bluuebunny/crossref_metadata_2025 huggingface dataset:
Institution-building, not nation-building: a structural-functional model
Authors: Kalu Kalu N.
Published: March 2011

By building on the essential tenets of Parsonian structural-functionalism, this article focuses on structure, process, and norms as critical to the development of enduring institutions. The contemporary orientation to nation-building that tends to focus on the structural and administrative elements of state reconstruction, especially in post-conflict situations, should be re-evaluated in favor of a more grass-roots, sociologically driven and institutionally based approach. The concept of institutions utilized here is derived from both macro (social organization) and micro (individual) levels of analysis on how a series of actions, practices, and differentiated roles are able to sustain a level of functional and organic equilibrium over time. While equilibrium suggests a type of ‘stable state’, it helps to reinforce the argument that effective institutions (including individual behaviors, norms and values) can provide the structural foundation needed for successful nation-building initiatives. Hence in that order, there should be a redirection of effort on institution-building rather than nation-building.

Points for practitioners

There needs to be a common but important realization that the little things that guide and regulate human conduct in private or public sectors are just as consequential as the big ones. But of equal importance is that administrative practices create regularized patterns of behavior, each dependent on the other, so that the resultant effect becomes a functional whole. Other points to note are that the structure of work (what we do) is as important as the structure of organizations (systems and relationships that allow us to do what we do), each playing essential roles that sustain system dynamics.
Molecular Inflammation as an Underlying Mechanism of the Aging Process and Age-related Diseases
Authors: Chung H.Y. , Lee E.K. , Choi Y.J. , Kim J.M. , Kim D.H. , Zou Y. , Kim C.H. , Lee J. , Kim H.S. , Kim N.D. , Jung J.H. , Yu B.P.
Published: March 2011

Aging is a biological process characterized by time-dependent functional declines that are influenced by changes in redox status and by oxidative stress-induced inflammatory reactions. An organism’s pro-inflammatory status may underlie the aging process and age-related diseases. In this review, we explore the molecular basis of low-grade, unresolved, subclinical inflammation as a major risk factor for exacerbating the aging process and age-related diseases. We focus on the redox-sensitive transcription factors, NF-κB and FOXO, which play essential roles in the expression of pro-inflammatory mediators and anti-oxidant enzymes, respectively. Major players in molecular inflammation are discussed with respect to the age-related up-regulation of pro-inflammatory cytokines and adhesion molecules, cyclo-oxygenase-2, lipoxygenase, and inducible nitric oxide synthase. The molecular inflammation hypothesis proposed by our laboratory is briefly described to give further molecular insights into the intricate interplay among redox balance, pro-inflammatory gene activation, and chronic age-related inflammatory diseases. The final section discusses calorie restriction as an aging-retarding intervention that also exhibits extraordinarily effective anti-inflammatory activity by modulating GSH redox, NF-κB, SIRT1, PPARs, and FOXOs.
Molecular Signaling Mechanisms of the Periopathogen, Treponema denticola
Authors: Frederick J.R. , Sarkar J. , McDowell J.V. , Marconi R.T.
Published: March 2011

In the healthy subgingiva, oral treponemes account for a small percentage of the total bacteria. However, in diseased periodontal pockets, treponemes thrive and become a dominant component of the bacterial population. Oral treponemes are uniquely adept at capitalizing on the environmental conditions that develop with periodontal disease. The molecular basis of adaptive responses of oral treponemes is just beginning to be investigated and defined. The completion of several treponeme genome sequences and the characterization of global regulatory systems provide an important starting point in the analysis of signaling and adaptive responses. In this review, we discuss existing literature focused on the genetic regulatory mechanisms of Treponema denticola and present an overview of the possible roles of regulatory proteins identified through genome analyses. This information provides insight into the possible molecular mechanisms utilized by oral spirochetes to survive in the periodontal pocket and transition from a minor to a dominant organism.
Evaluation of Outcome Change Scores for Patients With Pneumonia or Heart Failure
Authors: Scherb Cindy A. , Head Barbara J. , Hertzog Melody , Swanson Elizabeth , Reed David , Maas Meridean L. , Moorhead Sue , Conley Deborah Marks , Kozel Marie , Clarke Mary , Gillette Susan , Weinberg Barbara
Published: March 2011

This study was conducted to describe the variance in selected Nursing Outcomes Classification (NOC) outcome change scores of hospitalized older patients with pneumonia ( n = 216) or heart failure (HF; n = 67) that could be explained by age, length of stay (LOS), number of comorbid conditions, number of nursing diagnoses, and number of nursing interventions. Investigators used a descriptive correlational design to analyze data sets from three U.S. community hospitals. Study participants had at least two ratings on one of nine outcomes selected for their frequency and use across the three hospitals. A significant portion of the variance in the outcomes Knowledge: Illness Care and Fall Prevention Behavior was explained for pneumonia patients. None of the regression models for HF patients showed significance. Individual independent variables were significant in some of the models (i.e., LOS [pneumonia], number of nursing diagnoses [pneumonia and HF]). Implications for research and clinical practice are discussed.
Modeling everyday talk: Differences across communication media and sex composition of friendship dyads
Authors: Ledbetter Andrew M. , Broeckelman-Post Melissa A. , Krawsczyn Adam M.
Published: March 2011

This manuscript advances a mesolevel approach to everyday talk. Given frequent use of mediated communication within interpersonal relationships, we use a technique akin to multitrait/multimethod decomposition to separate content- and medium-specific variance sources. The results find that cross-sex friends enact everyday talk behaviors less frequently than do same-sex friends when communicating face-to-face and via telephone, but these differences do not emerge when online. After controlling for these sex differences, online communication attitudes predict everyday talk across specific media. Beyond offering methodological tools, these results may suggest cross-sex dyads communicate online to buffer against intimacy and thus preserve friendship as platonic.
Dopamine metabolism in adults with 22q11 deletion syndrome, with and without schizophrenia – relationship with COMT Val108/158 Met polymorphism, gender and symptomatology
Authors: Boot Erik , Booij Jan , Abeling Nico , Meijer Julia , da Silva Alves Fabiana , Zinkstok Janneke , Baas Frank , Linszen Don , van Amelsvoort Thérèse
Published: March 2011

22q11 Deletion syndrome (22q11DS) is a major risk factor for schizophrenia. In addition, both conditions are associated with alterations of the dopaminergic system. The catechol- O-methyltransferase (COMT) gene, located within the deleted region, encodes for the enzyme COMT that is important for degradation of catecholamines, including dopamine (DA). COMT activity is sexually dimorphic and its gene contains a functional polymorphism, Val108/158 Met; the Met allele is associated with lower enzyme activity. We report the first controlled catecholamine study in 22q11DS-related schizophrenia. Twelve adults with 22q11DS with schizophrenia (SCZ+) and 22 adults with 22q11DS without schizophrenia (SCZ-) were genotyped for the COMT Val108/158 Met genotype. We assessed dopaminergic markers in urine and plasma. We also correlated these markers with scores on the Positive and Negative Symptom Scale (PANSS). Contrary to our expectations, we found SCZ+ subjects to be more often Val hemizygous and SCZ- subjects more often Met hemizygous. Significant COMT cross gender interactions were found on dopaminergic markers. In SCZ+ subjects there was a negative correlation between prolactin levels and scores on the general psychopathology subscale of the PANSS scores. These findings suggest intriguing, but complex, interactions of the COMT Val108/158 Met polymorphism, gender and additional factors on DA metabolism, and its relationship with schizophrenia.
Neuronal Ceroid Lipofuscinosis in Qatar: Report of a Novel Mutation in Ceroid-Lipofuscinosis, Neuronal 5 in the Arab Population
Authors: Al-Kowari Moza K. , Hassan Sara , El-Said Mahmoud F. , Ben-Omran Tawfeg , Hedin Lars , Mole Sara E. , Badii Ramin
Published: March 2011

This study sought to genetically define the first family diagnosed with neuronal ceroid lipofuscinosis from Qatar. Onset was in late infancy (3 years), and sequencing in the affected children revealed a novel homozygous c.613C>T change in exon 3 of ceroid-lipofuscinosis, neuronal 5, corresponding to a missense mutation of a conserved amino acid, p.Pro205Ser. The clinical manifestations of the disease in this family largely resemble those of ceroid-lipofuscinosis, neuronal 5 disease, variant late infantile that was first described in Finland and include mental decline, visual deterioration, ataxia, and epileptic seizures. This description of ceroid-lipofuscinosis, neuronal 5 disease in an Arab family adds to the clinical and molecular diversity of the variant late-infantile neuronal ceroid lipofuscinoses, which were originally reported in Europe and are increasingly recognized in other populations.
Core Self-Evaluations, Career Decision Self-Efficacy, and Vocational Identity Among Greek Adolescents
Authors: Koumoundourou Georgia A. , Kounenou Kalliopi , Siavara Eftyxia
Published: March 2011

This study explored the mediating role of career decision self-efficacy between core self-evaluations (CSE), a newly established construct within the personality domain, and adolescents’ vocational identity. Using a sample of 200 Greek high school students, it was found that for female adolescents CSE influenced vocational identity both directly and indirectly (via career decision self-efficacy). For male students, CSE had only an indirect effect on vocational identity through career decision self-efficacy. The findings are discussed with reference to social cognitive career theory (SCCT) framework. Implications for research and adolescents’ career counseling are also discussed.
1,25 dihydroxyvitamin D3 limits monocyte maturation in lupus sera
Authors: Lerman MA , Burnham JM , Behrens EM
Published: March 2011

In this study we examined whether treatment with 1,25-dihydroxyvitaminD3 (1,25(OH)2D3) affects human APC maturation in vitro under multiple cytokine milieus. Human monocytes were elutriated from whole blood, incubated with human sera in the presence or absence of 1,25(OH)2D3, and stimulated with IFNα, GM-CSF/IL-4, or were cultured without stimulatory cytokines. Incubation of control monocytes with 1,25(OH)2D3 limited expression of cell surface makers of maturation whether monocytes were stimulated in IFNα, GM-CSF/IL-4, or in serum alone. The ability of 1,25(OH)2D3 to affect human monocyte phenotype was assessed by incubating cells with sera from 15 patients with SLE and from 5 healthy volunteers. Addition of 1,25(OH)2D3 resulted in significant reductions in the expression of MHC Class II, CD40, and CD86 and increases in expression of CD14 in both types of sera. Overall, 1,25(OH)2D3 limited human APC activation via IFNα-induced and independent mechanisms. 1,25(OH)2D3 inhibited APC activation by systemic lupus erythematosus (SLE) sera, suggesting that it may be possible for 1,25(OH)2D3 to reduce the immunostimulatory effects of the SLE milieu by interfering with the soluble cytokine mediators in the sera of SLE patients.
Adolescent Cancer Survivors: Identity Paradox and the Need to Belong
Authors: Jones Barbara L. , Parker-Raley Jessica , Barczyk Amanda
Published: March 2011

Adolescent cancer survivors face psychological effects that can include isolation, poor peer relations, anxiety, depression, and fear of recurrence, which can increase their risk for psychological late effects and poor health posttreatment. The purpose of this exploratory analysis was to understand the experiences of adolescent cancer survivors, with a particular focus on identity, health promotion, and meaning making. In-depth interviews were conducted with 12 adolescent cancer survivors. Constant comparative analysis was used to identify core themes from the data. Findings revealed that adolescent survivors might experience an identity paradox when making the transition to “survivor,” which can contribute to their sense of isolation and risk of health-detracting behaviors. Health promotion, prevention, and supportive programs need to be developed for health care professionals to address the isolation and identity transition needs of adolescent cancer survivors.
Using Integrated Mixed Methods to Develop Behavioral Measures of Factors Associated With Microbicide Acceptability
Authors: Morrow Kathleen M. , Rosen Rochelle K. , Salomon Liz , Woodsong Cynthia , Severy Lawrence , Fava Joseph L. , Vargas Sara , Barroso Candelaria
Published: March 2011

Our current understanding of factors associated with microbicide acceptability and consistent use typically has been derived from separate and distinct qualitative or quantitative studies. Specifically, rarely have investigators used mixed methods to both develop and validate behavioral measures. We utilized an integrated mixed methods design, including qualitative metasyntheses, cognitive interviews and expert reviews, psychometric evaluation, and confirmatory qualitative analyses of the correspondence between quantitative items and original qualitative data to develop and validate measures of factors associated with microbicide acceptability and use. We describe this methodology and use the development of the Relationship Context Scale to illustrate it. As a result of independent confirmatory analyses of qualitative passages corresponding to survey items, we demonstrated that items from the same subscales are frequently double coded within a particular textual passage, and thematically related, suggesting associations that resulted in a unique factor structure within the subscale. This integrated mixed method design was critical to the development of this psychometrically validated behavioral measure, and could serve as a model for future measure development.
Trying on Teaching
Authors: Austin James R. , Miksza Peter J.
Published: March 2011

The purpose of this study was to explore the effects of a precollegiate music teacher recruitment program that emphasized authentic context learning and mentoring. Study participants (21 high school students representing two cohorts) taught music to middle school band students over a 12-week period, completed an extensive questionnaire that addressed critical psychological facets of teacher development at the beginning and end of the study, and were video-recorded as they engaged in teaching activities. There were statistically significant increases in social motivation for teaching, teacher identity, and classroom management efficacy. A pattern of significant positive correlations linked teacher identity to intrinsic motivation, career commitment, and teaching strategy efficacy. Overall, there was no significant change in teaching effectiveness ratings, but participants who began the program with less teaching affect/skill demonstrated significantly larger gains than those who initially were considered more effective teachers. Greater end-of-program teaching effectiveness was associated with less commitment to music teaching as a career option.
The “Hero’s Journey”
Authors: Randles Clint
Published: March 2011

In this article, the author explores philosophically the possibility of a connection between music teacher socialization and the work of Joseph Campbell in comparative mythology. Campbell’s “hero’s journey” provides a way of viewing the life of the apprentice music teacher. The process of ritual, following the general theme of separation–initiation–return, where the protagonist leaves the ordinary world to enter the special world where adventure happens, followed by a return to the ordinary world in an altered—changed—state, is proposed to be akin to the struggles of the apprentice teacher. Christopher Vogler’s 12 subcategories of the hero’s journey are used to frame the journey of the apprentice teacher.
Multilevel Service Design: From Customer Value Constellation to Service Experience Blueprinting
Authors: Patrício Lia , Fisk Raymond P. , Falcão e Cunha João , Constantine Larry
Published: March 2011

The proliferation of complex service systems raises new challenges for service design and requires new methods. Multilevel Service Design (MSD) is presented as a new interdisciplinary method for designing complex service systems. MSD synthesizes contributions from new service development, interaction design, and the emerging field of service design. MSD enables integrated development of service offerings at three hierarchical levels: (a) Designing the firm’s service concept with the customer value constellation of service offerings for the value constellation experience; (b) Designing the firm’s service system, comprising its architecture and navigation, for the service experience; and (c) Designing each service encounter with the Service Experience Blueprint for the service encounter experience. Applications of the MSD method are described for designing a new retail grocery service and for redesigning a bank service. MSD contributes an interdisciplinary service design method that accommodates the cocreative nature of customer experiences and enables experience integration from the design of the service concept through the design of the service system and service encounter.
Developing practice and staff: Enabling improvement in care delivery through participatory action research
Authors: Beringer Antonia J , Fletcher Margaret E
Published: March 2011

We describe the process and outcomes of a programme to enable improvement in care coordination in a children’s hospital. Staff identified care coordination issues they wanted to improve and were facilitated to achieve change using a participatory action research (PAR) approach. The seven participating wards were each offered the same opportunity and yet the degree to which they were able to engage in the process, and the level to which they achieved outcomes, varied considerably. The most successful wards were those with proactive leadership and stable management and where a trusting relationship was established between the staff and the programme facilitator. The least successful were those experiencing ward closure, mergers or changes in management structure. We consider how the different levels of achievement can be understood and what implications this has for using participatory action research to promote service improvement and to facilitate staff development.
Temporary labour migration, global redistribution, and democratic justice
Authors: Lenard Patti Tamara , Straehle Christine
Published: March 2011

Calls to expand temporary work programmes come from two directions. First, as global justice advocates observe, every year thousands of poor migrants cross borders in search of better opportunities, often in the form of improved employment opportunities. As a result, international organizations now lobby in favour of expanding ‘guest-work’ opportunities, that is, opportunities for citizens of poorer countries to migrate temporarily to wealthier countries to fill labour shortages. Second, temporary work programmes permit domestic governments to respond to two internal, contradictory political pressures: (1) to fill labour shortages and (2) to do so without increasing rates of permanent migration. Temporary work programmes permit governments to appear ‘tough’ on migration, while responding to employer pressure to locate workers willing to work in low-skilled, poorly remunerated positions. The coincidence of national self-interest and global justice generates a strong case in favour of expanding guest-work. We evaluate the moral benefits and burdens of expanding guest-work opportunities, and conclude that although there are benefits to be gleaned from the perspective of global wealth redistribution, at present, temporary work programmes are generally unjust. We will argue that just temporary work programmes, in time, permit temporary workers to attain citizenship. This spells the end of traditional temporary work programmes, which require that workers return to their home country in time; instead, what is temporary is the employment obligation that must be fulfilled as a requirement to access citizenship. As long as this requirement is met, we endorse guest-work programmes as a tool to respond to global inequality.
The middle radioulnar joint and triarticular forearm complex
Authors: Soubeyrand M. , Wassermann V. , Hirsch C. , Oberlin C. , Gagey O. , Dumontier C.
Published: March 2011

The forearm is composed of the radial and ulnar shafts, which are linked by the interosseous membrane and intercalated between the elbow and wrist. The radius and ulna are connected by three joints, the proximal, middle, and distal radioulnar joints. The forearm ensures pronation/supination and longitudinal load transfer. The biomechanical and clinical relevance of the proximal and distal radioulnar joints is well established. In contrast, the middle radioulnar joint was considered relatively unimportant until studies published in the last decade showed that it fulfils crucial biomechanical functions and is of considerable clinical significance. We believe the conventional concept in which the forearm is viewed as part of either the elbow or the wrist is outdated and that a more relevant concept describes the forearm as a triarticular complex that functions as a full-fledged entity. In this concept, the three forearm radioulnar joints (proximal, middle, distal) work together to provide stability, mobility and load transfer. Here, we will argue for the relevance of the triarticular complex concept based on published data about forearm biomechanics and pathological conditions.
The Bolsa Família (family grant) program in Manguinhos: challenges and lessons learned in a case study
Authors: Magalhães Rosana , Bodstein Regina , Coelho Angela Virginia , Ferreira Nogueira Milena , Bocca Cláudia
Published: March 2011

This article discusses the results of an evaluation research on the implementation of the Bolsa Família, a conditional cash program targeted at poor families in Manguinhos, Brazil. The program pursues two main objectives: reducing current poverty and promoting human capital through the increased utilization of educational and health services. Connecting different agencies and stakeholders and building capacity for collaboration are two strategies associated with program effectiveness. Implementation evaluation showed that in Manguinhos, there were large gaps concerning the action’s adequacy in relation to the specific implementation context, intersectoral collaboration and shared knowledge. Evidence from this research was used to spearhead concrete changes in policy at the local level.
Tackling inequity through a Photovoice project on the social determinants of health
Authors: Haque Nasim , Eng Brian
Published: March 2011

St. Jamestown is the most densely populated vertical immigrant-receiving urban neighbourhood in Canada. The Photovoice project engaged and empowered immigrant residents of St. Jamestown to influence public policy and secure improved local services for promoting health and well-being. Twenty-seven residents used photography and storytelling to record neighbourhood characteristics and their implications on residents’ health and well-being. Eight participants presented recommendations actionable at neighbourhood level to the councillor and worked with the city to carry out the recommendations made that were recognized as important for neighbourhood residents’ health and well-being. The results indicate Photovoice can be used to generate dialogue on community concerns and priorities and promote community action. (Global Health Promotion, 2011; 18(1): pp. 16—19)
Neighbors Connected: the interactive use of multi-method and interdisciplinary evidence in the development and implementation of neighbors connected
Authors: Lezwijn Jeanette , Naaldenberg Jenneken , Vaandrager Lenneke , van Woerkum Cees
Published: March 2011

Neighbors Connected is a community-based intervention in the Netherlands. It helps the active older people to organize social activities for their less active older neighbors, facilitated by practical and financial support from the Community Health Service. The intervention is the outcome of a combination of semi-structured interviews with the older people, with organizations for older people and with local policy-makers, epidemiological data and interactive discussions, all of which support the notion that engaging in social activities is a way to enhance healthy ageing within the community. The use of different sources of evidence resulted in a comprehensive picture and actionable local knowledge.
The Battle River Project: school division implementation of the health-promoting schools approach
Authors: Gleddie Douglas L. , Hobin Erin P.
Published: March 2011

The Battle River Project (BRP) is a school division-level intervention in rural Alberta, Canada, built upon the health-promoting schools approach to health promotion. Using self-reported school and student-level data from administrators and students, the central aim of the BRP is to examine: ‘How can the school environment and health behaviours (healthy eating, physical activity and mental wellness) of children and youth be improved when a health-promoting schools model, the Ever Active Schools program, is implemented with school division support?’ Evidence used to inform school level changes included students’ demographic, behavioral, and psychosocial variables linked to school environment data, comprised of school demographics and administrator-assessed quality of policies, facilities, and programs related to physical activity. Each participating school and the division were provided with a tailored report of their schools’ results to reflect, plan and implement for positive health behavior change. The main lesson learned was that sharing school-specific evidence can operate as a catalyst for embedding health promoting policy and practices within the school and division culture. (Global Health Promotion, 2011; 18(1): pp. 39—42)
Pilot Health Promoting Hospital in rural South Africa: evidence-based approach to systematic hospital transformation
Authors: Delobelle Peter , Onya Hans , Langa Cynthia , Mashamba Joyce , Depoorter Anne-Marie
Published: March 2011

This project aimed at transforming a rural District Hospital in the Limpopo Province of South Africa into a Health Promoting Hospital according to standards developed by WHO-Europe. The intervention used a diagnostic approach and baseline needs assessment of hospital staff, patients, and their relatives to identify health education and promotion needs. Activities included empowerment training and skills development, implementation of health education and promotion activities, and the integration of health-promoting standards and values in the hospital structure and culture. The project indicated applicability of the model in a resource-limited setting, based on staff empowerment, local leadership, and stakeholder engagement.
Let’s Get Moving: a systematic pathway for the promotion of physical activity in a primary care setting
Authors: Bull Fiona , Milton Karen
Published: March 2011

Let’s Get Moving (LGM) represents a structured approach to physical activity promotion in the primary care setting in the United Kingdom. LGM was developed based on a systematic review which recommended the use of key strategies to support behaviour change, including: a short counselling session; written educational resources; and follow-up support. These findings provided the basis for the programme components and the specific protocols were refined in consultation with a representative group of health professionals. Key learning centred on how to translate the scientific evidence into a practical intervention in routine primary care practice.
Une stratégie d’advocacy pour favoriser l’adoption d’une politique publique provinciale en matière de réduction du tabagisme
Authors: Breton Eric , Richard Lucie , Gagnon France , Jacques Marie , Bergeron Pierre
Published: March 2011

Nous analysons le rôle joué par les données probantes dans la planification et l’implantation d’une stratégie d’ advocacy visant à neutraliser l’opposition à l’adoption de la Loi sur le tabac (1998) du Québec. Ce cas illustre la nécessité de compléter les données épidémiologiques traditionnelles avec d’autres informations faisant écho aux objections (principalement économiques) formulées contre le projet de loi. Il met également en exergue l’importance pour la santé publique de s’associer à des acteurs dont la légitimité leur confère le droit de cité dans les débats publics débordant des préoccupations sanitaires.
La construction du réseau de villes en santé de Pernambouc au Brésil : un exemple de mise à l’échelle
Authors: Franco de Sá Ronice , Schmaller Valdilene , Salles Rosane , Freire Socorro
Published: March 2011

L’intervention initiale cherchait à améliorer la qualité de vie de la population locale de cinq villes de l’État de Pernambouc. Le projet a réussi à obtenir des données probantes et à les utiliser comme source pour la formation et pour la réflexion sur la pratique dans les communautés participantes. De plus, grâce à la reconnaissance de partenaires externes, d’autres États du Brésil, du Japon et du Canada et grâce aussi à une stimulation venue de la part du gouvernement qui voulait obtenir ces données avant de s’engager dans la diffusion de l’expérience, un réseau comprenant maintenant 21 villes en santé a été créé.
Une évaluation participative confirme la pertinence sociale d’un modèle d’intervention communautaire en réussite scolaire
Authors: Bilodeau Angèle , Sampson Lucie , Daher Pierre , Bélanger Jean , Gagnon Francis , Lussier Nathalie
Published: March 2011

Cette étude de cas porte sur l’évaluation participative d’une intervention d’accompagnement scolaire à base communautaire dont le but est de favoriser la réussite scolaire en milieux montréalais socio-économiquement défavorisés. L’évaluation a été réalisée en collaboration étroite avec les acteurs de l’intervention. Elle compare les processus et les effets de l’intervention à base communautaire avec les interventions institutionnelles usuelles et montre les attributs innovants de l’intervention à base communautaire et son effet de protection auprès des enfants évoluant dans des conditions psychosociales adverses. Le partage de ces résultats motive la stabilisation du partenariat école—communauté à la base de l’intervention et la récurrence de son financement, et suscite la mobilisation de nouveaux partenariats sociaux.
Améliorer l’accessibilité financière des soins de santé au Burkina Faso
Authors: Ridde Valéry , Heinmüller Rolf , Queuille Ludovic , Rauland Kristina
Published: March 2011

L’intervention subventionne le paiement des soins de santé des enfants de moins de cinq ans et des femmes enceintes dans deux districts du Burkina Faso. Une stratégie de recherches opérationnelles à multi-niveaux utilise des méthodes mixtes et associe l’analyse des effets à celle des processus. L’article propose une analyse des chances de succès de l’utilisation des données probantes. L’étude montre notamment qu’il faut associer chercheurs et décideurs le plus tôt possible et tout au long du processus, intéresser les intervenants aux activités de recherche et adapter la méthodologie en fonction des besoins des décideurs, de la rigueur scientifique et de la temporalité de la prise de décision.
Unique Aspects of the Elderly Surgical Population
Authors: Yang Relin , Wolfson Matthew , Lewis Michael C.
Published: March 2011

Increasing life expectancies paired with age-related comorbidities have resulted in the continued growth of the elderly surgical population. In this group, age-associated changes and decreased physiological reserve impede the body’s ability to maintain homeostasis during times of physiological stress, with a subsequent decrease in physiological reserve. This can lead to age-related physiological and cognitive dysfunction resulting in perioperative complications. Changes in the cardiovascular, pulmonary, nervous, hepatorenal, endocrine, skin, and soft tissue systems are discussed as they are connected to the perioperative experience. Alterations affect both the pharmacodynamics and pharmacokinetics of administered drugs. Elderly patients with coexisting diseases are at a greater risk for polypharmacy that can further complicate anesthetic management. Consequently, the importance of conducting a focused preoperative evaluation and identifying potential risk factors is strongly emphasized. Efforts to maintain intraoperative normothermia have been shown to be of great importance. Procedures to maintain stable body temperature throughout the perioperative period are presented. The choice of anesthetic technique, in regard to a regional versus general anesthetic approach, is debated widely in the literature. The type of anesthesia to be administered should be assessed on a case-by-case basis, with special consideration given to the health status of the patient, the type of operation being conducted, and the expertise of the anesthesiologist. Specifically addressed in this article are age-related cognitive issues such as postoperative cognitive dysfunction and postoperative delirium. Strategies are suggested for avoiding these pitfalls.
A Prospective Review of Hip Fracture Subtypes, Surgical Procedure, Cognitive Status, and Analgesia Use Across 4 Australian Hospitals
Authors: Mak Jenson C. S. , Lattouf Ihab , Narushevich Alexei , Lai Charles , O’Rourke Fintan , Shen Qing , Chan Daniel K. Y. , Cameron Ian D.
Published: March 2011

Objectives: To correlate analgesia use among patients with hip fracture requiring surgery with hip fracture subtype, cognitive status, and type of surgery in the postacute period. Design and Participants: Prospective review of patients with hip fractures requiring surgical intervention. A total of 415 patients (mean age: 81.2 ± 9.1 years, 74.3% women) presented with 195 subcapital fractures (39 undisplaced, 156 displaced) and 220 trochanteric fractures (136 stable, 84 unstable) requiring surgery. Setting: Inpatient orthopedic units in 4 Australian hospitals. Measurements: The primary outcome measures were mean analgesia usage (oral morphine equivalent) for 4 defined time intervals and total amount 36 hours following surgery. Results: Patients with subtrochanteric fractures required more analgesia compared with displaced-subcapital, undisplaced-subcapital, basicervical, stable-pertrochanteric, and unstable-pertrochanteric fractures in the 24 to 36 hours following operation (24.7 vs 11.3 vs 8.8 vs 12.1 vs 7.6 vs 9.7, P = .001). Total analgesia requirements were higher in patients treated with an intramedullary nail, increasing by 1.3- to 3.3-fold in the 36 hours postsurgery. Patients with cognitive impairment utilized markedly less analgesia at all time periods measured. At 24 to 36 hours, higher levels of analgesia were noted in patients with higher premorbid level of mobility ( P = .015) and activities of daily living function ( P = .007). Conclusion: Important differences in utilization of analgesia following hip fracture across readily defined clinical groups exist. Proactive pain management for those with cognitive impairment, certain hip fracture subtypes, and surgical procedures may enable early functional mobility and other activities.
High-resolution genome-wide mapping of HIF-binding sites by ChIP-seq
Authors: Schödel Johannes , Oikonomopoulos Spyros , Ragoussis Jiannis , Pugh Christopher W. , Ratcliffe Peter J. , Mole David R.
Published: March 2011

Hypoxia-inducible factor (HIF) regulates the major transcriptional cascade central to the response of all mammalian cells to alterations in oxygen tension. Expression arrays indicate that many hundreds of genes are regulated by this pathway, controlling diverse processes that in turn orchestrate both oxygen delivery and utilization. However, the extent to which HIF exerts direct versus indirect control over gene expression together with the factors dictating the range of HIF-regulated genes remains unclear. Using chromatin immunoprecipitation linked to high throughput sequencing, we identify HIF-binding sites across the genome, independently of gene architecture. Using gene set enrichment analysis, we demonstrate robust associations with the regulation of gene expression by HIF, indicating that these sites operate over long genomic intervals. Analysis of HIF-binding motifs demonstrates sequence preferences outside of the core RCGTG-binding motif but does not reveal any additional absolute sequence requirements. Across the entire genome, only a small proportion of these potential binding sites are bound by HIF, although occupancy of potential sites was enhanced approximately 20-fold at normoxic DNAse1 hypersensitivity sites (irrespective of distance from promoters), suggesting that epigenetic regulation of chromatin may have an important role in defining the response to hypoxia.
Nuclear phospholipid scramblase 1 prolongs the mitotic expansion of granulocyte precursors during G-CSF-induced granulopoiesis
Authors: Chen Chun-Wei , Sowden Mark , Zhao Qian , Wiedmer Therese , Sims Peter J
Published: March 2011

PLSCR1−/− mice exhibit normal, steady-state hematologic parameters but impaired emergency granulopoiesis upon in vivo administration of G-CSF. The mechanism by which PLSCR1 contributes to G-CSF-induced neutrophil production is largely unknown. We now report that the expansion of bone marrow myelocytes upon in vivo G-CSF treatment is reduced in PLSCR1−/− mice relative to WT. Using SCF-ER-Hoxb8-immortalized myeloid progenitors to examine the progression of G-CSF-driven granulocytic differentiation in vitro, we found that PLSCR1 prolongs the period of mitotic expansion of proliferative granulocyte precursors, thereby giving rise to increased neutrophil production from their progenitors. This effect of PLSCR1 is blocked by a ΔNLS-PLSCR1, which prevents its nuclear import. By contrast, mutation that prevents the membrane association of PLSCR1 has minimal impact on the role of PLSCR1 in G-CSF-induced granulopoiesis. These data imply that the capacity of PLSCR1 to augment G-CSF-dependent production of mature neutrophils from myeloid progenitors is unrelated to its reported activities at the endofacial surface of the plasma membrane but does require entry of the protein into the nucleus, suggesting that this response is mediated through the observed effects of PLSCR1 on gene transcription.
DC-SIGN ligation greatly affects dendritic cell differentiation from monocytes compromising their normal function
Authors: Švajger Urban , Obermajer Nataša , Anderluh Marko , Kos Janko , Jeras Matjaž
Published: March 2011

DC-SIGN is a C-type lectin selectively expressed by certain types of DCs, including monocyte-derived DCs. Many reports have described the impact of DC-SIGN engagement with concomitant TLR signaling in tailoring of the DC maturation process, but so far, none has addressed the importance of DC-SIGN engagement during their differentiation from blood progenitors. We therefore examined the role of DC-SIGN engagement limited to the stage of IL-4-guided differentiation of DCs from human peripheral blood monocytes but not during maturation. We used two different anti-DC-SIGN antibodies with reported DC-SIGN-engaging activities. In cultures with DC-SIGN ligands, the resulting iDCs displayed abrogated expression of differentiation markers CD1a and DC-SIGN. Without further DC-SIGN activation, such DCs matured with low CD80/CD86 and high ILT3 expression, along with the appearance of macrophage marker CD14. Additionally, treated DCs indicated a tolerogenic potential by possessing a low, allostimulatory capacity and inducing naïve, allogeneic CD4+ T cells to produce low levels of IFN-γ. Upon activation, IL-10 production was greatly increased by such DCs; however, the use of IL-10-blocking antibodies could not completely reverse alternative DC activation. This suggests an alternative activation response that is a result of a different elementary state of DCs generated with concomitant ligation of DC-SIGN. During differentiation, IL-4-induced pSTAT6 was reduced by DC-SIGN ligands. Furthermore, during LPS-induced maturation, treated DCs displayed lowered activation levels of p38 MAPK, STAT1, as well as STAT6, compared with controls. Collectively, evidence is presented confirming a crucial role for DC-SIGN signaling in DC generation from monocytes.
Transcriptional regulation of the major HIV-1 coreceptor, CXCR4, by the κ opioid receptor
Authors: Finley Matthew J , Steele Amber , Cornwell William D , Rogers Thomas J
Published: March 2011

Previous studies have demonstrated that KOR activation results in decreased susceptibility to infection by HIV-1 in human PBMCs. In the present studies, we have found this effect is, in part, a result of down-regulation of the major HIV-1 coreceptor, CXCR4. Using a combination of biochemical approaches, our results show that CXCR4 protein and mRNA levels were reduced significantly following KOR activation. We evaluated the nature of the signaling pathway(s), which were induced by KOR activation, using transcription factor-binding array analysis and comparing extracts from control and KOR-activated cells. We determined that the IRFs and STATs were induced following KOR activation, and these events were important for the inhibition of CXCR4 expression. Using chemical inhibitors and siRNA constructs, we determined that JAK2, STAT3, and IRF2 were critical members of this signal transduction pathway. Immediately following KOR activation, JAK2 was phosphorylated, and this was required for the phosphorylation/activation of STAT3. Moreover, IRF2 mRNA and protein expression were also up-regulated, and further studies using ChIP analysis showed that IRF2 was induced to bind in vivo to the CXCR4 promoter. This is the first report detailing the initiation of a KOR-induced JAK2/STAT3 and IRF2 signaling cascade, and these pathways result in substantial down-regulation of CXCR4 expression. The capacity of KOR to down-regulate CXCR4 expression may provide a strategy for the development of novel therapeutics for the inhibition of HIV replication.
Chitin particles induce size-dependent but carbohydrate-independent innate eosinophilia
Authors: Kogiso Mari , Nishiyama Akihito , Shinohara Tsutomu , Nakamura Masataka , Mizoguchi Emiko , Misawa Yoshinori , Guinet Elisabeth , Nouri-Shirazi Mahyar , Dorey C Kathleen , Henriksen Ruth Ann , Shibata Yoshimi
Published: March 2011

Murine Mφ that phagocytose CMP develop into M1; this response depends on the size and the chemical composition of the particles. In contrast, recent studies concluded that chitin particles induce M2 and eosinophil migration, promoting acquired Th2 immune responses against chitin-containing microbes or allergens. This study examined whether these apparently inconsistent responses to chitin could be induced by variation in the size and chemical composition of the chitin particles. We compared the responses of Mφ with CMP, LCB, and Sephadex G-100 beads (>40 μm). Beads were given i.p. to WT mice and to mice deficient in a CRTH2, a receptor for the eosinophil chemoattractant PGD2. In contrast to the M1 activation induced by CMP, i.p. administration of LCB or Sephadex beads induced within 24 h a CRTH2-dependent peritoneal eosinophilia, as well as CRTH2-independent activation of peritoneal Mφ that expressed Arg I, an M2 phenotype. LCB-induced Mφ exhibited elevated Arg I and a surface MR, reduced surface TLR2 levels, and no change in the levels of CHI3L1 or IL-10 production. Our results indicate that the effects of chitin in vivo are highly dependent on particle size and that large, nonphagocytosable beads, independent of their chemical composition, induce innate eosinophilia and activate Mφ expressing several M2, but not M1, phenotypes.
The Type 2 Cannabinoid Receptor Regulates Bone Mass and Ovariectomy-Induced Bone Loss by Affecting Osteoblast Differentiation and Bone Formation
Authors: Sophocleous Antonia , Landao-Bassonga Euphemie , van‘t Hof Robert J. , Idris Aymen I. , Ralston Stuart H.
Published: March 2011

The type 2 cannabinoid receptor (CB2) has been reported to regulate bone mass and bone turnover but the mechanisms responsible are incompletely understood. In this study we investigated the role that the CB2 pathway plays in bone metabolism using a combination of genetic and pharmacological approaches. Bone mass and turnover were normal in young mice with targeted inactivation of CB2 receptor (CB2−/−), but by 12 months of age, they had developed high-turnover osteoporosis with relative uncoupling of bone resorption from bone formation. Primary osteoblasts from CB2−/− mice had a reduced capacity to form bone nodules in vitro when compared with cells from wild-type littermates and also had impaired PTH-induced alkaline phosphatase (ALP) activity. The CB2-selective agonist HU308 stimulated bone nodule formation in wild-type osteoblasts but had no effect in CB2−/− osteoblasts. Further studies in MC3T3-E1 osteoblast like cells showed that HU308 promoted cell migration and activated ERK phosphorylation, and these effects were blocked by the CB2 selective inverse agonist AM630. Finally, HU308 partially protected against ovariectomy induced bone loss in wild-type mice in vivo, primarily by stimulating bone formation, whereas no protective effects were observed in ovariectomized CB2−/− mice. These studies indicate that the CB2 regulates osteoblast differentiation in vitro and bone formation in vivo.
Autoimmune Oophoritis with Multiple Molecular Targets Mitigated by Transgenic Expression of Mater
Authors: Otsuka Noriyuki , Tong Zhi-Bin , Vanevski Konstantina , Tu Wei , Cheng Mickie H. , Nelson Lawrence M.
Published: March 2011

Primary ovarian insufficiency (POI) resulting from ovarian autoimmunity is a poorly understood clinical condition lacking in effective treatments. Understanding the targets of the autoimmune response and induction of ovarian-specific tolerance would allow development of focused therapies to preserve fertility in an at-risk population. MATER (maternal antigen that embryos require) is a known ovarian autoantigen targeted in autoimmune syndromes of POI. We attempt to induce ovarian-specific tolerance via transgenic expression of the MATER antigen on potentially tolerogenic antigen-presenting cells (APC), which typically present antigen via the major histocompatibility complex (MHC) class II molecule. We hypothesize that expression of MATER in a MHC class II-dependent manner on APC can mediate induction of ovarian tolerance.

We utilized a well-characterized murine model of ovarian autoimmunity, whereby oophoritis develops after d 3 neonatal thymectomy (NTx). Wild-type and transgenic mice, carrying an MHC Class II-driven Mater gene (IE-Mater), were subjected to NTx and assessed for evidence of autoimmune oophoritis. After disease induction by NTx, female mice carrying the IE-Mater transgene had significant reductions in histological oophoritis (56%) and circulating ovarian autoantibodies (28%) compared with wild-type females (94% and 82%, respectively). Incidence of other autoimmunity was unaffected as assessed by antinuclear autoantibodies. Transgenic expression of MATER in APC can induce antigen-specific tolerance with a significant reduction in ovarian autoimmunity. Lack of complete disease protection suggests that other antigens may also play a role in autoimmune oophoritis. As a known autoantigen in the human APS1 (autoimmune polyglandular syndrome type 1), which is associated with POI, MATER may represent a relevant target for future diagnostic and therapeutic clinical interventions.