bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjunctive Reperfusion Therapy Post-AMI
Authors: Reffelmann Thorsten , Kloner Robert
Published: May 2011

• Reperfusion of the occluded coronary artery in an ST-segment-elevation myocardial infarction is the most effective approach for reducing infarct size, preserving left ventricular ejection fraction, lowering the incidence and severity of congestive heart failure and improving prognosis

• Hence, several pharmacologic agents intended to improve target vessel patency as an adjunct to thrombolysis or primary percutaneous coronary intervention have been shown to be beneficial in patients with reperfusion therapy for acute myocardial infarction, namely antiplatelet and anticoagulation agents

• Animal investigations have suggested that coronary reperfusion may also result in undesirable cardiac alterations, termed ‘reperfusion injury’, such as reversible contractile dysfunction (‘stunning’), microvascular obstruction (‘no-reflow’), and in several studies the progression of myocardial necrosis (‘lethal reperfusion injury’)

• Clinical investigations of various pharmacologic interventions as an adjunctive therapy to reperfusion to reduce final infarct size, the amount of contractile dysfunction and to improve prognosis have been mostly inconsistent; only a few interventions, e.g. adenosine and atrial natriuretic peptide seem to show promise at least in certain subgroups.
Ectopic expression of the p23 silencing suppressor of Citrus tristeza virus differentially modifies viral accumulation and tropism in two transgenic woody hosts
Authors: FAGOAGA CARMEN , PENSABENE‐BELLAVIA GIOVANNI , MORENO PEDRO , NAVARRO LUÍS , FLORES RICARDO , PEÑA LEANDRO
Published: May 2011

Citrus tristeza virus (CTV), a phloem‐restricted closterovirus infecting citrus, encodes three different silencing suppressors (p25, p20 and p23), one of which (p23) is a pathogenicity determinant that induces aberrations resembling CTV symptoms when expressed ectopically in transgenic citrus hosts. In this article, the effect of p23 ectopic expression on virus infection was examined in sweet orange (SwO), a highly susceptible host, and sour orange (SO), which severely restricts CTV cell‐to‐cell movement. Transgenic plants of both species ectopically expressing p23, or transformed with an empty vector, were graft inoculated with the mild CTV isolate T385 or with CTV‐BC1/GFP, a clonal strain derived from the severe isolate T36 carrying the gene for the green fluorescent protein (GFP). CTV distribution in infected tissues was assessed by direct tissue blot immunoassay and fluorescence emission, and virus accumulation was estimated by quantitative real‐time reverse transcriptase‐polymerase chain reaction. CTV accumulation in p23‐expressing and control SwO plants was similar, whereas the viral load in transgenic SO expressing p23 was 10–105 times higher than in the cognate control plants. Although few infection foci composed of a single cell were observed in the phloem of CTV‐infected control SO, the number of foci in p23‐expressing plants was higher and usually comprised two to six cells, indicating viral cell‐to‐cell movement. CTV was detected in mesophyll protoplasts and cells from infected SO and SwO expressing p23, but not in similar protoplasts and cells from infected control plants. Our results show that the ectopic expression of p23 enables CTV to escape from the phloem and, in addition, facilitates systemic infection of the resistant SO host. This is the first report of a viral‐encoded protein that enhances virus accumulation and distribution in woody hosts.
Systematic review: the epidemiology and natural history of non‐alcoholic fatty liver disease and non‐alcoholic steatohepatitis in adults
Authors: Vernon G. , Baranova A. , Younossi Z. M.
Published: May 2011

Aliment Pharmacol Ther 2011; 34: 274–285

Background  Non‐alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease, and its worldwide prevalence continues to increase with the growing obesity epidemic. This study assesses the epidemiology of NAFLD in adults based on clinical literature published over the past 30 years.

Aim  To review epidemiology and natural history of non‐alcoholic fatty liver disease and non‐alcoholic steatohepatitis in adults based on clinical literature published over the past 30 years.

Methods  An in‐depth search of PubMed (1980–2010) was based on five search terms: ‘non‐alcoholic fatty liver disease’ OR ‘non‐alcoholic steatohepatitis’ OR ‘fatty liver’ OR ‘steatosis’ AND ‘incidence’ [MeSH Terms] OR ‘prevalence’ [MeSH Terms] OR ‘natural history’. Studies of paediatric cohorts were excluded. Articles were categorised by topic and summarised, noting generalisations concerning their content.

Results  Four study categories included NAFLD incidence, prevalence, risk factors and natural history. Studies related to NAFLD prevalence and incidence indicate that the diagnosis is heterogeneous and relies on a variety of assessment tools, including liver biopsy, radiological tests such as ultrasonography, and blood testing such as liver enzymes. The prevalence of NAFLD is highest in populations with pre‐existing metabolic conditions such as obesity and type II diabetes. Many studies investigating the natural history of NAFLD verify the progression from NASH to advanced fibrosis and hepatocellular carcinoma.

Conclusions  Non‐alcoholic fatty liver disease is the most common cause of elevated liver enzymes. Within the NAFLD spectrum, only NASH progresses to cirrhosis and hepatocellular carcinoma. With the growing epidemic of obesity, the prevalence and impact of NAFLD continues to increase, making NASH potentially the most common cause of advanced liver disease in coming decades.
The mediating role of hyperactivity and inattention on sex differences in paediatric injury risk
Authors: Karazsia B. T. , Guilfoyle S. M. , Wildman B. G.
Published: May 2011

Background  Extensive research suggests that risk of injury is higher among young boys versus young girls. The present study examined a mediational model to identify mechanisms that may explain differences in injury risk.

Methods  Reports of child behaviour and two indices of injury risk among 114 children in early childhood were obtained from parents in community‐based paediatric medical centres.

Results  Regression analyses and post‐hoc examination of indirect effects supported a mediation model in which the relationship between child sex and child injury risk was explained by hyperactivity and inattention.

Conclusions  Interventions that promote child well‐being by targeting constellations of externalizing behaviour problems may simultaneously decrease paediatric injury risk.
Oxidative stress in ischaemic stroke
Authors: Nanetti Laura , Raffaelli Francesca , Vignini Arianna , Perozzi Cecilia , Silvestrini Mauro , Bartolini Marco , Provinciali Leandro , Mazzanti Laura
Published: May 2011

Eur J Clin Invest 2011; 41 (12): 1318–1322

Background  Production of reactive oxygen species after ischaemic stroke may enhance tissue damage through multiple molecular pathways.

Materials and methods  In this study, we examined the serum levels of lipoperoxide and hydroperoxide, conjugated dienes and total antioxidant capacity levels in 50 patients with acute ischaemic stroke (T0) to evaluate the possibility to use them as specific biochemical markers for cerebral ischaemia. Determinations were repeated after a month (T1) to correlate their relative changes with clinical evolution.

Results  Lipoperoxide, hydroperoxide and conjugated diene levels in platelets were significantly higher in the early stages with respect to their late evaluation. On the contrary, total antioxidant capacity showed a significant increase at T1 with respect to T0. A significant negative correlation between total antioxidant capacity and NIHSS score at T0 and T1 was found. There was a significant positive correlation between lipoperoxide, hydroperoxide and conjugated dienes levels and NIHSS score at T0 and at T1.

Conclusions  These findings suggest that changes in free radical generation and consequent oxidative stress may have a role in the pathogenesis of acute ischaemic lesions. The activation of defence mechanisms like total antioxidant capacity could be involved in the limitation of ischaemic damage progression.
Adiponectin in chronic heart failure: influence of diabetes and genetic variants
Authors: Masson Serge , Gori Francesca , Latini Roberto , Milani Valentina , Flyvbjerg Allan , Frystyk Jan , Crociati Luisa , Pietri Silvia , Vago Tarcisio , Barlera Simona , Maggioni Aldo P. , Tognoni Gianni , Tavazzi Luigi , Omland Torbjørn , Franzosi Maria Grazia ,   on behalf of the GISSI‐HF Investigators
Published: May 2011

Eur J Clin Invest 2011; 41 (12): 1330–1338

Background  We hypothesized that, besides type 2 diabetes (T2D) and body mass index (BMI), circulating adiponectin concentration would be associated with variants of the ADIPOQ gene in patients with chronic heart failure (CHF). We also assessed the influence of these confounders on the prognostic value of adiponectin.

Methods  Plasma adiponectin was measured at entry and after 3 months in approximately 1200 patients with CHF enrolled in the GISSI‐HF trial. Four common single‐nucleotide polymorphisms (SNPs) spanning the ADIPOQ gene were studied: rs17300539 (−11391G→A), rs266729 (−11377C→G), rs2241766 (+45T→G) and rs1501299 (+276G→T). Associations with clinical characteristics and mortality were evaluated in patients with or without T2D.

Results  Adiponectin concentrations were negatively related to BMI, higher in women and older persons, but lower in patients with diabetes. T‐allele carriers for rs1501299 and A‐allele carriers for rs17300539 had significantly elevated adiponectin concentrations. Irrespective of diabetes, baseline plasma adiponectin was independently associated with mortality (adjusted HR [95%CI] per 1 SD increase in adiponectin concentration = 1·24[1·12–1·37], P < 0·0001) and improved prognostic discrimination beyond clinical risk factors (integrated discrimination improvement, P = 0·005). Patients with increasing adiponectin concentration over 3 months had worse outcome than those with stable levels (unadjusted HR = 1·46[1·09–1·96], P = 0·01); this relation was attenuated by the genetic variants examined and by robust confounders like age, diabetes, BMI or NT‐proBNP (adjusted HR = 1·37[0·97–1·94], P = 0·075).

Conclusions  Although diabetes and genetic variants at the ADIPOQ gene influence the circulating levels of adiponectin in CHF, higher plasma adipokine levels, but not genetic variants, are consistently associated with a poor prognosis.
Assessing the incremental value of diagnostic and prognostic markers: a review and illustration
Authors: Steyerberg Ewout W. , Pencina Michael J. , Lingsma Hester F. , Kattan Michael W. , Vickers Andrew J. , Van Calster Ben
Published: May 2011

Eur J Clin Invest 2011

Background  New markers may improve prediction of diagnostic and prognostic outcomes. We review various measures to quantify the incremental value of markers over standard, readily available characteristics.

Methods  Widely used traditional measures include the improvement in model fit or in the area under the receiver operating characteristic (ROC) curve (AUC). New measures include the net reclassification index (NRI) and decision‐analytic measures, such as the fraction of true‐positive classifications penalized for false‐positive classifications [net benefit (NB)]. For illustration, we discuss a case study on the presence of residual tumour vs. benign tissue in 544 patients with testicular cancer. We assessed three tumour markers [Alpha‐fetoprotein (AFP), Human chorionic gonadotropin (HCG) and Lactate dehydrogenase (LDH)] for their incremental value over currently standard clinical predictors.

Results  AUC and R2 values suggested adding continuous LDH and AFP whereas NB only favoured HCG as a potentially promising marker at a clinically defendable decision threshold of 20% risk. The NRI suggested reclassification potential of all three markers.

Conclusions  The improvement in standard discrimination measures, which focus on finding variables that might be promising across all decision thresholds, may not detect the most informative markers at a specific threshold of particular clinical relevance. When a marker is intended to support decision‐making, calculation of the improvement in a decision‐analytic measure, such as NB, is preferable over an overall judgment as obtained from the AUC in ROC analysis.
A degradation threshold for irreversible loss of soil productivity: a long‐term case study in China
Authors: Gao Yang , Zhong Binglin , Yue Hui , Wu Bin , Cao Shixiong
Published: May 2011

1. During the past three decades, conservation and restoration biologists have increasingly recognized that ecological communities are likely to exhibit threshold changes in structure. However, because long‐term monitoring data are generally lacking, little is known about the consequences of such ecological thresholds for the processes of ecosystem degradation and recovery.

2. To identify whether a degradation threshold exists that defines the boundary between the possibility of natural recovery and the need for artificial restoration of an ecosystem and to use this knowledge to support the development of a suitable strategy for environmental restoration, we performed long‐term monitoring of vegetation recovery in China’s Changting County since 1984.

3. A major problem was identified, which we refer to as the ‘irreversible loss of soil services’; when vegetation cover decreases below a degradation threshold, this leads to sustained degeneration of the vegetation community, erosion of the surface soil and declining soil fertility. These changes represent a severe and long‐lasting disturbance that will prevent ecosystem recovery in the absence of comprehensive artificial restoration measures.

4.
 Synthesis and applications. We identified a degradation threshold at about 20% vegetation cover suggesting that for some sites, vegetation cover can serve as a simple proxy for more sophisticated approaches to identifying thresholds; restoration must start with the restoration of soil fertility and continue by facilitating vegetation development. Our results support the concept of ecological thresholds (specifically, for soil services in a warm and wet region) and provide a model to inform restoration strategies for other degraded ecosystems.
Emplacement and exhumation of the Kuznetsk‐Alatau basement (Siberia): implications for the tectonic evolution of the Central Asian Orogenic Belt and sediment supply to the Kuznetsk, Minusa and West Siberian Basins
Authors: De Grave Johan , Glorie Stijn , Zhimulev Fedor I. , Buslov Mikhail M. , Elburg Marlina , Vanhaecke Frank , Van den haute Peter
Published: May 2011

Terra Nova, 23, 248–256, 2011

New geochronological data [zircon U/Pb, titanite fission‐track (TFT) and apatite fission‐track (AFT) dating and apatite (U‐Th‐Sm)/He thermochronology] and thermal history modelling yield constraints on the development of the granitoid basement of the Kuznetsk‐Alatau Mountains, southern Siberia. The final stages of magmatism in the Kuznetsk‐Alatau palaeo‐island‐arc are Late Cambrian, and collision of the arc with Siberia occurred in the Early Ordovician. The basement was exhumed by the Early Devonian. Continuous Devonian–Early Triassic sedimentation filled the adjoining Kuznetsk and Minusa basins and buried (and re‐heated) the Kuznetsk‐Alatau basement. After initial Pangaea break‐up and Siberian flood‐basalt magmatism, the basement reached TFT and AFT retention‐temperatures in the Middle Triassic and Early Cretaceous, respectively, during denudation‐induced cooling.

Terra Nova, 00, 1–9, 2011
Origin of uranium deposits revealed by their rare earth element signature
Authors: Mercadier Julien , Cuney Michel , Lach Philippe , Boiron Marie‐Christine , Bonhoure Jessica , Richard Antonin , Leisen Mathieu , Kister Philippe
Published: May 2011

Terra Nova, 23, 264–269, 2011

Uranium deposits form in a wide range of geological settings, including deep magmatic to surficial conditions, and range in age from Archaean to recent. These temporal and spatial variations have given rise to an extreme diversity of ore deposits. However, understanding their conditions of formation has remained challenging. This article reports rare earth element (REE) abundances, measured by microbeam methods in uranium oxides, for a series of worldwide uranium occurrences. The REE patterns are very specific to each deposit type and directly reflect the conditions of their genesis. We propose an evaluation of the first‐order parameters controlling the REE behaviour in each mineralised system. This study demonstrates that the REE pattern is the most efficient tool for constraining the geological models of uranium deposits and for genetically discriminating new uranium discoveries. This approach may form the starting point for a new procedure in the fight against nuclear trafficking.

Terra Nova, 00, 1–6, 2011
Isolation of mesenchymal stem cells using the total length of umbilical cord for transplantation purposes
Authors: Tsagias N. , Koliakos I. , Karagiannis V. , Eleftheriadou M. , Koliakos G. G.
Published: May 2011

Background: Umbilical cord (UC) mesenchymal cells have the ability to differentiate into various cell types, which make them an easily obtainable source for therapeutic uses. Different approaches have been used to isolate mesenchymal stem cells (MSC).

Aim: Here, we report a detailed enzymatic method where large number of cells can be efficiently isolated from the cord matrix and cryopreserved on the same day of arrival at the laboratory.

Methods/Materials: Cells were successfully isolated from 12 samples, with a new procedure that uses the total length of the UC. MSC have been isolated using a detailed enzymatic method with collagenase and hyaluronidase followed by trypsin, without removing the vessels and without mincing the cord. Stem cells were measured with flow cytometry before cryopreservation and post‐thaw. Cultured cells were assessed for MSC marker expression and adherence plasticity for three passages. Multilineage differentiation was performed.

Results: Nucleated cell yield was calculated at 0·95 × 106/cm. MSC yield was calculated at 0·65 × 106/cm of cord with flow cytometry while the mean length was 31 cm. Cultured cells expressed the mesenchymal markers CD29, CD90, CD105 and CD44. Mesenchymal marker expression remained intact over the three passages and post‐thaw. Osteogenic and adipogenic differentiation was evaluated.

Conclusions: Our findings provide a fast and efficient method for mesenchymal cell isolation from Wharton's jelly using the total length of the UC. This method resulted in a large number of cells while the cells retained their mesenchymal character after thawing. This method can be easily applied, along with UC blood, for UC banking.
Aspects of reproductive ecology of Clusia valerioi Standl. and Clusia peninsulae Hammel (sp. nov.), two Central American species of Clusiaceae with resin flowers
Authors: Hochwallner H. , Vogel S. , Huber W. , Hammel B. E. , Weber A.
Published: May 2011

Clusia valerioi Standl. and C. peninsulae Hammel, sp. nov. (formally established in the Appendix), two Central American species of Clusiaceae offering resin as a floral reward, were studied in the Piedras Blancas National Park, SW Costa Rica. Basic data on phenology, flower structure, course of anthesis, flower visitors, flower visitation and pollination processes, fruit development and seed dispersal are communicated. Resin collection and pollen release are reported and documented in greater detail. The significance of stingless bees for pollination is confirmed, but honeybees were also observed to visit the flowers and to collect resin. The seeds of C. valerioi, exhibiting a clearly ornithochorous character syndrome, were observed to be eaten and dispersed by four species of the tanager family (Thraupidae) and one species of finch (Fringillidae). Ants were also observed to carry away the seeds.
Phenotypic plasticity to light of two congeneric trees from contrasting habitats: Brazilian Atlantic Forest versus cerrado (savanna)
Authors: Barros F. de V. , Goulart M. F. , Sá Telles S. B. , Lovato M. B. , Valladares F. , Lemos‐Filho J. P. de
Published: May 2011

The Brazilian Atlantic Forest is a typically multi‐layer tropical forest, while cerrado (savanna) is a patchy habitat with different physiognomy. Despite these differences, both habitats have high light heterogeneity. Functional traits of Dalbergia nigra and D. miscolobium from the Atlantic Forest and cerrado, respectively, were evaluated under shade (25% of full sunlight) and full sunlight in a nursery experiment. We hypothesised that both species should benefit from high phenotypic plasticity in relation to light. Plasticity was estimated using the relative distance phenotypic index (RDPI). D. miscolobium had lower shoot growth under both light conditions, suggesting it has low competitive capacity in the forest environment, which could explain its limited ability to expand over areas of Atlantic Forest. The studied species exhibited photoprotection strategies under high light and improved light capture under low light. Stomatal conductance, ETRmax (maximum electron transport rate), PPFDsat (saturating photosynthetically active photon flux density), chlorophyll and carotenoid content had higher RDPI than stem morphological traits. Although both species showed considerable phenotypic plasticity, D. miscolobium had higher RDPI for eight of 11 evaluated traits. This high plasticity could be one of the factors that explain the occurrence of this species in a wide range of environmental conditions, from open grassland to dense woodlands, and it could also reflect its adaptation to high light. D. nigra also had considerable plasticity and good growth performance in both shade and full sunlight, but its absence in areas of cerrado suggests that factors other than light limit its occurrence in these habitats.
Progress in the utilization of Cajanus platycarpus (Benth.) Maesen in pigeonpea improvement
Authors: Mallikarjuna Nalini , Senapathy Senthilvel , Jadhav Deepak R. , Saxena Kulbhushan , Sharma Hari C. , Upadhyaya Hari D. , Rathore Abishek , Varshney Rajeev
Published: May 2011

With 1 figure and 4 tables

Cultivated pigeonpea (Cajanus cajan L. Millsp.) has a narrow genetic base; hence, utilization of wild relatives in the crossing programme would broaden its genetic base and introduce useful traits. Cajanus platycarpus (Benth.) Maesen, an annual wild relative from the tertiary gene pool, was successfully crossed with the cultigen, utilizing hormone‐aided pollinations, embryo rescue and tissue culture techniques, and backcrossed using cultigen as the recurrent parent. Advance generation progeny showed a range of useful traits such as resistance to phytophthora blight, pod borer, bruchid and podfly resistance. Variation was also observed for plant type, growth habit and seed colour. A new source of cytoplasmic male sterility was identified in one of the progeny lines. Molecular analysis of the progeny after four backcrosses showed the presence of genomic segments from C. platycarpus accompanied by the presence of recombinant DNA sequences signifying recombination between the parental genomes.
Primary localized cutaneous nodular amyloidosis successfully treated with cyclophosphamide
Authors: Tong Philip L , Walker William A , Glancy Ross J , Cooney Julian P , Gebauer Kurt
Published: May 2011

Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare subtype of localized cutaneous amyloidosis and can be associated with various connective tissue disorders. It can be difficult to treat and past therapies include surgical excision, dermabrasion, electrodessication and curettage, cryotherapy and laser therapy. We present a case of a middle‐aged woman with PLCNA associated with CREST (calcinosis, Raynaud phenomenon, oesophageal motility disorders, sclerodactyly and telangiectasia) syndrome and Sjögren's syndrome responding to cyclophosphamide with no new amyloid deposits and resolution of skin ulceration after many years of resistance to drug therapy. It is important to monitor these patients for progression into systemic amyloidosis.
An exploration of rural women's knowledge of heart disease and the association with lifestyle behaviours
Authors: Crouch Rosanne , Wilson Anne
Published: May 2011

Crouch R, Wilson A. International Journal of Nursing Practice 2011; 17: 238–245

An exploration of rural women's knowledge of heart disease and the association with lifestyle behaviours

Heart disease is the leading cause of morbidity and mortality in Australian women. The purpose of the study was to investigate Australian rural women's knowledge of heart disease and the association with lifestyle behaviours. A questionnaire was developed to collect data on rural women's knowledge and risk of heart disease. Despite having an overall good knowledge of heart disease, there was an identified lack of health promoting behaviours by the women to reflect their knowledge. Over half of the women participants of this study reported two or more lifestyle risk factors for heart disease. This study shows that women might know about heart disease risk factors, nevertheless they might be unaware of their susceptibility to heart disease in relation to the risk factors. Without an awareness of personal susceptibility, women might be less likely to take action to reduce the risk of heart disease.
Religion, faith and the empowerment process: Stories of Iranian people with diabetes
Authors: Abdoli Samereh , Ashktorab Tahereh , Ahmadi Fazlollah , Parvizy Soroor , Dunning Trisha
Published: May 2011

Abdoli S, Ashktorab T, Ahmadi F, Parvizy S, Dunning T. International Journal of Nursing Practice 2011; 17: 289–298

Religion, faith and the empowerment process: Stories of Iranian people with diabetes

Empowerment concerning people with diabetes is well researched. However, few researchers specifically focus on the barriers to and facilitators of empowerment in Iranian people with diabetes. Understanding the factors could help health professionals facilitate self‐empowerment more effectively. This study aims to determine the barriers to and facilitators of empowerment in Iranian people with diabetes. A qualitative exploratory study was conducted using in‐depth interviews to collect the data from 11 women and men in 2007. Themes were identified using constant comparative analysis method. Common barriers to empowerment were similar to other chronic diseases: prolonged stress, negative view about diabetes, ineffective health‐care systems, poverty and illiteracy. Diabetes education, fear of diabetes' complications, self‐efficacy and hope for a better future emerged as being crucial to empowerment. Facilitators specific to Iranians were: the power of religion and faith, the concept of the doctor as holy man, accepting diabetes as God's will, caring for the body because it was God's gift and support from families especially daughters. Empowerment was strongly influenced by cultural and religious beliefs in Iran and the power of faith emerged as an important facilitator of diabetes empowerment. The findings will help health professionals understand how Iranian people with diabetes view life and the factors that facilitate empowerment.
Task‐shifting in the delivery of hormonal contraceptive methods: Validation of a questionnaire and preliminary results
Authors: Guilbert Edith Raphaëlle , Morin Diane , Guilbert Alexis Couture , Gagnon Hélène , Robitaille Jean , Richardson Mary
Published: May 2011

Guilbert ER, Morin D, Guilbert AC, Gagnon H, Robitaille J, Richardson M. International Journal of Nursing Practice 2011; 17: 315–321

Task‐shifting in the delivery of hormonal contraceptive methods: Validation of a questionnaire and preliminary results

In order to palliate the access problem to effective contraceptive methods in Quebec, Canada, as well as to legitimate nurses' practices in family planning, a collaborative agreement was developed that allow nurses, in conjunction with pharmacists, to give hormonal contraceptives to healthy women of reproductive age for a 6 month period. Training in hormonal contraception was offered to targeted nurses before they could begin this practice. A questionnaire, based on Rogers's theory of diffusion of innovations, was elaborated and validated to specifically evaluate this phenomenon. Preliminary results show that the translation of training into practice might be suboptimal. The validated questionnaire can now be used to fully understand the set of factors influencing this new practice.
Nursing activities in intensive care units in Turkey
Authors: Kaya Hatice , Kaya Nurten , Turan Yüksel , Tan Yasemin Melek , Terzi Banu , Barlas Deniz Büke
Published: May 2011

Kaya H, Kaya N, Turan Y, Tan YM, Terzi B, Barlas DB. International Journal of Nursing Practice 2011; 17: 304–314

Nursing activities in intensive care units in Turkey

This cross‐sectional study was conducted to determine applications practiced by nurses working in intensive care units of various institutions in Turkey. The research setting was neurosurgery, surgery, coronary and general intensive care units. The population of the study comprised nurses working in intensive care units, which were under the scope of this study, and these nurses' functions were studied. Data were collected using a Personal Information Form, the Cheltenham Patient Classification Scale and Nursing Activity List. It was observed that nurses spend most of their time on direct nursing care, clerical nursing duties and patient assessment. The most frequent activities included recording observations, calculating fluid balance, recording ventilator parameters, talking to patients, conversation not task orientated, drug preparation and administration. Although nurses spend most of their time on direct nursing care, they might also be obliged to get around to activities not in relation with direct patient care.
New species of Trogidae (Coleoptera: Scarabaeoidea) from Australia
Authors: Strümpher Werner P , Scholtz Clarke H
Published: May 2011

Two new species of Omorgus Erichson, O. capillamentis and O. incognitus, from north‐eastern Australia are described. The former is an unusual, rotund flightless (brachypterous) species which is characterised by plumose glands covering the clypeus and pronotum; the latter is a more typical winged species. This brings the total number of Australian Omorgus species to 55. The new species are illustrated by photographs of habitus and aedeagi. A distribution map for the new species is provided.
Laparoscopic total mesorectal excision can be performed on a nonselective basis in patients with rectal cancer with excellent medium‐term results
Authors: Glancy D. G. , Chaudhray B. N. , Greenslade G. L. , Dixon A. R.
Published: May 2011

Aim  Concerns exist regarding laparoscopic rectal cancer surgery due to increased rates of open conversion, complications and circumferential resection margin positivity. This study reports medium‐term results from consecutive unselected cases in a single surgeon series.

Method  The results of laparoscopic total mesorectal excision (TME) for rectal cancer over a 9‐year period within the context of an evolving ‘enhanced recovery protocol’ (ERP) were reviewed from analysis of a prospectively maintained database.

Results  One hundred and fifty patients (91 male, median age 69 years, median BMI 26) underwent laparoscopic TME over 9 years. Median follow up was 28.5 months (range 0–88). Sixteen (10.6%) patients underwent neoadjuvant radiotherapy. Six (4.0%) required open conversion and 13 (9.0%) had an anastomotic leakage. The proportion of Dukes stages were: A, 33.3%; B, 30.7%; C, 31.3%; D, 4.7%. Five (3.3%) patients had an R1 and one an R2 resection. Median length of postoperative stay was 6 days. Three (2.0%) patients died within 30 days. Four (2.7%) developed local recurrence and 14 (9.3%) developed distant metastases. Predicted 5‐year disease‐free and overall survival rates by Kaplan–Meier analysis were 85.8% and 78.7%, respectively.

Conclusion  Laparoscopic TME surgery can safely be offered to unselected patients with rectal cancer with excellent medium‐term results.
The clinical features and management of testicular germ cell tumours in patients aged 60 years and older
Authors: Wheater Matthew J. , Manners James , Nolan Luke , Simmonds Peter D. , Hayes Matthew C. , Mead Graham M.
Published: May 2011

Study Type – Therapy (case series)

Level of Evidence 4

What’s known on the subject ? and What does the study add?

The treatment of younger men with testicular germ cell cancers is well documented with established intensive chemotherapy regimens for those with advanced disease. Although the majority of patients present in the third or fourth decade, men also present in later life. These patients are typically excluded from clinical trials and there are no contemporary published series describing their management.

This series describes the management of older patients with testicular germ cell tumours at both early and advanced stages of disease. Patients with stage I seminoma can be safely managed with all recognised treatment strategies and state I non‐seminomas were managed with surveillance. Cure can still be achieved in older patients with advance germ cell tumours however chemotherapy regimens developed in younger patients must be tailored to the presence of co‐morbidity.

OBJECTIVES

• To review the practice of a large referral centre for the management of older patients with testicular germ cell cancer (GCC).

• There are few published data available on the management of testicular GCC in elderly patients, who often have medical comorbidities and have been excluded from clinical trials.

PATIENTS AND METHODS

• We reviewed our prospectively collected database for patients presenting with GCC who were aged ≥60 years.

• Details of presentation, management and outcome were recorded.

RESULTS

• In total, 60 patients aged ≥60 years were identified from 1461 patients treated with GCC from 1979–2005, representing 4% of the total population.

• Median age was 67 years, 44 had seminoma (73%) and 16 had non‐seminoma histology (27%).

• Stage I seminoma patients were managed with surveillance, adjuvant radiotherapy and adjuvant carboplatin. All stage I non‐seminomas underwent surveillance.

• In total, 15 patients received systemic chemotherapy for metastatic disease with modified bleomycin, etoposide and cisplatin; etoposide and cisplatin; carboplatin‐based regimens; or other combinations. Toxicity was manageable, with no toxic deaths.

• In total, four patients (6.7%) died of GCC.

CONCLUSIONS

• In elderly patients, GCC should be managed with curative intent.

• Conventional therapies are tolerable for most men with stage I seminoma. In metastatic disease, comorbidity may necessitate treatment modifications.

• Most patients are cured with manageable toxicity.
Evaluation of the safety and efficiency of the dorsal slit and sleeve methods of male circumcision provided by physicians and clinical officers in Rakai, Uganda
Authors: Buwembo Dennis Rogers , Musoke Richard , Kigozi Godfrey , Ssempijja Victor , Serwadda David , Makumbi Fredrick , Watya Stephen , Namuguzi Dan , Nalugoda Fredrick , Kiwanuka Noah , Sewankambo Nelson K. , Wabwire‐Mangen Fredrick , Kiggundu Valerian , Wawer Maria J. , Gray Ronald H.
Published: May 2011

Study Type – Therapy (outcomes research)

Level of Evidence 2c

What’s known on the subject? and What does the study add?

MC reduces heterosexual acquisition of HIV in men for safe and efficient rapid scale‐up; task shifting from physicians to clinical officers is safe and the use of bipolar cautery will reduce operative time, but is associated with higher adverse events.

OBJECTIVE

• To assess the safety and efficiency of the dorsal slit and sleeve male circumcision (MC) procedures performed by physicians and clinical officers (COs).

PATIENTS AND METHODS

• We evaluated the time required for the MC procedure (efficiency) and moderate/severe adverse events (AEs) for MC (safety) by trained physicians and COs using the sleeve and dorsal slit MC methods in a service programme.

• Univariate and multiple regressions with robust variance estimation were used to assess factors associated with operative duration (linear) and AEs (logistic).

RESULTS

• Six physicians and eight COs conducted 1934 and 3218 MCs, respectively; there were 2471 dorsal slit and 2681 sleeve MC procedures. The overall mean operative duration was 33 min for newly trained providers, whichdecreased to ≈20 min after ≈100 MCs.

• The adjusted mean operative duration for dorsal slit MC was significantly shorter than that for the sleeve MC method (Δ− 2.7 min, P < 0.001).

• The operative duration was longer for COs than physicians for the sleeve procedure, but not the dorsal slit procedure; however this difference reduced with increasing numbers of MCs completed.

• The unadjusted AE rates were 0.6% for dorsal slit MC and 1.4% for the sleeve method (P= 0.006) and 1.5% for physicians and 0.68% for COs (P= 0.003); however, there were no significant differences after multivariate adjustment.

• Use of bipolar cautery significantly reduced operative duration (Δ− 4.0 min, P= 0.008), but was associated with higher AE rates (adjusted odds ratio 2.13, 95% confidence interval 1.26–3.61, P= 0.005).

CONCLUSION

• The dorsal slit MC method is faster than sleeve resection, and can be safely performed by non‐physicians; however, use of bipolar cautery may be inadvisable in this setting.
Impact of hip circumference and height on incident diabetes: results from 6‐year follow‐up in the Tehran Lipid and Glucose Study
Authors: Bozorgmanesh M. , Hadaegh F. , Zabetian A. , Azizi F.
Published: May 2011

Diabet. Med. 28, 1330–1336 (2011)

Aim  To investigate the effects of height and hip circumference, individually and in combination with waist circumference, on incident diabetes.

Methods  A total of 1589 men and 2132 women, free of diabetes at baseline aged ≥ 20 years participated in a 6‐year follow‐up examination. The standard 2‐h post‐challenge plasma glucose test was performed at baseline and during follow‐up. The Cox model was used to regress the hazard of diabetes on height and hip circumference individually and in combination with waist circumference.

Results  Median follow‐up was 6 years, with a total of 9433 and 12 607 person‐years follow‐up among men and women, respectively. The incidence rate of diabetes (95% CIs) was 9.0 (7.6–11.5) and 11.0 (9.6–−13.4) per 1000 persons per year in men and women, respectively. Among men, after multiple adjustments, the anthropometric measures were no longer associated with incident diabetes. Among women, the age‐adjusted hazard ratio (95% CIs) of diabetes was 0.80 (0.61–1.04) for height, 1.39 (1.21–1.60) for hip circumference and 1.86 (1.59–2.17) for waist circumference. After further adjustment for waist circumference, the hazard ratios were 0.69 (0.53–0.90) for height and 0.76 (0.61–0.96) for hip circumference. These inverse associations resisted multiple adjustments. The hazard ratio for waist circumference increased by 7 and 54% when height and hip circumference were included in the models.

Conclusion  We observed that height and hip circumference were inversely associated with incident diabetes among women and that these associations could be explored by considering the effect of waist circumference. The risk of diabetes attributable to waist circumference might be underestimated were the effects of height and hip circumference not considered.
Placing Immigrant and Minority Family and Community Members at the School's Centre: the role of community participation
Authors: Díez Javier , Gatt Suzanne , Racionero Sandra
Published: May 2011

Schools alone cannot reverse the high rates of school failure in the poorest communities in Europe; they need the contributions of the entire community. Coordination between families, the larger community, and the school has proven crucial to enhance student learning and achievement, especially for minority and disadvantaged families. However, families from such backgrounds often participate in their schools only peripherally because the schools take a ‘tourist’ approach, call parents to inform them about school projects and teachers' programmes, or consult them about decisions to be made by professionals, rather than engaging them in their children's education. In contrast, the INCLUD‐ED project studied schools across Europe whose students are culturally diverse and from low SES backgrounds; here, the communities are deeply involved in the schools and the students do well academically. This article focuses on three strategies used by these successful schools to engage immigrant and minority community members in more active, decisive, and intellectual ways and thus have greater impact on the school and the students' learning. It also describes some specific practices of involvement grounded in those strategies and the improvements they generate. Though the schools studied use different practices, the three strategies have been found to contribute to a transformative result in all schools: moving minority and disadvantaged families from the periphery of school participation to the centre.

The opinion of the community is what moves things forward.

— Laura, head teacher of a primary school
Lifelong Learning, Equality and Social Cohesion1
Authors: Green Andy
Published: May 2011

This article compares the evidence from the 2009 PISA survey on the distribution of skills amongst 15‐year‐olds in different regions and country groups and explores how education systems in these regions contribute to different levels of inequality. In the second part, it presents evidence from surveys on adult skills and attitudes on how skills inequality affects social attitudes and social cohesion.
Does Vocational Training Help Transition to Work? The ‘New French Vocational Bachelor Degree’
Authors: Giret Jean‐François
Published: May 2011

This article analyses whether graduates in university vocational courses benefited from better labour market outcomes in France than those in academic courses. We focus on bachelor degrees in France, comparing ‘general’ or ‘academic’ degrees with ‘vocational’ degrees. The vocational bachelor degree was created in 1999 in the continuity of the education policy of expanding the number of vocational courses in French universities and in the framework of the Bologna Process. It aimed to lead to a new qualification at the intermediate level between the qualified technicians’ diplomas and the engineering or senior management diplomas. We use a French survey on higher education leavers in 2001 who were interviewed in 2004. In order to take into account the selection in the vocational track, we applied statistical methods which allow us to compare graduates with similar characteristics. Our results show that education mismatch is less great for vocational bachelor graduates, which is coherent with the idea that the vocational track better responds to employers' needs. In addition, we find empirical evidence that vocational bachelors tend to be associated with higher pay even after accounting for the heterogeneity of students. Our last findings suggest that the university‐employer link specifically developed for the vocational bachelor course influences the way vocational graduates find their job: they are significantly more likely to use university‐based contacts to obtain their first jobs.
Latino social network dynamics and the Hurricane Katrina disaster
Authors: Messias DeAnne K. Hilfinger , Barrington Clare , Lacy Elaine
Published: May 2011

The aim of this qualitative research was to examine the dynamics of existing and emerging social networks among Latino survivors of Hurricane Katrina. Data were generated through individual, in‐depth interviews conducted with 65 Latinos within six months of the storm striking the Gulf Coast of the United States in August 2005. The findings illustrated both the role of social networks in gathering information, making decisions and accessing resources, and how these existing social networks were disrupted and strained by overwhelming needs. Broader structural issues, including poverty and a lack of transportation, combined with marginalised status as immigrants, further constrained access to essential information and resources. In response, new, if temporary, social networks emerged, based primarily on shared nationality, language, and a sense of collective commitment. Practice implications include the need to consider the social network dynamics of marginalised groups in developing innovative strategies to overcome structural barriers to accessing resources essential for disaster preparedness and survival.
Controlling disasters: recognising latent goals after Hurricane Katrina
Authors: Miller Lee M.
Published: May 2011

Classic sociological theory can be used to interpret the aftermath of Hurricane Katrina, which made landfall in the United States on 29 August 2005. The delayed and ineffective response to the storm and the subsequent failure of the levees become more understandable when one considers the latent goals of social control in disaster recovery. Constructing the survivors as suspect or criminal and conceptualising the impacts of the disaster as individual problems occurred in order to justify the emphasis on controlling the survivors of Katrina rather than on assisting them. Parallels are drawn here between the disaster response featuring social control efforts and a recent paradigmatic shift in criminal justice from justice to ‘risk management’. Recognition of the implicit aims of the inadequate disaster response provides a more complete explanation of why post‐Katrina efforts failed to achieve the manifest goals of response and recovery. The conclusion suggests ways to ensure more equitable and just disaster responses.
The need for innovative strategies to improve immunisation services in rural Zimbabwe
Authors: Chadambuka Addmore , Chimusoro Anderson , Apollo Tsitsilina , Tshimanga Mufuta , Namusisi Olivia , Luman Elizabeth T.
Published: May 2011

Gokwe South, a rural district in Midlands Province, Zimbabwe, reported the lowest rate of immunisation coverage in the country in 2005: 55 per cent of children vaccinated with three doses of diphtheria/pertussis/tetanus vaccine (DPT3) and 35 per cent dropout between the first and third dose of DPT. In January 2007, the authors assessed local barriers to immunisation and proposed strategies to improve immunisation rates in the district, in the face of nationwide economic and political challenges. A situational analysis was performed to assess barriers to immunisation using focus‐group discussions with health workers, key informant interviews with health management and community leaders, and desk reviews of records. Responses were categorised and solutions proposed. Health workers and key informants reported that immunisation service delivery was hampered by insufficient availability of gas for cold‐chain equipment, limited transport and fuel to conduct basic activities, and inadequate staff and supervision. Improving coverage will require prioritising gas for vaccine cold‐chain equipment, identifying reliable transportation or alternative transportation solutions, and increased staff, training and supervision. Local assessment is critical to pinpointing site‐specific barriers, and innovative strategies are needed to overcome existing contextual challenges.
Existing at the Interface: Indian NGO Activists as Strategic Cosmopolitans
Authors: Baillie Smith Matt , Jenkins Katy
Published: May 2011

Abstract: This paper uses life history narratives to explore the multiple and overlapping scales and sites through which the cosmopolitan subjectivities of activists in local Indian NGOs are constituted. We particularly emphasise the “intermediate” status of the activists, and the ways their positioning shapes their subjectivities in diverse ways over time and place. We draw on the idea of a strategic cosmopolitanism to consider the multiple ways their cosmopolitanism shapes the negotiation of development from their intermediate position, and to reflect on the normative and political possibilities that emerge from this process.