bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating factors associated with depression of older women in Macau
Authors: Chan Moon Fai , Zeng Wen
Published: September 2009

Background.  Mental health burdens pose a grave threat to quality of life and economic productivity worldwide. Women must balance the economic, emotional and health needs of the household with their own emotional and health needs.

Aims.  The purpose of this study is to explore the depression level of a group of older women in the community in Macau, and to identify factors associated with depression.

Design.  A descriptive survey.

Research method.  The survey was conducted during the period July and August 2004 in six parishes in Macau; 1042 older people aged 60–98 completed a structured questionnaire.

Outcome measures.  Four main outcome variables were employed in the study: predisposing characteristics, physical, psychosocial and health needs/behaviours outcomes.

Results.  Among the women, 11·9% (n = 124) had been identified as depressed. Multiple logistic regression analyses were used to identify a model to predict older women who will have depression. The results showed that variables like having hypertension (p = 0·010), a poor social network (p < 0·001), low self‐perceived scores on health status (p < 0·001) and ability to meet living costs (p < 0·001), and a low level of ability to do housework (p < 0·001) were significant risk factors for depression.

Conclusion.  Providing a suitable living environment and improving health conditions for older people may improve depressive symptoms, and maintaining their cognitive function and improving their functional abilities may be crucial for preventing suffering from depressive symptoms. Apart from the findings, these conclusions resonate with recent Macau guidance on managing depression in older women. This stresses the importance of prevention, early detection and stepped care, with more intensive treatment for greater severity of illness and a multifaceted approach to management.

Relevance to clinical practice.  It is important to regularly screen for depressive symptoms among older women in the community. Focusing on older women with increasing physical disability and social isolation should help in both the prevention and recognition of onset of depression. Light therapy and antidepressants were suggested and providing a suitable living environment and improving health conditions for older people may improve depressive symptoms; maintaining their cognitive function and improving their functional abilities may be crucial for preventing suffering from depressive symptoms.
The effect of health education through the internet on university female students’ hepatitis B knowledge and cognition
Authors: Huang Ya‐Wen , Hung Chich‐Hsiu
Published: September 2009

Aims and objectives.  The purpose of this study was to investigate the effect of internet health education on female university students’ knowledge and cognition regarding hepatitis B.

Background.  One of the focal points of preventing hepatitis B is to improve students’ knowledge of hepatitis B. The internet is thought to attract learners, ensure privacy and provide channels for help.

Design.  Cluster sampling was used to select 189 female students from two universities in Kaohsiung City. The participants were divided into 130 participants who agreed to participate in an internet health education program and 59 who did not.

Method.  The participants were administered questionnaires on ‘hepatitis B knowledge’ and ‘hepatitis B cognition’ before, two weeks after and four weeks after the health education intervention. The experimental group received an additional ‘user satisfaction’ survey at two weeks after the health education intervention.

Results.  Participants in the internet hepatitis B educational program scored significantly higher in knowledge of hepatitis B at two and four weeks post intervention. No significant score differences were found in hepatitis B cognition in either of the groups two and four weeks. Sixty per cent of the experimental group indicated that the program was easy to understand, 67·69% found it helpful, 66·15% were generally satisfied with the content. Almost 67% (66·92%) thought the university should adopt and promote the web site.

Relevance to clinical practice.  This study provides health professionals with a reference for hepatitis B health education programs.
Hospital‐based home care for people with severe mental illness in Taiwan: a substantive grounded theory
Authors: Huang Xuan‐Yi , Lin Mei‐Jue , Yang Tuz‐Ching , Sun Fan‐Ko
Published: September 2009

Aim and objectives.  The purpose of this study is to generate a substantive theory of hospital‐based home care for people with severe mental illness in Taiwan.

Background.  Despite the documented advantages of hospital‐based home care services, there is a lack of information and understanding regarding the practices, functions and limitations. Currently, there is no model for how those services are to be provided and what factors will affect these services.

Design.  The grounded theory method of Strauss and Corbin (Basics of Qualitative Research: Grounded Theory Procedures and Techniques, SAGE Publications, 1990) was used to develop a substantive theory through a paradigm model, including causal conditions, context, intervening conditions, action/interaction strategies and consequences.

Methods.  This study was conducted in six different hospital areas in Central Taiwan in 2007–2008. Data were collected using semi‐structured face‐to‐face interviews. Constant comparative analysis continued during the open, axial and selective coding process until data saturation occurred. Participants were selected by theoretical sampling. When theoretical saturation was achieved, 21 clients with mental illness, 19 carers and 25 professionals were interviewed.

Results.  A substantive theory of hospital‐based home care for people with severe mental illness in Taiwan was developed. The core category was the process of hospital‐based home care in helping people with severe mental illness, with 15 categories and 33 sub‐categories of the substantive theory.

Conclusion.  The substantive theory is the first to emerge from hospital‐based home care services in Taiwan. Results showed those services had several effective functions for helping people with severe mental illness and their families.

Relevance to clinical practice.  The recommendations based on the findings of this research can be used as a guide to improve the delivery of hospital‐based home care services to community‐dwelling people with severe mental illness and their carers.
Matrix‐free UV‐laser desorption/ionization (LDI) mass spectrometric imaging at the single‐cell level: distribution of secondary metabolites of Arabidopsis thaliana and Hypericum species
Authors: Hölscher Dirk , Shroff Rohit , Knop Katrin , Gottschaldt Michael , Crecelius Anna , Schneider Bernd , Heckel David G. , Schubert Ulrich S. , Svatoš Aleš
Published: September 2009

The present paper describes matrix‐free laser desorption/ionisation mass spectrometric imaging (LDI‐MSI) of highly localized UV‐absorbing secondary metabolites in plant tissues at single‐cell resolution. The scope and limitations of the method are discussed with regard to plants of the genus Hypericum. Naphthodianthrones such as hypericin and pseudohypericin are traceable in dark glands on Hypericum leaves, placenta, stamens and styli; biflavonoids are also traceable in the pollen of this important phytomedical plant. The highest spatial resolution achieved, 10 μm, was much higher than that achieved by commonly used matrix‐assisted laser desorption/ionization (MALDI) imaging protocols. The data from imaging experiments were supported by independent LDI‐TOF/MS analysis of cryo‐sectioned, laser‐microdissected and freshly cut plant material. The results confirmed the suitability of combining laser microdissection (LMD) and LDI‐TOF/MS or LDI‐MSI to analyse localized plant secondary metabolites. Furthermore, Arabidopsis thaliana was analysed to demonstrate the feasibility of LDI‐MSI for other commonly occurring compounds such as flavonoids. The organ‐specific distribution of kaempferol, quercetin and isorhamnetin, and their glycosides, was imaged at the cellular level.
LEW3, encoding a putative α‐1,2‐mannosyltransferase (ALG11) in N‐linked glycoprotein, plays vital roles in cell‐wall biosynthesis and the abiotic stress response in Arabidopsis thaliana
Authors: Zhang Min , Henquet Maurice , Chen Zhizhong , Zhang Hairong , Zhang Yi , Ren Xiaozhi , Van Der Krol Sander , Gonneau Martine , Bosch Dirk , Gong Zhizhong
Published: September 2009

N‐linked glycosylation is an essential protein modification that helps protein folding, trafficking and translocation in eukaryotic systems. The initial process for N‐linked glycosylation shares a common pathway with assembly of a dolichol‐linked core oligosaccharide. Here we characterize a new Arabidopsis thaliana mutant lew3 (leaf wilting 3), which has a defect in an α‐1,2‐mannosyltransferase, a homolog of ALG11 in yeast, that transfers mannose to the dolichol‐linked core oligosaccharide in the last two steps on the cytosolic face of the ER in N‐glycan precursor synthesis. LEW3 is localized to the ER membrane and expressed throughout the plant. Mutation of LEW3 caused low‐level accumulation of Man3GlcNAc2 and Man4GlcNAc2 glycans, structures that are seldom detected in wild‐type plants. In addition, the lew3 mutant has low levels of normal high‐mannose‐type glycans, but increased levels of complex‐type glycans. The lew3 mutant showed abnormal developmental phenotypes, reduced fertility, impaired cellulose synthesis, abnormal primary cell walls, and xylem collapse due to disturbance of the secondary cell walls. lew3 mutants were more sensitive to osmotic stress and abscisic acid (ABA) treatment. Protein N‐glycosylation was reduced and the unfolded protein response was more activated by osmotic stress and ABA treatment in the lew3 mutant than in the wild‐type. These results demonstrate that protein N‐glycosylation plays crucial roles in plant development and the response to abiotic stresses.
Enhancing adherence to antiretroviral therapy at the HIV clinic in resource constrained countries; the Tanzanian experience
Authors: Mugusi F. , Mugusi S. , Bakari M. , Hejdemann B. , Josiah R. , Janabi M. , Aboud S. , Aris E. , Swai H. , Mhalu F. , Biberfeld G. , Pallangyo K. , Sandstrom E.
Published: September 2009

Objective  To evaluate various strategies aimed at improving adherence to antiretroviral therapy (ART).

Methods  Patients initiated on ART at Muhimbili National Hospital HIV clinic were randomly assigned to either regular adherence counseling, regular counseling plus a calendar, or regular counseling and a treatment assistant. Patients were seen monthly; during these meetings self‐reported adherence to treatment was recorded. Disease progression was monitored clinically and immunologically.

Results  Of the 621 patients randomized, 312 received regular counseling only, 242 regular counseling and calendars, while 67 had treatment assistants in addition to regular counseling. The mean (SD) follow‐up time was 14.5 (4.6) months. During follow‐up 20 (3.2%) patients died, and 102 (16.4%) were lost to follow‐up; this was similar in all groups. In 94.8% of all visits, patients reported to have adhered to treatment. In only 39 (0.7%) visits did patients report a ≤95% adherence. There were no differences in adherence (P = 0.573) or differences in CD4 count and weight changes over time in the interventions.

Conclusions  Good adherence to ART is possible in resource constrained countries. Persistent adherence counseling in clinic settings by itself may be effective in improving adherence to ART.
Pulmonary venous obstruction after lung transplantation. Diagnostic advantages of transesophageal echocardiography
Authors: González‐Fernández Camilo , González‐Castro Alejandro , Rodríguez‐Borregán Juan Carlos , López‐Sánchez Marta , Suberviola Borja , Francisco Nistal Juan , Martín‐Durán Rafael
Published: September 2009

Abstract:  Pulmonary venous vascular complications after lung transplantation are rare and a major cause of morbidity and mortality unless diagnosed and treated early. The epidemiological, diagnostic, and management characteristics of 33 patients (two of them in our hospital) with post‐transplant pulmonary vein obstruction published in the literature were reviewed. We consider of utmost importance to differentiate stenosis from thrombosis as the cause of the obstruction. The angiography, considered the gold standard for diagnosis, was replaced by transesophageal echocardiography (TEE) in 79% of the cases, but no echocardiographic diagnostic criteria were defined. A diameter of the pulmonary veins, with 2D/color TEE, <0.5 cm, peak systolic flow velocity (PSFV) >1 m/s, pulmonary vein‐left atrial pressure gradient (PVLAG) ≥10–12 mmHg, non‐permeable flow through the stenosis and the presence of thrombus at that level, must lead us to suspect this complication. Higher mortality rates were found in unilateral procedures and in women. We consider that TEE must be carried out as part of the intraoperative routine or within the first 24 h of the post‐operative period.
Safety of anti‐IgE treatment with omalizumab in children with seasonal allergic rhinitis undergoing specific immunotherapy simultaneously
Authors: Kamin Wolfgang , Kopp Matthias Volkmar , Erdnuess Frank , Schauer Uwe , Zielen Stefan , Wahn Ulrich
Published: September 2009

Kamin W, Kopp MV, Erdnuess F, Schauer U, Zielen S, Wahn U. Safety of anti‐IgE treatment with omalizumab in children with seasonal allergic rhinitis undergoing specific immunotherapy simultaneously. Pediatr Allergy Immunol 2010: 21: e160–e165. © 2009 John Wiley & Sons A/S

Introduction  Seasonal allergic rhinitis (SAR) affects at least 10–25% of the Caucasian race and about 40% of patients are children. Standard treatment of SAR is specific immunotherapy (SIT), but anti‐allergic drugs can significantly enhance efficacy of SIT. One candidate is the humanized monoclonal anti‐IgE antibody omalizumab.

Material and Methods  Randomized, double‐blind, placebo‐controlled, multi‐centre trial in Germany. A total of 221 children were randomly assigned to four different groups and treated with SIT (either grass or birch pollen), starting at least 14 wk before the local birch pollen season. After the 12‐wk SIT titration phase, either anti‐IgE (omalizumab) or placebo (NaCl 0.9%) therapy was added. This combination therapy with SIT and anti‐IgE or placebo lasted 24 wk. To record local reactions and adverse events (AE), the injection site was examined by a clinician 20 min after application of study medication. Further, patients stated any AE and the use of rescue medication by means of a diary 3 days after every injection. Finally, any AE or serious adverse event (SAE) reported by the patients was specified on a standard form by clinicians. Overall tolerance was judged by the doctors according to the patient’s diaries. To test differences between the groups, we used either the two‐sided Wilcoxon rank‐sum test or the two‐sided chi‐square test.

Results  Tolerability of SIT and omalizumab treatment was good (82% of patients). Only some AE with possible causal relationship to treatment occurred slightly more often in the verum groups, i.e. local reactions (16.8 vs. 12.3%) and gastrointestinal (2.7 vs. 0.9%) and ear symptoms (1.8 vs. 0%). Most AE (93.4% in omalizumab and 87.2% in placebo group) were judged by the patients as mild to moderate. SAE were restricted to four patients with asthma in the placebo group, two subjects with headache in the verum group and three patients with infections (two in verum and one in placebo group). Only the cases of asthma were judged to be possibly related to study medication. Further, redness and swelling at the SIT injection site appeared significantly more often in the placebo group which suggests a positive effect of omalizumab on local reaction induced by SIT.

Conclusion  Omalizumab represents an important clinical advance in the management of allergic diseases and can be considered to be safe in children.
Space, sympatry and speciation
Authors: MALLET J. , MEYER A. , NOSIL P. , FEDER J. L.
Published: September 2009

Sympatric speciation remains controversial. ‘Sympatry’ originally meant “in the same geographical area”. Recently, evolutionists have redefined ‘sympatric speciation’ non‐spatially to require panmixia (m = 0.5) between a pair of demes before onset of reproductive isolation. Although panmixia is a suitable starting point in models of speciation, it is not a useful definition of sympatry in natural populations, because it becomes virtually impossible to find or demonstrate sympatry in nature. The newer, non‐spatial definition fails to address the classical debate about whether natural selection within a geographic overlap regularly causes speciation in nature, or whether complete geographic isolation is usually required. We therefore propose a more precise spatial definition by incorporating the population genetics of dispersal (or ‘cruising range’). Sympatric speciation is considerably more likely under this spatial definition than under the demic definition, because distance itself has a powerful structuring effect, even over small spatial scales comparable to dispersal. Ecological adaptation in two‐dimensional space often acts as a ‘magic trait’ that causes pleiotropic reductions of gene flow. We provide examples from our own research.
Evolution of host resistance and trade‐offs between virulence and transmission potential in an obligately killing parasite
Authors: BÉRÉNOS C. , SCHMID‐HEMPEL P. , MATHIAS WEGNER K.
Published: September 2009

Standard epidemiological theory predicts that parasites, which continuously release propagules during infection, face a trade‐off between virulence and transmission. However, little is known how host resistance and parasite virulence change during coevolution with obligate killers. To address this question we have set up a coevolution experiment evolving Nosema whitei on eight distinct lines of Tribolium castaneum. After 11 generations we conducted a time‐shift experiment infecting both the coevolved and the replicate control host lines with the original parasite source, and coevolved parasites from generation 8 and 11. We found higher survival in the coevolved host lines than in the matching control lines. In the parasite populations, virulence measured as host mortality decreased during coevolution, while sporeload stayed constant. Both patterns are compatible with adaptive evolution by selection for resistance in the host and by trade‐offs between virulence and transmission potential in the parasite.
The maintenance of sex: host–parasite coevolution with density‐dependent virulence
Authors: LIVELY C. M.
Published: September 2009

Why don’t asexual females replace sexual females in most natural populations of eukaryotes? One promising explanation is that parasites could counter the reproductive advantages of asexual reproduction by exerting frequency‐dependent selection against common clones (the Red Queen hypothesis). One apparent limitation of the Red Queen theory, however, is that parasites would seem to be required by theory to be highly virulent. In the present study, I present a population‐dynamic view of competition between sexual females and asexual females that interact with co‐evolving parasites. The results show that asexual populations have higher carrying capacities, and more unstable population dynamics, than sexual populations. The results also suggest that the spread of a clone into a sexual population could increase the effective parasite virulence as population density increases. This combination of parasite‐mediated frequency‐dependent selection, and density‐dependent virulence, could lead to the coexistence of sexual and asexual reproductive strategies and the long‐term persistence of sex.
Spatially heterogeneous stochasticity and the adaptive diversification of dormancy
Authors: Rajon E. , Venner S. , Menu F.
Published: September 2009

Diversified bet‐hedging, a strategy that leads several individuals with the same genotype to express distinct phenotypes in a given generation, is now well established as a common evolutionary response to environmental stochasticity. Life‐history traits defined as diversified bet‐hedging (e.g. germination or diapause strategies) display marked differences between populations in spatial proximity. In order to find out whether such differences can be explained by local adaptations to spatially heterogeneous environmental stochasticity, we explored the evolution of bet‐hedging dormancy strategies in a metapopulation using a two‐patch model with patch differences in stochastic juvenile survival. We found that spatial differences in the level of environmental stochasticity, restricted dispersal, increased fragmentation and intermediate survival during dormancy all favour the adaptive diversification of bet‐hedging dormancy strategies. Density dependency also plays a major role in the diversification of dormancy strategies because: (i) it may interact locally with environmental stochasticity and amplify its effects; however, (ii) it can also generate chaotic population dynamics that may impede diversification. Our work proposes new hypotheses to explain the spatial patterns of bet‐hedging strategies that we hope will encourage new empirical studies of this topic.
Connecting behaviour and performance: the evolution of biting behaviour and bite performance in bats
Authors: SANTANA S. E. , DUMONT E. R.
Published: September 2009

Variation in behaviour, performance and ecology are traditionally associated with variation in morphology. A neglected part of this ecomorphological paradigm is the interaction between behaviour and performance, the ability to carry out tasks that impact fitness. Here we investigate the relationship between biting behaviour and performance (bite force) among 20 species of ecologically diverse bats. We studied the patterns of evolution of plasticity in biting behaviour and bite force, and reconstructed ancestral states for behaviour and its plasticity. Both behavioural and performance plasticity exhibited accelerating evolution over time, and periods of rapid evolution coincided with major dietary shifts from insect‐feeding to plant‐feeding. We found a significant, positive correlation between behavioural plasticity and bite force. Bats modulated their performance by changing their biting behaviour to maximize bite force when feeding on hard foods. The ancestor of phyllostomids was likely a generalist characterized by high behavioural plasticity, a condition that also evolved in specialized frugivores and potentially contributed to their diversification.
Patients' experiences of absconding from a psychiatric setting in Indonesia
Authors: Nurjannah Intansari , FitzGerald Mary , Foster Kim
Published: September 2009

ABSTRACT:  Absconding from psychiatric institutions is a relatively common phenomenon. Yet patients' experience of absconding is a perspective that has received little attention in the West and none in Indonesia. A case study using mixed methods was undertaken in order to provide a profile of absconding events over a 1‐year period in a psychiatric setting in Indonesia. In the qualitative phase of the study, in a semistructured interview, 16 patients who absconded described their experiences of absconding. Three themes of experience were identified: the call to home, hopes and realities, and us and them. The call to home theme described patients' eagerness to connect with family and others and to feel safe. Hopes and realities identified patients' hopes for happiness, which were dashed by the realities of life at home and in the hospital. The final theme, us and them, described the competing interests and different opinions of patients in relation to others including hospital staff and family. There is a need for changes to mental health policy and service provision in order to reduce the incidence of absconding in Indonesia and enable patients and their families to receive adequate support while living in the community.
An examination of frequent nursing interventions and outcomes in an adolescent psychiatric inpatient unit
Authors: Bobier Candace , Dowell Joanne , Swadi Harith
Published: September 2009

ABSTRACT:  Little is known about which nursing interventions used in adolescent psychiatric inpatient treatment demonstrate improvements in outcome in the ‘real world’ setting, despite an increase in external outcomes reporting requirements.This paper examines nursing and other multidisciplinary interventions commonly used at the Youth Inpatient Unit, Christchurch, New Zealand, in relation to improvements in outcomes as measured by the Health of the Nation Outcome Scales for Children and Adolescents, utilizing data gathered prospectively as part of an ongoing quality assurance and outcomes project. We found the majority of interventions investigated were utilized equally across diagnostic groups, although stress management and problem‐solving education was used more for patients with mixed affective disorders. Further, the results contribute to growing evidence toward the value of providing medication and problem‐solving education to this population. Mental health nurses working with children and adolescents should be supported to utilize and develop their unique skill set to offer targeted interventions and to examine their practice to identify the most valuable interventions for their patients within this developmental context.
Personality traits among burnt out and non‐burnt out health‐care personnel at the same workplaces: A pilot study
Authors: Gustafsson Gabriella , Persson Birgitta , Eriksson Sture , Norberg Astrid , Strandberg Gunilla
Published: September 2009

ABSTRACT:  Stress‐related illnesses, such as burnout, have increased over the last decade, but not everyone at the same workplace develops burnout, suggesting that individual factors may contribute to this phenomenon. The aim of this study was to describe patterns of personality traits among two groups of health‐care personnel from the same workplaces, one group on sick leave due to medically‐assessed burnout, and one group with no indication of burnout, respectively. Fourteen psychiatric‐ (n = 7) and elderly (n = 7)‐care units, located in one specific area in a municipality in northern Sweden, participated in this questionnaire‐based study. The participants (n = 40), on sick leave due to medically‐assessed burnout (n = 20), and those with no indication of burnout (n = 20), respectively, completed Cattell's 16 Personality Factors Questionnaire between February and December 2004. Conventional statistical methods and partial least square regression were used to analyze data. The results showed that the burnout group had lower scores regarding emotional stability and higher scores regarding anxiety than the non‐burnout group, but the results also showed a wide variation of personality traits within groups. The most important indicators for belonging to the burnout group were ‘openness to changes’ and ‘anxiety’, and for belonging to the non‐burnout group, ‘emotional stability’, ‘liveliness’, ‘privateness’ (i.e. forthright or discreet), and ‘tension’. The result indicates complex interactions between personality traits and the context in which the individual lives. It seems to be important to increase our awareness of when personality traits may constitute opportunities versus risks in dealing with one's existing circumstances.
Redressing the balance in mental health nursing education: Arguments for a values‐based approach
Authors: Hewitt Jeanette
Published: September 2009

ABSTRACT:  Evidence‐based practice (EBP) has become a dominant epistemology in nursing education, and has devalued the complex interpersonal components of mental health nursing. A curriculum for mental health nursing, which values the personhood of service users, should focus on those processes that promote recovery within a therapeutic relationship committed to collaboration and respect for diversity. These relationships become possible where the preparation of mental health nurses for practice includes an examination of self in terms of beliefs and values and their consequences on others. The combination of action and reflection in praxis provides a means by which self‐examination and professional obligation can be examined in order to construct a moral identity, which is responsive to the needs of people with mental health problems. Praxis is more than a means of reflecting on practice: it draws together skill, practice knowledge, attitudinal style, and moral reasoning. For this reason, ethical values have a vital role to play in the development of contemporary nursing praxis.
Evaluation of novel particles as an inhalation system for GLP‐1
Authors: Leone‐Bay A. , Grant M. , Greene S. , Stowell G. , Daniels S. , Smithson A. , Villanueva S. , Cope S. , Carrera K. , Reyes S. , Richardson P.
Published: September 2009

Aim: The feasibility of administering native glucagon‐like peptide 1 (GLP‐1) as GLP‐1 Technosphere® Inhalation Powder for diabetes therapy has been demonstrated in a rat model.

Methods: GLP‐1 Technosphere Inhalation Powders containing 5, 10 and 15% GLP‐1 were prepared and administered to healthy female Sprague–Dawley rats and to male Zucker diabetic obese rats. Rats received a single dose of GLP‐1 Technosphere Powder by pulmonary insufflation. GLP‐1 pharmacokinetic and pharmacodynamic responses were measured.

Results: Maximum circulating GLP‐1 concentrations were achieved at ∼10 min after dosing with detectable levels at 40 min. In a food consumption study, Sprague–Dawley rats receiving GLP‐1 Technosphere Powder once‐daily consumed less food than control rats for up to 24 h after dosing. Cumulative food consumption was decreased approximately 10% after 78 h. In an intraperitoneal glucose tolerance test, Zucker diabetic fatty rats receiving 2 mg GLP‐1 Technosphere Powder (0.3 mg GLP‐1) by pulmonary insufflation exhibited lower glucose concentrations and higher insulin concentrations than control rats. Pancreatic evaluations showed no differences in apoptotic index or cell proliferation of β‐cells. In addition, a dose‐related increase in insulin expression within the pancreas was observed.

Conclusions: These data demonstrate the feasibility of administering native GLP‐1 as GLP‐1 Technosphere Inhalation Powder for diabetes therapy.
The PPAR‐γ agonist rosiglitazone facilitates Akt rephosphorylation and inhibits apoptosis in cardiomyocytes during hypoxia/reoxygenation
Authors: Kilter H. , Werner M. , Roggia C. , Reil J.‐C. , Schäfers H.‐J. , Kintscher U. , Böhm M.
Published: September 2009

Background and Aim: Results on the cardiovascular effects of PPAR‐γ agonists are conflicting. On one hand, it was suggested that the PPAR‐γ agonist rosiglitazone may increase the risk of cardiovascular events. On the other hand, PPAR‐γ agonists reduce myocardial infarct size and improve myocardial function during ischemia/reperfusion in animal studies in vivo. However, the mechanism of this effect is unclear, and it is open if PPAR‐γ agonists have a direct effect on cardiac myocyte survival in ischemia/reperfusion. The aim of this study was to determine the effect of the PPAR‐γ agonist rosiglitazone on hypoxia/reoxygenation‐induced apoptosis of isolated cardiomyocytes.

Methods: Isolated rat cardiac myocytes were pretreated with rosiglitazone or vehicle for 30 min before they were subjected to hypoxia for 4 h followed by different times of reoxygenation (5 min to 12 h). Apoptosis was determined by in situ hybridization for DNA fragmentation (TUNEL) as well as detection of cytoplasmic accumulation of histone‐associated DNA fragments by enzyme‐linked immunosorbent assay (ELISA). Activation of apoptosis regulating intracellular signalling pathways was studied by immunoblotting using phosphospecific antibodies.

Results: Rosiglitazone significantly reduced apoptosis of isolated cardiomyocytes subjected to hypoxia/reoxygenation, independently determined with two methods. After 4 h of hypoxia and 12 h of reoxygenation, 34 ± 3.6% of the vehicle treated cardiac myocytes stained positive for DNA fragmentation in the TUNEL staining. Rosiglitazone treatment reduced this effect by 23% (p < 0.01). Even more pronounced, cytoplasmic accumulation of histone‐associated DNA fragments detected by ELISA was reduced by 35% (p < 0.05) in the presence of rosiglitazone. This inhibition of hypoxia/reoxygenation‐induced apoptosis was associated with an increased reoxygenation‐induced rephosphorylation of the protein kinase Akt, a crucial mediator of cardiomyocyte survival in ischemia/reperfusion of the heart. This effect was reversed by GW‐9662, an irreversible PPAR‐γ antagonist. However, rosiglitazone did not alter phosphorylation of the MAP kinases ERK1/2 and c‐Jun N‐terminal kinase (JNK).

Conclusion: It can be concluded that cardiac myocytes are direct targets of PPAR‐γ agonists promoting its survival in ischemia/reperfusion, at least in part by facilitating Akt rephosphorylation. This effect may be of clinical relevance inhibiting the reperfusion‐induced injury in patients suffering from myocardial infarction or undergoing cardiac surgery.
Prostate cancer grading: the effect of stratification of needle biopsy Gleason Score 4 + 3 as high or intermediate grade
Authors: Fanning Deirdre M. , Kay Elaine , Fan Yue , Fitzpatrick John M. , Watson R. William G.
Published: September 2009

Study Type – Prognosis (case series) Level of Evidence 4

OBJECTIVES

To assess the discrepancy between needle biopsy (NB) and radical prostatectomy (RP) Gleason score (GS) in Irish men, specifically the influence of the stratification of GS 4 + 3 on overall levels of agreement, levels of discrepancy and κ coefficients, as the GS assigned to prostate cancer NBs affects clinical decision‐making and influences future therapeutic strategies.

PATIENTS AND METHODS

We reviewed retrospectively a database of the discrepancies between NB and RP Gleason grades (GG) from 2003 to 2008. All patients had clinically localized prostate cancer, and none had had neoadjuvant therapy. Grading of 206 NB specimens was compared with their corresponding RP specimens. The discrepancy rate between NB and RP GS was assessed for each combination of GG. Intermediate‐ (GS 7, defined as GS 3 + 4 alone vs GS 7) and high‐grade (GS 4 + 3 and GS 8–10 vs GS 8–10) classifications were compared. The level of agreement and the κ coefficient for each system was assessed.

RESULTS

In NB, GS 6 was most frequently diagnosed (53%); after RP, GS 3 + 4 was most frequent (36%). In 42% of cases the exact GG remained unchanged after RP, increasing to 48% for GS 6 and GS 3 + 4. Overall 42% of cases showed an increase in their GG. In GS 6 NBs, the rate of increase in the primary GG or increase in the GS was 52%. Biopsy GS 6 and 3 + 4 showed the highest levels of agreement between NB and RP. Low‐grade prostate cancer on NB was upgraded in 52% of cases; high‐grade prostatic adenocarcinoma was downgraded in 27–77% of cases depending on the grading system used.

CONCLUSIONS

Classification of high‐grade prostate cancer as GS 4 + 3 and GS 8–10 results in higher levels of agreement between NB and RP GS. Reliable identification of well differentiated prostatic adenocarcinoma in NB specimens represents an ongoing diagnostic challenge, necessitating careful preoperative consideration of the definitive grade of a patient’s disease.
Changes in peak urinary flow and voiding efficiency in men with signs and symptoms of benign prostatic hyperplasia during once daily tadalafil treatment
Authors: Roehrborn Claus G. , Kaminetsky Jed C. , Auerbach Stephen M. , Montelongo Rafael Martínez , Elion‐Mboussa Albert , Viktrup Lars
Published: September 2009

Study Type – Therapy (RCT) Level of Evidence 1b

OBJECTIVE

To determine, by post hoc analysis, the effects of tadalafil (a long‐acting phosphodiesterase 5 inhibitor) on peak urinary flow (Qmax), bladder capacity, voiding efficiency and the obstructive symptoms of benign prostatic hyperplasia (BPH) in men with lower urinary tract symptoms secondary to BPH (BPH‐LUTS), compared with placebo.

PATIENTS AND METHODS

After a 4‐week placebo run‐in period, 1058 men with BPH‐LUTS were randomly allocated to receive once daily treatment with placebo or tadalafil (2.5, 5, 10, or 20 mg) for 12 weeks. Uroflowmetry, postvoid residual volume (PVR), and BPH symptom score measurements were assessed throughout the trial.

RESULTS

Increases in Qmax were numerically greater for tadalafil (2.5, 5, 10, and 20 mg with percentage changes of 15%, 16%, 17%, 22%, respectively) vs placebo (12%), but did not reach statistical significance. Age, baseline Qmax, erectile dysfunction history, sexual activity, and previous α‐blocker therapy significantly influenced the Qmax response. Tadalafil was not associated with significant changes in PVR. Tadalafil had its greatest effects on bladder capacity and voiding efficiency in men with a Qmax of <10 mL/s at baseline, but these changes were not significantly different from placebo responses. Tadalafil treatment significantly improved the IPSS obstructive subscores (tadalafil 2.5, 5, 10, 20 mg with percentage changes of 24%, 31%, 33%, 33%, respectively) vs placebo (13%).

CONCLUSIONS

Once daily tadalafil did not significantly change Qmax or voiding efficiency compared with placebo in men with BPH‐LUTS, although there were dose‐dependent improvements. No subgroups were identified where tadalafil or placebo treatment had a deleterious effect on Qmax. Despite these minimal changes in uroflowmetric measures, tadalafil was associated with clinically meaningful and statistically significant improvements in the obstructive symptoms of BPH.
Predicting invasions in Australia by a Neotropical shrub under climate change: the challenge of novel climates and parameter estimation
Authors: Van Klinken Rieks D. , Lawson Ben E. , Zalucki Myron P.
Published: September 2009

Aim  To test how well species distributions and abundance can be predicted following invasion and climate change when using only species distribution and abundance data to estimate parameters.

Location  Models were developed for the species' native range in the Americas and applied to Australia.

Methods  We developed a predictive model for an invasive neotropical shrub (Parkinsonia aculeata) using a popular ecophysiological bioclimatic modelling technique (CLIMEX) fitted against distribution and abundance data in the Americas. The effect of uncertainty in model parameter estimates on predictions in Australia was tested. Alternative data sources were used when model predictions were sensitive to uncertainty in parameter estimates. The resulting best‐fit model was run under two climate change scenarios.

Results  Of the 19 parameters used, 9 could not be fitted using data from the native range. However, only parameters that lowered temperature or increased moisture requirements for growth noticeably altered the model prediction in Australia. Differences in predictions were dramatic, and reflect climates in Australia that were not represented in the Americas (novel climates). However, these poorly fitted parameters could be fitted post hoc using alternative data sources prior to predicting responses to climate change.

Conclusions  Novel climates prevented the development of a predictive model which relied only on native‐range distribution and abundance data because certain parameters could not be fitted. In fact, predictions were more sensitive to parameter uncertainty than to climate change scenarios. Where uncertainty in parameter estimates affected predictions, it could be addressed through the inclusion of alternative data sources. However, this may not always be possible, for example in the absence of post‐invasion data.
Ensemble models predict Important Bird Areas in southern Africa will become less effective for conserving endemic birds under climate change
Authors: Coetzee Bernard W. T. , Robertson Mark P. , Erasmus Barend F. N. , Van Rensburg Berndt J. , Thuiller Wilfried
Published: September 2009

Aim  To examine the impacts of climate change on endemic birds, which are of global significance for conservation, on a continent with few such assessments. We specifically assess projected range changes in relation to the Important Bird Areas (IBAs) network and assess the possible consequences for conservation.

Location  South Africa, Lesotho and Swaziland.

Methods  The newly emerging ensemble modelling approach is used with 50 species, four climate change models for the period 2070–2100 and eight bioclimatic niche models in the statistical package biomod. Model evaluation is done using the receiver operating characteristic and the recently introduced true skill statistic. Future projections are made considering two extreme assumptions: species have full dispersal ability and species have no dispersal ability. A consensus forecast is identified using principal components analysis. This forecast is interpreted in terms of the IBA network. An irreplaceability analysis is used to highlight priority IBAs for conservation attention in terms of climate change.

Results  The majority of species (62%) are predicted to lose climatically suitable space. Five species lose at least 85% of their climatically suitable space. Many IBAs lose species (41%; 47 IBAs) and show high rates of species turnover of more than 50% (77%; 95 IBAs). Highly irreplaceable regions for endemic species become highly localized under climate change, meaning that the endemic species analysed here experience similar range contractions to maintain climate niches.

Main conclusions  The South African IBAs network is likely to become less effective for conserving endemic birds under climate change. The irreplaceability analysis identified key refugia for endemic species under climate change, but many of these areas are not currently IBAs. In addition, many of these high‐priority areas that are IBAs fall outside the current formal protected areas network.
Molecular analysis of menadione‐induced resistance against biotic stress in Arabidopsis
Authors: Borges Andrés A. , Dobon Albor , Expósito‐Rodríguez Marino , Jiménez‐Arias David , Borges‐Pérez Andrés , Casañas‐Sánchez Verónica , Pérez Jose A. , Luis Juan C. , Tornero Pablo
Published: September 2009

Menadione sodium bisulphite (MSB) is a water‐soluble derivative of vitamin K3, or menadione, and has been previously demonstrated to function as a plant defence activator against several pathogens in several plant species. However, there are no reports of the role of this vitamin in the induction of resistance in the plant model Arabidopsis thaliana. In the current study, we demonstrate that MSB induces resistance by priming in Arabidopsis against the virulent strain Pseudomonas syringae pv. tomato DC3000 (Pto) without inducing necrosis or visible damage. Changes in gene expression in response to 0.2 mm MSB were analysed in Arabidopsis at 3, 6 and 24 h post‐treatment using microarray technology. In general, the treatment with MSB does not correlate with other publicly available data, thus MSB produces a unique molecular footprint. We observed 158 differentially regulated genes among all the possible trends. More up‐regulated genes are included in categories such as ‘response to stress’ than the background, and the behaviour of these genes in different treatments confirms their role in response to biotic and abiotic stress. In addition, there is an over‐representation of the G‐box in their promoters. Some interesting functions are represented among the individual up‐regulated genes, such as glutathione S‐transferases, transcription factors (including putative regulators of the G‐box) and cytochrome P450s. This work provides a wide insight into the molecular cues underlying the effect of MSB as a plant resistance inducer.
Changes in Poverty Rates during the Howard Era
Authors: Rodgers Joan R. , Siminski Peter , Bishop James
Published: September 2009

This article considers changes in poverty rates under the Howard government. We also make three methodological contributions. We consider the statistical significance of the estimated changes in poverty. We propose a decomposition technique that reconciles the trends in absolute and relative poverty. We also use ‘poverty profiles’, which illustrate sensitivity to alternative poverty lines. We find decreases in absolute poverty and increases in relative poverty, both of which are statistically significant over a range of poverty lines. At a poverty line equal to half of the median income, the increase in relative poverty is statistically significant for all people and borders on significance for children.
What Happened to Australia's Productivity Surge?
Authors: Dolman Ben
Published: September 2009

Australia's productivity has grown 1 percentage point per year slower in the current decade than in the 1990s. This article shows that almost one‐half of the slowdown is related to unusual developments in the mining industry, the effects of drought and the overstatement of productivity growth in the 1990s. Part of the remainder might be as a result of a combination of slower technological change, unmeasured declines in labour quality, the diminishing effects of past reforms and the increasing profitability of Australian firms.
Which Networks Matter in Education Governance? A Reply to Ball's ‘New Philanthropy, New Networks and New Governance in Education’
Authors: Goodwin Mark
Published: September 2009

Stephen Ball's recent article offers an intriguing perspective on the education policy process by engaging with the political science literature on policy networks and governance. Ball opens up the possibility of a fruitful dialogue between political scientists and education researchers by introducing some challenging interpretations of recent developments in the governance of education. In this reply I suggest that a sustained focus on understanding power in the governance process could help to build on Ball's work. I argue that understanding power is crucial to deciding which networks matter and to building explanations of the effects of networks on policy outcomes. Without a focus on power, I claim, policy studies risk conflating the existence of networks with the existence of network governance.
Beyond Networks? A Brief Response to ‘Which Networks Matter in Education Governance?’
Authors: Ball Stephen J.
Published: September 2009

Mark Goodwin's commentary on and critique, in this issue, of my 2008 article in this journal ( Ball, 2008 ) is both pertinent and constructive and indeed I agree with almost all of it. Goodwin makes the point that the distribution of power and capabilities within policy networks was not properly addressed in my article and that as a result I may tend to overestimate the looseness of such networks and underestimate the continuing prominence of the formal legal powers of the state in processes of governance. He also suggests that the existence of and work done by the networks I describe should not in themselves be taken to be indicative of a shift from government to network governance. These concerns raise very proper and important questions and pose major challenges for empirical policy network analysis. However, I would want to say that my 2008 article represents a first foray into the issues and problems of a grounded analysis of network governance in education. Many of the points made in Goodwin's reply are ones on which I am engaged in a current ESRC-funded project (RES-062-23-1484) on philanthropy and education policy.