bluuebunny/crossref_metadata_2025 huggingface dataset:
The changing role of veterinary expertise in the food chain
Authors: Enticott Gareth , Donaldson Andrew , Lowe Philip , Power Megan , Proctor Amy , Wilkinson Katy
Published: May 2011

This paper analyses how the changing governance of animal health has impacted upon veterinary expertise and its role in providing public health benefits. It argues that the social sciences can play an important role in understanding the nature of these changes, but also that their ideas and methods are, in part, responsible for them. The paper begins by examining how veterinary expertise came to be crucial to the regulation of the food chain in the twentieth century. The relationship between the veterinary profession and the state proved mutually beneficial, allowing the state to address the problems of animal health, and the veterinary profession to become identified as central to public health and food supply. However, this relationship has been gradually eroded by the application of neoliberal management techniques to the governance of animal health. This paper traces the impact of these techniques that have caused widespread unease within and beyond the veterinary profession about the consequences for its role in maintaining the public good of animal health. In conclusion, this paper suggests that the development of the social sciences in relation to animal health could contribute more helpfully to further changes in veterinary expertise.
Integrating natural and social science perspectives on plant disease risk, management and policy formulation
Authors: Mills Peter , Dehnen-Schmutz Katharina , Ilbery Brian , Jeger Mike , Jones Glyn , Little Ruth , MacLeod Alan , Parker Steve , Pautasso Marco , Pietravalle Stephane , Maye Damian
Published: May 2011

Plant diseases threaten both food security and the botanical diversity of natural ecosystems. Substantial research effort is focused on pathogen detection and control, with detailed risk management available for many plant diseases. Risk can be assessed using analytical techniques that account for disease pressure both spatially and temporally. We suggest that such technical assessments of disease risk may not provide an adequate guide to the strategies undertaken by growers and government to manage plant disease. Instead, risk-management strategies need to account more fully for intuitive and normative responses that act to balance conflicting interests between stakeholder organizations concerned with plant diseases within the managed and natural environments. Modes of effective engagement between policy makers and stakeholders are explored in the paper, together with an assessment of such engagement in two case studies of contemporary non-indigenous diseases in one food and in one non-food sector. Finally, a model is proposed for greater integration of stakeholders in policy decisions.
Infectious diseases of animals and plants: an interdisciplinary approach
Authors: Wilkinson Katy , Grant Wyn P. , Green Laura E. , Hunter Stephen , Jeger Michael J. , Lowe Philip , Medley Graham F. , Mills Peter , Phillipson Jeremy , Poppy Guy M. , Waage Jeff
Published: May 2011

Animal and plant diseases pose a serious and continuing threat to food security, food safety, national economies, biodiversity and the rural environment. New challenges, including climate change, regulatory developments, changes in the geographical concentration and size of livestock holdings, and increasing trade make this an appropriate time to assess the state of knowledge about the impact that diseases have and the ways in which they are managed and controlled. In this paper, the case is explored for an interdisciplinary approach to studying the management of infectious animal and plant diseases. Reframing the key issues through incorporating both social and natural science research can provide a holistic understanding of disease and increase the policy relevance and impact of research. Finally, in setting out the papers in this Theme Issue, a picture of current and future animal and plant disease threats is presented.
Optimization of environmental factors using RSM for Spirulina platensis cultivation
Authors: Prabuthas P. , Srivastav P.P. , Mishra H.N.
Published: May 2011

Purpose

The purpose of this paper is to optimize the environmental growth factors for maximum yield of biomass and protein content of Spirulina platensis var lonor.

Design/methodology/approach

Central composite design with four independent variables (namely, Temperature (°C), Light intensity (μmol m−2 s−1), incubation period (days) and inoculum concentration (per cent)) and two dependent variables (namely, Biomass yield (g/L) and Protein content (per cent)) were used for designing the experiment. The quadratic model was selected for analysis of data using analysis of variance and optimization was performed using response surface methodology (RSM). Central Food Technological Research Institute (CFTRI) medium was used for growing the organisms.

Findings

The predicted values of optimization showed that the maximum yield of dried biomass (1.13 g/L) and protein (57.45 per cent) were obtained at temperature of 33.6°C, light intensity of 67.50 μmol m−2 s−1, incubation period of 16 days and inoculum concentration of 20 per cent. The actual values of biomass (1.23 g/L) and protein (58.46 per cent) yield were almost similar to the predicted responses.

Practical implications

The data obtained with this optimization method help Spirulina researchers/producers to cultivate the S. platensis var lonor strain with maximum biomass and protein content using the CFTRI medium.

Originality/value

Earlier works on optimization of growth conditions for Spirulina biomass, revealed that maximum of two factors were employed at a time using factorial design. But unlike other studies here in this study, optimization of multi factors using at a time using RSM on better biomass and protein yield was employed.
International harmonization of training and qualification in the manufacturing industry
Authors: Quintino L. , Fernandes I. , Miranda R.M.
Published: May 2011

Purpose

The aim of this paper is to propose a model for international harmonization of the training and qualification of human resources for industrial professions. The outcome is a system based on training guidelines and a quality assurance methodology that is now in use in 42 countries around the world.

Design/methodology/approach

The paper describes the motivations that led to the development of the International System for the Training and Qualification of Welding Personnel. The structure of this system and the documents on which it is based are outlined.

Findings

The approach used has gained wide international acceptance. The progress achieved is analysed in the final part of the paper. More than 150,000 qualifications have so far been awarded around the world.

Practical implications

The need for a harmonized International System for the Training and Qualification of Welding Personnel has been recognized by industry and the authorities. The reference to this system in international standards and the general recognition of its reliability by stake holders is leading to its widespread use in more countries and by more professionals.

Originality/value

The harmonized international system for the qualification of human resources in welding technology is unique in Europe. The methodology used has proved to be successful and can be benchmarked for application in human resources development for other professions.
Re‐thinking positions in academic libraries
Authors: Jackson Mildred L.
Published: May 2011

Purpose

Librarians in the twenty‐first century require different skills from their predecessors. The purpose of this paper is to examine what those skills are and how they correlate with new position descriptions.

Design/methodology/approach

The paper looks at ways to analyze vacant positions so that libraries can hire the faculty and staff with the necessary skills.

Findings

The paper finds that creative ways of thinking about vacant positions are necessary in the current environment and that different skills are needed in the twenty‐first century from those that might have been sought previously.

Originality/value

The paper provides a way to evaluate and assess vacant positions.
Enhancing narrative coherence in simulated interviews about child abuse
Authors: Powell Martine B. , Feltis Brooke B. , Hughes‐Scholes Carolyn H.
Published: May 2011

Purpose

Simulated child interviews, where adults play the role of a child witness for trainee investigative interviewers, are an essential tool used to train investigators to adhere to non‐leading, open‐ended questions. The aim of this study is to examine whether the use of a training procedure that guides persons playing the role of a child in simulated interviews results in interviewees producing more coherent narratives (measured by the number of story grammar details).

Design/methodology/approach

A total of 80 police officers individually engaged in ten‐minute interviews, whereby an untrained (colleague), or trained respondent, played the role of the child interviewee. For each child respondent condition, the interviews varied according to child age (five or eight years).

Findings

As predicted, trained respondents reported a higher proportion of story grammar elements and a lower proportion of contextual information than the untrained respondents, as well as more story grammar elements in response to open‐ended questions. However, there were limitations in how well both groups tailored their story grammar to the age of the child they were representing.

Originality/value

These findings demonstrate that our training procedure promotes a more coherent interviewee account, and facilitates a response style that is more reinforcing of open‐ended questions.
The emergent development of public portals moulding the state‐individual relationship
Authors: Ranerup Agneta
Published: May 2011

Purpose

The relationship between the state and the individual is, more than ever before, being mediated by public portals. The requirement specifications for public portals can be said to define the level of expectation among influential actors concerning the roles of the individual in this relationship at a certain point in time. At the same time, they are part of an emergent‐development process. The purpose of this paper is to test this perspective in the empirical context of healthcare.

Design/methodology/approach

This research proposes a framework for analysing the requirement specifications for public portals, making various roles possible, such as being a patient, a citizen, a consumer, and a customer. The framework is tested in a case study of a Swedish national healthcare portal.

Findings

It can be concluded that prominent actors in this particular context of design defined the requirement specification so that the patient and citizen roles were well supported, whereas the roles of the consumer and customer were supported in a less well‐developed manner. The case study also indicated the importance of reusing already existing functionality to attain quick and tangible results. Consequently, the individual is both enhanced and limited by the “travel of ideas” in the form of the reuse of existing functionality.

Originality/value

This paper puts forward the view that the requirement specifications for public portals are part of the emergent formation of an e‐governance relationship.
Phase I and II study of azacitidine in Japanese patients with myelodysplastic syndromes
Authors: Uchida Toshiki , Ogawa Yoshiaki , Kobayashi Yukio , Ishikawa Takayuki , Ohashi Haruhiko , Hata Tomoko , Usui Noriko , Taniwaki Masafumi , Ohnishi Kazunori , Akiyama Hideki , Ozawa Keiya , Ohyashiki Kazuma , Okamoto Shinichiro , Tomita Akihiro , Nakao Shinji , Tobinai Kensei , Ogura Michinori , Ando Kiyoshi , Hotta Tomomitsu
Published: May 2011

Azacitidine, an inhibitor of DNA methyltransferase, is reported to have antileukemic efficacy and is approved for the treatment of myelodysplastic syndromes in Western countries. We have conducted a Phase I/II study of azacitidine in Japanese patients with myelodysplastic syndromes to evaluate its pharmacokinetics, efficacy, and safety. In all, 53 patients received 75 mg/m2 azacitidine subcutaneously or intravenously once daily for seven consecutive days on a 28‐day cycle. The Cmax following intravenous administration was approximately 3.7‐fold higher than that following subcutaneous administration, whereas the area under the plasma concentration–time curve from time zero to infinity was comparable for subcutaneous and intravenous administration. The bioavailability of azacitidine following subcutaneous administration was 91.1%, indicating that azacitidine is nearly completely absorbed after subcutaneous administration. The hematologic improvement and hematologic response rates were 54.9% (28/51) and 28.3% (15/53), respectively, and there were no differences between the two routes of administration. Azacitidine was generally well tolerated and clinically manageable in Japanese patients with myelodysplastic syndromes. Adverse events occurred in ≥20% of patients included hematologic toxicity, gastrointestinal events, and general disorders, such as malaise. Grade 3/4 adverse events that occurred in ≥50% of patients were all due to hematologic toxicity. The safety profile of azacitidine was generally similar for both routes of administration, with the exception of injection site reactions observed following subcutaneous administration. These results indicate that azacitidine can be expected to be a useful therapeutic agent in Japanese patients with myelodysplastic syndromes. (Cancer Sci 2011; 102: 1680–1686)
Feasibility and pharmacokinetic study of bendamustine hydrochloride in combination with rituximab in relapsed or refractory aggressive B cell non‐Hodgkin’s lymphoma6
Authors: Ogura Michinori , Ando Kiyoshi , Taniwaki Masafumi , Watanabe Takashi , Uchida Toshiki , Ohmachi Ken , Matsumoto Yosuke , Tobinai Kensei ,   for the Japanese Bendamustine Lymphoma Study Group
Published: May 2011

Although bendamustine plus rituximab has demonstrated efficacy in indolent B cell non‐Hodgkin’s lymphoma (B‐NHL), data for this combination in aggressive B‐NHL are extremely limited. The present dose‐escalation study evaluated the safety, efficacy, and pharmacokinetics of bendamustine hydrochloride in combination with rituximab in patients with relapsed/refractory, CD20‐positive, aggressive B‐NHL. Patients received rituximab 375 mg/m2, i.v., on Day 1 and bendamustine at either 90 (Cohort 1) or 120 mg/m2 (Cohort 2), i.v., on Days 2 and 3 of a 21‐day cycle. The primary endpoint was the proportion of patients experiencing dose‐limiting toxicity (DLT). Secondary endpoints were adverse events (AE), the overall response rate (ORR), and pharmacokinetic parameters. Nine patients received rituximab plus bendamustine: three in Cohort 1 and six in Cohort 2. Histologies included diffuse large B cell lymphoma (n = 5), mantle cell lymphoma (n = 2), and transformed lymphoma (n = 2). No DLT was observed at either dose level. Grade 3/4 hematologic AE included lymphocytopenia, leukocytopenia, and neutropenia (n = 9 each; 100%), and thrombocytopenia (n = 2; 22%). No Grade 3/4 gastrointestinal AE were reported. The ORR was 33% (one partial response) in Cohort 1 and 100% (five complete and one partial response) in Cohort 2. The maximum drug concentration and area under the blood concentration–time curve for bendamustine increased dose dependently, with time to maximum blood concentration = 1.0 h in both cohorts; these pharmacokinetic data were similar to those reported previously for single‐agent bendamustine in patients with indolent B‐NHL. In conclusion, bendamustine 120 mg/m2 plus rituximab 375 mg/m2 was feasible and generally well tolerated, with promising efficacy in relapsed or refractory aggressive B‐NHL. (Cancer Sci 2011; 102: 1687–1692)
Aberrations of NEGR1 on 1p31 and MYEOV on 11q13 in neuroblastoma
Authors: Takita Junko , Chen Yuyan , Okubo Jun , Sanada Masashi , Adachi Masatoki , Ohki Kentaro , Nishimura Riki , Hanada Ryoji , Igarashi Takashi , Hayashi Yasuhide , Ogawa Seishi
Published: May 2011

MYEOV and NEGR1 are novel candidate gene targets in neuroblastoma that were identified by chromosomal gain in 11q13 and loss in 1p31, respectively, through single nucleotide polymorphism array analysis. In the present study, to assess the involvement of MYEOV and NEGR1 in the pathogenesis of neuroblastoma, we analyzed their mutation status and/or expression profiles in a panel of 55 neuroblastoma samples, including 25 cell lines, followed by additional functional studies. No tumor‐specific mutations of MYEOV or NEGR1 were identified in our case series. Expression of MYEOV was upregulated in 11 of 25 cell lines (44%) and in seven of 20 fresh tumors (35%). The siRNA‐mediated knockdown of MYEOV in NB‐19 cells, which exhibit high expression of MYEOV, resulted in a significant decrease in cell proliferation (P = 0.0027). Conversely, expression studies of NEGR1 revealed significantly lower expression of this gene in neuroblastomas at an advanced stage of the disease. Exogenous NEGR1 expression in neuroblastoma cells induced significant inhibition of cell growth (P = 0.019). The results of these studies provide supporting evidence for MYEOV and NEGR1 as gene targets of 11q13 gains and 1p31 deletions in a neuroblastoma subset. In addition, the findings suggest a possible prognostic value for NEGR1 in neuroblastoma. (Cancer Sci 2011; 102: 1645–1650)
Systematic review: epidemiology of hepatitis C genotype 6 and its management
Authors: Chao D. T. , Abe K. , Nguyen M. H.
Published: May 2011

Aliment Pharmacol Ther 2011; 34: 286–296

Background  Hepatitis C virus (HCV) genotype 6 is common among patients from Southeast Asia and the surrounding regions, where HCV prevalence is also high. HCV genotype 6 has great genetic diversity and different response to antiviral therapy compared with the more commonly known genotype 1.

Aim  Our goal was to provide a systematic review of the current literature on the epidemiology, classification and treatment of HCV genotype 6.

Methods  A search using PubMed for ‘hepatitis C’ AND ‘genotype 6’ produced a total of 47 articles, of which 33 articles were found to be relevant and included in this review. Additional articles were identified using the reference lists of these 33 primary articles.

Results  The prevalence of HCV genotype 6 is estimated to be as high as 50% in some regions of Southeast Asia with demonstrated significance among intravenous drug users and thalassemia major patients. Although previous line probe assays may have misclassified HCV genotype 6 as genotype 1, newer line probe assays can more accurately and reliably determine HCV genotype. Patients infected with HCV genotype 6 respond better to interferon‐based therapy compared with those infected with genotype 1, although patient baseline clinical characteristics and side effect profiles are similar between HCV genotype 6 and other HCV genotypes.

Conclusions  Future studies should seek to clarify issues regarding early predictors for treatment response in patients with HCV genotype 6, and the impact of ethnic and genotypic factors to treatment response in HCV genotype 6 patients.
Meta‐analysis: insulin resistance and sustained virological response in hepatitis C
Authors: Eslam M. , Aparcero R. , Kawaguchi T. , Del Campo J. A. , Sata M. , Khattab M. A. , Romero‐Gomez M.
Published: May 2011

Aliment Pharmacol Ther 2011; 34: 297–305

Background  A higher baseline homeostasis model assessment of insulin resistance (HOMA‐IR) score has sometimes predicted a poorer sustained virological response (SVR) rate to peginterferon/ribavirin therapy in treatment‐naïve chronic hepatitis C patients.

Aim  To perform a meta‐analysis to evaluate the impact of HOMA‐IR on SVR in hepatitis C.

Methods  Relevant studies were identified by searching Medline and EMBASE. We identified 17 publications that addressed the influence of insulin resistance on SVR. The random effect model of Der Simonian and Laird method were used for heterogeneous studies using the Meta‐Disc software 1.4, Madrid, Spain.

Results  Normal insulin sensitivity was associated with a higher rate of SVR [odds ratio (OR) 2.86 (95%CI: 1.97–4.16)] in comparison with insulin resistance. Moreover, in separate analysis by genotype selecting studies that used HOMA‐IR > 2 as cut‐off defining insulin resistance, SVR was higher in patients with HOMA‐IR < 2 in all genotypes: HCV‐1 [OR: 2.16 (95%CI: 1.51–3.08)], HCV‐2&3 [OR: 3.06 (95%CI: 1.06–8.82)] and HCV‐4 [OR: 6.65(95%CI: 2.51–17.61)]. Studies reporting no association between HOMA and SVR included easy‐to‐cure cohorts, analysed variables strongly related with insulin resistance like body mass index, steatosis, hyper γGT, age and fibrosis and reported differences in handling and interpretation of HOMA‐IR.

Conclusion  Elevated HOMA‐IR was associated with a lower cure rate of patients with hepatitis C treated with Peg‐IFN‐α/ribavirin irrespective of genotype, and the more difficult‐to‐treat cohort, the better the HOMA‐IR prediction. HOMA‐IR is, as a surrogate marker of insulin resistance, susceptible to some biases derived from both handling and interpretation.
Dietary polyphenols in the prevention and treatment of allergic diseases
Authors: Singh A. , Holvoet S. , Mercenier A.
Published: May 2011

Allergic disorders encompass skin, food and respiratory allergies. Sensitization to a normally harmless allergen results in the immune system being biased to a predominant T‐helper type 2 response. Re‐exposure to the same allergen leads to a robust secretion of allergy‐related mediators that eventually triggers symptoms. Our understanding of these disorders has enabled the search of therapeutic approaches that can either modulate the sensitization process or impact on allergic mediators, thus helping manage allergic symptoms. Polyphenols are one such class of compounds that are found in foods and plant sources and have been investigated for their anti‐allergic effect in different disease models and in human clinical trials. Their anti‐inflammatory profile is known to impact on the recruitment of immune cells to the skin and in preventing the development of secondary infections following disruption of the skin barrier. The interaction of polyphenols with proteins can modulate the process of allergic sensitization and their direct effect on allergic effector cells such as mast cells inhibit mediator release, resulting in the alleviation of symptoms. In addition, their endogenous anti‐oxidant ability limits the extent of cellular injury from free radicals during the allergic insult. Overall, polyphenols hold promise as anti‐allergy agents capable of influencing multiple biological pathways and immune cell functions in the allergic immune response and deserve further investigation. The objective of the current review is to summarize the key findings and progress made in studying polyphenols as anti‐allergic ingredients. Special emphasis is placed in this review to highlight key physiological, cellular and signalling pathways implicated in the mechanism of action of different polyphenols in the context of allergic disorders and their manifestations.

Cite this as: A. Singh, S. Holvoet and A. Mercenier, Clinical & Experimental Allergy, 2011 (41) 1346–1359.
Role of osteopontin, a multifunctional protein, in allergy and asthma
Authors: Konno S. , Kurokawa M. , Uede T. , Nishimura M. , Huang S.‐K.
Published: May 2011

Osteopontin (OPN) is an extracellular matrix protein and immune modulator with a wide range of functions. OPN is recognized as a key cytokine in Th1 immune responses, yet its potential involvement in allergic/asthmatic responses has been investigated only recently. Current data from molecular and cellular studies and studies of OPN‐deficient mice provide evidence that OPN plays multiple roles in the regulation of allergic responses, including regulation of IgE response, inflammatory cell migration, and the development of airway fibrosis and angiogenesis. These results suggest that OPN is a pleiotropic cytokine that functions both systemically and locally in tissue mucosa. Notably, OPN is able to exert its effects through different functional domains, and the secreted and intracellular forms of OPN may have distinct functions. Future research to elucidate all aspects of OPN function is needed to ultimately establish its role in the regulation of immune responses and various disease processes, including those critically involved in the development of allergies and asthma.

Cite this as: S. Konno, M. Kurokawa, T. Uede, M. Nishimura and S.‐K. Huang, Clinical & Experimental Allergy, 2011 (41) 1360–1366.
Drug-induced bullous pemphigoid: cases triggered by intravenous iodine and etanercept
Authors: Kluk J. , Goulding J. M. R. , Bhat J. , Finch T. M.
Published: May 2011

Bullous pemphigoid (BP) is one of the most common acquired immunobullous diseases. Rarely, the development of BP is attributed to drug exposure. We present two cases of BP, one triggered by intravenous iodine, and one associated with etanercept treatment in a patient with psoriasis; the first time, to our knowledge, that either of these associations has been reported. The recognition of occasional cases of drug-induced BP such as ours, with timely cessation of the offending agent, may produce rapid clinical improvement with decreased exposure to potent immunosuppressive therapy.
Acquired progressive kinking of hair affecting the scalp and eyelashes in an adult woman
Authors: MacDonald A. , Holmes S.
Published: May 2011

Acquired hair kinking of scalp hair in adults is an unusual, rarely reported phenomenon. There are several possible aetiologies, including drug-induced changes, diffuse partial woolly hair, and acquired progressive kinking of hair (APKH). We report a case of focal APKH occurring in an adult woman. This was associated with a previously unreported feature, that of eyelash involvement.
Increased interleukin-4-positive lymphocytes in patients with Hashimoto's thyroiditis and concurrent non-endocrine autoimmune disorders
Authors: Santaguida M G , Nardo S , Del Duca S C , Lococo E , Virili C , Gargano L , Lenti L , Centanni M
Published: May 2011

A prevalent T helper type 1 (Th1) subset of lymphocytes has been described in Hashimoto's thyroiditis (HT), but whether a similar polarization may characterize HT when associated with non-endocrine autoimmune disorders (NEAD) is not known. The aim of the present study was to analyse the intracellular Th1 and Th2 distinctive cytokines in patients with isolated HT or associated with non-endocrine autoimmune disorders. Intracellular cytokine expression was assessed in peripheral blood lymphocytes (PBL) of 68 out-patients (females = 55; males = 13; median age = 36 years) with HT : 33 had isolated HT and 35 had a concurrent NEAD. The percentage of interferon (IFN)-γ and interleukin (IL)-2 Th1- and IL-4 Th2-positive cells was measured by flow cytometric analysis. We found an increased percentage of IL-2-positive cells in all patients, without differences between patients with isolated HT or associated with NEAD. IFN-γ+ cells were also increased in both groups, but the median percentage of those with isolated HT was lower than in patients with HT+NEAD (19·0 versus 29·9%; P = 0·0082). An increased number of IL-4-positive cells was observed in three of 33 (9·1%) patients with isolated HT and in 25 of 35 patients with NEAD [71%; P < 0·0001; relative risk (RR) = 3·18]. The median values of IL-4+ cells (HT = 5·0% versus HT + NEAD = 16·8%) confirmed this large difference (P < 0·0001). A clear-cut increase of IL-4+ lymphocytes characterizes patients with autoimmune thyroiditis who have associated non-endocrine autoimmune disorders. These findings may represent an initial tool to detect patients with autoimmune thyroiditis in which additional non-endocrine autoimmune disorders may be awaited.
A Systematic Review: The use of desmopressin for treatment and prophylaxis of bleeding disorders in pregnancy
Authors: TRIGG D. E. , STERGIOTOU I. , PEITSIDIS P. , KADIR R. A.
Published: May 2011

Summary.  Desmopressin (DDAVP) is commonly used for treatment and prevention of bleeding complications in patients with bleeding disorders including haemophilia A, von Willebrand’s disease (VWD) and other less common disorders. This article reviews the current evidence for the use of DDAVP in pregnancy to clarify its efficacy and safety with regard to maternal and foetal outcome. A search of the literature found 30 studies that reported DDAVP use in pregnancy for prophylaxis or treatment of bleeding complications with 216 pregnancies reported in total. The most common indication was prophylaxis for prevention of bleeding during pregnancy and postpartum haemorrhage. DDAVP was used successfully in the first and early second trimester for bleeding prophylaxis in 50 pregnancies. No postpartum bleeding complications were reported in 167 out of 172 pregnancies when DDAVP was used for peripartum haemostatic cover. Twenty‐nine studies reported no significant adverse events as a result of treatment with DDAVP. One case of water intoxication seizure and one case of premature labour following the use of DDAVP was reported in a single study. Other maternal side effects included facial flushing and headache and were reported by one study. These side effects were generally well tolerated by patients. There were no other significant adverse events reported in any of the studies as a result of DDAVP use. Foetal outcome was recorded in ten studies with no adverse foetal outcomes. In conclusion, this review shows that DDAVP in selected cases is effective in reducing bleeding complications associated with pregnancy and childbirth with a good safety record. Further research is needed to confirm these findings as they are based on the currently available evidence from small studies and case series only.
Genome‐wide association studies provide new insights into the genetic basis of testicular germ‐cell tumour
Authors: Turnbull C. , Rahman N.
Published: May 2011

Testicular germ‐cell tumour (TGCT) is the most common cancer in young men, and genetic epidemiological studies suggest that the disease has a strong genetic basis. Until 2009, very little of this genetic component had been explained. Genome‐wide association studies have since identified eight SNPs at six loci which together account for approximately 15% of the genetic risk of TGCT and offer novel biological insights into testicular germ‐cell oncogenesis. In this review, we summarize the genetic epidemiology of TGCT, detail the contribution genome‐wide association studies have made to our understanding of the genetic basis of TGCT and reflect on how future technological advances may assist in revealing the remaining genetic factors underlying TGCT susceptibility.
Peritubular myoid cell‐derived factors and its potential role in the progression of testicular germ cell tumours
Authors: Díez‐Torre A. , Silván U. , Moreno P. , Gumucio J. , Aréchaga J.
Published: May 2011

The tumour surrounding stroma, known as reactive stroma, is a crucial factor to understand cancer cell growth and invasion. In the normal adult testis, the stroma contains extracellular matrix components, fibroblasts, infiltrating leucocytes, lymphocytes, macrophages and capillaries, as well as other specific cell populations, like Leydig cells and a thin myoepithelium surrounding the seminiferous tubules constituted by the peritubular cells. All these cells are an important source of proliferation and survival promoting signals, proteolytic enzymes, migratory cues and pro‐angiogenic factors. Ascribable to this pro‐invasive activity, the tumour reactive stroma cells, especially cancer‐associated myofibroblasts, have emerged as a promising target for cancer therapy. This review is focused on the potential role of the peritubular myoid cells in the development of testicular germ cell tumours as the precursors of cancer‐associated myofibroblast and on an experimental model for the study of testis germinal cancer stroma and on the differences between normal and tumour‐associated stromal cells, including the molecular mechanisms that mediate the important cancer stroma crosstalk. Special attention will be paid to the cancer‐associated myofibroblasts as possible therapeutic targets, because they are one of the main components of the reactive stroma and are known to secrete a variety of paracrine factors that stimulate tumour progression.
Impact of classification of mixed germ‐cell tumours on incidence trends of non‐seminoma
Authors: Trabert B. , Stang A. , Cook M. B. , Rusner C. , McGlynn K. A.
Published: May 2011

Seminomas and non‐seminomas [embryonal carcinomas, yolk sac tumours, teratomas, choriocarcinomas, mixed germ‐cell tumours (MGCT)] are the major histological types of testicular germ‐cell tumours (TGCT). TGCTs composed of both seminomatous and non‐seminomatous elements have been coded as their non‐seminoma component in the World Health Organization classification. In the late 1980s, a provisional International Classification of Diseases for Oncology (ICD‐O) morphology code for MGCT was introduced. Using data from the Surveillance, Epidemiology and End Results Program and two population‐based German cancer registries, we examined the impact of MGCT classification on TGCT trends. Cases were identified using ICD‐O topography (ICD‐9: 186; ICD‐10: C62) and morphology codes (seminoma = 9060–9062, 9064; embryonal carcinoma = 9070; yolk sack tumour = 9071; teratoma = 9080–9084, 9102; choriocarcinoma = 9100, 9101; MGCT = 9085; all non‐seminoma = 9065–9102). As MGCTs and teratoma are often grouped as a single histological group, we analysed teratoma both including and excluding MGCTs. Between 1988 and 2007, incidence rates of MGCT in the US increased 407%. Rates of teratoma including MGCT increased 80%, whereas rates of teratoma excluding MGCT decreased 71%. Rates of embryonal carcinoma [−40%] and choriocarcinoma [−22%] also declined, suggesting that the code for MGCT is now being used for any mixed histology. Similar declines in incidence were observed in the German comparison populations. The declines in incidence of teratoma (excluding MGCT), embryonal carcinoma and choriocarcinoma in the US data since 1988 are likely in part because of increases in classifying any TGCT with mixed histology as MGCT. These results suggest that analysis of trends in specific histological types of non‐seminoma should be interpreted cautiously.
The effect of ezetimibe, administered alone or in combination with simvastatin, on lymphocyte cytokine release in patients with elevated cholesterol levels
Authors: Krysiak R. , Zmuda W. , Okopien B.
Published: May 2011

Abstract.  Krysiak R, Zmuda W, Okopien B (Medical University of Silesia, Katowice; and and Electrotherapy and Angiology Centre, Oswiecim, Poland). The effect of ezetimibe, administered alone or in combination with simvastatin, on lymphocyte cytokine release in patients with elevated cholesterol levels. J Intern Med 2012; 271: 32–42.

Objective.  Studies assessing the extra‐lipid effects of ezetimibe have provided contrasting results. In the present study, we compared the effects of ezetimibe and simvastatin, administered alone or in combination, on the secretory function of human lymphocytes, systemic inflammation and endothelial function in subjects with elevated cholesterol levels.

Methods.  A prospective study involving a group of 178 ambulatory patients with isolated hypercholesterolaemia who were randomly assigned in a double‐blind fashion to 90 days of treatment with ezetimibe (10 mg), simvastatin (40 mg), ezetimibe (10 mg) plus simvastatin (40 mg) or placebo. A total of 170 patients completed the study.

Main outcome measures.  Lymphocyte cytokine release and plasma levels of high‐sensitivity C‐reactive protein (hsCRP) and intercellular adhesion molecule 1 (ICAM‐1).

Results.  Although both drugs reduced lymphocyte release of tumour necrosis factor‐α, interferon‐γ and interleukin‐2 in a lipid‐independent manner, only the effect of simvastatin was statistically significant (P < 0.001). This lymphocyte‐suppressing effect, which was accompanied by a decrease in plasma levels of hsCRP and ICAM‐1 (P < 0.001), was strongest in patients receiving both simvastatin and ezetimibe. There were no differences in lymphocyte‐suppressing, systemic anti‐inflammatory and endothelial protective effects of simvastatin between insulin‐resistant and insulin‐sensitive subjects, whereas the effects of ezetimibe and the combined treatment were greater in the former group of patients (P < 0.01 and P < 0.001, respectively).

Conclusions.  The results of this study indicate that simvastatin is superior to ezetimibe in producing lymphocyte‐suppressing, systemic anti‐inflammatory and endothelial protective effects in patients with elevated cholesterol levels. Hypercholesterolaemic patients with high cardiovascular risk may receive the greatest benefits from concomitant treatment with a statin and ezetimibe.
Training mental health promotion workers in programme evaluation
Authors: REUPERT A. , MCHUGH C. , MAYBERY D. , MITCHELL D.
Published: May 2011

Accessible summary

The evaluation of mental health promotion programmes can strengthen the evidence base of such programmes. However, mental health promotion workers often lack the skills and knowledge to conduct programme evaluations.

Evaluation training, consisting of interactive workshops and follow‐up individual mentoring, was offered to mental health promotion workers. The programme was based on adult learning values, mental health promotion principles and guidelines for evaluation training.

The programme was evaluated using a questionnaire, immediately before, after and six months after training, as well as interviews with participants.

Evaluation of the training demonstrated significant knowledge, confidence and behaviour change.

In this paper, a programme to train mental health promotion workers in programme evaluation is described and evaluated. The programme is based on adult learning values, guidelines for programme evaluation training and the general principles of mental health promotion. Facilitated over 2 days, the programme also provided individual mentoring. Training was evaluated via a questionnaire immediately before and post training, and 6 months post training (n = 28, n = 18, n = 18). Additionally, individual interviews were used with seven participants and qualitatively analysed. Results indicate significant and sustained positive changes in knowledge, confidence and behaviour and while satisfaction reduced significantly at the six month follow‐up, participants' level of satisfaction towards mentoring was consistent. Post training, participants reported a greater appreciation of the importance of evaluation planning and working collaboratively.
Irish psychiatric nurses' self‐reported sources of knowledge for practice
Authors: YADAV B. L. , FEALY G. M.
Published: May 2011

Accessible summary

The work of health professionals is generally of a better quality if it is based on reliable knowledge or evidence that comes from good research.

While nurses are frequently recommended to use best available research evidence to guide them in their practice, it seems that many do not heed this recommendation.

A survey was undertaken among Irish psychiatric nurses to find out from them the sources of knowledge or evidence that they use in order to guide their practice.

Psychiatric nurses in Ireland get most of their knowledge from their everyday experiences of nursing patients and from fellow practitioners, but few seem to get knowledge to guide their practice from sources such as published professional and research journals.

Based on these findings, it may be concluded that psychiatric nurses are similar to general nurses in their tendency to not use published information to guide their practice.

Evidence‐based practice (EBP) is an approach to health care in which health professionals use the best evidence available to guide their clinical decisions and practice. Evidence is drawn from a range of sources, including published research, educational content and practical experience. This paper reports the findings of a study that investigated the sources of knowledge or evidence for practice used by psychiatric nurses in Ireland. The paper is part of a larger study, which also investigated barriers, facilitators and level of skills in achieving EBP among Irish psychiatric nurses. Data were collected in a postal survey of a random sample of Irish psychiatric nurses using the Development of Evidence‐Based Practice Questionnaire. The findings revealed that the majority of survey respondents based their practice on information which was derived from interactions with patients, from their personal experience and from information shared by colleagues and members of the multidisciplinary team, in preference to published sources of empirically derived evidence. These findings are consistent with those of the previous similar studies among general nurses and suggest that Irish psychiatric nurses face similar challenges to their general nursing counterparts in attaining of EBP.
Acute mental health nurses: comprehensive practitioners or specialist therapists?
Authors: MATHERS B.
Published: May 2011

Accessible summary

Psychosocial interventions (PSI) is an approach for helping people with mental health problems in addition to medication. It is a way for nurses to work closely with patients to help them with their problems.

Nurses (trainees) who were taught PSI on two modules were interviewed to find out the aids and barriers to using the PSI when they were working with patients on acute (admissions) wards.

Most of the trainees found it difficult to use these new skills because of the pressure of time on acute wards.

This article makes recommendations for more effective implementations of PSI in acute wards in the future.

This paper examines the aids and barriers to implementing the psychosocial interventions (PSI) which trainees learned on two teaching modules. The main purpose of the modules is to teach trainees PSI to help them be more effective in their care of patients with severe mental illness. The trainees were qualified nurses working in acute mental health wards in various London hospitals. PSI has been found to be helpful for patients with psychotic symptoms in community contexts. In this study, the implementation of PSI specific to acute inpatient mental health settings is explored. This was achieved by conducting semi‐structured audiotaped interviews with all 20 trainees from a single cohort. The data were analysed by categories and themes to elicit not only the problems but also helpful strategies which can be used when working with PSI in acute inpatient mental health settings. The paper concludes by offering recommendations for future good practice for this area of mental health service.
Sense of coherence and suicidality in suicide attempters: a prospective study
Authors: SJÖSTRÖM N. , HETTA J. , WAERN M.
Published: May 2011

Accessible summary

The usefulness of the Sense of Coherence (SOC) scale in the nursing setting is well‐established.

The aim of this prospective clinical study was to test whether low SOC predicted future suicidality in suicide attempters.

Low SOC at index attempt was associated with suicidality at 2‐month follow‐up, and associations were independent of major depression and symptom burden.

Low SOC at index attempt was associated with repeat self‐harm during a 3‐year observation period. However, the association did not remain after adjustment for depression and symptom burden.

The SOC may help to identify patients at continued risk for suicidal behaviour.

The usefulness of the Sense of Coherence (SOC) scale in the nursing setting is well‐established, and an association between SOC and suicidality has been suggested. The aim was to test whether low SOC at index attempt is an independent predictor of suicidality at 2‐month follow‐up and of risk for repeat attempt. The study, which had a prospective cross‐sectional design, included patients admitted to hospital after a suicide attempt. They were interviewed by means of Structured Clinical Interview for DSM‐IV. Participants (n= 155) completed the SOC scale and the Comprehensive Psychopathological Self‐rating Scale for Affective Syndromes. Suicidality was rated with the Suicide Assessment Scale. Instruments were employed again at follow‐up. Non‐fatal/fatal repetition within 3 years was determined by review of hospital records. Low SOC at baseline predicted high suicidality at follow‐up. The association remained after adjustment for major depression and affective symptom burden. Repeat attempts were made by 54 persons. Low baseline SOC was associated with repeat attempt, but the association did not remain after adjustment for major depression and symptom burden. Low SOC ratings could be a marker of risk for high suicidality in the aftermath of a suicide attempt. The SOC scale could be incorporated in nursing assessments of suicide attempters.
Ethnicity predicts perceptions of smoking and smoking cessation among veterans
Authors: KARVONEN‐GUTIERREZ C. A. , EWING L. A. , TAYLOR N. J. , ESSENMACHER C. A. , DUFFY S. A.
Published: May 2011

Accessible summary

This study shows that, compared with White smokers, non‐White smokers treated in a primarily psychiatric Veterans Affairs hospital were more motivated to quit smoking, yet less likely to be interested in traditional cessation interventions such as intensive nurse counselling and medications.

Novel strategies such as take‐home cessation materials, Web‐based interventions and peer counselling may be needed to reach non‐White veteran smokers.

These and other strategies will be needed to address the increasing numbers of non‐Whites entering the military, especially returning Operation Enduring Freedom/Operation Iraqi Freedom veterans, many of whom smoke and have co‐morbid post‐traumatic stress disorder and traumatic head injuries making quitting smoking difficult.

The objective of this study was to determine if race/ethnicity predicts motivation to quit smoking and preferences for cessation services among smokers serviced by a primarily psychiatric Veterans Affairs hospital. A self‐administered survey was given to a convenience sample of smokers (n= 146) at the Battle Creek Veterans Affairs Medical Center. Univariate, bivariate and multivariate regression analyses were calculated to determine the association between race/ethnicity and motivation to quit smoking. Forty‐two per cent of the sample was non‐White. Non‐White patients smoked significantly less cigarettes per day as compared with White patients (P= 0.002). In the multivariate analyses, compared with Whites, non‐Whites had 3.5 times greater odds of thinking that quitting smoking was extremely/very important to health (P= 0.01), 4.0 times greater odds of thinking of quitting using tobacco products in the next 30 days (P= 0.004) and 3.4 times greater odds of being interested in receiving smoking cessation services (P= 0.007). Yet, non‐White patients were less likely to be interested in intensive nurse counselling and cessation medications. As the number of non‐Whites continues to increase in the military, novel strategies may be needed to capitalize on the high motivation to quit smoking and preference for non‐traditional interventions among non‐White smokers treated in Veterans Affairs hospitals.