Number Of Crises Research Articles

Complement haemolytic activity, circulating immune complexes and the morbidity of sickle cell anaemia.

The aim of this study was to find out if the number of crises and complications of sickle cell anaemia (SCA) relate to complement function, or the levels of circulating immune complexes (CIC), complement factor B (Bf), C3 and C4. In 73 steady-state HbSS patients and 50 HbAA control subjects, we determined the haemolytic activity of the alternative pathway of complement (AP50), of the classical pathway (CH50); and the serum concentrations of Bf, C3, C4 and CIC. By clinical examination of each patient and review of the medical records, we determined the number of complications of SCA which had occurred and the mean number of crises per year over a minimum period of 3 years. The mean+/-SD AP50 for the patients (14+/-2 U/ml) was significantly lower than the control value of 16+/-3 U/ml (p<0.001). AP50 had a significant inverse correlation with the number of crises (r=-0.30, p<0.02). Mean+/-SD CIC in patients (0.45+/-0.38 g/l) was significantly higher than in controls: 0.24+/-0.15 g/l (p<0.002). CIC showed a significant direct correlation with the number of complications of SCA (r=+/-0.28, p<0.02). Mean+/-SD Bf in SCA patients (0.19+/-0.09) was higher than in controls (0.17+/-0.05). The difference reached marginal statistical significance (p=0.049). SCA patients and controls had no significant differences in CH50, C3 and C4. These parameters and Bf did not correlate with either the number of crises or complications. The mechanisms underlying the correlations observed in this study are yet to be fully elucidated.

Control and accountability in the NHS market: a practical proposition or logical impossibility?

Before the imposition of the NHS internal market, systems of accountability and control were far from adequate and could be criticized on a number of grounds. The market was offered as a panacea to address these inadequacies. However, in practice there have only been partial improvements which could have been achieved without the imposition of the market. The market also creates new problems and a number of crises and scandals seem to be addressed at the political level by pleas to utilize resources more effectively. These pleas mean that more and more the focus is turning back to central planning in the provision of care and further away from so-called market mechanisms. The NHS "managed" market has been imperfect and will continue to be so. Argues that there is no alternative but to return to the planned provision of health care in order to improve on accountability and control in the NHS. Hopefully the adverse impact of the market on clinicians and others will force a more rational reappraisal of the fundamental raison d'être of the NHS and the need for those involved in the delivery of services, at all levels, to be more openly accountable.

An Encomium to Richard Raack, Historian-Filmmaker

An Encomium to Richard Raack, Historian-Filmmaker | Rollins Peter C. Rollins Oklahoma State University An Encomium to Richard Raack, Historian-Filmmaker Film & Historyhas known Richard Raack for twenty years, beginning our relations with him in the late 1960s when "The Historian as Filmmaker" theme was very popular at American Historical Association meetings. Both Richard Raack, and his colleague, Patrick Griffin, were the center of much discussion because of their historian-made documentary entitled Goodbye Billy: America Goes to War, 19171918 (1972). This short historical compilation ignited considerable excitement because of the philosophical position behind the film—that historians should wrest the researching and making ofhistorical films away from the showbiz folks. John O'Connor, Editor of Film & History opened the pages of the journal to these two pioneers, allowing them to explain their reasons and methods. The call to action was electric! Raack and Griffin were endlessly generous with their writings, bibliographies, and other advice to novices—to include a graduate student named Peter Rollins. Both were willing to talk on the telephone and to share their thoughts for revolutionizing methods in making historical films for the classroom. Alas, the revolution never occurred. But R.C. Raack has shared his insights and writings with a whole generation of historians. Richard, Pat, and I worked together to make Will Rogers 1920s: A Cowboy's Guide to the Times (1976), an experience which changed my life as a scholar and artist. During the project, I was shown how to research filmic materials in archives; how to record the materials; how to process the film; and how to edit and mix. A number of crises also taught me how to handle the tensions and vicissitudes ofproduction and post-production. We really got our hands dirty with that project and I have been a better scholar—and filmmaker—as a result. At the same time, Richard Raack was tapping his language skills in German, Polish, and Russian to conduct both film research and major historical research in the archives of Berlin, Warsaw, and Moscow. His revolutionary book of 1995, Stalin's Drive to the West: The Origins ofthe Cold War has profited from Richard's language skills and his willingness to expend his own savings in the search for truth. At a recent conference at Salisbury, Maryland, a number of filmmakers (with no training in history) presented themselves to the assembled scholars as "historians." One of the British producers got up at a very elaborate, evening session and said directly, "I am a historian." Only Richard Raack was curmudgeon enough to challenge these claims; indeed, Richard has exemplified the kind of scholar and filmmaker we were promised in the 1960s. Like a scholarly Moses, he stands at the edge of the Promised Land, sipping a glass of California wine and chortling over the absurdities of our fin de siede. He scans the horizon ... Perhaps a new generation will bring along a group of creative people who will fulfill the promise ... Surely, we hope so .... Until then, we celebrate the work of Richard C. Raack— a fine and original scholar, lover of all the arts, and one of the first historian/filmmakers. May there be many more and may Film & Historyhelp to promote that movement! Cover for Raack's film resource material workbook for Goodbye Billy. Vol. 28.3-4(1998) | 57 ...

Control and accountability in the NHS market: a practical proposition or logical impossibility?

Before the imposition of the NHS internal market, systems of accountability and control were far from adequate and could be criticized on a number of grounds. The market was offered as a panacea to address these inadequacies. However, in practice there have only been partial improvements which could have been achieved without the imposition of the market. The market also creates new problems and a number of crises and scandals seem to be addressed at the political level by pleas to utilize resources more effectively. These pleas mean that more and more the focus is turning back to central planning in the provision of care and further away from so‐called market mechanisms. The NHS “managed” market has been imperfect and will continue to be so. Argues that there is no alternative but to return to the planned provision of health care in order to improve on accountability and control in the NHS. Hopefully the adverse impact of the market on clinicians and others will force a more rational reappraisal of the fundamental raison d’être of the NHS and the need for those involved in the delivery of services, at all levels, to be more openly accountable.

The articulation of cultural processes and Late Quaternary environmental changes in Cisjordan.

The dynamics of Epipalaeolithic and Early Neolithic adaptations in the southern Levant from areas west of the Rift Valley are briefly described and evaluated against the backdrop of climatic changes. Taking account of recent advances in environmental studies and important revisions in the chronological framework of pollen diagrams from the Hula, a high degree of correlation between environmental and cultural developments is apparent. The variable nature of environmental changes and the mosaic of ecological zonation on human adaptive systems are stressed, with differentiation between : long-term incremental trends; sudden climatic changes; and predictable annual fluctuations about a mean. The nature and flexibility of the responses by communities to such external changes depended upon specific combinations of technological, social and ideological, psychological as well as idiosyncratic factors. Favourable niches alternately expanded or contracted. At times human adaptation systems in Cisjordan can be divided into two provinces, Mediterranean and Steppe/Desert ; at other times they included adjacent areas, such as Transjordan and the northern part of the Levantine corridor. A number of crises or "bottle-neck" situations, most resulting from environmental changes, are described which caused radical re-alignments in social and subsistence systems. It is against this backdrop, together with generally conservative social systems, that the transformation from foraging to plant and animal husbandry should be viewed.

Effects of alpha thalassaemia and haemoglobin F (HbF) level on the clinical severity of sickle-cell anaemia.

Three clinical parameters - average steady-state haematocrit (ASSH), number of crises per year (Cr/Y), and number of transfusions per year (Tx/Y) - were evaluated in 52 patients with sickle-cell anaemia in relation to their foetal haemoglobin (HbF) levels. No correlation was observed between HbF and any of these parameters. A comparison of these three clinical parameters and the alpha globin gene status was also made in 28 of these patients. The relationships between (ASSH) or (Cr/Y) and alpha globin gene status were not significantly different (p > 0.05) but a significantly different value (p < 0.05) was observed between (Tx/Y) and the alpha globin gene status in these patients. It is concluded that, although HbF levels did not affect any of these parameters, alpha thalassaemia deletion significantly reduces the transfusion requirements of these patients.

An intercultural assessment of the type, intensity and number of crisis precipitating factors in three cultures: United States, Brazil and Taiwan

The precipitating factors of crisis have cultural interpretations that make diagnostic criteria and intervention methods ethnologically different. The crisis precipitating factors of individuals seeking intervention in the Republic of China (Taiwan), Brazil and the United States (U.S.) were investigated toward the end of isolating correlates and discrepancies of ethnic-related precipitants of crisis. The primary objective of the study was to influence crisis intervention in the profession of nursing from the almost universally utilized Western Model, to one that takes cultural uniqueness into account. Stressors and stressor intensities which lead to help-seeking behavior of clients in selected crisis intervention facilities in the three countries were identified. A 60 question instrument ranked client responses according to Axis 4 of the Diagnostic and Statistical Manual-III of the American Psychiatric Association (APA, 1980; 1986). Each item also reflected one of four Human Response Patterns of the North American Nursing Diagnostic Association (NANDA) taxonomy, which was utilized as a clustering device in data analysis. Somatization versus psychologization of crisis precipitating factors was also measured through the NANDA categories. A convenience sample of 30 subjects were queried in each country by nurse interviewers. Data analysis through ANOVA showed cultural uniqueness and mutuality.

Living on the edge—the development of silviculture in South Australian pine plantations

Summary South Australia has one of the world's oldest man-made forests based upon classical sustained-yield management and funded totally from loans. Necessity to augment scarce local supplies of timber, in a climate “not naturally conducive to tall forest growth”, was realised over 120 years ago. The development of silviculture, from species selection and marketing factors through extensive, low cost practices into the current, highly intensive ones, is reviewed historically. A number of crises have been resolved and each has led to a greater understanding of silvicultural potential. Philosophical considerations that have inspired the development of silviculture to capture much of the great potential shown by the principal commercial species, Pirtus radiata, include a review of the scarce resources that have to be met by forest managers. A strongly-sustained demand for local supplies of timber and a limited land base support the continuation of intensive development in the future. This envisages conservation of site-based resources augmented by legume culture and judicious use of fertiliser mixtures. Safer formulations and more efficient supply systems allied with site-specific silviculture and vigorous application of tree-breeding are likely to lead to further refinement of silviculture.

State and Class in Kenya – Notes on the Cohesion of the Ruling Class

This article attempts to situate the recent power struggle between President Daniel arap Moi and the ex-Minister for Constitutional Affairs, Charles Njonjo, in the context of class antagonisms in the Kenyan state. Over the past few years, Moi survived a number of crises partly as a result of the consistent support he has received from Njonjo. During the run-up to the general election of 26 September 1983, however, Moi was hoping that he could mobilise sufficient support amongst Kenya's political élite to be able to dispense with Njonjo, and thereby remove the only politician powerful enough to pose any threat to his leadership. SinceJomo Kenyatta's death in 1978, Njonjo had been regarded as the third member of a ruling triumvirate, with Moi and Vice-President Mwai Kibaki. In the following analysis, we examine the class context for conflict with the figure most closely associated with the conservative, capitalistic, and pro-British tendency in Kenyan nationalism.

Life Crises among the Religiously Committed: Do Sectarian Differences Matter?

Members of three sectarian groups (Catholic Charismatics, Christian Scientists, and Baha'is) were studied in terms of their perceptions of the number, types and reactions to crises they had experienced. It was hypothesized that ideological and structural differences between groups would result in differential perceptions of and adaptations to crises. It was found that the groups did not differ in the number of crises reported by members. Further, in all but a few cases, definitions of types of crises experienced were a function of member characteristics rather than group affiliation. We found, however, that sectarian differences exert a consistent effect regardless of member characteristics on reactions to crises.

Mobility, genetic markers, susceptibility to malaria and race mixture in Manaus, Brazil

A total of 519 individuals a affected with malaria and 435 matched controls have been studied in Manaus, the capital of the Brazilian State of Amazonas. Most of the sample (81%) is composed of relatively recent migrants to the city. The exogamy index of the parents of the individuals studied is high (24), more than doubling that obtained in the previous generation (9·5). Seven genetic systems have been investigated (blood groups ABO and Rh, Hemoglobin, Haptoglobin, Transferrin, Ceruloplasmin and Albumin types). The combined frequency in the ABO blood groups of B+AB as compared with O+A persons is significantly higher among subjects with malaria, the number of crises also showing a positive correlation (r: 0·21; P

Stress Relief for Transportation Employees

Providing transportation for a city the The stress within a large service or size of Detroit requires a complex organization is intensified by other issues ganization of over two thousand staff such as conflict among different age members functioning in many roles. groups, sexism, favoritism, high com The most visible employee in the community unemployment, and the cur munity is the bus driver. He or she rent pressure for expanding public symbolizes the entire service and is, as transportation. Given the complexity of a result, the target of abuse and praise, the transportation system, job-related He or she is heaped with blame for stress inevitably has an impact on all faulty service and must make decisions transportation employees in Detroit. for an untold number of crises that the

Self-image formation in adopted children: The environment within

Adoption of a child is an event in which a number of crises have converged. Both the biologic and adoptive families have contributed their failures and crises, and the subsequent interpretations of these by the adopted child can lead to polarized themes of goodness and badness. The absence of the biologic parents and of a coherent history reinforces the tendency to splitting. This paper explores these operations and raises questions about prevailing adoption practices.

The Problem of International Criminal Jurisdiction

States are closely connected with each other in the modern world. This interconnection is due to the objective necessity for all of them to enter into certain relations. Peaceful co-existence of states with different economic and social systems determines the growing significance of co-operation between them. The necessity for cooperation can be explained not only from the economic point of view but also by the fact that a number of crises in the international intercourse still remain unregulated, thus presenting a threat to maintenance of the peace in many parts of the world.

5-Hydroxytryptophan in the prophylaxis of migraine

Out of 40 patients affected by migraine, after a 40 days control period without therapy, 20 have been treated with methysergide and other 20 with L-5-Hydroxytryptophan for 40 days. Efficiency of the drugs was evaluated through the number of crises and the migraine index. The statistical evaluation shows significant differences between control and treatment periods, and no difference between methysergide and 5-HTP periods. These results could support the serotonin theory of migraine, pointing out a possible brain 5-HT deficiency, and consequently central monoamine supersensitivity. Methysergide has been suggested as a migraine prophylactic agent, according to the hypothesis that 5-Hydroxytryptamine (5-HT) could be involved in the pathogenesis of essential headache (Sicuteri, 1959). Biochemical investigations on the urinary excretion of 5-hydroxyndolacetic acid (5-HIAA) and blood levels of 5-HT indicate some changes in the 5-HT turnover during migraine attacks (Sicuteri et al. 1961; Curran et al. 1965). Nitroglycerin and reserpine do not modify the 5-HIAA urinary excretion in normal subjects and migraine sufferers; on the other hand, when these drugs cause an attack in migraine sufferers, a significant increase in the 5-HIAA urinary excretion is observed (Campus et al. 1967; Curzon et al. 1969). Parachlorophenylalanine (fenclonine), a specific inhibitor of 5-HT synthesis, when administered to patients affected by untreatable migraine, reduced the frequency and intensity of the crises (Sicuteri et al. 1970). However, in about 20% of the treated patients an unusual systemic pain syndrome arose. Pain was relieved or reproduced by interruption or readministration of the drug (Sicuteri 1971). The serotonin theory of essential headache could thus be more characterized in the sense of a deficiency of this amine, conditioning a state of supersensitivity of the structures on which 5-HT usually acts. The features of the fenclonine syndrome suggest that pain is central in nature. Following the serotonin theory, a trial was carried out with the aim of correcting the presumable lack or deficiency of the monoamine. 5-Hydroxytryptophan (5-HTP) was used, since 5-HT does not penetrate in the blood brain barrier. The effect of 5-HTP was compared with that of methysergide, a proved migraine prophylactic agent, in an open clinical screening.

Psychological status and the perception of primary and secondary support from the social milieu in time of crisis.

The psychologically impaired apparently are more likely to seek secondary sources of help than the unimpaired in response to a wide variety of crises. (Secondary sources of help are denned in this article as those distinct from family or friends and for which one usually has to leave home and pay a fee.) This implies that psychological impairment predisposes to differential perception of social support as helpful or unhelpful for different types of crises Impairment leads to the perception of formal surroundings as helpful for a much greater number of crises than unimpairment. This implies that the structural elements within society are quite important to those whose adjustment by virtue of impairment is marginal While we can only speculate why individuals perceive one form of help as more useful than another, our attention is directed to the potential problem of knowledgeably increasing the social support structure, formal and informal, within our society so as to minimize the reliance of the impaired on informal supports which apparently have largely failed or been inadequate for the needs of the impaired person

The Suppression of Salts of Chlorine from the Diet in the Treatment of Epilepsy by Bromides [La diète hypochlorinée dans le traitement bromique de l'épilepsie] (Rev. de Psychiat., No. 4, April, 1902.) Cappelletti and D'Orméa

The authors give the results of their treatment of epileptics by the method suggested by Richet and Toulouse, according to whom diminution of the excess of chlorides present in the organism favours the curative action of bromide salts in epilepsy without disturbing appreciably the normal physiological metabolism. They experimented on twenty patients, eleven men and nine women, who were taking from 45 to 120 grains of bromide per diem. Chlorine was suppressed from the diet. They noted the number of crises during the six months preceding this special treatment, during the forty days of treatment, and during the two months following. A brief history of each case is given. No objection to the treatment occurred on the part of the patients. Their general conclusions may be thus summarised: