bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of temperature and light on germination and early seedling development of the pine pink orchid (Bletia purpurea)
Authors: JOHNSON TIMOTHY R. , KANE MICHAEL E.
Published: September 2011

Orchid seed physiology is a poorly understood phenomenon owing to an emphasis on production and the challenges associated with propagating orchids from minute seed. We investigated the role of simulated south Florida temperatures and illumination (dark and 12 h photoperiod) in regulating germination and seedling development using asymbiotic seed germination assays of Bletia purpurea. Our objectives were to determine whether in situ germination is limited by seasonal temperatures and to determine whether temperature alters responses to illumination. Bletia purpurea seeds were able to germinate to > 90% under all treatments. The greatest germination after 3 weeks was observed at 29/19°C under continual darkness and at 25°C under dark and illuminated conditions. The slowest germination was observed at simulated winter temperatures (22/11°C). Illumination initially inhibited germination and development, but resulted in equal or greater development by week six. Germination under 22/11°C was strongly inhibited by illumination, indicating an interaction between temperature and light sensing systems.
Quality of life in mothers of children with obstetrical brachial plexus palsy
Authors: Oskay Deran , Öksüz Çiğdem , Akel Semin , Fırat Tüzün , Leblebicioğlu Gürsel
Published: September 2011

Background:  The aim of this study was to explore impairment in quality of life (QOL) of the mothers who were primarily responsible for taking care of children with obstetrical brachial plexus palsy (OBPP) and to state its association with the age, sex and functional status of the child with OBPP.

Methods:  Ninety‐three mothers of children with OBPP and 88 mothers of children without any health problems were included in the study. Children's demographic characteristics were recorded and the functional status of the upper extremity was determined with the active movement scale. The QOL of the mothers was assessed with the Turkish version of the Nottingham Health Profile (NHP).

Results:  There were significant differences between mothers of children with OBPP and the control group in total, physical activity, energy expenditure, and pain score of the NHP. A decrease in energy expenditure and physical activity levels were found to be related to children's active movement scale results in elbow flexion and extension, and forearm supination. A statistically meaningful difference was found between mothers of children aged 0–2 and mothers of children aged 2–7 years in emotional reaction, social isolation and total score of NHP.

Conclusions:  The results of this study revealed that mothers of children with OBPP have poor QOL compared with mothers of healthy children. The limitation in elbow joint movements was found to be important for the mothers. The strongest impact of the illness is on the emotional reactions and social isolation of the mothers. Professionals involved in the care of children with OBPP should also help parents to cope with the burden of caregiving.
Angiotensin‐converting enzyme gene insertion/deletion polymorphism and essential hypertension in the Chinese population: a meta‐analysis including 21 058 participants
Authors: Li Y.
Published: September 2011

Background:  The angiotensin‐converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been suggested to influence susceptibility to essential hypertension (EH), but the results of many individual studies are conflicting.

Aim and methods:  To explore the relationship between the ACE gene I/D polymorphism and EH in the Chinese population, 67 separated studies were analyzed in a meta‐analysis including 21 058 participants. The electronic databases PubMed, Embase, Web of Science, China Biological Medicine Database and China National Knowledge Infrastructure were searched. The pooled odds ratio (ORs) and its corresponding 95% confidence interval were calculated by the random effects model.

Results:  In this ACE I/D gene polymorphism meta‐analysis, the distribution of the D allele frequency was 0.45 for the EH group and 0.40 for the control group. The summary OR for the distribution frequency of D allele was 1.27 (5% confidence interval 1.17–1.37). The heterogeneity among the 67 studies was also significant (P < 0.00001, I2= 71.4%). There was a significant association between distribution frequency of the D allele and EH risk in Han, Kazakh, Tibetan, Zhuang and unclassified nationalities (P < 0.05). In contrast, in the national minorities, such as Mongolian, Uigur, Yi, Dongxiang, Yugu, Korean and Gamel, the association between distribution frequency of the D allele and EH risk was not significant (P > 0.05).

Conclusions:  In the whole Chinese population, the D allele was significantly linked with EH susceptibility. However, the relation between the I/D polymorphism and EH is still inconclusive in some national minorities and must await larger scale studies.
General practitioners' knowledge of and attitudes to inflammatory bowel disease
Authors: Tan M. , Holloway R. H. , Lange K. , Andrews J. M.
Published: September 2011

Background:  Inflammatory bowel disease (IBD) is a chronic disease requiring long‐term management. General practitioners (GPs) are often the first point of contact for initial symptoms and flares. Thus we assessed GPs' attitudes to and knowledge of IBD.

Methods:  A state‐wide postal survey of GPs was performed collecting demographic details, practice and attitudes in IBD‐specific management and knowledge.

Results:  Of 1800 GPs surveyed in South Australia, 409 responded; 58% were male, 80% Australian trained and 73% practised in metropolitan areas. Most GPs (92%) reported seeing zero to five IBD patients per month. Overall, 37% of the GPs reported being generally ‘uncomfortable’ with IBD management. Specifically, they were only somewhat comfortable in providing/using maintenance therapy, steroid therapy or unspecified therapy for an acute flare. They were uncomfortable with the use of immunomodulators and biologicals (71 and 91% respectively). No GP reported never referring, referring sometimes (12%), often (34%) or always (55%). Most (87%) GPs rated their communication with private specialists positively; while only 32% were satisfied with support from public hospitals. Of concern, most (70%) monitored patients on immunosuppression on a case‐by‐case basis rather than by protocol. In multivariable analyses, GPs' IBD‐specific knowledge did not influence comfort with overall management, nor did knowledge influence GP comfort with any particular therapy.

Conclusion:  Individual GPs care for few IBD patients and have variable attitudes in their practice. Whether improvement can realistically be achieved given individual GP's paucity of patients is questionable. These data support the provision of better support and specific action plans for IBD patients.
Biological control of invasive plant species: A stochastic analysis
Authors: CHALAK MORTEZA , RUIJS ARJAN , VAN IERLAND EKKO C.
Published: September 2011

Biological control agents are regarded as a relatively safe method to control weeds. However, their impact on weeds can be relatively low and unpredictable. The aims of this article were to: (i) assess whether or not a weevil (Apion onopordi) and a mycoherbicide (Sclerotinia sclerotiorum) are desirable as biological agents for the control of Californian thistle (Cirsium arvense) in New Zealand despite their uncertain effectiveness; (ii) identify the combination of control options that is optimal to control the thistle; (iii) analyze the economic consequences of excluding chemicals from the weed control strategy; and (iv) assess the feasibility of the eradication of this weed. Two optimization models were developed and compared: one deterministic model and one stochastic model. The results showed that taking into account the stochastic effectiveness of biological agents can change the optimal integrated strategy, particularly if the biological control agent is relatively expensive. However, for a cheaper biological agent, the stochastic efficacy is less likely to change the optimal control strategy. On the basis of the modeling results, the authors argue that, in the context of the agri‐environmental setting of this article's case study, chemicals can be replaced by more environmentally friendly control options at a relatively low cost. The authors also show that the eradication of the thistle is unlikely, at least given the efficacy of the existing control methods.
Overcompensation of seed production caused by clipping of Bidens pilosa var. radiata (Compositae): Implications for weed control on Iriomote‐Jima Island, Japan
Authors: SHIMAMOTO YUKO , NOMURA NAOFUMI , TAKASO TOKUSHIRO , SETOGUCHI HIROAKI
Published: September 2011

The invasion of natural ecosystems by exotic species is a major threat to biodiversity on a local, regional, and global scale. Endemic island flora are particularly vulnerable to invasive species. Bidens pilosa var. radiata is a common invasive weed of roadsides, which are subject to clipping, on Japanese subtropical islands. To assess compensation by the weed to damage by clipping, a pot experiment was conducted under common garden conditions. The above‐ground parts were clipped with pruning shears at various frequencies, ranging from no clipping (the control) to clipping at 4–16 week intervals for 32 weeks in summer. The clipped individuals regenerated new branches from the axillary buds and flowered for ≤12 weeks after the clipping. The regeneration after the clipping gave rise to secondary reproduction, whereas minimal regeneration occurred in the unclipped individuals after the maturation of the fruit. Consequently, the total flower head mass, represented by the dry weight of the inflorescences throughout the experiment, was higher on the individuals that were clipped at 12 and 16 week intervals than on the unclipped individuals, suggesting overcompensation in fecundity. At the higher frequencies of above‐ground clipping, the flower head mass was suppressed at 8 week clipping intervals, while both the flower head mass and the productive biomass were suppressed at 4 week clipping intervals. This indicates that clipping at intervals of ≤8 weeks is required to prevent the reproduction of this weed.
Neonatal revolution – the introduction of PEEP
Authors: Brown T.C.K.
Published: September 2011

Fifty years ago, a baby born at 24–26 weeks was not considered viable. It was a tragedy for the mother having carried it for so long. I witnessed such an event as a student.

The scourge of premature deliveries was the lack of surfactant in many tiny babies. In general, if a premature infant with hyaline membrane disease, as it was called respiratory distress syndrome (RDS), could not maintain a pO2 above 60 mmHg in 100% oxygen, it was not expected to survive. In late 1969, two babies with suspected RDS came to ICU and were treated by the author with the buffer (tris hydroxyl amino methane, [THAM] which reduced both metabolic and respiratory acidosis and did not contain sodium) and an isoprenaline infusion (β1 stimulant and pulmonary vasodilator). The X‐ray appearances of RDS disappeared. Unfortunately, one died of portal vein thrombosis because the drugs were administered by umbilical catheter, which were commonly used at the time. The other one recovered but the physicians then said the diagnosis must have been wrong!
Resuscitation strategies from bupivacaine‐induced cardiac arrest
Authors: Mauch Jacqueline , Martin Jurado Olga , Spielmann Nelly , Bettschart‐Wolfensberger Regula , Weiss Markus
Published: September 2011

Objectives:  Local anesthetic (LA) intoxication with cardiovascular arrest is a potential fatal complication of regional anesthesia. Lipid resuscitation has been recommended for the treatment of LA‐induced cardiac arrest. Aim of the study was to compare four different rescue regimens using epinephrine and/or lipid emulsion and vasopressin to treat cardiac arrest caused by bupivacaine intoxication.

Methods:  Twenty‐eight piglets were randomized into four groups (4 × 7), anesthetized with sevoflurane, intubated, and ventilated. Bupivacaine was infused with a syringe driver via central venous catheter at a rate of 1 mg·kg−1·min−1 until circulatory arrest. Bupivacaine infusion and sevoflurane were then stopped, chest compression was started, and the pigs were ventilated with 100% oxygen. After 1 min, epinephrine 10 μg·kg−1 (group 1), Intralipid® 20% 4 ml·kg−1 (group 2), epinephrine 10 μg·kg−1 +  Intralipid® 4 ml·kg−1 (group 3) or 2 IU vasopressin + Intralipid® 4 ml·kg−1 (group 4) were administered. Secondary epinephrine doses were given after 5 min if required.

Results:  Survival was 71%, 29%, 86%, and 57% in groups 1, 2, 3, and 4. Return of spontaneous circulation was regained only by initial administration of epinephrine alone or in combination with Intralipid®. Piglets receiving the combination therapy survived without further epinephrine support. In contrast, in groups 2 and 4, return of spontaneous circulation was only achieved after secondary epinephrine rescue.

Conclusions:  In cardiac arrest caused by bupivacaine intoxication, first‐line rescue with epinephrine and epinephrine + Intralipid® was more effective with regard to survival than Intralipid® alone and vasopressin + Intralipid® in this pig model.
Identification and analysis of the gene cluster involved in biosynthesis of paenibactin, a catecholate siderophore produced by Paenibacillus elgii B69
Authors: Wen Yanping , Wu Xuechang , Teng Yi , Qian Chaodong , Zhan Zhajun , Zhao Yuhua , Li Ou
Published: September 2011

Bacteria belonging to the genus Paenibacillus are recognized as rich sources of bioactive natural products. To date, there are few characterized siderophores from this genus. Here, through genome analysis, we identified a non‐ribosomal peptide biosynthetic gene cluster (pae) responsible for siderophore assembly in Paenibacillus elgii B69. The 12.8 kb gene cluster comprises six open reading frames encoding proteins similar to the components of the bacillibactin biosynthetic machinery and bacillibactin esterase. To examine the product of the pae gene cluster, we cultured P. elgii B69 in iron‐deficient medium for siderophore expression. A novel siderophore structurally similar to bacillibactin, designated paenibactin, was purified and characterized. Its structure was determined as a cyclic trimeric lactone of 2,3‐dihydroxybenzoyl‐alanine‐threonine. The involvement of the pae gene cluster in paenibactin biosynthesis was confirmed by the biochemical assay of adenylation domain specificity. Furthermore, we demonstrated that the pae gene cluster evolves from an ancestral bacillibactin biosynthetic gene cluster via sequence and phylogenetic analyses. The structural difference between paenibactin and bacillibactin may stem from a mutation‐induced change in the adenylation domain specificity. Based on these findings and published models for bacillibactin, we proposed models for paenibactin biosynthesis, ferric–paenibactin uptake and paenibactin‐bounded iron release.
Colonization of cucumber seeds by bacteria during germination
Authors: Ofek Maya , Hadar Yitzhak , Minz Dror
Published: September 2011

Detailed analysis revealed fundamental differences between bacterial association with cucumber (Cucumis sativus) seeds and seedlings roots. Seed colonization by bacteria seems to result from passive encounter between bacteria, conveyed by imbibed soil solution, and the germinating seed. In accordance, the seed‐associated bacterial community composition directly reflected that of the germination medium and was characterized by low dominance. Transition from seed to root was marked by a shift in bacterial community composition and in an increase in dominance values. Furthermore, settlement of bacteria on roots was tightly controlled by the specific properties of each root segment. Size and richness of the seed‐associated bacterial community were clearly determinate by the community in the germination medium. In contrast, for fully developed and active roots, the medium effect on these parameters was negligible. Perturbation of the seed environment by a pathogen (Pythium aphanidermatum) had major consequences on the seed bacterial community. However, those were mostly related to direct pathogen–bacteria rather than seed–bacteria interactions. In conclusion, simple, even passive processes may determine the initial stage of plant–microbe association during seed germination, prior to extension of the primary root. Therefore, seed germination is a unique phase in the plant life cycle, with respect to its interaction with the below‐ground microbiome.
New roles for bacterial siderophores in metal transport and tolerance
Authors: Schalk Isabelle J. , Hannauer Mélissa , Braud Armelle
Published: September 2011

Siderophores are chelators with extremely strong affinity for ferric iron and are best known for their capacity to feed microorganisms with this metal. Despite their preference for iron, they can also chelate numerous other metals with variable affinities. There is also increasing evidence that metals other than iron can activate the production of siderophores by bacteria, thereby implicating siderophores in the homeostasis of metals other than iron and especially heavy metal tolerance. This article considers this new concept that siderophores play a role in protecting bacteria against metal toxicity and discusses the possible contribution of these chelators to the transport of biological relevant metals in addition to iron.
Risk factors for surgical site infection after elective resection for rectal cancer. A multivariate analysis on 2131 patients
Authors: Biondo S. , Kreisler E. , Fraccalvieri D. , Basany E. E. , Codina‐Cazador A. , Ortiz H.
Published: September 2011

Aim  Surgical site infection (SSI) is the most common cause of morbidity after colorectal surgery. The aim of this study was to analyze risk factors for SSI in patients who had undergone surgery for rectal cancer.

Method  A multicentre observational study was carried out on 2131 patients operated on for rectal cancer between May 2006 and May 2009. Twenty‐nine centres were involved. SSI included wound infection and organ space infection within 30 days after the operation. Univariate and multivariate analyses were carried out to study possible risk factors for SSI.

Results  Wound infection and organ space infection were diagnosed in 8.9% and 10%, respectively, of patients. The anastomotic leakage rate was 8%. Multivariate analysis showed that wound infection was related to tumour stage, a converted laparoscopic procedure and open surgery. Organ space infection was related to Stage IV tumour, a tumour < 11 cm from the anal verge, low anterior resection and Hartmann’s procedure.

Conclusion  Rectal surgery for malignant disease is associated with a considerable rate of SSI. Wound infection and organ space infection are related to different factors and therefore should be evaluated separately.
Elective partial nephrectomy is equivalent to radical nephrectomy in patients with clinical T1 renal cell carcinoma: results of a retrospective, comparative, multi‐institutional study
Authors: Antonelli Alessandro , Ficarra Vincenzo , Bertini Roberto , Carini Marco , Carmignani Giorgio , Corti Serena , Longo Nicola , Martorana Giuseppe , Minervini Andrea , Mirone Vincenzo , Novara Giacomo , Serni Sergio , Simeone Claudio , Simonato Alchiede , Siracusano Salvatore , Volpe Alessandro , Zattoni Filiberto , Cunico Sergio Cosciani ,   members of the SATURN Project – LUNA Foundation
Published: September 2011

Study Type – Therapy (cohort)

Level of Evidence 2b

What's known on the subject? and What does the study add?

Few studies supported the expanded indications for nephron‐sparing surgery (NSS) in selected patients with 4.1 cm renal tumours in the size range (T1b). However, all these comparative studies included both imperative and elective partial nephrectomy and patient selection for analysis was based on pathological stage (pT1) and not on clinical stage (cT1).

Patients with clinically organ‐confined RCC (cT1) who are candidates for elective PN have a limited risk of clinical understaging. NSS is not associated with an increased risk of recurrence and cancer‐specific mortality both in cT1a and cT1b tumours

OBJECTIVE

To compare the oncological outcomes of patients who underwent elective partial nephrectomy (PN) or radical nephrectomy (RN) for clinically organ‐confined renal masses ≤7 cm in size (cT1).

PATIENTS AND METHODS

The records of 3480 patients with cT1N0M0 disease were extracted from a multi‐institutional database and analyzed retrospectively.

RESULTS

In patients who underwent PN, the risk of clinical understaging was 3.2% in cT1a cases and 10.6% in cT1b cases.

With regard to the cT1a patients, the 5‐ and 10‐year cancer‐specific survival (CSS) estimates were 94.7% and 90.4%, respectively, after RN and 96.1% and 94.9%, respectively, after PN (log‐rank test: P = 0.01).

With regard to cT1b patients, the 5‐year CSS probabilities were 92.6% after RN and 90% after PN, respectively (log‐rank test: P = 0.89).

Surgical treatment failed to be an independent predictor of CSS on multivariable analysis, both for cT1a and cT1b patients.

Interestingly, PN was oncologically equivalent to RN also in patients with pT3a tumours (log‐rank test: P = 0.91).

CONCLUSIONS

Elective PN is not associated with an increased risk of recurrence and cancer‐specific mortality in both cT1a and cT1b tumours.

Data from the present study strongly support the use of partial nephrectomy in patients with clinically T1 tumours, according to the current recommendations of the international guidelines.
Role of Rho‐kinase and protein kinase C during contraction of hypertrophic detrusor in mice with partial urinary bladder outlet obstruction
Authors: Boberg Lena , Poljakovic Mirjana , Rahman Awahan , Eccles Rachel , Arner Anders
Published: September 2011

What's known on the subject? and What does the study add?

Intracellular signaling via Rho‐kinase and protein kinase C modulate contraction of urinary bladder smooth muscle. These systems can be involved in the bladder overactivity and may constitute pharmalogical targets for treatment of OAB.

This study describes the integrated action of these two cellular pathways in BOO and normal bladders, using a mouse model. It is also shown that the activation via membrane depolarization could specifically be inhibited in BOO bladders using Rho‐kinase blockers.

OBJECTIVE

To study muscarinic/purinergic receptor activation and Rho‐kinase/protein kinase C (PKC) signalling during smooth muscle contraction in normal and hypertrophic mouse urinary bladders.

METHODS

Partial urinary outflow obstruction was induced in adult female (10–12 weeks) C57Bl/6 mice and comparisons were made with sham‐operated controls.

Bladder preparations were examined in vitro.

Expression of signalling proteins was examined using Western blot analysis.

RESULTS

Obstructed bladders increased more than threefold in weight and were found to have enhanced muscarinic and attenuated purinergic components during nerve‐induced contractions.

The contractile response to carbachol was shifted towards lower concentrations of carbachol for the peak response and had a markedly enhanced sustained component. The amplitude of the α,β‐methylene ATP‐induced responses was lowered. Rho‐kinase inhibitor Y27632 (10 µm) inhibited peak and sustained contractile responses to carbachol in control bladders (peak by 38%; plateau 57%) and obstructed bladders (peak 37% plateau 47%).

PKC inhibitor GF109203X (1 µm) inhibited carbachol contractions in controls (peak by 29%; plateau 29%) and obstructed bladders (peak 17%; plateau 12%). Inhibition by a similar extent was observed after nerve stimulation.

Sensitivity to Ca2+ in high‐K+ depolarized intact tissues increased in obstructed bladders. This increased receptor‐independent Ca2+‐sensitivity was abolished by Y27632.

Tissue contents of the myosin‐binding phosphatase subunit MYPT‐1 and catalytic phosphatase subunit PP1β, were decreased and the contents of RhoGDI, RhoA and CPI‐17 increased. A decrease in the Rho‐kinase isoform ROCK‐1 was observed.

CONCLUSION

Based on these results, one can speculate that Rho‐kinase inhibition would preferentially target the pathological phasic activity in the urinary bladder rather than inhibit the physiological receptor‐mediated bladder emptying.
Diffusion‐weighted magnetic resonance imaging in patients selected for radical cystectomy: detection rate of pelvic lymph node metastases
Authors: Papalia Rocco , Simone Giuseppe , Grasso Rosario , Augelli Raffaele , Faiella Eliodoro , Guaglianone Salvatore , Cazzato Roberto , Vescovo Riccardo Del , Ferriero Mariaconsiglia , Zobel Bruno , Gallucci Michele
Published: September 2011

Study Type – Diagnostic (exploratory cohort)

Level of Evidence 3a

What's known on the subject? and What does the study add?

Preoperative imaging of nodal status in patients undergoing radical cystectomy for bladder cancer lacks diagnostic accuracy. This is the first study that has investigated nodal metastates in bladder cancer using DW‐MRI. ADC derived from DW‐MRI may be used to differentiate metastatic from non‐metastatic lymph nodes.

OBJECTIVE

• To evaluate whether DW‐MRI improves the detection of pelvic lymph nodes metastates in patients with bladder cancer undergoing radical cystectomy.

PATIENTS AND METHODS

• 36 patients with CT scan negative for nodal metastates underwent DW‐MRI before surgery. Diagnostic accuracy of DW‐MRI was compared with histopathological findings.

RESULTS

• Mean ADC value was 0.85 × 10−3 mm3/s in the nodal metastatic group and 1 × 10−3 mm3/s in the nodal non‐metastatic group (P = 0.02).

• The ADC cut‐off value, obtained by the ROC curve was 0.86 × 10−3 mm3/s.

• Patient‐based sensitivity, specificity and positive and negative predictive values were 76.4%, 89.4%, 26.6%, and 71.4%, respectively.

CONCLUSION

• DW‐MRI may be used to differentiate metastatic from non‐metastatic lymph nodes in patients with high‐grade bladder cancer.
Information needs of men on androgen deprivation therapy
Authors: Soeyonggo Tony , Warde Padraig , Fleshner Neil , Timilshina Narhari , Alibhai Shabbir M.H.
Published: September 2011

Study Type – Needs assessment survey

Level of Evidence 2b

What's known on the subject? and What does the study add?

Although androgen deprivation therapy (ADT) is widely used to treat men with prostate cancer, little is known about the information needs of patients on ADT.

We found that patients are generally very satisfied with using ADT and expressed minimal decisional regret with its use up to four years later. For men receiving ADT in the adjuvant setting, their survival estimates with the addition of ADT were quite reasonable when compared to findings in randomized trails. A key area to enhance patient education appears to be side effects, especially around hot flashes and fatigue, which were also the most bothersome treatment sequelae for patients.

OBJECTIVE

To evaluate information needs of men receiving androgen deprivation therapy (ADT).

PATIENTS AND METHODS

A cross‐sectional survey was distributed to English‐speaking prostate cancer patients receiving ADT adjuvant to radical therapy or for biochemical relapse.

Three cohorts were recruited based on duration of ADT use: <6 months (cohort 1), 6–18 months (cohort 2) and 18 months to 4 years (cohort 3).

Several validated questionnaires were used, including the Control Preferences Scale (CPS), Satisfaction with Treatment Decision Scale (SWD) and Decisional Regret Scale (DRS).

Patients on adjuvant ADT were asked to estimate their overall survival with and without ADT.

RESULTS

Eighty‐five men were recruited, of whom 91.8% were receiving a gonadotrophin‐releasing hormone agonist, 4.7% were receiving anti‐androgen monotherapy and 3.5% were receiving combined androgen blockade.

Patients preferred the following decision‐making roles: 23.5% active, 50.6% collaborative, 27.0% passive.

Mean patient satisfaction for ADT use was high at 24.0/30 and decisional regret was low at 7.9/25.

There was a perceived overall survival benefit of 3.9–6.9% at 5 years, 3.6–17.8% at 10 years and 5.7–18.1% at 15 years with the addition of adjuvant ADT.

Hot flushes and fatigue were reported as the most common theoretical adverse effects as well as those experienced most commonly by patients.

CONCLUSIONS

Patients on ADT were generally satisfied with their decisions to start ADT and expressed minimal decisional regret up to 4 years later.

A key area to enhance patient education appears to be adverse effects, especially around hot flushes and fatigue.
Diabetes medication patient safety incident reports to the National Reporting and Learning Service: the care home setting
Authors: Milligan F. J. , Krentz A. J. , Sinclair A. J.
Published: September 2011

Diabet. Med. 28, 1537–1540 (2011)

Aims  To analyse adverse drug events in older people with diabetes in the care home setting via incident reports obtained from the National Reporting and Learning Service.

Methods  A Freedom of Information request was made to the National Reporting and Learning Service via the National Patient Safety Agency. Within the National Reporting and Learning Service, reports on diabetes within the category of ‘medication’ using the location limiter of ‘hospice or nursing home or residential home’ were searched. We requested information about the number and nature of adverse drug event reports that had been received in relation to diabetes. The data were subdivided into reports (1) relating to insulin therapy and (2) oral glucose‐lowering agents.

Results  Data were collected between 1 January 2005 and 31 December 2009. There were 684 reports related to insulin and 84 incidents related to oral glucose‐lowering agents. The most common error category with both types of drug therapy was wrong or unclear dose: 173 reports for insulin, including one death, and 20 reports for oral therapy.

Conclusions  Residents with diabetes in care homes are potentially at risk of harm from adverse drug events pertaining to insulin and oral glucose‐lowering agents. Because of under‐reporting, our data most likely represent only a fraction of events.
Time trends in absolute and modifiable coronary heart disease risk in patients with Type 2 diabetes in the Swedish National Diabetes Register (NDR) 2003–2008
Authors: Fhärm E. , Cederholm J. , Eliasson B. , Gudbjörnsdottir S. , Rolandsson O.
Published: September 2011

Diabet. Med. 29, 198–206 (2012)

Aims  The aim was to evaluate treatment goal achievements early in the course of Type 2 diabetes, and their effect on 10‐year risk of coronary heart disease in patients receiving usual care.

Methods  Assessment of risk factor control 3 years after diagnosis in patients with Type 2 diabetes with no previous coronary heart disease included from the Swedish National Diabetes Register; a total of 19 382 patients (mean age 58 years) in cross‐sectional surveys from 2003 to 2008, and a subgroup of 4293 patients followed individually from year of diagnosis to follow‐up after a mean 2.6 years. Estimation of absolute 10‐year risk of coronary heart disease using the UK Prospective Diabetes Study risk engine, and modifiable 10‐year risk defined as percentage excess risk above patients with ‘normal’ risk factor values.

Results  Treatment goals for HbA1c, blood pressure, total and LDL cholesterol were achieved in 78.4, 65.5, 55.6% and 61.0%, respectively, in the cross‐sectional survey in 2008, following a trend of generally improved control. In the individually followed patients in the subgroup, mean absolute 10‐year coronary heart disease risk increased from 13.7% (men/women 16.9/9.5%) to 14.2 (men/women 17.6/9.6%) (P < 0.001) from year of diagnosis to follow‐up after 2.6 years, while mean modifiable risk decreased from 37.7% (men/women 28.6/49.9%) to 19.1% (13.2/26.9%) (P < 0.001 in all).

Conclusions  A high achievement of treatment goals and a low mean modifiable 10‐year coronary heart disease risk was found at the 3‐year follow‐up, both in the cross‐sectional survey in 2008 and in patients individually followed since diagnosis. This indicates the feasibility and significance of early multifactorial risk factor treatment.
Cost–utility analysis of liraglutide compared with sulphonylurea or sitagliptin, all as add‐on to metformin monotherapy in Type 2 diabetes mellitus
Authors: Davies M. J. , Chubb B. D. , Smith I. C. , Valentine W. J.
Published: September 2011

Diabet. Med. 29, 313–320 (2012)

Aim  To investigate the cost‐effectiveness of liraglutide as add‐on to metformin vs. glimepiride or sitagliptin in patients with Type 2 diabetes uncontrolled with first‐line metformin.

Methods  Data were sourced from a clinical trial comparing liraglutide vs. glimepiride, both in combination with metformin, and a clinical trial comparing liraglutide vs. sitagliptin, both as add‐on to metformin. Only the subgroup of patients in whom liraglutide was added to metformin monotherapy was included in the cost–utility analysis. The CORE Diabetes Model was used to simulate outcomes and costs with liraglutide 1.2 and 1.8 mg vs. glimepiride and vs. sitagliptin over patients’ lifetimes. Treatment effects were taken directly from the trials. Costs and outcomes were discounted at 3.5% per annum and costs were accounted from a third‐party payer (UK National Health System) perspective.

Results  Treatment with liraglutide 1.2 and 1.8 mg resulted, respectively, in mean increases in quality‐adjusted life expectancy of 0.32 ± 0.15 and 0.28 ± 0.14 quality‐adjusted life years vs. glimepiride, and 0.19 ± 0.15 and 0.31 ± 0.15 quality‐adjusted life years vs. sitagliptin, and was associated with higher costs of £3003 ± £678 and £4688 ± £639 vs. glimepiride, and £1842 ± £751 and £3224 ± £683 vs. sitagliptin, over a patient’s lifetime. Both liraglutide doses were cost‐effective, with incremental cost‐effectiveness ratios of £9449 and £16 501 per quality‐adjusted life year gained vs. glimepiride, and £9851 and £10 465 per quality‐adjusted life year gained vs. sitagliptin, respectively.

Conclusions  Liraglutide, added to metformin monotherapy, is a cost‐effective option for the treatment of Type 2 diabetes in a UK setting.
Lightening the load? A systematic review of community pharmacy‐based weight management interventions
Authors: Gordon J. , Watson M. , Avenell A.
Published: September 2011

The extent to which community pharmacies can increase capacity for weight management is unknown. Thus, the objective of the present paper was to evaluate the effectiveness and cost‐effectiveness of community pharmacy weight management interventions. This paper used a design of systematic review and narrative synthesis. Electronic databases (1999–2009) were searched, including Medline, EMBASE, CINAHL and Pharm‐line. Weight management studies in community pharmacies were eligible for the inclusion criteria. All languages and study designs were considered. Outcome measures included body weight or anthropometry (at baseline and at least one follow‐up time point). Data were extracted through independent, duplicate data extraction and quality assessment. As a result, 10 studies were included, totalling 2,583 service users and 582 pharmacies from the USA, the UK, Switzerland, Spain and Denmark. One was a randomized controlled trial of a meal‐replacement versus a reduced calorie diet. A non‐randomized controlled before and after study compared community pharmacist treatment using Orlistat with usual care. Eight studies were uncontrolled. Five studies described behaviour change techniques. Long‐term (12 months) mean weight loss measured in three studies ranged from 1.1 to 4.1 kg. Four uncontrolled studies reported statistically significant weight loss. No study reported economic evaluations. Currently, there is insufficient evidence for the effectiveness and cost‐effectiveness of community pharmacy‐based weight management initiatives to support investment in their provision.
Impact of laparoscopic adjustable gastric banding on type 2 diabetes
Authors: Dixon J. B. , Murphy D. K. , Segel J. E. , Finkelstein E. A.
Published: September 2011

Bariatric surgery is becoming an accepted option for obese people with type 2 diabetes. Our aim was to assess the impact of laparoscopic adjustable gastric banding (LAGB) through a systematic review of the literature. Data was sourced from Scopus, MEDLINE and EMBASE published from 2000 through May 2011, and five unpublished studies that were performed by industry for regulatory approval were also included. Studies were selected on the basis that they provide some detail of diabetes status before and after LAGB. There were 35 studies meeting the inclusion criteria. There was considerable heterogeneity in study design, sample size, length of follow‐up, attrition rates and classification of diabetes status. Weight loss was progressive over the first 2 years with a weighted average of 47% excess weight loss at 2 years. Remission or improvement in diabetes varied from 53% to 70% over different time periods. Results were broadly consistent, demonstrating clinically relevant improvements in diabetes outcomes with sustained weight loss in obese people with type 2 diabetes following LAGB surgery. However, there were significant shortcomings in the reviewed literature with few high‐quality studies, inconsistent reporting of diabetes outcomes and high attrition rates. Long‐term studies that address these limitations are needed.
Dialogue Between Past and Present: Policy Evaluation and History
Authors: Perche Diana
Published: September 2011

While public policy is about shaping the future, it must at the same time be understood as a response to the past. Decision‐makers in the present inevitably build on the accumulated policies of their predecessors. Much of this process is explained by path dependency, as policy options are shaped by the institutional structures and cultural expectations established by past policies. This explanation is incomplete, however, as it leaves unexamined the strategic, deliberate use of the past through the evaluation of previous policies, even years after implementation. As policy actors choose to revisit earlier policy decisions, policy successes can be reconstructed as failures. Indigenous policy is one area where “policy failure” has gained currency in Australia, as governments have critically re‐examined past policies to justify new policy directions. The Aboriginal Land Rights (Northern Territory) Act 1976 provides a useful case study of multiple evaluations over time, revealing contingency and continuity in the repeated evaluations of the role of the land councils.
Applause as an achievement‐based reward during a computerised self‐assessment test
Authors: Moridis Christos N. , Economides Anastasios A.
Published: September 2011

Affective feedback during a self‐assessment test could help induce the learner to an optimal emotional state regarding the learning material. However, there is a lack of experimental evidence concerning the influence of affective feedback during a self‐assessment test. This paper is a step towards this direction. The effect of achievement‐based reward feedback on students' state and trait anxiety was examined. Ninety‐two students participated in an experiment. Half of these students received an applause sound after a correct answer to a question. Results highlight gender differences concerning this emotional type of feedback.
Rent‐Sharing under Different Bargaining Regimes: Evidence from Linked Employer–Employee Data
Authors: Rusinek Michael , Rycx François
Published: September 2011

Using Belgian linked employer–employee data, we examine how collective bargaining arrangements affect the relationship between firms' profitability and individual wages via rent‐sharing. In industries where agreements are usually renegotiated at firm‐level (‘decentralized industries’) wages and firm‐level profits are positively correlated regardless of the type of collective wage agreement by which the workers are covered (industry or firm). On the other hand, where firm‐level wage renegotiation is less common (‘centralized industries’), wages are only significantly related to firms' profitability for workers covered by a firm‐level collective agreement. Thus, industry‐wide contracts that are not complemented by a firm‐level collective agreement suppress the impact of firm profits on workers' wages in centralized industries.
Critical Actors vs. Critical Mass: The Substantive Representation of Women in the Scottish Parliament
Authors: Chaney Paul
Published: September 2011

Recent theory-building on the substantive representation of women (SRW) in parliamentary settings contends that in addition to traditional concerns about achieving a ‘critical mass’ of women, scholars need to question who the ‘critical actors’ are. Analysis of a range of deliberative functions of the Scottish Parliament supports the critical actor thesis—yet, while female critical actors have disproportionate policy-making influence, the present study adds to contemporary understanding by highlighting that it is how critical actors interact with critical mass that plays a key role in the SRW. Thus future work needs to be cognisant of a range of factors shaping critical mass/critical actor interaction, including: institutional mechanisms, type of parliamentary proceeding, party allegiance and whether women representatives belong to the party forming the executive.
Antecedents and Outcomes of Joint Trajectories of Mother–Son Conflict and Warmth During Middle Childhood and Adolescence
Authors: Trentacosta Christopher J. , Criss Michael M. , Shaw Daniel S. , Lacourse Eric , Hyde Luke W. , Dishion Thomas J.
Published: September 2011

This study investigated the development of mother–son relationship quality from ages 5 to 15 in a sample of 265 low‐income families. Nonparametric random effects modeling was utilized to uncover distinct and homogeneous developmental trajectories of conflict and warmth; antecedents and outcomes of the trajectory groups also were examined. Four conflict trajectory groups and 3 warmth trajectory groups were identified. Difficult temperament in early childhood discriminated both conflict and warmth trajectory group membership (TGM), and adult relationship quality in early childhood was related to warmth trajectories. In addition, conflict TGM differentiated youth antisocial behavior during adolescence, and warmth trajectories predicted adolescent peer relationship quality and youth moral disengagement. Implications for socialization processes are discussed.
The Effect of Narrative Cues on Infants’ Imitation From Television and Picture Books
Authors: Simcock Gabrielle , Garrity Kara , Barr Rachel
Published: September 2011

Infants can imitate a novel action sequence from television and picture books, yet there has been no direct comparison of infants’ imitation from the 2 types of media. Varying the narrative cues available during the demonstration and test, the current experiments measured 18‐ and 24‐month‐olds’ imitation from television and picture books. Infants imitated from both media types when full narrative cues (Experiment 1; N = 76) or empty, meaningless narration (Experiment 2; N = 135) accompanied the demonstrations, but they imitated more from television than books. In Experiment 3 (N = 27), infants imitated from a book based on narration alone, without the presence of pictures. These results are discussed in relation to age‐related changes in cognitive flexibility and infants’ emerging symbolic understanding.
Effect of Secondary School Fees on Educational Attainment*
Authors: Riphahn Regina T.
Published: September 2011

In this study, the heterogeneity of the fee abolition process in West German secondary schools is used to identify the effect of school fees on educational attainment and to obtain an estimate of the price elasticity of upper secondary education. The analysis is based on representative individual‐level data from three annual surveys of the German Mikrozensus. While coefficients cannot be estimated precisely, the results suggest that, on average, upper secondary school attainment increased by at least 8 percent in response to the fee abolition. The educational attainment of females appears to be more price sensitive than that of males.
Public or Private Sector Wage Leadership? An International Perspective*
Authors: Lamo Ana , Pérez Javier J. , Schuknecht Ludger
Published: September 2011

Whether a government acts as a wage leader, placing pressure on private‐sector wages (more open to competition), or whether it plays a passive role and merely follows wage negotiations in the private sector, there are important implications for macroeconomic development, particularly in small open economies and/or countries that are members of a monetary union, such as those of the European Monetary Union. With the notable exception of the case of Sweden, opinion on this issue is still divided. In this paper, we look at public‐ and private‐sector wage interactions from an international perspective (18 OECD countries). We focus on the causal two‐way relationship between public and private wage setting, confirming that the private sector, on the whole, appears to have a stronger influence on the public sector, rather than vice versa. However, we also find evidence of feedback effects from public wage setting, which affect private‐sector wages in a number of countries. When the private sector takes the lead on wages, there are few feedback effects from the public sector, while public wage leadership is typically accompanied by private‐sector feedback effects.
Lives Beyond Suspicion: Gender and the Construction of Respectability in Mid‐twentieth Century Rural North Wales
Authors: Brown Brian , Baker Sally , Day Graham
Published: September 2011

This article explores and extends the field of historical rural sociology using the idea of respectability via a biographical study of 20 older adults from North Wales (UK) for whom the performance of respectability represented a form of social, symbolic or cultural capital. It entailed the active negotiation and management of barriers between differing constituencies of opinion, generations and family members. Key to this situated respectability in practice was the notion that harsher systems of exclusion for transgressors were located elsewhere, rather than in the present or immediate community. The sense of the past evoked by participants highlights an historical, diachronic dimension to respectability. A particularised, carefully constructed image of the past was present in participants' evocations of respectability, providing a way of talking about identity and historical progression, as well as a means of managing potentially contentious events to preserve the dignity of the people concerned.
The Global Extent of the Great Moderation*
Authors: Ćorić Bruno
Published: September 2011

In 2008 the US financial crisis spilled over into a number of other economies causing declines in GDP across the world. Yet the decades preceding the current downturn had been a period of unprecedented stability for the US economy. This article examines annual data for 98 countries over the period 1961–2007 and finds that lower GDP growth volatility in the period preceding the current crisis was not confined to the US. It is detected in a number of developed and developing countries, suggesting that a reduction in volatility in this period was a more general phenomenon.
Multi‐product Firms and Product Variety
Authors: Caminal Ramon , Granero Lluís M.
Published: September 2011

We examine the role of multi‐product firms in the provision of product variety using the Chen–Riordan spokes model. In the presence of economies of scope, the equilibrium includes a small number of multi‐product firms that use their product range strategically in order to affect rivals' prices. We show that under some conditions, firms drastically restrict their product range in order to relax price competition, causing a substantial underprovision of variety. However, in general, product variety under multi‐product firms may be higher or lower with respect to both the first best and the equilibrium with single‐product firms.