Role of endogenous opioids on nociceptive threshold in patients with exercise-induced myocardial ischemia.

To evaluate whether endogenous opioids (EO) play a role in the perception of anginal pain, a randomized double blind clinical trial, using naloxone (N) and placebo (P) and measuring beta-endorphin (beta-ep) plasma levels, was performed. We studied 10 patients with angiographically assessed coronary artery disease (CAD) and stable exercise-induced myocardial ischemia (established by 2 preliminary bicycle ergometric tests) of whom 5 symptomatic (SYM) and 5 asymptomatic (ASYM) and 5 subjects without CAD as a control group (CON). On a third exercise test the beta-ep plasma level (fmol/ml) was measured at rest (SYM 5.4 +/- 2.3 vs ASYM 7.2 +/- 2.3 vs CON 6.8 +/- 2.6, NS), at peak exercise (SYM 4.4 +/- 1.8 vs ASYM 8.0 +/- 4.2 and vs CON 6.2 +/- 2.7, NS) and during recovery (SYM 7.5 +/- 4.2 vs ASYM 7.2 +/- 3.0 vs CON 6.7 +/- 2.5, NS). On 2 subsequent tests patients received N (0.2 mg/kg) or P intravenously and chest pain was evaluated on an analogue scale (score from 1 to 10). After N compared to P we observed: an increased perception of chest pain in SYM (6.8 +/- 1.5 vs 4.2 +/- 1.0; p less than 0.01) without significant changes of the ischemic threshold (total work, heart rate-blood pressure product, ST segment changes, 2D-echocardiographic wall motion abnormalities); no modifications in ASYM and CON.(ABSTRACT TRUNCATED AT 250 WORDS

Explaining Neighborhood Organizations (Greensboro, Exit/Voice, Community, North Carolina, Political Participation).

Neighborhood groups represent the most basic level of quasi-political organization in the United States. Participation in these groups and the number of groups in existence has risen dramatically in the 1970's and 1980's. Although a great deal of research has been done on the phenomenon of neighborhood organizations, a general theory of their existence and growth has yet to be developed. This dissertation begins to develop such a theory based on the Exit/Voice theory of Albert Hirschman. Neighborhood organizations are hypothesized to be functional to city governments in that these organizations represent a relatively inexpensive way for cities to fulfill Voice needs of their populations. An elaborated neighborhood organization structure should thus stabilize city populations and potentially reduce the outflow of middle class, taxpaying residents from cities. Data from a general survey of Greensboro, North Carolina are used to look at the determinants of neighborhood organization activity. Residents of Greensboro see three general areas of problems in their neighborhoods. These were titled seediness problems, public works problems and nuisance problems. Each of these has a different set of variables which explains problem perception. Public works problems are better explained by situational conditions, seediness problems are better explained by personal attributes and nuisance problems are better explained by a combination of both. Problem perception is related to overall levels of neighborhood satisfaction which, in turn, is related to intention to Exit from the neighborhood. Participation in neighborhood organizations appears to reduce the intention to Exit from a neighborhood where minor levels of problems are perceived to occur. Participation in politics at the city level reduces that intention better than participation in neighborhood groups where problems become more major. The implications of these findings are probed and policy options for city governments are suggested.Ph.D.Political scienceUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/161026/1/8612622.pd

Challenges to Federalism: Homeland Security and Disaster Response

This article examines the state of federalism in the Bush Administration from the perspective of the policy area of homeland security and disaster response. The article uses the International City and County Management Association homeland security survey completed in the spring and summer of 2005 as a source of data. The article argues that while it is tempting to look for one single agency to control homeland security and disaster response, a networked model is better supported by the survey data and by recent experience in terrorist and natural disaster response. Copyright 2008, Oxford University Press.