Psychiatric comorbidity in refractory focal epilepsy: A study of 490 patients

We studied the prevalence and associated factors of psychiatric comorbidities in 490 patients with refractory focal epilepsy. Of these, 198 (40.4%) patients had psychiatric comorbidity. An Axis I diagnosis was made in 154 patients (31.4%) and an Axis II diagnosis (personality disorder) in another 44 (8.97%) patients. After logistic regression, positive family history of psychiatric comorbidities (O.R.=1.98; 95% CI=1.10-3.58; p=0.023), the presence of Axis II psychiatric comorbidities (O.R.=3.25; 95% CI=1.70-6.22; p<0.0001), and the epileptogenic zone located in mesial temporal lobe structures (O.R.=1.94; 95% CI=1.25-3.03; p=0.003) remained associated with Axis I psychiatric comorbidities. We concluded that a combination of clinical variables and selected structural abnormalities of the central nervous system contributes to the development of psychiatric comorbidities in patients with focal epilepsy. (C) 2012 Published by Elsevier Inc.

Aquaporin-4 Antibodies Are Not Related to HTLV-1 Associated Myelopathy

Introduction: The seroprevalence of human T-cell leukemia virus type 1 (HTLV-1) is very high among Brazilians (,1:200). HTLV-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP) is the most common neurological complication of HTLV-1 infection. HAM/TSP can present with an acute/subacute form of longitudinally extensive myelitis, which can be confused with lesions seen in aquaporin-4 antibody (AQP4-Ab) positive neuromyelitis optica spectrum disorders (NMOSD) on MRI. Moreover, clinical attacks in patients with NMOSD have been shown to be preceded by viral infections in around 30% of cases. Objective: To evaluate the frequency of AQP4-Ab in patients with HAM/TSP. To evaluate the frequency of HTLV-1 infection in patients with NMOSD. Patients and Methods: 23 Brazilian patients with HAM/TSP, 20 asymptomatic HTLV-1+ serostatus patients, and 34 with NMOSD were tested for AQP4-Ab using a standardized recombinant cell based assay. In addition, all patients were tested for HTLV-1 by ELISA and Western blotting. Results: 20/34 NMOSD patients were positive for AQP4-Ab but none of the HAM/TSP patients and none of the asymptomatic HTLV-1 infected individuals. Conversely, all AQP4-Ab-positive NMOSD patients were negative for HTLV-1 antibodies. One patient with HAM/TSP developed optic neuritis in addition to subacute LETM; this patient was AQP4-Ab negative as well. Patients were found to be predominantly female and of African descent both in the NMOSD and in the HAM/TSP group; Osame scale and expanded disability status scale scores did not differ significantly between the two groups. Conclusions: Our results argue both against a role of antibodies to AQP4 in the pathogenesis of HAM/TSP and against an association between HTLV-1 infection and the development of AQP4-Ab. Moreover, the absence of HTLV-1 in all patients with NMOSD suggests that HTLV-1 is not a common trigger of acute attacks in patients with AQP4-Ab positive NMOSD in populations with high HTLV-1 seroprevalence.

Análisis geográfico de las actuales relaciones comerciales entre Canarias y Marruecos

[ES] En este trabajo formulamos como hipótesis de partida que Canarias, como frontera meridional de Europa, en un contexto de creciente internacionalización, tiene en los mercados africanos una gran baza histórica que desempeñar. Dado el interés general que este asunto suscita entre las ciencias sociales, se requiere abordarlo desde el análisis geográfico. Para cumplimentar este estudio se emplearon las estadísticas que ofrecen organismos oficiales como el Instituto Nacional de Estadística, Instituto Canario de Estadística, Agencia Estatal de la Administración Tributaria, Instituto de Comercio Exterior y entidades internacionales como la Conferencia de las Naciones Unidas para el Comercio y el Desarrollo (UNCTAD) y la Organización Mundial del Comercio (OCM).

["Constanze": a trinational project on avian influenza in wild birds at Lake Constance]

When highly pathogenic avian influenza H5N1 (HPAI H5N1) arrived at Lake Constance in February 2006, little was known about its ecology and epidemiology in wild birds. In order to prevent virus transmission from wild birds to poultry, the adjacent countries initiated the tri-national, interdisciplinary research program <> to investigate avian influenza infections in water birds at Lake Constance. In collaboration with government agencies scientists examined the prevalence of AI virus in the region of Lake Constance for a period of 33 months, compared the effectiveness of different surveillance methods and analysed the migration behaviour of water birds. Although virus introduction from regions as far as the Ural Mountains seemed possible based on the migration behaviour of certain species, no influenza A viruses of the highly pathogenic subtype H5N1 (HPAIV) was found. However, influenza A viruses of different low pathogenic subtypes were isolated in 2.2 % of the sampled birds (swabs). Of the different surveillance methods utilised in the program the sampling of so called sentinel birds was particularly efficient.

EPA's Council for Regulatory Environmental Modeling : a case study of science policy implementation

As environmental problems became more complex, policy and regulatory decisions become far more difficult to make. The use of science has become an important practice in the decision making process of many federal agencies. Many different types of scientific information are used to make decisions within the EPA, with computer models becoming especially important. Environmental models are used throughout the EPA in a variety of contexts and their predictive capacity has become highly valued in decision making. The main focus of this research is to examine the EPA’s Council for Regulatory Modeling (CREM) as a case study in addressing science issues, particularly models, in government agencies. Specifically, the goal was to answer the following questions: What is the history of the CREM and how can this information shed light on the process of science policy implementation? What were the goals of implementing the CREM? Were these goals reached and how have they changed? What have been the impediments that the CREM has faced and why did these impediments occur? The three main sources of information for this research came from observations during summer employment with the CREM, document review and supplemental interviews with CREM participants and other members of the modeling community. Examining a history of modeling at the EPA, as well as a history of the CREM, provides insight into the many challenges that are faced when implementing science policy and science policy programs. After examining the many impediments that the CREM has faced in implementing modeling policies, it was clear that the impediments fall into two separate categories, classic and paradoxical. The classic impediments include the more standard impediments to science policy implementation that might be found in any regulatory environment, such as lack of resources and changes in administration. Paradoxical impediments are cyclical in nature, with no clear solution, such as balancing top-down versus bottom-up initiatives and coping with differing perceptions. These impediments, when not properly addressed, severely hinder the ability for organizations to successfully implement science policy.

Quantifying the ecological benefits of lakeshore restoration in northern Wisconsin

Housing development has increased dramatically in the Midwest with a high concentration around lakes. This development plays an important role in the economy of Northwoods communities. However, poorly planned development has the potential to alter a lake’s ecological processes and integrity. Studies have documented the impacts of housing developments and reported dramatic, negative changes to the flora and fauna in Vilas County, Wisconsin. One component of my research included examining the previously unstudied effects of residential development on the abundance and diversity of medium to large-bodied mammals using lakeshore ecosystems. The results suggest that a higher diversity of mammals were detected on low-development lakes. Coyotes were the most numerous species detected with the majority encountered on low-development lakes. White-tailed deer and red fox were more abundant on high-development lakes as compared to low-development lakes. I concluded that high-development lakes are having a negative affect on the mammal community in this area. Recently, lakeshore restoration has occurred on privately owned property in Vilas County and elsewhere in the Northwoods, but little is known about the benefit, if any, from these restoration efforts. A partnership between government agencies and academia has launched a long-term research project investigating the ecological benefits of lakeshore restoration. I investigated the impacts of using down woody material (DWM) to increase the success of restoration projects. Specifically, I tested the hypothesis that down woody material would reduce the variation in soil temperature, retain soil moisture, and improve plant survival and growth rates. I randomly assigned three DWM coverage treatments (0%, 25%, and 50%) on 3 m × 3 m experimental plots (n = 10 per treatment). The mean maximum soil temperature, temperature variation, and change in soil moisture content were significantly lower in the 25% and 50% DWM plots. I found no difference in survival, but snowberry (Symphoricarpos albus) and Barren strawberry (Waldstenia fragaroides) growth was significant greater in the 25% and 50% DWM plots. DWM addition can be considered a useful technique to physically manipulate soil properties and improve plant growth. Finally, I provided baseline data on vegetation structure, bird and small mammal community diversity and abundance for three lakes targeted for restoration efforts and their paired reference lakes. This study is one of the first of it kind in the area and continuing to document the degree of change in subsequent years will provide insight into the way the local ecosystem functions and how ecological communities are structured.

Development and improvement of warm-mix asphalt technology

Traditionally, asphalt mixtures were produced at high temperatures (between 150°C to 180°C) and therefore often referred to as Hot Mix Asphalt (HMA). Recently, a new technology named Warm Mix Asphalt (WMA) was developed in Europe that allows HMA to be produced at a lower temperature. Over years of research efforts, a few WMA technologies were introduced including the foaming method using Aspha-min® and Advera® WMA; organic additives such as Sasobit® and Asphaltan B®; and chemical packages such as Evotherm® and Cecabase RT®. Benefits were found when lower temperatures were used to produce asphalt mixtures, especially when it comes to environmental and energy savings. Even though WMA has shown promising results in energy savings and emission reduction, however, only limited studies and laboratory tests have been conducted to date. The objectives of this project are to 1) develop a mix design framework for WMA by evaluating its mechanical properties; 2) evaluate performance of WMA containing high percentages of recycled asphalt material; and 3) evaluate the moisture sensitivity in WMA. The test results show that most of the WMA has higher fatigue life and TSR which indicated WMA has better fatigue cracking and moisture damage resistant; however, the rutting potential of most of the WMA tested were higher than the control HMA. A recommended WMA mix design framework was developed as well. The WMA design framework was presented in this study to provide contractors, and government agencies successfully design WMA. Mixtures containing high RAP and RAS were studied as well and the overall results show that WMA technology allows the mixture containing high RAP content and RAS to be produced at lower temperature (up to 35°C lower) without significantly affect the performance of asphalt mixture in terms of rutting, fatigue and moisture susceptibility. Lastly, the study also found that by introducing the hydrated lime in the WMA, all mixtures modified by the hydrated lime passed the minimum requirement of 0.80. This indicated that, the moisture susceptibility of the WMA can be improved by adding the hydrated lime.

Add a Dash of Rhetoric, a Pinch of Technical Communication, a Handful of Pedagogy, and Mix Well: Cookbooks and Recipes as Instructional Texts, and What Domestic Texts from 1870 to 1935 Can Teach Us About Technical Communication

Through the use of rhetoric centered on authority and risk avoidance, scientific method has co-opted knowledge, especially women's everyday and experiential knowledge in the domestic sphere. This, in turn, has produced a profound affect on technical communication in the present day. I am drawing on rhetorical theory to study cookbooks and recipes for their contributions to changes in instructional texts. Using the rhetorical lenses of metis (cunning intelligence), kairos (timing and fitness) and mneme (memory), I examine the way in which recipes and cookbooks are constructed, used and perceived. This helps me uncover lost voices in history, the voices of women who used recipes, produced cookbooks and changed the way instructions read. Beginning with the earliest cookbooks and recipes, but focusing on the pivotal temporal interval of 1870-1935, I investigate the writing and rhetorical forces shaping instruction sets and domestic discourse. By the time of scientific cooking and domestic science, everyday and experiential knowledge were being excluded to make room for scientific method and the industrial values of the public sphere. In this study, I also assess how the public sphere, via Cooperative Extension Services and other government agencies, impacted the domestic sphere, further devaluing everyday knowledge in favor of the public scientific model. I will show how the changes in the production of food, cookbooks and recipes were related to changes in technical communication. These changes had wide rippling effects on the field of technical communication. By returning to some of the tenets and traditions of everyday and experiential knowledge, technical communication scholars, practitioners and instructors today can find new ways to encounter technical communication, specifically regarding the creation of instructional texts. Bringing cookbooks, recipes and everyday knowledge into the classroom and the field engenders a new realm of epistemological possibilities.

EC Electronic Communications and Competition Law

Telecommunications have developed at an incredible speed over the last couple of decades. The decreasing size of our phones and the increasing number of ways in which we can communicate are barely the only result of this (r)evolutionary development. The latter has indeed multiple implications. The change of paradigm for telecommunications regulation, epitomised by the processes of liberalisation and reregulation, was not sufficient to answer all regulatory questions pertinent to communications. Today, after the transition from monopoly to competition, we are faced perhaps with an even harder regulatory puzzle, since we must figure out how to regulate a sector that is as dynamic and as unpredictable as electronic communications have proven to be, and as vital and fundamental to the economy and to society at large. The present book addresses the regulatory puzzle of contemporary electronic communications and suggests the outlines of a coherent model for their regulation. The search for such a model involves essentially deliberations on the question "Can competition law do it all?", since generic competition rules are largely seen as the appropriate regulatory tool for the communications domain. The latter perception has been the gist of the 2002 reform of the European Community (EC) telecommunications regime, which envisages a withdrawal of sectoral regulation, as communications markets become effectively competitive and ultimately bestows the regulation of the sector upon competition law only. The book argues that the question of whether competition law is the appropriate tool needs to be examined not in the conventional contexts of sector specific rules versus competition rules or deregulation versus regulation but in a broader governance context. Consequently, the reader is provided with an insight into the workings and specific characteristics of the communications sector as network-bound, converging, dynamic and endowed with a special societal role and function. A thorough evaluation of the regulatory objectives in the communications environment contributes further to the comprehensive picture of the communications industry. Upon this carefully prepared basis, the book analyses the communications regulatory toolkit. It explores the interplay between sectoral communications regulation, competition rules (in particular Article 82 of the EC Treaty) and the rules of the World Trade Organization (WTO) relevant to telecommunications services. The in-depth analysis of multilevel construct of EC communications law is up-to-date and takes into account important recent developments in the EC competition law in practice, in particular in the field of refusal to supply and tying, of the reform of the EC electronic communications framework and new decisions of the WTO dispute settlement body, such as notably the Mexico-Telecommunications Services Panel Report. Upon these building elements, an assessment of the regulatory potential of the EC competition rules is made. The conclusions drawn are beyond the scope of the current situation of EC electronic communications and the applicable law and explore the possible contours of an optimal regulatory framework for modern communications. The book is of particular interest to communications and antitrust law experts, as well as policy makers, government agencies, consultancies and think-tanks active in the field. Experts on other network industries (such as electricity or postal communications) can also profit from the substantial experience gathered in the communications sector as the most advanced one in terms of liberalisation and reregulation.

Internationale Kontrolle lokaler Verwaltung in einer Konfliktregion. Das Experiment „Freie Stadt Danzig“ (1920-1939)

The Free City of Danzig was founded by the Allies after World War One to settle the conflict between Poles and Germans as to which territory the town belonged. The League of Nations was designated to be the guarantor of its status. British and American experts and policy advisors saw it as an experiment on the way to new forms of statehood, by means of which nationalism as the founding principle of territorial entities could be overcome. However, the „Free City“ status was rejected by both the city’s inhabitants and German and Polish government agencies, with the result that the League and its local representative, the High Commissioner, were constantly confronted with difficulties in the interpretation of the international treaties and conventions relating to Danzig. In addition, hardly anyone in Danzig, Germany or Poland was interested in the economic and financial situation of the Free City, but were more interested in winning political battles than in the well-being of the city and its inhabitants. As a result, the situation in Danzig became more and more hopeless. The city became increasingly dependent on (illegal) German subsidies, while the High Commissioners generally cared more about their own prestige and that of their home countries than about the interests of the League of Nations. But as no political means of modifying the city’s status had been provided for, nothing changed formally in Danzig until Germany started the Second World War and annexed the city in September 1939. In retrospect, the international control of local government could not contribute to a long-term solution for Danzig. It merely postponed its violent solution for twenty years.

The prevalence of burnout among psychologists and psychological associates in the state of Texas

This study investigates the prevalence of burnout among a sample of Texas psychologists and psychological associates as well as differences between the three categories of practitioners within that group (Licensed Psychology Health Care Providers (LPHCP), Licensed Psychologists - Certified Psychologists (LP-CP), Psychological Associates (PA)).^ The Maslach Burnout Inventory and a questionnaire seeking demographic information was used in this cross-sectional survey. Sample size was 654. A stratified proportionate random sample of Texas Psychologists was drawn. The response rate based on usable returns was 55% (n = 359). General demographic characteristics were determined mainly by frequency distributions. For comparing means of samples, t and multiple range tests were used. A series of one-way and two-way analysis of variance procedures were used to compare subgroup differences in burnout.^ The universe was representative for the sample and for the three categories of psychologists. Urban subjects were more likely to respond, as were male PAs. Practitioners were as likely male as female, working in an urban area, in their present job eight years, and in the occupation for fifteen. The LPHCP group were older, had been in psychology and at their present job longer, and were more likely to belong to both state and local professional organizations than the other two groups. Males outnumbered females in this group and in LP-CPs. This gender trend was reversed for PAs. Of the total sample, 76% reported high job satisfaction and 77% had high levels of perceived job autonomy. There was no significant difference between the study sample and the mental health norms in emotional exhaustion (EE). Our sample had significantly less feelings of depersonalization (DP) and higher feelings of personal accomplishment (PA). Psychological Associates felt significantly less personal accomplishment than the other groups. Predictors for the total sample indicated younger practitioners and those with low job satisfaction had significantly higher burnout, as did males when compared to their female cohorts. Some types of jobs were more likely to contribute to burnout than others. Membership in their local area professional organization lessened the chances for burnout significantly. Predictors for categories of psychologists indicated that males in the LPHCP and LP-CP groups were at higher risk than females. Further, for LP-CPs low job satisfaction and job autonomy, as well as job sites, were significant. Those in this group who worked as school psychologists were at the highest risk for burnout. Job dissatisfaction was the major predictor of burnout for psychological associates. Practitioners working in state or government agencies, school systems and administrative jobs generally had higher burnout than those on a university faculty or in private practice. (Abstract shortened by UMI.) ^

Managing the risks of medical technology: Do hazard surveillance systems provide an early warning of medical device problems?

The Food and Drug Administration (FDA) is responsible for risk assessment and risk management in the post-market surveillance of the U.S. medical device industry. One of the FDA regulatory mechanisms, the Medical Device Reporting System (MDR) is an adverse event reporting system intended to provide the FDA with advance warning of device problems. It includes voluntary reporting for individuals, and mandatory reporting for device manufacturers. ^ In a study of alleged breast implant safety problems, this research examines the organizational processes by which the FDA gathers data on adverse events and uses adverse event reporting systems to assess and manage risk. The research reviews the literature on problem recognition, risk perception, and organizational learning to understand the influence highly publicized events may have on adverse event reporting. Understanding the influence of an environmental factor, such as publicity, on adverse event reporting can provide insight into the question of whether the FDA's adverse event reporting system operates as an early warning system for medical device problems. ^ The research focuses on two main questions. The first question addresses the relationship between publicity and the voluntary and mandatory reporting of adverse events. The second question examines whether government agencies make use of these adverse event reports. ^ Using quantitative and qualitative methods, a longitudinal study was conducted of the number and content of adverse event reports regarding breast implants filed with the FDA's medical device reporting system during 1985–1991. To assess variation in publicity over time, the print media were analyzed to identify articles related to breast implant failures. ^ The exploratory findings suggest that an increase in media activity is related to an increase in voluntary reporting, especially following periods of intense media coverage of the FDA. However, a similar relationship was not found between media activity and manufacturers' mandatory adverse event reporting. A review of government committee and agency reports on the FDA published during 1976–1996 produced little evidence to suggest that publicity or MDR information contributed to problem recognition, agenda setting, or the formulation of policy recommendations. ^ The research findings suggest that the reporting of breast implant problems to FDA may reflect the perceptions and concerns of the reporting groups, a barometer of the volume and content of media attention. ^

EC Electronic Communications and Competition Law

Telecommunications have developed at an incredible speed over the last couple of decades. The decreasing size of our phones and the increasing number of ways in which we can communicate are barely the only result of this (r)evolutionary development. The latter has indeed multiple implications. The change of paradigm for telecommunications regulation, epitomised by the processes of liberalisation and reregulation, was not sufficient to answer all regulatory questions pertinent to communications. Today, after the transition from monopoly to competition, we are faced perhaps with an even harder regulatory puzzle, since we must figure out how to regulate a sector that is as dynamic and as unpredictable as electronic communications have proven to be, and as vital and fundamental to the economy and to society at large. The present book addresses the regulatory puzzle of contemporary electronic communications and suggests the outlines of a coherent model for their regulation. The search for such a model involves essentially deliberations on the question "Can competition law do it all?", since generic competition rules are largely seen as the appropriate regulatory tool for the communications domain. The latter perception has been the gist of the 2002 reform of the European Community (EC) telecommunications regime, which envisages a withdrawal of sectoral regulation, as communications markets become effectively competitive and ultimately bestows the regulation of the sector upon competition law only. The book argues that the question of whether competition law is the appropriate tool needs to be examined not in the conventional contexts of sector specific rules versus competition rules or deregulation versus regulation but in a broader governance context. Consequently, the reader is provided with an insight into the workings and specific characteristics of the communications sector as network-bound, converging, dynamic and endowed with a special societal role and function. A thorough evaluation of the regulatory objectives in the communications environment contributes further to the comprehensive picture of the communications industry. Upon this carefully prepared basis, the book analyses the communications regulatory toolkit. It explores the interplay between sectoral communications regulation, competition rules (in particular Article 82 of the EC Treaty) and the rules of the World Trade Organization (WTO) relevant to telecommunications services. The in-depth analysis of multilevel construct of EC communications law is up-to-date and takes into account important recent developments in the EC competition law in practice, in particular in the field of refusal to supply and tying, of the reform of the EC electronic communications framework and new decisions of the WTO dispute settlement body, such as notably the Mexico-Telecommunications Services Panel Report. Upon these building elements, an assessment of the regulatory potential of the EC competition rules is made. The conclusions drawn are beyond the scope of the current situation of EC electronic communications and the applicable law and explore the possible contours of an optimal regulatory framework for modern communications. The book is of particular interest to communications and antitrust law experts, as well as policy makers, government agencies, consultancies and think-tanks active in the field. Experts on other network industries (such as electricity or postal communications) can also profit from the substantial experience gathered in the communications sector as the most advanced one in terms of liberalisation and reregulation.