Peadiatric social admission

The phenomenon of paediatric social admission describes the hospitalisation of children for medicallynon- urgent and/or social reasons. Much of the research in this field has been in relation to avoidable admissions which have been identified, studied and condoned based on strict medical criteria. Such research has tended to mask the significance of social factors and the commonplace practice of Paediatric Social Admission. This paper examines decision making from the perspective of the health professionals at the clinical coal face. It explores how health professionals are influenced by social, organisational and subjective factors which determine their decision to admit or not to admit a child to hospital. The paper reports findings from interviews with 27 health professionals involved in PSA and a document audit of 21 specific cases. In doing so it begins to address the inherent paradox of responding to a child and families social needs in a medical context.

Help or hindrance? Supplier involvement and causal ambiguity within inter-organisational NPD teams

Suppliers are increasingly involved in buyer firms’ interorganizational new product development (NPD) teams. Yet the transfer of knowledge within this context may be subject to varying degrees of causal ambiguity, potentially limiting the effect of supplier involvement on performance. We develop a theoretical model exploring the effect of supplier involvement practices on the level of causal ambiguity within interorganizational NPD teams, and the subsequent impact on competitor imitation, new product advantage, and project performance. Our model also serves as a test of the paradox that causal ambiguity both inhibits imitation by competitors, but also adversely affects organisational outcomes. Results from an empirical study of 119 R&D intensive manufacturing firms in the United Kingdom largely support these hypotheses. Results from structural equation modeling show that supplier involvement orientation and long-term commitment lower causal ambiguity within interorganizational NPD teams. In turn, this lower causal ambiguity generates a new product advantage and increases project performance for the buyer firm, but has no significant effect on competitor imitation. Instead, competitor imitation is delayed by the extent to which the firm develops a new product advantage within the market. These results shed light on the causal ambiguity paradox showing that lower causal ambiguity during interorganizational new product development increases both product and project performance, but without reducing barriers to imitation. Product development managers are encouraged to utilize supplier involvement practices to minimise ambiguity in the NPD project, and to target their supplier involvement efforts on solving causally ambiguous technological problems to sustain a competitive advantage.

Phototextual Journeys: Nicolas Bouvier in Asia

Travel literature's inherent intergenericity extends into the realm of the interaesthetic in Nicolas Bouvier's textual and photographic representations of Asia. Although produced as distinct narratives, successive editorial decisions and the layering of these two media in the mind of the reader have transformed Bouvier's already palimpsestic texts into fluid, phototextual constructs. This article will offer ‘contrapuntal’ readings of a selection of Bouvier's texts in relation to the photographs charting his intercultural encounters in China and Japan. Countering the relegation of these photographs to the conventional status of aide-mémoire, the article will consider the shifting relationships of complementarity, tension, or disjuncture between image and text. These relationships are characterised by slippage, subversion and paradox. Text does not ‘load’ image, and images do not illustrate text. Indeed, Bouvier's photographs frequently contest, modify, or debunk the textual narratives. Ultimately, the article will argue that Bouvier's representations of Asia, both textual and visual, offer a challenge to cultural essentialism, to self-other binaries, and to monolithic discourses of otherness.

Association Analysis of the PIP4K2A Gene on Chromosome 10p12 and Schizophrenia in the Irish Study of High Density Schizophrenia Families (ISHDSF) and the Irish Case-Control Study of Schizophrenia (ICCSS)

Molecular studies support pharmacological evidence that phosphoinositide signaling is perturbed in schizophrenia and bipolar disorder. The phosphatidylinositol-4-phosphate-5-kinase type-II alpha (PIP4K2A) gene is located on chromosome 10p12. This region has been implicated in both diseases by linkage, and PIP4K2A directly by association. Given linkage evidence in the Irish Study of High Density Schizophrenia Families (ISHDSF) to a region including 10p12, we performed an association study between genetic variants at PIP4K2A and disease. No association was detected through single-marker or haplotype analysis of the whole sample. However, stratification into families positive and negative for the ISHDSF schizophrenia high-risk haplotype (HRH) in the DTNBP1 gene and re-analysis for linkage showed reduced amplitude of the 10p12 linkage peak in the DTNBP1 HRH positive families. Association analysis of the stratified sample showed a trend toward association of PIP4K2A SNPs rs1417374 and rs1409395 with schizophrenia in the DTNBP1 HRH positive families. Despite this apparent paradox, our data may therefore suggest involvement of PIP4K2A in schizophrenia in those families for whom genetic variation in DTNBP1 appears also to be a risk factor. This trend appears to arise from under-transmission of common alleles to female cases. Follow-up association analysis in a large Irish schizophrenia case-control control sample (ICCSS) showed significant association with disease of a haplotype comprising these same SNPs rs1417374-rs1409395, again more so in affected females, and in cases with negative family history of the disease. This study supports a minor role for PIP4K2A in schizophrenia etiology in the Irish population. (C) 2009 Wiley-Liss, Inc.

Apc(MIN) modulation of vitamin D secosteroid growth control

A central paradox of vitamin D biology is that 1alpha,25-(OH)(2) D(3) exposure inversely relates to colorectal cancer (CRC) risk despite a capacity for activation of both pro- and anti-oncogenic mediators including osteopontin (OPN)/CD44 and E-cadherin, respectively. Most sporadic CRCs arise from adenomatous polyposis coli (APC) gene mutation but understanding of its effects on vitamin D growth control is limited. Here we investigate effects of the Apc(Min/+) genotype on 1alpha,25-(OH)(2) D(3) regulation of OPN/CD44/E-cadherin signalling and intestinal tumourigenesis, in vivo. In untreated Apc(Min/+) versus Apc(+/+) intestines, expression levels of OPN and its CD44 receptor were increased, whereas E-cadherin tumour suppressor signalling was attenuated. Treatment by 1alpha,25-(OH)(2) D(3) or rationally designed analogues (QW or BTW) enhanced OPN but inhibited expression of CD44, the OPN receptor implicated in cell growth. These treatments also enhanced E-cadherin tumour suppressor activity, characterized by inhibition of beta-catenin nuclear localization, T-cell factor 1 and c-myelocytomatosis protein expression in Apc(Min/+) intestine. All secosteroids suppressed Apc(Min/+)-driven tumourigenesis although QW and BTW had lower calcium-related toxicity. Taken together, these data indicate that the Apc(Min/+) genotype modulates vitamin D secosteroid actions to promote functional predominance of E-cadherin tumour suppressor activity within antagonistic molecular networks. APC heterozygosity may promote favourable tissue- or tumour-specific conditions for growth control by vitamin D secosteroid treatment.

A Syntax-based approach to measuring the degree of inconsistency for belief bases

Measuring the degree of inconsistency of a belief base is an important issue in many real world applications. It has been increasingly recognized that deriving syntax sensitive inconsistency measures for a belief base from its minimal inconsistent subsets is a natural way forward. Most of the current proposals along this line do not take the impact of the size of each minimal inconsistent subset into account. However, as illustrated by the well-known Lottery Paradox, as the size of a minimal inconsistent subset increases, the degree of its inconsistency decreases. Another lack in current studies in this area is about the role of free formulas of a belief base in measuring the degree of inconsistency. This has not yet been characterized well. Adding free formulas to a belief base can enlarge the set of consistent subsets of that base. However, consistent subsets of a belief base also have an impact on the syntax sensitive normalized measures of the degree of inconsistency, the reason for this is that each consistent subset can be considered as a distinctive plausible perspective reflected by that belief base,whilst eachminimal inconsistent subset projects a distinctive viewof the inconsistency. To address these two issues,we propose a normalized framework formeasuring the degree of inconsistency of a belief base which unifies the impact of both consistent subsets and minimal inconsistent subsets. We also show that this normalized framework satisfies all the properties deemed necessary by common consent to characterize an intuitively satisfactory measure of the degree of inconsistency for belief bases. Finally, we use a simple but explanatory example in equirements engineering to illustrate the application of the normalized framework.

Non-union employee representation, union avoidance and the managerial agenda

Non-union employee representation is an area which has attracted much interest in the voice literature. Much of the literature has been shaped by a dialogue which considers NERs as a means of union avoidance. More recently however scholars have suggested that for NERs to work in such contexts, they may need to be imbued with a higher set of functionalities to remain viable entities. Using a critical case study of a union recognition drive and managerial response in the form of an NER, this article contributes to a more nuanced interpretation of the literature dialogue than hitherto exists. A core component of the findings directly challenge existing interpretations within the field; namely that NERs are shaped by a paradox of managerial action. It is argued that the NER failed to satisfy for employees because of a structural remit, rather than through any paradox in managerial intent.

Inclusive development? State-led land development model in New Town, Kolkata

Urban land development in India is changing under the auspices of economic liberalisation. Kolkata has been in the forefront of this transformation through development of new townships in the urban peripheries based on a distinctive state-led land development model. Within this context New Town, Kolkata (also known as Rajarhat) provides a highly illuminative case to articulate the ways in which the state is implementing its neoliberal agenda in land development. It rides on political and ideological high ground by seeking to create a ‘model development’ of state–market partnership for dual goals of fostering capitalist interest while fulfilling welfarist principles. Interesting insights have emerged that point to a policy paradox. On one hand, the process follows market principles of efficacy and efficiency; on the other hand, state’s keenness to extend control persists, thereby creating a highly uneven terrain for state–market interaction. New Town reflects a typical quasi-market condition shaped by the monopolistic state, the poorly structured role of the private sector, an absence of civic bodies, and minimal land and housing provision for the poor. In India, as internationally, the economic liberalisation market ideology is increasingly construed as good governance. In this context New Town is a step in the right direction, but the progress is patchy, uneven, and still evolving.

Long-term bone marrow culture profiles in patients with myelodysplastic syndromes are not explicable by defective apoptosis

It has been suggested that increased intramedullary apoptosis may explain the paradox between peripheral blood cytopenias and the hyper- or normo-cellular bone marrow observed in the myelodysplastic syndromes (MDS). We wished to see if culture performance could be related to the presence of apoptotic cells in a group of patients with MDS (12 patients) and other patients with peripheral blood cytopenias (six patients) which caused diagnostic difficulty. There was no correlation between LTBMC or adherent cell growth and the presence of apoptotic cells in the original marrow sample. A variable degree of apoptosis was observed in both groups of patients. LTBMC profiles correlated well with diagnosis but were unrelated to the extent of intramedullary apoptosis. This suggests that apoptosis is a much more ubiquitous process in disease than previously thought. (C) 1998 Elsevier Science Ltd. All rights reserved.

Dirty Hands and the Complicity of the Democratic Public

The alleged problem of the dirty hands of politicians has been much discussed since Michael Walzer’s original piece (Walzer 1974). The discussion has concerned the precise nature of the problem or sought to dissolve the apparent paradox. However there has been little discussion of the putative complicity, and thus also dirtying of hands, of a democratic public that authorizes politicians to act in its name. This article outlines the sense in which politicians do get dirty hands and the degree to which a democratic public may also get dirty hands. It separates the questions of secrecy, authorisation, and wrongfulness in order to spell out the extent of public complicity. Finally it addresses the ways in which those who do and those who do not acknowledge the problem of dirty hands erroneously discount or deny the problem of complicity by an appeal to the nature of democracy, a putatively essential need for political openness or to the scope of ideal theory.

Defending the Faith(s)?:Democracy and Hereditary Right in England

The persistence of traditional monarchies in modern societies, which are otherwise characterized by democratic and egalitarian values, remains a paradox in the social sciences. In part this is attributable to the lack of psychological investigation into the relationship between subject and sovereign, and in particular the ways in which the political and social values of the citizenry shape understandings of a hereditary monarch’s right to represent a national community. Adopting the qualitative analysis methods of discursive psychology and grounded theory, the current study examines vernacular accounts of nationhood and monarchy in England in both formalized conversational interviews (n = 60) and impromptu street interviews (n = 56). Focusing on accounts of Prince Charles’s recent proposal to change the role of the monarch, from “Defender of the (Christian) Faith” to “Defender of Faiths,” those in favor treated it as a positive step towards reflecting a diverse (religious) community, bringing the monarchy into line with current concerns of pluralism and upholding
values of personal choice and individual rights. Participants who rejected the proposed change in title construed it as antithetical to these values in terms of reflecting personal stake and interest, an abuse of power, or an imposition on other faiths. In all accounts, the prime concern was in safeguarding the political and social values of the citizenry. In conclusion it is argued that the study of subjects’ relationship to the monarch, its function and legitimacy, can provide an opportunity to examine how values can characterize a national community and facilitate national diversity.

Coelum non animum muto? Milton's Neo-Latin Poetry and Catholic Italy

Milton’s Elegiarum Liber, the first half of his Poemata published in Poems of Mr John Milton Both English and Latin (1645), concludes with a series of eight Latin epigrams: five bitterly anti-Catholic pieces on the failed Gunpowder Plot of 1605, followed by three encomiastic poems hymning the praises of an Italian soprano, Leonora Baroni, singing in Catholic Rome. The disparity in terms of subject matter and tone is self-evident yet surprising in an epigrammatic series that runs sequentially. Whereas the gunpowder epigrams denigrate Rome, the Leonora epigrams present the city as a cultured hub of inclusivity, the welcome host of a Neapolitan soprano. In providing the setting for a human song that both enthrals its audience and attests to the presence of a divine power, Rome now epitomizes something other than brute idolatry, clerical habit or doctrine. And for the poet this facilitates an interrogation of theological (especially Catholic) doctrines. Coelum non animum muto, dum trans mare curro wrote the homeward-bound Milton in the autograph book of Camillo Cardoini at Geneva on 10 June 1639. But that this was an animus that could indeed acclimatize to religious and cultural difference is suggested by the Latin poems which Milton “patch [ed] up” in the course of his Italian journey. Central to that acclimatisation, as this chapter argues, is Milton’s quasi-Catholic self-fashioning. Thus Mansus offers a poetic autobiography of sorts, a self-inscribed vita coloured by intertextually kaleidoscopic links with two Catholic poets of Renaissance Italy and their patron; Ad Leonoram 1 both invokes and interrogates Catholic doctrine before a Catholic audience only to view the whole through the lens of a neo-Platonic hermeticism that may refreshingly transcend religious difference. Finally, Epitaphium Damonis, composed upon Milton’s return home, seems to highlight the potential interconnectedness of Protestant England and Catholic Italy, through the Anglo-Italian identity of its deceased subject, and through a pseudo-monasticism suggested by the poem’s possible engagement with the hagiography of a Catholic Saint. Perhaps continental travel and the physical encounter with the symbols, personages and institutions of the other have engendered in the Milton of the Italian journey a tolerance or, more accurately, the manipulation of a seeming tolerance to serve poetic and cultural ends.


First reviewer:
Haan: a fine piece by the senior neo-Latinist in Milton studies.

Second reviewer:
Chapter 7 is ... a high-spot of the collection. Its argument that in his Latin poetry Milton’s is a ‘quasi-Catholic self-fashioning’ stressing ‘the potential interconnectedness of Protestant England and Catholic Italy’ is striking and is advanced with learning, clarity and insight. Its sensitive exploration of the paradox of Milton’s coupling of humanistically complimentary and tolerant address to Roman Catholic friends with fiercely Protestant partisanship demonstrates that there is much greater complexity to his poetic persona than the self-construction and self-presentation of the later works would suggest. The essay is always adroit and sure-footed, often critically acute and illuminating (as, for example, in its discussion of the adjective and adverb mollis and molliter in Mansus, or in the identification in n. 99 of hitherto unnoticed Virgilian echoes). It has the added merits of being very well written, precise and apt in its citation of evidence, and absolutely central to the concerns of the volume.

Measles immune suppression:lessons from the Macaque Model

Measles remains a significant childhood disease, and is associated with a transient immune suppression. Paradoxically, measles virus (MV) infection also induces robust MV-specific immune responses. Current hypotheses for the mechanism underlying measles immune suppression focus on functional impairment of lymphocytes or antigen-presenting cells, caused by infection with or exposure to MV. We have generated stable recombinant MVs that express enhanced green fluorescent protein, and remain virulent in non-human primates. By performing a comprehensive study of virological, immunological, hematological and histopathological observations made in animals euthanized at different time points after MV infection, we developed a model explaining measles immune suppression which fits with the "measles paradox". Here we show that MV preferentially infects CD45RA - memory T-lymphocytes and follicular B-lymphocytes, resulting in high infection levels in these populations. After the peak of viremia MV-infected lymphocytes were cleared within days, followed by immune activation and lymph node enlargement. During this period tuberculin-specific T-lymphocyte responses disappeared, whilst strong MV-specific T-lymphocyte responses emerged. Histopathological analysis of lymphoid tissues showed lymphocyte depletion in the B- and T-cell areas in the absence of apoptotic cells, paralleled by infiltration of T-lymphocytes into B-cell follicles and reappearance of proliferating cells. Our findings indicate an immune-mediated clearance of MV-infected CD45RA - memory T-lymphocytes and follicular B-lymphocytes, which causes temporary immunological amnesia. The rapid oligoclonal expansion of MV-specific lymphocytes and bystander cells masks this depletion, explaining the short duration of measles lymphopenia yet long duration of immune suppression. © 2012 de Vries et al.