bluuebunny/crossref_metadata_2025 huggingface dataset:
User involvement in mental health nursing practice: rhetoric or reality?
Authors: RUDMAN M. J.
Published: February 2008

Following the review of mental health nursing, nurses need to address the dilemma of providing empowering care in a climate of increasing control and stigma. This paper discusses tile background to, and significance for nursing, of the ‘user movement’ in the UK. A current ‘explosion’ of user groups does not imply that these form a homogeneous group, nor that they share similar perspectives. Consultation and involvement mean little if unmatched with action. This may be constrained by the ‘market’ in which the ‘true power’ is held by the budget holder, and by stigmatizing policy imperatives claimed to be in the public interest. Self‐advocacy may be legitimized by the desire to prevent providers ‘speaking out’. These difficulties may, however, provide convenient excuses for inaction. A new professional identity may be found in forging political alliances with users, in which a reappraisal of traditional boundaries may go some way towards reducing the stigma surrounding mental health problems.
Genogram: a useful tool for nurse practitioners
Authors: PUSKAR K. , NERONE M.
Published: February 2008

This paper presents the genogram, originated by family therapists and utilized in the psychosocial field, as a valuable tool to be used by the nurse practitioner. The nurse practitioner from any area of practice, primary care, women's health, paediatrics, geriatrics, psychiatry, in any setting (hospital, clinic, school, industry, community and home), requires a tool that provides a comprehensive assessment of the client and the factors that affect their health. The theoretical background of Bowen's family systems theory and of systems theory is reviewed as the genogram evolved from the theories. Two hypothetical case illustrations utilizing the genogram are presented, one presenting only medical problems, the other presenting medical, psychiatric and family relationships. The usefulness of the genogram is not new, but it is reviewed here for its value to the nurse practitioner. Evidence leads to the conclusion that the genogram is an assessment tool that enhances intervention strategy and communication in the client's record. It augments treatment planning, care provision, health promotion and prevention, as well as cost management.
Photometric properties of the Local Volume dwarf galaxies
Authors: Sharina M. E. , Karachentsev I. D. , Dolphin A. E. , Karachentseva V. E. , Tully R. Brent , Karataeva G. M. , Makarov D. I. , Makarova L. N. , Sakai S. , Shaya E. J. , Nikolaev E. Yu. , Kuznetsov A. N.
Published: February 2008

We present surface photometry and metallicity measurements for 104 nearby dwarf galaxies imaged with the Advanced Camera for Surveys and Wide Field and Planetary Camera 2 aboard the Hubble Space Telescope. In addition, we carried out photometry for 26 galaxies of the sample and for Sextans B on images of the Sloan Digital Sky Survey. Our sample comprises dwarf spheroidal, irregular and transition type galaxies located within ∼10 Mpc in the field and in nearby groups: M81, Centaurus A, Sculptor and Canes Venatici I cloud. It is found that the early-type galaxies have on average higher metallicity at a given luminosity in comparison to the late-type objects. Dwarf galaxies with MB≥−12 to −13 mag deviate towards larger scalelengths from the scalelength–luminosity relation common for spiral galaxies, h∝L0.5B. The following correlations between fundamental parameters of the galaxies are consistent with expectations if there is pronounced gas loss through galactic winds: (1) between the luminosity of early-type dwarf galaxies and the mean metallicity of constituent red giant branch stars, Z∼L0.4, (2) between mean surface brightness within the 25 mag arcsec−2 isophote and the corresponding absolute magnitude in the V and I bands, SB 25∼ 0.3M25 and (3) between the central surface brightness (or effective surface brightness) and integrated absolute magnitude of galaxies in the V and I bands, SB0∼ 0.5ML, SB e∼ 0.5 Me. The knowledge of basic photometric parameters for a large sample of dwarf galaxies is essential for a better understanding of their evolution.
A critical role for ureides in dark and senescence‐induced purine remobilization is unmasked in the Atxdh1 Arabidopsis mutant
Authors: Brychkova Galina , Alikulov Zerekbai , Fluhr Robert , Sagi Moshe
Published: February 2008

The remobilization of metabolites during stress and senescence plays an important role in optimal plant adaptation to the environment. The plant molybdenum co‐factor (MoCo) and flavin‐containing enzyme xanthine dehydrogenase (XDH; EC 1.2.1.37) are pivotal for purine remobilization, and catalyze the conversion of the purine catabolic products hypoxanthine and xanthine to uric acid, which is subsequently degraded to the ureides allantoin and allantoate. We observed that in wild‐type plants conditions of extended darkness or increasing leaf age caused induction of transcripts related to purine catabolism, resulting in marked accumulation of the purine catabolic products allantoin and allantoate. In contrast, Arabidopsis mutants of XDH, Atxdh1, accumulated xanthine and showed premature senescence symptoms, as exemplified by enhanced chlorophyll degradation, extensive cell death and upregulation of senescence‐related transcripts. When dark‐treated mutant lines were re‐exposed to light, they showed elevated levels of reactive oxygen species (ROS) and a higher mortality rate compared with wild‐type plants. Interestingly, the level of ROS and mortality could be attenuated by the addition of allantoin and allantoate, suggesting that these metabolites can act as scavengers of ROS. The results highlight a crucial need for the controlled maintenance of ureide levels mediated by AtXDH1 activity during dark stress and ageing, and point to the dual functionality of ureides as efficient stores of nitrogen and as cellular protectants. Thus, the regulation of ureide levels by Atxdh1 has general implications for optimal plant survival during nutrient remobilization, such as occurs during normal growth, dark stress and senescence.
Overexpression of zeaxanthin epoxidase gene enhances the sensitivity of tomato PSII photoinhibition to high light and chilling stress
Authors: Wang Ning , Fang Wei , Han Han , Sui Na , Li Bin , Meng Qing‐Wei
Published: February 2008

A tomato (Lycopersicon esculentum Mill.) zeaxanthin epoxidase gene (LeZE) was isolated. The deduced amino acid sequence of LeZE showed high identities with zeaxanthin epoxidase in other plant species. Northern blot analysis showed that the mRNA accumulation of LeZE in the wild‐type (WT) was not induced by light and temperature but regulated by the diurnal rhythm. The sense transgenic plants were obtained under the control of the cauliflower mosaic virus 35S promoter (35S‐CaMV). Northern and western blot analysis confirmed that sense LeZE was transferred into the tomato genome and overexpressed. The ratio of (A + Z)/(V + A + Z) and the values of non‐photochemical quenching were lower in transgenic plants than in WT plants under high light and chilling stress with low irradiance. The O2 evolution rate and the maximal photochemical efficiency of PSII (Fv/Fm) in transgenic plants decreased more quickly during both stresses and recovered slower than that in WT under optimal conditions. These results suggested that overexpression of LeZE impaired the function of the xanthophyll cycle and aggravated PSII photoinhibition in tomato under high light and chilling stress.
Renal ageing: Changes in the cellular mechanism of energy metabolism and oxidant handling (Review Article)
Authors: PERCY CHRISTINE J , POWER DAVID , GOBE GLENDA C
Published: February 2008

SUMMARY:  The age‐dependent changes in the kidney are often debilitating, can be life‐threatening and are a significant cause of increasing health costs worldwide. Excessive fibrosis, a general lack of regenerative ability and an increase in apoptosis in cells that determine healthy renal function work together to cause chronic kidney disease. This review provides information on the molecules and mechanisms that determine the age‐dependent effects in the kidney, and in particular, the effects of cellular metabolism and oxidant handling on the ageing kidney. With a better understanding of the influence of ageing on the structural and functional alterations that occur, new targeted therapies may be developed to minimize renal damage and promote health in the elderly.
Cellular prion protein co‐localizes with nAChR β4 subunit in brain and gastrointestinal tract
Authors: Petrakis S. , Irinopoulou T. , Panagiotidis C. H. , Engelstein R. , Lindstrom J. , Orr‐Urtreger A. , Gabizon R. , Grigoriadis N. , Sklaviadis T.
Published: February 2008

PrPC, the cellular isoform of prion protein, is widely expressed in most tissues, including brain, muscle and gastrointestinal tract. Despite its involvement in several bioprocesses, PrP has still no apparent physiological role. During propagation of transmissible spongiform encephalopathies (TSE), prion protein is converted to the pathological isoform, PrPSc, in a process believed to be mediated by unknown host factors. The identification of proteins associated with PrP may provide information about both the biology of prions and the pathogenesis of TSE. Thus far, PrPC has been shown to interact with synaptic proteins, components of the cytoskeleton and intracellular proteins involved in signalling pathways. Here, we describe the association of PrP with the β4 subunit of nicotinic acetylcholine receptor (nAChR), as indicated by co‐immunoprecipitation assays and double‐label immunofluorescence. The interaction between prion protein and native β4 subunit was further studied by affinity chromatography, using immobilized and refolded recombinant PrP as a bait and brain homogenates from normal individuals. Additionally, the participation of β4 subunit in the pathogenesis of TSE was studied by in vivo assays. β4–/– and wild‐type mice were challenged with the RML (Rocky Mountain Laboratories) infectious agent. Transgenic animals displayed altered incubation times but the deletion of β4 subunit did not result in a significant change of the incubation period of the disease. Our results suggest that PrPC is a member of a multiprotein membrane complex participating in the formation and function of α3β4 nAChR.
Blunted neurogenesis and gliosis due to transgenic overexpression of human soluble IL‐1ra in the mouse
Authors: Spulber Stefan , Oprica Mircea , Bartfai Tamas , Winblad Bengt , Schultzberg Marianne
Published: February 2008

Interleukin‐1 (IL‐1) is one of the most important cytokines in neuroinflammation, in acute conditions as well as during natural ageing and neurodegenerative disorders. Using a transgenic mouse strain with brain‐directed overexpression of IL‐1 receptor antagonist (Tg hsIL‐1ra), we show that blocking IL‐1 receptor‐mediated activity resulted in abolishing the alterations in neurogenesis in response to acute and chronic neuroinflammation. In addition, using a novel approach to quantifying glial activation, we show that expression of the astrocyte cytoskeletal marker glial fibrillary acidic protein (GFAP) following kainic acid (KA)‐induced seizures or during ageing did not change in Tg hsIL‐1ra animals. Nevertheless, the astrocyte morphology showed major alterations, consisting of fragmentation of the processes in Tg hsIL‐1ra mice. Similarly, although there was a higher degree of basal microglial activation in the transgenic mice than wild‐type animals, there was no change following KA‐induced seizures or with ageing. Taken together, our results indicate that IL‐1 is crucial for the adaptability of the brain to acute and chronic neuroinflammation.
Making Management Auditable: The Implementation of Best Value in Local Government
Authors: ARNABOLDI MICHELA , LAPSLEY IRVINE
Published: February 2008

This article examines the implementation of Best Value—an audit tool of the U.K. government's modernization policy—in local government, specifically in Scotland. This is a study of the impact of this key concept, primarily on the management of these public services. The aim of Best Value Audit is to enhance transparency and accountability of management actions in local government. The article draws on Power's (1997) Audit Society thesis to inform this research. The Best Value approach has been heavily influenced by audit processes and oversight bodies both in its design and implementation. This article supports the Power thesis of the Audit Society: It reveals the manner in which audit practices are deployed by agencies of central government with the intent to shape the management of local government.
Rescue Missions and Risk Management: Highly Reliable or Over Committed?
Authors: Ash John S. , Smallman Clive
Published: February 2008

Management in rescue organizations are often faced by conflicts between a spectrum of emergency types, and legal duties to ensure rescuer safety on the incident ground. Drawing on two case studies we consider how rescuers react to cues in order to make sense of unsafe work environments and so make decisions in emergency situations. We explore problems of over‐commitment by rescue workers, together with the nature of its manifestation, and management options for engendering high reliability. We find that the identity and social aspects of ensuring the ‘sensemaking’ are particularly relevant in rescue workers that it is morally and professionally acceptable to decline an overly hazardous rescue. Cue‐based training as well as equipment provision is also vital in assessing risk.
Involvement of dopamine receptors and β‐arrestin in metamphetamine‐induced inclusions formation in pc12 cells
Authors: Fornai Francesco , Lenzi Paola , Capobianco Loredana , Iacovelli Luisa , Scarselli Pamela , Lazzeri Gloria , De Blasi Antonio
Published: February 2008

Exposure of PC12 cells to metamphetamine (MA) induces the formation of multilamellar structures (whorls) resembling autophagic granules that subsequently develop as intracellular inclusions. These inclusions stain for a variety of antigens belonging to the ubiquitin proteasome pathway. Since MA‐induced intracellular bodies require the presence of dopamine in the present study we analyzed the role of dopamine (DA) receptors in producing neuronal inclusions. Moreover, we investigated potential signaling pathways which could lead to ubiquitination in the presence of MA. Based on recent reports that ubiquitination of β‐adrenergic receptors is promoted by β‐arrestin which shuttles proteins from the plasma membrane to the ubiquitin proteasome system we investigated whether β‐arrestin is involved in MA‐induced inclusion formation. Our experiments document that (i) β‐arrestin was associated with MA‐induced intracellular bodies; (ii) MA induced a rapid and reversible ubiquitination of β‐arrestin; (iii) dopamine antagonists reduced both MA‐induced β‐arrestin ubiquitination and intracellular whorls formation; (iv) the number of MA‐induced intracellular bodies was reduced in cells transfected with the β‐arrestin dominant negative mutant, βarrV53D and was increased by the persistently ubiquitinated β‐arrestin‐ubiquitin fusion protein. In conclusion, the present study demonstrates the involvement of β‐arrestin in MA‐induced intracellular bodies and the participation of dopamine receptors in this process.
Consequences of slotting on the pore characteristics of a sandy soil in northeast Thailand
Authors: Hartmann C. , Lesturgez G. , Sindhusen P. , Ratana‐Anupap S. , Hallaire V. , Bruand A. , Poss R.
Published: February 2008

In the sandy soils of northeast Thailand, root development is generally limited to the topsoil (0–20 cm depth) but a simple slotting intervention (20–40 cm) significantly increased the root frequency in the slotted material (Eslot) compared with the undisturbed subsoil (E horizon). The aim of this study was to investigate the consequences of slotting on the soil structure by analysing at different scales the pore characteristics of the original soil profile and of the soil material inside the slot. These characteristics were studied using bulk density measurements, image analysis of thin sections and mercury porosimetry. Our results showed that the total porosity of the E horizon and Eslot material was similar when measured in 100 cm3 cylinders, but that the pore size distribution had been changed by slotting. The unaltered E horizon contained mainly small pores characterized by a narrow distribution related to close packing of the sand grains, associated with some biological macropores probably with poor continuity as they did not contain roots despite their size. On average, pores were larger in the Eslot material, with a broader distribution resulting from looser packing of the sand grains but with fewer biological macropores. Although slotting reduced the number of biological pores, the looser packing appeared to be more favourable to root development than the presence of macropores in the E horizon. Finally, the comparison of the porosity in the different horizons with the porosity of the Eslot material, indicated the significance of the closeness of the sand packing on root development.
Madonna Bellina, ‘astounding’ Jewish musician in mid‐sixteenth‐century Venice
Authors: Harrán Don
Published: February 2008

Jewish female musicians were a rarity in the sixteenth century, let alone later times. All the more interest attaches to the description of Madonna Bellina, in an ardent ‘love letter’ that the renowned Venetian playwright and satirist Andrea Calmo wrote to her (in Venetian) around 1550, as a Jewess who ‘astounded her listeners’ (meraveiar i auditori) by her singing and playing. As the only known document about her, the letter deserves closer investigation to establish as much as one can of her person (age, appearance, character) and musical talents; to gauge the attitude of its author toward singing or playing Jewesses and, more generally, toward Judaism; and to probe the question whether Madonna Bellina was real or a figment of his imagination. The study concludes with an appendix, in which Calmo's letter to Bellina is transcribed in the original and translated.
Epidemiologic Analysis of Factors Associated with Local Disappearances of Native Ranid Frogs in Arizona
Authors: WITTE CARMEL L. , SREDL MICHAEL J. , KANE ANDREW S. , HUNGERFORD LAURA L.
Published: February 2008

Abstract:  We examined factors that may independently or synergistically contribute to amphibian population declines. We used epidemiologic case–control methodology to sample and analyze a large database developed and maintained by the Arizona Game and Fish Department that describes historical and currently known ranid frog localities in Arizona, U.S.A. Sites with historical documentation of target ranid species (n= 324) were evaluated to identify locations where frogs had disappeared during the study period (case sites) and locations where frog populations persisted (control sites). Between 1986 and 2003, 117 (36%) of the 324 sites became case sites, of which 105 were used in the analyses. An equal number of control sites were sampled to control for the effects of time. Risk factors, or predictor variables, were defined from environmental data summarized during site surveys and geographic information system data layers. We evaluated risk factors with univariate and multifactorial logistic‐regression analyses to derive odds ratios (OR). Odds for local population disappearance were significantly related to 4 factors in the multifactorial model. Disappearance of frog populations increased with increasing elevation (OR = 2.7 for every 500 m, p < 0.01). Sites where disappearances occurred were 4.3 times more likely to have other nearby sites that also experienced disappearances (OR = 4.3, p < 0.01), whereas the odds of disappearance were 6.7 times less (OR = 0.15, p < 0.01) when there was a source population nearby. Sites with disappearances were 2.6 times more likely to have introduced crayfish than were control sites (OR = 2.6, p= 0.04). The identification of factors associated with frog disappearances increases understanding of declines occurring in natural populations and aids in conservation efforts to reestablish and protect native ranids by identifying and prioritizing implicated threats.
White matter angiopathy is common in pediatric patients with intractable focal epilepsies
Authors: Hildebrandt Michelle , Amann Kerstin , Schröder Rolf , Pieper Tom , Kolodziejczyk Dieter , Holthausen Hans , Buchfelder Michael , Stefan Hermann , Blumcke Ingmar
Published: February 2008

Summary

Purpose: The blood–brain barrier (BBB) and functional organization of blood vessels is severely affected in many epilepsy disorders. This was repetitively shown with respect to the cause, effect and treatment of seizures. In the present study, we investigated pathomorphological abnormalities of blood vessels in a cohort of young patients with chronic intractable seizures submitted to an epilepsy surgery program.

Methods: Histopathological examination was performed in surgical specimens obtained from 87 children with intractable epilepsies. Immunohistochemistry was employed to further characterize the basal membrane as well as specific cellular and tissue reactions. Pathological findings were correlated with clinical data including antiepileptic drug prescription.

Results: We identified an intriguing pattern of white matter angiopathy in 64.4% of our patient cohort. Major alterations included splitting of the basal membrane into endothelial and parenchymal leaves, which was restricted to arterioles and capillaries of the white matter and resulted in an extensively enlarged perivascular space. These cavities contained numerous blood cells and showed a spongiform appearance at the ultrastructural level. Angiopathic changes occurred independent from specific epilepsy‐associated lesions, i.e., dysplasia, neoplasia, or hippocampal sclerosis, and showed no correlation with antiepileptic drug treatment or seizure semiologies.

Discussion: A high frequency of spongiform white matter angiopathy was identified in young patients with chronic epilepsies. The severity of basal membrane pathology and adjacent tissue reaction is compatible with compromised BBB function. Further clinicopathological investigations will be mandatory to clarify its relation to the cause or consequence of seizures in children with intractable seizures.
Antipsychotic Drug Use and Risk of Pneumonia in Elderly People
Authors: Knol Wilma , Van Marum Rob J. , Jansen Paul A. F. , Souverein Patrick C. , Schobben Alfred F. A. M. , Egberts Antoine C. G.
Published: February 2008

OBJECTIVES: To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people.

DESIGN: A nested case‐control analysis.

SETTING: Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records.

PARTICIPANTS: A cohort of 22,944 elderly people with at least one antipsychotic prescription; 543 cases of hospital admission for pneumonia were identified. Cases were compared with four randomly selected controls matched on index date.

MEASUREMENTS: Antipsychotic drug use in the year before the index date was classified as current, recent, or past use. No prescription for an antipsychotic in the year before the index date was classified as no use. The strength of the association between use of antipsychotics and the development of pneumonia was estimated using multivariate logistic regression analysis and expressed as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Current use of antipsychotics was associated with an almost 60% increase in the risk of pneumonia (adjusted OR=1.6, 95% CI=1.3–2.1). The risk was highest during the first week after initiation of an antipsychotic (adjusted OR=4.5, 95% CI=2.8–7.3). Similar associations were found after exclusion of elderly people with a diagnosis of delirium. Current users of atypical agents showed a higher risk of pneumonia (adjusted OR=3.1, 95% CI=1.9–5.1) than users of conventional agents (adjusted OR=1.5, 95% CI=1.2–1.9). There was no clear dose‐response relationship.

CONCLUSION: Use of antipsychotics in elderly people is associated with greater risk of pneumonia. This risk is highest shortly after the initiation of treatment, with the greatest increase in risk found for atypical antipsychotics.
Trajectories Based on Postcomprehensive and Higher Education: Their Correlates and Antecedents
Authors: Kokko Katja , Pulkkinen Lea , Mesiäinen Päivi , Lyyra Anna‐Liisa
Published: February 2008

The aim of this study was to investigate different trajectories of education, based on annual attendance in postcomprehensive and higher education between ages 15 and 42, and their correlates and antecedents. A special focus was on education that occurred after spending several years in the labor market (i.e., off‐time education). Analyses were based on the Finnish Jyväskylä Longitudinal Study of Personality and Social Development in which the same participants have been followed from age 8 to 42. Four trajectories were obtained: no or early, off‐time, on‐time, and continuing education. Through adulthood, career stability, and occupational status were lower among off‐time and no or early education participants than among the others. Women on the off‐time education trajectory showed an increased level of optimism and achieved identity from age 27 to 42. Both off‐time and no or early education participants came from a low socioeconomic (SES) family and had problems in their social behavior at age 8 and school adjustment at age 14. Different types of, and reasons for attending, adult education should be better understood, and adult education should be individually targeted.
Individual Differences in the Pathways into and Beyond Higher Education in the UK: A Life‐Course Approach
Authors: Feinstein Leon , Vignoles Anna
Published: February 2008

This article uses data from the UK 1970 Birth Cohort (N= 10,000) to address the research questions: (a) Who in this cohort made the transition to higher education (HE), and (b) how are the benefits and risks of such participation distributed? We assess the way that the benefits and risks of participation differ according to family background and child development, finding risks to mental health for individuals who attend HE against the odds. We also explore the errors in prediction of standard statistical models in order to introduce a discussion of selection bias linked to a broader policy question of the appreciation of the complexity and idiosyncrasy of individuals' educational pathways. We explore this question in relation to three particular cases that confound the prediction of the statistical analysis in order to clarify the assumptions and limitations of a standard analysis in approaching the problems of developing policy that recognizes individual heterogeneity and diversity.
Global Public Policy, Transnational Policy Communities, and Their Networks
Authors: Stone Diane
Published: February 2008

Public policy has been a prisoner of the word “state.” Yet, the state is reconfigured by globalization. Through “global public–private partnerships” and “transnational executive networks,” new forms of authority are emerging through global and regional policy processes thatcoexistalongside nation‐state policy processes. Accordingly, this article asks what is “global public policy”? The first part of the article identifies new public spaces where global policies occur. These spaces are multiple in character and variety and will be collectively referred to as the “globalagora.” Thesecond sectionadapts the conventional policy cycle heuristic by conceptually stretching it to the global and regional levels to reveal the higher degree of pluralization of actors and multiple‐authority structures than is the case at national levels. Thethird sectionasks: who is involved in the delivery of global public policy? The focus is on transnational policy communities. The global agora is a public space of policymaking and administration, although it is one where authority is more diffuse, decision making is dispersed and sovereignty muddled. Trapped by methodological nationalism and an intellectual agoraphobia of globalization, public policy scholars have yet to examine fully global policy processes and new managerial modes of transnational public administration.
Detection of Significant Disease Risks Using a Spatial Conditional Autoregressive Model
Authors: Escaramís Geòrgia , Carrasco Josep L. , Ascaso Carlos
Published: February 2008

SummaryThe conditional autoregressive (CAR) model is widely used to describe the geographical distribution of a specific disease risk in lattice mapping. Successful developments based on frequentist and Bayesian procedures have been extensively applied to obtain two‐stage disease risk predictions at the subregional level. Bayesian procedures are preferred for making inferences, as the posterior standard errors (SE) of the two‐stage prediction account for the variability in the variance component estimates; however, some recent work based on frequentist procedures and the use of bootstrap adjustments for the SE has been undertaken. In this article we investigate the suitability of an analytical adjustment for disease risk inference that provides accurate interval predictions by using the penalized quasilikelihood (PQL) technique to obtain model parameter estimates. The method is a first‐order approximation of the naive SE based on a Taylor expansion and is interpreted as a conditional measure of variability providing conditional calibrated prediction intervals, given the data. We conduct a simulation study to demonstrate how the method can be used to estimate the specific subregion risk by interval. We evaluate the proposed methodology by analyzing the commonly used example data set of lip cancer incidence in the 56 counties of Scotland for the period 1975–1980. This evaluation reveals a close similarity between the solutions provided by the method proposed here and those of its fully Bayesian counterpart.
Forecasting Daily Patient Volumes in the Emergency Department
Authors: Jones Spencer S. , Thomas Alun , Evans R. Scott , Welch Shari J. , Haug Peter J. , Snow Gregory L.
Published: February 2008

Background:  Shifts in the supply of and demand for emergency department (ED) resources make the efficient allocation of ED resources increasingly important. Forecasting is a vital activity that guides decision‐making in many areas of economic, industrial, and scientific planning, but has gained little traction in the health care industry. There are few studies that explore the use of forecasting methods to predict patient volumes in the ED.

Objectives:  The goals of this study are to explore and evaluate the use of several statistical forecasting methods to predict daily ED patient volumes at three diverse hospital EDs and to compare the accuracy of these methods to the accuracy of a previously proposed forecasting method.

Methods:  Daily patient arrivals at three hospital EDs were collected for the period January 1, 2005, through March 31, 2007. The authors evaluated the use of seasonal autoregressive integrated moving average, time series regression, exponential smoothing, and artificial neural network models to forecast daily patient volumes at each facility. Forecasts were made for horizons ranging from 1 to 30 days in advance. The forecast accuracy achieved by the various forecasting methods was compared to the forecast accuracy achieved when using a benchmark forecasting method already available in the emergency medicine literature.

Results:  All time series methods considered in this analysis provided improved in‐sample model goodness of fit. However, postsample analysis revealed that time series regression models that augment linear regression models by accounting for serial autocorrelation offered only small improvements in terms of postsample forecast accuracy, relative to multiple linear regression models, while seasonal autoregressive integrated moving average, exponential smoothing, and artificial neural network forecasting models did not provide consistently accurate forecasts of daily ED volumes.

Conclusions:  This study confirms the widely held belief that daily demand for ED services is characterized by seasonal and weekly patterns. The authors compared several time series forecasting methods to a benchmark multiple linear regression model. The results suggest that the existing methodology proposed in the literature, multiple linear regression based on calendar variables, is a reasonable approach to forecasting daily patient volumes in the ED. However, the authors conclude that regression‐based models that incorporate calendar variables, account for site‐specific special‐day effects, and allow for residual autocorrelation provide a more appropriate, informative, and consistently accurate approach to forecasting daily ED patient volumes.
Evaluation of Risk Score Algorithms for Detection of Chlamydial and Gonococcal Infections in an Emergency Department Setting
Authors: Al‐Tayyib Alia A. , Miller William C. , Rogers Susan M. , Leone Peter A. , Law Dionne C. Gesink , Ford Carol A. , Rothman Richard E.
Published: February 2008

Objectives:  To develop and evaluate screening algorithms to predict current chlamydial and gonococcal infections in emergency department (ED) settings and assess their performance.

Methods:  Between 2002 and 2005, adult patients aged 18 to 35 years attending an urban ED were screened for Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (GC) and completed a brief demographic and behavioral questionnaire. Using multiple unconditional logistic regressions, the authors developed four separate predictive models and applicable clinical risk scores to screen for infection. They developed models for females and males separately, for Ct and GC infections combined, and for Ct infection alone. The sensitivities and specificities of the clinical risk scores at different cutoffs were used to examine performance of the algorithms.

Results:  Among 5,537 patients successfully screened for Ct and GC, the overall prevalence of infection was 9.6%. Age was the strongest predictor of infection. Adjusting for other predictors, the prevalence odds ratio (POR) was 2.2 (95% confidence interval [CI] = 1.7 to 2.8) for Ct and GC combined and 2.9 (95% CI = 2.1 to 4.1) for Ct alone comparing females 25 years and younger to females older than 25 years. Among males, the association was stronger with an adjusted POR of 3.3 (95% CI = 2.3 to 4.7) for Ct and GC combined and 3.2 (95% CI = 2.1 to 4.7) for Ct infection alone.

Conclusions:  If the decision to incorporate Ct and GC screening into routine ED care is made, age alone appears to be a sufficient screening criterion.
Non‐invasive imaging of adaptive immunity using positron emission tomography
Authors: Nair‐Gill Evan D. , Shu Chengyi J. , Radu Caius G. , Witte Owen N.
Published: February 2008

Summary: Non‐invasive monitoring of adaptive immunity in infection, cancer, and autoimmunity remains a major challenge. Current techniques to monitor lymphocytes involve numeric and functional determinations of immune cells isolated from the peripheral blood (most often) and tissue (rarely). Invasive measurements are prone to sampling errors and are poorly reflective of the dynamic changes in the location, number, and movement of lymphoid cells. These limitations indicate the need for non‐invasive whole‐body imaging methodologies that allow longitudinal, quantitative, and functional analyses of the immune system in vivo. Positron emission tomography (PET), a clinically based whole‐body imaging modality, has the potential to revolutionize diagnostics and therapeutic monitoring in both clinical and pre‐clinical settings. This review discusses studies using PET to image adaptive immune responses in small animal models. We address the challenges inherent in assessing whole‐body immunity with PET and recent developments that can improve its performance. Finally, we discuss work to translate PET immune imaging into clinical practice.
Making friends in out‐of‐the‐way places: how cells of the immune system get together and how they conduct their business as revealed by intravital imaging
Authors: Germain Ronald N. , Bajénoff Marc , Castellino Flora , Chieppa Marcello , Egen Jackson G. , Huang Alex Y. C. , Ishii Masaru , Koo Lily Y. , Qi Hai
Published: February 2008

Summary: A central characteristic of the immune system is the constantly changing location of most of its constituent cells. Lymphoid and myeloid cells circulate in the blood, and subsets of these cells enter, move, and interact within, then leave organized lymphoid tissues. When inflammation is present, various hematopoietic cells also exit the vasculature and migrate within non‐lymphoid tissues, where they carry out effector functions that support host defense or result in autoimmune pathology. Effective innate and adaptive immune responses involve not only the action of these individual cells but also productive communication among them, often requiring direct membrane contact between rare antigen‐specific or antigen‐bearing cells. Here, we describe our ongoing studies using two‐photon intravital microscopy to probe the in situ behavior of the cells of the immune system and their interactions with non‐hematopoietic stromal elements. We emphasize the importance of non‐random cell migration within lymphoid tissues and detail newly established mechanisms of traffic control that operate at multiple organizational scales to facilitate critical cell contacts. We also describe how the methods we have developed for imaging within lymphoid sites are being applied to other tissues and organs, revealing dynamic details of host‐pathogen interactions previously inaccessible to direct observation.
Revisiting the UDI and IIQ: proposed more stable models
Authors: Sheward Louisa , Hagen Suzanne , McFadyen Angus
Published: February 2008

Assessing and reviewing a person’s incontinence status is an essential task for nurses. Two clinically‐useful and widely used scales which measure the symptoms and impact of incontinence are the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ). Short forms, more amenable for use in nursing assessments, have been derived from sub‐scales contained within the long forms. The aim of the research was to assess the suitability of the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ) sub‐scales and their short forms for use with a Scottish population. Study participants were 237 females with urinary incontinence from two Scottish regions. Principal Components Analysis, Best Subset Regression, Structural Equation Modelling and Cronbach’s alpha were used to assess reliability and stability. New scales and sub‐scales were generated and tested for goodness‐of‐fit on the Scottish data. Stability was assessed using test‐retest data from the same population. The same structure of sub‐scales previously reported did not emerge, although some overlap was apparent. Different short forms also emerged. Using more flexible modelling methods, sub‐scales with greater stability were developed for the UDI and IIQ. The resulting 11‐item UDI and 11‐item IIQ models had good internal consistency. Cronbach’s alpha was 0.829 and 0.898 respectively. The researchers conclude that internationally robust yet practical measures of incontinence are needed in nursing. Previous reports on the UDI and IIQ sub‐scales and short forms and their associated psychometric properties may not be relevant to populations different to those in which the instruments were developed. Further retrospective and prospective assessment is recommended.
Staging anorexia nervosa: conceptualizing illness severity
Authors: Maguire Sarah , Le Grange Daniel , Surgenor Lois , Marks Peta , Lacey Hubert , Touyz Stephen
Published: February 2008

In recent years, there has been increasing attention to the conceptualization of anorexia nervosa (AN) and its diagnostic criteria. While varying levels of severity within the illness category of AN have long been appreciated, neither a precise definition of severity nor an empirical examination of severity in AN has been undertaken. The aim of this article is to review the current state of knowledge on illness severity and to propose a theoretical model for the definition and conceptualization of severity in AN. AN is associated with significant medical morbidity which is related to the ‘severity’ of presentation on such markers as body mass index, eating and purging behaviours. The development of a functional staging system, based on symptom severity, is indicated for reasons similar to those cited by the cancer lobby. Improving case management and making appropriate treatment recommendations have been the primary purpose of staging in other fields, and might also apply to AN. Such a standardized staging system could potentially ease communication between treatment settings, and increase the specificity and comparability of research findings in the field of AN.
An aid to the dissection of a cyst in the floor of the mouth: a technical note
Authors: Bhatt V. , Whear N.M. , Shetty S.
Published: February 2008

The dissection of cysts in the floor of the mouth is technically difficult. The dissection of a thin‐walled large ranula invariably results in rupture and as a result subsequent dissection and removal of the cyst can be difficult. We describe a simple method to allow for easier dissection of the cyst following rupture, which reduces the risk of damage to adjacent structures.
Submandibular gland excision: a 16 year clinicopathological review of cases in a Nigerian Teaching Hospital
Authors: Adeyemo W.L. , Ajayi O.F. , Anunobi C.C. , Ogunlewe M.O. , Ladeinde A.L. , Omitola O.G. , Abdulkareem F.B.
Published: February 2008

Aim:  This study presents a review of the clinicopathological features of excised submandibular glands over a 16 year period of time at the Lagos University Teaching Hospital, Nigeria.

Materials and methods:  A retrospective review of excised submandibular glands over a period of 16 years (January 1990 to December 2005) was conducted. Parameters studied included: age and gender of patients, symptoms and duration of symptoms and histologic diagnosis.

Results:  A total of 47 patients had their submandibular gland excised during the period of the study. There were 28 men and 19 women (men :  women ratio of 1.5:1). Mean age [standard deviation (SD)] of patients at presentation was 40.5 ± 18.1 years (range, 13–84 years). There were 34 (72%) histologically diagnosed neoplasms and 13 (28%) non‐neoplastic pathologies. Patients with neoplastic pathologies were significantly older than those with non‐neoplastic pathologies (P = 0.004). The most common neoplasm was pleomorphic adenoma (35%), followed by adenocystic carcinoma (12%) and anaplastic carcinoma (12%). Chronic sialadenitis with or without sialolithiasis (85%) was the most common non‐neoplastic pathology.

Conclusion:  The most common submandibular salivary gland pathology that necessitated surgical excision, in our institution, was neoplasia, predominately pleomorphic adenomas. The most common non‐neoplastic pathology was chronic sialadenitis with or without sialolithiasis.
Elastic Anisotropy of Earth's Inner Core
Authors: Belonoshko Anatoly B. , Skorodumova Natalia V. , Rosengren Anders , Johansson Börje
Published: February 2008

Earth's solid-iron inner core is elastically anisotropic. Sound waves propagate faster along Earth's spin axis than in the equatorial plane. This anisotropy has previously been explained by a preferred orientation of the iron alloy hexagonal crystals. However, hexagonal iron becomes increasingly isotropic on increasing temperature at pressures of the inner core and is therefore unlikely to cause the anisotropy. An alternative explanation, supported by diamond anvil cell experiments, is that iron adopts a body-centered cubic form in the inner core. We show, by molecular dynamics simulations, that the body-centered cubic iron phase is extremely anisotropic to sound waves despite its high symmetry. Direct simulations of seismic wave propagation reveal an anisotropy of 12%, a value adequate to explain the anisotropy of the inner core.
The Size, Scale, and Shape of Cities
Authors: Batty Michael
Published: February 2008

Despite a century of effort, our understanding of how cities evolve is still woefully inadequate. Recent research, however, suggests that cities are complex systems that mainly grow from the bottom up, their size and shape following well-defined scaling laws that result from intense competition for space. An integrated theory of how cities evolve, linking urban economics and transportation behavior to developments in network science, allometric growth, and fractal geometry, is being slowly developed. This science provides new insights into the resource limits facing cities in terms of the meaning of density, compactness, and sprawl, and related questions of sustainability. It has the potential to enrich current approaches to city planning and replace traditional top-down strategies with realistic city plans that benefit all city dwellers.
Escherichia coli
Strains of Serotype O51:H40 Comprise Typical and Atypical Enteropathogenic
E. coli
Strains and Are Potentially Diarrheagenic
Authors: Moreira Fabiana C. , Vieira Mônica A. M. , Ferreira Antonio J. P. , Girão Dennys M. , Vaz Tânia M. I. , Rosa Ana Cláudia P. , Knobl Terezinha , Irino Kinue , Freymüller Edna , Gomes Tânia A. T.
Published: February 2008

Escherichia coli
strains of serotype O51:H40 were studied with regard to the presence of several virulence properties and their genetic diversity and enteropathogenicity in rabbit ileal loops. This serotype encompasses potential enteropathogenic strains mostly classified as being atypical enteropathogenic
E. coli
(EPEC) strains, which are genetically closer to enterohemorrhagic
E. coli
than to typical EPEC strains.
Differential Mucoid Exopolysaccharide Production by Members of the
Burkholderia cepacia
Complex
Authors: Zlosnik James E. A. , Hird Trevor J. , Fraenkel Monica C. , Moreira Leonilde M. , Henry Deborah A. , Speert David P.
Published: February 2008

We demonstrate that all nine species of the
Burkholderia cepacia
complex can express the mucoid phenotype. A survey of clinical isolates showed that strains of
B. cenocepacia
, the most virulent species of the complex, are most frequently nonmucoid. Additionally, isolates from patients with chronic infections can convert from mucoid to nonmucoid.