bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Group Training and Individual Feedback on Parent Use of Milieu Teaching
Authors: Kaiser Ann P. , Hemmeter Mary Louise , Ostrosky Michaelene M. , Alpert Cathy L. , Hancock Terry B.
Published: December 2008

This study examined the effects of training five parents to use Milieu Teaching procedures with their preschool-aged children with disabilities. In a multiple baseline design across families, parents were trained in two conditions: group instruction with home feedback sessions and intensive home feedback sessions. Parents were trained to use seven environmental arrangement strategies and four Milieu Teaching procedures to facilitate their children's acquisition of specific communication targets during eight sessions of group training. The results of the study showed modest levels of performance of the language teaching procedures during the group instruction condition although parents did not reach criterion performance levels during the condition. Intensive feedback and coaching was then implemented in the home which resulted in criterion level performance by most parents and in acquisition of the target skills by the children. These results suggest that parents can learn some basic Milieu Teaching skills in a short-term group instruction format, but intensive practice of these skills will be required before parents reach criterion levels of performance. Also, longer term implementation of the Milieu procedures was required before systematic changes in child learning of targets were observed for most children. Factors contributing to variability in parent and child performance are discussed.
Maternal Communication Style With Developmentally Delayed Preschoolers
Authors: Marcovitch Sharon , Chiasson Lorraine , Ushycky Irene , Goldberg Susan , MacGregor Daune
Published: December 2008

Videotaped interactions of 98 mother-child dyads (40 with Down syndrome, 23 with neurological problems, and 35 with delays of unknown etiology)were examined for mothers' language facilitation strategies (modeling or eliciting)in two situations (play and teaching). Mothers emphasized modeling strategies more than eliciting techniques. This discrepancy increased in the teaching task. Mothers' level of communication was responsive to the child's ability level. Thus mothers' speech to delayed children takes account of their childrens' linguistic skills. However mothers appear to focus on child “performance”, rather than eliciting speech, and this is more evident during “teaching” activities. Being more specific about the child's turn to talk may be an enhancing addition to the language repertoire of mothers of children with delayed language and may be a useful focus for interventions with families.
Idaho's Three-Tiered System for Speech-Language Paratherapist Training and Utilization
Authors: Longhurst Thomas M.
Published: December 2008

In Idaho, the support personnel providing speech-language services to learners with special communication needs in educational settings must obtain at least one of three levels of certification. These levels indicate the degree of education and scope of responsibility of the paratherapist. Beginning at the most basic level, these levels are: (1)speech-language aide, (2)associate degree speech-language assistant, and (3)bachelor's level speech-language associate. This article provides an historical perspective for the development and implementation of the speech-language paratherapist category in Idaho, a brief review of the rationale for and description of a 3-tiered system of speech-language paratherapists that incorporates an articulated career pathway for advancement and a discussion of the system's potential to address national concerns regarding the delivery of speech-language services in educational settings.
Personal Narrative Structures of Children with Specific-Language Impairment
Authors: Bliss Lynn S. , Pierre Karrie St.
Published: December 2008

The purpose of this investigation was to compare the narrative discourse of children with specific-language impairment (SLI)and children with normal language development (NL). Their personal narratives were analyzed for length, number and complexity of narrative structures. The categories described by Glenn and Stein (1980)were used to identify narrative structures. Differences between the groups were not obtained for length of narrative. The children with SLI produced fewer narrative structures and less complex ones than their peers with NL. They did not produce narrative structures in which aims, motivations, and consequences occurred as frequently as did the children with NL. Clinical considerations are discussed.
Phonological Awareness Skills of Children With Articulation Disorders in Kindergarten to Third Grade
Authors: Cowan Wendy E. , Moran Michael J.
Published: December 2008

The nature of the relationship between phonological awareness and articulation performance has not as yet been defined clearly. In the present study 14 children in grades K to 3 with articulation disorders were compared to 14 age matched subjects with normal articulation on three tests of phonological awareness (rhyming, phoneme blending and phoneme counting). Additionally, the performance of subjects with articulation disorders on phonological awareness tasks involving their error sounds and the same tasks not involving error sounds was compared. Articulation impaired subjects performed more poorly than subjects with normal articulation. The articulation impaired group did not make more errors on tasks involving their error sounds. Results of the present study revealed that subjects with articulation disorders made significantly more errors on three phonological awareness tasks than did subjects without articulation disorders.
A Survey of Educators and Speech-Language Pathologists Regarding Figurative Language Instruction
Authors: Ezell Helen K.
Published: December 2008

A national survey of educators and speech-language pathologists was conducted to determine current perceptions and practices regarding figurative language instruction. The overall survey response rate (N=806)was 69%. Results showed that the majority of respondents provided either formal or informal figurative language instruction to students; fourth grade teachers taught figurative language more often than third grade teachers, special educators, or speech-language pathologists; a variety of instructional methods and materials were used; and there exists a moderate to great need for more instructional materials in this area. The majority of respondents believed that understanding figurative language could benefit students both socially and academically, and that students in special education had more problems understanding and using these forms than regular education students. A discrepency was found between the perceived value of figurative language instruction for certain special education students and their perceived problems in this area.
English, Spanish, and Code-Switching Use in the ESL Classroom
Authors: Brice Alejandro , Mastin Maria , Perkins Carol
Published: December 2008

Speech-language pathologists (SLPs) in the schools, and English as a second language (ESL) teachers currently face the challenge of how to best provide instruction for students who are learning English. The purpose of this study was to describe the results of a qualitative study performed in an ESL classroom to determine teacher and student functional uses of language (i.e., pragmatics), particularly language involving code-switching and code-mixing use. The data for this study were gathered via classroom observations and interviews with the ESL teacher and ESL teacher aide in an elementary school with a 30% Hispanic/Latino population. Overall, the ESL classroom appeared to be teacher directed as evidenced by a high degree of questioning, commands, feedback, and informatives. Of all the instances of code-switching and code-mixing, none were judged to be grammatically inappropriate for either English, Spanish or the combined switched/mixed language form. The authors have developed a clinical intervention approach focused on Real, Experiences, Acknowledgment and Language (REAL). Taken from the data, REAL can be used by both SLPs and teachers to make language more meaningful.
Development of Proverb Comprehension in Adolescents
Authors: Nippold Marilyn A. , Hegel Susan L. , Uhden Linda D. , Bustamante Silvia
Published: December 2008

This study demonstrated that proverb comprehension improves during adolescence and that growth is most apparent at two transitional points in development: when students move from late childhood into early adolescence, and again when they move from late adolescence into adulthood. It was also shown that the concreteness of the nouns contained in proverbs plays an important role in determining how easily such expressions are understood, a result which confirms previous research (Nippold & Haq, 1996). Additional findings were that proverb comprehension was positively related to performance on standardized measures of academic achievement for tenth grade students. Implications for instruction in proverb comprehension are described for use with adolescents who experience difficulty with this literate aspect of language. The procedures make use of current information concerning the manner in which typical students learn the meanings of proverbs. Activities are designed to model strategies that students can apply in other language-learning contexts as well.
Self-Adjusting Fluency Therapy
Authors: Schneider Phillip
Published: December 2008

The purpose of this paper is to describe a rationale and methodology for a self-adjusting approach to working with children, which we called “fluency sensitive”. These techniques may be applied as a component of a therapy program for preschoolers and school aged children who exhibit overt fluency interruptions and a minimal amount of avoidance behavior. The goal of this approach is to help children integrate fluency enhancing speech adjustments by repeatedly experiencing the effects of volitional increases and decreases in loudness and pausing. Case examples are presented to demonstrate how several fluency sensitive children responded to this approach. The paper concludes with a discussion of issues related to the nature of change in self-adjusting therapy. To begin, we describe the nature of fluency and fluency sensitivity.
The Speech-Language Pathologist's Changing Role
Authors: Dohan Margaret , Schulz Henry
Published: December 2008

This study gathered descriptive information on the status of classroom-based speech and language services in Canada through a questionnaire mailed to school speech-language pathologists (SLPs). Seven service delivery approaches for classroom-based intervention ranging from least collaborative to most collaborative were listed. The approaches were used by the largest percentages of respondents for language disorders, followed in order by those for articulation, fluency, and voice disorders, and for students in Kindergarten to Grade 3, followed in order by those for Grades 4 to 6, Grades 7 to 9, and Grades 10 to 12. The approaches were judged to be successful with all disorder types and all grade level categories by the majority of respondents who used them. The less collaborative approaches were used by larger percentages of SLPs than the more collaborative approaches.

Results are consistent with reports in the literature on the use of classroom-based approaches by SLPs. Findings reflect the SLP's current role as a communication and language specialist who collaborates with teachers to meet students' communication needs, often through the use of classroom-based approaches. Conclusions of the study lead to suggestions for facilitating collaboration between SLPs and teachers.
A Pilot Study of Reading Comprehension Strategies of Students Who are Deaf/Hard of Hearing in a Non-English-Speaking Country
Authors: Sartawi Abdelaziz , Al-Hilawani Yasser A. , Easterbrooks Susan R.
Published: December 2008

Twenty students from the United Arab Emirates who were deaf or hard of hearing participated in this study of three different techniques for teaching reading comprehension: the Experience-Based Approach, a modified version of Reciprocal Teaching, and a Key Word Strategy. Students were currently being taught under the Experience-Based Approach. Three units of reading instruction were covered, one using each of the three strategies. Reading comprehension was assessed after intervention. Reading comprehension was highest under the Key Word Strategy conditions. Descriptions of the three approaches are given along with suggestions for further research.
Preliteracy Domains and Stages
Authors: van Kleeck Anne
Published: December 2008

This article begins by providing a model of the domains of preliteracy development that is derived from a model of the later reading process adapted by Adams (1990) from Seidenberg and McClelland (1989). Adams' model, as the one for preliteracy development offered here, contains four components: an orthographic, phonological, meaning, and context processor. Two of the preliteracy processors — the orthographic and the phonological—- contain various subskills that are foundational for later development of the form aspect of print. Two other processors — the meaning and the context — contain subskills foundational to the meaning component of print. The relationship of the various subskills in the preliteracy model to prereading activities and later reading is discussed. The model is then related to two stages of preliteracy development revised from those presented by van Kleeck (1995). The first stage emphasizes the meaning and functions of print. The second stage adds, in separate activities, an emphasis on print form (letters; sounds in words) and early form-meaning correspondences (letter knowledge and phonological awareness are related to meaning at the word level). Developmental progressions for various preliteracy skills are provided in this section. Finally, formal and informal methods of assessing all of the domains of preliteracy development are discussed. Approaches to teaching or intervention are interspersed throughout the article as the development and nature of numerous preliteracy subskills are discussed.
The Tong Ren Healing Method: A Survey Study
Authors: Sullivan Amy M. , Bauer-Wu Susan , Miovic Michael
Published: December 2008

Tong Ren (TR) is an untested energy healing modality with anecdotally-reported effectiveness for a variety of disorders. Study objective: To describe participant reports of effectiveness and safety. Design: Cross-sectional, anonymous survey. Setting: Weekly group sessions in the Northeast US. Participants: Adults attending group sessions. Measures: Changes in conditions attributed to TR. Results: Response rate 89% (n = 265). Cancer (30.6%), endocrine/autoimmune (17.5%) and musculoskeletal disorders (17.2%) were the most commonly reported conditions. Among respondents who had attended more than one session (n = 216), 30% used superlatives (e.g., ``amazing'') to describe TR's impact, and one-third noted improved quality of life. No adverse effects were described. Anxiety, depression, cancer, and autoimmune disorders appeared to have the greatest treatment responses, with 63.8%, 61.0%, 60.3%, and 58.1% of participants with these conditions reporting substantial improvements. Conclusion: This first study documenting self-reported effects of TR shows subjective benefits and no adverse effects. Further research on this approach is warranted.
Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the Lokomat in Subacute Stroke
Authors: Hidler Joseph , Nichols Diane , Pelliccio Marlena , Brady Kathy , Campbell Donielle D. , Kahn Jennifer H. , Hornby T. George
Published: December 2008

Objective. To compare the efficacy of robotic-assisted gait training with the Lokomat to conventional gait training in individuals with subacute stroke. Methods. A total of 63 participants <6 months poststroke with an initial walking speed between 0.1 to 0.6 m/s completed the multicenter, randomized clinical trial. All participants received twenty-four 1-hour sessions of either Lokomat or conventional gait training. Outcome measures were evaluated prior to training, after 12 and 24 sessions, and at a 3-month follow-up exam. Self-selected overground walking speed and distance walked in 6 minutes were the primary outcome measures, whereas secondary outcome measures included balance, mobility and function, cadence and symmetry, level of disability, and quality of life measures. Results. Participants who received conventional gait training experienced significantly greater gains in walking speed ( P = .002) and distance ( P = .03) than those trained on the Lokomat. These differences were maintained at the 3-month follow-up evaluation. Secondary measures were not different between the 2 groups, although a 2-fold greater improvement in cadence was observed in the conventional versus Lokomat group. Conclusions. For subacute stroke participants with moderate to severe gait impairments, the diversity of conventional gait training interventions appears to be more effective than robotic-assisted gait training for facilitating returns in walking ability.
Population-specific genetic variants important in susceptibility to cytarabine arabinoside cytotoxicity
Authors: Hartford Christine M. , Duan Shiwei , Delaney Shannon M. , Mi Shuangli , Kistner Emily O. , Lamba Jatinder K. , Huang R. Stephanie , Dolan M. Eileen
Published: December 2008

Cytarabine arabinoside (ara-C) is an antimetabolite used to treat hematologic malignancies. Resistance is a common reason for treatment failure with adverse side effects contributing to morbidity and mortality. Identification of genetic factors important in susceptibility to ara-C cytotoxicity may allow for individualization of treatment. We used an unbiased whole-genome approach using lymphoblastoid cell lines derived from persons of European (CEU) or African (YRI) ancestry to identify these genetic factors. We interrogated more than 2 million single nucleotide polymorphisms (SNPs) for association with susceptibility to ara-C and narrowed our focus by concentrating on SNPs that affected gene expression. We identified a unique pharmacogenetic signature consisting of 4 SNPs explaining 51% of the variability in sensitivity to ara-C among the CEU and 5 SNPs explaining 58% of the variation among the YRI. Population-specific signatures were secondary to either (1) polymorphic SNPs in one population but monomorphic in the other, or (2) significant associations of SNPs with cytotoxicity or gene expression in one population but not the other. We validated the gene expression-cytotoxicity relationship for a subset of genes in a separate group of lymphoblastoid cell lines. These unique genetic signatures comprise novel genes that can now be studied further in functional studies.
Successful treatment of canine hemophilia by continuous expression of canine FVIIa
Authors: Margaritis Paris , Roy Elise , Aljamali Majed N. , Downey Harre D. , Giger Urs , Zhou Shangzhen , Merricks Elizabeth , Dillow Aaron , Ezban Mirella , Nichols Timothy C. , High Katherine A.
Published: December 2008

Continuous expression of activated factor VII (FVIIa) via gene transfer is a potential therapeutic approach for hemophilia patients with or without inhibitory antibodies to human factor VIII (FVIII) or IX (FIX). Here, we investigate whether gene transfer of an engineered canine FVIIa (cFVIIa) transgene can affect hemostasis in a canine model of hemophilia, a good predictor of efficacy of hemophilia treatments. Purified recombinant cFVIIa exhibited 12-fold higher tissue factor–dependent activity than purified recombinant zymogen cFVII. Subsequently, we generated a serotype 8 recombinant adeno-associated viral vector expressing cFVIIa from a liver-specific promoter. Vector delivery via the portal vein in hemophilia A and B dogs was well tolerated, and long-term expression of cFVIIa resulted in a shortening of the prothrombin time, partial correction of the whole blood clotting time and thromboelastography parameters, and a complete absence of spontaneous bleeding episodes. No evidence of hepatotoxicity, thrombotic complications, or inhibitory immune response was found. These data provide the first evidence for in vivo efficacy and safety of continuously expressed FVIIa as a FVIII/FIX-bypassing agent in a large animal model of hemophilia, avoiding the risk of inhibitor formation associated with bolus FVIII or FIX infusion.
Genotyping and drug resistance patterns of M. tuberculosis strains in Pakistan
Authors: Tanveer Mahnaz , Hasan Zahra , Siddiqui Amna R , Ali Asho , Kanji Akbar , Ghebremicheal Solomon , Hasan Rumina
Published: December 2008

Background

The incidence of tuberculosis in Pakistan is 181/100,000 population. However, information about transmission and geographical prevalence of Mycobacterium tuberculosis strains and their evolutionary genetics as well as drug resistance remains limited. Our objective was to determine the clonal composition, evolutionary genetics and drug resistance of M. tuberculosis isolates from different regions of the country.

Methods

M. tuberculosis strains isolated (2003–2005) from specimens submitted to the laboratory through collection units nationwide were included. Drug susceptibility was performed and strains were spoligotyped.

Results

Of 926 M. tuberculosis strains studied, 721(78%) were grouped into 59 "shared types", while 205 (22%) were identified as "Orphan" spoligotypes. Amongst the predominant genotypes 61% were Central Asian strains (CAS ; including CAS1, CAS sub-families and Orphan Pak clusters), 4% East African-Indian (EAI), 3% Beijing, 2% poorly defined TB strains (T), 2% Haarlem and LAM (0.2). Also TbD1 analysis (M. tuberculosis specific deletion 1) confirmed that CAS1 was of "modern" origin while EAI isolates belonged to "ancestral" strain types.

Prevalence of CAS1 clade was significantly higher in Punjab (P < 0.01, Pearsons Chi-square test) as compared with Sindh, North West Frontier Province and Balochistan provinces. Forty six percent of isolates were sensitive to five first line antibiotics tested, 45% were Rifampicin resistant, 50% isoniazid resistant. MDR was significantly associated with Beijing strains (P = 0.01, Pearsons Chi-square test) and EAI (P = 0.001, Pearsons Chi-square test), but not with CAS family.

Conclusion

Our results show variation of prevalent M. tuberculosis strain with greater association of CAS1 with the Punjab province. The fact that the prevalent CAS genotype was not associated with drug resistance is encouraging. It further suggests a more effective treatment and control programme should be successful in reducing the tuberculosis burden in Pakistan.
The cancer translational research informatics platform
Authors: McConnell Patrick , Dash Rajesh C , Chilukuri Ram , Pietrobon Ricardo , Johnson Kimberly , Annechiarico Robert , Cuticchia A Jamie
Published: December 2008

Background

Despite the pressing need for the creation of applications that facilitate the aggregation of clinical and molecular data, most current applications are proprietary and lack the necessary compliance with standards that would allow for cross-institutional data exchange. In line with its mission of accelerating research discoveries and improving patient outcomes by linking networks of researchers, physicians, and patients focused on cancer research, caBIG (cancer Biomedical Informatics Grid™) has sponsored the creation of the caTRIP (Cancer Translational Research Informatics Platform) tool, with the purpose of aggregating clinical and molecular data in a repository that is user-friendly, easily accessible, as well as compliant with regulatory requirements of privacy and security.

Results

caTRIP has been developed as an N-tier architecture, with three primary tiers: domain services, the distributed query engine, and the graphical user interface, primarily making use of the caGrid infrastructure to ensure compatibility with other tools currently developed by caBIG. The application interface was designed so that users can construct queries using either the Simple Interface via drop-down menus or the Advanced Interface for more sophisticated searching strategies to using drag-and-drop. Furthermore, the application addresses the security concerns of authentication, authorization, and delegation, as well as an automated honest broker service for deidentifying data.

Conclusion

Currently being deployed at Duke University and a few other centers, we expect that caTRIP will make a significant contribution to further the development of translational research through the facilitation of its data exchange and storage processes.
Splenic rupture, secondary to G-CSF use for chemotherapy induced neutropenia: a case report and review of literature
Authors: Masood Nehal , Shaikh Asim Jamal , Memon Wasim Ahmed , Idress Romana
Published: December 2008

Introduction

Chemotherapy Induced neutropenia is a frequent and serious complication of cytotoxic cancer treatment.

Granulocyte colony stimulating factors (G-CSF) are frequently used to counter neutropenia, attempt rapid recovery of patients and allow for continuation of treatment without compromise on dose, especially in curative malignancies. Generally regarded as safe, G-CSF use has been very rarely reported to have resulted in serious side effects, such as, splenic rupture.

Case presentation

We are reporting a case of a twenty years old man, who was being treated for T cell acute lymphoblastic leukemia and received colony stimulating factors for treatment of severe neutropenia and suffered from splenic rupture, He was treated with splenectomy.

Conclusion

Although extremely rare, splenic rupture can be a serious and sometimes life threatening complication of high dose colony stimulating factors therapy.
Sex between men in the context of HIV: The AIDS 2008 Jonathan Mann Memorial Lecture in health and human rights
Authors: Saavedra Jorge , Izazola‐Licea Jose Antonio , Beyrer Chris
Published: December 2008

Gay, bisexual, and other men who have sex with men (MSM) have been among the most affected populations by HIV since the AIDS pandemic was first identified in the 1980s. Evidence from a wide range of studies show that these men remain at the highest risk for HIV acquisition in both developed and developing countries, and that despite three decades of evidence of their vulnerability to HIV, they remain under‐served and under‐studied. Prevention strategies targeted to MSM are markedly under‐funded in most countries, leading to limited access to health services including prevention, treatment, and care. We explore the global epidemic among MSM in 2008, the limited funding available globally to respond to these epidemics, and the human rights contexts and factors which drive HIV spread and limit HIV responses for these men.

What do we mean by the term MSM? MSM is a construct from the 1990s that tries to capture behavior and not identity. It was crafted to avoid stigmatizing and culturally laden terms such as gay or bisexual, which do not capture the wide diversity of orientations, sexual practices, cultures, and contextual settings in which male same‐sex behaviors occur, and where HIV transmission and acquisition risks are centered. MSM includes both gay and non‐gay identified men, bisexual men, and MSM who identify themselves as heterosexuals. It also includes men engaging in “situational” sex between men, such as can occur in prisons, schools, militaries or other environments; and it includes male sex workers who may be of any orientation but are often at very high risk for HIV. MSM may include some biologically male transgender persons, though some do not identify as male. And MSM includes a wide array of traditional and local terms worldwide–with enormous cultural diversity in Asia, Africa, Latin America and elsewhere. We use the term MSM here at its most inclusive.
Induction of caspase- and reactive oxygen species-independent phosphatidylserine externalization in primary human neutrophils: role in macrophage recognition and engulfment
Authors: Jitkaew Siriporn , Witasp Erika , Zhang Shouting , Kagan Valerian E , Fadeel Bengt
Published: December 2008

Macrophage recognition and disposal of neutrophils are important steps in the resolution of inflammation. Externalization of phosphatidylserine (PS) on the cell surface serves as a common recognition signal for macrophages and is associated with the apoptosis program in neutrophils. Here, we report that macrophage-differentiated PLB-985 cells induce rapid, caspase-independent PS externalization in human neutrophils. A similar degree of PS externalization was seen when neutrophils were cocultured with gp91phox-deficient PLB-985 macrophages, thus demonstrating that macrophage-induced PS externalization was NADPH oxidase-independent. Macrophage-induced PS externalization required cell-to-cell contact and kinase activation and was shown to correlate with neutrophil degranulation. Of note, the degree of engulfment of such PS-positive neutrophils by activated human monocyte-derived macrophages was considerably lower than for neutrophils undergoing constitutive apoptosis, indicating that PS externalization alone is not sufficient for macrophage disposal of neutrophils. However, addition of recombinant milk fat globule epidermal growth factor 8, a PS-binding protein, restored engulfment of the macrophage-cocultured target cells. Finally, neutrophils undergoing spontaneous apoptosis but not macrophage-cocultured neutrophils displayed surface expression and release of annexin I, and the addition of N-t-Boc-Phe-D-Leu-Phe-D-Leu-Phe (Boc1), a formyl peptide receptor/lipoxin receptor antagonist, suppressed clearance of apoptotic neutrophils. Conditioned medium from apoptotic neutrophils also promoted the engulfment of macrophage-cocultured neutrophils, and Boc1 blocked this process. Taken together, these studies highlight a novel pathway of PS externalization in primary human neutrophils and also provide evidence for an auxiliary function of annexin I in macrophage clearance of neutrophils.
Somatostatin Actions via Somatostatin Receptors on the Ocular Surface Are Modulated by Inflammatory Processes
Authors: Minsel Ivonne , Mentlein Rolf , Sel Saadettin , Diebold Yolanda , Bräuer Lars , Mühlbauer Eckhard , Paulsen Friedrich P.
Published: December 2008

Recent investigations support the presence of human somatostatin (SS) in the excretory system of the human lacrimal gland. To get deeper insights into a possible role of SS at the ocular surface and in the lacrimal apparatus, we investigated the distribution pattern of SS and its receptors 1–5 (SSTR1-5) by means of RT-PCR, real-time RT-PCR, Western blot and immunodot blot analysis as well as immunohistochemistry in lacrimal gland, tear fluid, conjunctiva, cornea, nasolacrimal duct epithelium, and conjunctival (HCjE) and corneal (HCE) epithelial cell lines. Cell culture experiments with HCjE and HCE were performed to analyze a possible impact of SS and inflammatory mediators on the regulation of SSTR. The results confirmed the presence of SS in lacrimal gland and tear fluid, whereas it was absent at the protein level in all other tissues and cell lines investigated. Expression of SSTR1, -2, and -5 was detectable in lacrimal gland, conjunctiva, cornea, and nasolacrimal ducts. HCjE expressed only hSSTR1 and -2, and HCE revealed only SSTR2. SSTR3 and -4 were not detected in any of the analyzed samples or cell lines. In vitro on cultured immortalized HCjE cells SS leads to a concentration-dependent down-regulation of SSTR1 mRNA but does not affect SSTR2 mRNA expression. Relative expression of SSTR1 and -2 is differentially modulated by proinflammatory cytokines and bacterial components, suggesting that the expression of both receptors is immunomodulated. Our data support an autocrine and paracrine role of SS in the lacrimal system and at the ocular surface and implicate a role of SS in corneal immunology.
Endogenous Aldosterone Contributes to Acute Angiotensin II-Stimulated Plasminogen Activator Inhibitor-1 and Preproendothelin-1 Expression in Heart But Not Aorta
Authors: Luther James M. , Wang Zuofei , Ma Ji , Makhanova Natalia , Kim Hyung-Suk , Brown Nancy J.
Published: December 2008

To test the hypothesis that angiotensin (Ang) II induces profibrotic gene expression through endogenous aldosterone, we measured the effect of 4 h infusion (600 ng/kg · min) of Ang II on tissue mRNA expression of plasminogen activator inhibitor 1 (PAI-1), preproendothelin-1 (ppET-1), TGF-β, and osteopontin in wild-type (WT), aldosterone synthase-deficient (AS−/−), and AS−/− mice treated with aldosterone (either 500 ng/d for 7 d or 250 ng as a concurrent 4 h infusion). Ang II increased aldosterone in WT (P < 0.001) but not in AS−/− mice. Aldosterone (7 d) normalized basal aldosterone concentrations in AS−/− mice; however, there was no further effect of Ang II on aldosterone (P = NS). Basal cardiac and aortic PAI-1 and ppET-1 expression were similar in WT and AS−/− mice. Ang II-stimulated PAI-1 (P < 0.001) and ppET-1 expression (P = 0.01) was diminished in the heart of AS−/− mice; treatment with aldosterone for 4 h or 7 d restored PAI-1 and ppET-1 mRNA responsiveness to Ang II in the heart. Ang II increased PAI-1 (P = 0.01) expression in the aorta of AS−/− as well as WT mice. In the kidney, basal PAI-1, ppET-1, and TGF-β mRNA expression was increased in AS−/− compared with WT mice and correlated with plasma renin activity. Ang II did not stimulate osteopontin or TGF-β expression in the heart or kidney. Endogenous aldosterone contributes to the acute stimulatory effect of Ang II on PAI-1 and ppET-1 mRNA expression in the heart; renin activity correlates with basal profibrotic gene expression in the kidney.
Potential Role of Growth Hormone in Impairment of Insulin Signaling in Skeletal Muscle, Adipose Tissue, and Liver of Rats Chronically Treated with Arginine
Authors: de Castro Barbosa Thais , Nicoletti de Carvalho José Edgar , Lourenço Poyares Leonice , Bordin Silvana , Fabres Machado Ubiratan , Nunes Maria Tereza
Published: December 2008

We have shown that rats chronically treated with Arginine (Arg), although normoglycemic, exhibit hyperinsulinemia and decreased blood glucose disappearance rate after an insulin challenge. Attempting to investigate the processes underlying these alterations, male Wistar rats were treated with Arg (35 mg/d), in drinking water, for 4 wk. Rats were then acutely stimulated with insulin, and the soleus and extensorum digitalis longus muscles, white adipose tissue (WAT), and liver were excised for total and/or phosphorylated insulin receptor (IR), IR substrate 1/2, Akt, Janus kinase 2, signal transducer and activator of transcription (STAT) 1/3/5, and p85α/55α determination. Muscles and WAT were also used for plasma membrane (PM) and microsome evaluation of glucose transporter (GLUT) 4 content. Pituitary GH mRNA, GH, and liver IGF-I mRNA expression were estimated. It was shown that Arg treatment: 1) did not affect phosphotyrosine-IR, whereas it decreased phosphotyrosine-IR substrate 1/2 and phosphoserine-Akt content in all tissues studied, indicating that insulin signaling is impaired at post-receptor level; 2) decreased PM GLUT4 content in both muscles and WAT; 3) increased the pituitary GH mRNA, GH, and liver IGF-I mRNA expression, the levels of phosphotyrosine-STAT5 in both muscles, phosphotyrosine-Janus kinase 2 in extensorum digitalis longus, phosphotyrosine-STAT3 in liver, and WAT as well as total p85α in soleus, indicating that GH signaling is enhanced in these tissues; and 4) increased p55α total content in muscles, WAT, and liver. The present findings provide the molecular mechanisms by which insulin resistance and, by extension, reduced GLUT4 content in PM of muscles and WAT take place after chronic administration of Arg, and further suggest a putative role for GH in its genesis, considering its diabetogenic effect.
Estrogen Receptor β Functions through Nongenomic Mechanisms in Lung Cancer Cells
Authors: Zhang GuangFeng , Liu Xuwan , Farkas Adam M. , Parwani Anil V. , Lathrop Kira L. , Lenzner Diana , Land Stephanie R. , Srinivas Harish
Published: December 2008

Recent studies have shown that estrogens promote the growth of lung cancer cells and may potentially be responsible for increased susceptibility to lung cancer in women. These observations raise the possibility of using antiestrogens in treating and preventing lung cancer. However, it is not clear how estrogen receptors (ERs) modulate the growth of non-small cell lung cancer (NSCLC) cells. Our Western blotting and real-time PCR analysis showed that NSCLC cells expressed ERβ, but not ERα. In addition, ERβ-specific ligands, but not ERα-specific ligands, promoted the growth of lung cancer cells. Furthermore, knockdown of ERβ by short hairpin RNA constructs resulted in loss of estrogen-dependent growth of lung cancer cells. Interestingly, endogenous ERβ failed to transcriptionally activate estrogen response element (ERE)-luciferase constructs in NSCLC cells, suggesting a lack of genomic function. Upon further investigation, ERβ was found to be in the cytoplasm in all lung cancer cells and failed to translocate to the nucleus in the presence of estrogen, as observed by biochemical, ArrayScan, and confocal microscopy experiments. Nonetheless, estrogen caused rapid activation of cAMP, Akt, and MAPK signaling pathways in lung cancer cells. Immunohistochemical analysis of lung tumor biopsies showed strong ERβ staining in the cytoplasm, whereas no staining was observed for ERα. In conclusion, our results suggest that that proliferative effects of estrogen in lung cancer cells is mediated primarily, if not exclusively, by the nongenomic action of ERβ.
Pharmacist-led medication review for knee pain in older adults: content, process and outcomes
Authors: Phelan Mike , Foster Nadine E , Thomas Elaine , Hay Elaine M , Blenkinsopp Alison
Published: December 2008

Objective

To describe the content and evaluate the effects of pharmacist-conducted medication review delivered in the context of a randomised controlled trial. The intervention aimed to optimise the pharmacological management of knee pain in older adults by negotiating an individualised treatment plan with patients.

Method

A structured medicines review was conducted by a pharmacist in the general practice setting for patients aged over 55 years with knee pain in a randomised controlled trial. According to patients' needs they could receive three to six consultations of approximately 20 minutes' duration over a 10 week period. During reviews the patients' use of prescribed and over-the-counter medicines was explored and perceived effectiveness in pain control was discussed. The pharmacist made treatment recommendations based on an algorithm previously agreed with the participating general practitioners. The pharmacist also provided education and advice on medicines and relevant lifestyle aspects. Patients in the comparison group received a control intervention (information leaflet and telephone call).

Key findings

One hundred and eight patients from 13 general medical practices were randomised to the enhanced pharmacy review group and 106 attended. Knee-pain scores showed significant improvement at 3 but not 12 months compared with the control intervention. The pharmacist made treatment recommendations for all patients and provided advice and education to over 90%. For eight out of 10 patients the treatment recommendation was for changes to treatment. Of the 36 patients for whom a non-steroidal anti-inflammatory drug was being prescribed at baseline the pharmacist recommended discontinuation in 17 cases and change to intermittent use in three cases. The mean amount of time spent per patient was around 60 minutes in three sessions.

Conclusion

Pharmacist-conducted medicines review identified substantial opportunities to improve pharmacological treatment for knee pain, and to reduce side effects from analgesic medicines. The findings of this study suggest that pharmacists can make a positive contribution to the management of patients with knee pain in primary care in the short-term. These findings support the wider implementation of pharmacist-led medicines review for patients with knee pain.
Effect of prescribed minimum benefits on the prevalence of possible drug-drug interactions of antiretroviral agents in a section of the private health care sector in South Africa: a 2 year comparative study
Authors: Katende-Kyenda Norah L , Lubbe Martie S , Serfontein Jan H P , Truter Ilse
Published: December 2008

Objective

The aim of this study was to determine the impact of prescribed minimum benefits (PMBs) after implementation, on the prevalence of possible drug-drug interactions (DDIs) between antiretrovirals (ARVs) themselves and other drugs on prescriptions claimed in a section of the private health care sector in South Africa.

Setting

A section of the private health care sector in South Africa.

Method

A comparative, retrospective drug-utilisation study was performed using 2004 and 2005 data from a medicine claims database. Possible DDIs found were classified according to Tatro (2005).

Key findings

The data consisted of 43 482 ARV prescriptions claimed during 2004 and 51 613 for 2005. A total of 5 305 882 and 3 606 992 medicine items were claimed during 2004 and 2005 respectively, of which 1.92% were ARVs for 2004 and 3.38% for 2005. Of 18 035 DDIs identified, 83.89% were between ARVs and other medications, and 16.11% were between ARVs themselves for 2004. Of 25 130 DDIs identified for 2005, 92.59% were between ARVs and other medications, and 7.41% were between ARVs themselves.

Conclusions

The decrease in DDIs between ARVs alone for 2005 as compared to 2004 could indicate a possible impact of PMBs on HIV/AIDS, as a chronic disease in which management programmes were introduced to ensure the appropriateness and effectiveness of drugs in HIV/AIDS. It is therefore recommended that further investigations be done on the management of the most important DDIs between ARVs alone and other drugs prescribed on the same prescription.
Micromechanical modelling and gasket stress evaluation in flange joints under bolt load and internal pressure
Authors: Mathan G , Prasad N Siva
Published: December 2008

Stresses in Teflon-filled spiral wound gaskets in flange joints are analysed by an axisymmetric finite-element method using micromechanical models constructed based on layer geometry. The constituents of the gasket are represented by hyperelastic and elasto-plastic material models. The inplane and bending stiffness and the non-linearity of the gasket are considered through micromechanical modelling. The micromechanical model is validated with experimental data available in the literature. An improved gasket stress distribution across the width of the gasket is obtained under different bolt preloads and internal pressures. At lower bolt preloads, only half of the gasket is effective for sealing. The results are compared with the average gasket stress model results with bolt axial force.
A Review of Gregory Clark'sA Farewell to Alms: A Brief Economic History of the World
Authors: Allen Robert C
Published: December 2008

A Farewell to Alms advances striking claims about the economic history of the world. These include (1) the preindustrial world was in a Malthusian preventive check equilibrium, (2) living standards were unchanging and above subsistence for the last 100,000 years, (3) bad institutions were not the cause of economic backwardness, (4) successful economic growth was due to the spread of “middle class” values from the elite to the rest of society for “biological” reasons, (5) workers were the big gainers in the British Industrial Revolution, and (6) the absence of middle class values, for biological reasons, explains why most of the world is poor. The empirical support for these claims is examined, and all are questionable.
A Review of Tito Boeri, Lans Bovenberg, Benoît Coeuré, and Andrew Roberts's Dealing with the New Giants and Peter J. Orszag, Mark Iwry, and William G. Gale's Aging Gracefully
Authors: Mitchell Olivia S
Published: December 2008

Global aging will impose greater economic demands on the young and may entail dramatic consumption shortfalls for the old. Against this gloomy backdrop, many analysts hail the world's funded pension systems as a means to protect future retirement security. The monographs reviewed ask how funded pension plans might be restructured to better meet the policy challenges of global aging. Both show that the pension institution must be reformulated to better provide for both economic growth and demographic aging. Questions remain regarding how retirement policy can better integrate intergenerational adequacy and incentive considerations.
Pharmacist Involvement in Improving Asthma Outcomes in Various Healthcare Settings: 1997 to Present
Authors: Benavides Sandra , Rodriguez Juan Carlos , Maniscalco-Feichtl Maria
Published: December 2008

OBJECTIVE

To evaluate pharmacists’ impact on asthma management outcomes in various healthcare settings on the basis of updated guidelines set by the National Heart, Lung, and Blood Institute (NHLBI).

DATA SOURCES

A search of MEDLINE (1997–April 2008) and International Pharmaceutical Abstracts (1997–April 2008) was conducted using the MeSH terms asthma, community pharmacy services, pharmacists, pharmacies, clinic, hospital, disease state management, medication therapy management, emergency department, and community.

STUDY SELECTION AND DATA EXTRACTION

Articles were included if pharmacists participated in the intervention and the report measured outcomes of asthma as defined by symptoms, pulmonary function, asthma severity, quality of life (QOL), or healthcare utilization.

DATA SYNTHESIS

Since January 1997, a substantial number of studies have been published examining pharmacists’ impact on asthma clinical outcomes. Twenty-five studies were included in this review: 15 were conducted in community pharmacies, 5 in ambulatory clinics, 2 in an in-patient hospital setting, and 3 as various community initiatives. The studies varied in the type of intervention provided and outcomes measured. The most common outcome in community pharmacies was pulmonary function measures, in which all but one trial found improvements. Half of the community pharmacy trials found improvements in asthma severity, 75% found improvements in healthcare utilization, and although some trials found improvements in QOL, 2 trials found decreases in QOL. Ambulatory clinics reported improvements in asthma symptoms and pulmonary function and decreased healthcare utilization. Most trials in the ambulatory care setting reported decreases in QOL postintervention. Trials in the hospital setting most often reported decreases in healthcare utilization. Limitations of the studies, however, included varying definitions of asthma control, methodologies used in the studies, and the lack of long-term follow-up.

CONCLUSIONS

Future study designs may require larger sample size and measure outcomes that better assess disease severity in asthma, such as impairment and risk domains. This review supports the National Heart, Lung, and Blood Institutes of the National Institutes of Health Expert Panel Report 3 guidelines in recognizing pharmacists as accessible healthcare practitioners who, via patient education and medication management, may help patients with asthma attain better control of their disease state.