bluuebunny/crossref_metadata_2025 huggingface dataset:
Conducting research in everyday psychiatric settings: identifying the challenges to meaningful evaluation
Authors: OESTRICH I. H. , AUSTIN S. F. , TARRIER N.
Published: January 2007

A distinction is often made between research into the efficacy of a treatment, i.e. whether it can be shown to work under ideal conditions, and research into the effectiveness of a treatment, i.e. whether it can be shown to work within a routine health service or usual clinical practice. The purpose of this article is to use descriptive information collected from personnel on the implementation and evaluation of a psychological intervention as a way to highlight some of the challenges faced when conducting research within everyday clinical settings. A psychological intervention for low self‐esteem was evaluated within a standard inpatient ward for dual diagnosis patients. Descriptive information was collected from interviews to identify the challenges encountered during the research process. A qualitative analysis of interview content was undertaken to identify the major themes. Personnel described a range of patient variables, staff characteristics and organizational factors that hindered the research process. A detailed account of these factors along with potential solutions that can facilitate research in clinical settings is provided. Conducting research within clinical settings requires considerable planning and monitoring throughout the whole research process. Particular attention should be given to the impact of patient characteristics, staff variables and organizational context when designing and implementing research protocols. The value of this type of research within everyday clinical settings has significant implications for improving patient treatment and outcomes across psychiatric services.
Being burdened and balancing boundaries: a qualitative study of nurses' experiences caring for patients who self‐harm
Authors: WILSTRAND C. , LINDGREN B.‐M. , GILJE F. , OLOFSSON B.
Published: January 2007

Although nurses encounter self‐harm patients in various settings, self‐harm has seldom been addressed in psychiatric nursing research. The research question was: ‘What are nurses’ descriptions of experiences of caring for psychiatric patients who self‐harm?' The data were comprised of text based on narrative interviews with six nurses employed in a psychiatric hospital in Sweden. By using qualitative content analysis, two themes and seven sub‐themes were constructed. The theme ‘Being burdened with feelings’ involved the sub‐themes: ‘Fearing for the patient’s life‐threatening actions', ‘Feeling overwhelmed by frustration’ and ‘Feeling abandoned by co‐workers and management’. The theme ‘Balancing professional boundaries’ involved the sub‐themes: ‘Maintaining professional boundaries between self and patient’, ‘Managing personal feelings’, ‘Feeling confirmed by co‐workers’ and ‘Imagining better ways of care’. Of significance are the nurses' feelings of fear, frustration and abandonment creating the sense of being burdened. This study points to the importance of releasing these burdens, not only for the sake of the nurses, but to improve the care of the patients. The importance of increased knowledge, support and supervision for professionals working with people who self‐harm, not only in psychiatric care, needs to be addressed in research, education and development of practice.
Extinguishing the voices: living with the ghost of the disenfranchised
Authors: MUNCEY T. , ROBINSON R.
Published: January 2007

As a user of the mental health service, Rob has first‐hand experience of the marginalization that accompanies a mental health label. In seeking to validate his experience, centre and assimilate the shadow within, he has participated in teaching students within mental health programmes. Tessa in her role as an academic has sought to validate her experience of teenage pregnancy in a world that denied her experience. The chance meeting of these two people on their respective journeys highlights the voices that have not been heard and the ghosts that link them. Journeys that seek to reconcile memory and truth and entwine numinance within the narrative of mental health.
Testing the effectiveness of an educational intervention aimed at changing attitudes to self‐harm
Authors: PATTERSON P. , WHITTINGTON R. , BOGG J.
Published: January 2007

Nurses' attitudes toward service users who repeatedly self‐harm can be negative and may interfere with the user's willingness to engage with services. The effectiveness of an educational intervention aimed at improving nurses' attitudes in this area was tested in this study. The intervention consisted of attendance on an accredited course on self‐harm over a period of 15 weeks and the outcome of interest was attitudes as measured by the Self Harm Antipathy Scale. When deployed in a before‐and‐after design with two non‐randomly allocated groups, there was evidence of a 20% reduction in antipathy toward self‐harm among course attenders maintained over a period of at least 18 months (compared with a 9% reduction in a comparison group). Three of the six Self Harm Antipathy Scale attitude dimensions showed significant short‐term change with some further long‐term effects. This is preliminary evidence for the effectiveness of the chosen intervention in reducing overall antipathy toward self‐harm clients and enhancing a sense of competence, a valuing of the care process and an awareness of the factors contributing to self‐harm.
Microsatellite analysis of genetic structure in natural Triatoma infestans (Hemiptera: Reduviidae) populations from Argentina: its implication in assessing the effectiveness of Chagas’ disease vector control programmes
Authors: PÉREZ DE ROSAS ALICIA R. , SEGURA ELSA L. , GARCÍA BEATRIZ A.
Published: January 2007

The genetic structure in populations of the Chagas’ disease vector Triatoma infestans was examined. Comparisons of the levels of genetic variability in populations of this species from areas with different periods since last insecticide treatment and from areas that never received treatment were also carried out. A total of 598 insects from 19 populations were typed for 10 polymorphic microsatellite loci. The average observed and expected heterozygosities ranged from 0.186 to 0.625 and from 0.173 to 0.787, respectively. Genetic drift and limited gene flow appear to have generated a substantial degree of genetic differentiation among the populations of T. infestans. Departures from Hardy–Weinberg expectations due to an excess of homozygotes suggested the presence of null alleles and population subdivision. Microgeographical analysis supports the existence of subdivision in T. infestans populations. Levels of genetic diversity in the majority of the populations of T. infestans from insecticide‐treated localities were similar or higher than those detected in populations from areas without treatment. Since the populations of T. infestans are subdivided, a population bottleneck would result in independent genetic drift effects that could randomly preserve different combinations of alleles in each subpopulation. These events followed by a rapid population growth could have preserved high levels of genetic diversity. This study supports the hypothesis of vector population recovery from survivors of the insecticide‐treated areas and therefore highlights the value of population genetic analyses in assessing the effectiveness of Chagas’ disease vector control programmes.
A Ras1‐Cdc24 signal transduction pathway mediates thermotolerance in the fungal pathogen Cryptococcus neoformans
Authors: Nichols Connie B. , Perfect Zahra H. , Alspaugh J. Andrew
Published: January 2007

Pathogenic microorganisms must precisely regulate morphogenesis to survive and proliferate within an infected host. This regulation is often controlled by conserved signal transduction pathways that direct morphological changes in varied species. One such pathway, whose components include Ras proteins and the PAK kinase Ste20, allows the human fungal pathogen Cryptococcus neoformans to grow at high temperature. Previously, we found that Ras1 signalling is required for differentiation, thermotolerance and pathogenesis in C. neoformans. We show here that the guanine nucleotide exchange factor Cdc24 is a Ras1 effector in C. neoformans to mediate the ability of this fungus to grow at high temperature and to cause disease. In addition, we provide evidence that the Ras1‐Cdc24 signalling cascade functions specifically through one of the three Cdc42/Rac1 homologues in C. neoformans. In conclusion, our studies illustrate how components of conserved signalling cascades can be specialized for different downstream functions, such as pathogenesis.
Paired kidney donation by shipment of living donor kidneys
Authors: Waki Kayo , Terasaki Paul I.
Published: January 2007

Abstract:  It is apparent from calculations that for paired kidney donation programs, a national program will provide optimum benefit. To obviate major problems associated with donors traveling long distances, we propose shipping donor kidneys. Evidence is provided from the United Network for Organ Sharing (UNOS) Kidney Transplant Registry, that 14 873 immediate functioning kidneys from deceased head‐trauma donors with an average cold ischemia time of 18.3 h had 85.7% three‐yr graft survival compared with 87.8% survival of 23 369 transplants from living donors with 2.4 h of ischemia. Grafts from 10 368 deceased donors with 13–24 h cold ischemia time had three‐yr graft survival of 82.6% compared with 84.2% for 1153 transplants with up to six h cold ischemia time. After adjusting for major confounding factors, cold ischemia does not significantly influence graft survival. We conclude that shipment of donor kidneys can be performed safely and will significantly increase paired donor transplants.
The fate of recipient‐derived hepatocytes in sex‐mismatched liver allograft following liver transplantation
Authors: Idilman Ramazan , Erden Esra , Kuzu Isınsu , Ersoz Sadik , Karayalcin Selim
Published: January 2007

Abstract:  Background:  ‘‘Bone marrow‐derived stem cells’’ have attracted great attention as potential candidates for liver‐directed gene therapy and as a tool for regenerative medicine. However, the fate of these cells is not well‐known. The aim of this present study was to investigate the fate of ‘‘recipient‐derived repopulated hepatocytes’’ in sex‐mismatched liver allografts in individuals following liver transplantation during systematic longitudinally performed liver biopsies.

Methods:  Paraffin‐embedded sex‐mismatched liver biopsy samples of nine recipients (male/female ratio 5/4; mean age: 39.7 yr) were reviewed. Double labeling with immunohistochemistry for hepatocytes and recipient‐specific bone marrow‐derived cells and fluorescence in‐situ hybridization for visualizing X and Y chromosomes were performed. These slides were examined systematically using an image analyzer system (Olympus microscope; Cyto‐Vision, Applied Imaging, Biosciences Centre, Newcastle, UK). Only cells with two nuclear spots were considered for interpretation.

Results:  The mean times from transplantation to first biopsy and between the first and the second biopsies were 5.9 and 20.9 months respectively. The proportion of recipient‐derived repopulated hepatocytes was significantly decreased in the late biopsies when compared with the early biopsies (p = 0.001). All nine samples of the first biopsies had demonstrated recipient‐derived hepatocyte repopulation, with a mean of 2.0%, whereas only seven of nine samples of the second biopsies had demonstrated recipient‐derived hepatocyte repopulation with a low mean of 0.5% (p = 0.001).

Conclusion:  Based on these results, we suggest that ‘‘recipient‐specific bone marrow‐derived hepatocyte repopulation’’ in liver allograft during tissue injury is a relatively early event.
Glutathione S‐transferase A1 polymorphisms and acute graft‐vs.‐host disease in HLA‐matched sibling allogeneic hematopoietic stem cell transplantation
Authors: Kim Inho , Keam Bhumsuk , Lee Kyung‐Hun , Kim Jin Hee , Oh So Yeon , Ra Eun Kyung , Yoon Sung‐Soo , Park Sung Sup , Kim Chul Soo , Park Seonyang , Hong Yun‐Chul , Kim Byoung Kook
Published: January 2007

Abstract:  Busulfan and the metabolites of cyclophosphamide are conjugated with glutathione and catabolized by enzymes of the cytosolic glutathione S‐transferases family. There are clearly linked single nucleotide polymorphisms in the promoter region of the glutathione S‐transferase A1 gene (i.e., GSTA1*A, −567T, −69C and −52G; GSTA1*B, −567G, −69T and −52A). We assessed whether the clinical outcomes, including acute graft‐vs.‐host disease, of 61 patients with hematological malignancies, following HLA‐matched sibling allogeneic stem cell transplantation using busulfan/cyclophosphamide conditioning are altered by glutathione S‐transferase A1 genotypes. Globally, grade II–IV acute graft‐vs.‐host disease developed in 13 patients (21%). Grade II–IV acute graft‐vs.‐host disease developed in 15.2% of 46 patients with GSTA1*A/*A diplotype and in 40.0% of 15 patients with GSTA1*A/*B or GSTA1*B/*B diplotype (p = 0.04). Moreover, this relationship between GSTA1*A/*A diplotypes and lower incidence of acute graft‐vs.‐host disease was independent of the age, gender, stem cell source, and disease status. The incidences of acute skin graft‐vs.‐host disease were 7% (3/46) in patients with GSTA1*A/*A and 27% (4/15) in patients without GSTA1*A/*A (p = 0.009, univariate; p = 0.01, multivariate). Acute hepatic graft‐vs.‐host disease developed in 6 (13%) of 46 patients with the GSTA1*A/*A diplotype and in 4 (27%) of 15 patients without this diplotype (p = 0.09, univariate; p = 0.12, multivariate). Ten patients (16%) developed hepatic veno‐occlusive disease. No significant difference was found in the incidence of hepatic veno‐occlusive disease between patients with and without the GSTA1*A/*A diplotype (19.6% vs. 6.7%; p = 0.24). We conclude that the GSTA1*A/*A diplotype is an independent protective factor against acute graft‐vs.‐host disease, especially for skin graft‐vs.‐host disease, and probably for hepatic graft‐vs.‐host disease, in patients using busulfan/cyclophosphamide conditioning. The identification of glutathione S‐transferase A1 genotypes prior to allogeneic stem cell transplantation could allow conditioning regimens and graft‐vs.‐host disease prophylaxis to be modified to improve outcome.
Histologic eosinophilia as an aid to diagnose acute cellular rejection after living donor liver transplantation
Authors: Kishi Yoji , Sugawara Yasuhiko , Tamura Sumihito , Kaneko Junichi , Matsui Yuichi , Makuuchi Masatoshi
Published: January 2007

Abstract:  The significance of histologic eosinophilia in the diagnosis of acute cellular rejection (ACR) after living donor liver transplantation was evaluated. A retrospective analysis was performed on 185 liver biopsy specimens to determine the presence of eosinophil infiltration around the portal tracts. Data were collected and analyzed to determine whether there was a correlation between ACR and the maximum eosinophil counts per portal triad (Em) and the rate of portal triads that included at least one eosinophil (Er). A receiver operating characteristic curve revealed the best cut‐off value of Em and Er as 2% and 8% respectively. The sensitivity and specificity of an Em of two to predict ACR were 54% and 84% respectively. The sensitivity and specificity of Er were 72% and 65% respectively. One‐way analysis of variance revealed that both Em and Er correlated with ACR severity. Histologic eosinophilia can be a useful parameter for confirming the occurrence of ACR and for evaluating ACR severity.
Effects of simulated hypovolaemia on haemodynamics, left ventricular function, mesenteric blood flow and gastric Pco2
Authors: Steiner L. A. , Staender S. , Sieber C. C. , Skarvan K.
Published: January 2007

Background:  Compensated clinically silent hypovolaemia may lead to low cardiac output, hypoperfusion and ischaemia. We investigated the cardiovascular effects of simulated hypovolaemia to determine whether it caused mesenteric ischaemia detectable by gastric tonometry.

Methods:  Thirteen healthy volunteers, aged 21–36 years, were investigated. Lower body negative pressure (LBNP) was used to simulate normotensive hypovolaemia. Cardiovascular parameters were measured using echocardiography. Mesenteric blood flow was investigated using Doppler sonography of the superior mesenteric artery (SMA). Gastric Pco2 (Pgco2) was measured using gas tonometry. Data were collected at baseline, LBNP and during a recovery period.

Results:  Normotensive hypovolaemia was induced successfully in 11 volunteers. There were no significant differences in mean arterial pressure between the three data points (91 ± 6, 93 ± 10 and 95 ± 9 mmHg, respectively). With the induction of LBNP, the heart rate increased from 64 ± 16 to 73 ± 16 beats/min (P < 0.001), the cardiac index decreased from 2.7 ± 1.0 to 1.8 ± 0.6 l/min/m2 (P= 0.002) and the systemic vascular resistance increased from 1535 ± 445 to 2270 ± 550 dyn s/cm5 (P < 0.001). The SMA mean flow velocity decreased from 53 ± 18 to 37 ± 20 cm/s (69 ± 20%) (P= 0.007), and increased to 56 ± 34 cm/s (106 ± 38%) (P= 0.001) during reperfusion. The SMA resistance increased from 92 ± 30 to 174 ± 110 mmHg/l/min (P= 0.004). These changes were reversible after termination of LBNP. By contrast, there were no significant differences in Pgco2 between the three data points.

Conclusions:  In these volunteers, the mesenteric vascular bed contributed importantly to the maintenance of arterial pressure during normotensive hypovolaemia. However, this compensated hypovolaemia did not compromise the mesenteric perfusion sufficiently to increase Pgco2 and to allow detection by tonometry.
Measurement properties of the Short Form 36 and health‐related quality of life after intensive care in Morocco
Authors: Khoudri I. , Ali Zeggwagh A. , Abidi K. , Madani N. , Abouqal R.
Published: January 2007

Background:  Intensive care patients have a health‐related quality of life (HRQL) that differs from the normal population. The aim of this study was to evaluate the measurement properties of the Arabic version of the short form (SF)‐36 and study the HRQL determinants in adult patients 3 months after discharge from an intensive care unit (ICU).

Methods:  A prospective cohort study after ICU discharge. At 3‐month follow up, the SF‐36 was administered in consultation or by telephone. Multitrait scaling analysis was used to confirm the hypothesized scale structure of the SF‐36. Reliability was tested using (i) measuring internal consistency; and (ii) the test–retest reliability assessed using an intraclass correlation coefficient. Construct validity was tested by known‐groups comparison using one‐way analysis of variance (ANOVA) and analysis of covariance (ANCOVA).

Results:  A total of 145 survivors answered the SF‐36. Item internal convergency was higher than 0.40 (0.77–0.99; 100% scaling success) and item discriminant validity was perfect (100% scaling success) except for physical functioning (81% scaling success). Cronbach’s alpha exceeded 0.70 in all eight scales (0.84–0.99). Test–retest reliability conducted in 73 patients was above 0.80. Acceptability to patients appeared reasonable although considerable interview time was required to administer the SF‐36. Construct validity was confirmed by lower scores being reported by women, older age and a high level of comorbidities groups. When adjusted for background data, ICU variables were not associated with the SF‐36 scores.

Conclusions:  The Arabic version of the SF‐36 appears to be a robust tool in ICU. Background variables are the only significant determinants of HRQL 3 months after medical ICU discharge.
Impaired neuromuscular transmission after recovery of the train‐of‐four ratio*
Authors: Eikermann M. , Gerwig M. , Hasselmann C. , Fiedler G. , Peters J.
Published: January 2007

Background:  Residual neuromuscular blockade may increase the risk of development of post‐operative pulmonary complications, but is difficult to detect clinically. It was speculated that patients may have impaired neuromuscular transmission after surgery of long duration, despite the recovery of the train‐of‐four (TOF) ratio.

Methods:  The muscle force (mechanomyography), motor compound muscle action potential amplitude and fatigue of the adductor pollicis (AP) muscle were assessed after recovery of the TOF ratio to 0.9. Thirteen patients receiving repetitive administration of neuromuscular blocking agents (NMBAs) during surgery (median, 5.3 h; interquartile range, 3.4–6 h) were studied post‐operatively in the intensive care unit. At the time of the measurements, patients were scheduled for extubation and the AP TOF ratio amounted to a mean (standard deviation, SD) of 0.94 (0.05). Six healthy volunteers of similar age, weight and gender were studied for comparison. Force–frequency curves were generated by stimulation (10–80 Hz) of the ulnar nerve, and the AP electromyogram (EMG) amplitude was measured, in parallel, before and after evoked muscle fatigue.

Results:  The maximum AP force at a stimulation frequency of 20–80 Hz was significantly lower in patients than in controls [40 N (16 N) vs. 65 N (18 N) at 80 Hz]. In patients, but not in controls, the EMG amplitude decreased with increasing nerve stimulation frequency, and a tetanic fade of both force and EMG, amounting to 0.41 (0.33) (EMG) and 0.61 (0.35) (mechanomyography) at 80 Hz, was observed. Force after fatiguing contractions did not differ between the groups.

Conclusion:  After repetitive administration of NMBAs during surgery, even with recovery of the TOF ratio to 0.9 or more, muscle weakness from impaired neuromuscular transmission can occur. The clinician should consider that post‐operative recovery of the TOF ratio to 0.9 does not exclude an impairment of neuromuscular transmission.
Incidence of regurgitation and pulmonary aspiration of gastric contents in survivors from out‐of‐hospital cardiac arrest
Authors: Virkkunen I. , Ryynänen S. , Kujala S. , Vuori A. , Piilonen A. , Kääriä J.‐P. , Kähärä V. , Pettilä V. , Yli‐Hankala A. , Silfvast T.
Published: January 2007

Background:  The regurgitation of gastric contents and subsequent pulmonary aspiration remain serious adverse events in cardiac arrest and cardiopulmonary resuscitation. The aim of this study was to determine the association between clinical signs of regurgitation and radiological findings consistent with aspiration in resuscitated out‐of‐hospital cardiac arrest (OHCA) patients admitted to hospital.

Methods:  The incidence of regurgitation was studied in 182 successfully resuscitated OHCA patients. The inclusion criterion was the restoration of spontaneous circulation after OHCA not caused by trauma or drug overdose.

Results:  The incidence of regurgitation was 20%. Regurgitation was associated with radiological findings consistent with aspiration with a high specificity (81%) and a low sensitivity (46%).

Conclusions:  Although there was a strong association between clinical regurgitation and radiological findings consistent with aspiration, our data suggest that regurgitation is not invariably followed by radiological findings compatible with aspiration. Radiological findings consistent with aspiration are relatively infrequent without preceding signs of regurgitation in resuscitated patients.
Treating disseminated fusariosis: amphotericin B, voriconazole or both?
Authors: Ho Dora Y. , Lee Jason D. , Rosso Fernando , Montoya Jose G.
Published: January 2007

Disseminated Fusarium infection can cause significant morbidity and mortality in immunocompromised patients. We present a case of disseminated fusariosis in a patient with neutropenic fever successfully treated using both liposomal amphotericin B and voriconazole. Combination anti‐fungal therapy may be considered for such patients, particularly for those failing single‐drug therapy.
Two cases of cryptococcal meningitis in immunocompromised patients not infected with HIV*
Authors: Akcaglar S. , Sevgican E. , Akalin H. , Ener B. , Tore O.
Published: January 2007

We present the cases of two patients with cryptococcal meningitis who were predisposed to fungal infection because of diabetes mellitus (Case 1) and systemic lupus erythematosus (Case 2). Both patients were tested negative for anti‐HIV antibodies.
Hand carriage of Candida species and risk factors in hospital personnel
Authors: Y1ıld1ır1ım Mustafa , Sahin Idris , Kucukbayrak Abdulkadir , Ozdemir Davut , Tevfik Yavuz M. , Oksuz Sukru , Cakir Selma
Published: January 2007

The hands of healthcare workers (HCWs) are considered to be important for colonisation and infection of Candida spp. The objective of this study was to evaluate the rate of Candida carriage on the hands of the hospital personnel the potential risk factors. Samples were collected from the hands of 214 (139 female and 75 male) hospital personnel working at Duzce Medical Faculty Hospital, Duzce, Turkey. Of these, 88 were nurses, 62 resident doctors, 21 laboratory workers, 30 officers and 13 dining room personnel. The hands of all participants were tested by culture with the broth wash technique. Overall, 34.1% of the people analysed were found to harbour Candida spp. on their hands: 30.7% were nurses, 25.8% resident doctors, 28.6% laboratory workers, 84.6% dining room personnel and 43.3% officers. Candida carriage rates of the dining room personnel were higher than found in the other groups (P = 0.001). Isolated Candida species were C. parapsilosis (38.4%), C. tropicalis (26.0%), C. albicans (23.3%), C. kefyr (11.0%) and C. globosa (1.4%). Candida carriage rate was higher in the glove‐using group (35.1%) than the non‐glove using group (7.1%, P = 0.031). We concluded that carriage of Candida species on the hands of personnel was common especially in non‐medical staff. Wearing gloves was found to be related to increased rates of Candida carriage in the nurse group. Candida parapsilosis was the most frequently colonising species that may be a predisposing condition for nosocomial infections transmitted with the hands of HCWs. Hospital personnel should be educated for regular hand washing practice for preventing Candida colonisation.
Production of hybrid phage displaying secreted aspartyl proteinase epitope of Candida albicans and its application for the diagnosis of disseminated candidiasis
Authors: Yang Qiong , Su Quan‐ping , Wang Gui‐yun , Wen De‐zhong , Zhang Yan‐hui , Bao Hui‐zheng , Wang Li
Published: January 2007

The secreted aspartyl proteinases (Saps) of Candida albicans have been implicated as immunodominant antigens and virulence factors associated with adherence and tissue invasion. A hybrid phage displaying the Sap epitope VKYTS was constructed by cloning the corresponding DNA fragments into the pfd88 vector. Similar to native Sap, the phage‐displayed epitope showed reactivity to sera from mice and patients with systemic C. albicans infection but not from those with oropharyngeal candidiasis and healthy individuals on Western blot. Furthermore, a new enzyme‐linked immunosorbent assay was developed to detect the anti‐Sap antibody with hybrid phage displaying Sap epitope VKYTS that can be recognised by anti‐Sap antibodies. Sequential sera were tested from patients and mice with systemic candidiasis and oropharyngeal candidiasis, and serum samples from healthy individuals were also included. The sensitivity and specificity were 77% and 88.3% for experimental mice, respectively. These values reached 60% and 85%, respectively, for human patients. These data indicate this phage‐displayed epitope as an effective and less expensive reagent would be a valuable probe for the detection of specific Sap antibody in the sera of patients and mice with systemic C. albicans infection.
Tracheoscopy assisted repair of tracheo‐esophageal fistula (TARTEF): a 10‐year experience
Authors: DEANOVIC DUBRAVKA , GERBER ANDREAS C. , DODGE‐KHATAMI ALI , DILLIER CLAUDIA M. , MEULI MARTIN , WEISS MARKUS
Published: January 2007

Background:  Fiberoptic tracheoscopy assisted repair of tracheoesophageal fistula (TARTEF) has been reported to be useful for the surgeon with regards to identification of the fistula and proper fistula ligation. The aim of this article is to report our 10‐year experience using TARTEF with intermittent positive pressure ventilation (IPPV) during tracheoesophageal fistula (TEF) repair in newborns.

Methods:  With ethical committee approval, we included all patients undergoing TARTEF from 1995–2005. Variables of interest were (1) respiratory deterioration caused by gastric inflation because of IPPV during surgery and endoscopy; (2) detection of additional airway anomalies; (3) success of intubation of the fistula; (4) other side effects or adverse events. Data are given in median and range.

Results:  Forty‐seven neonates with TARTEF were included. Mean gestational age was 37 weeks (31–42) and mean weight was 2.5 kg (1.1–3.8). The patients were intubated with tracheal tubes size 2.5–3.5 mm ID. Appropriately sized fiberoptic bronchoscopes with an outer diameter of 2.0, 2.4 and 2.8 mm were used; passed through the lumen of the tracheal tube (TT) thereby requiring the use of IPPV to ensure adequate ventilation. No respiratory deterioration was noted as a consequence of intraoperative fiberoptic manipulation within the trachea or because of gastric hyperinflation with IPPV. In all patients, the TEF was successfully penetrated with the fiberscope and this clearly helped the surgeon to rapidly identify and dissect the fistula. In two patients a tracheal bronchus was identified. In two patients accidental extubation occurred during endoscopic confirmation of successful fistula repair.

Conclusions:  While fiberoptic TARTEF through the tracheal tube with IPPV did expedite and facilitate surgery, it did not cause clinically relevant impairment of ventilation. Careful manipulation during fiberoptic assessment is required to avoid tube displacement.
Trophic control of mesopredators in terrestrial ecosystems: top‐down or bottom‐up?
Authors: Elmhagen Bodil , Rushton Stephen P.
Published: January 2007

It has been argued that widespread extinctions of top predators have changed terrestrial ecosystem structures through mesopredator release, where increased abundances of medium‐sized predators have detrimental effects on prey communities. This top‐down concept has received much attention within conservation biology, but few studies have demonstrated the phenomenon. The concept has been criticized since alternative explanations involving bottom‐up impacts from bioclimatic effects on ecosystem productivity and from anthropogenic habitat change are rarely considered. We analyse the response of a mesopredator (the red fox) to declines in top predators (wolf and Eurasian lynx) and agricultural expansion over 90 years in Sweden, taking bioclimatic effects into account. We show a top‐down mesopredator release effect, but ecosystem productivity determined its strength. The impacts of agricultural activity were mediated by their effects on top predator populations. Thus, both top‐down and bottom‐up processes need to be understood for effective preservation of biodiversity in anthropogenically transformed ecosystems.
Methanogenesis and methanogenic pathways in a peat from subarctic permafrost
Authors: Metje Martina , Frenzel Peter
Published: January 2007

Few studies have dealt so far with methanogenic pathways and populations in subarctic and arctic soils. We studied the effects of temperature on rates and pathways of CH4 production and on the relative abundance and structure of the archaeal community in a mildly acidic peat from a permafrost region in Siberia (67°N). We monitored the production of CH4 and CO2 over time and measured the consumption of Fe(II), ethanol and volatile fatty acids. All experiments were performed with and without specific inhibitors [2‐bromoethanesulfonate (BES) for methanogenesis and CH3F for acetoclastic methanogenesis]. The optimum temperature for methanogenesis was between 26°C and 28°C [4.3 μmol CH4 (g dry weight)−1 day−1], but the activity was high even at 4°C [0.75 μmol CH4 (g dry weight)−1 day−1], constituting 17% of that at 27°C. The population structure of archaea was studied by terminal restriction fragment length polymorphism analysis and remained constant over a wide temperature range. Acetoclastic methanogenesis accounted for about 70% of the total methanogenesis. Most 16S rRNA gene sequences clustered with Methanosarcinales, correlating with the prevalence of acetoclastic methanogenesis. In addition, sequences clustering with Methanobacteriales were recovered. Fe reduction occurred in parallel to methanogenesis. At lower and higher temperatures Fe reduction was not affected by BES. Because butyrate was consumed during methanogenesis and accumulated when methanogenesis was inhibited (BES and CH3F), it is proposed to serve as methanogenic precursor, providing acetate and H2 by syntrophic oxidation. In addition, ethanol and caproate occurred as intermediates. Because of thermodynamic constraints, homoacetogenesis could not compete with hydrogenotrophic methanogenesis.
Using a bioaerosol personal sampler in combination with real‐time PCR analysis for rapid detection of airborne viruses
Authors: Pyankov Oleg V. , Agranovski Igor E. , Pyankova Olga , Mokhonova Ekaterina , Mokhonov Vlad , Safatov Alexander S. , Khromykh Alexander A.
Published: January 2007

We have recently developed a new personal sampler and demonstrated its feasibility for detection of viable airborne microorganisms including bacteria, fungi and viruses. To accelerate the time‐consuming analytical procedure involving 2–5 days of biological testing, we employed a real‐time PCR protocol in conjunction with the personal sampler for collection of airborne viruses. The advantage of this approach is that if the presence of a particular pathogen in the air is detected by the PCR, the remaining collecting liquid can be further analysed by more time‐consuming biological methods to estimate the number of airborne infectious/live microorganisms. As sampling of bioaerosols in natural environments is likely to be associated with substantial contamination by a range of microorganisms commonly existing in an ambient air, an investigation of the specificity of detection by targeted PCR analysis is required. Here we present the results of the study on the detection of Influenza virus in the ambient air contaminated with high concentrations of bacteria and fungi using real‐time PCR protocol. The combined sampling PCR detection method was found to be fully feasible for the rapid (∼2.5 h) and highly specific (no cross‐reactivity) identification of the labile airborne virus in the air containing elevated concentrations of other microorganisms.
Identifying the genetic basis of ecologically and biotechnologically useful functions of the bacterium Burkholderia vietnamiensis
Authors: O'Sullivan Louise A. , Weightman Andrew J. , Jones T. Hefin , Marchbank Angela M. , Tiedje James M. , Mahenthiralingam Eshwar
Published: January 2007

Signature‐tagged mutagenesis (STM) was used to identify genetic determinants of fitness associated with two key ecological processes mediated by bacteria. Burkholderia vietnamiensis strain G4 was used as a model bacterium to investigate: phenol degradation as a model of bioremediation, and pea rhizosphere colonization as a prerequisite to biological control and phytoremediation. A total of 1900 mutants were screened and 196 putative fitness mutants identified; the genetic basis of 137 of these mutations was determined by correlation to the G4 genome. The phenol‐STM screen was more successful at identifying phenol degradation mutations (83 mutants; 4.4% hit rate) than a conventional agar‐based phenol screen (49 mutants, 5319 screened, 0.92% hit rate). The combination of both screens completely defined the components of the TOM pathway in strain G4 and also identified novel accessory genes not previously implicated in phenol utilization. The rhizosphere‐STM screen identified 113 mutants (5.9% hit rate); 107 had reduced tag signals indicative of poor rhizosphere colonization (Rhiz–), while six mutants produced high hybridization signals suggesting increased rhizosphere competence (Rhiz+). Competition assays confirmed that 69% of Rhiz– mutants tested (24/35) were severely compromised in their rhizosphere fitness. Seventy Rhiz– mutations mapped to genes with the following putative functions: amino acid biosynthesis (25; 36%), general metabolism (18; 26%), hypothetical (9; 13%), regulatory genes (4; 5.7%), transport and stress (2 each; 2.8% respectively). One of the most interesting discoveries mediated by the rhizosphere‐STM screen was the identification of three Rhiz+ mutants inactivated within a single virulence‐associated autotransporter adhesin gene; this mutation consistently produced a hyper‐colonization phenotype suggesting a highly novel role for this surface adhesin during plant interactions. Our study has shown that STM can be successfully applied to ecologically important microbial interactions, defining the underlying genetic systems important for biotechnological fitness of environmental bacteria such those from the Burkholderia cepacia complex.
Long‐term survival of Legionella pneumophila associated with Acanthamoeba castellanii vesicles
Authors: Bouyer Sabrina , Imbert Christine , Rodier Marie‐Hélène , Héchard Yann
Published: January 2007

Legionella pneumophila, the causative agent of Legionnaires' disease, is ubiquitously found in aquatic environments, associated with free living amoebae. Trophozoite forms of the genus Acanthamoeba have been shown to support the intracellular growth of Legionella while it has been proposed that cyst forms are related to survival in harsh environments. This underlines that amoebae are of primary importance in Legionella spreading. In this study, we followed the survival of L. pneumophila Lens over 6 months in a poor medium, with or without Acanthamoeba castellanii. The results demonstrated that L. pneumophila Lens could survive for at least 6 months in association with A. castellanii and that cultivable bacteria are to be found within expelled vesicles rather than within cysts. Our findings suggest that vesicles might be further studied in order to elucidate their production and their role in the environmental spreading of Legionella.
Pathotyping of Salmonella enterica by analysis of single‐nucleotide polymorphisms in cyaA and flanking 23S ribosomal sequences
Authors: Morales Cesar A. , Musgrove Michael , Humphrey T. J. , Cates Carolyn , Gast Richard , Guard‐Bouldin J.
Published: January 2007

The egg‐contaminating phenotype of Salmonella enterica serotype Enteritidis was linked to single‐nucleotide polymorphisms (SNPs) occurring in cyaA, which encodes adenylate cyclase that produces cAMP and pyrophosphate from ATP. Ribotyping indicated that SNPs in cyaA were linked to polymorphisms occurring in the rrlC and rrlA 23S ribosomal subunits. Phylogenetic analysis of cyaA discriminated between Salmonella enterica serotypes and within serotype Enteritidis. Serotypes Typhimurium, Heidelberg and Enteritidis produced one, three and six cyaA allelic variants, respectively, among the set of 56 isolates examined. Asparagine702 of CyaA was converted to serine in a biofilm‐producing isolate. Statistical analysis was applied to 42 other genes encoding proteins between 800 and 1000 amino acids (aa). Results show that the 848 aa CyaA of serovar Enteritidis evolved by nucleotide substitutions that did not significantly alter the purine‐to‐pyrimidine nucleotide substitution ratio, which was a characteristic of large genes that was positively correlated with increasing gene size. In summary, these analyses link SNPs occurring in the rrlC–rrlA genomic fragment of S. enterica to genetic drift within S. Enteritidis that is associated with egg contamination.
The Current State and Future Direction of Counseling Psychology in Australia
Authors: Pryor Robert G.L. , Bright Jim E.H.
Published: January 2007

Cet article décrit l’état actuel de la psychologie du counseling en Australie en termes de forces, faiblesses, opportunités et menaces. Parmi les forces identifiées, on trouve un champ professionnel très énergique, un large éventail d’activités de plus en plus acceptées de la part du public, des revues à comité de lecture, et une activité de recherche significative s’appuyant sur un engagement manifeste dans une démarche basée sur la preuve et appliquée au counseling. Les faiblesses soulignent l’accès inéquitable en termes de coût et d’éloignement géographique aux services de counseling de larges parties de la population australienne. La technologie fournit une occasion de relever des défis d’accès, de coût et d’implantation. En outre, les rapides changements économiques fournissent des opportunités pour les counselors de travailler activement avec des clients confrontés à des changements rapides et inattendus. Clairement, la psychologie du counseling se différencie comme champ théorique, de recherche et de pratique. Simultanément, elle peut mettre à disposition les compétences des psychologues du counseling lors d’investigations transdisciplinaires et d’applications ce qui constitue l’un des plus grands défis pour les psychologues australiens du counseling. Les développements futurs de la psychologie du counseling en Australie sont dépeints.

This article outlines the current state of counseling psychology in Australia in terms of its strengths, weaknesses, opportunities, and threats. Strengths identified include a vibrant field of professional activity, a wide range of activities, increasing levels of public acceptance, successful peer‐reviewed journals, and significant research activity that underlies a widespread commitment to an evidence‐based approach to counseling. Weaknesses include the inequitable access to counseling services both in terms of cost and the geographic remoteness of parts of the Australian population. Technology provides an opportunity to address access, cost, and delivery challenges. Furthermore, the rapidly changing economic landscape provides opportunities for counselors to work proactively with clients who are confronted by rapid and unplanned change. Clearly differentiating counseling psychology as a field of theory, research, and practice while at the same time being able to integrate the skills of counseling psychologists within cross‐disciplinary investigations and applications constitute the greatest challenges for Australian counseling psychologists. A vision of the future development of counseling psychology in Australia is proffered.
Counselling Psychology in Canada: Advancing Psychology for All1
Authors: Young Richard A. , Nicol Jennifer J.
Published: January 2007

La psychologie du counseling au Canada est examinée à l’aide de la matrice SWOT. Quatre forces sont identifiées: l’identité, le paradigme, l’ensemble des compétences ainsi que l’éducation et la formation. Les tensions entre les trois premières forces sont aussi considérées comme des faiblesses. Les opportunités externes à la psychologie du counseling comprennent les changements de la société, la diversité sociale et la santé. Parmi les menaces auxquelles la psychologie du counseling au Canada est confrontée, sont identifiés le contexte universitaire avec les contenus de formation, la compétition avec d’autres groupes professionnels et les pressions externes visant à définir la pratique de la psychologie du counseling. L’un des objectifs pour la psychologie du counseling au Canada est de rendre la psychologie disponible à un large éventail de la population par de nombreux moyens. L’Association Internationale de Psychologie Appliquée peut travailler à accroître cette aire d’application et prendre le Canada comme modèle pour développer ce champ dans d’autres pays.

Counselling psychology in Canada was examined using a SWOT analysis. Four strengths were identified: identity, paradigm, skill set, and education and training. Tensions within the first three of these strengths were also considered weaknesses. External opportunities for counselling psychology included changes in society, social diversity, and health. Among the threats to counselling psychology in Canada are the university context for training programmes, competition with other professional groups, and pressure from external influences on how to define counselling psychology practice. The vision for the future of counselling psychology in Canada is based on the principle of making psychology available to a wide range of the Canadian population through a variety of means. The International Association of Applied Psychology can work to enhance this area of professional psychology and can look to Canada for support and models in developing this field in other countries.
Counselling Psychology in India: At the Confluence of Two Traditions
Authors: Arulmani Gideon
Published: January 2007

En Inde, les besoins en counseling ont émergé dans une situation de changement social important. La réforme économique des dix dernières années a accentué le rythme de ces changements et a transformé les styles de vie. Les services en counseling sont peu définis et actuellement quelqu’un, avec peu ou sans aucune formation dans cette discipline, peut offrir ses services. Les services en counseling se réfèrent largement aux approches occidentales de la psychologie bien qu’elles soient largement critiquées comme n’étant pas appropriées au contexte culturel indien. Ainsi, une psychologie du counseling culturellement pertinente et valide n’en est qu’à ses débuts. La pensée psychologique n’est pas nouvelle en Inde, les traditions anciennes ainsi que les idées actuelles et les concepts sont riches en possibilités d’application. Ce papier examine les approches occidentales et indiennes et propose qu’ensemble elles participent au développement d’une psychologie du counseling empiriquement solide et culturellement appropriée au contexte indien.

Counselling needs in the Indian context emerge against the background of tremendous social change. In addition, the last ten years of economic reform have enhanced the pace of these changes and further transformed life styles. Counselling services are poorly defined and presently anyone at all with little or no training can offer these services. Available counselling services are largely based on Western approaches to psychology. These approaches have been widely criticised as not being relevant to the Indian cultural context. A relevant and culturally valid counselling psychology therefore has remained a fledgling discipline. Psychological thought is not new to India, and ancient traditions present ideas and constructs that are rich in possibilities for application. This paper examines the Western and the traditional Indian approaches and proposes that these approaches could together inform the development of a psychology of counselling that is empirically sound and culturally relevant to the Indian context.
Current Status and Prospects of Korean Counseling Psychology: Research, Clinical Training, and Job Placement
Authors: Seo Young Seok , Kim Dong Min , Kim Dong‐il
Published: January 2007

En Corée, la psychologie du counseling s’est développée régulièrement au cours des six dernières décennies. Au cours de ce développement, divers problèmes sont apparus en provenance aussi bien de l’intérieur que de l’extérieur de la discipline. Dans cet article, nous survolons rapidement l’histoire de la psychologie du counseling coréenne et analysons ses forces et ses faiblesses internes, ainsi que les opportunités et les menaces en provenance de l’environnement. Cette analyse SWOT a été focalisée sur trois thèmes majeurs de la discipline, la recherche, le soutien clinique et l’orientation professionnelle. En conclusion, on esquisse un projet pour la psychologie du counseling en Corée.

Counseling psychology in Korea has been steadily growing in the past six decades. Along with its growth, various issues have emerged from the inside of the field as well as from the outside. In this article, we briefly review the history of Korean counseling psychology and then discuss internal strengths and weaknesses of the field and external opportunities and threats that the field is facing. This SWOT analysis was centered on three major themes of the discipline: i.e. research, clinical training, and job placement. Finally, a vision for counseling psychology in Korea is discussed.