked to elasticity patterns. Sharks characterized by early age at maturity, short lifespan, and large litter size had high , values and short generation times, whereas sharks that mature late and have long lifespans and small litters have low , values and long generation times. Sharks at the "fast" end of the spectrum tended to have comparable adult and juvenile survival elasticities, whereas sharks at the "slow" end of the continuum had high juvenile survival elasticity and low age,zero survival ( or fertility ) elasticity. Ratios of adult survival to fertility elasticities and juvenile survival to fertility elasticities suggest that many of the populations studied do not possess the biological attributes necessary to restore , to its original level after moderate levels of exploitation. Elasticity analysis suggests that changes in juvenile survival would have the greatest effect on ,, and correlation analysis indicates that variation in juvenile survival, age at maturity, and reproduction account for most of the variation in ,. In general, combined results from elasticity and correlation analyses suggest that research, conservation, and management efforts should focus on these demographic traits. Resumen: Exploré los efectos de la incertidumbre en los caracteres demográficos en análisis demográficos de tiburones, un método no empleado con anterioridad para este taxón. Utilicé tablas de vida estructuradas por edades y matrices de Leslie basadas en evaluaciones pre-gestación y pasos de tiempo de un año aplicados solo a las hembras para modelar la demografía de 41 poblaciones de 38 especies de tiburones que representan cuatro órdenes y nueve familias. Utilicé la simulación de Monte Carlo para reflejar la incertidumbre en las estimaciones de caracteres demográficos y calcular las estadísticas y elasticidades poblacionales para estas poblaciones y el análisis de correlación para identificar los caracteres demográficos que explican la mayoría de la variación en las tasas de crecimiento poblacional ( , ). Las poblaciones examinadas caen dentro de un continuo de características de historias de vida que pueden estar vinculadas con los patrones de elasticidad. Los tiburones que maduran a temprana edad y tienen corta duración de vida y grupos grandes de crías tuvieron valores altos de , y tiempos generacionales cortos, mientras que los tiburones que maduran tarde y tienen una duración de vida larga y grupos pequeños de crías tienen valores bajos de , y tiempos generacionales largos. Los tiburones que se encuentran en el punto final "rápido" del espectro tendieron a tener elasticidades de supervivencia de adultos y juveniles comparables, mientras que los tiburones en el punto final "lento" del continuo tuvieron una alta elasticidad de supervivencia de juveniles y una baja elasticidad en supervivencia a la edad cero (o fertilidad ). Las proporciones de elasticidades de supervivencia de adultos y fertilidad y de elasticidades de supervivencia de juveniles y fertilidad sugieren que muchas de las poblaciones estudiadas no poseen los atributos biológicos necesarios para restaurar , a su nivel original después de niveles moderados de explotación. El análisis de elasticidad sugiere que en la supervivencia de juveniles se podría tener el efecto mayor de , y el análisis de correlación indica que la variación en la supervivencia de juveniles, la edad de maduración y reproducción explican la mayor parte de la variación en ,. En general, los resultados combinados de los análisis de elasticidad y correlación sugieren que los esfuerzos de investigación, conservación y manejo deberían enfocarse a estas características demográficas. [source] Systemic nitric oxide clamping in normal humans guided by total peripheral resistanceACTA PHYSIOLOGICA, Issue 2 2010J. A. Simonsen Abstract Aim:, We wanted to stabilize the availability of nitric oxide (NO) at levels compatible with normal systemic haemodynamics to provide a model for studies of complex regulations in the absence of changes in NO levels. Methods:, Normal volunteers (23,28 years) were infused i.v. with the nitric oxide synthase (NOS) inhibitor NG -nitro- l -arginine methyl ester (l -NAME) at 0.5 mg kg,1 h,1. One hour later, the NO donor sodium nitroprusside (SNP) was co-infused in doses eliminating the haemodynamic effects of l -NAME. Haemodynamic measurements included blood pressure (MABP) and cardiac output (CO) by impedance cardiography. Results:,l -NAME increased MABP and total peripheral resistance (TPR, 1.02 ± 0.05 to 1.36 ± 0.07 mmHg s mL,1, mean ± SEM, P < 0.001). With SNP, TPR fell to a stable value slightly below control (0.92 ± 0.05 mmHg s mL,1, P < 0.05). CO decreased with l -NAME (5.8 ± 0.3 to 4.7 ± 0.3 L min,1, P < 0.01) and returned to control when SNP was added (6.0 ± 0.3 L min,1). A decrease in plasma noradrenaline (42%, P < 0.01) during l -NAME administration was completely reversed by SNP. Plasma renin activity decreased during l -NAME administration and returned towards normal after addition of SNP. In contrast, plasma aldosterone was increased by l -NAME and remained elevated. Conclusions:, Concomitant NOS inhibition and NO donor administration can be adjusted to maintain TPR at control level for hours. This approach may be useful in protocols in which stabilization of the peripheral supply of NO is required. However, the dissociation between renin and aldosterone secretion needs further investigation. [source] Treatment of Parthenium dermatitis with methotrexateCONTACT DERMATITIS, Issue 2 2007Vinod K. Sharma Patients with parthenium dermatitis are often unresponsive to topical steroids, and immunosuppressive agents may be necessary to reduce their need for systemic corticosteroids. We evaluated the efficacy of methotrexate in parthenium dermatitis. Sixteen patients unresponsive to topical treatment were included after baseline investigations, and treated with oral methotrexate (15 mg/week). Clinical response was monitored using a dermatitis area and severity index (DASI). Seven patients completed ,6 months' follow-up, and their mean DASI fell to 5, 2.7 and 2.1 at the end of 1, 3 and 6 months respectively, from a baseline score of 10. Only 3/7 patients required oral prednisolone in the initial 2,4 weeks. Side effects were minor, being mainly folliculitis and furuncles. Methotrexate may hence be a useful alternative for patients with severe parthenium dermatitis. [source] FS13.3 Development of risk reduction strategies for preventing dermatitisCONTACT DERMATITIS, Issue 3 2004Terry Brown Introduction:, A recent survey of the UK printing industry found a prevalence of 11% of occupational contact dermatitis (OCD), much higher than previously identified. Objective:, This pilot study aimed to evaluate risk reduction strategies derived from recommendations of a literature review of preventive intervention studies and a series of focus groups of printers and observations of printers undertaking their normal duties. Methods:, Four interventions were evaluated: (1) Provision of gloves of the correct size/type, plus use of an after-work skin cream; (2) Provision of information; (3) Provision of skin checks; (4) Development of best practice skin care policy. Each intervention was evaluated in two companies over a three-month period, at the end of which printers and managers were interviewed as to the effectiveness and acceptability of each intervention. Results:, Although this pilot study was short, all interventions were acceptable to some extent. The prevalence of frank dermatitis fell over the study period, particularly in intervention (3). Intervention (1) achieved an improvement of awareness in both management and workforce and an increase in the use of both gloves and cream. Intervention (2) highlighted problems of dissemination and the need for relevant information in an appropriate format. However. no single intervention was completely effective. Conclusions:, This qualitative research approach forms an essential first stage to improving understanding of ways in which OCD may be reduced among workers in the printing industry, and points towards the need for further testing of preventive strategies in larger-scale intervention trials, in printing and other industries. [source] Force,frequency and force,length properties in skeletal muscle following unilateral focal ischaemic insult in a rat modelACTA PHYSIOLOGICA, Issue 3 2009G. N. Dormer Abstract Aim:, Our purpose was to quantify skeletal muscle properties following unilateral focal ischaemic insult (stroke) in a rat model. Methods:, Male rats were divided into two groups: stroke and 2 weeks recovery (n = 8) and control group (n = 7). Stroke was induced in the area of the motor neocortex containing hind limb corticospinal neurones. Contractile properties of the medial gastrocnemius muscle were measured in situ in both limbs. Force,length and force,frequency properties were measured before and 35 min after 5 min fatiguing stimulation. Results:, Stroke resulted in bilateral tetanic fade during 200 Hz stimulation. When normalized to 100 Hz contractions, force at 200 Hz was 95.4 ± 0.9% for the paretic muscles, 96.7 ± 1.7% for non-paretic muscles and 102.2 ± 1.0% for muscles of control rats (P = 0.006). Prior to fatiguing contractions, there was no difference in the length dependence of force. During repetitive contractions, active force fell significantly to 19 ± 4 and 25 ± 5% of initial force in paretic and non-paretic muscles of animals with a stroke respectively. In control animals active force fell to 37 ± 5%. During repetitive contractions, fusion index increased in muscles of stroke animals to 1.0 ± 0 but in control animals it was 0.95 ± 0.02. There was selective force depression at short lengths for fatigued paretic muscle (significant difference at muscle lengths less than reference length ,2 mm). Conclusion:, The tetanic fade at high stimulation frequencies indicates that there may be activation failure following focal ischaemic insult. The greater magnitude of fatigue and selective depression at short lengths following repetitive contractions should be investigated further. [source] INJUSTICE AND IRRATIONALITY IN CONTEMPORARY YOUTH POLICYCRIMINOLOGY AND PUBLIC POLICY, Issue 4 2004DONNA M. BISHOP Lionel Tate was 12 years old when he killed 6-year-old Tiffany Eunick. Tiffany had been staying at the Tate home and, by all accounts, got along well with Lionel. The two were playing at "wrestling" when Lionel decided to try out some moves that he had seen on television. He threw Tiffany across the room, inflicting fatal injuries. Despite the boy's tender age, the prosecutor transferred Lionel to criminal court on a charge of first-degree murder, an offense carrying a mandatory penalty of life without parole. The boy was given an opportunity to plead guilty to second-degree murder in return for a sentence of three years incarceration, but he rejected the offer. A jury subsequently convicted him of first-degree murder. At sentencing, the prosecution recommended leniency, which drew an angry response from the judge: If the state believed the boy did not deserve to be sent to prison for life, why hadn't it charged him with a lesser offense? Without any inquiry into the boy's cognitive, emotional, or moral maturity, the judge imposed the mandatory sentence.1 Raymond Gardner was 16 years old when he shot and killed 20-year-old Mack Robinson.2 Raymond lived in a violent urban neighborhood with his mother, who kept close watch over him. He had no prior record. He was an A student and worked part-time in a clothing store to earn money for college. On the day of the shooting, a friend came into the store to tell Raymond that Mack had a beef with him about talking to a girl, and was "looking to get him." The victim was known on the street as "Mack the Knife" because he always carried a small machete and was believed to have stabbed several people. To protect himself on the way home, Raymond took the gun kept under the counter of the shop where he worked. As he neared home, Mack and two other men approached and blocked his path. According to eyewitness testimony, Raymond began shaking, then pulled out the gun and fired. Mack ran into the street and fell. Raymond followed and fired five more shots into the victim's back as he lay dying on the ground. Raymond did not run. He just stood there crying. The prosecutor filed a motion in juvenile court to transfer Raymond on a charge of first-degree murder. The judge ordered a psychological evaluation, which addressed the boy's family and social background, medical and behavioral history, intelligence, maturity, potential for future violence and prospects for treatment. The judge subsequently denied the transfer motion. He found Raymond delinquent and committed him to a private psychiatric treatment facility.3 [source] Platelet activating factor (PAF) increases plasma protein extravasation and induces lowering of interstitial fluid pressure (Pif) in rat skinACTA PHYSIOLOGICA, Issue 1 2005V. V. Iversen Abstract Aim:, To investigate the ability of the microdialysis technique to measure capillary selectivity of different sized plasma proteins induced by local administration of platelet activating factor (PAF). Methods:, We used hollow plasmapheresis fibres with 3 cm membrane (cut off 3000 kDa) placed on the back of anaesthetized rats. Results:, Platelet activating factor (50 ,g mL,1) administered locally via the fibre, increased extravasation of radiolabelled 125I-HSA from plasma to the microdialysis fibre by approximately 900% compared both to baseline and the control fibre within 70 min (n = 6, P < 0.05). The extravasation in the control fibre did not change over time. HPLC measurement of plasma proteins in the microdialysis perfusate also demonstrated decreased capillary selectivity for proteins in the diameter range of 73 Å, 56 Å and 39 Å after local administration of PAF (n = 6, P < 0.05). PAF also significantly lowered interstitial fluid (Pif) pressure after subcutaneous administration (50 ,g mL,1). Mean arterial pressure (MAP) after intravenous injection of PAF (0.4 ,g kg,1) fell instantly by about 50 mmHg, and stabilized at 50 mmHg after 15 min (n = 6). MAP was unaltered when PAF was given through the microdialysis fibre (n = 4). Both total tissue water (TTW) and extravasation of albumin, measured as the plasma-to-tissue clearance (E-alb) showed a significant increase after PAF (n = 7, P < 0.05). Conclusions:, The present study demonstrates that PAF induces plasma protein extravasation and decrease capillary selectivity of different sized plasma proteins. It also increases transcapillary fluid flux, and lowers Pif, indicating a role for PAF in the interstitium for generation of transcapillary transport of water and large molecules followed by formation of oedema. [source] Impact of National Aquarium in Baltimore on Visitors' Conservation Attitudes, Behavior, and KnowledgeCURATOR THE MUSEUM JOURNAL, Issue 1 2000LESLIE M. ADELMAN ABSTRACT This study at the National Aquarium in Baltimore (NAIB) was conducted to assess four key aspects of the visitor experience: (1) incoming conservation knowledge, attitudes, and behavior of NAIB visitors; (2) patterns of use and interaction with exhibition components throughout the NAIB; (3) exiting conservation knowledge, attitudes, and behaviors of visitors; and (4) over time, how the NAIB experience altered or affected individuals' conservation knowledge, attitudes, and behaviors. Three hundred six visitors participated in the study, which was conducted from March through July, 1999. The study utilized four data-collection techniques: (1) face-to-face interviews, (2) Personal Meaning Mapping (PMM), (3) tracking, and (4) follow-up telephone interviews. Participants were a self-selected population and were generally more knowledgeable about, more concerned about, and more involved in conservation-related issues than the general public. However, they were far from conservationists. Visitors in this study clearly absorbed the fundamental conservation message at the NAIB. In fact, the NAIB visit appeared to focus visitors' conservation-related thoughts, while also broadening their understanding of conservation. Changes in visitors' conservation knowledge, understanding, and interests by and large persisted over six to eight weeks after visiting NAIB. The NAIB experience also connected to visitors' lives in a variety of ways following their visit. However, these personal experiences rarely resulted in new conservation actions. In fact, their enthusiasm and emotional commitment to conservation (inspired during the NAIB visit) generally fell back to original levels, presumably in the absence of reinforcing experiences. The findings of this study are guiding subsequent investigations at the NAIB. More generally, the results suggest strategies to enhance current understanding of the impact free-choice learning institutions have on their visiting public. [source] Effect of angiotensin II and endothelin-1 receptor blockade on the haemodynamic and hormonal changes after acute blood loss and after retransfusion in conscious dogsACTA PHYSIOLOGICA, Issue 4 2004R. C. E. Francis Abstract Aim:, This study investigates angiotensin II and endothelin-1 mediated mechanisms involved in the haemodynamic, hormonal, and renal response towards acute hypotensive haemorrhage. Methods:, Conscious dogs were pre-treated with angiotensin II type 1 (AT1) and/or endothelin-A (ETA) receptor blockers or not. Protocol 1: After a 60-min baseline period, 25% of the dog's blood was rapidly withdrawn. The blood was retransfused 60 min later and data recorded for another hour. Protocol 2: Likewise, but preceded by AT1 blockade with i.v. Losartan. Protocol 3: Likewise, but preceded by ETA blockade with i.v. ABT-627. Protocol 4: Likewise, but with combined AT1plus ETAblockade. Results:, In controls, haemorrhage decreased mean arterial pressure (MAP) by approximately 25%, cardiac output by approximately 40%, and urine volume by approximately 60%, increased angiotensin II (3.1-fold), endothelin-1 (1.13-fold), vasopressin (116-fold), and adrenaline concentrations (3.2-fold). Glomerular filtration rate and noradrenaline concentrations remained unchanged. During AT1 blockade, the MAP decrease was exaggerated (,40%) and glomerular filtration rate fell. During ETA blockade, noradrenaline increased after haemorrhage instead of adrenaline, and the MAP recovery after retransfusion was blunted. The decrease in cardiac output was similar in all protocols. Conclusions:, Angiotensin II is more important than endothelin-1 for the short-term regulation of MAP and glomerular filtration rate after haemorrhage, whereas endothelin-1 seems necessary for complete MAP recovery after retransfusion. After haemorrhage, endothelin-1 seems to facilitate adrenaline release and to blunt noradrenaline release. Haemorrhage-induced compensatory mechanisms maintain blood flow more effectively than blood pressure, as the decrease in cardiac output , but not MAP , was similar in all protocols. [source] Borderline nuclear change; can a subgroup be identified which is suspicious of high-grade cervical intraepithelial neoplasia, i.e. CIN 2 or worse?CYTOPATHOLOGY, Issue 5 2002J. M. Edwards Borderline nuclear change; can a subgroup be identified which is suspicious of high-grade cervical intraepithelial neoplasia, i.e. CIN 2 or worse? Only 10% of first borderline smears are associated with a histological high-grade (HG) abnormality, i.e. CIN 2,3, invasive malignancy or glandular neoplasia on subsequent investigation. The advantages of highlighting this subgroup are obvious but is this possible? From 1996 and 1997, 242 borderline smears with histological follow-up were examined by two independent experienced observers (observer 1 and 2) without prior knowledge of further investigation results. For each smear a profile of nuclear details was produced, also noting the type of cell mainly affected by the process; then the observers were asked to assess the degree of worry of HG disease for each smear i.e. whether the smear fell into group 1 borderline changes indicative of low-grade (normal, inflammatory, CIN1/HPV) disease (BL/LG) or group 2 difficult borderline smear, HG disease (CIN 2,3, invasive neoplasia or glandular neoplasia) cannot be excluded (BL/HG). Observer 1 selected a group of BL/HG with a PPV for HG disease of 38%, with observer 2 having a PPV of 50%; this compared with the overall laboratory HG disease PPV for borderline smears of 14%. Both observers found the most useful criterion to be the increase in nuclear:cytoplasmic ratio. Our results show that it is possible to separate a small group of borderline smears which should be classified as ,borderline/high grade lesion difficult to exclude' (BL/HG). Both observers had some success in arriving at this classification although their method of selecting out this group was quite different. [source] Macroarray-based analysis of tail regeneration in Xenopus laevis larvae,DEVELOPMENTAL DYNAMICS, Issue 4 2005Akira Tazaki Abstract Xenopus larvae possess a remarkable ability to regenerate their tails after they have been severed. To gain an understanding of the molecular mechanisms underlying tail regeneration, we performed a cDNA macroarray-based analysis of gene expression. A Xenopus cDNA macroarray representing 42,240 independent clones was differentially hybridized with probes synthesized from the total RNA of normal and regenerating tails. Temporal expression analysis revealed that the up-regulated genes could be grouped into early or late responding genes. A comparative expression analysis revealed that most genes showed similar expression patterns between tail development and regeneration. However, some genes showed regeneration-specific expression. Finally, we identified 48 up-regulated genes that fell into several categories based on their putative functions. These categories reflect the various processes that take place during regeneration, such as inflammation response, wound healing, cell proliferation, cell differentiation, and control of cell structure. Thus, we have identified a panel of genes that appear to be involved in the process of regeneration. Developmental Dynamics 233:1394,1404, 2005. © 2005 Wiley-Liss, Inc. [source] Clinical and Economic Factors Associated with Ambulance Use to the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 8 2006Jennifer Prah Ruger PhD Background: Concern about ambulance diversion and emergency department (ED) overcrowding has increased scrutiny of ambulance use. Knowledge is limited, however, about clinical and economic factors associated with ambulance use compared to other arrival methods. Objectives: To compare clinical and economic factors associated with different arrival methods at a large, urban, academic hospital ED. Methods: This was a retrospective, cross-sectional study of all patients seen during 2001 (N= 80,209) at an urban academic hospital ED. Data were obtained from hospital clinical and financial records. Outcomes included acuity and severity level, primary complaint, medical diagnosis, disposition, payment, length of stay, costs, and mode of arrival (bus, car, air-medical transport, walk-in, or ambulance). Multivariate logistic regression identified independent factors associated with ambulance use. Results: In multivariate analysis, factors associated with ambulance use included: triage acuity A (resuscitation) (adjusted odds ratio [OR], 51.3; 95% confidence interval [CI] = 33.1 to 79.6) or B (emergent) (OR, 9.2; 95% CI = 6.1 to 13.7), Diagnosis Related Group severity level 4 (most severe) (OR, 1.4; 95% CI = 1.2 to 1.8), died (OR, 3.8; 95% CI = 1.5 to 9.0), hospital intensive care unit/operating room admission (OR, 1.9; 95% CI = 1.6 to 2.1), motor vehicle crash (OR, 7.1; 95% CI = 6.4 to 7.9), gunshot/stab wound (OR, 2.1; 95% CI = 1.5 to 2.8), fell 0,10 ft (OR, 2.0; 95% CI = 1.8 to 2.3). Medicaid Traditional (OR, 2.0; 95% CI = 1.4 to 2.4), Medicare Traditional (OR, 1.8; 95% CI = 1.7 to 2.1), arrived weekday midnight,8 AM (OR, 2.0; 95% CI = 1.8 to 2.1), and age ,65 years (OR, 1.3; 95% CI = 1.2 to 1.5). Conclusions: Ambulance use was related to severity of injury or illness, age, arrival time, and payer status. Patients arriving by ambulance were more likely to be acutely sick and severely injured and had longer ED length of stay and higher average costs, but they were less likely to have private managed care or to leave the ED against medical advice, compared to patients arriving by independent means. [source] Reliability of personality disorder diagnosis during depression: the contribution of collateral informant reportsACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2007B. G. Case Objective:, Research has found low concordance of personality disorder diagnoses made during depression versus after remission and made using patient versus collateral informants, but little is known about the reliability of personality disorder (PD) diagnoses made during depression using patient and collateral reports. Method:, A total of 168 patients were evaluated for PDs during depression and following response using patient and close informant reports. , coefficients of inter-informant and test,retest reliability were calculated. Results:, After depression response, the proportion diagnosed with cluster A and C PDs fell by both patient and close informant report, and overall inter-informant reliability declined. Overall test,retest reliability did not differ between patients and informants. Conclusion:, Collateral informants do not improve the reliability of PD diagnoses made during depressive episodes. [source] Moxonidine improves glycaemic control in mildly hypertensive, overweight patients: a comparison with metforminDIABETES OBESITY & METABOLISM, Issue 4 2006Irina Chazova Aim:, To compare the effects of moxonidine and metformin on glycaemic control in patients with impaired glucose tolerance and signs of the metabolic syndrome. Methods:, A multicentre, prospective, randomized, open-label study design was adopted with blinded endpoint evaluation. Patients ,40 years old, with impaired glucose tolerance (or diabetes mellitus treated with diet alone) and a body mass index (BMI) of at least 27 kg/m2 were treated twice daily with moxonidine 0.2 mg or metformin 500 mg for 16 weeks. Oral glucose tolerance test (OGTT) was performed at baseline and end-of-study; plasma insulin and plasma glucose levels were measured at 0, 60, 120 and 180 min after administration. Results:, With regard to effects on insulin [mean area under the curve (AUC) for insulin], the primary efficacy endpoint of the study, both drugs did not show equivalence. On the contrary, in the per protocol (PP) population, moxonidine statistically significantly (p = 0.025) decreased the AUC for insulin from baseline in the PP population; for metformin, the treatment effect on insulin was a small, net increase resulting in a statistically significant between-group difference of 16.2% (95% CI = 0.1,35.0). The change in mean insulin AUC was most marked in the subgroup of patients with higher sympathetic activity (heart rate >80 bpm). Mean fasting plasma glucose (FPG) levels and HbA1c levels were largely unchanged by moxonidine treatment but significantly decreased by metformin treatment. The difference between the groups was 14.7% (p = 0.0523) in the intent-to-treat (ITT) sample. By study end, both treatments had significantly increased the Matsuda Insulin Sensitivity Index (ISI) from baseline to a comparable extent: moxonidine by reducing plasma insulin after a glucose challenge, metformin by reducing FPG. BMI fell significantly in both groups and blood pressure normalized; both drugs were well tolerated. Conclusions:, Moxonidine improved insulin sensitivity in response to glucose challenge in patients with evidence of metabolic syndrome. This improvement resulted from a reduction in plasma insulin levels and was most marked in patients with high sympathetic drive at baseline. By enhancing insulin sensitivity, moxonidine treatment may help prevent the development of diabetes and thereby ameliorate the risk for cardiovascular disease. [source] The relationship between peripheral glucose utilisation and insulin sensitivity in the regulation of hepatic glucose production: studies in normal and alloxan-diabetic dogsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2006M. J. Christopher Abstract Background Hepatic glucose overproduction (HGP) of diabetes could be primary or could occur in response to the metabolic needs of peripheral (skeletal muscle (SkM)) tissues. This question was tested in normal and diabetic dogs. Methods HGP, SkM glucose uptake (Rdtissue), metabolic clearance of glucose (MCRg) and glycolytic flux (GFexog), and SkM biopsies were measured in the same dogs before and after alloxan-induced diabetes. Normal dogs were exposed to (1) an extended 20-h fast, (2) low- and high-dose glucose infusions (GINF) at basal insulinaemia, and chronic diabetic dogs were exposed to (3) hyperglycaemia, (4) phlorizin-induced normoglycaemia, and (5) poor and good diabetic control. Results (1) Prolonged fast: HGP, Rdtissue, and GFexog fell in parallel (p < 0.05). (2) Low-dose GINF: plasma glucose, insulin, Rdtissue, MCRg, and GFexog were unchanged, but HGP fell by ,40%, paralleling the supplemental GINF. (3) High-dose GINF at basal insulin: plasma glucose doubled and synchronous changes in HGP, Rdtissue, MCRg, and GFexog occurred; ICglucose, G6P, and glycogen were unchanged. (4) Hyperglycaemic diabetes: HGP was raised (p < 0.05), matching urinary glucose loss (UGL) and decreased MCRg, and maintaining normal basal Rdtissue and GFexog. SkM ICglucose was increased and glycogen decreased (both p < 0.05). (5) Phlorizin-induced normoglycaemia in diabetic dogs: HGP rose, matching the increased UGL, while maintaining normal Rdtissue and GFexog. Intramuscular substrates normalised. (6) Whole body and SkM metabolism normalised with correction of the insulin resistance and good diabetic control. Conclusion HGP reflects whether SkM is in a state of relative glucose ,excess' or absolute/relative glucose ,deprivation'. Copyright © 2005 John Wiley & Sons, Ltd. [source] Short Report: Safe and rapid resolution of severe hypertriglyceridaemia in two patients with intravenous insulinDIABETIC MEDICINE, Issue 9 2010J. M. Triay Diabet. Med. 27, 1080,1083 (2010) Abstract Aim, To rapidly reduce serum triglyceride to a safe serum level. Severe hypertriglyceridaemia is associated with uncontrolled diabetes, obesity and poor physical activity. Even moderate increases in triglyceride levels (> 5mmol/L) confer an increased risk of pancreatitis and coronary artery disease. We present two patients with diabetes and serum triglyceride levels of greater than 85mmol/L despite polypharmacy intervention. Method, 72-hour intravenous insulin infusion was administered. Results, Serum triglyceride levels fell to 9.4 and 4.6 mmol/L respectively, without adverse events and sustained effect over several months. Conclusion, We suggest the use of intravenous insulin infusion where lifestyle and oral drug therapies have failed can impact on severe hypertriglyceridaemia. [source] Hub-and-spoke model for a 5-day structured patient education programme for people with Type 1 diabetesDIABETIC MEDICINE, Issue 9 2009H. Rogers Abstract Aims, Structured education programmes for people with Type 1 diabetes can deliver improved diabetes control (including reduced severe hypoglycaemia) and quality of life. They can be cost-effective but are resource intensive. We tested the ability to deliver an evidence-based 5-day programme in diabetes centres too small to deliver the courses. Methods, Specialist medical and nursing staff from three district general hospital diabetes services (the ,spokes') were trained in all aspects of the education programme, except those directly related to course delivery, by a larger centre (the ,hub'). The hub staff delivered the 5-day patient education courses, but all other patient education and management was managed locally. Diabetes control and quality of life were assessed at 1 year post-course. Results, In 63 patients with follow-up data, glycated haemoglobin (HbA1c) fell by 0.42 ± 1.0% (P = 0.001), with a greater fall in those with high HbA1c at baseline, and no mean weight gain. Emergency call-out for severe hypoglycaemia fell from 10 episodes in seven patients the year before to one episode in one patient (P = 0.03). Quality-of-life measures improved, with reduced negative impact of diabetes on diabetes-related quality of life (P < 0.00004) and ,present quality of life' improving (P < 0.001). Conclusions, The benefits of a 5-day structured education programme can be provided to patients with Type 1 diabetes attending centres without the resources to provide the teaching course itself, by a ,hub-and-spoke' methodology. [source] Mild peripheral neuropathy prevents both leg muscular ischaemia and activation of exercise-induced coagulation in Type 2 diabetic patients with peripheral artery diseaseDIABETIC MEDICINE, Issue 10 2007F. Piarulli Abstract Aim, To study the influence of peripheral neuropathy on intermittent claudication in patients with Type 2 diabetes (T2DM). Methods, Twenty-five patients with T2DM were grouped according to the ankle/brachial index (ABI): 10 with ABI > 0.9 without peripheral artery disease (PAD; group T2DM) and 15 with ABI < 0.9 with PAD (group T2DM + PAD). Twelve individuals without T2DM with PAD (group PAD without T2DM) were also enrolled. Tests for peripheral neuropathy were performed in all patients. ABI, rate pressure product, prothrombin fragments 1 + 2 (F1+2), thrombin-anti-thrombin complex (TAT), and d -dimer were measured before and after a treadmill test. During exercise both initial and absolute claudication distance and electrocardiogram readings were recorded. Results, We found mild peripheral neuropathy in 20% of group T2DM and 46.7% of group T2DM + PAD (P < 0.01). After exercise, the rate pressure product increased in each group; ABI fell in T2DM + PAD (P < 0.0001) and in PAD without T2DM (P = 0.0005); the fall was greater in the latter group. Initial and absolute claudication distances were similar in PAD patients. In group T2DM + PAD, absolute claudication distance was longer in the subgroup without peripheral neuropathy (P < 0.05), whereas ABI and rate pressure products were similar. F1+2 values at rest were higher in group T2DM + PAD. After exercise, F1+2 values and TAT increased only in group PAD without T2DM. Conclusion, Only group PAD without T2DM experienced muscular ischaemia, whereas group T2DM + PAD did not. Mild peripheral neuropathy may have prevented them from reaching the point of muscular ischaemia during the treadmill test, because they stopped exercising with the early onset of pain. Reaching a false absolute claudication distance may induce ischaemic preconditioning. These findings suggest a possible protective role of mild peripheral neuropathy in T2DM patients with intermittent claudication, by preventing further activation of coagulation during treadmill testing. [source] Low-dose metformin improves hyperglycaemia related to myotonic dystrophyDIABETIC MEDICINE, Issue 3 2005T. Kouki Abstract Background One of the clinical features of myotonic dystrophy is insulin resistance with non-obese diabetes mellitus (DM). Recently, the mechanism of insulin resistance in patients with myotonic dystrophy was revealed. The optimal treatment of DM with myotonic dystrophy has not been established. We report the effect of metformin in a patient with myotonic dystrophy without obesity. Case report A 58-year-old woman (BMI = 22.1 kg/m2) with myotonic dystrophy and DM was followed at our clinic. She had been treated with glimepiride for DM for the last 6 months, without achieving good control (HbA1c 9.3%). She was admitted with congestive heart failure and cholecystitis. She was treated with diuretics, antibiotics and insulin. As her blood glucose fell, we discontinued insulin and started glimepiride, but her glycaemic control had worsened. We started metformin instead of glimepiride. After 4 weeks of metformin, HbA1c was decreased to 7.4%, while HOMA-IR during glimepiride treatment was 4.9, and 3.7 with metformin. Three months later, HbA1c was maintained (7.5%). Conclusion It is important to choose the optimal treatment for DM in myotonic dystrophy, because the patients have hyperinsulinemia caused by specific mechanism and could not reduce the insulin resistance. Metformin improved hyperglycemia through increased insulin-independent glucose uptake in peripheral muscle. We believe metformin is the optimal agent for these patients. [source] Factors predictive of nephropathy in DCCT Type 1 diabetic patients with good or poor metabolic controlDIABETIC MEDICINE, Issue 7 2003L. Zhang Abstract Aims The study aim was to assess the time-related risk of developing diabetic nephropathy [albumin excretion rate (AER) , 40 mg/24 h] from baseline covariates in Type 1 diabetic patients with either good or poor metabolic control (MC). Methods Based on material from the Diabetes Control and Complications Trial study (n = 1441), patients were considered as under good or poor MC if their HbA1c mean level up to last visit fell in the lowest (, 6.9%) or highest (, 9.5%) quintile of the overall HbA1c distribution, respectively. Prevalence cases of nephropathy were excluded from the study. Survival analysis and Cox regression were applied to the data. Results Among patients with good MC (n = 277), 15% had developed nephropathy at the end of the study. Conversely, among patients with poor MC (n = 268), the proportion without the complication was 52%. When adjusting for MC, time to diabetic nephropathy was related to age (P < 0.0001), AER (P < 0.001), duration of diabetes (P < 0.005), body mass index (BMI) (P < 0.005), all at baseline, and to gender (P < 0.01). Patients with upper normal range AER levels, longer duration of diabetes and lower BMI were at higher risk, regardless of MC. The adverse effect of younger age on diabetic nephropathy was more marked in good than in poor MC. Although women tended to develop the complication more often under good MC, they appeared to be better protected under poor MC. Conclusions This study confirms occurrence of diabetic nephropathy under good MC and non-occurrence of the complication despite poor MC. It also demonstrates that some baseline covariates can affect, in a differential manner, time to diabetic nephropathy depending on MC. Diabet. Med. 20, 580,585 (2003) [source] Decreased red blood cell aggregation subsequent to improved glycaemic control in Type 2 diabetes mellitusDIABETIC MEDICINE, Issue 4 2003B. Chong-Martinez Abstract Aims Reports of rheological changes following intensification of metabolic control are limited and not concordant. The present study was designed to test the hypothesis that intensification of management of Type 2 diabetes (T2DM) with diet, exercise and insulin improves haemorheological behaviour by reducing red blood cell (RBC) aggregation. Methods Blood was sampled from 55 subjects before and following 14 ± 3 weeks of intensified management. RBC aggregation was measured in vitro for cells in plasma or in an aggregating 70 kD dextran solution. Plasma viscosity and whole blood viscosity were also measured. Results During treatment, fasting glucose fell 27%, HbA1c fell 21%, and serum triglycerides and total cholesterol fell 28% and 12%, respectively (P < 0.0001 for each). The extent and strength of RBC aggregation in plasma fell by 10,13% (P < 0.002). Similar decreases of RBC aggregation were seen for cells suspended in dextran (P < 0.002). Plasma viscosity decreased by 3% (P < 0.02) and high shear blood viscosity by 6,7% (P < 0.0001). Changes of RBC aggregation in plasma and in dextran were significantly correlated, supporting a cellular rather than a plasmatic origin for these changes. However, there were no significant correlations between RBC aggregation changes and changes of fasting glucose, HbA1c, serum triglycerides, serum cholesterol, or plasma fibrinogen. Conclusions Intensified metabolic control results in a reduction of RBC aggregation that appears to be intrinsic to RBC. Since increased RBC aggregation can impair microcirculatory flow, it is possible that haemorheological factors may contribute to the reduction of microvascular complications resulting from improved metabolic control in T2DM. [source] No reactive hypoglycaemia in Type 2 diabetic patients after subcutaneous administration of GLP-1 and intravenous glucoseDIABETIC MEDICINE, Issue 2 2001T. Vilsbøll SUMMARY Aims It has previously been shown that intravenous and subcutaneous administration of glucagon-like peptide (GLP)-1 concomitant with intravenous glucose results in reactive hypoglycaemia in healthy subjects. Since GLP-1 is also effective in Type 2 diabetic patients and is presently being evaluated as a therapeutic agent in this disease, it is important to investigate whether GLP-1 can cause hypoglycaemia in such patients. Methods Eight Type 2 diabetic patients (age 54 (49,67) years; body mass index 31 (27,38) kg/m2; HbA1c 9.4 (7.0,12.5)%) and seven matched non-diabetic subjects (HbA1c 5.5 (5.2,5.8)%, fasting plasma glucose 5.4 (5.0,5.7) mmol/l) were given a subcutaneous injection of 1.5 nmol GLP-1/kg body weight (maximally tolerated dose), and 15 min later, plasma glucose (PG) was raised to 15 mmol/l with an intravenous glucose bolus. Results Hypoglycaemia with a PG at or below 2.5 mmol/l was seen in five of the seven healthy subjects after 60,70 min, but PG spontaneously increased again, reaching 3.7 (3.3,4.0) mmol/l at 90 min. In the patients, PG fell slowly and stabilized at 8.6 (4.2,12.1) mmol/l after 80 min. In both groups, glucagon levels initially decreased, but later increased, exceeding basal levels in healthy subjects, in spite of persistent, high concentrations of GLP-1 (P < 0.02). Conclusions Subcutaneous GLP-1 plus intravenous glucose induced reactive hypoglycaemia in healthy subjects, but not in Type 2 diabetic patients. Therefore, a GLP-1-based therapy would not be expected to be associated with an increased risk of hypoglycaemia in Type 2 diabetes mellitus. [source] A rapid technique for assessing the suitability of areas for invasive species applied to New Zealand's riversDIVERSITY AND DISTRIBUTIONS, Issue 2 2008Cathy Kilroy ABSTRACT Early responses to incursions of non-indigenous species (NIS) into new areas include modelling and surveillance to define the organisms' potential and actual distributions. For well-studied invasive species, predictive models can be developed based on quantitative data describing environmental tolerances. In late 2004, an invasive freshwater diatom Didymosphenia geminata, an NIS for which we had no such quantitative data, was detected in a New Zealand river. We describe a procedure used to rapidly develop a classification of suitability for all New Zealand's rivers, based on two sources of information. First, from a review of the limited available literature and unpublished data, we determined that temperature, hydrological and substrate stability, light availability, and water pH were the most important environmental gradients determining D. geminata's broad-scale distribution and capacity for establishing and forming blooms in rivers. The second information source was a GIS-based river network developed for a national classification of New Zealand's rivers, with associated data describing environmental characteristics of each section of the network. We used six variables that were available for every section of the network as surrogates for the environmental gradients that determine suitability. We then determined the environmental distance of all the river sections in the network from our assessment of the optimal conditions conducive to D. geminata blooms. The analysis suggested that > 70% of New Zealand's river sections (stream order > 3) fell into the two highest suitability categories (on a five-point scale). At the time of writing, D. geminata had spread to 12 catchments, all of which were within these two categories. The technique is applicable in initial responses to incursions of NIS where quantitative information is limited, and makes optimal use of available qualitative information. Our assessment contributed to evaluations of the potential ecological, social, and economic impacts of D. geminata and is currently being used to stratify site selection for ongoing surveillance. [source] Hazardous alcohol consumption and other barriers to antiviral treatment among hepatitis C positive people receiving opioid maintenance treatmentDRUG AND ALCOHOL REVIEW, Issue 3 2007BIANCA WATSON Abstract Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study. [source] Geomorphic and sedimentological signature of a two-phase outburst ,ood from moraine-dammed Queen Bess Lake, British Columbia, CanadaEARTH SURFACE PROCESSES AND LANDFORMS, Issue 1 2005Jane A. Kershaw Abstract On 12 August 1997, the lower part of Diadem Glacier in the southern Coast Mountains of British Columbia fell into Queen Bess Lake and produced a train of large waves. The waves overtopped the broad end moraine at the east end of the lake and ,ooded the valley of the west fork of Nostetuko River. The displacement waves also incised the out,ow channel across the moraine. Stratigraphic and sedimentologic evidence supports the conclusion that the ,ood had two phases, one related to wave overtopping and a second to breach formation. Empirical equations were used to calculate the peak discharge of the ,ood at various points along the west fork of the Nostetuko valley and to describe the attenuation of the ,ood wave. The velocity of the ,ood was also calculated to determine the time it took for the ,ood to reach the main fork of Nostetuko River. The highest peak discharges were achieved in the upper reach of the valley during the displacement phase of the ,ood. Peak discharge declined rapidly just below the moraine dam, with little change thereafter for approximately 7 km. Empirical formulae and boulder measurements indicate a rise in peak discharge in the lower part of the west fork valley. We suggest that ,ow in the upper part of the valley records the passage of two separate ,ood peaks and that the rise in discharge in the lower part of the valley is due to amalgamation of the wave and breach peaks. Hydraulic ponding in con,ned reaches of the valley extended the duration of the ,ood. In addition, erosion of vegetation and sediment in the channel and valley sides may also have exerted an in,uence on the duration and nature of ,ooding. Sediments were deposited both upstream and downstream of channel constrictions and on a large fan extending out into the trunk Nostetuko River valley. This study extends our understanding of the variety and complexity of outburst ,oods from naturally dammed lakes. It also shows that simple empirical and other models for estimating peak discharges of outburst ,oods are likely to yield erroneous results. Copyright © 2005 John Wiley & Sons, Ltd. [source] Determining friction coefficients for interrill flows: the significance of flow filaments and backwater effectsEARTH SURFACE PROCESSES AND LANDFORMS, Issue 5 2003Dr David L. Dunkerley Abstract Friction coefficients in overland flows are customarily estimated from mean flow properties (depth, velocity, slope) that subsume spatial variations in flow arising from two major causes: microtopography and obstacles. This paper uses laboratory experiments in shallow flumes to examine the extent of non-uniformity in flow conditions associated with each cause. Randomly placed emergent obstacles in a flume with a shallow axial channel generally yielded higher hydraulic roughness than the same pattern of obstacles on a planar flume, as well as greater variation in roughness as the obstacle locations were altered. In both flumes, hydraulic roughness fell with increasing Reynolds number for 10% obstacle cover, showed a flattening trend at 20% cover, and exhibited a convex-downward trend at 30% obstacle cover. These results indicate the progressive onset of flow controls at narrow gaps in the obstacle field. In such flows, the use of mean flow properties conceals the existence of two main subdivisions of flow: flow filaments and backwater flows. In the experiments, flow filaments involved velocities more than twice the overall mean, whereas backwater flows were much slower than the mean. The existence of fast-moving flow filaments may be significant in understanding soil transport in surface runoff, and backwater depths may modify splash detachment. Similarly, friction coefficients that fail to reflect these important non-uniform flow components may not be optimal for hydraulic calculations or in erosion models. It is concluded that new approaches to observing and processing flow data may be required, in order to avoid the loss of important flow detail that is entailed in assuming uniform flow conditions. Copyright © 2003 John Wiley & Sons, Ltd. [source] Estimating the number of alcohol-attributable deaths: methodological issues and illustration with French data for 2006ADDICTION, Issue 6 2010Grégoire Rey ABSTRACT Aims Computing the number of alcohol-attributable deaths requires a series of hypotheses. Using French data for 2006, the potential biases are reviewed and the sensitivity of estimates to various hypotheses evaluated. Methods Self-reported alcohol consumption data were derived from large population-based surveys. The risks of occurrence of diseases associated with alcohol consumption and relative risks for all-cause mortality were obtained through literature searches. All-cause and cause-specific population alcohol-attributable fractions (PAAFs) were calculated. In order to account for potential under-reporting, the impact of adjustment on sales data was tested. The 2006 mortality data were restricted to people aged between 15 and 75 years. Results When alcohol consumption distribution was adjusted for sales data, the estimated number of alcohol-attributable deaths, the sum of the cause-specific estimates, was 20 255. Without adjustment, the estimate fell to 7158. Using an all-cause mortality approach, the adjusted number of alcohol-attributable deaths was 15 950, while the non-adjusted estimate was a negative number. Other methodological issues, such as computation based on risk estimates for all causes for ,all countries' or only ,European countries', also influenced the results, but to a lesser extent. Discussion The estimates of the number of alcohol-attributable deaths varied greatly, depending upon the hypothesis used. The most realistic and evidence-based estimate seems to be obtained by adjusting the consumption data for national alcohol sales, and by summing the cause-specific estimates. However, interpretation of the estimates must be cautious in view of their potentially large imprecision. [source] The rise and quick fall of the theory of ancient economic imperialismECONOMIC HISTORY REVIEW, Issue 4 2009SVIATOSLAV DMITRIEV The theory of ancient economic imperialism has declined for two reasons. The first is the absence of any reliable evidence that the politics of ancient states was dictated by economic considerations. Additionally, the usual focus on the Roman provincial system limits the understanding of ,economic imperialism' to that of a ,formal empire' and ignores other ancient societies. The second reason, which so far has been neglected, is the changing vision of modern imperialism. Once the modern colonial system fell, the understanding of imperialism returned to that of the precolonial period, which saw imperialism in political and military terms. [source] | |||||||||||||||||||||||||||||||||||||||||||