bluuebunny/crossref_metadata_2025 huggingface dataset:
The Limits of Confidentiality
Authors: Cain Paul
Published: November 2006

Two conditions are commonly taken to constitute an obligation of confidentiality: information is entrusted by one person to another; and there is an express understanding that this will not be divulged. This conception of confidentiality, however, does not match much of the practice of health care. Health care practitioners would, for example, hold themselves to be under an obligation of confidentiality in situations where neither of these conditions obtain. The discussion proposes, therefore, two additional grounds for confidentiality. This is in order to clarify, in general terms, the scope of this obligation (i.e. to clarify at what point confidentiality can be said to have been broken). The ‘limits of confidentiality’, it is argued, are set by the wishes of the client or, where these are not known, by reference to those whose right and need to know relate to the care of the client. Anonymous references to the client outside this limit may not be breaches of confidence; whether they are or not depends, it is suggested, on if such reference is responsible.
Ethical Problems in Research on Families Who Are Abusing Children
Authors: Paavilainen Eija , Åstedt-Kurki Päivi , Paunonen Marita
Published: November 2006

Child abuse within the family is a highly sensitive issue and therefore difficult to research. This article is based on our experiences of a child abuse research project in Finland. Special attention is given to ethical considerations during the initiation of the study, and in the sampling procedures, data collection and reporting. Most importantly, all those taking part in studies on sensitive issues must be guaranteed full confidentiality and anonymity. There are also other ethical considerations that go beyond the usual concerns in the research process.
Administrative Decision Making in Response to Sudden Health Care Agency Funding Reductions: is there a role for ethics?
Authors: Wilson Donna M
Published: November 2006

In October 1993, a survey of health care agency administrators was undertaken shortly after they had experienced two sudden reductions in public funding. The purpose of this investigation was to gain insight into the role of ethics in health administrator decision making. A mail questionnaire was designed for this purpose. Descriptive statistics and content analysis were used to summarize the data.

Staff reductions and bed closures were the two most frequently reported mechanisms for addressing the funding reductions. Most administrators did not believe that these changes would have a negative public impact. In contrast, the majority indicated that future changes in reaction to additional funding reductions would have a negative public impact. Approximately one-third of the administrators reported ethics to be an element of recent administrative decision making, and one-half could foresee that ethics would be important in the future if reductions continued. These findings are discussed in relation to ethics. Issues for additional research are outlined.
Tensions in Sharing Client Confidences While Respecting Autonomy: implications for interprofessional practice
Authors: Allison Althea , Ewens Ann
Published: November 2006

This article aims to explore the ethical issues arising from the sharing of information in the context of interprofessional collaboration. The increased emphasis on interprofessional working has highlighted the need for greater collaboration and sharing of client information. Through the medium of a case study, we identify a number of tensions that arise from collaborative relationships, which are not conducive to supporting interprofessional working in an ethically sound manner.

Within this article, it is argued that the way forward within these collaborative relationships is to set clear parameters to the professional-client relationship, paying full regard to the autonomy of both the clients and the professionals involved. We conclude that this approach to working will place the client at the centre of care provision and arguments used for not collaborating that are based on breaches of confidentiality will be negated. Using the approach offered, collaborative working will be not only possible but desirable.
Maintaining Integrity Through Clinical Supervision
Authors: de Raeve Louise
Published: November 2006

This article suggests that there is a relationship between successfully maintaining integrity in nursing and the practical provision of opportunities for shared reflection offered by good clinical supervision. In order to establish this case, I will first give some definitions and then proceed to consider how these ideas relate conceptually. The article makes no attempt to offer empirical research as confirmation, but provides a conceptual and moral argument making use of anecdotes for puposes of clarification and illumination. It is the author’s belief that, if it is understood and implemented properly, clinical supervision offers a radical challenge to nursing’s existing culture. If nurses are interested in the survival of the profession, it is perhaps a challenge that has to be addressed.
Educating for Interprofessional Collaboration: Teaching about Values
Authors: Glen Sally
Published: November 2006

Effective interprofessional collaboration depends upon establishing understanding that respects differences in values and beliefs, and thus differences in response to the multiplicity of patient/client/user needs. To facilitate the latter, this article suggests that health and social care students need a formal knowledge of the meaning of values and the varieties of systems within which values are expressed. Students need especially to understand the genesis of their own professional value system and to recognize the gap that inevitably develops between the values of the professional and those of the society within which a professional may function. The conceptual framework that underpins the approach to teaching values to health and social care professionals advocated here is derived from key concepts identified from the literature relating to education for, and participation in, a democratic, multicultural, multifaith society. These are: tolerance, compromise and education for dialogue. Finally, it is suggested that professional educators must take seriously the tasks of educating for professional pluralism.
The Importance of Ethics in the Clinical Supervision of Nursing Students
Authors: Nylund Lillemor , Lindholm Lisbet
Published: November 2006

This article investigates whether or not an ethical attitude manifests itself in the clinical supervision of nursing students. The data consist of 57 narratives written by nursing students, which were subjected to latent content analysis. The interpretation represents a caring science perspective based on Eriksson’s ‘caring ethics’. The results showed that some students received good supervision, while others felt hurt and humiliated. The students were of the opinion that they should feel welcome, be allowed to take responsibility and be treated as individuals by their supervisors. Supervision can take a form such that the ethical element comes to the fore in the conduct of the students as well as of their supervisor. Both the students’ and the supervisor’s disposition permeates all the questions, actions and reflections that form part of supervision, which could help to bring students’ ethical sense to maturity.
Intrusion into Patient Privacy: a moral concern in the home care of persons with chronic mental illness
Authors: Magnusson Annabella , Lützén Kim
Published: November 2006

The aim of this study was to identify and analyse ethical decision making in the home care of persons with long-term mental illness. A focus was placed on how health care workers interpret and deal with the principle of autonomy in actual situations. Three focus groups involving mental health nurses who were experienced in the home care of persons with chronic mental illness were conducted in order to stimulate an interactive dialogue on this topic. A constant comparative analysis of the transcribed audiotaped sessions identified a central theme that concerned the moral symbolic meaning of ‘home’. This reflected the health care workers’ conflict between their professional role and their moral role, which they perceived as unclear.
Informed Consent for Short-Stay Surgery
Authors: Kanerva Anne-Maria , Suominen Tarja , Leino-Kilpi Helena
Published: November 2006

This study in the context of short-stay surgery is based on a definition according to which informed consent consists of five elements: consent, voluntariness, disclosure of information, understanding and competence. The data were collected in four district hospitals in southern Finland by using a structured questionnaire. The population consisted of short-stay and one-day surgery patients ( n = 107). Data analysis was based on statistical methods. The results indicated some problems in the realization of informed consent. Most commonly, consent was expressed by voluntary admission. Most patients had indicated their voluntary consent by making their decision independently. There were also certain problems with information. The respondents were least well informed about the drawbacks of anaesthesia and about alternative forms of treatment. The patients had not understood all the information they had received; problems of understanding were greatest with information about the advantages and disadvantages of anaesthesia. Problems were also reported with competence. These patients had the most difficulty in assessing the advantages and drawbacks of different treatments and anaesthesia.
A Study of the Ethics of Induced Abortion in Korea
Authors: Um Young-Rhan
Published: November 2006

The purposes of this study were to investigate the ethical aspects of induced abortion from the viewpoint of Korean women, and to compare and contrast their ethical considerations and values with the views of western ethical scholars. The two extremes of ethical arguments about induced abortion are pro-life and pro-choice. However, the Korean women who participated in this study showed that conflicting ethical values were raised between the principle of caring and the sanctity of life or the principle of respect for the person, not between the right of self-determination and the sanctity of life. The results of the study suggest that it would be better to include the viewpoints of women in any ethical discussion on abortion in order for ethicists and health professionals to understand more fully the dimensions of moral clinical problems and be in a better position to discuss them in a practical manner.
Can Foster Carers Help Children Resolve Their Emotional and Behavioural Difficulties?
Authors: Wilson Kate
Published: November 2006

Although foster care is generally seen as providing a positive experience for the children and young people for whom it caters, it is rarely conceived of as a place where the children are helped to address their emotional difficulties and modify their often difficult behaviour. Yet research evidence suggests that some foster carers are consistently less likely to have placements which break down, and that foster carers who show particular skills in parenting can make a difference to successful outcomes. The article draws on a large longitudinal study of foster care to argue that it is possible to learn from what these foster carers do in order to develop these skills in others. A model of successful foster care. developed from the main statistical part of the study is first described. Two cases from the qualitative, case-studies component of the research are then analysed to demonstrate a quality of responsive parenting. The model is further developed within the framework of the dynamic of attachment and interest sharing proposed by Heard and Lake (1997), to show how this can be used as a basis for future approaches to working with foster placements.
Cognitive-behavioural Group Intervention for PTSD Symptoms in Children Following the Athens 1999 Earthquake: A Pilot Study
Authors: Giannopoulou Ioanna , Dikaiakou Anastasia , Yule William
Published: November 2006

This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups - Group 1 ( N = 10), which started treatment 2 months after the earthquake and Group 2 ( N = 10), which started treatment at 4 months postearthquake. A statistically significant reduction in overall PTSD (Posttraumatic Stress Disorder) symptoms across the three PTSD symptom clusters - intrusion, avoidance, and arousal - as well as in depressive symptoms was reported immediately after the intervention. The treatment also produced a statistically significant improvement in children’s psychosocial functioning. Further significant improvement was reported in children at an 18-month follow-up. Treatment gains were maintained at a 4-year follow-up. Despite several limitations to this study, short-term group CBT (cognitive-behavioural therapy) was found to be a useful treatment approach, which can be offered in clinical settings, particularly if resources are limited.
Integrating Treatment and Education for Mood Disorders: An Adolescent Case Report
Authors: Navalta Carryl P. , Goldstein Jessica , Ruegg Laura , Perna David A. , Frazier Jean A.
Published: November 2006

This case study illustrates one successful outcome of an intensive, outpatient, treatment project for adolescents with mood disorders. An 18-year-old female with symptoms across several DSM-IV Axis I classifications, including a depressive disorder, and her parents participated in a year-long, multimodal intervention that included mood-focused psychoeducation and coaching designed to impact on her, her family, school, and community systems. Self-report, clinician-driven, and ecologically valid measures were used to assess treatment effects on psychiatric symptoms and psychosocial functioning. Results on the Child and Adolescent Functional Assessment Scale demonstrated considerable gains in the following areas: Home, school/work, social behavior, self-harm, thinking/communication, and substance use. During the intervention, she went from failing several of her classes to graduating from high school. In addition, she made the Honours’ List in her first semester at a local community college. A discussion of intervention pluses and pitfalls specific to the case highlight the necessity to influence the various spheres of the young person’s life.
Reducing Hyperactivity with a Feedback Actigraph: Initial Findings
Authors: Tryon Warren W. , Tryon Georgiana Shick , Kazlausky Thomas , Gruen William , Swanson James M.
Published: November 2006

Schulman and colleagues demonstrated that classroom activity level can be reduced in hyperactive boys using activity-level feedback and positive reinforcement. This article reports preliminary results using a device that combines modern beeper and actigraphy technology for the purpose of measuring, monitoring, and modifying motor excess in children with confirmed diagnoses of Attention Deficit Hyperactivity Disorder (ADHD). Nine boys ranging in age from 8 to 9 years with the ADHD Combined Type wore prototype BuzzBee® feedback actigraphs during school periods and were reinforced for activity-level reductions in the context of a simple pre/post research design. The findings indicated that 7 of the 9 boys reduced their activity level from 20 to 47% of baseline levels while the activity levels of the two remaining boys increased from 2 to 7% of baseline levels. These changes were statistically significant and constitute a large effect.
Screening for Conduct Disorder in an Adolescent Male Sample from Colombia
Authors: Pineda David A. , Kamphaus Randy W. , Restrepo Maria A. , Puerta Isabel C. , Arango Clara P. , Lopera Francisco J. , García-Barrera Mauricio A. , Dowdy Erin T.
Published: November 2006

This study assessed the validity, reliability, and utility of a screening measure for detecting the signs or symptoms of Conduct Disorder in male adolescents from schools in Medellín, Colombia. A first study examined the differences between 70 male offender adolescents (aged 12-16 years) attending alternative education institutions, and 68 (sex, age, and socioeconomic status (SES)-matched) adolescent controls attending regular schools. A CD checklist (CD-CL) was constructed to be used by mothers (CD-CL-M) and for self-report by adolescents (CD-CL-SR). The validity of the screener for CD diagnosis was supported by significant differences between groups (ANOVA, p < .001). The CD-CL-SR had better sensitivity/specificity with a diagnostic cut-off point of 5 (sensitivity = 95.3% and specificity = 90.5%) than the CD-CL-M. A second study used the CD-CLSR with a random sample of 190 male adolescents (aged 12 to 16 years) from schools of low, middle and high SES. Reliability as assessed by Cronbach’s alpha was 0.86. An epidemiological cut point of 5 classified 35.5% of the adolescents assessed as probable CD cases. A psychometric cut point at T score > 59 (85th percentile) estimated 16.8% of the sample as probable CD cases. A psychometric cut point at T score > 64 (90th percentile) revealed that 10.5% of the sample would be severe CD cases. Some significant differences ( p < 0.001) in proportions of CD adolescents were found between age and SES groups. It was concluded that such a high frequency of conduct problems in adolescence argues for the need for preventive programs in Colombian schools.
Pneumococcal conjugate vaccine provides early protective antibody responses in children after related and unrelated allogeneic hematopoietic stem cell transplantation
Authors: Meisel Roland , Kuypers Lisa , Dirksen Uta , Schubert Ralf , Gruhn Bernd , Strauss Gabriele , Beutel Karin , Groll Andreas H. , Duffner Ulrich , Blütters-Sawatzki Renate , Holter Wolfgang , Feuchtinger Tobias , Grüttner Hans-Peter , Schroten Horst , Zielen Stefan , Ohmann Christian , Laws Hans-Jürgen , Dilloo Dagmar ,   for the Impfung von Kindern nach allogener Stammzelltransplantation (IKAST) Study Group
Published: November 2006

Following allogeneic hematopoietic stem cell transplantation (alloHSCT), children are at risk of life-threatening pneumococcal infections. Whereas vaccination with polysaccharide vaccines fails to elicit protective immunity in most alloHSC transplant recipients, pneumococcal conjugate vaccines may effectively prevent invasive disease by eliciting T-cell–dependent antibody responses. Here, we report safety and immunogenicity in 53 children immunized with a regimen of 3 consecutive doses of a heptavalent pneumococcal conjugate vaccine (7vPCV) in monthly intervals starting 6 to 9 months after alloHSCT. Immunization was well tolerated with no vaccine-related serious adverse events. Serologic response rates evaluable in 43 patients ranged from 41.9% to 86.0% and 58.1% to 93.0% after 2 and 3 vaccinations, respectively, with 55.8% and 74.4% of patients achieving protective antibody levels to all 7 vaccine serotypes. Our study provides the first evidence that vaccination with 7vPCV is safe and elicits protective antipneumococcal antibody responses in pediatric recipients of related or unrelated donor alloHSC transplants within the first year following transplantation. This trial was registered at www.clinicaltrials.gov as NCT00169728.
Barriers and motivators to gaining access to smoking cessation services amongst deprived smokers – a qualitative study
Authors: Roddy Elin , Antoniak Marilyn , Britton John , Molyneux Andrew , Lewis Sarah
Published: November 2006

Background

Smoking is strongly associated with disadvantage and is an important contributor to inequalities in health. Smoking cessation services have been implemented in the UK targeting disadvantaged smokers, but there is little evidence available on how to design services to attract this priority group.

Methods

We conducted focus groups with 39 smokers aged 21–75 from the most socio-economically deprived areas of Nottingham UK who had made an unsuccessful attempt to quit within the last year without using smoking cessation services, to identify specific barriers or motivators to gaining access to these services.

Results

Barriers to use of existing services related to fear of being judged, fear of failure, a perceived lack of knowledge about existing services, a perception that available interventions – particularly Nicotine Replacement Therapy – are expensive and ineffective, and negative media publicity about bupropion. Participants expressed a preference for a personalised, non-judgemental approach combining counselling with affordable, accessible and effective pharmacological therapies; convenient and flexible timing of service delivery, and the possibility of subsidised complementary therapies.

Conclusion

We conclude that smokers from these deprived areas generally had low awareness of the services available to help them, and misconceptions about their availability and effectiveness. A more personalised approach to promoting services that are non-judgemental, and with free pharmacotherapy and flexible support may encourage more deprived smokers to quit smoking.
Emergency laparotomy for misdiagnosed biliary cystadenoma originating from caudate lobe
Authors: Ramacciato Giovanni , Nigri Giuseppe R , D'Angelo Francesco , Aurello Paolo , Bellagamba Riccardo , Colarossi Cristina , Pilozzi Emanuela , Del Gaudio Massimo
Published: November 2006

Background

Biliary cystadenoma is a rare benign neoplasm, which is often misdiagnosed for a hepatic abscess or a hydatid cyst that tends to recur and is at risk for progression to malignant neoplasm.

Case presentation

This case describes a 30-year-old woman admitted to our institution in an emergency setting. The patient was originally misdiagnosed as affected by a hepatic hydatid cyst at another hospital, and then emergently treated at our Institution for severe abdominal pain. Histologic evaluation of the cyst showed that it was a biliary cystadenoma and, therefore, the patient underwent a hepatic resection in order to completely remove the lesion.

Conclusion

Complete excision of any suspicious hepatic cystic lesion remains the best method for diagnosis and treatment of cystadenoma. Incomplete excision of most biliary cystadenoma results in a higher rate of recurrence and the risk of malignant transformation. We report this case to elucidate the clinical presentation, preoperative evaluation, and surgical treatment of these rare lesions.
Effects of nitric oxide synthase inhibitor ω-Nitro-L-Arginine Methyl Ester, on silica-induced inflammatory reaction and apoptosis
Authors: Wang He , Leigh James
Published: November 2006

Background

Although nitric oxide is overproduced by macrophages and neutrophils after exposure to silica, its role in silica-induced inflammatory reaction and apoptosis needs further clarification. In this study, rats were intratracheally instilled with either silica suspension or saline to examine inflammatory reactions and intraperitoneally injected with ω-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthases, or saline to examine the possible role of nitric oxide production in the reaction.

Results

Results showed that silica instillation induced a strong inflammatory reaction indicated by increased total cell number, number of neutrophils, protein concentration and lactate dehydrogenase (LDH) activity in bronchoalveolar lavage fluid (BALF). There were no significant differences in these indices between silica-instilled groups with and without L-NAME injection (p > 0.05) except LDH level. The results also showed that apoptotic leucocytes were identified in BALF cells of silica-instilled groups whereas no significant difference was found between silica-instilled groups with and without L-NAME injection in the apoptotic reaction (p > 0.05). Silica instillation significantly increased the level of BALF nitrite/nitrate and L-NAME injection reduced this increase.

Conclusion

Intratracheal instillation of silica caused an obvious inflammatory reaction and leucocyte apoptosis, but these reactions were not influenced by intraperitoneal injection of L-NAME and reduced production of NO. This supports the possibility that silica-induced lung inflammation and BALF cell apoptosis are via NO-independent mechanisms.
A rapid and robust method of identifying transformed Arabidopsis thaliana seedlings following floral dip transformation
Authors: Harrison Samuel J , Mott Ellie K , Parsley Kate , Aspinall Sue , Gray John C , Cottage Amanda
Published: November 2006

Background

The floral dip method of transformation by immersion of inflorescences in a suspension of Agrobacterium is the method of choice for Arabidopsis transformation. The presence of a marker, usually antibiotic- or herbicide-resistance, allows identification of transformed seedlings from untransformed seedlings. Seedling selection is a lengthy process which does not always lead to easily identifiable transformants. Selection for kanamycin-, phosphinothricin- and hygromycin B-resistance commonly takes 7–10 d and high seedling density and fungal contamination may result in failure to recover transformants.

Results

A method for identifying transformed seedlings in as little as 3.25 d has been developed. Arabidopsis T1 seeds obtained after floral dip transformation are plated on 1% agar containing MS medium and kanamycin, phosphinothricin or hygromycin B, as appropriate. After a 2-d stratification period, seeds are subjected to a regime of 4–6 h light, 48 h dark and 24 h light (3.25 d). Kanamycin-resistant and phosphinothricin-resistant seedlings are easily distinguished from non-resistant seedlings by green expanded cotyledons whereas non-resistant seedlings have pale unexpanded cotyledons. Seedlings grown on hygromycin B differ from those grown on kanamycin and phosphinothricin as both resistant and non-resistant seedlings are green. However, hygromycin B-resistant seedlings are easily identified as they have long hypocotyls (0.8–1.0 cm) whereas non-resistant seedlings have short hypocotyls (0.2–0.4 cm).

Conclusion

The method presented here is an improvement on current selection methods as it allows quicker identification of transformed seedlings: transformed seedlings are easily discernable from non-transformants in as little as 3.25 d in comparison to the 7–10 d required for selection using current protocols.
Myelodysplastic Syndromes in Patients Younger Than Age 50
Authors: Kuendgen Andrea , Strupp Corinna , Aivado Manuel , Hildebrandt Barbara , Haas Rainer , Gattermann Norbert , Germing Ulrich
Published: November 2006

Purpose

Myelodysplastic syndromes (MDS) mainly occur in the elderly but can affect younger individuals too. The latter require special consideration to identify suitable candidates for allogeneic stem-cell transplantation, a potentially curative approach carrying a high risk of treatment-related complications.

Patients and Methods

We report the largest series of young MDS patients as yet, including 232 patients younger than 50 years. Their clinical characteristics and prognosis are compared with 2,496 patients older than 50 years.

Results

Survival was significantly longer in the younger versus older age group (40 v 23 months, respectively; P < .00005). The difference arose from patients belonging to the low- and intermediate-I–risk categories of the International Prognostic Scoring System (median survival not reached v 45 months, respectively; P < .00005). In contrast, survival was identical for both age groups (8 months for both younger and older patients; P = .81) in the intermediate-II–and high-risk categories. Established classification systems and risk scores were applicable to young patients with primary MDS. Interestingly, a particularly large difference in median survival time was seen between the intermediate-I–and intermediate-II–risk groups (176 v 8 months, respectively). For low-risk patients, the overall survival rate was more than 86% at 20 years.

Conclusion

According to these results, aggressive treatment approaches should rarely be recommended to younger MDS patients belonging to the low and intermediate-I risk groups.
The Arabidopsis elch mutant reveals functions of an ESCRT component in cytokinesis
Authors: Spitzer Christoph , Schellmann Swen , Sabovljevic Aneta , Shahriari Mojgan , Keshavaiah Channa , Bechtold Nicole , Herzog Michel , Müller Stefan , Hanisch Franz-Georg , Hülskamp Martin
Published: November 2006

Recently, an alternative route to the proteasomal protein-degradation pathway was discovered that specifically targets transmembrane proteins marked with a single ubiquitin to the endosomal multivesicular body (MVB) and,subsequently, to the vacuole (yeast) or lysosome (animals), where they are degraded by proteases. Vps23p/TSG101 is a key component of the ESCRT I-III machinery in yeast and animals that recognizes mono-ubiquitylated proteins and sorts them into the MVB. Here, we report that the Arabidopsis ELCH(ELC) gene encodes a Vps23p/TSG101 homolog, and that homologs of all known ESCRT I-III components are present in the Arabidopsis genome. As with its animal and yeast counterparts, ELC binds ubiquitin and localizes to endosomes. Gel-filtration experiments indicate that ELC is a component of a high-molecular-weight complex. Yeast two-hybrid and immunoprecipitation assays showed that ELC interacts with Arabidopsis homologs of the ESCRT I complex. The elc mutant shows multiple nuclei in various cell types,indicating a role in cytokinesis. Double-mutant analysis with kaktusshows that increased ploidy levels do not influence the cytokinesis effect of elc mutants, suggesting that ELC is only important during the first endoreduplication cycle. Double mutants with tubulin folding cofactor a mutants show a synergistic phenotype, suggesting that ELC regulates cytokinesis through the microtubule cytoskeleton.
LobeandSerrateare required for cell survival during early eye development inDrosophila
Authors: Singh Amit , Shi Xiao , Choi Kwang-Wook
Published: November 2006

Organogenesis involves an initial surge of cell proliferation, leading to differentiation. This is followed by cell death in order to remove extra cells. During early development, there is little or no cell death. However,there is a lack of information concerning the genes required for survival during the early cell-proliferation phase. Here, we show that Lobe(L) and the Notch (N) ligand Serrate (Ser), which are both involved in ventral eye growth, are required for cell survival in the early eye disc. We observed that the loss-of-ventral-eye phenotype in L or Ser mutants is due to the induction of cell death and the upregulation of secreted Wingless (Wg). This loss-of-ventral-eye phenotype can be rescued by (i) increasing the levels of cell death inhibitors, (ii)reducing the levels of Hid-Reaper-Grim complex, or (iii) reducing canonical Wg signaling components. Blocking Jun-N-terminal kinase (JNK) signaling, which can induce caspase-independent cell death, significantly rescued ventral eye loss in L or Ser mutants. However, blocking both caspase-dependent cell death and JNK signaling together showed stronger rescues of the L- or Ser-mutant eye at a 1.5-fold higher frequency. This suggests that L or Ser loss-of-function triggers both caspase-dependent and -independent cell death. Our studies thus identify a mechanism responsible for cell survival in the early eye.
Renal function – estimation of glomerular filtration rate
Authors: Thomas Lothar , Huber Andreas R.
Published: November 2006

Assessment and follow-up of renal dysfunction is important in the early detection and management of chronic kidney disease. The glomerular filtration rate (GFR) is the most accurate measurement of kidney disease and is reduced before the onset of clinical symptoms. Drawbacks to the measurement of GFR include the high cost and incompatibility with routine laboratory monitoring. Serum creatinine determination is a mainstay in the routine laboratory profile of renal function. The measurement of serum cystatin C has been proposed as a more sensitive marker for GFR. According to National Kidney Foundation-K/DOQ1 clinical guidelines for chronic kidney disease, serum markers should not be used alone to assess GFR. Based on prediction equations, clinical laboratories should report an estimate of GFR, in addition to reporting the serum value. In this article, information is presented on how best to estimate GFR using prediction equations for adults and for children. Using serum creatinine concentration with the Modification of Diet in Renal Disease (MDRD) study equation offers a suitable estimation of GFR in adults. The cystatin C prediction equation with the use of a prepubertal factor seems superior to creatinine-based prediction equations in children of <14years.

Clin Chem Lab Med 2006;44:1295–302.
Serum pro-hepcidin concentrations and their responses to oral iron supplementation in healthy subjects manifest considerable inter-individual variation
Authors: Luukkonen Susanna , Punnonen Kari
Published: November 2006

Hepcidin participates in the regulation of iron homeostasis and its precursor pro-hepcidin can be measured in serum. We evaluated pro-hepcidin serum concentrations in healthy subjects and the possible effects of iron supplementation on the results. The results suggest extensive physiological variation in serum pro-hepcidin concentrations between healthy subjects with no symptoms or signs of anaemia, infections, inflammations, chronic disease or other interpretative factors. Before pro-hepcidin measurements can be used in clinical practise, further investigations are required to identify the physiological factors affecting normal serum pro-hepcidin variations in healthy subjects. The responses of serum pro-hepcidin to a 100-mg oral dose of iron also showed considerable inter-individual variation. In male subjects, no systematic changes in serum pro-hepcidin concentrations were found and the increase in serum iron was fairly modest. In nine out of the ten female subjects who had rather low amounts of storage iron, iron supplementation was followed by an increase in both serum iron and serum pro-hepcidin concentrations. There were considerable inter-individual differences in the timing and magnitude of the response. We also evaluated the conceivable influences of sample storage and freeze-thaw cycles on the results of serum pro-hepcidin ELISA. We did not observe any changes in the results after serum samples were frozen and thawed up to four times and/or stored at room temperature for up to 6h.

Clin Chem Lab Med 2006;44:1361–2.
Automation and validation of a fast method for the assessment of in vivo oxidative stress levels
Authors: Vassalle Cristina , Boni Claudio , Di Cecco Pietro , Ndreu Rudina , Zucchelli Gian Carlo
Published: November 2006

Clin Chem Lab Med 2006;44:1372–5.
Urine flow cytometry and detection of glomerular hematuria
Authors: Scharnhorst Volkher , Gerlag Paul G.G. , Nanlohy Manuhutu Miel L. , van der Graaf Fedde
Published: November 2006

Clin Chem Lab Med 2006;44:1330–4.
Analytical validation of the new plasma calibrated Accu-Chek® Test Strips (Roche Diagnostics)
Authors: Meex Cécile , Poncin José , Chapelle Jean-Paul , Cavalier Etienne
Published: November 2006

Clin Chem Lab Med 2006;44:1376–8.
Chymotrypsin effects on the determination of sperm parameters and seminal biochemistry markers
Authors: Chen Fang , Lu Jin-Chun , Xu Hui-Ru , Huang Yu-Feng , Lu Nian-Qing
Published: November 2006

Clin Chem Lab Med 2006;44:1335–9.
MTRR 66A>G polymorphism in relation to congenital heart defects
Authors: van Beynum Ingrid M. , Kouwenberg Margreet , Kapusta Livia , den Heijer Martin , van der Linden Ivon J.M. , Daniels Otto , Blom Henk J.
Published: November 2006

Clin Chem Lab Med 2006;44:1317–23.
Regelungs- und Steuerungskonzepte für Neuroprothesen am Beispiel der oberen Extremitäten (Closed- and Open-Loop Control Concepts for Neuroprostheses of Upper Extremities)
Authors: Mikut Ralf , Krüger Thilo , Reischl Markus , Burmeister Ole , Rupp Rüdiger , Stieglitz Thomas
Published: November 2006

In der funktionellen Rehabilitation werden Neuroprothesen eingesetzt, um verloren gegangene motorische, sensorische oder vegetative Funktionen wiederherzustellen. Die notwendige Kopplung zwischen technischen Systemen und dem Nervensystem erfordert Schnittstellen, die unterschiedliche Anforderungen zur Ableitung sensorischer oder motorischer Signale sowie zur Stimulation von absteigenden (Efferenzen) bzw. aufsteigenden Nervenbahnen (Afferenzen) erfüllen müssen. Die vorliegende Arbeit konzentriert sich hauptsächlich auf Problemstellungen der funktionellen Wiederherstellung der oberen Extremitäten und gliedert sich in drei Teile: Zum einen gibt sie einen Überblick über den Stand der Technik für Neuroprothesen, bei denen bisher nur einfache Steuerungen mit beschränkter Griff-Funktionalität sowohl bei künstlichen Unterarmprothesen als auch bei einer Funktionellen Elektrostimulation dominieren. Zweitens zeigt sie exemplarisch anhand eigener tierexperimenteller Daten Möglichkeiten und Grenzen der Erfassung und intelligenten Auswertung afferenter, sensorischer Signale nach mechanischer Stimulation der Haut auf. Drittens diskutiert sie Perspektiven am Beispiel der Funktionswiederherstellung der oberen Extremität, insbesondere der Greiffunktion. Zur Verbesserung der Funktionalität werden Konzepte zur Regelung und zum Einsatz natürlicher, adäquater Signale für die Rückkopplung zum Patienten vorgeschlagen.
Kamerabasierte Regelung von Feuerungsprozessen mit dem Software-Werkzeug INSPECT (Camera Aided Control of Combustion Processes with the Software Tool INSPECT)
Authors: Zipser Stephan , Matthes Jörg , Keller Hubert B.
Published: November 2006

Für eine energieeffiziente und gleichzeitig schadstoffarme Nutzung variabler Brennstoffe wie Biomasse oder Abfallstoffe sind auf Grund stark schwankender Brennstoffeigenschaften adaptive Regelstrategien erforderlich. Die hierzu notwendigen Informationen über den — wegen der inhomogenen Brennstoffe zeitlich und örtlich stark variierenden — Verbrennungszustand lassen sich nur durch den Einsatz von Kameras erfassen. Mit dem Software-System INSPECT werden in zuverlässiger Weise diese Informationen mittels Bildverarbeitung aus Infrarot- und Videoaufnahmen online ermittelt. INSPECT liefert charakteristische Kenngrößen zur Überwachung, Analyse und Regelung von Verbrennungsprozessen. Anhand industrieller Anwendungen des INSPECT-Systems wird in diesem Beitrag das Potential einer kamerabasierten Verbrennungsoptimierung aufgezeigt.
Recurrent Infections, Hypotonia, and Mental Retardation Caused by Duplication of MECP2 and Adjacent Region in Xq28
Authors: Friez Michael J. , Jones Julie R. , Clarkson Katie , Lubs Herbert , Abuelo Dianne , Bier Jo-Ann Blaymore , Pai Shashidhar , Simensen Richard , Williams Charles , Giampietro Philip F. , Schwartz Charles E. , Stevenson Roger E.
Published: November 2006

OBJECTIVE. Our goal was to describe the neurologic and clinical features of affected males from families with X-linked patterns of severe mental retardation, hypotonia, recurrent respiratory infection, and microduplication of Xq28 that consistently includes the MECP2 (methyl-CpG binding protein 2) gene.

STUDY DESIGN. To identify duplications, multiplex ligation-dependent probe amplification of the MECP2 gene was performed on male probands from families with X-linked mental retardation. The males either had linkage to Xq28 or had a phenotype consistent with previous reports involving Xq28 functional disomy. After detection of a duplication of MECP2, additional family members were tested to confirm the MECP2 duplication segregated with the affected phenotype, and X-inactivation studies were performed on carrier females.

RESULTS. Six families with multiple affected males having MECP2 duplications were identified by multiplex ligation-dependent probe amplification, and the carrier mothers were subsequently shown to have highly skewed X inactivation. In 5 of 6 families, the microduplication extended proximally to include the L1 cell adhesion molecule gene. The primary clinical features associated with this microduplication are infantile hypotonia, recurrent respiratory infection, severe mental retardation, absence of speech development, seizures, and spasticity.

CONCLUSIONS. Although many of the phenotypic features of our patients are rather nonspecific in cohorts of individuals with syndromic and nonsyndromic mental retardation, the proneness to infection is quite striking because the patients had normal growth and were not physically debilitated. Although the etiology of the infections is not understood, we recommend considering MECP2 dosage studies and a genetics referral in individuals with severe developmental delay and neurologic findings, especially when a history of recurrent respiratory ailments has been documented.
Monozygotic Twins With Turner Syndrome Develop Slipped Capital Femoral Epiphysis on Growth Hormone Therapy
Authors: Nabhan Zeina M. , Eugster Erica A.
Published: November 2006

Monozygotic twins with Turner syndrome have rarely been reported. An increased incidence of slipped capital femoral epiphysis has been associated with growth hormone therapy, as well as with Turner syndrome, but has never been described in twins with Turner syndrome. We report the first case of monozygotic twins with Turner syndrome with a 46,Xi(Xq) karyotype, both of whom developed slipped capital femoral epiphysis during growth hormone therapy. This report adds to existing reports of monozygotic twins with Turner syndrome and contributes to recognition of the potential clinical course in such patients. In addition, the association between slipped capital femoral epiphysis, growth hormone therapy, and Turner syndrome is emphasized.
Development and validation of the Portuguese version of the WHOQOL-OLD module
Authors: Fleck Marcelo P , Chachamovich Eduardo , Trentini Clarissa
Published: November 2006

OBJECTIVE: The increasing proportion of older adults in the general population and the specific characteristics of this age group show the need for the development of specific instruments to measure quality of life in older adults. The study aimed at describing the development and validation of the Portuguese version of the World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) module. METHODS: The WHOQOL-OLD instrument was administered in a sample of 424 older adults in the city of Porto Alegre, Southern Brazil, in 2005. The questionnaire comprises 24 items divided into six facets: sensory abilities; autonomy; past, present and future activities; social participation; death and dying; and intimacy. Besides the WHOQOL-OLD module, the WHOQOL-BREF, BDI and BHS instruments were also applied. The instrument's internal consistency was assessed using Cronbach's alpha coefficient. RESULTS: The instrument showed adequate internal consistency (Cronbach's coefficients ranging from 0.71 to 0.88), discriminant validity (p<0.01), concurrent validity (correlation coefficients ranging from -0.61 to -0.50) and test-retest reliability (correlation coefficients ranging from 0.58 to 0.82). Findings concerning criterion validity need further studies. CONCLUSIONS: The WHOQOL-Old module is a useful alternative with good psychometric performance in the investigation of quality of life in older adults.
Análise geoestatística de casos de hanseníase no Estado de São Paulo, 1991-2002
Authors: Opromolla Paula A , Dalben Ivete , Cardim Márcio
Published: November 2006

OBJETIVO: Analisar o padrão espacial da ocorrência dos casos de hanseníase para identificar áreas com probabilidade de riscos de transmissão da doença. MÉTODOS: Estudo ecológico, tendo como unidade de análise os municípios do Estado de São Paulo georreferenciados em seus centróides. A fonte de dados utilizada foi o banco informatizado dos casos de hanseníase notificados do Centro de Vigilância Epidemiológica do Estado de São Paulo, no período de 1991 a 2002. Utilizou-se de técnicas de geoestatística para a detecção das áreas de probabilidade de risco para hanseníase e quantificação da dependência espacial dos casos. RESULTADOS: Detectou-se o alcance de dependência espacial de 0,55 graus de coordenadas georreferenciadas, correspondendo aproximadamente a 60 km. As principais áreas de probabilidade de risco encontradas foram as regiões nordeste, norte e noroeste do Estado. CONCLUSÕES: A verificação de áreas com probabilidades de riscos de casos de hanseníase, utilizando-se a análise da dependência espacial, pode ser ferramenta útil para avaliar a situação de saúde e planejar alocação de recursos.
Controle público e eqüidade no acesso a hospitais sob gestão pública não estatal
Authors: Carneiro Junior Nivaldo , Elias Paulo Eduardo
Published: November 2006

OBJETIVO: Analisar as organizações sociais de saúde à luz do controle público e da garantia da eqüidade no acesso aos serviços de saúde. MÉTODOS: Utilizou-se a técnica de estudo de caso e foram selecionadas duas organizações sociais de saúde na região metropolitana de São Paulo. As categorias analíticas foram eqüidade no acesso e controle público, baseando-se em entrevistas com informantes-chave e relatórios técnico-administrativos. RESULTADOS: Observou-se que financiamento global e o controle administrativo das organizações sociais de saúde são atribuições do gestor estadual. A presença do gestor local é importante para a garantia da eqüidade no acesso, sendo que o controle público se expressa por ações fiscalizadoras mediante procedimentos contábil-financeiros. CONCLUSÕES: A eqüidade no acesso e o controle público não são contemplados na gestão dessas organizações. A questão central encontra-se na capacidade do poder público se fazer presente na implementação dessa modalidade no âmbito local, garantido a eqüidade no acesso e contemplando o controle público.
Prevalência da soropositividade do anti-HCV em pacientes dialisados
Authors: Gomes Marcia , Gigante Luciana Petrucci , Gomes Jane , Boschetti Jaqueline , Carvalho Glayds
Published: November 2006

Estudo transversal para verificar a prevalência de anticorpos contra hepatite em pacientes dialisados e fatores associados. Foi realizada revisão de prontuários de todos os pacientes dialisados (n=1.261) de Porto Alegre, RS, de agosto a dezembro de 2003. Os testes estatísticos aplicados foram o qui-quadrado e o teste de tendência linear. A medida de efeito foi a razão de prevalências. A análise de regressão logística múltipla foi realizada por regressão de Cox. A prevalência de anticorpos contra hepatite foi 29,1%, com prevalência maior entre pacientes atendidos em hemodiálise onde não havia separação dos soropositivos e existia reutilização do dialisador. Essa associação permaneceu mesmo após controle para fatores de confusão. Pacientes que receberam transfusão sangüínea tiveram acréscimo linear na prevalência de anticorpos. O tempo de diálise mostrou associação do tipo dose-resposta com os anticorpos contra hepatite.