bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving eye care for Indigenous Australians in primary health care settings
Authors: Boudville Andrea I. , Anjou Mitchell D. , Taylor Hugh R.
Published: April 2013

Background

This paper aims to assess the barriers and solutions to the delivery of eye care in primary care settings and solutions to improve the use of comprehensive eye care among Indigenous Australians.

Design, setting, participants

Qualitative, mixed method study participants include Aboriginal community members, and health and eye care providers in urban, rural and remote settings.

Main outcome measures

Present evidence for health care providers to better understand and address some of the barriers that limit access to eye care in primary care settings.

Results

Patient perspectives on barriers to accessing eye care and reasons they choose to seek care or not are presented. Health system barriers identified by health and eye care providers are also presented. Additionally, key enablers for improving access to eye care through primary care services are identified.

Conclusion

Primary health care services have an important role in Indigenous eye health. There is a critical role for primary care in the coordination of the patient journey and cooperating with other services to improve access to comprehensive eye care. Through improved provision of primary eye care, monitoring of Indigenous eye health indicators and supporting patients to access eye care, it is possible to close the gap for vision.
Indigenous perspectives on the desired attributes of medical graduates practising in remote communities: A Northwest Queensland pilot study
Authors: Woolley Torres , Sivamalai Sundram , Ross Simone , Duffy Glenda , Miller Adrian
Published: April 2013

Introduction

Providing an emphasis on Indigenous health in medical undergraduate education is seen as a high priority by Australian medical organisations. A regional North Queensland medical school asked local Indigenous people to list personal attributes they want to see in graduate doctors who choose to practise in their remote community.

Methods

This 2011 pilot study used a participatory action research design, with 13 local Indigenous health professionals, elders and community members from Mount Isa participating as co‐researchers in ‘Yarning Circles’ discussing desired medical graduate attributes. Medical school co‐researchers inductively extracted themes from the discussions via a qualitative ‘grounded theory’ approach.

Results

Eight major subtopics were identified by the Mount Isa Indigenous community around desired skills, knowledge and attitudes for graduate doctors: provision of quality patient care; culturally appropriate communication; medical knowledge; culturally appropriate knowledge; knowing the local health system; a positive personality; a positive attitude to working with Indigenous peoples; and a desire to engage with the Indigenous community.

Discussion

Effective communications with Indigenous patients and working in remote Indigenous communities requires doctors to have appropriate clinical skills, medical knowledge, knowledge about how local health systems operate, familiarity with significant Indigenous health issues such as child safety and alcohol management, and positive attitudes to working with, learning about and providing an advocacy role for Indigenous peoples.

Conclusions

Findings have implications for enhancing the professional behaviours and engagement of James Cook University medical students in Indigenous communities while on rural placement and after graduation, and for Australian medical and health practitioners more broadly.
Helping policy‐makers address rural health access problems
Authors: Russell Deborah J. , Humphreys John S. , Ward Bernadette , Chisholm Marita , Buykx Penny , McGrail Matthew , Wakerman John
Published: April 2013

This paper provides a comprehensive review of the key dimensions of access and their significance for the provision of primary health care and a framework that assists policy‐makers to evaluate how well policy targets the dimensions of access. Access to health care can be conceptualised as the potential ease with which consumers can obtain health care at times of need. Disaggregation of the concept of access into the dimensions of availability, geography, affordability, accommodation, timeliness, acceptability and awareness allows policy‐makers to identify key questions which must be addressed to ensure reasonable primary health care access for rural and remote Australians. Evaluating how well national primary health care policies target these dimensions of access helps identify policy gaps and potential inequities in ensuring access to primary health care. Effective policies must incorporate the multiple dimensions of access if they are to comprehensively and effectively address unacceptable inequities in health status and access to basic health services experienced by rural and remote Australians.
Factors affecting parents' presence with their extremely preterm infants in a neonatal intensive care room
Authors: Heinemann Ann‐Britt , Hellström‐Westas Lena , Hedberg Nyqvist Kerstin
Published: April 2013

Aim

To describe parents' experiences of factors that influenced their stay with their extremely preterm infants in a neonatal intensive care unit (NICU).

Methods

This study has a qualitative descriptive design based on semistructured interviews conducted with seven mothers and six fathers.

Results

Opportunities to stay overnight together with their infant facilitated parental presence, and opportunities for taking over their infant's care empowered the parents in their parental role and increased their motivation to stay. Kangaroo mother care helped them to feel in control and feel needed, which increased their presence. High levels of illumination and noise rendered it difficult for parents to sleep and stay overnight with the infant. Low staffing levels limited their use of kangaroo mother care when they had to wait for assistance to transfer the infant from the incubator. Several participants perceived the performance of painful procedures on their child as stressful and as an obstacle to their presence.

Conclusion

Kangaroo mother care and active involvement in the infant's care gave parents a sense of control and strengthened their motivation to be with their infant. High levels of noise and illumination and a dismissive staff attitude were obstacles to parents' presence.
Therapeutic Window for Combination Therapy of A91 Peptide and Glutathione Allows Delayed Treatment After Spinal Cord Injury
Authors: del Rayo Garrido María , Silva‐García Raúl , García Elisa , Martiñón Susana , Morales Mariana , Mestre Humberto , Flores‐Domínguez Carmina , Flores Adrian , Ibarra Antonio
Published: April 2013

Immunisation with neural‐derived peptides is a promising strategy in models of spinal cord (SC) injury. Recent studies have also demonstrated that the addition of glutathione monoethyl ester (GHSE) to this strategy further improves motor recovery, tissue protection and neuronal survival after SC injury. As it is realistic to envision that this combination therapy could be tested in clinical trials, the therapeutic window should be experimentally explored before implementing its use in SC‐injured human beings. For this purpose, 50 rats (10 per group) were subjected to a moderate SC contusion. The combined therapy was initiated at 10 min., 24, 72 or 120 hr after injury. Motor recovery and the survival of rubrospinal (RS) and ventral horn (VH) neurones were evaluated 60 days after injury. Results showed a significant motor improvement even if the combined therapy was initiated up to 72 hr after injury. BBB scores were as follows: 10 min.: 10.5 ± 0.7, 24 hr: 10.7 ± 0.5, 72 hr: 11.0 ± 1.3 and PBS: 6.7 ± 1 (mean ± S.D.). Initiation of combined therapy 120 hr after injury had no beneficial effect on motor recovery. Survival of RS and VH neurones was significantly higher in animals treated during the first 72 hr than those treated only with PBS. In this case again, animals treated with combined therapy 120 hr after injury did not present significant survival of neurones. Treatment with this combined strategy has a clinically feasible therapeutic window. This therapy provides enough time to transport and diagnose the patient and allows the concomitant use of other neuroprotective therapies.
“Prion‐Like” Templated Misfolding in Tauopathies
Authors: Clavaguera Florence , Lavenir Isabelle , Falcon Ben , Frank Stephan , Goedert Michel , Tolnay Markus
Published: April 2013

The soluble microtubule‐associated protein tau forms hyperphosphorylated, insoluble and filamentous inclusions in a number of neurodegenerative diseases referred to as “tauopathies.” In Alzheimer's disease, tau pathology develops in a stereotypical manner, with the first lesions appearing in the locus coeruleus and entorhinal cortex, from where they appear to spread to the hippocampus and neocortex. Propagation of tau pathology is also a characteristic of argyrophilic grain disease, where the tau lesions spread throughout the limbic system. Significantly, isoform composition and morphology of tau filaments can differ between tauopathies, suggesting the existence of distinct tau strains. Extensive experimental findings indicate that prion‐like mechanisms underly the pathogenesis of tauopathies.
Magnetic anomalies associated with salt tectonism, deep structure and regional tectonics in the Maritimes Basin, Atlantic Canada
Authors: Hayward N. , Dehler S. A. , Grant A. C. , Durling Paul
Published: April 2013

The structure and tectonic evolution of an evaporite basin are investigated in this case study, which combines the interpretation of magnetic data with the more commonly applied seismic reflection and gravity methods. The Maritimes Basin contains up to 18 km of Upper Palaeozoic sedimentary rocks resting on the basement of the Acadian orogeny. Carboniferous rocks are intensely deformed to the southeast of the Magdalen Islands as a result of deformation of evaporites of the Viséan Windsor Group. Short‐wavelength (<5 km) magnetic lineations define NNE‐ and ENE‐trending linear belts, coincident with the mapped pattern of salt structures. Magnetic models show that these lineations can be explained by the infill of subsidence troughs by high‐susceptibility sediment and/or the presence of basaltic rocks, similar to those uplifted and exposed on the Magdalen Islands. Additional shallow, magnetic sources are interpreted to result from alteration mineralization in salt‐impregnated, iron‐rich sedimentary rocks, brecciated during salt mobilization. Magnetic susceptibility measurements of samples from the Pugwash mine confirm the presence of higher susceptibility carnallite‐rich veins within salt units. Salt tectonism and basin development were influenced by the structure of the base group, the deepest regionally continuous seismic reflections (ca. 5–11 km), associated with an unconformity at the base of the Windsor Group, sampled at the Cap Rouge well. Salt structural evolution, formation of the magnetic lineations and geometry of the base group are associated with regional dextral transpression during basin development (late Carboniferous) and/or Alleghanian Orogeny (late Carboniferous to Permian). In this and similar studies, the effective use of magnetics is dependent upon the presence of rocks of high magnetic susceptibility in contrast to the low‐susceptibility salt bodies. In the absence of high‐susceptibility rocks, magnetic lows over the salt structures may be modelled, similar to commonly applied gravity techniques, to derive the internal structure and geometry.
Anomalous passive subsidence of deep‐water sedimentary basins: a prearc basin example, southern New Caledonia Trough and Taranaki Basin, New Zealand
Authors: Baur Jan , Sutherland Rupert , Stern Tim
Published: April 2013

Stratigraphic data from petroleum wells and seismic reflection analysis reveal two distinct episodes of subsidence in the southern New Caledonia Trough and deep‐water Taranaki Basin. Tectonic subsidence of ~2.5 km was related to Cretaceous rift faulting and post‐rift thermal subsidence, and ~1.5 km of anomalous passive tectonic subsidence occurred during Cenozoic time. Pure‐shear stretching by factors of up to 2 is estimated for the first phase of subsidence from the exponential decay of post‐rift subsidence. The second subsidence event occured ~40 Ma after rifting ceased, and was not associated with faulting in the upper crust. Eocene subsidence patterns indicate northward tilting of the basin, followed by rapid regional subsidence during the Oligocene and Early Miocene. The resulting basin is 300–500 km wide and over 2000 km long, includes part of Taranaki Basin, and is not easily explained by any classic model of lithosphere deformation or cooling. The spatial scale of the basin, paucity of Cenozoic crustal faulting, and magnitudes of subsidence suggest a regional process that acted from below, probably originating within the upper mantle. This process was likely associated with inception of nearby Australia‐Pacific plate convergence, which ultimately formed the Tonga‐Kermadec subduction zone. Our study demonstrates that shallow‐water environments persisted for longer and their associated sedimentary sequences are hence thicker than would be predicted by any rift basin model that produces such large values of subsidence and an equivalent water depth. We suggest that convective processes within the upper mantle can influence the sedimentary facies distribution and thermal architecture of deep‐water basins, and that not all deep‐water basins are simply the evolved products of the same processes that produce shallow‐water sedimentary basins. This may be particularly true during the inception of subduction zones, and we suggest the term ‘prearc’ basin to describe this tectonic setting.
A total‐evidence phylogenetic analysis ofHormaphidinae (Hemiptera:Aphididae), with comments on the evolution of galls
Authors: Chen Jing , Jiang Li‐Yun , Qiao Ge‐Xia
Published: April 2013

A phylogenetic analysis of Hormaphidinae is presented based on a total‐evidence approach. Four genes (two mitochondrial,COIandCytB, and two nuclear,EF‐1αandLWO) are combined with 65 morphological and seven biological characters. Sixty‐three hormaphidine species representing three tribes and 36 genera as well as nine outgroups are included. Parsimony and model‐based approaches are used, and several support values and implied weighting schemes are explored to assess clade stability. The monophyly of Hormaphidinae and Nipponaphidini is supported, but Cerataphidini and Hormaphidini are not recovered as monophyletic. Based on the parsimony hypothesis from the total‐evidence analysis, the phylogenetic relationships within Hormaphidinae are discussed. Cerataphidini is re‐delimited to excludeDoraphisandTsugaphis, and Hormaphidini is redefined to includeDoraphis.CeratocallisQiao & Zhang is established as a junior synonym ofCeratoglyphinavan der Goot, syn. nov.Lithoaphis quercisuctaQiao, Guo & Zhang is transferred to the genusNeohormaphisNoordam asNeohormaphis quercisucta(Qiao, Guo & Zhang) comb. nov. Galls have evolved independently within three tribes of Hormaphidinae. In Cerataphidini, pseudogalls are ancestral, both single‐cavity and multiple‐cavity galls have evolved once, and galls appear to have evolved towards greater complexity. Galling on secondary hosts has evolved twice in hormaphidines.
A Comparison of Linear Demographic Models and Fraction of Lifetime Egg Production for Assessing Sustainability in Sharks
Authors: CHAPPLE TAYLOR K. , BOTSFORD LOUIS W.
Published: April 2013

Conventional methods for management of data‐rich fisheries maintain sustainable populations by assuring that lifetime reproduction is adequate for individuals to replace themselves and accounting for density‐dependent recruitment. Fishing is not allowed to reduce relative lifetime reproduction, the fraction of current egg production relative to unfished egg production (FLEP), below a sustainable level. Because most shark fisheries are data poor, other representations of persistence status have been used, including linear demographic models, which incorporate life‐history characteristics in age‐structured models with no density dependence. We tested how well measures of sustainability from 3 linear demographic methods (rebound potential, stochastic growth rate, and potential population increase) reflect actual population persistence by comparing values of these measures with FLEP for 26 shark species. We also calculated the value of fishing mortality (F) that would allow all 26 species to maintain an accepted precautionary threshold for sharks of FLEP = 60%, expressing F as a fraction of natural mortality (M). Values of stochastic growth rate and potential population growth did not covary in rank order with FLEP (p = 0.057 and p = 0.077, respectively) and neither was significantly correlated with FLEP. Ordinal ranking of rebound potential positively covaried with FLEP (p = 0.00013), but the relative rankings of some species were substantially out of order. Adopting a sustainable limit of F = 0.16M would maintain all 26 species above the precautionary minimum value of FLEP (60%). We concluded that shark‐fishery and conservation policies should rely on calculation of replacement (i.e., FLEP), and that sharks should be fished at a precautionary level that would protect all stocks (i.e., F< 0.16M).

Comparación entre Modelos Demográficos Lineales y la Fracción de Producción de Huevos a lo Largo de la Vida para Estudiar la Sustentabilidad en Tiburones Resumen
Parental rearing behavior prospectively predicts adolescents’ risky decision‐making and feedback‐related electrical brain activity
Authors: Euser Anja S. , Evans Brittany E. , Greaves‐Lord Kirstin , Huizink Anja C. , Franken Ingmar H.A.
Published: April 2013

The present study examined the role of parental rearing behavior in adolescents’ risky decision‐making and the brain's feedback processing mechanisms. Healthy adolescent participants (n = 110) completed the EMBU‐C, a self‐report questionnaire on perceived parental rearing behaviors between 2006 and 2008 (T1). Subsequently, after an average of 3.5 years, we assessed (a) risky decision‐making during performance of the Balloon Analogue Risk Task (BART); (b) event‐related brain potentials (ERPs) elicited by positive (gain) and negative feedback (loss) during the BART; and (c) self‐reported substance use behavior (T2). Age‐corrected regression analyses showed that parental rejection at T1 accounted for a unique and significant proportion of the variance in risk‐taking during the BART; the more adolescents perceived their parents as rejecting, the more risky decisions were made. Higher levels of perceived emotional warmth predicted increased P300 amplitudes in response to positive feedback at T2. Moreover, these larger P300 amplitudes (gain) significantly predicted risky decision‐making during the BART. Parental rearing behaviors during childhood thus seem to be significant predictors of both behavioral and electrophysiological indices of risky decision‐making in adolescence several years later. This is in keeping with the notion that environmental factors such as parental rearing are important in explaining adolescents’ risk‐taking propensities.
Atypical phenotype associated with reported GCK exon 10 deletions: clinical judgement is needed alongside appropriate genetic investigations
Authors: Thanabalasingham G. , Kaur K. , Talbot F. , Colclough K. , Mathews A. , Taylor J. , Ellard S. , Owen K. R.
Published: April 2013

Background

Maturity‐onset diabetes of the young (MODY) caused by heterozygous mutations in the glucokinase (GCK) gene typically presents with lifelong, stable, mild fasting hyperglycaemia. With the exception of pregnancy, patients with GCK‐MODY usually do not require pharmacological therapy. We report two unrelated patients whose initial genetic test results indicated a deletion of GCK exon 10, but whose clinical phenotypes were not typical of GCK‐MODY.

Case reports

In case 1, the patient was hyperglycaemic at diagnosis (glucose > 30 mmol/l) and elevated glucose levels > 10 mmol/l persisted after withdrawal of insulin therapy. The patient in case 2 was also hyperglycaemic at diagnosis [HbA1c > 86 mmol/mol (10%)], which improved with the introduction of oral hypoglycaemic agents. These clinical features were not consistent with GCK‐MODY. Both patients had a single nucleotide variant that prevented multiplex ligation‐dependent probe analysis, which generated a false positive result of a GCK exon 10 deletion.

Conclusion

False positive genetic results in these two unrelated cases were attributable to the presence of a rare single nucleotide variant that prevented ligation of the probe in the multiplex ligation‐dependent probe analysis kit used and falsely indicated deletion of exon 10 within GCK. Both cases had clinical features that did not tally with the typical GCK‐MODY phenotype. These cases emphasize the need to interpret the results of definitive genetic tests within the specific clinical context. Increased medical sequencing is likely to lead to more reports of novel mutations of uncertain significance. If genetic investigations do not agree with the clinical picture, clinicians should exercise caution when making therapeutic changes based on these results.
Pesticides and human diabetes: a link worth exploring?
Authors: Swaminathan K.
Published: April 2013

It is no exaggeration to claim that the ‘diabetes epidemic’ has become a ‘runaway train’ causing huge health and economic consequences, especially in the developing nations. Traditionally, the risk factors for diabetes have largely focused on genetics and lifestyle. Great emphasis is placed on lifestyle measures and finding novel pharmacological treatment options to combat diabetes, but there is increasing evidence linking environmental pollutants, especially pesticides, to the development of insulin resistance and Type 2 diabetes. Pesticide use has increased dramatically worldwide and the effects of pesticides on glucose metabolism are too significant for a possible diabetogenic link to be dismissed. The aim of this review article was to assess the links between pesticides and human diabetes with the goal of stimulating further research in this area.
Thickness and fit of mouthguard according to changing the holding conditions and the heating conditions of the mouthguard sheet
Authors: Mizuhashi Fumi , Koide Kaoru , Takahashi Mutsumi
Published: April 2013

The aim of this study was to examine the difference of the thickness and fit of the mouthguard sheet according to the holding conditions and the heating conditions. The material used in this study was Sports Mouthguard (3.8 mm thickness). Two holding conditions of the sheet were undertaken: One was the condition that the sheet was held all around the periphery, and the other was that the sheet was held at only four points. The sheets were formed using a vacuum former when the sheets were heated until they hung 2.0, 3.0, and 4.0 cm from the baseline. We measured the thickness of the mouthguard and calculated the ratio of changes. The fit of the mouthguard was also investigated. The differences of the ratio of changes in the thickness and the fit according to the holding conditions, heating conditions, and measurement areas were analyzed by three‐way anova. The results showed that the thickness differed significantly among the holding conditions, heating conditions, and measurement areas (P < 0.01). The condition that the sheet was held at only four points could maintain the thickness especially on the heating condition set at a hanging distance of 4.0 cm. The fit of the sheet differed among the heating conditions and measurement areas (P < 0.01), but not by the holding conditions. The thickness of the sheet could be maintained by holding the sheet only at four points without being inferior to the sheet held all around the periphery in the fit, and this result could be useful on fabricating proper mouthguard.
Spawning migration and larval drift of anadromous North Sea houting (Coregonus oxyrinchus) in the River IJssel, the Netherlands
Authors: Borcherding Jost , Breukelaar André W. , Winter Hendrik V. , König Ulrike
Published: April 2013

Anadromous North Sea houting (NSH, Coregonus oxyrinchus) was historically distributed in the Wadden Sea extending from Jutland (Denmark) to the Schelde delta (Netherlands). The species has been considered extinct in the Rhine since the 1940s; however, a successful re‐introduction programme re‐established a self‐reproducing population. Telemetry data of adult NSH (NEDAP TRAIL System®) were used for a first description of the timing of spawning migrations of NSH in winter, but also suggested that the River IJssel, a lower branch of the Rhine, may serve as spawning ground. This was further proven in spring 2010 with drift net catches of 218 freshly hatched NSH larvae sampled directly upstream from Kampen, where the IJssel discharges into Lake IJsselmeer. These larvae did not differ between controls from a hatchery that were about 12 h of age, indicating that the drifting larvae of NSH must have hatched in upstream areas of the River IJssel.
Early stimulation treatment provides complete sensory‐induced protection from ischemic stroke under isoflurane anesthesia
Authors: Lay Christopher C. , Jacobs Nathan , Hancock Aneeka M. , Zhou Yi , Frostig Ron D.
Published: April 2013

Using a rodent model of ischemia [permanent middle cerebral artery occlusion (pMCAO)], previous studies demonstrated that whisker stimulation treatment completely protects the cortex from impending stroke when initiated within 2 h following pMCAO. When initiated 3 h post‐pMCAO, the identical treatment exacerbates stroke damage. Rats in these studies, however, were anesthetised with sodium pentobarbital, whereas human stroke patients are typically awake. To overcome this drawback, our laboratory has begun to use the anesthetic isoflurane, which allows rats to rapidly recover from pMCAO within minutes, to test stimulation treatment in awake rats and to determine whether isoflurane has an effect upon the pMCAO stroke model. We found no difference in infarct volume between pMCAO in untreated controls under either sodium pentobarbital or isoflurane, and the primary finding was that rats that received treatment immediately post‐pMCAO maintain cortical function and no stroke damage, whereas rats that received treatment 3 h post‐pMCAO exhibited eliminated cortical activity and extensive stroke damage. The only difference between anesthetics was the broad extent of evoked cortical activity observed during both functional imaging and electrophysiological recording, suggesting that the extent of evoked activity evident under isoflurane anesthesia is supported by underlying neuronal activity. Given the high degree of similarity with previous data, we conclude that the pMCAO stroke model is upheld with the use of isoflurane. This study demonstrated that the isoflurane‐anesthetised rat pMCAO model can be used for cerebrovascular studies, and allows for highly detailed investigation of potential novel treatments for ischemic stroke using awake, behaving animals.
Beauty in Proofs:Kant on Aesthetics in Mathematics
Authors: Breitenbach Angela
Published: April 2013

It is a common thought that mathematics can be not only true but also beautiful, and many of the greatest mathematicians have attached central importance to the aesthetic merit of their theorems, proofs and theories. But how, exactly, should we conceive of the character of beauty in mathematics? In this paper I suggest thatKant's philosophy provides the resources for a compelling answer to this question. Focusing on §62 of the ‘Critique of Aesthetic Judgment’, I argue against the common view thatKant's aesthetics leaves no room for beauty in mathematics. More specifically, I show that on theKantian account beauty in mathematics is a non‐conceptual response felt in light of our own creative activities involved in the process of mathematical reasoning. TheKantian proposal I thus develop provides a promising alternative toPlatonist accounts of beauty widespread among mathematicians. While on thePlatonist conception the experience of mathematical beauty consists in an intellectual insight into the fundamental structures of the universe, according to theKantian proposal the experience of beauty in mathematics is grounded in our felt awareness of the imaginative processes that lead to mathematical knowledge. TheKantian accountIdevelop thus offers to elucidate the connection between aesthetic reflection, creative imagination and mathematical cognition.
Brave New Fathers for a Brave New World? Fathers as Caregivers in an Evolving European Union
Authors: Caracciolo di Torella Eugenia
Published: April 2013

This article focuses on the role that fathers play when it comes to family responsibility, in particular the care of young children, and how EU policy and legislation have contributed to it. This is important for several reasons. From a theoretical perspective, access to care for fathers represents the other side of the access to paid employment for mothers debate, and completes the deconstruction of the two‐sphere structure. From a more practical point of view, including fathers in the work/family life reconciliation debate is essential for the achievement of important EU policies, such as employment and gender equality.

Although society is ready for a change, the legislator has been slow to address it, thus fathers are still missing from the EU's reconciliation policy and legislation. Against this background, the decision of the Court of Justice in Roca Álvarez has, potentially, laid down the basis for a new model of fatherhood.
Cohesive zone modelling of low cycle fatigue cracks in cracked and notched specimens
Authors: Li H. , Yuan H.
Published: April 2013

A cyclic cohesive zone model (CZM) combined with the extended finite element method for the fatigue crack initiation and propagation in ductile materials was investigated under different loading conditions in C(T) specimens. Detailed experimental verification confirmed the known CZM could not predict effects of the loading ratio in fatigue crack properly. Including the loading ratio into the damage evolution equation described the loading ratio correctly. The CZM was used to predict both fatigue crack nucleation and propagation in a deep notched C(T) specimen. The simulations displayed reasonable agreement with experimental data in the stable stage of fatigue crack propagation and showed the potential for a unified description of fatigue crack nucleation and growth.
A new approach to HLA typing designed for solid organ transplantation: epityping and its application to the HLA‐A locus
Authors: Lougee E. , Morjaria S. , Shaw O. , Collins R. , Vaughan R.
Published: April 2013

HLA‐specific antibodies bind discrete clusters of amino acids called epitopes, but serological assignment of antibody specificities makes no reference to this. As HLA typing for solid organ transplantation is provided at only medium (serologically equivalent) resolution, this means that recipient HLA antibodies to donor HLA epitopes may not be identified. We have designed a novel and rapid HLA‐A epitope typing method (epityping) using a two‐stage PCR‐SSP‐based method to detect the HLA‐A locus epitopes described by El Awar et al. 2007, Transplantation, 84, 532. The initial PCR step utilizes HLA‐A locus‐specific primers; the product is cleaned using the QIAquick Spin Purification procedure. The purified product is tested using our in‐house epitope‐specific primer panel, the results being visualized using gel electrophoresis. Twenty two UCLA DNA Exchange samples were epityped, blinded to the HLA type. Of the 75 primer pairs, the mean correlation coefficient was 0.95 with each sample giving 67 or more correct primer results. In all cases, it was possible to derive the first field classic HLA type from the epityping results. These results indicate that a method for identification of HLA epitopes which is comparable in time, cost and technical expertise to current HLA typing methods is achievable. Redesigning HLA typing to correlate with what the antibody binds should minimize inappropriate organ allocation. We suggest that epityping provides a more effective method than standard HLA typing for solid organ transplantation.
Longitudinal leak point pressure measurements in rats using a modified port à cath system
Authors: van Asselt Els , van Mastrigt Ron
Published: April 2013

Stress urinary incontinence, defined as involuntary loss of urine secondary to an increase in abdominal pressure, represents one of the most significant urological problems. Several animal models to simulate stress urinary incontinence have been presented, including methods to quantify leak point pressure. We have modified an existing leak point pressure procedure to longitudinally quantify stress urinary incontinence in rats by introducing the port à cath system. Reproducible leak point pressure measurements were carried out over a period of more than 40 days at different bladder volumes. Leak point pressure neither showed a significant relationship with the number of times anesthesia was applied nor a significant change over time. The port à cath system provided a reliable, sensitive device for longitudinal urinary bladder pressure measurements in animals with an implanted bladder catheter. This set‐up therefore enables the evaluation of bladder pressure in different models for stress urinary incontinence, such as vaginal distention or pudendal transection over long periods of time within the same animal.
Consumer involvement in the tertiary‐level education of mental health professionals: A systematic review
Authors: Happell Brenda , Byrne Louise , McAllister Margaret , Lampshire Debra , Roper Cath , Gaskin Cadeyrn J. , Martin Graham , Wynaden Dianne , McKenna Brian , Lakeman Richard , Platania‐Phung Chris , Hamer Helen
Published: April 2013

A systematic review of the published work on consumer involvement in the education of health professionals was undertaken using the PRISMA guidelines. Searches of the CINAHL, MEDLINE, and PsychINFO electronic databases returned 487 records, and 20 met the inclusion criteria. Further papers were obtained through scanning the reference lists of those articles included from the initial published work search (n = 9) and contacting researchers in the field (n = 1). Thirty papers (representing 28 studies) were included in this review. Findings from three studies indicate that consumer involvement in the education of mental health professionals is limited and variable across professions. Evaluations of consumer involvement in 16 courses suggest that students gain insight into consumers' perspectives of: (i) what life is like for people with mental illness; (ii) mental illness itself; (iii) the experiences of admission to, and treatment within, mental health services; and (iv) how these services could be improved. Some students and educators, however, raised numerous concerns about consumer involvement in education (e.g. whether consumers were pursuing their own agendas, whether consumers' views were representative). Evaluations of consumer involvement in education are limited in that their main focus is on the perceptions of students. The findings of this review suggest that public policy expectations regarding consumer involvement in mental health services appear to be slowly affecting the education of mental health professionals. Future research needs to focus on determining the effect of consumer involvement in education on the behaviours and attitudes of students in healthcare environments.
Corporate Governance and the CEO Pay–Performance Link: Australian Evidence
Authors: Schultz Emma , Tian Gloria Y. , Twite Garry
Published: April 2013

We examine the influence of corporate governance mechanisms, namely blockholdings and board structure, on CEO pay–performance sensitivity in listed Australian firms. Results highlight blockholders' role in shaping observed pay–performance associations and their impact varying with their independence and relative magnitude of ownership. Monitoring blockholders increase the sensitivity of long‐term at‐risk pay to performance, better aligning manager and shareholder interests. However, consistent with a shorter investment horizon, insider blockholders increase (decrease) the responsiveness of cash bonuses (long‐term at‐risk pay). Finally, consistent with them affording less‐effective monitoring, larger boards raise (lower) the sensitivity of known pay (long‐term at‐risk pay) to performance.
First Japanese case of Pierson syndrome with mutations in LAMB2
Authors: Togawa Hiroko , Nakanishi Koichi , Mukaiyama Hironobu , Hama Taketsugu , Shima Yuko , Nakano Masaru , Fujita Naoya , Iijima Kazumoto , Yoshikawa Norishige
Published: April 2013

Pierson syndrome (OMIM 609049) is typically characterized by congenital nephritic syndrome and peculiar ocular anomalies with microcoria. It is caused by mutations in LAMB2, which encodes laminin β2. Approximately 50 mutations of LAMB2 from approximately 40 unrelated families have been identified; however, most of them were from Western countries. Although three patients in Asia with mutations of LAMB2 have been reported, they were not typical cases. We report the first Japanese case of Pierson syndrome with proven causative LAMB2 mutations. She presented with congenital nephrotic syndrome and bilateral microcoria at birth, and developed end‐stage renal disease at 2 months of age. This is the first report of a typical case from Asia. LAMB2 analysis by direct sequencing revealed the compound heterozygous mutations c.3974_3975insA (p.N1325KfsX1331, maternal, novel) in exon 25 and c.4519C>T (p.Q1507X, paternal) in exon 27. The phenotype due to LAMB2 mutations appears to be similar between different ethnic groups.
Hallopeau–Siemens dystrophic epidermolysis bullosa due to homozygous 5818delC mutation in the COL7A gene
Authors: Koshida Shigeki , Tsukamura Atsushi , Yanagi Takahide , Nakahara Sayuri , Takeuchi Yoshihiro , Kato Takashi , Tanaka Toshihiro , Nakano Hajime , Shimizu Hiroshi
Published: April 2013

Epidermolysis bullosa (EB) is a group of inherited mechanobullous skin disease. The dystrophic EB (DEB), one subtype of EB, is inherited in an autosomal dominant DEB or in an autosomal recessive (RDEB). DEB is caused by mutations in the COL7A1 gene encoding type VII collagen, the major component of anchoring fibrils. Over 300 pathogenic mutations have been detected within COL7A in DEB. Patients with the Hallopeau‐Siemens type (HS‐RDEB), most severe form of DEB, frequently have premature termination codon (PTC) mutations on both alleles. PTC mutations on both alleles result in depleted mRNA and α1 helix, and failure to form the triple helix structure characteristic of type VII collagen. As patients with HS‐RDEB usually have a pair of heterozygous PTC mutations, there have been rarely reported homozygous ones in HS‐RDEB. We report the first case of HS‐RDEB homozygous PTC mutations of 5818delC in both COL7A1 alleles. This case report suggests the positional effect of PTC mutations and vigilance against early infantile death in EB including HS‐RDEB.
Elizabethkingia meningoseptica: Emergent bacteria causing pneumonia in a critically ill child
Authors: da Silva Paulo Sergio Lucas , Pereira Graziella Hanna
Published: April 2013

Elizabethkingia meningoseptica is an unusual, highly resistant, gram‐ negative bacillus. While E. meningoseptica–associated meningitis outbreaks have been well‐documented in hospital neonatal wards and among immunocompromised adults, reports describing this microorganism in critically ill children are scarce. The purpose of this report was to describe a case of a 3 year‐old girl who developed pneumonia caused by E. meningoseptica in the setting of previous use of broad‐spectrum antibiotics and to review the pediatric literature regarding this pathogen.
Rapidly progressive and fatal neurocutaneous melanosis presenting as recurrent headache
Authors: Yamazaki Yasuhiro , Matsuzawa Tohru , Takasugi Kazuo , Suzuki Nozomu , Kanda Makoto , Kobayashi Ichiro
Published: April 2013

Neurocutaneous melanosis is an extremely rare disease characterized by large or multiple congenital melanocytic nevi and benign or malignant proliferation of melanocytes in the central nervous system. Neurological manifestations usually develop during the first three years of life and the prognosis of patients with NCM who manifest neurological symptoms is very poor. Here we describe a 9‐year‐old girl who manifested neurological symptoms caused by communicating hydrocephalus and died of proliferation of melanocytes in the central nervous system 11 months after the initial symptoms. Serum and cerebrospinal fluid 5‐S‐CD levels could be a useful marker of disease progression, even in patients with NCM without apparent malignant findings at initial biopsy.
Coronary artery dilatation and vasculitis in a case of rabies: Similarity with Kawasaki disease?
Authors: Boukas Ibtissama , Dahdah Nagib , Robitaille Yves , Fournier Anne
Published: April 2013

A 9‐year‐old boy died of rabies complications. We report the unusual combination between rabies, coronary dilatation on echocardiography and coronary vasculitis documented upon autopsy. In the search for the etiological agent of Kawasaki disease, we suggest that a viral infection with potential antigenic similarities to rabies virus should be entertained.
Diagnosis of epilepsy using an implantable loop recorder in a child with long‐QT syndrome type 3
Authors: Takahashi Kazuhiro , Miyake Akira , Otsuka Yoshimitsu , Ohfu Masaharu , Ganaha Hitoshi
Published: April 2013

We describe a case of a 10‐year‐old girl with genetically confirmed LQTS type 3 developed recurrent episodes of loss of consciousness due to epilepsy that was diagnosed by using an implantable loop recorder (ILR).
Peritoneal tuberculosis due to multidrug‐resistant Mycobacterium tuberculosis
Authors: Esposito Susanna , Bosis Samantha , Canazza Lorena , Tenconi Rossana , Torricelli Maurizio , Principi Nicola
Published: April 2013

The emergence of drug‐resistant Mycobacterium tuberculosis has been widely reported throughout the world, but there are very few data regarding children. We describe the case of a 14‐year‐old Peruvian adolescent who had been living in Italy since the age of 8 years and was diagnosed as having peritoneal tuberculosis (TB). While she was receiving first‐line anti‐TB therapy, she developed pyrazinamide‐associated thrombocytopenia and cultures revealed a multidrug‐resistant strain of Mycobacterium tuberculosis. Pyrazinamide, rifampicin and isoniazid were replaced by moxifloxacin, which was continued for 9 months together with ethambutol. The patient recovered without experiencing any drug‐related adverse event or the recurrence of TB in the following year. In conclusion, this case illustrates some of the problems that can arise when multidrug‐resistant TB has to be treated in children and adolescents, and also highlights the fact that further studies are needed to clarify which drugs should be used and for how long.
Japanese boy with maturity‐onset diabetes of the young type 3 who developed diabetes at 19 months old
Authors: Iwabuchi Atsushi , Kamoda Tomohiro , Shinohara Hiroyuki , Sumazaki Ryo
Published: April 2013

Maturity‐onset diabetes of the young type 3 (MODY3) is caused by hepatocyte nuclear factor 1α gene mutation and is clinically characterized by young onset and insufficient insulin secretion. We report a 19‐month‐old Japanese boy with a family history of young‐onset diabetes who was initially diagnosed with type 1 diabetes. Mutational analysis of the hepatocyte nuclear factor 1α gene revealed a novel heterozygous frameshift mutation (c.593delA p.Lys198fs) resulting in a truncated protein in the patient and his father. The patient was diagnosed as having MODY3 and was successfully treated with insulin glargine. We could not determine the genetic or environmental factors to explain the difference in the age of disease onset within the same family. This is the youngest case of a MODY3 child presenting with overt diabetes. Our experience suggests that clinicians should always consider the possible diagnosis of MODY3 in a diabetic child with a family history of young‐onset diabetes and should perform molecular investigations.
Comparison of nutrient profiling schemes for restricting the marketing of food and drink to children
Authors: Brinsden H. , Lobstein T.
Published: April 2013

What is already known about this subject

Many companies have signed voluntary agreements to restrict the marketing of foods high in fat, sugar and salt directly to children.

Several nutrient profiling schemes have been proposed for defining products which can be advertised to children.

What this study adds

Provides evidence that industry‐led nutrient profiling schemes are less effective in restricting the advertising of energy‐dense foods compared to government‐led models.

Provides evidence that industry‐led nutrient profiling schemes particularly favour the continued advertising of foods high in sugar.

Background

The food and beverage industry have made voluntary pledges to reduce children's exposure to the marketing of energy‐dense foods and beverages, and in 2012 announced the replacement of company‐specific nutrient profiling schemes with uniform sets of criteria from 2013 (in the USA) and 2014 (in the European Union [EU]).

Objective

To compare the proposed USA and EU nutrient profiling schemes and three government‐led schemes, paying particular attention to the differences in sugar criteria.

Method

Food and beverage products permitted to be advertised in the USA under pre‐2013 criteria were examined using five nutrient profiling schemes: the forthcoming USA and EU schemes and three government‐approved schemes: the US Interagency Working Group (IWG) proposals, the United Kingdom Office of Communications (OfCom) regulations and the Danish Forum co‐regulatory Code.

Results

Under the new USA and EU nutrient profiling schemes, 88 (49%) and 73 (41%) of a total of 178 products would be permitted to be advertised, respectively. The US IWG permitted 25 (14%) products; the Ofcom regulations permitted 65 (37%) and the Danish Code permitted 13 (7%).

Conclusion

Government‐led schemes are significantly more restrictive than industry‐led schemes, primarily due to their tougher sugar criteria. The Danish Forum (93%) and USA IWG scheme (86%) are the most restrictive of the five examined. Further harmonization of nutrient profiling schemes is needed to reduce children's exposure to the promotion of energy‐dense foods.
Specialty Care Delivery: Bringing Infectious Disease Expertise to the Residents of a Veterans Affairs Long‐Term Care Facility
Authors: Jump Robin L. P. , Olds Danielle M. , Jury Lucy A. , Sitzlar Brett , Saade Elie , Watts Brook , Bonomo Robert A. , Donskey Curtis J.
Published: April 2013

Objective

To initiate a long‐term care facility (LTCF) infectious disease (LID) service that provides on‐site consultations to LTCF residents to improve the care of residents with possible infections.

Design

Clinical demonstration project.

Setting

A 160‐bed LTCF affiliated with a tertiary care Veterans Affairs (VA) hospital.

Participants

Residents referred to the LID team.

Measurements

The reason for and source of LTCF residents' referral to the LID team and their demographic characteristics, infectious disease diagnoses, interventions, and hospitalizations were determined.

Results

Between July 2009 and December 2010, the LID consultation service provided 291 consultations for 250 LTCF residents. Referrals came from LTCF staff (75%) or the VA hospital's ID consult service (25%). The most common diagnoses were Clostridium difficile infection (14%), asymptomatic bacteriuria (10%), and urinary tract infection (10%). More than half of referred residents were receiving antibiotic therapy when they first saw the LID team; 46% of residents required an intervention. The most common interventions, stopping (32%) or starting (26%) antibiotics, were made in accordance with principles of antibiotic stewardship.

Conclusion

The LID team represents a novel and effective means to bring subspecialty care to LTCF residents.