bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescents’ experiences of coping with domestic violence
Authors: Lepistö Sari , Åstedt‐Kurki Päivi , Joronen Katja , Luukkaala Tiina , Paavilainen Eija
Published: April 2010

lepistö s., åstedt‐kurki p., joronen k., luukkaala t. & paavilainen e. (2010) Adolescents’ experiences of coping with domestic violence. Journal of Advanced Nursing 66(6), 1232–1245.

Title.  Adolescents’ experiences of coping with domestic violence.

Aim.  This paper is a report of a study of experiences of domestic violence and coping among ninth‐grade (14–17 years old) adolescents.

Background.  Domestic violence is commonplace and adolescents are involved in it either as witnesses or victims. Research has shown that different degrees of domestic violence play a major role in adolescent well‐being and coping.

Method.  A survey of ninth graders in one municipality in Finland was conducted in 2007. A total of 1393 adolescents participated, giving a 78% response rate. The survey included two validated scales, the Violence Scale and the Adolescent Coping Scale. Logistic regression analysis was performed to determine coping among adolescents with and without experience of domestic violence.

Results.  Sixty‐seven per cent of adolescents had experienced parental symbolic aggression, 55% mild violence and 9% serious violence. The multivariate logistic regression model showed that experiences of violence were associated with deterioration in self‐rated health, life satisfaction, adolescent giving in when in a conflict situation, approval of corporal punishment and coping by seeking to belong and self‐blame. Those with experience of domestic violence did not seek professional help.

Conclusion.  Adolescents experiencing domestic violence do not seek help and care providers should therefore take active measures to help them. These adolescents reported that they were satisfied with life, which makes it difficult to identify their need for help. Resources should be developed to identify and help these adolescents.
Clinical Learning Environment Inventory: factor analysis
Authors: Newton Jennifer M. , Jolly Brian C. , Ockerby Cherene M. , Cross Wendy M.
Published: April 2010

newton j.m., jolly b.c., ockerby c.m. & cross w.m. (2010) Clinical Learning Environment Inventory: factor analysis.Journal of Advanced Nursing 66(6), 1371–1381.

Title. Clinical Learning Environment Inventory: factor analysis.

Aim. This paper is a report of the psychometric testing of the Clinical Learning Environment Inventory.

Background. The clinical learning environment is a complex socio‐cultural entity that offers a variety of opportunities to engage or disengage in learning. The Clinical Learning Environment Inventory is a self‐report instrument consisting of 42 items classified into six scales: personalization, student involvement, task orientation, innovation, satisfaction and individualization. It was developed to examine undergraduate nursing students’ perceptions of the learning environment whilst on placement in clinical settings.

Method. As a component of a longitudinal project, Bachelor of Nursing students (n = 659) from two campuses of a university in Australia, completed the Clinical Learning Environment Inventory from 2006 to 2008. Principal components analysis using varimax rotation was conducted to explore the factor structure of the inventory.

Results. Data for 513 students (77%) were eligible for inclusion. Constraining data to a 6‐factor solution explained 51% of the variance. The factors identified were: student‐centredness, affordances and engagement, individualization, fostering workplace learning, valuing nurses’ work, and innovative and adaptive workplace culture. These factors were reviewed against recent theoretical developments in the literature.

Conclusion. The study offers an empirically based and theoretically informed extension of the original Clinical Learning Environment Inventory, which had previously relied on ad hoc clustering of items and the use of internal reliability of its sub‐scales. Further research is required to establish the consistency of these new factors.
Experience of parents with head and neck cancer who are caring for young children
Authors: Semple Cherith J. , McCance Tanya
Published: April 2010

semple c.j. & mccance t. (2010) Experience of parents with head and neck cancer who are caring for young children. Journal of Advanced Nursing 66(6), 1280–1290.

Title.  Experience of parents with head and neck cancer who are caring for young children.

Aim.  This paper is a report of a study exploring the experience and support needs of parents with head and neck cancer, who are also caring for their young children.

Background.  The incidence of head and neck cancer is steadily rising in the younger age groups (under 50 years). As a direct consequence, more parents of young children are being diagnosed with this cancer.

Methods.  Using a qualitative descriptive design, 12 patients with young children under the age of 16 were interviewed during 2008. The data were analysed using cognitive mapping.

Findings.  At diagnosis, parents experienced the fear of missing milestones in the life of their children and fear of telling the children about their diagnosis. During treatment, parents’ inevitable stays in hospital led to separation from the children and the need to prepare their children for the first hospital visit. Parents experienced many debilitating effects of treatment, which had an impact on family activities, especially those that involved eating. There was often changing roles within the family. After treatment, the experience of living with cancer for parents resulted in the desire to get back to day‐to‐day life. Parents had an increased appreciation of life but were also living with uncertainties. The most important support networks for parents were their spouse, family and friends.

Conclusion.  Oncology nurses are in an excellent position to offer support and guidance to parents with cancer who have children, and should encourage them to explore with the family the best way of managing role change during treatment.
Human non‐rapid eye movement stage II sleep spindles are blocked upon spontaneous K‐complex coincidence and resume as higher frequency spindles afterwards
Authors: KOKKINOS VASILEIOS , KOSTOPOULOS GEORGE K.
Published: May 2010

The purpose of this study was to investigate a potential relation between the K‐complex (KC) and sleep spindles of non‐rapid eye movement (NREM) stage II of human sleep. Using 58 electroencephalogram electrodes, plus standard electrooculogram and electromyogram derivations for sleep staging, brain activity during undisturbed whole‐night sleep was recorded in six young adults (one of them participated twice). NREM stage II spindles (1256 fast and 345 slow) and 1131 singular generalized KCs were selected from all sleep cycles. The negative peak of the KC, the positive peak of the KC (where applicable), and the prominent negative wave peak of slow and fast spindles were marked as events of reference. Fast Fourier transform‐based time–frequency analysis was performed over the marked events, which showed that: (a) fast spindles that happen to coincide with KC are interrupted (100% of 403 cases) and in their place a slower rhythmic oscillation often (80%) appears; and (b) spindles that are usually (72% of 1131) following KCs always have a higher frequency (by ∼1 Hz) than both the interrupted spindles and the individual fast spindles that are not in any way associated with a KC. This enhancement of spindle frequency could not be correlated to any of the KC parameters studied. The results of this study reveal a consistent interaction between the KC and the sleep spindle during NREM stage II in human sleep.
Low retention of HIV‐infected patients on antiretroviral therapy in 11 clinical centres in West Africa
Authors: Ekouevi Didier K. , Balestre Eric , Ba‐Gomis Franck‐Olivier , Eholie Serge Paul , Maiga Moussa , Amani‐Bosse Clarisse , Minga Albert , Messou Eugène , Sow Papa Salif , Lewden Charlotte , Traoré Hamar Allassane , Bissagnene Emmanuel , Dabis François ,   for the IeDEA West Africa Collaboration
Published: April 2010

Objective  To study factors associated with the probability of retention in antiretroviral therapy (ART) programmes in West Africa.

Methods  The International epidemiologic Databases to Evaluate AIDS (IeDEA) in West Africa is a prospective, operational, observational cohort study based on collaboration between 11 cohorts of HIV‐infected adult patients in Benin, Côte d’Ivoire, Gambia, Mali and Senegal. All patients aged 16 and older at ART initiation, with documented gender and date of ART initiation, were included. For those with at least 1 day of follow‐up, Kaplan–Meier method and Weibull regression model were used to estimate the 12‐month probability of retention in care and the associated factors.

Results  In this data merger, 14 352 patients (61% female) on ART were included. Median age was 37 (interquartile range (IQR): 31–44 years) and median CD4 count at baseline was 131 cells/mm3 (IQR: 48–221 cells/mm3). The first‐line regimen was NNRTI‐based for 78% of patients, protease inhibitor‐based for 17%, and three NRTIs for 3%. The probability of retention was 0.90 [95% confidence interval (CI): 0.89–0.90] at 3 months, 0.84 (95% CI: 0.83–0.85) at 6 months and 0.76 (95% CI: 0.75–0.77) at 12 months. The probability of retention in care was lower in patients with baseline CD4 count <50 cells/mm3 [adjusted hazard ratio (aHR) = 1.37; 95% CI: 1.27–1.49; P < 0.0001] (reference CD4 > 200 cells/mm3, in men (aHR = 1.17; 95% CI: 1.10–1.24; P = 0.0002), in younger patients (<30 years) (aHR = 1.10; 95% CI: 1.03–1.19; P = 0.01) and in patients with low haemoglobinaemia <8 g/dl (aHR = 1.33; 95% CI: 1.21–1.45; P < 0.0001). Availability of funds for systematic tracing was associated with better retention (aHR = 0.29; 95% CI: 0.16–0.55; P = 0.001).

Conclusions  Close follow‐up, promoting early access to care and ART and a decentralized system of care may improve the retention in care of HIV‐infected patients on ART.
Situational analysis of varying models of adherence support and loss to follow up rates; findings from 27 treatment facilities in eight resource limited countries
Authors: Etienne M. , Burrows L. , Osotimehin B. , Macharia T. , Hossain B. , Redfield R. R. , Amoroso A.
Published: April 2010

Objectives  Large‐scale provision of ART in the absence of viral load monitoring, resistance testing, and limited second‐line treatment options places adherence support as a vital therapeutic intervention. We aimed to compare patient loss to follow up rates with the degree of adherence support through a retrospective review of patients enrolled in the AIDSRelief program between August 2004 and June 2005.

Methods  Loss to follow up data were analysed and programs were categorised into one of four tiered levels of adherence support models: Tier I, II, III, and IV which increase from lowest to highest support. Bivariate and t‐test analyses were used to test for significant differences between the models.

Results  13,391 patients at 27 treatment facilities from six African and two Caribbean countries began antiretroviral therapy within the first year of the AIDSRelief program. The mean loss to follow up within the first year was 7.5%. Eight facilities were Tier I, three (Tier II), nine (Tier III), and seven (Tier IV). Facilities in Tier I had a loss to follow up rate of 14%, Tier II (10%), Tier III (5%), and Tier IV (1%). The proportion of loss to follow up for Tier I and Tier III were significantly different from each other (P < 0.02), as were Tier I and Tier IV (P < 0.006). There were differences between Tier II and Tier IV (P < 0.009) as well as Tier III and Tier IV (P < 0.017).

Conclusion  These data strongly support the use of proactive adherence support programs, beyond routine patient counselling and defaulter tracking to support the’public health approach’to ART.
Depressive symptoms and mortality in lung transplant
Authors: Evon Donna M. , Burker Eileen J. , Galanko Joseph A. , Dedert Eric , Egan Thomas M.
Published: April 2010

Evon DM, Burker EJ, Galanko JA, Dedert E, Egan TM. Depressive symptoms and mortality in lung transplant. Clin Transplant 2010 DOI: 10.1111/j.1399‐0012.2010.01236.x. © 2010 John Wiley & Sons A/S.

Abstract: Objective: To determine whether depressive symptoms predicted survival before and after lung transplantation. We hypothesized that depressive symptoms might predict survival of wait‐listed patients, but would not predict survival post‐transplant.

Methods: This was a prospective, longitudinal study. Participants completed the Beck Depression Inventory pre‐transplant. Pre‐transplant survival analyses were conducted (n = 124) based on time from list date, to death, transplant, or censoring, if still alive. Post‐transplant survival analyses were conducted (n = 76) based on time from transplant, to death or censoring. Cox proportional hazards regression analyses were utilized.

Results: In the unadjusted model, depressive symptoms predicted mortality for candidates awaiting lung transplant (p = 0.02); however, once models were adjusted for demographics and pulmonary status, the relationship between depressive symptoms and mortality rates was attenuated (p > 0.05). Depressive symptoms did not predict survival after lung transplant (p > 0.05).

Conclusions: Pre‐transplant depressive symptoms were associated with mortality among lung transplant candidates in an unadjusted model and a model fit with demographics and forced expiratory volume in one second. Depressive symptoms do not exert an independent effect when forced expiratory vital capacity is added. Depressive symptoms do not predict mortality after transplant. Future studies need to determine whether pre‐transplant psychosocial characteristics confer a greater risk for poorer transplant outcomes.
Identification of rice purple acid phosphatases related to posphate starvation signalling
Authors: Zhang Q. , Wang C. , Tian J. , Li K. , Shou H.
Published: May 2010

Purple acid phosphatases (PAPs) are a family of metallo‐phosphoesterases involved in a variety of physiological functions, especially phosphate deficiency adaptations in plants. We identified 26 putative PAP genes by a genome‐wide analysis of rice (Oryza sativa), 24 of which have isolated EST sequences in the dbEST database. Amino acid sequence analysis revealed that 25 of these genes possess sets of metal‐ligating residues typical of known PAPs. Phylogenetic analysis classified the 26 rice and 29 Arabidopsis PAPs into three main groups and seven subgroups. We detected transcripts of 21 PAP genes in roots or leaves of rice seedlings. The expression levels of ten PAP genes were up‐regulated by both phosphate deprivation and over‐expression of the transcription factor OsPHR2. These PAP genes all contained one or two OsPHR2 binding elements in their promoter regions, implying that they are directly regulated by OsPHR2. Both acid phosphatase (AP) and surface secretory acid phosphatase (SAP) activity assays showed that the up‐regulation of PAPs by Pi starvation, OsPHR2 over‐expression, PHO2 knockout or OsSPX1 RNA interference led to an increase in AP and SAP activity in rice roots. This study reveals the potential for developing technologies for crop improvement in phosphorus use efficiency.
Antigliadin antibodies in psoriasis
Authors: Sultan Sheikh Javeed , Ahmad Qazi Masood , Sultan Sheikh Tariq
Published: April 2010

Background/Objectives:  Although antigliadin antibodies (AGA) are markers of coeliac disease, elevated levels of these antibodies are also seen in many other autoimmune, neurological, haematological, collagen vascular and cutaneous disorders, even in the absence of clinically overt gastrointestinal disease. Several studies have reported an association between psoriasis and AGA, with improvement in severity of psoriasis on a gluten‐free diet. This study aims to determine whether patients with psoriasis in Kashmir have an increased prevalence of elevated AGA.

Methods:  A total of 120 patients (all native Kashmiris) with psoriasis and an equal number of age‐ and sex‐matched controls without any personal or family history of autoimmune disorders were included in the study. Both groups were tested for IgA and IgG AGAs using a standard enzyme‐linked immunosorbent assay method.

Results:  No statistically significant difference in the prevalence of AGA among patients with psoriasis (6.67% for IgA and 4.17% for IgG) and control group individuals (7.5% IgA and 5.0% IgG) was observed. The mean AGA levels in the two groups were not statistically different. Furthermore, no significant association between AGA levels and psoriasis severity, joint involvement, age of onset of psoriasis or arthritis was observed.

Conclusions:  The results of our study show that AGA are not elevated in psoriasis patients as compared with a healthy population, and there is no association between AGA and psoriasis, its onset, severity and joint symptoms.
9p21 deletion in the diagnosis of malignant mesothelioma, using fluorescence in situ hybridization analysis
Authors: Takeda Maiko , Kasai Takahiko , Enomoto Yasunori , Takano Masato , Morita Kouhei , Kadota Eiji , Nonomura Akitaka
Published: April 2010

Homozygous deletion of 9p21, the locus harboring the p16 gene, has been reported as one of the most common genetic alterations in malignant mesotheliomas (MMs). Previous studies showed that this alteration might be useful for differentiating benign from malignant mesothelial tumors in cytology and surgical specimens. Although the diagnostic utility of 9p21 homozygous deletion by fluorescence in situ hybridization (FISH) analysis has been reported only recently, it has not been well demonstrated. The purpose of this study is to evaluate the diagnostic utility of 9p21 homozygous deletion assessed by FISH in mesothelial neoplasm and hyperplasia of Japanese patients using paraffin‐embedded tissue. Simultaneously, p16 protein immunoexpression was explored as a potential diagnostic aid. FISH analysis demonstrated 9p21 deletion in 35 of 40 cases with MM (88%) (P < 0.001). In contrast, no cases of adenomatoid tumor, benign mesothelial multicystic tumor, reactive mesothelial hyperplasia or pleuritis showed 9p21 deletion (P < 0.005). 9p21 homozygous deletion correlated well with p16 protein expression in the tumor cells. Our study suggests that 9p21 homozygous deletion assessed by FISH on paraffin‐embedded tissue may be very useful for differentiating MM from reactive mesothelial proliferation.
Steroid and Xenobiotic Receptor (SXR) as a possible prognostic marker in epithelial ovarian cancer
Authors: Yue Xiaoni , Akahira Jun‐ichi , Utsunomiya Hiroki , Miki Yasuhiro , Takahashi Naomi , Niikura Hitoshi , Ito Kiyoshi , Sasano Hironobu , Okamura Kunihiro , Yaegashi Nobuo
Published: April 2010

We examined the expression of the steroid and xenobiotic receptor (SXR) and evaluated its clinical significance in human epithelial ovarian carcinoma. One hundred forty‐one cases were examined using immunohistochemistry for SXR with archival specimens. All cases were scored using a semi‐quantitative histological scoring (HSCORE) method. Specimens with an HSCORE > 60 were regarded as SXR‐positive. Various clinicopathologic variables were examined. SXR showed significant differences in age, histology, grade, ERα and PR. SXR was detected in 35 of 141 (24.8%) ovarian cancer tissues. There was a statistically significant negative correlation between SXR‐positive status and both disease‐free survival and overall survival (P= 0.0415 and 0.0316, respectively), independent of stage (P= 0.0167 and 0.021, respectively). In multivariate analysis, SXR was a statistically independent risk factor for both disease‐free survival and overall survival (P= 0.049 and 0.0354). Our results support an association of SXR between ERα and PR in epithelial ovarian cancers. Our data suggest that SXR is a prognostic factor in epithelial ovarian cancer and may represent a useful marker to identify patients at risk of recurrence or death.
Association of retinal vessel calibre with diabetic retinopathy in an urban Australian indigenous population
Authors: Dirani Mohamed , McAuley Annie K , Maple‐Brown Louise , Kawasaki Ryo , McIntosh Rachel L , Harper C Alex , Lamoureux Ecosse L , Tatipata Shaun , Dunbar Terry , O'Dea Kerin , Cunningham Joan
Published: April 2010

Abstract

Purpose:  To assess the relationship of retinal vessel diameter and diabetic retinopathy (DR) in a subgroup of participants recruited through the Darwin Region Urban Indigenous Diabetes study.

Methods:  Participants were examined as part of the Darwin Region Urban Indigenous Diabetes study. All participants with gradable fundus photographs were included in the current analysis. Assessment of retinal vascular diameter, including arteriolar diameter (central retinal arteriolar equivalent) and venular diameter (central retinal venular equivalent), was undertaken using a semi‐automated retinal vascular imaging program. DR was graded according to the modified Early Treatment DR Study scale.

Results:  A total of 110 participants, 25 men and 85 women, with a mean age of 50.8 years were included in the analysis. The odds ratio for having DR for each standard deviation increase in central retinal venular equivalent was as high as 1.62 (95% confidence intervals 0.94, 2.80); however, this did not reach statistical significance (P = 0.08). Moreover, individuals with severe non‐proliferative DR and proliferative DR were found to have narrower arteriolar diameters compared with those with no DR, but this was not statistically significant (−8.1 µm, 95% confidence intervals, −39.3 µm, 23.1 µm; P = 0.612).

Conclusion:  Our data indicate a trend for narrower arteriole diameter and wider venular diameter with DR in this high‐risk ethnic group, which concurs with overall trends seen in non‐indigenous populations.
Climate change scenarios and models yield conflicting predictions about the future risk of an invasive species in North America
Authors: Mika Anna M. , Newman Jonathan A.
Published: April 2010

The pea leafminer Liriomyza huidobrensis (Blanchard) (Diptera: Agromyzidae) is an invasive species in North America and a serious economic pest on a wide variety of crops. We developed a bioclimatic envelope model (BEM) for this species and examined the envelope's potential location in North America under various future climates.

We compared the future bioclimatic envelopes for L. huidobrensis using either simple scenarios comprising uniform changes in temperature/precipitation or climate projections from general circulation models (GCMs). Our simple scenarios were: (i) an increase of 0.1°C per degree in latitude with a 20% increase in summer precipitation and a 20% decrease in winter precipitation and (ii) an overall increase of 3°C everywhere, also with the same changes in precipitation. For GCM‐modelled climate change, we used the Canadian Centre for Climate Modelling and Analysis GCM (CGCM2) and the Hadley Centre climate model (HadCM3), each in combination with two scenarios from the Special Report on Emissions Scenarios (A2 and B2).

The BEM results using the simple scenarios were more similar to each other than to the results obtained using GCM projections. The results were also qualitatively different (i.e. spatially different and divergent) depending on which GCM‐scenario combination was used.

This modelling exercise illustrates that: (i) results using first approximation simple climate change scenarios can give predictions very different from those that use GCM‐modelled climate projections (comprising a result that has worrying implications for empirical impact research) and that (ii) different GCM‐models using the same scenario can give very different results (implying strong model dependency in projected biological impacts).
Transvaginal ultrasound measurement of bladder wall thickness: a more reliable approach than transperineal and transabdominal approaches
Authors: Panayi Demetri C. , Khullar Vikram , Fernando Ruwan , Tekkis Paris
Published: April 2010

Study Type – Diagnosis (exploratory cohort) Level of Evidence 2b

OBJECTIVES To validate transperineal, transabdominal and transvaginal ultrasound (US) techniques to measure bladder wall thickness (BWT).

SUBJECTS AND METHODS Women underwent US measurement of BWT at three different anatomical sites: anterior wall, dome and trigone of the bladder by two ‘blinded’ operators using transabdominal, transperineal and transvaginal approaches at separate visits and by a single operator using transabdominal and transperineal techniques. Bland–Altman analysis was used to determine interobserver reliability for all three techniques and intraobserver reliability for transabdominal and transperineal methods.

RESULTS In all, 25 women were scanned. The transperineal US had a high interobserver mean difference when measuring the anterior BWT (−0.34) and a high intraobserver mean difference when measuring the anterior (0.54) and dome BWT (0.33). Transabdominal US had a high interobserver mean difference for all measurements of BWT, and a high intraobserver mean difference when measuring the trigonal thickness (0.56). Transvaginal US had a consistent interobserver mean difference for all three measurements. The transperineal and transabominal approaches had the widest intraobserver and interobserver 95% confidence intervals of the mean difference when compared with the transvaginal approach.

CONCLUSIONS Transabdominal and transperineal US for measuring BWT did not have good intraobserver and interobserver reliability for measurement of the three anatomical sites to determine mean BWT. Transvaginal US had good interobserver reliability, thus mean BWT is best measured using the transvaginal approach.
Dose‐dependent effects of the once‐daily GLP‐1 receptor agonist lixisenatide in patients with Type 2 diabetes inadequately controlled with metformin: a randomized, double‐blind, placebo‐controlled trial
Authors: Ratner R. E. , Rosenstock J. , Boka G. ,   on behalf of the DRI6012 Study Investigators
Published: May 2010

Diabet. Med. 27, 1024–1032 (2010)

Aims  To evaluate the dose–response relationship of lixisenatide (AVE0010), a glucagon‐like peptide‐1 (GLP‐1) receptor agonist, in metformin‐treated patients with Type 2 diabetes.

Methods  Randomized, double‐blind, placebo‐controlled, parallel‐group, 13 week study of 542 patients with Type 2 diabetes inadequately controlled [glycated haemoglobin (HbA1c) ≥ 7.0 and < 9.0% (≥ 53 and < 75 mmol/mol)] on metformin (≥ 1000 mg/day) treated with subcutaneous lixisenatide doses of 5, 10, 20 or 30 μg once daily or twice daily or placebo. The primary end‐point was change in HbA1c from baseline to 13 weeks in the intent‐to‐treat population.

Results  Lixisenatide significantly improved mean HbA1c from a baseline of 7.55% (59.0 mmol/mol); respective mean reductions for 5, 10, 20 and 30 μg doses were 0.47, 0.50, 0.69 and 0.76% (5.1, 5.5, 7.5 and 8.3 mmol/mol), on once‐daily and 0.65, 0.78, 0.75 and 0.87% (7.1, 8.5, 8.2 and 9.5 mmol/mol) on twice‐daily administrations vs. 0.18% (2.0 mmol/mol) with placebo (all P < 0.01 vs. placebo). Target HbA1c < 7.0% (53 mmol/mol) at study end was achieved in 68% of patients receiving 20 and 30 μg once‐daily lixisenatide vs. 32% receiving placebo (P < 0.0001). Dose‐dependent improvements were observed for fasting, postprandial and average self‐monitored seven‐point blood glucose levels. Weight changes ranged from −2.0 to −3.9 kg with lixisenatide vs. −1.9 kg with placebo. The most frequent adverse event was mild‐to‐moderate nausea.

Conclusions  Lixisenatide significantly improved glycaemic control in mildly hyperglycaemic patients with Type 2 diabetes on metformin. Dose–response relationships were seen for once‐ and twice‐daily regimens, with similar efficacy levels, with a 20 μg once‐daily dose of lixisenatide demonstrating the best efficacy‐to‐tolerability ratio. This new, once‐daily GLP‐1 receptor agonist shows promise in the management of Type 2 diabetes to be defined further by ongoing long‐term studies.
Dietary glycaemic carbohydrate in relation to the metabolic syndrome in adolescents: comparison of different metabolic syndrome definitions
Authors: O’Sullivan T. A. , Lyons‐Wall P. , Bremner A. P. , Ambrosini G. L. , Huang R. C. , Beilin L. J. , Mori T. A. , Blair E. , Oddy W. H.
Published: May 2010

Diabet. Med. 27, 770–778 (2010)

Aims  High dietary glycaemic carbohydrate, as measured by the dietary glycaemic index and glycaemic load has been associated with increased risk of the metabolic syndrome in adults, but limited research exists for younger populations. We aimed to evaluate associations between dietary glycaemic carbohydrate and insulin resistance or the prevalence of the metabolic syndrome defined by three different criteria in a population‐based adolescent cohort.

Methods  Diet was assessed using 3 day food records in 769 adolescents aged 13–15 years participating in the Western Australian Pregnancy Cohort (Raine) Study. The metabolic syndrome was identified using age‐specific adolescent definitions from the International Diabetes Federation, the National Cholesterol Education Program Adult Treatment Panel III and a population‐derived ‘high‐risk’ metabolic cluster algorithm. Presence of a high waist circumference was mandatory only in the International Diabetes Federation definition. Insulin resistance was measured using homeostasis model assessment (HOMA‐IR).

Results  The prevalence of the metabolic syndrome as defined by the International Diabetes Federation and the Adult Treatment Panel III was 3.6 and 4.0%, respectively; 25.9% of subjects were classified into the high‐risk cluster. Significantly increased odds of International Diabetes Federation‐defined metabolic syndrome were independently associated with a 20 unit glycaemic load increase (odds ratio 2.18; 95% confidence interval 1.26–3.78) and a 30 g carbohydrate increase (odds ratio 3.86; 95% confidence interval 1.80–8.28). No significant associations were observed when using the Adult Treatment Panel III, or the cluster‐defined metabolic syndrome, or with HOMA‐IR.

Conclusions  This study supports the concept that high dietary glycaemic carbohydrate is associated with a higher prevalence of the metabolic syndrome in adolescents. However, relationships vary according to the definition of the metabolic syndrome used, with waist circumference a potentially relevant factor.
Stopping insulin injections following genetic testing in diabetes: impact on identity
Authors: Shepherd M.
Published: May 2010

Diabet. Med. 27, 838–843 (2010)

Background  Identification of genes causing monogenic diabetes has led to treatment change, from insulin to sulphonylureas for many previously considered insulin dependent. Changing treatment has led to improved glycaemic control and quality of life; however, the impact of a genetic diagnosis and consequent treatment change on identity has not been explored.

Methods  This paper examines the experiences of patients and their families using Bury’s theory of biographical disruption in chronic illness to offer insight and comparison with the disruption caused by treatment change following genetic testing. This qualitative study is a longitudinal follow‐up using in‐depth interviews over time. Thirty‐one individuals were interviewed following genetic testing and again 12 months later.

Results  Key themes identified were: (i) embodied practices of diabetes; (ii) perceived identity on insulin; (iii) ‘holding on’ to insulin treatment; (iv) challenges and benefits of treatment change; (v) identity reconstruction. Participants were categorized into ‘Transferers’ who successfully transferred to sulphonylureas, ‘Attempters’ who attempted transfer but recommenced insulin and ‘Decliners’ who declined treatment change.

Conclusions  Injecting insulin was integral to participant’s lives and fundamental to their identity. Embodied practices of diabetes were deeply embedded in self identity; the possibility of stopping insulin injections was a major challenge contradicting previous beliefs and led to identity reconstruction.
Knowledge acquisition in vague objective information systems based on rough sets
Authors: Feng Lin , Wang Guo‐Yin , Li Xin‐Xin
Published: April 2010

Abstract: The growing volume of vague information poses interesting challenges and calls for new theories, techniques and tools for analysis of vague data sets. In this paper, we study how to extract knowledge from vague objective information systems (VOISs) based on rough sets theory. We first introduce the basic notion termed rough vague sets by combining rough sets theory and vague sets theory. By using the rough vague lower approximation distribution in the VOIS, the concept of attribute reduction is introduced. Then, we develop an algorithm based on a discernibility matrix to compute all the attribute reductions. Finally, a viable approach for extracting decision rules from the VOIS is proposed. An example is also presented to illustrate the application of the proposed theories and approaches in handling medical diagnosis problems.
Defining high HIV incidence subgroups of Australian homosexual men: implications for conducting HIV prevention trials in low HIV prevalence settings
Authors: Poynten IM , Jin F , Prestage GP , Kaldor JM , Kippax S , Grulich AE
Published: April 2010

Objectives

The aim of the study was to assess whether subpopulations with sufficiently high HIV incidences for HIV prevention trials can be identified in low HIV incidence settings such as Australia.

Methods

In a community‐based cohort study of HIV‐negative homosexually active men in Sydney, Australia, potential risk factors associated with an annual HIV incidence of ≥2 per 100 person‐years (PY) were identified. A stepwise procedure ranked these factors according to HIV incidence, to create a ‘high‐incidence’ subgroup of participants. Willingness to participate in HIV prevention trials was assessed.

Results

Although the incidence in the cohort overall was only 0.78 per 100 PY, nine risk variables were associated with an HIV incidence of 2 per 100 PY or greater. Stepwise inclusion of these variables revealed a ‘high‐incidence’ subgroup of men representing 24% of the total follow‐up time with a combined HIV incidence of 2.71 per 100 PY, who reported at least one of three risk factors in the past 6 months. These men were more willing than others to participate in vaccine and antiretroviral therapy HIV prevention trials.

Conclusions

These findings demonstrate that it is possible to identify high HIV incidence subpopulations in low‐incidence settings such as Australia, and these men are of above average willingness to participate in HIV prevention trials.
‘Weak‐Center’ Gentrification and the Contradictions of Containment: Deconcentrating Poverty in Downtown Los Angeles
Authors: REESE ELLEN , DEVERTEUIL GEOFFREY , THACH LEANNE
Published: April 2010

This case study of recent efforts to deconcentrate poverty within the Skid Row area of Los Angeles examines processes of ‘weak‐center’ gentrification as it applies to a ‘service dependent ghetto,’ thus filling two key gaps in prior scholarship. We document the collaboration between the government, business and development interests, and certain non‐profit agencies in this process and identify two key mechanisms of poverty deconcentration: housing/service displacement and the criminalization of low income residents. Following Harvey, we argue that these efforts are driven by pressures to find a ‘spatial fix’ for capital accumulation through Downtown redevelopment. This process has been hotly contested, however, illustrating the strength of counter‐pressures to gentrification/poverty deconcentration within ‘weak‐center’ urban areas.

Cette étude de cas porte sur les efforts entrepris récemment pour déconcentrer la pauvreté dans le quartier de Skid Row à Los Angeles. Elle examine les processus de gentrification d'un ‘centre faible’ lorsqu'ils s'appliquent à un ‘ghetto de populations dépendantes de services’, et comble ainsi deux grandes lacunes des recherches antérieures. Elle montre comment les intérêts du gouvernement, des entreprises et de l'urbanisme se joignent à certains organismes non lucratifs impliqués dans le processus. De plus, elle identifie deux mécanismes clés de la déconcentration de la pauvreté: le déplacement des logements et/ou services, et la criminalisation des habitants à faible revenu. Dans le sillage de Harvey, l'étude préconise que les efforts entrepris sont suscités par des pressions visant à trouver une ‘solution spatiale’à l'accumulation de capital en réaménageant le centre‐ville. Toutefois, cette démarche a été vivement contestée, illustrant ainsi la vigueur de la résistance à l'encontre de la gentrification et de la déconcentration de la pauvreté dans le cadre d'un modèle urbain à‘centre faible’.
High frequency, diversity and severity of skin diseases in a paediatric emergency department
Authors: Kramkimel N , Soussan V , Beauchet A , Duhamel A , Saiag P , Chevallier B , Mahé E
Published: April 2010

Background  Skin disorders are a major concern in the Paediatric Emergency Department (PED). We provide an accurate evaluation of the incidence, characteristics and severity of skin disorders seen in our PED over a 1‐year period.

Methods  A total of 20 652 children’s medical notes were reviewed in a single centre, retrospective study in the PED of a University Hospital over a 1‐year period. The dermatological disorders were analysed on the basis of different criteria including their incidence, patient age, sex ratio, diagnosis, seasonal variations and hospitalization rates.

Results  A total of 1897 (9.2%, F/M: 1.2; mean age: 4.1 ± 3.6 years) children presented with 1999 skin diseases and 69 different diagnoses. This frequency increased in the summer months (more than 14% of all patients). A total of 46.5% of diseases were infectious in nature (27.6% viral and 14.4% bacterial), inflammatory diseases accounted for 26.2% (urticaria and angio‐oedema 15.9%, atopic dermatitis 3.5%, Henoch‐Schönlein purpura: 2.1%), non‐specific focal disease (balanitis, vulvitis, etc.) and insect bites, burns, transient diseases of the newborn and drug reactions for 9.2%, 7.8%, 6.4%, 3.7% and 1.2% respectively. More than 90% of children presented at the hospital for an acute condition and 155 (8.2% of children with skin disorders; F/M: 0.9; age: 4.0 ± 4.0 years) were hospitalized. More than 90% of hospitalizations were for infectious and inflammatory diseases.

Conclusion  Our data reveal the extremely high frequency, diversity and potential severity of paediatric emergency skin disorders. Specific educational measures and closer co‐operation between Dermatologists and Paediatricians are essential if the skin care dispensed to children and teenagers is to be improved.
Calcium channels in photosynthetic eukaryotes: implications for evolution of calcium‐based signalling
Authors: Verret Frédéric , Wheeler Glen , Taylor Alison R. , Farnham Garry , Brownlee Colin
Published: May 2010

Much of our current knowledge on the mechanisms by which Ca2+ signals are generated in photosynthetic eukaryotes comes from studies of a relatively small number of model species, particularly green plants and algae, revealing some common features and notable differences between ‘plant’ and ‘animal’ systems. Physiological studies from a broad range of algal cell types have revealed the occurrence of animal‐like signalling properties, including fast action potentials and fast propagating cytosolic Ca2+ waves. Genomic studies are beginning to reveal the widespread occurrence of conserved channel types likely to be involved in Ca2+ signalling. However, certain widespread ‘ancient’ channel types appear to have been lost by certain groups, such as the embryophytes. More recent channel gene loss is also evident from comparisons of more closely related algal species. The underlying processes that have given rise to the current distributions of Ca2+ channel types include widespread retention of ancient Ca2+ channel genes, horizontal gene transfer (including symbiotic gene transfer and acquisition of bacterial genes), gene loss and gene expansion within taxa. The assessment of the roles of Ca2+ channel genes in diverse physiological, developmental and life history processes represents a major challenge for future studies.

Contents

Summary
23

I.
Introduction
24

II.
Physiological features of Ca2+ channel activity ineukaryotic photoautotrophs
25

III.
Expansion, loss and horizontal gene transfer of Ca2+‐permeable channels in photoautotrophs
28

IV.
Conclusions
36

Acknowledgements
37

References
37
Visual field function in school‐aged children with spastic unilateral cerebral palsy related to different patterns of brain damage
Authors: JACOBSON LENA , RYDBERG AGNETA , ELIASSON ANN‐CHRISTIN , KITS ANNIKA , FLODMARK OLOF
Published: May 2010

Aim  To relate visual field function to brain morphology in children with unilateral cerebral palsy (CP).

Method  Visual field function was assessed using the confrontation technique and Goldmann perimetry in 29 children (15 males, 14 females; age range 7–17y, median age 11y) with unilateral CP classified at Gross Motor Function Classification System (GMFCS) level I and Manual Ability Classification System levels I to III. The type and extent of brain lesions were determined using cerebral imaging.

Results  Eighteen children had subnormal visual field function. The visual fields were severely restricted in six. The underlying brain lesions were malformation (n=7), white matter damage of immaturity (WMDI; n=13), and cortical–subcortical lesions (n=9). Visual field function could be correlated with the pattern of brain damage in children with cortical–subcortical lesions or extensive lesions caused by malformation or WMDI. Total homonymous hemianopia was common in the cortical–subcortical group but rare in children with malformation or WMDI. Five children had normal visual field function despite having malformation or WMDI involving parts of the brain usually encompassing the visual system.

Interpretation  Visual field function may be preserved by plasticity of the immature brain in children with malformation and WMDI. Severely restricted visual fields were more often associated with lesions occurring later in the developing brain. All children with severely restricted visual fields were identified by the confrontation technique. Goldmann perimetry was a suitable method to identify relative visual field defects.
Functioning and health‐related quality of life of adolescents with cerebral palsy: self versus parent perspectives
Authors: GATES PHILIP , OTSUKA NORMAN , SANDERS JAMES , MCGEE‐BROWN JEANIE
Published: May 2010

Aim  To determine whether there is a difference between perspectives of functioning and health‐related quality of life (HRQL) of parents and ambulatory adolescents with spastic cerebral palsy (CP).

Method A total of 139 parent patient pairs (73 females, 66 males; median age 14y 6mo, age range 11–18y, Gross Motor Function Classification System [GMFCS] levels I–III, with hemiplegia [n=23], diplegia [n=103], triplegia [n=9], and quadriplegia [n=4]) were recruited from outpatient CP clinics at three pediatric orthopaedic hospitals, between 2000 and 2006, from whom Pediatric Outcomes Data Collection Instrument (PODCI) responses were collected.

Results Cross‐sectional data, calculated with intraclass correlation coefficients [ICC], showed parents and adolescents agreed more on functioning (ICC=0.488–0.748) than HRQL (ICC=0.242–0.568; PODCI). Parents and adolescents both recognized significant comorbidities (ICC=0.502–0.713), but adolescents saw themselves as less limited (ICC=0.330) than parents. The greatest differences between parents and adolescents were in HRQL scales for male adolescents, with only a small part explained by GMFCS level difference between sexes (effect size 0.002–0.143). Age, parent well‐being, and parent sex had little effect and comorbidities had no effect. GMFCS level was the most common predictor.

Interpretation Most scales on health conditions, function, and HRQL agreed between parents and adolescents aged11 to 18 years. Parent proxy is reasonable when necessary, but assessing both parents and adolescents gives additional insight. Adolescents do not consider themselves as limited by health conditions as parents do; parents have greater satisfaction with current level of symptoms than adolescents, and findings vary on expectations for treatment.
Construct validity of the Infant Motor Profile: relation with prenatal, perinatal, and neonatal risk factors
Authors: HEINEMAN KIRSTEN R , LA BASTIDE‐VAN GEMERT SACHA , FIDLER VACLAV , MIDDELBURG KARIN J , BOS AREND F , HADDERS‐ALGRA MIJNA
Published: May 2010

Aim  The Infant Motor Profile (IMP) is a qualitative assessment of motor behaviour of infants aged 3 to 18 months. The aim of this study was to investigate construct validity of the IMP through the relation of IMP scores with prenatal, perinatal, and neonatal variables, including the presence of brain pathology indicated by neonatal ultrasound imaging of the brain.

Method  A longitudinal prospective study was performed in a group of 30 term infants (12 females, 18 males; median gestational age 40.1wks, range 37.6–42wks) and 59 preterm infants (25 females, 34 males; median gestational age 29.7wks, range 25–34.7wks). IMP assessments were performed at (corrected) ages of 4, 6, 10, 12, and 18 months. Socio‐economic and perinatal data were collected, which, in the case of preterm infants, included information on periventricular leukomalacia and intraventricular haemorrhage based on neonatal cranial ultrasound. Data were analysed by fitting mixed‐effects models.

Results  Gestational age, socio‐economic status, and 5‐minute Apgar scores were significant determinants of IMP scores in the total group of infants (p<0.001, <0.002, and <0.042 respectively). In the subgroup of preterm infants, IMP scores were significantly affected by brain lesions on neonatal ultrasound (p<0.001) and by socio‐economic status (p=0.001).

Interpretation  The findings support the construct validity of the IMP: IMP scores are clearly associated with relevant determinants of neuromotor function.
Neuroimaging in childhood arterial ischaemic stroke: evaluation of imaging modalities and aetiologies
Authors: BUERKI SARAH , ROELLIN KATJA , REMONDA LUCA , MERCATI DANIELLE GUBSER , JEANNET PIERRE‐YVES , KELLER ELMAR , LUETSCHG JUERG , MENACHE CAROLINE , RAMELLI GIAN PAOLO , SCHMITT‐MECHELKE THOMAS , WEISSERT MARKUS , BOLTSHAUSER EUGEN , STEINLIN MAJA
Published: May 2010

Aim  The aim of this study was to describe neuroimaging patterns associated with arterial ischaemic stroke (AIS) in childhood and to differentiate them according to stroke aetiology.

Method  Clinical and neuroimaging (acute and follow‐up) findings were analysed prospectively in 79 children (48 males, 31 females) aged 2 months to 15 years 8 months (median 5y 3mo) at the time of stroke by the Swiss Neuropaediatric Stroke Registry from 2000 to 2006.

Results  Stroke was confirmed in the acute period in 36 out of 41 children who underwent computed tomography, in 53 of 57 who underwent T2‐weighted magnetic resonance imaging (MRI) and in all 48 children who underwent diffusion‐weighted MRI. AIS occurred in the anterior cerebral artery (ACA) in 63 participants and in all cases was associated with lesions of the middle cerebral artery (MCA). The lesion was cortical–subcortical in 30 out of 63 children, cortical in 25 out of 63, and subcortical in 8 of 63 children. Among participants with AIS in the posterior circulation territory, the stroke was cortical–subcortical in 8 out of 16, cortical in 5 of 16, and thalamic in 3 out of 16 children.

Interpretation  AIS mainly involves the anterior circulation territory, with both the ACA and the MCA being affected. The classification of Ganesan is an appropriate population‐based classification for our Swiss cohort, but the neuroimaging pattern alone is insufficient to determine the aetiology of stroke in a paediatric population. The results show a poor correlation between lesion pattern and aetiology.