bluuebunny/crossref_metadata_2025 huggingface dataset:
Intoxication by large amounts of barium nitrate overcome by early massive K supplementation and oral administration of magnesium sulphate
Authors: Payen Christine , Dellinger Arnaud , Pulce Corine , Cirimele Vincent , Carbonnel Vincent , Kintz Pascal , Descotes Jacques
Published: March 2010

Suicide by ingestion of barium is exceptionally rare. Adverse health effects depend on the solubility of the barium compound. Severe hypokalemia, which generally occurs within 2 hours after ingestion, is the predominating feature of acute barium toxicity, subsequently leading to adverse effects on muscular activity and cardiac automaticity. We report one case of acute poisoning with barium nitrate, a soluble barium compound. A 75-year-old woman was hospitalized after suicidal ingestion of a burrow mole fumigant containing 12.375 g of barium nitrate. About 1 hour post-ingestion, she was only complaining of abdominal pain. The ECG recording demonstrated polymorphic ventricular premature complexes (VPCs). Laboratory data revealed profound hypokalemia (2.1 mmol/L). She made a complete and uneventful recovery after early and massive potassium supplementation combined with oral magnesium sulphate to prevent barium nitrate absorption.
Reliability of history of acetaminophen ingestion in intentional drug overdose patients
Authors: Bentur Yedidia , Lurie Yael , Tamir Ada , Keyes Daniel C , Basis Fuad
Published: March 2010

The objective of this study was to determine the reliability of denial of acetaminophen ingestion in intentional drug overdose patients. All intentional drug overdose patients admitted to an emergency department who were able to provide a history were included. A detailed history was obtained on names, timing and number of medications ingested, and serum acetaminophen was assayed. Multidrug ingestion was defined as the reporting of ≥2 medications. Patients were considered ‘reliable’ if they reported acetaminophen ingestion and had detectable acetaminophen levels or the other way around. Validity parameters of acetaminophen history were assessed by sensitivity, specificity and positive and negative predictive values. A total of 154 patients were included. History was significantly more reliable in patients who denied ingestion of acetaminophen (n = 107) compared with patients who reported it (n = 47; 95.3% vs 65.9%, respectively; p < 0.0001, 95% CI of the difference 17.5%—41.2%). No suicidal patient who denied both acetaminophen and multidrug ingestions had a detectable acetaminophen level (negative predictive value 1, 95% CI 0.93—1.0). It is suggested that denial of both acetaminophen and multidrug ingestions by intentional drug overdose patients after a thorough history taking can be considered reliable for acetaminophen history. In facilities with limited resources, these patients may not require routine acetaminophen screening.
Are Group Leader Knowledge Structures Related to Member Satisfaction With the Leader?
Authors: Kivlighan Dennis M. , Kivlighan D. Martin
Published: March 2010

Knowledge structures are people’s ways of organizing the concepts in a domain. Educational effectiveness can be documented by examining changes in novices’ knowledge structures. Studies show that group counseling trainees begin to structure their knowledge of group members and group leader interventions in a manner similar to the knowledge structure of experienced group counselors. This research assumes that trainees with knowledge structures more similar to experienced practitioners will be more effective group leaders. We tested this assumption and found that group members were more satisfied when the trainee’s knowledge structure of group counseling leader interventions converged with the knowledge structure of experienced group therapists.
Dyads Can Be Groups (and Often Are)
Authors: Williams Kipling D.
Published: March 2010

Moreland eloquently argues for excluding dyads from group process research and theory. Although dyads can have properties that do not lend themselves to certain group process research (e.g., coalition formation) and have properties that can go beyond typical group processes (e.g., intimate relations and love), in most instances dyads are groups of two and operate under the same principles and theories that explain group processes for groups of three and larger. In this article, the author presents research and theory that support the inclusion of dyads as groups.
Sterilization Decision Making Among Medically At-Risk Obese Pregnant Women
Authors: Hastings-Tolsma Marie , Clark Lauren , Nodine Priscilla , Teal Stephanie
Published: March 2010

In this article, we describe a study using a qualitative, naturalistic grounded theory design to explore sterilization decision making by pregnant obese women. Semistructured interviews of women who intended to undergo sterilization at the time of delivery were conducted in the third trimester of pregnancy ( n = 15) and again postpartum ( n = 11). The decision for sterilization was based on personal criteria for family composition and the nature of each woman’s relationship with her partner. The process of decision making began with developing a personal comfort with cessation of childbearing, followed by social confirmation, informing the provider, and then awaiting the procedure. Sterilization was seen as reversible, despite a desire for “something permanent.” Obesity was rarely viewed as related to any part of the decision for or against sterilization, and was rarely discussed by providers. Participants made sterilization decisions in their personal and social contexts, and then shared the decision with their providers, whom they often perceived as challenging that decision.
Differences in Perceptions of the Diagnosis and Treatment of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Therapy Among Adherers and Nonadherers
Authors: Sawyer Amy M. , Deatrick Janet A. , Kuna Samuel T. , Weaver Terri E.
Published: March 2010

Obstructive sleep apnea (OSA) patients’ consistent use of continuous positive airway pressure (CPAP) therapy is critical to realizing improved functional outcomes and reducing untoward health risks associated with OSA. We conducted a mixed methods, concurrent, nested study to explore OSA patients’ beliefs and perceptions of the diagnosis and CPAP treatment that differentiate adherent from nonadherent patients prior to and after the first week of treatment, when the pattern of CPAP use is established. Guided by social cognitive theory, themes were derived from 30 interviews conducted postdiagnosis and after 1 week of CPAP use. Directed content analysis, followed by categorization of participants as adherent/nonadherent from objectively measured CPAP use, preceded across-case analysis among 15 participants with severe OSA. Beliefs and perceptions that differed between adherers and nonadherers included OSA risk perception, symptom recognition, self-efficacy, outcome expectations, treatment goals, and treatment facilitators/ barriers. Our findings suggest opportunities for developing and testing tailored interventions to promote CPAP use.
Breast Cancer Messaging for Younger Women: Gender, Femininity, and Risk
Authors: Haines Rebecca J. , Bottorff Joan L. , Barclay McKeown Stephanie , Ptolemy Erin , Carey Joanne , Sullivan Kelli
Published: March 2010

Evidence linking both active smoking and secondhand smoke exposure to premenopausal breast cancer makes the development of health messages specific to younger women a pressing priority. To determine how to communicate information about this modifiable breast cancer risk to young women, we analyzed a selection of 32 recent English-language breast cancer messages and campaigns that targeted young women. In addition, we obtained young women’s responses to three breast cancer campaign images during focus group discussions. A visual analysis of messages points to an explicitly gendered discourse within contemporary campaigns, one that entails conflicting messages regarding breast cancer, health, feminine beauty, and risk. Although the intent might be to educate and empower young women to “fight” against breast cancer, paradoxically, the messages employ imagery that sexually objectifies young women’s breasts and bodies. Recommendations are made for messaging about tobacco and breast cancer risk to avoid reproducing one-dimensional or stereotypical presentations of gender and femininity.
Thermodynamic Significance and Basis of Damage Variables and Equivalences
Authors: Qiang Yang  , Zhou Wei-Yuan , Xin Chen
Published: March 2010

In this article, thermodynamic significance and basis of damage variables and equivalences are addressed within the irreversible thermodynamic framework with internal variables by Rice [Rice, J.R. (1971). Inelastic Constitutive Relations for Solids: An Internal Variable Theory and its Application to Metal Plasticity. Journal of the Mechanics and Physics of Solids, 19:433—455]. It is revealed that, as soon as the multiscale kinematic relation is prescribed, the condition of free or complementary energy equivalence leads to the full equivalence of the microscale and macroscale thermodynamic formulations. In order to achieve the fully thermodynamic equivalence, the damage equivalence hypothesis should be based on free energy or (thermodynamic) complementary energy from a thermodynamic viewpoint. In this sense, the complementary energy equivalence hypothesis by Sidoroff [Sidoroff, F. (1981) Description of Anisotropic Damage Application to Elasticity, IUTAM Colloquium on Physical Nonlinearities in Structural Analysis, pp. 237—244, Springer, Berlin] is much better than the strain equivalence hypothesis by Lemaitre and Chaboche [Lemaitre, J. and Chaboche, J. L. (1978). Aspect Phenomnologique de la Rupture par Endommagement (in French). J. de Mecanique Appliquee, 2:317—365]. One single scalar damage variable plays a role of fictitious or intrinsic time. The introduction of the scalar damage variable implies that the microscale thermodynamic fluxes measured by the intrinsic time should be potential or irrotational and the corresponding flow potential function is just thermodynamic force conjugate to the damage variable.
Will working in an academic health science centre enhance nursing/midwifery research capacity and capability?
Authors: Grainger Angela
Published: March 2010

In this paper we discuss the factors that have already had an impact on the build-up of nursing/ midwifery research capacity and capability, and highlight other factors that have not yet been touched upon, but which are pertinent to the overall discussion of how nursing/midwifery research is being taken forward in an academic health science centre. The paper concludes by proposing ideas for short-term to medium-term research-building activities, but which need to sit alongside a supportive, infrastructural model in order to achieve the longer-term goals of (1) advancing nursing/midwifery research generally, and (2) ensuring nursing/midwifery research achieves equal-partner status in academic health science centres, which are predominantly biomedically research led organisations.
An exploration of personal initiative theory in the role of consultant nurses
Authors: Redfern Sally , Coster Samantha , Evans Amanda , Dewe Philip
Published: March 2010

The aim in this paper is to investigate the contribution personal initiative theory makes in understanding the consultant nurse role. The role was introduced in the UK in 2000 to improve patient outcomes, clinical leadership and retention of experienced clinicians. A larger study used a multi-method approach to collect quantitative and qualitative data from focus groups, interviews and a questionnaire administered nationally at two time points. Findings from longitudinal telephone interviews with 30 consultant nurses are the focus of this paper.

Three consultant nurses were selected as case studies to examine the potential of personal initiative theory when applied to new nursing roles. The activities of two of the three demonstrated a high level of personal initiative in the job. They persisted in overcoming problems faced in improving practice. The third scored lower: she emerged as a reactive conformist and less likely than the other two to pursue initiatives of her own.

Personal initiative theory has potential as a framework for evaluating the consultant nurse role, although further research is needed to test it. The longitudinal analysis revealed a determination to stay in the job and overcome difficult challenges when consultants show initiative and are making progress in achieving change.
Legitimizing fascism through the Holocaust? The reception of the miniseries Perlasca: un eroe italiano in Italy
Authors: Perra Emiliano
Published: March 2010

This article discusses the rise in recent years of Giorgio Perlasca as a key symbolic figure in public memory constructs of the Holocaust in Italy, culminating in RAI’s broadcast of the miniseries Perlasca: un eroe italiano in 2002. After almost 50 years of silence, Perlasca’s complex profile of unreconstructed fascist and rescuer of thousands of Hungarian Jews has been instrumental in proposing different but coexisting narratives. On the one hand, it has reinforced the established myth of the ‘good Italian’. On the other hand, Perlasca’s personal history has implicitly concurred in downplaying fascist crimes before 1938 and in levelling out distinctions between fascists and anti-fascists. The study of Perlasca’s place in contemporary Italian memory culture sheds light on some of the country’s problems in coming to terms with the past.
A history of images or an image of history? Jonathan Littell’s The Kindly Ones
Authors: Cazenave Jennifer
Published: March 2010

First published in France in 2006, Jonathan Littell’s The Kindly Ones (2009) has re-sparked an ongoing debate regarding the Holocaust and the limits of representation. A fictional memoir written from the point of view of a German perpetrator, The Kindly Ones recounts a quasi-odyssey through Europe during the Second World War, thereby vividly exposing the atrocities committed in Eastern Poland and the Ukraine. The object of significant praise, including two prestigious French literary prizes, The Kindly Ones has nonetheless met the objection of many who have reduced Littell’s representation of the Holocaust to a pornography of violence. Wishing to counter this particular reading of The Kindly Ones, this article examines the signification of a representation of the human body as an image forever tainted by the atrocities.
Blurring the boundaries between perpetrators and victims: Pied-noir memories and the harki community
Authors: Eldridge Claire
Published: March 2010

This article seeks to trace the evolving relationship between the collective memories of the pied-noir community, the former settler population of French Algeria, and the harkis, Algerians who fought for the French during the Algerian War of Independence (1954—62). Although regarded by many as at best complicit in, and at worst the perpetrators of, a system of colonial domination, the pieds-noirs view themselves as innocent casualties of a destructive and erroneous historical force, decolonization. This article will focus on the ways in which pieds-noirs, primarily through their strong associational network, have attempted to retrospectively redeem themselves by converting their status from that of perpetrators into that of victims by grafting their collective memories onto those of a clearly identified ‘victim’ population, the harkis, with whom they feel a special affinity. The reaction of the harki community to this process and the implications for the development of their own memories will also be examined.
Discrete Emotions in Infancy: Perception without Production?
Authors: Hoehl Stefanie , Striano Tricia
Published: March 2010

Camras and Shutter review evidence suggesting that infants’ facial expressions do not represent discrete emotions and cannot easily be matched to the facial expressions of adults. This raises the important question of whether infants have a notion about the meanings of discrete emotions at all. The authors do not discuss whether infants are sensitive to discrete emotional expressions when perceiving others. In our commentary we discuss evidence for the perception of discrete emotional facial expressions in infancy.
Cautions in the Study of Infant Emotional Displays
Authors: Hertenstein Matthew J.
Published: March 2010

Camras and Shutter persuasively argue for the complexity of infant emotional displays and provide evidence in opposition to some of the central claims of Differential Emotions Theory (DET). I discuss two points of caution to the study of emotion that are implicitly raised by the target article and describe briefly directions for research in the field.
Emotion, Motive States, Appraisal, and Kagan: Commentary to Jerome Kagan, What is Emotion?
Authors: Frijda Nico H.
Published: March 2010

Kagan mistakes the emphasis on action readiness in emotions for emphasis on action. He moreover neglects the appraisal processes that form the origins of emotional feeling and other responses.
Defending the Validity of Pragmatism in the Classification of Emotion
Authors: Zachar Peter
Published: March 2010

I critically analyze Kagan’s claim that in order to advance the science of emotion we should abandon the practice of referring to emotions with common folk psychological names, such as fear and anger. Kagan recommends discovering more homogenous constructs that are segregated by the type of evidence used to infer those constructs. He also argues that variable origins, biological implementations, and psychological and sociocultural contexts may combine to create distinct kinds of emotional states that require distinct names. I acknowledge that such a splitting strategy will provide increased validity, but also claim that atomizing alone may not give us everything we want from a scientific classification.
From Appraisal to Emotion
Authors: Kuppens Peter
Published: March 2010

For appraisal to be a likely cause of automatically elicited emotions, we not only need to account for how appraisals can occur automatically, but also how emotional experience can follow from appraised meaning in an automatic fashion. The simplest way to construe this is to assume that emotional feeling directly reflects the appraised meaning and its implications. Emotional feeling should be distinguished from verbally categorizing and labeling the experience, however, for understanding the relationship between appraisals and emotion terms.
Complexities in the Study of Infant Emotional Facial Expressions
Authors: Shutter Jennifer M. , Camras Linda A.
Published: March 2010

In the target article, we reviewed empirical evidence regarding the relationship between facial expressions and emotion in infancy. In our response to commentators, we make three main points. First, we concur with Hertenstein that the field has thus far relied too heavily on deductive reasoning, and suggest that future research strike a balance between inductive and deductive reasoning. Second, we maintain that infant recognition of discrete emotions remains an open question. Third, we state our position regarding the revised version of DET.
Automatic Constructive Appraisal: A Reply to the Commentaries of Parkinson and Kuppens
Authors: Moors Agnes
Published: March 2010

My reply to the comments of Parkinson (2010) and Kuppens (2010) is organized in three parts. The first part deals with Parkinson’s claim that the scope of our research is limited because no real emotions were elicited. I suggest that the outcomes in our studies are structurally similar to real emotions but that they lack intensity. In the second part, I try to correct three potential misunderstandings regarding the nature of the comparison process that I proposed. In the third part, I respond to Kuppens’ suggestion that we also need to consider the transition of appraisal values into the other components of emotion (actions tendencies, responses, and subjective experience).
A Linguist’s View of “Pride”
Authors: Gladkova Anna
Published: March 2010

This commentary offers a linguistic perspective on “pride”. On the basis of a semantic analysis it demonstrates that the interpretation of pride put forward by Tracy, Shariff, and Cheng (2010) is Anglocentric and is consistent with the contemporary use of the English word pride. It compares the English concept of pride with the Russian concept of gordit’sja and demonstrates their differences. It calls for a psychological account of “pride” free from an ethnocentric bias.
Please, No More Naked Predicates: A Reply
Authors: Kagan Jerome
Published: March 2010

The nodes of controversy detected by the commentators on “Once More into the Breach” center on the meanings of words and the strategies for classifying observations rather than on empirical facts. This rejoinder explains why I continue to believe that: (1) consequences are not a useful criterion for classifying emotions, (2) the utility of the concept of basic emotions remains ambiguous, and (3) psychologists should spend more time probing the conditions that contribute to robust phenomena rather than trying to affirm the validity of popular emotional words that fail to specify the agent, the incentive, or the local setting.
Surveying the Emotions
Authors: Leys Ruth
Published: March 2010

A commentary on Robert Kagan’s What is Emotion? (2007). The commentary praises the author for the range and breadth of his analysis and for his skepticism concerning the common tendency to equate emotions with brain states. At the same time, I raise questions about the terms in which Kagan attempts to separate out the distinct components of the emotional “cascade.” In particular, I suggest that by treating the appraisal or interpretation of the changes in bodily feelings as a distinct phase of the emotional response, Kagan appears to dissociate the relevant brain and bodily feeling states from the contexts or meanings in which they are embedded, and to do so in ways that obscure the relationship between the successive components or phases he has identified.
Naturalism and the Tale of Two Facets
Authors: Shariff Azim F. , Tracy Jessica L. , Cheng Joey T.
Published: March 2010

Williams and DeSteno (2010) and Gladkova (2010) question the validity, utility, and theoretical support for the bifurcation of pride into hubristic and authentic facets. Though these commentators highlight unanswered questions and important directions for future research, we argue that the broad, evolutionarily informed framework for the two facets, presented in our target article nonetheless provides the best fit and explanation for the existing pattern of evidence. We offer several empirical suggestions for future studies addressing the questions raised by the commentators, and emphasize the need for emotion researchers to hew closely to empirical data in developing theoretical accounts.
Health inequalities in the Caribbean: increasing opportunities and resources
Authors: Cloos Patrick
Published: March 2010

Social inequalities in health are not a priority in the Caribbean region. However, a few studies suggested such disparities and indicators show important socioeconomic disparities between and within countries. There are indications that governments’ investment in health and other social programs is insufficient in the region and that regional health institutions that guide national health policies and programs do not make the reduction of social inequalities a priority. Furthermore, the public health sector is generally weak and health services are mainly focusing on curative services. The author argues that there is a need to develop and to implement social policies that include equity and social justice as core values. In order to increase the focus on health inequalities in the region, there is also a need to strengthen the Public Health field that integrates Health Promotion strategies. It is also suggested that international, regional and national health sectors that include academic and research institutions, health-related journals and associations, and non-governmental organizations put health inequalities in the Caribbean on their agenda. Furthermore, there should be a fundamental switch from a biomedical perspective of health to a paradigm that considers health as the expression of political, social and economic circumstances. (Global Health Promotion, 2010; 17 (1): pp. 73—76)
Sustainability of community-capacity to promote safer motherhood in northwestern Tanzania: what remains?
Authors: Ahluwalia Indu B. , Robinson Dorcas , Vallely Lisa , Gieseker Karen E. , Kabakama Alfreda
Published: March 2010

Objective. To examine the remains of the Community-Based Reproductive Health Project (CBRHP) implemented by CARE-Tanzania to address high maternal mortality in two rural districts. Methods. In early 2007, data were collected from 29 villages and used to assess sustainability of emergency transport systems, retention of village health workers (VHWs), and their potential impact on maternal health. Surveillance data from the Ministry of Health were reviewed to assess changes in prenatal and service use indicators. Results. From 2001 through 2006, the CBRHP-trained VHWs have continued to provide education and referrals to women in their communities including prenatal and emergency obstetric care; six villages with emergency transport systems have continued for more than 5 years providing free or low-cost transport to health facilities. Selected maternal and infant health indicators, such as early prenatal care, identification of pregnancy-related danger signs, and data on maternal and infant outcomes, improved in the two targeted districts over time. Conclusions. The two components of CBRHP, work of VHWs and community-financing for emergency transport systems in six villages, have continued. Both of these promote maternal health and linkages with the health delivery systems. Surveillance data show changes in maternal health indicators that were targeted by the district-wide CBRHP interventions. Programs such as CBRHP, with focus on capacity-building and empowerment, can assist in mobilizing the formal and informal systems in communities, components of which may be sustained over time. (Global Health Promotion, 2010; 17(1): pp. 39—49)
Policy analysis of oral health promotion in South Africa
Authors: Singh Shenuka , Myburgh Neil G. , Lalloo Ratilal
Published: March 2010

This article reports an analysis of oral health promotion in South African health policy. The central aim of this research was to determine the form and coherence of oral health promotion elements within health policies of post-apartheid South Africa. The study set out to test the hypothesis that oral health promotion elements are fully integrated into health policy and programmatic efforts. A conceptual framework was developed to systematically analyse oral health promotion policy and subsequent decision-making across the country at national and provincial levels. The information was drawn from policy documents, protocols and programme plans, complemented by interviews. The results indicate distinct contradictions between the policy formulation process and its impact on health system decision-making. South African health policy was found to be strong on the rhetoric of equity, health promotion, integration and several other features of the Primary Health Care Approach, but showed little evidence of translating this into action. The development and implementation of oral health promotion appears to be dominated by the influence of dental professionals that perpetuate a curative focus on service delivery. There is an urgent need to re-examine the process and content of oral health policy-making in South Africa. The conceptual framework developed for this study could facilitate further research in this area. (Global Health Promotion, 2010; 17(1): pp. 16—24)
Network evaluation: principles, structures and outcomes of the German working group of Health Promoting Universities
Authors: Stock Christiane , Milz Simone , Meier Sabine
Published: March 2010

With more than 60 participating universities, the German working group of Health Promoting Universities (German HPU network) is the largest and most active network of universities as healthy settings. This study aims at evaluating processes and effects of the German HPU network and at supporting the future development of the network. The evaluation was based on the multi faceted network assessment instrument developed by Broesskamp-Stone (7). We used a document analysis, two expert interviews and a survey among members ( n = 33) to collect relevant data for the assessment. The analysis showed that the visions of the network can be regarded as fulfilled in most aspects. The members of the network received network support through trustful and mutual relationships. The network ranked high on general network principles like implementation of mutual relationships, sharing of information, risks and resources, equal access to resources, responsibility and consensus orientation. However, a high degree of centralization was found as a negative indicator. Other critical aspects of the network’s structures and processes have been the regional predominance of universities from the northern and middle part of Germany, the low representation of students in the network, and the low proportion of members that could successfully implement health promotion into the guiding principles of their university. Overall, the evaluation has shown that the network has worked effectively, has developed meaningful processes and structures and has formulated practical guidelines. Since its 12 years of existence the German HPU network has been able to adapt and to adequately respond to changing contextual conditions regarding health promotion at universities in Germany. The network should develop strategies to counteract the critical aspects and detected imbalances in order to further increase its impact on universities as healthy settings. (Global Health Promotion, 2010; 17(1): pp. 25—32)
Améliorer le système d’information sur les décès maternels dans quatre hôpitaux du Burkina Faso : le point de vue des soignants
Authors: Yaogo Maurice , Barro Mamoudou , Sanou/Tamini Cécile , Sombié Issiaka
Published: March 2010

Introduction. Dans le cadre d’un programme de recherche pluridisciplinaire, une étude a été réalisée pour évaluer la faisabilité d’une application à grande échelle d’une méthode de surveillance institutionnelle active pour enregistrer les décès maternels. L’objectif principal de la composante qualitative présentée ici était d’identifier les barrières et les conditions favorables à une meilleure collecte de l’information sur les décès maternels dans quatre hôpitaux de la région des Hauts-Bassins au Burkina Faso. Méthodes. Deux types d’outils méthodologiques ont été utilisés : le focus group et les entretiens individuels approfondis. Au total, 33 professionnels de la santé ont été impliqués dans deux focus groups et 24 entretiens individuels ont été réalisés à partir de guides thématiques. Les informations enregistrées ont été transcrites et soumises à une analyse de contenu et une analyse de discours. Résultats. Les principales barrières identifiées portent essentiellement sur l’inadaptation des supports d’enregistrement, l’absence d’organisation et d’incitation des agents pour une collecte systématique des décès maternels dans l’environnement hospitalier. Les conditions favorables à une meilleure notification et enregistrement des décès maternels concernent principalement la possibilité d’introduire des changements qualitatifs (dispositions institutionnelles incitatrices pour les prestataires, système de suivi et d’évaluation intégré au circuit de l’information sanitaire) pour mieux sensibiliser et impliquer les acteurs, harmoniser les supports et le système opératoire. Conclusions. Améliorer la qualité et la complétude des données sur les décès maternels et d’autres indicateurs socio-sanitaires est une approche permettant de documenter en temps réel les efforts et de suivre les progrès dans les actions spécifiques pour lutter contre la mortalité maternelle et d’autres préoccupations majeures de santé publique. En dehors du dispositif de collecte des informations à parfaire, des conditions de travail plus incitatives permettront de mieux impliquer les prestataires et d’avoir un système plus fonctionnel pour éclairer efficacement la prise de décision. (Global Health Promotion, 2010; 17(1): pp. 86—94)
A congenital activating mutant of WASp causes altered plasma membrane topography and adhesion under flow in lymphocytes
Authors: Burns Siobhan O. , Killock David J. , Moulding Dale A. , Metelo Joao , Nunes Joao , Taylor Ruth R. , Forge Andrew , Thrasher Adrian J. , Ivetic Aleksandar
Published: March 2010

Leukocytes rely on dynamic actin-dependent changes in cell shape to pass through blood vessels, which is fundamental to immune surveillance. Wiskott-Aldrich Syndrome protein (WASp) is a hematopoietic cell–restricted cytoskeletal regulator important for modulating cell shape through Arp2/3-mediated actin polymerization. A recently identified WASpI294T mutation was shown to render WASp constitutively active in vivo, causing increased filamentous (F)–actin polymerization, high podosome turnover in macrophages, and myelodysplasia. The aim of this study was to determine the effect of WASpI294T expression in lymphocytes. Here, we report that lymphocytes isolated from a patient with WASpI294T, and in a cellular model of WASpI294T, displayed abnormal microvillar architecture, associated with an increase in total cellular F-actin. Microvillus function was additionally altered as lymphocytes bearing the WASpI294T mutation failed to roll normally on L-selectin ligand under flow. This was not because of defects in L-selectin expression, shedding, cytoskeletal anchorage, or membranal positioning; however, under static conditions of adhesion, WASpI294T-expressing lymphocytes exhibited altered dynamic interaction with L-selectin ligand, with a significantly reduced rate of adhesion turnover. Together, our results demonstrate that WASpI294T significantly affects lymphocyte membrane topography and L-selectin–dependent adhesion, which may be linked to defective hematopoiesis and leukocyte function in affected patients.
Two mutations in the KINDLIN3 gene of a new leukocyte adhesion deficiency III patient reveal distinct effects on leukocyte function in vitro
Authors: McDowall Alison , Svensson Lena , Stanley Paula , Patzak Irene , Chakravarty Probir , Howarth Kimberley , Sabnis Himalee , Briones Michael , Hogg Nancy
Published: March 2010

In the disorder leukocyte adhesion deficiency III (LAD-III), integrins on platelets and leukocytes are expressed but fail to function and this leads to severe bleeding and infections at an early age. Mutation in the KINDLIN3 (FERMT3) gene is the cause of LAD-III in patients from the Middle East, Malta, and Turkey. We describe 2 novel homozygous mutations in the KINDLIN3 gene of a new African-American patient that destabilize KINDLIN3 mRNA leading to loss of kindlin-3 protein. Transfection of wild-type (WT) KINDLIN3 cDNA restored integrin-related adhesion and migration in the LAD-III patient's T and B lymphocytes. We analyzed the individual mutations separately in vitro to learn more about the function of the kindlin-3 protein. The first G>A mutation gives rise to a Gly308Arg change at the end of FERM (protein 4.1, ezrin, radixin, moesin) subdomain 2, and the second mutation is a base deletion causing early termination within the pleckstrin homology (PH) domain. This second mutation prevented membrane association of kindlin-3 and did not restore either adhesion or migration, whereas the FERM subdomain 2 mutation affected only migration. Thus, these LAD-III patient mutations have highlighted functionally important regions of kindlin-3 that alter leukocyte integrin-dependent function in 2 distinct ways.
AKT1 and AKT2 maintain hematopoietic stem cell function by regulating reactive oxygen species
Authors: Juntilla Marisa M. , Patil Vineet D. , Calamito Marco , Joshi Rohan P. , Birnbaum Morris J. , Koretzky Gary A.
Published: March 2010

Although AKT is essential for multiple cellular functions, the role of this kinase family in hematopoietic stem cells (HSCs) is unknown. Thus, we analyzed HSC function in mice deficient in the 2 isoforms most highly expressed in the hematopoietic compartment, AKT1 and AKT2. Although loss of either isoform had only a minimal effect on HSC function, AKT1/2 double-deficient HSCs competed poorly against wild-type cells in the development of myeloid and lymphoid cells in in vivo reconstitution assays. Serial transplantations revealed an essential role for AKT1 and AKT2 in the maintenance of long-term HSCs (LT-HSCs). AKT1/2 double-deficient LT-HSCs were found to persist in the G0 phase of the cell cycle, suggesting that the long-term functional defects are caused by increased quiescence. Furthermore, we found that the intracellular content of reactive oxygen species (ROS) is dependent on AKT because double-deficient HSCs demonstrate decreased ROS. The importance of maintaining ROS for HSC differentiation was shown by a rescue of the differentiation defect after pharmacologically increasing ROS levels in double-deficient HSCs. These data implicate AKT1 and AKT2 as critical regulators of LT-HSC function and suggest that defective ROS homeostasis may contribute to failed hematopoiesis.
Toll-like receptor–induced reactivity and strongly potentiated IL-8 production in granulocytes mobilized for transfusion purposes
Authors: Drewniak Agata , Tool Anton T. J. , Geissler Judy , van Bruggen Robin , van den Berg Timo K. , Kuijpers Taco W.
Published: March 2010

Transfusion of granulocytes from granulocyte-colony stimulating factor (G-CSF)/dexamethasone (dexa)–treated donors can be beneficial for neutropenic recipients that are refractory to antimicrobial therapy. G-CSF/dexa treatment not only increases the number of circulating neutrophils but also affects their gene expression. Because of the intended transfusion of these granulocytes into patients who are severely ill, it is of importance to establish to what extent mobilization affects the cellular behavior of neutrophils. Here, we studied the effects of mobilization on Toll-like receptor (TLR)–mediated responses. Mobilized granulocytes displayed increased gene and protein expression of TLR2, TLR4, TLR5, and TLR8. Although mobilized granulocytes displayed normal priming of nicotinamide adenine dinucleotide phosphate oxidase activity and a slight increase in adhesion in response to TLR stimulation, these cells produced massive amounts of interleukin-8 (IL-8), in particular to TLR2 and TLR8 stimulation. The increase in IL-8 release occurred despite reduced IL-8 mRNA levels in the donor granulocytes after in vivo G-CSF/dexa treatment, indicating that the enhanced TLR-induced IL-8 production was largely determined by posttranscriptional regulation. In summary, granulocytes mobilized for transfusion purposes show enhanced TLR responsiveness in cytokine production, which is anticipated to be beneficial for the function of these cells on transfusion into patients.
Molecular mechanisms involving sigma receptor–mediated induction of MCP-1: implication for increased monocyte transmigration
Authors: Yao Honghong , Yang Yanjing , Kim Kee Jun , Bethel-Brown Crystal , Gong Nan , Funa Keiko , Gendelman Howard E. , Su Tsung-Ping , Wang John Q. , Buch Shilpa
Published: March 2010

Cocaine abuse hastens the neurodegeneration often associated with advanced HIV-1 infection. The mechanisms, in part, revolve around the neuroinflammatory processes mediated by the chemokine monocyte chemotactic protein-1 (MCP-1/CCL2). Understanding factors that modulate MCP-1 and, in turn, facilitate monocyte extravasation in the brain is thus of paramount importance. We now demonstrate that cocaine induces MCP-1 in rodent microglia through translocation of the sigma receptor to the lipid raft microdomains of the plasma membrane. Sequential activation of Src, mitogen-activated protein kinases (MAPKs), and phosphatidylinositol-3′ kinase (PI3K)/Akt and nuclear factor κB (NF-κB) pathways resulted in increased MCP-1 expression. Furthermore, conditioned media from cocaine-exposed microglia increased monocyte transmigration, and thus was blocked by antagonists for CCR2 or sigma receptor. These findings were corroborated by demonstrating increased monocyte transmigration in mice exposed to cocaine, which was attenuated by pretreatment of mice with the sigma receptor antagonist. Interestingly, cocaine-mediated transmigratory effects were not observed in CCR2 knockout mice. We conclude that cocaine-mediated induction of MCP-1 accelerates monocyte extravasation across the endothelium. Understanding the regulation of MCP-1 expression and functional changes by cocaine/sigma receptor system may provide insights into the development of potential therapeutic targets for HIV-1–associated neurocognitive disorders.
Acute mercury poisoning: a case report
Authors: Sarikaya Sezgin , Karcioglu Ozgur , Ay Didem , Cetin Aslı , Aktas Can , Serinken Mustafa
Published: March 2010

Background

Mercury poisoning can occur as a result of occupational hazard or suicide attempt. This article presents a 36-year-old case admitted to emergency department (ED) due to exposure to metallic mercury.

Case Presentatıon

A 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. One week ago her daughter had brought mercury in the liquid form from the school. She had put it on the heating stove. One day later, her 14-month old sister baby got fever and died before admission to the hospital. Her blood pressure was 134/87 mmHg; temperature, 40.2°C; heart rate 105 bpm and regular; respiration, 18 bpm; O2 saturation, 96%. Nothing was remarkable on examination and routine laboratory tests. As serine or urinary mercury levels could not be tested in the city, symptomatic chelation treatment with N-acetyl cysteine (NAC) was instituted with regard to presumptive diagnosis and history. At the 7th day of admission she was discharged without any sequelae or complaint. At the discharge day blood was drawn and sent for mercury levels which turned out to be 30 μg/dL (normal range: 0 - 10 μg/dL).

Conclusion

Public education on poisoning and the potential hazards of mercury are of vital importance for community health.
Association analysis of ADPRT1, AKR1B1, RAGE, GFPT2 and PAI-1 gene polymorphisms with chronic renal insufficiency among Asian Indians with type-2 diabetes
Authors: Prasad Pushplata , Tiwari Arun K , Kumar KM Prasanna , Ammini AC , Gupta Arvind , Gupta Rajeev , Thelma BK
Published: March 2010

Background

To determine association of nine single nucleotide polymorphisms (SNPs) in ADP ribosyltransferase-1 (ADPRT1), aldo-keto reductase family 1 member B1 (AKR1B1), receptor for advanced glycation end-products (RAGE), glutamine:fructose-6-phosphate amidotransferase-2 (GFPT2), and plasminogen activator inhibitor-1 (PAI-1) genes with chronic renal insufficiency (CRI) among Asian Indians with type 2 diabetes; and to identify epistatic interactionss between genes from the present study and those from renin-angiotensin-aldosterone system (RAAS), and chemokine-cytokine, dopaminergic and oxidative stress pathways (previously investigated using the same sample set).

Methods

Type 2 diabetes subjects with CRI (serum creatinine ≥3.0 mg/dl) constituted the cases (n = 196), and ethnicity and age matched individuals with diabetes for a duration of ≥ 10 years, normal renal functions and normoalbuminuria recruited as controls (n = 225). Allelic and genotypic constitution of 10 polymorphisms (SNPs) from five genes namely- ADPRT1, AKR1B1, RAGE, GFPT2 and PAI-1 with diabetic CRI was investigated. The genetic associations were evaluated by computation of odds ratio and 95% confidence interval. Multiple logistic regression analysis was carried out to correlate various clinical parameters with genotypes, and to study epistatic interactions between SNPs in different genes.

Results

Single nucleotide polymorphisms -429 T>C in RAGE and rs7725 C>T SNP in 3' UTR in GFPT2 gene showed a trend towards association with diabetic CRI. Investigation using miRBase statistical tool revealed that rs7725 in GFPT2 was a perfect target for predicted miRNA (hsa miR-378) suggesting the presence of the variant 'T' allele may result in an upregulation of GFPT2 contributing to diabetic renal complication. Epistatic interaction between SNPs in transforming growth factor TGF-β1 (investigated using the same sample set and reported elsewhere) and GFPT2 genotype was observed.

Conclusions

Association of SNPs in RAGE and GFPT2 suggest that the genes involved in modulation of oxidative pathway could be major contributor to diabetic chronic renal insufficiency. In addition, GFPT2 mediated overproduction of TGF-β1 leading to endothelial expansion and thereby CRI seems likely, suggested by our observation of a significant interaction between GFPT2 with TGF-β1 genes. Further, identification of predicted miRNA targets spanning the associated SNP in GFPT2 implicates the rs7725 SNP in transcriptional regulation of the gene, and suggests GFPT2 could be a relevant target for pharmacological intervention. Larger replication studies are needed to confirm these observations.
Low HIV testing rates among tuberculosis patients in Kampala, Uganda
Authors: Sendagire Ibrahim , Schreuder Imke , Mubiru Mesach , van der Loeff Maarten Schim , Cobelens Frank , Konde-Lule Joseph
Published: March 2010

Background

HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level of HIV test uptake among newly diagnosed pulmonary tuberculosis (PTB) patients; to assess patient and health worker factors associated with HIV test uptake; and to determine factors associated with HIV test uptake at the primary care clinics

Methods

Adult patients who had been diagnosed with smear-positive PTB at a primary care clinic or at the referral hospital and who were being treated at any of the three clinics were interviewed. Associations between having taken the test as the main outcome and explanatory variables were assessed by multivariate logistic regression.

Results

Between April and October 2007, 112 adults were included in the study. An HIV test had been offered to 74 (66%). Of the 112 patients, 61 (82%) had accepted the test; 45 (74%) had eventually been tested; and 32 (29%) had received their test results.

Patients who were <25 yeas old, female or unemployed, or had reported no previous HIV testing, were more likely to have been tested. The strongest predictor of having been tested was if patients had been diagnosed at the referral hospital compared to the city clinic (adjusted OR 24.2; 95% CI 6.7-87.7; p < 0.001). This primarily reflected an "opt-out" (uptake 94%) versus an "opt-in" (uptake 53%) testing policy.

Conclusions

The overall HIV test uptake was surprisingly low at 40%. The HIV test uptake was significantly higher among TB patients who were identified at hospital, among females and in the unemployed.
Primary tubercular caecal perforation: a rare clinical entity
Authors: Jain Devendra K , Aggarwal Gaurav , Lubana Parvinder S , Moses Sonia , Joshi Nitin
Published: March 2010

Background

Intestinal tuberculosis is a common problem in endemic areas, causing considerable morbidity and mortality. An isolated primary caecal perforation of tubercular origin is exceptionally uncommon.

Case presentation

We report the case of a 39 year old male who presented with features of perforation peritonitis, which on laparotomy revealed a caecal perforation with a dusky appendix. A standard right hemicolectomy with ileostomy and peritoneal toileting was done. Histopathology revealed multiple transmural caseating granulomas with Langerhans-type giant cells and acid-fast bacilli, consistent with tuberculosis, present only in the caecum.

Conclusions

We report this extremely rare presentation of primary caecal tuberculosis to sensitize the medical fraternity to its rare occurrence, which will be of paramount importance owing to the increasing incidence of tuberculosis all over the world, especially among the developing countries.