bluuebunny/crossref_metadata_2025 huggingface dataset:
Mai i te Whenua ki te Rangi - Transferring Māori pedagogical practices into cyberspace
Authors: Ferguson Sheryl Lee
Published: December 2012

Abstract

E-Learning has become the norm in many of our tertiary institutes in Aotearoa New Zealand. The digital age is upon us and as agents of change in a Māori tertiary environment, we are constantly having to keep abreast of new and innovative ways of teaching and learning. Te Iti Rearea, Bachelor of Teaching and Learning (0-8) Early Years Māori Medium degree at Te Whare Wānanga ō Awanuiārangi has recently made the move from the conventional face to face model of teaching and learning to the mixed mode model. E-Learning is one of the modes of delivery for this programme. The degree is a Māori medium degree and ako or the Māori preferred reciprocal pedagogy underpins the programme. The transfer of Māori pedagogical practices from the conventional face to face model to the e-Learning environment can seem like a mammoth task, but is it? This paper outlines some of the key indicators for the successful transfer of Māori pedagogical practices from conventional to the e-Learning environment from recent studies and projects completed by the author.
End-of-life care for older rural people: just being there
Authors: Horrell Barbara , Stephens Christine
Published: December 2012

This paper discusses the experience of caring for someone over 65, with a terminal illness, in rural New Zealand. The narratives from seven participants offer some contextual understanding of complex lived realities, potentially informing future rural EoL care and contributing to contemporary goals of positive ageing and dying well. Positioning themselves as carers, rather than as rural people, the participants speak about similar issues, with diverging perspectives reflecting their different carer standpoints. Limited access to 24 hour support and specialist palliative care services, and negotiating complex needs are juxtaposed with the joys and rewards of caring. Ambivalence and conflict permeate the stories, reflecting a particular socio-historical moment as, caught between two paradigms of care, the participants vacillate between desiring the empathic, compassionate care of yesteryear and the benefits of modern medical technology. Overall however, therapeutic relationships unambiguously emerge as the most valued aspect of quality EoL care.
The liminality of palliative care
Authors: McKechnie Roz , Jaye Chrys , MacLeod Rod
Published: December 2012

Introduction:
This paper discusses the application of the anthropological concept of liminality to narratives of New Zealanders living in the community with life threatening conditions, both malignant and non-malignant.
Method:
This qualitative research aimed to explore the ways in which people diagnosed with life-threatening conditions managed their life world. Using a narrative approach, 13 participants, eight spousal caregivers, three adult children, three specialists, one general practitioner and one psychotherapist were interviewed. Analysis was thematic and interpretive within a phenomenological framework.
Conclusion:
Receiving a diagnosis with a poor prognosis heralded significant life changes for patients and their families and precipitated a transition from an identity as a productive member of society and community participant to that of patient living with an uncertain future. Conceptualising end of life care in terms of liminality offers a powerful framework for understanding the experiences and challenges faced by people with life threatening conditions and their families.
Palliative care for newborn infants – the current scene in New Zealand and the way forward
Authors: Kumaran Vazhkudai Sankaran , Bray Yvonne
Published: December 2012

Palliative care is increasingly recognized as an important aspect of neonatal care of medical illness especially with neonatal deaths accounting for half the children dying under five years of age. This article examines the state of palliative care for newborn infants in New Zealand and discusses the issues involved in the organization of a comprehensive neonatal palliative care strategy
Liver transplant recipients’ reflections on organ donors and organ donation: a preliminary analysis
Authors: Wainwright Bethli Vivienne
Published: December 2012

This article discusses preliminary findings from phenomenological research into the lived experience of liver transplant recipients in New Zealand, focusing on their views about the organ donor, the donor family, and organ donation more generally. It examines data collected during two phases of research; phase one, comprising seventeen qualitative interviews with transplant recipients across New Zealand, and phase two, which entailed a qualitative survey sent to 180 potential research participants. A brief background to liver transplantation in New Zealand is provided, followed by an outline of the eligibility criteria used to select participants for this research. The perspectives of liver transplant recipients are then explored through the themes of the donated liver as a gift, gratitude, what information recipients have about their donor families, communication with donor families, and conceptions of liver transplantation as a transformative experience.
Imagining transpecies kinship in xenotransplantation
Authors: Sharp Lesley A.
Published: December 2012

Xenotransplantation, as a highly experimental realm of science, is plagued by serious moral concerns: driven in part by the imperative to alleviate human suffering in a medical realm plagued by a scarcity in human organs, xeno experts must nevertheless quell public concern over the use of animals as ‘donor’ species, and the potential threats xenografting poses to human body integrity. Embedded within the language of xeno science is an intriguing grammar of kinship, one which reorders unsettling ideas of ‘monstrous’ science as a legitimate field intent on establishing interspecies compatibility. As this essay illustrates, a logic of kinship abounds within the realm of organ transfer more generally, yet it takes on special meanings within the rarified world of experimental xenotransplantation, where a range of bodies—be they animal or human—occupy highly vulnerable positions in the scientific search for transpecies integrity.
Xenotransplantation, xenozoonosis and contemporary imaginings of monstrosity
Authors: Murray Mary
Published: December 2012

This paper considers contemporary imaginings about monstrosity surrounding xenotransplantation and zoonosis. The impact of human-to-human organ transplantation on identity is considered, and provides context for consideration of possible effects of animal-to-human transplantation and zoonotic disease on human identity. The paper looks at ways in which fearful imaginings about monstrosity, xenotransplantation and zoonosis have been conjoined with ideas about the animal, feminine and racial other, and have pointed to the possibility of significant social disruption as well as destabilisation of body and self. The conclusion to the paper includes consideration of some of the implications of such monstrous imaginings for tissue transfer.
Modelling cultural, national and innovation identities in order to understand New Zealand's modest innovation performance
Authors: Rinne Tiffany , Fairweather John
Published: December 2012

In a world that has moved swiftly to global trade, innovation rates have become one of the tools by which nations achieve success in the world. New Zealand is a middling international performer with regards to innovation. Utilizing discourse analysis and cultural consensus analysis we built models of New Zealand culture, national identity and innovation identity in order to gain insights into cultural and identity attributes that help and hinder New Zealand’s level of innovation. Results show that while inventiveness is an important cultural trait, a trait based in New Zealand’s history as a pioneering nation, there are other cultural factors such as a ‘make do’ attitude, the tall poppy syndrome, and an emphasis on lifestyle which potentially limit the innovation performance of New Zealand.
Collective person, connected gift: some preliminary thoughts on taonga, whakapapa, and ‘the gift’ in Maori art.
Authors: O'Byrne Ryan
Published: December 2012

In this paper I use interviews with one Maori artist to provide some preliminary thoughts on the ways Maori art can be used to understand Maori personhood. Art work is defined as taonga-whakairo and artistic talent as taonga-tuku-iho. Maori conceive both artistic talent and production as taonga and I argue that the relationships between art, taonga, whakapapa and tipuna encompass networks of connections between persons, objects, and ideas simultaneously. I suggest a structural linkage between art, taonga, and exchange which form distributed social relationships. Underlying this is the proposition that artistic comes from the ancestors and involves particular responsibilities. Major points of argument are that: in Maori art, taonga and whakapapa interact to allow the possibility of things being persons and persons being things; taonga are fundamental to the Maori concepts of tipuna and whakapapa; taonga and Maussian exchange relations are co-constituting; art-as-taonga is a productive means of understanding a Maori worldview; and that study should be conducted into Gell’s (1998) ‘distributed person’ through taonga and Maori art.
Maori business news in the mass media
Authors: McCreanor Tim
Published: December 2012

Despite numerous historical and contemporary demonstrations of their business acumen, hegemonic discourses represent Maori as dishonest, lazy, incompetent and unfairly privileged in this domain. We studied the items about Maori business in a large representative national sample of newspaper coverage gathered in 2007/8 using content, thematic and discursive analyses. From these data we conclude that mass media newspapers in Aotearoa reproduce hegemonic views through very low levels of coverage and frequent recourse to Pakeha expectations about Maori business. The overall effect is to minimise, marginalise and denigrate important Maori contributions to this vital arena of national life.
Good care and capabilities theory: the development of a relational framework for carers and adults with severe disability
Authors: Butler Mary
Published: December 2012

In this paper the capability approach is used to describe the work of family carers of adults with severe disability. This approach provides a framework for equality that takes dependence into account. The philosopher Amartya Sen presses for the necessity to have public discourse in arriving at specific capability frameworks that will meet particular needs. In this paper a capability framework is proposed that might fit the situation of carers. It draws particularly on the work of philosopher Hannah Arendt in “The Human Condition”, and the work of Sarah Ruddich in her classic ethnography “Maternal thinking”. A relational perspective is developed using literary ethnography. The development of this list has the potential to enhance public debate about the use of the capabilities approach with carers and adults with severe disability.
Whakapapa in anthropological research on tuberculosis in the Pacific
Authors: Park Julie , Littleton Judith
Published: December 2012

As a theory of knowledge encompassing ecological and cosmological frameworks, Maori whakapapa of non-human species bring a diverse array of emergent entities into kinship relations over time and space. Whakapapa narratives explain the coming into being of those relationships and their moral foundations in utu (reciprocity). In this paper, the authors demonstrate that the ‘mind map’ (Roberts 2010) of whakapapa can provide a coordinating framework for social theories of complexity used in medical anthropology. A whakapapa approach also responds effectively to the challenge posed by Gillett (2009:98): ‘How exactly should we position indigenous knowledges in a discussion of policy in post-colonial society? We conclude that the principle of utu provides both a workable local social theory and a moral framework that can be used to assess policies which shape peoples’ lives, in this case, the lives of Tuvaluans who are contending with tuberculosis in our shared transnational space.
The legacy of an intervention: Exploring teenage walking school bus ‘graduates’ mobilities in Auckland.
Authors: Kearns Robin , Boyle Alexandra , Ergler Christina R.
Published: December 2012

This paper explores the mobility experiences of 20 young people in three Auckland neighbourhoods who had, as primary school children, participated in walking school buses (WSB). This intervention engages children in routine chaperoned walking to and from school. Our contention was that this experience would leave a ‘traces’ of enthusiasm for walking as an everyday form of active travel in an environment in which driving is the aspirational norm. An analysis of narrative evidence revealed a range of themes indicating that, for these adolescents, walking is a multi-facetted practise that allows independence and sociability as well as access to friends and amenities. An openness to, if not advocacy of, walking on the part of teenagers appears to be a positive downstream benefit of WSB programmes. This disposition on the part of ‘graduates’ suggests they become informal advocates for more sustainable urban mobilities through a legacy of WSB participation.
The problems and possibilities of mobility for home-based elders in New Zealand
Authors: Mansvelt Juliana Ruth
Published: December 2012

Physical immobility can be a means of social and spatial exclusion. Qualitative interviews with 19 home-based elders aged 65-96 about their interactions with a range of public and private service providers show that concepts of mobility are not dependent on the physical ability to move, but centre on the ways in which people are able to, as part of socio-technical networks, connect with others and make things flow both within and across the boundaries of home. In highlighting three themes (getting out, letting in and finding a way) we suggest that home-based elders are not inactive or immobile, rather their mobile practices centre on connection rather than corporeal travel. A relational view of mobility as ‘connection’ which is ‘more than human’ consequently enables us to understand the problems and possibilities of being differently mobile and the practical implications of this.
The mobilities, immobilities and moorings of work-life on cargo ships
Authors: Borovnik Maria
Published: December 2012

Despite the rather obvious mobilities of cargo ships there are not so obvious immobilities. Both are negotiated through global economic processes, the (ir)regular and repetitive processes of ships crisscrossing international waters and encountering ports of differing nation states, and the agency of people involved in these processes. This paper argues that so called fixities within a mobilities approach do not only enable mobile processes, as assumed widely within mobilities research, but that mobilities also can become immobilising. The circumstances of these immobilising dynamics are linked with neoliberal processes within the shipping industry, the need for increased border security, and the need for workers from developing countries to compromise their employment conditions. In contrast to these paralysing factors this paper also discusses the enabling and anchoring mooring processes by linking these to a positive view on social construction of place.
Mobilities Research in the Southern Hemisphere
Authors: Perkins Anita Jean
Published: December 2012

Is there something distinctive about mobilities research being carried out in the Southern Hemisphere? This question arose in the course of a conversation I had with Professor Gordon Pirie over lunch at the Berlin Transport Museum, during the inaugural T2M Summer School held in September 2011.
Mobilities and the Asian Migrations Research Theme
Authors: Clery Tui Nicola
Published: December 2012

N/A
Evaluation of material heterogeneity dosimetric effects using radiochromic film for COMS eye plaques loaded with 125I seeds (model I25.S16)
Authors: Acar Hilal , Chiu‐Tsao Sou‐Tung , Özbay İsmail , Kemikler Gönül , Tuncer Samuray
Published: December 2012

Purpose:

(1) To measure absolute dose distributions in eye phantom for COMS eye plaques with125I seeds (model I25.S16) using radiochromic EBT film dosimetry. (2) To determine the dose correction function for calculations involving the TG‐43 formalism to account for the presence of the COMS eye plaque using Monte Carlo (MC) method specific to this seed model. (3) To test the heterogeneous dose calculation accuracy of the new version of Plaque Simulator (v5.3.9) against the EBT film data for this seed model.

Methods:

Using EBT film, absolute doses were measured for125I seeds (model I25.S16) in COMS eye plaques (1) along the plaque's central axis for (a) uniformly loaded plaques (14–20 mm in diameter) and (b) a 20 mm plaque with single seed, and (2) in off‐axis direction at depths of 5 and 12 mm for all four plaque sizes. The EBT film calibration was performed at 125I photon energy. MC calculations using MCNP5 code for a single seed at the center of a 20 mm plaque in homogeneous water and polystyrene medium were performed. The heterogeneity dose correction function was determined from the MC calculations. These function values at various depths were entered into PS software (v5.3.9) to calculate the heterogeneous dose distributions for the uniformly loaded plaques (of all four sizes). The dose distributions with homogeneous water assumptions were also calculated using PS for comparison. The EBT film measured absolute dose rate values (film) were compared with those calculated using PS with homogeneous assumption (PS Homo) and heterogeneity correction (PS Hetero). The values of dose ratio (film/PS Homo) and (film/PS Hetero) were obtained.

Results:

The central axis depth dose rate values for a single seed in 20 mm plaque measured using EBT film and calculated with MCNP5 code (both in ploystyrene phantom) were compared, and agreement within 9% was found. The dose ratio (film/PS Homo) values were substantially lower than unity (mostly between 0.8 and 0.9) for all four plaque sizes, indicating dose reduction by COMS plaque compared with homogeneous assumption. The dose ratio (film/PS Hetero) values were close to unity, indicating the PS Hetero calculations agree with those from the film study.

Conclusions:

Substantial heterogeneity effect on the125I dose distributions in an eye phantom for COMS plaques was verified using radiochromic EBT film dosimetry. The calculated doses for uniformly loaded plaques using PS with heterogeneity correction option enabled were corroborated by the EBT film measurement data. Radiochromic EBT film dosimetry is feasible in measuring absolute dose distributions in eye phantom for COMS eye plaques loaded with single or multiple 125I seeds. Plaque Simulator is a viable tool for the calculation of dose distributions if one understands its limitations and uses the proper heterogeneity correction feature.
A Stringent Limit on a Drifting Proton-to-Electron Mass Ratio from Alcohol in the Early Universe
Authors: Bagdonaite Julija , Jansen Paul , Henkel Christian , Bethlem Hendrick L. , Menten Karl M. , Ubachs Wim
Published: December 2012

Varying Constant?

Searches for time-varying fundamental constants provide a means to look beyond the standard model of particle physics.

Bagdonaite
et al.

(p.
46
, published online 13 December) set an improved limit on the possible timevariation of the proton-to-electron mass ratio by comparing the frequencies of methanol transitions observed in a galaxy at a look-back time of 7 billion years with those measured in the laboratory. The values agree within 10
−7
, consistent with no variation over cosmic time.
Second-Generation Cobas AmpliPrep/Cobas TaqMan HCV Quantitative Test for Viral Load Monitoring: a Novel Dual-Probe Assay Design
Authors: Zitzer Heike , Heilek Gabrielle , Truchon Karine , Susser Simone , Vermehren Johannes , Sizmann Dorothea , Cobb Bryan , Sarrazin Christoph
Published: December 2012

Hepatitis C virus (HCV) RNA viral load (VL) monitoring is a well-established diagnostic tool for the management of chronic hepatitis C patients. HCV RNA VL results are used to make treatment decisions with the goal of therapy to achieve an undetectable VL result. Therefore, a sensitive assay with high specificity in detecting and accurately quantifying HCV RNA across genotypes is critical. Additionally, a lower sample volume requirement is desirable for the laboratory and the patient. This study evaluated the performance characteristics of a second-generation real-time PCR assay, the Cobas AmpliPrep/Cobas TaqMan HCV quantitative test, version 2.0 (CAP/CTM HCV test, v2.0), designed with a novel dual-probe approach and an optimized automated extraction and amplification procedure. The new assay demonstrated a limit of detection and lower limit of quantification of 15 IU/ml across all HCV genotypes and was linear from 15 to 100,000,000 IU/ml with high accuracy (<0.2-log
10
difference) and precision (standard deviation of 0.04 to 0.22 log
10
). A specificity of 100% was demonstrated with 600 HCV-seronegative specimens without cross-reactivity or interference. Correlation to the Cobas AmpliPrep/Cobas TaqMan HCV test (version 1) was good (
n
= 412 genotype 1 to 6 samples,
R
2
= 0.88;
R
2
= 0.94 without 105 genotype 4 samples). Paired plasma and serum samples showed similar performance (
n
= 25,
R
2
= 0.99). The sample input volume was reduced from 1 to 0.65 ml in the second version. The CAP/CTM HCV test, v2.0, demonstrated excellent performance and sensitivity across all HCV genotypes with a smaller sample volume. The new HCV RNA VL assay has performance characteristics that make it suitable for use with currently available direct-acting antiviral agents.
HIV-1 Genetic Diversity and Drug Resistance among Senegalese Patients in the Public Health System
Authors: Thiam Moussa , Diop-Ndiaye Halimatou , Diouf Aminata Diaw , Vidal Nicole , Ndiaye Ousseynou , Ndiaye Ibrahima , Ngom-Gueye Ndeye Fatou , Diallo Sada , Diongue Oumy Diop , Camara Makhtar , Seck Abdoulaye , Mboup Souleymane , Toure-Kane Coumba
Published: December 2012

In this study, we investigated the prevalence of human immunodeficiency virus type 1 (HIV-1) drug resistance mutations and genetic variability among Senegalese patients undergoing highly active antiretroviral therapy (ART) in the public health system. We conducted a cross-sectional study of 72 patients with suspected therapeutic failure. HIV-1 genotyping was performed with Viroseq HIV-1 Genotyping System v2.0 or the procedure developed by the ANRS AC11 resistance study group, and a phylogenetic analysis was performed. The median follow-up visit was at 40 (range, 12 to 123) months, and the median viral load was 4.67 (range, 3.13 to 6.94) log10copies/ml. The first-line therapeutic regimen was nucleoside reverse transcriptase inhibitors (NRTIs) plus efavirenz (EFV) or NRTIs plus nevirapine (NVP) (54/72 patients; 75%), and the second-line therapy was NRTIs plus a protease inhibitor (PI/r) (18/72; 25%). Fifty-five patients (55/72; 76.39%) had at least one drug resistance mutation. The drug resistance rates were 72.22 and 88.89% for the first-line and second-line ARTs, respectively. In NRTI mutations, thymidine analog mutations (TAMs) were found in 50.79% and the M184V mutation was found in 34.92% of the samples. For non-NRTI resistance, we noted a predominance of the K103N mutation (46.27%). For PI/r, several cases of mutations were found with a predominance of M46I and L76V/F at 24% each. The phylogenetic analysis revealed CRF02_AG as the predominant circulating recombinant form (43/72; 59.72%). We found a high prevalence of resistance mutations and a high rate of TAMs among Senegalese patients in the public health system. These findings emphasize the need to improve virological monitoring in resource-limited settings.
Rasamsonia argillacea Pulmonary and Aortic Graft Infection in an Immune-Competent Patient
Authors: Doyon Jeffrey B. , Sutton Deanna A. , Theodore Pierre , Dhillon Gurmohan , Jones Kirk D. , Thompson Elizabeth H. , Fu Jianmin , Wickes Brian L. , Koehler Jane E. , Schwartz Brian S.
Published: December 2012

Rasamsonia argillacea
(formerly known as
Geosmithia argillacea
) is a fungus recently recognized as a pathogen of immunocompromised patients. Here we report the first case of
Rasamsonia
infection in an immunocompetent host, presenting as a pulmonary and aortic graft infection. Its morphological similarity to nonpathogenic
Penicillium
species delayed the diagnosis and initiation of appropriate treatment.
Screening for carbon monoxide exposure in selected patient groups attending rural and urban emergency departments in England: a prospective observational study
Authors: Clarke Simon , Keshishian Catherine , Murray Virginia , Kafatos George , Ruggles Ruth , Coultrip Elizabeth , Oetterli Sam , Earle Daniel , Ward Patricia , Bush Stephen , Porter Crispin ,   for the Carbon Monoxide in Emergency Departments (COED) Working Group
Published: December 2012

Objectives

Carbon monoxide (CO) exposure does not produce a classical toxidrome and so it is thought that it may easily be missed, allowing patients to continue to be exposed to CO. The aim of this study was to determine the proportion of raised carboxyhaemoglobin (COHb) levels in a targeted population of patients presenting to four emergency departments (EDs) in England.

Design

A prospective observational study undertaken over a 9-month period.

Setting

Four EDs; one in a rural/suburban area and three serving urban populations.

Participants

1758 patients presenting to the EDs with chest pain, exacerbation of chronic obstructive pulmonary disease (COPD), non-traumatic headache, seizures or flu-like symptoms.

Main outcome

Measures COHb levels measured using a pulse CO-oximeter or venous sample. Patients with COHb levels ≥2.5% (non-smokers) or ≥5% (smokers) completed a questionnaire assessing potential sources. Patients were defined to be positive for CO exposure if they had a positive COHb and either an identified source or no other reason for their raised level.

Results

Proportion of positive patients was: overall—4.3%; COPD—7.5%; headache—6.3%; flu-like—4.3%; chest pain—3.3%; seizures—2.1%. A variety of gas and solid (predominantly charcoal) fossil fuel sources were identified.

Conclusions

This study showed that 4.3% of patients presenting to EDs with non-specific symptoms had unexpectedly raised COHb levels 1.4% of patients had a source of CO identified. Study limitations included non-consecutive recruitment, delays in COHb measurements and a lack of ambient CO measurements, which precludes precise determination of incidence. However, this study should alert clinicians to consider CO exposure in patients presenting with non-specific symptoms, in particular headache and exacerbation of COPD, and if necessary refer patients for suitable public-health follow-up, even in the presence of low COHb readings. Further research should include standardised scene assessments.
Workplace bullying and subsequent psychotropic medication: a cohort study with register linkages
Authors: Lallukka Tea , Haukka Jari , Partonen Timo , Rahkonen Ossi , Lahelma Eero
Published: December 2012

Objectives

We aimed to examine longitudinally whether workplace bullying was associated with subsequent psychotropic medication among women and men.

Design

A cohort study.

Setting

Helsinki, Finland.

Participants

Employees of the City of Helsinki, Finland (n=6606, 80% women), 40–60 years at baseline in 2000–2002, and a register-based follow-up on medication.

Primary and secondary outcome measures

Workplace bullying comprised questions about current and earlier bullying as well as observing bullying. The Finnish Social Insurance Institution's register data on purchases of prescribed reimbursed psychotropic medication were linked with the survey data. All psychotropic medication 3 years prior to and 5 years after the baseline survey was included. Covariates included age, prior psychotropic medication, childhood bullying, occupational class, and body mass index. Cox proportional hazard models (HR, 95% CI) were fitted and days until the first purchase of prescribed psychotropic medication after baseline were used as the time axis.

Results

Workplace bullying was associated with subsequent psychotropic medication after adjusting for age and prior medication among both women (HR 1.51, 95% CI 1.18 to 1.93) and men (HR 2.15, 95% CI 1.36 to 3.41). Also observing bullying was associated with subsequent psychotropic medication among women (HR 1.53, 95% CI 1.25 to 1.88) and men (HR 1.92, 95% CI 1.23 to 2.99). The associations only modestly attenuated after full adjustment.

Conclusions

Our findings highlight the significance of workplace bullying to subsequent psychotropic medication reflecting medically confirmed mental problems. Tackling workplace bullying likely helps prevent mental problems among employees.
Vitamin D3supplementation in patients with frequent respiratory tract infections: a randomised and double-blind intervention study
Authors: Bergman Peter , Norlin Anna-Carin , Hansen Susanne , Rekha Rokeya Sultana , Agerberth Birgitta , Björkhem-Bergman Linda , Ekström Lena , Lindh Jonatan D , Andersson Jan
Published: December 2012

Background

Low serum levels of 25-hydroxyvitamin D3are associated with an increased risk of respiratory tract infections (RTIs). Clinical trials with vitamin D3against various infections have been carried out but data are so far not conclusive. Thus, there is a need for additional randomised controlled trials of effects of vitamin D3on infections.

Objective

To investigate if supplementation with vitamin D3could reduce infectious symptoms and antibiotic consumption among patients with antibody deficiency or frequent RTIs.

Design

A double-blind randomised controlled trial.

Setting

Karolinska University Hospital, Huddinge.

Participants

140 patients with antibody deficiency (selective IgA subclass deficiency, IgG subclass deficiency, common variable immune disorder) and patients with increased susceptibility to RTIs (>4 bacterial RTIs/year) but without immunological diagnosis.

Intervention

Vitamin D3(4000 IU) or placebo was given daily for 1 year.

Primary and secondary outcome measures

The primary endpoint was an infectious score based on five parameters: symptoms from respiratory tract, ears and sinuses, malaise and antibiotic consumption. Secondary endpoints were serum levels of 25-hydroxyvitamin D3, microbiological findings and levels of antimicrobial peptides (LL-37, HNP1–3) in nasal fluid.

Results

The overall infectious score was significantly reduced for patients allocated to the vitamin D group (202 points) compared with the placebo group (249 points; adjusted relative score 0.771, 95% CI 0.604 to 0.985, p=0.04).

Limitations

A single study centre, small sample size and a selected group of patients. The sample size calculation was performed using p=0.02 as the significance level whereas the primary and secondary endpoints were analysed using the conventional p=0.05 as the significance level.

Conclusions

Supplementation with vitamin D3may reduce disease burden in patients with frequent RTIs.
Assessing Preventable Hospitalisation InDicators (APHID): protocol for a data-linkage study using cohort study and administrative data
Authors: Jorm Louisa R , Leyland Alastair H , Blyth Fiona M , Elliott Robert F , Douglas Kirsty M A , Redman Sally ,   on behalf of the APHID Investigators
Published: December 2012

Introduction

Potentially preventable hospitalisation (PPH) has been adopted widely by international health systems as an indicator of the accessibility and overall effectiveness of primary care. The Assessing Preventable Hospitalisation InDicators (APHID) study will validate PPH as a measure of health system performance in Australia and Scotland. APHID will be the first large-scale study internationally to explore longitudinal relationships between primary care and PPH using detailed person-level information about health risk factors, health status and health service use.

Methods and analysis

APHID will create a new longitudinal data resource by linking together data from a large-scale cohort study (the 45 and Up Study) and prospective administrative data relating to use of general practitioner (GP) services, dispensing of pharmaceuticals, emergency department presentations, hospital admissions and deaths. We will use these linked person-level data to explore relationships between frequency, volume, nature and costs of primary care services, hospital admissions for PPH diagnoses, and health outcomes, and factors that confound and mediate these relationships. Using multilevel modelling techniques, we will quantify the contributions of person-level, geographic-level and service-level factors to variation in PPH rates, including socioeconomic status, country of birth, geographic remoteness, physical and mental health status, availability of GP and other services, and hospital characteristics.

Ethics and dissemination

Participants have consented to use of their questionnaire data and to data linkage. Ethical approval has been obtained for the study. Dissemination mechanisms include engagement of policy stakeholders through a reference group and policy forum, and production of summary reports for policy audiences in parallel with the scientific papers from the study.
Protocol for the Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS) study: a cluster randomised controlled trial using ePrescribing data
Authors: Guthrie Bruce , Treweek Shaun , Petrie Dennis , Barnett Karen , Ritchie Lewis D , Robertson Chris , Bennie Marion
Published: December 2012

Introduction

High-risk prescribing in primary care is common and causes considerable harm. Feedback interventions to improve care are attractive because they are relatively cheap to widely implement. There is good evidence that feedback has small to moderate effects, but the most recent Cochrane review called for more high-quality, large trials that explicitly test different forms of feedback.

Methods and analysis

The study is a three-arm cluster-randomised trial with general practices being randomised and outcomes measured at patient level. 262 practices in three Scottish Health Board areas have been randomised (94% of all possible practices). The two active arms receive different forms of prescribing safety data feedback, with rates of high-risk prescribing compared with a ‘usual care’ arm. Sample size estimation used baseline data from participating practices. With 85 practices randomised to each arm, then there is 93% power to detect a 25% difference in the percentage of high-risk prescribing (from 6.1% to 4.5%) between the usual care arm and each intervention arm. The primary outcome is a composite of six high-risk prescribing measures (antipsychotic prescribing to people aged ≥75 years; non-steroidal anti-inflammatory drug (NSAID) prescribing to people aged ≥75 without gastroprotection; NSAID prescribing to people prescribed aspirin/clopidogrel without gastroprotection; NSAID prescribing to people prescribed an ACE inhibitor/angiotensin receptor blockeranda diuretic; NSAID prescription to people prescribed an oral anticoagulant without gastroprotection; aspirin/clopidogrel prescription to people prescribed an oral anticoagulant without gastroprotection). The primary analysis will use multilevel modelling to account for repeated measurement of outcomes in patients clustered within practices.

Ethics and dissemination

The study was reviewed and approved by the NHS Tayside Committee on Medical Research Ethics B (11/ES/0001). The study will be disseminated via a final report to the funder with a publicly available research summary, and peer reviewed publications.

Trial registration

ClinicalTrials.gov, dossier numberNCT01602705.
Atmospheric degradation of 2,3,7,8-tetrachlorinated dibenzo-p-dioxins in the presence of NO3 at night
Authors: Zhao Yuyang , Sun Xiaomin , Bai Jing , Zhang Chenxi , Zhang Jianghua
Published: December 2012

The density functional theory (DFT) has been applied to studies on the homogeneous gas-phase degradation of 2,3,7,8-tetrachlorinated dibenzo-p-dioxins (2,3,7,8-TeCDD) initiated by the NO3 radical, which is an important atmospheric species at night. The geometrical parameters and vibrational frequencies of all the stationary points were calculated at the MPWB1K/6-31+G (d,p) level. Potential energies were calculated at the MPWB1K/6-311+G (3df,2p) level. Three sites on 2,3,7,8-TeCDD react with the NO3 radical with different barriers and reaction heats. The addition of NO3 to the carbon atom on the central C–O ring is the most appropriate pathway and with the lower barriers, and the central ring of polychlorinated dibenzo-p-dioxin is opened in the subsequent reactions. Some other pathways are stressed for the dechlorination mechanism. Canonical variational transition-state theory with small curvature tunneling contribution was used to calculate the rate constants of each elementary reaction over the temperature range of 200–400 K. The Arrhenius equations were fitted to show the relationship between rate constants and temperature.
Persistence of a southern Atlantic salmon population: diversity of natal origins from otolith elemental and Sr isotopic signatures
Authors: Martin Jean , Bareille Gilles , Berail Sylvain , Pécheyran Christophe , Gueraud François , Lange Frédéric , Daverat Françoise , Bru Noëlle , Beall Eddy , Barracou David , Donard Olivier
Published: December 2012

We investigated the use of Sr:Ca, Ba:Ca, and87Sr:86Sr ratios as natural tags for determining the natal origins of juvenile and adult Atlantic salmon (Salmo salar) from 12 tributaries in the Adour basin (southwestern France) and estimated homing on a tributary scale. Geochemical signatures from core regions of the otolith were also used to identify fish from hatchery or naturally spawned sources. Quadratic discriminant function analysis (QDFA) was on average 80% successful at classifying juveniles according to their natal rivers. Adults of unknown natal origin were assigned to their natal rivers using the juvenile fingerprints from QDFA approach. Only 18 adults originated from streams not included in the juvenile database. Although most of the adults showed a marked homing instinct, homing was not perfect, and some wild fish strayed into non-natal spawning areas. Returns of hatchery-reared fish as adult spawners represented 10% of the total sampled fish. Allocation of fish to natal tributaries or hatcheries illustrated the abundance and relative contributions of natal sources, important for the recovery of Atlantic salmon in this area.
Canadian meteorites: a brief review
Authors: Wilson Graham C. , McCausland Phil J.A.
Published: December 2012

We present a brief overview of Canadian meteorites with a focus on noting significant recent falls, finds, and research developments. To date, 60 Canadian meteorites have received official international recognition from the Nomenclature Committee of the Meteoritical Society, while at least 13 more are “in process” for submission to the Meteoritical Bulletin, that organization’s official database of the world’s meteorites. The 60 meteorites (44 finds and 16 falls since the recognition of the Madoc iron in 1854) include 25 irons, 3 pallasite stony-irons, and 32 stony meteorites. The latter include 14, 11 and 3 H, L and LL chondrites, 2 carbonaceous chondrites and 2 enstatite chondrites, but no achondrites. The most intensively researched meteorites are Tagish Lake (C2 ungrouped) and Abee (EH5), followed by Bruderheim (L6) and Springwater (pallasite). Bruderheim, a 1960 fall, is widely distributed, being the most massive reported Canadian meteorite at 303 kg total known weight (TKW). Seven Canadian meteorites exceed 100 kg TKW, 36 are between 1 and 50 kg, and 17 are <1 kg. Recent years have seen the addition of the Tagish Lake, Buzzard Coulee and Grimsby meteorite falls, all of which have well-determined fireball trajectories and therefore well-known orbits, a striking Canadian addition to the handful that are known worldwide. The discovery of the Holocene Whitecourt iron impact crater is similarly a significant recent development in understanding the impactor flux. The lessons learned on meteorites can be applied to newly recovered samples from the Moon, Mars, asteroids, and comets.
Magnesium, Zinc, and Chromium Nutrition and Athletic Performance
Authors: Lukaski Henry C.
Published: December 2012

Magnesium, zinc and chromium are mineral elements required in modest amounts for health and optimal performance. Accumulating evidence supports the hypothesis that magnesium and zinc play significant roles in promoting strength and cardiorespiratory function in healthy persons and athletes. Differences in study designs, however, limit conclusions about recommendations for intakes of magnesium and zinc needed for optimal performance and function. The role of chromium in supporting performance is not well established. There is a compelling need to confirm and extend findings of beneficial effects of magnesium and zinc function and performance of humans. Suggestions for an experimental model and specific topics for research to advance knowledge of mineral nutrition to promote attainment of genetic potential for optimal performance are provided.
Do We Have Unrealistic Expectations of the Potential of Immuno-Nutrition?
Authors: Cynober Luc A.
Published: December 2012

Heavy sports training schedules and competition is often associated with immuno-suppression, and so there is a theoretical justification for providing athletes with nutrients that display immuno-regulatory properties. Among such immuno-nutrients, considerable attention has been paid in recent years to two amino acids, arginine (ARG) and glutamine (GLN). ARG and GLN availability regulate the function ofT lymphocytes, macro phages and polymorphonuclear cells. ARG acts through nitric oxide and polyamine synthesis. The mechanism of action of GLN in immune cells remains unclear. Experience in clinical nutrition suggests that an ARG-enriched diet may limit infectious morbidity in critically ill patients. Data concerning oral/enteral GLN supplementation are more controversial. There have been few trials of supplementation in sports medicine, but results are promising, justifying further studies in which dosages and administration schedules should be taken into account.
Diet and Training in the Week Before Competition
Authors: Kiens Bente
Published: December 2012

For many years athletes have used carbohydrate loading to enhance endurance performance. This practice has been based on findings demonstrating that 1) exercise induced depletion of the muscle glycogen stores followed by the intake of a carbohydrate rich diet, resulted in muscle glycogen stores above normal values and 2) that the pre-exercise muscle glycogen content was the main determinant of the capacity to perform strenuous exercise to exhaustion. Lately it has been speculated whether a period of a high fat diet, followed by carbohydrate loading to restore or increase muscle glycogen levels above normal, would be of further advantage for exercise performance. From the discussed data it emerges, however, that varying periods offat adaptation followed by a carbohydrate rich diet prior to exercise is of no benefit for exercise performance. Despite an increased fat oxidation and a concomitant decrease in carbohydrate oxidation during submaximal exercise, no benefit in a subsequent time trial appeared. Data suggest that this dietary regimen impairs the ability to utilise carbohydrates.
Caffeine, Coffee and Ephedrine: Impact on Exercise Performance and Metabolism
Authors: Graham Terry E.
Published: December 2012

This paper addresses areas where there is controversy regarding caffeine as an ergogenic aid and also identifies topics that have not been adequately addressed. It is clear that caffeine, in moderate amounts, can be used orally as an ergogenic aid in aerobic activity lasting for more than 1 min. It increases endurance and speed, but not maximal [Formula: see text] and related parameters. While there are fewer well-controlled studies for resistance exercise, the literature would suggest similar improvements: increased endurance at submaximal tension and power generated in repeated contractions and no change in maximal ability to produce force. It is likely that theophylline (a related methylxanthine) has similar actions and it has been suggested that the combination of caffeine and sympathomimetics may be a more potent erogenic aid. The voids in our understanding of caffeine include the dose (what amount is optimal, what vehicle is used to deliver the drug as well as method, pattern, and mode of administration), the potential side effects (particularly in competitive settings), health implications (insulin resistance and if combined with ephedrine, cardiovascular risks) and mechanisms of action. It appears unlikely that increased fat oxidation and glycogen sparing is the prime ergogenic mechanism.
Sport Nutritional Supplements: Quality and Doping Controls
Authors: Ayotte Christiane , Lévesque Jean-François , Cléroux Marilyn , Lajeunesse André , Goudreault Danielle , Fakirian Anahid
Published: December 2012

Nutritional supplements are part of the diet of many athletes. With the exception of caffeine and ephedrine alkaloids, most of these products do not contain substances that are prohibted to competing sportsmen. In recent years, androgens, pro-hormones such as DHEA, androstenedione, androstenediol and 19-norsteroids became available for oral self-administration in many countries and on the Internet. Their claimed actions, efficiency or potency, and the possible adverse effects have not been thoroughly investigated by controlled clinical studies. Some products were shown to contain prohibited substances such as ephedrine, caffeine, or steroids, that were not listed on the label. Urine samples collected after the administration of these supplements can test positive. The administration of natural steroids such as testosterone and its precursors cannot be proven by the sole identification of the substances in the urine. The approach to detection is based upon the deviation of selected parameters of the metabolic profiles from the range of values normally found in humans. The individual ‘s norm is also studied to exclude the few cases of systematic and natural excretion of extreme values. The combination of the GC/MS and the GC/C/IRMS offers a powerful tool to discriminate between the natural and synthetic origin of the urinary steroids.
Protein and Amino Acid Requirements of Adults: Current Controversies
Authors: Millward D. Joe
Published: December 2012

Protein intakes vary widely but costs and benefits of such variation is a long standing unresolved issue. The wide range of reported values for the minimum protein intakefor N equilibrium in adults, i.e. 0.39 to 1. 09 g/kg is best explained by an Adaptive Metabolic Demands model in which metabolic demands include amino acid oxidation at a rate varying with habitual protein intake and which changes slowly with dietary change. Thus within the reported data the true minimum requirement intake, the lowest values in the range at intakes approaching the Obligatory Nitrogen Loss, allows onlyfully adaptedsubjects to achieve N equilibrium. The higher values reflect incomplete adaptation. 13C-1 leucine tracer balance studies of this model show (a) a fall with age in apparent protein requirements, (b) better than predicted efficiency of wheat protein utilization, and (c) controversially, lower lysine requirements than other workers, consistent with new evidence ofde novo synthesis of lysine from urea salvaged by large bowel microflora. The main implication of the requirements model for athletes on high protein diets is increased exercise induced amino acid oxidation and risk of loss ofbody N when such high intakes are not maintained.