bluuebunny/crossref_metadata_2025 huggingface dataset:
Review management for children with asthma in primary care: a qualitative case study
Authors: Lyte Geraldine , Milnes Linda , Keating Peggy , Finke Arthur
Published: June 2007

Aims of the study.  To present an overview of review management of childhood asthma in one UK primary care trust with respect to organization and perceptions of key stakeholders and children's and families’ needs.

Background.  Review management of childhood asthma in primary care is important in addressing the continuing high levels of morbidity. However, the delivery of this service appears to be fragmented, so it is not known how well primary care asthma clinics function. Children's, parents’ and professionals’ perceptions of such clinics and the roles they play within them are also poorly understood.

Research design.  A qualitative case study design was used in the study. This is a form of enquiry that investigates contemporary issues within their real life contexts, using particular situations within the case to describe important phenomena.

Methods.  Eighteen children, 16 parents, 14 practice purses and 14 general practitioners from 14 general practices in one primary care trust were interviewed. Review appointments were observed and asthma‐related documentation examined.

Findings.  Key findings point to diversity in the service and that key stakeholders’ view practice nurses as primarily responsible for the review management. However, there are issues related to their levels of responsibility, other health professionals’ roles and interdisciplinary communication. Finally, families felt some of their needs were neglected and professionals reported uncertainties in providing family‐centred care.

Conclusions.  This case study indicates that responsibility for review consultations in childhood asthma needs to be formalized, including a more proactive and family‐centred approach. There are implications for the practice nurse role regarding professional education and preparation for family‐centred care.

Relevance to clinical practice.  This paper shows that unstructured, diverse care delivery persists in primary care; children and their families identify both strengths and unmet needs in review management visits; and professionals have uncertainties about providing effective child and family‐centred care.
Nurses’ perceived and actual level of diabetes mellitus knowledge: results of a cluster analysis
Authors: Chan Moon Fai , Zang Yu‐Li
Published: June 2007

Aims.  Nurses’ perceived and actual diabetes knowledge was explored by identifying profiles of nurses working in two hospitals in Hong Kong. Relationships between nurses’ perceived and actual diabetes knowledge are explored.

Background.  In non‐specialist clinical settings in Hong Kong, nurses provide diabetes self‐management education to patients, therefore, nurse's knowledge and skill in giving diabetes care is very important. Though patients’ perceptions are important, if patients solely select and set their own priorities for learning about and managing diabetes, their care could be compromised by knowledge deficits.

Method.  A descriptive correlational survey was conducted during the period September 2004 to July 2005 in two local hospitals in Hong Kong. 245 nurses completed a structured questionnaire. Nurses’ demographic data, competence, perceived and actual diabetes mellitus knowledge were collected.

Results.  Two‐step cluster analysis yielded three clusters: Cluster 1 nurses were characterized by relatively good competence and high diabetes knowledge than nurses in Clusters 2 and 3. Cluster 3 nurses reported low competence and diabetes knowledge than nurses in Clusters 1 and 2. Cluster 2 was a large group of nurses holding both positive and moderate competence and diabetes knowledge. Statistically significant differences were found between clusters. Overall, nurses’ perceived diabetes knowledge was statistically significant correlated with actual knowledge (rs = 0·32).

Conclusions.  Nurses have the responsibility to educate patients with correct and updated information, therefore, knowledge should be provided and maintained to a certain standard.

Relevance to clinical practice.  Lack of knowledge among nursing staff has contributed to diabetes patients receiving inadequate health care instruction. As indicated by the results of this study, ‘tailor‐made’ educational programmes should be designed to meet the learning needs of each subgroup. Expertise and nurse education should be recognized when such educational programmes are designed.
An evaluation of an insulin transfer programme delivered in a group setting
Authors: Kelley Kate , Dempsey Carole
Published: June 2007

Aim.  This study assesses the efficacy of a group education programme through the improvement of the patients’ HbA1c status and their overall understanding of diabetes.

Background.  The transfer from tablets to insulin is a crucial time for patients with diabetes. The provision of diabetes education is essential, enabling patients to develop a knowledge base from which to manage their diabetes and consequently take control of their life. The growing numbers of referrals for insulin transfer meant that the traditional one‐to‐one education approach is unrealistic and a local diabetes team developed a group programme to meet the demand.

Method.  The study has a pre–post test design. Biomedical outcomes are: HbA1c and weight. Self‐report outcomes are: diabetes knowledge, diabetes treatment satisfaction (DTSQ) and quality of life (EQ‐5D). All outcomes were measured prior to the group education programme and then after the programme had been completed. HbA1c was also measured again at three months after the education programme had finished. A repeated measures anova was used to analyse the main data.

Results.  Seventy‐two patients were recruited into the study and at follow‐up 77% (n = 65) remained in the study. The mean age of the participants was 64·5 (SD 12·01) years and the median time since being diagnosed with diabetes was 7·3 years (range two months to 20 years). There was an overall significant reduction in the HbA1c scores across the three time points (F(1·5) = 57·87, p < 0·0001). Post hoc tests indicate there are significant reductions (p < 0·0001) from the pregroup mean at both the postgroup (9·84% vs. 8·54%) and three‐month follow up means (9·84% vs. 8·10%). The difference from times 2 and 3 (8·54% vs. 8·10%) was also significant (p < 0·0001). There were no significant changes in weight. After the programme, satisfaction with diabetes treatment was high and knowledge about diabetes had improved (t(54) = 7·46, p < 0·0001). There were significant improvements reported on the five health dimensions of the EQ‐5D.

Conclusion.  These results indicate that a group education programme can be an effective method of helping patients transfer from tablets to insulin.

Relevance to clinical practice.  These group sessions have reduced waiting times for patients transferring from tablets to insulin and have proved an effective use of time management by Diabetes Specialist Nurses.
Lived experience of significant others of persons with diabetes
Authors: Rosa Stödberg , Sunvisson Helena , Ahlström Gerd
Published: June 2007

Aim.  To elucidate the lived experience of being a significant other of a person with diabetes.

Background.  A person's illness has consequences not only for the affected. Despite an increasing number of studies on significant others, there have been few about the experience of being a significant other of a person with diabetes.

Design.  Phenomenological‐hermeneutic approach.

Method.  Fifteen significant others of persons with diabetes were interviewed. The interviews were conversational, starting with an open question. They were audiotaped and transcribed verbatim. The texts were analysed and interpreted.

Results.  The meaning of the lived experienced as narrated by the significant others is presented by way of four major themes: living in concern about the other's health, striving to be involved, experiencing confidence and handling the illness. Many significant others said that they lived a normal life and had come to accept diabetes as a normal part of life. At the same time, the significant others experienced sorrow when they saw the health of the person with diabetes deteriorate over time.

Conclusions.  Living near a person with diabetes meant being constantly attentive to how the person was feeling. The significant others wanted to be involved in the illness by the persons with diabetes and healthcare staff. They felt confidence both in the way the person with diabetes handled the illness and in the ongoing research about diabetes. The significant others had found ways to handle the illness but lacked support from healthcare staff.

Relevance to Clinical Practice.  Nurses need to provide support for significant others as well as good caring for the patients and this requires a profound understanding of significant others from their own perspective.
Quality of care for people with osteoarthritis: a qualitative study
Authors: McHugh Gretl A , Silman Alan J , Luker Karen A
Published: June 2007

Aim.  The overall aim of this qualitative study was to explore within primary care the experiences of management and care of individuals with end‐stage lower limb osteoarthritis who are on the waiting list for joint replacement.

Background.  Osteoarthritis, one of the most common chronic diseases, causes loss of physical function and severe pain among sufferers. Improving quality of care and service provision for individuals with chronic diseases is high on the UK's NHS agenda.

Methods.  Data were collected by semi‐structured qualitative interviews with 21 individuals with osteoarthritis who were waiting for a hip or knee replacement operation. Interviews were analysed using framework analysis.

Results.  Participants had been suffering with osteoarthritis for between seven months and 38 years. The management by health professionals for people on the waiting list for joint replacement was minimal. However, participants spoke of ‘hiding’ their symptoms from health professionals and were trying to ‘self‐manage’ their symptoms. Families became more involved in helping individuals with osteoarthritis to manage with everyday life.

Conclusion.  Management of individuals’ osteoarthritis while on the waiting list needs to be given consideration by health professionals in primary and secondary care. Health professionals need to be working with each other to provide more comprehensive care across the primary and secondary care interface.

Relevance to clinical practice.  Case managers or community matrons could be identified as the co‐ordinator and assessor of the needs of patients with osteoarthritis so as to try and improve pain management and service provision for these individuals especially while on the waiting list.
A randomized clinical trial to evaluate the effect of diet on weight loss and coping of people living with HIV and lipodystrophy
Authors: Reid Carol , Courtney Mary
Published: June 2007

Aim.  The purpose of the research study was to evaluate a diet intervention in relation to the perceived weight loss and ways of coping of people living with HIV and lipodystrophy. The objectives were (i) to measure the perceived impact of weight loss upon men with HIV and lipodystrophy following a diet intervention and (ii) to identify strategies used by men to cope with HIV and lipodystrophy following a diet intervention.

Background.  HIV positive people on antiretroviral treatments are normalizing their lives and are facing a life‐long future. Morphological changes occur as a result of antiretroviral therapy causing HIV positive people to hesitate commencing treatment.

Design.  An experimental design incorporating pretests and posttests of experimental and control groups was used in the study.

Methods.  The sample consisted of 30 men over 18 years of age, living with HIV and lipodystrophy. All participants were surveyed by questionnaires and their perceived weight loss and ways of coping were measured at baseline and 10 weeks.

Results.  Findings indicated a significant improvement for perceived weight loss and although not significant, all coping processes were used more by the participants in the intervention group compared with the control group.

Conclusions.  The diet intervention demonstrated a positive effect particularly upon perceived weight loss on men living with HIV and Lipodystrophy in the study setting.

Relevance to clinical practice.  Diet is a recommended management option for people who endure severe and distressing symptoms from antiretroviral therapy.
Identification and detection of Pseudomonas plecoglossicida isolates with PCR primers targeting the gyrB region
Authors: Izumi S , Yamamoto M , Suzuki K , Shimizu A , Aranishi F
Published: June 2007

Pseudomonas plecoglossicida is the agent of bacterial haemorrhagic ascites (BHA) in freshwater fish farming in Japan. To develop a rapid identification and detection method for P. plecoglossicida, a PCR amplification technique targeting the chromosomal DNA region coding the B subunit of the DNA gyrase (gyrB) was used. The nucleotide sequences of gyrB were determined in nine isolates of P. plecoglossicida and two other Pseudomonas species. On the basis of these determined sequences and the gyrB sequences of other Pseudomonas species or fish pathogenic bacteria deposited in international nucleotide sequence databases (GenBank/EMBL/DDBJ), PCR primers PL‐G1F, PL‐G1R, PL‐G2F and PL‐G2R were designed for specific amplification of the partial gyrB of P. plecoglossicida. The specificity of these primers in amplifying the gyrB of P. plecoglossicida was verified using selected strains of related bacterial species. The nested PCR technique was used to detect P. plecoglossicida from kidney and intestine of ayu. Primer pair PL‐G1F and PL‐G1R was used for the external PCR, and primer pair PL‐G2F and PL‐G2R for the internal PCR. Of 10 ayu juveniles, expected size PCR products were observed from intestine and kidney samples in one and two specimens, respectively. The PCR technique with primers based on the gyrB sequence is thus useful for the diagnosis of BHA.
Development of real‐time PCR assays for the detection and differentiation of Australian and European ranaviruses
Authors: Pallister J , Gould A , Harrison D , Hyatt A , Jancovich J , Heine H
Published: June 2007

Serious systemic disease in fish and amphibians is associated with the ranaviruses, epizootic haematopoietic necrosis virus (EHNV) and Bohle iridovirus (BIV) in Australia, and European sheatfish virus (ESV) and European catfish virus (ECV) in Europe. EHNV, ESV and ECV are recognized causative agents of the OIE (Office International des Epizooties) notifiable systemic necrotizing iridovirus syndrome and are currently identified by protein‐based assays, none of which are able to rapidly identify the specific agents. The aim of this study was to develop TaqMan real‐time PCR assays that differentiated these viruses using nucleotide sequence variation in two ranavirus genes. A conserved probe representing 100% sequence homology was used as a reference for virus‐specific probes. The virus‐specific probes produced a similar signal level to the conserved probe while those probes binding to non‐target viral DNA produced an altered fluorescent curve. The pattern of probe binding was characteristic for each virus. Sensitivity, specificity and dynamic range of the assay were assessed. The test is currently useful as a research and initial screening tool, with the potential to become a sensitive and specific method for detection and differentiation of ranaviruses with further development.
The interplay between radio galaxies and cluster environment
Authors: Magliocchetti Manuela , Brüggen Marcus
Published: June 2007

By combining the REFLEX and NORAS cluster data sets with the NVSS radio catalogue, we obtain a sample of 145, z < 0.3, X-ray-selected clusters brighter than 3 × 10−12  erg s−1 cm−2 that show a central radio emission above 3 mJy. For virial masses Mvir≲ 1014.5 M⊙, 11 clusters out of 12 (corresponding to 92 per cent of the systems) are inhabited by a central radio source. This fraction decreases with higher masses as ∝M−0.4vir. If this decrease is a selection effect, it suggests that the majority of X-ray-selected clusters host in their centre a radio source brighter than ∼1020 W Hz−1 sr−1. A division of the sample into clusters harbouring either point-like or an extended radio-loud active galactic nucleus (AGN) reveals that the steepening of the LX–T relation for low-temperature clusters is strongly associated with the presence of central radio objects with extended jets and/or lobe structures. In the latter case, LX∝T4 while for point-like sources one recovers an approximately self-similar relation LX∝T2.3. Monte Carlo simulations show that the steepening of the LX–T relation is not caused by clusters being underluminous in the X-ray band, but rather by overheating, most likely caused by the interplay between the extended radio structures and the intracluster medium. In the case of low-mass systems, we also find a tight correlation between radio luminosity and cluster temperature. The effects of the central radio source on the thermal state of a cluster become less important with increasing cluster mass.

The presence of radio sources with extended structures (61, corresponding to ∼42   per cent of the sample) is enhanced in X-ray luminous clusters with respect to ‘field’ radio-loud AGN. Furthermore, we find that the luminosity distribution of the cluster radio population differs from that of all radio sources, as there is a deficit of low-luminosity (LR≲ 1022 W Hz−1 sr−1) objects, while the number of high-luminosity ones is boosted. The net effect on the radio luminosity function of radio galaxies associated with cluster centres is of a flattening at all luminosities LR≲ 1024 W Hz−1 sr−1.
The Immuno‐endocrine Component in the Pathogenesis of Tuberculosis
Authors: Bottasso O. , Bay M. L. , Besedovsky H. , Del Rey A.
Published: June 2007

Abstract Tuberculosis (TB) may be regarded as a disease in which the immune response to Mycobacterium tuberculosis, its etiologic agent, is engaged both in protection and pathology. Different T‐lymphocyte subsets are involved in the immune response against M. tuberculosis, but production of interferon‐gamma (IFN‐γ) by T cells seems to be fundamental for disease control. Th1‐type cytokine responses predominate in patients with mild or moderate forms of pulmonary TB, whereas the production of Th2‐type cytokines prevails in the severe disease. Since the immune response fails to definitely eradicate the pathogen, a chronic infection is established, and it is likely that a broad range of regulatory mechanisms operate in this situation. Cytokines released during the course of an immune response activate the hypothalamus‐pituitary‐adrenal axis leading to the production of glucocorticoids and dehydroepiandrosterone (DHEA), with known immunomodulatory effects. TB patients exhibit increased concentrations of interleukin‐6 and cortisol in plasma, reduced DHEA and testosterone levels, together with remarkably increased growth hormone concentrations that were not accompanied by an expected raise in insulin‐like growth factor‐1. Significant increases in estradiol, prolactin, and thyroid hormone concentrations were also detected in patients. Cortisol inhibits the mycobacterial antigen‐driven proliferation and IFN‐γ production, whereas DHEA suppresses transforming growth factor beta production by lymphoid cells from TB patients with advanced disease. Furthermore, supernatants from cultures of M. tuberculosis‐stimulated mononuclear cells of TB patients inhibit DHEA secretion by a human adrenal cell line. This type of immuno‐endocrine interactions may affect the control of tissue damage and the development of protective immune responses, partly accounting for disease aggravation.
Trypanosoma cruzi Infection Beats the B‐cell Compartment Favouring Parasite Establishment: Can we Strike First?
Authors: Acosta Rodriguez E. V. , Zuniga E. I. , Montes C. L. , Merino M. C. , Bermejo D. A. , Amezcua Vesely M. C. , Motran C. C. , Gruppi A.
Published: June 2007

Abstract Trypanosoma cruzi, the causative agent of Chagas’ disease, may sabotage humoral response by affecting B cells at the different stages of its development. The present review highlights the contributions of our laboratory in understanding how T. cruzi hinders B‐cell generation and B‐cell expansion limiting host defence and favouring its chronic establishment. We discuss how homoeostatic mechanisms can be triggered to control exacerbated B‐cell proliferation that favour T. cruzi infection by eliminating parasite‐specific B cells. Specific targeting of evasion mechanisms displayed in T. cruzi infection, as in vivo Fas/FasL blockade or Gal‐3 expression inhibition, allowed us to modulate B‐cell responses enhancing the anti‐parasite humoral immune response. A comprehensive understanding of the biology of the B cell in health and disease is strictly required to devise immunointervention strategies aimed at enhancing protective immune responses during infections.
Undertreatment of rhinitis symptoms in Europe: findings from a cross‐sectional questionnaire survey
Authors: Maurer M. , Zuberbier T.
Published: June 2007

Background:  Allergic rhinitis is a frequent disease affecting one in five Europeans with a significant impact on patient quality of life, health‐care costs, and economic productivity. Although effective treatments exist, the disease often remains undiagnosed and not correctly treated, despite clear diagnostic and therapeutic guidelines from WHO, EAACI (European Academy of Allergology and Clinical Immunology), and GA2LEN (Global Allergy and Asthma European Network). This study elucidates the reasons for this discrepancy from the patients’ point of view.

Methods:  An internet and telephone survey was conducted with 2966 randomly selected adults with allergies from the general population in the five major EU countries: UK, France, Germany, Italy, and Spain.

Results:  The main reason that the majority of respondents first visited a medical professional for their rhinitis symptoms was because these symptoms became intolerable. The respondents had not seen a medical professional in the past year for their rhinitis symptoms in 52.6% of the cases, and 30.2% of the respondents preferred nonprescription medication because it did not require visiting a doctor. ‘Nontreaters’ and ‘homeopathic treaters’ together made up 26.2% of the respondents, and 40.2% of them gave the cost of medication as a reason they do not use allergy medications.

Conclusions:  Allergic rhinitis remains widely undertreated in Europe with avoidable socioeconomic consequences. Effective treatment exists, but patients wait too long to seek medical advice, and health providers neglect to actively screen early for allergies.
Efficacy of prednisolone in children hospitalized for recurrent wheezing
Authors: Jartti Tuomas , Lehtinen Pasi , Vanto Timo , Vuorinen Tytti , Hartiala Jaakko , Hiekkanen Heikki , Malmberg Pekka , Mäkelä Mika , Ruuskanen Olli
Published: June 2007

Data on the efficacy of corticosteroids on respiratory picornavirus‐induced wheezing are limited. To determine whether prednisolone is effective in rhinovirus‐ or enterovirus‐induced recurrent wheezing, we conducted a controlled trial comparing oral prednisolone (2 mg/kg/day in three divided doses for 3 days) with placebo in hospitalized wheezing children and studied post hoc virus‐specific efficacy in early wheezing (<3 episodes, reported elsewhere) and in recurrent wheezing (≥3 episodes). Virus‐negative children where excluded. Our primary endpoint was the time until children were ready for discharge. Secondary endpoints included oxygen saturation and exhaled nitric oxide during hospitalization, duration of symptoms, blood eosinophil count, and impulse oscillometry 2 wk after discharge, and occurrence of relapses during the following 2 months. Virus‐specific effects were analyzed with interaction analysis in a multivariate regression model. During the study period, 661 patients were hospitalized, 293 randomized, and 59 were accepted in this analysis (mean age 2.6 yr, s.d. 1.3). Prednisolone did not significantly decrease the time until ready for discharge in all patients (prednisolone vs. placebo, medians, 18 vs. 24 h, p = 0.11). However, prednisolone decreased the time until ready for discharge in children with picornavirus infection (respectively, 12 vs. 24 h, p = 0.0022) and more specifically, in children with enterovirus infection (6 vs. 35 h, p = 0.0007). In the secondary endpoints, prednisolone decreased the duration of cough and dyspnea in rhinovirus‐affected children (p = 0.033 for both). Prospectively designed clinical trial is needed to test the hypothesis that prednisolone reduces symptoms in picornavirus‐affected wheezing children.
Dietary supplementation of neutral and acidic oligosaccharides enhances Th1‐dependent vaccination responses in mice
Authors: Vos Arjan P. , Haarman Monique , VanGinkel Jan‐Willem H. , Knol Jan , Garssen Johan , Stahl Bernd , Boehm Guenther , M'Rabet Laura
Published: June 2007

Immunomodulatory effects of oligosaccharide preparations that resemble chemical and functional aspects of human milk oligosaccharides (HMOS) were studied for the development of new concepts in infant nutrition. A dose range of 1–5% (w/w) dietary pectin‐derived acidic oligosaccharides (AOS) was tested in a murine influenza vaccination model. In addition, combinations of AOS and a 9:1 mixture of galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides (GOS/FOS) were tested at a fixed total dietary dose of 2% (w/w). It was found that AOS significantly enhanced vaccine‐specific delayed‐type hypersensitivity (DTH) responses in a dose‐dependent manner. This was accompanied by a reduction in T‐helper2 (Th2) cytokine production by splenocytes in vitro. Overall, this indicates that the systemic immune response to the vaccine was Th1‐skewed by the dietary intervention. Combinations of GOS/FOS and AOS were more effective in enhancing DTH responses than either of the oligosaccharides alone, suggesting interaction effects between these agents. Similar to effects in infants, supplementation of the murine diets with GOS/FOS and combinations of GOS/FOS and AOS for 6‐wk enhanced the proportion of fecal bifidobacteria and lactobacilli, but AOS alone did not. In conclusion, these data indicate that GOS/FOS and AOS enhance systemic Th1‐dependent immune responses in a murine vaccination model. As Th1‐responses are weak in early life in humans, this might suggest that application of these oligosaccharides in infant formulas will be beneficial for the development of the infant's immune system.
Comparison of Der p1‐specific antibody levels in children with allergic airway disease and healthy controls
Authors: Aydogan Metin , Mete Nihal , Yazi Didem , Akkoc Tunc , Ozdemir Cevdet , Blaser Kurt , Akdis Mubeccel , Akdis Cezmi , Bahceciler Nerin , Barlan Isıl
Published: June 2007

Although children, with allergic airway disease, who are sensitized to house‐dust mite (HDM) are known to have increased levels of allergen‐specific IgE and IgG, the association between the quantity of those immunoglobulins and the clinical features of disease is not yet well established. The purpose of this study was (i) to evaluate Der p1‐specific IgA, IgG1, IgG4, and IgE levels of children with HDM‐allergic asthma and allergic rhinitis and to compare it with that of healthy controls (ii) to assess the association with disease duration. A total of 73 patients were included. Of those, 58 had asthma (M/F: 27/31, mean age 7.9 ± 2.7 yr) and 15 were diagnosed as allergic rhinitis (M/F: 8/7, mean age 10.1 ± 4.0 yr) without asthma. Twenty‐five (M/F: 13/12, mean age 9.5 ± 4.2 yr) non‐allergic children were included as healthy controls. Data on age at onset and duration of disease were recorded. Then, Der p1‐specific IgA, IgG1, IgG4, IgE levels were measured in all of the 98 subjects by ELISA. Comparison of Der p1‐specific antibody levels of patients and controls revealed that Der p1‐specific IgG1, IgG4 and IgE levels of patients with asthma (p = 0.012, p = 0.021, p = 0.004, respectively) were significantly higher than healthy controls. Also, the ratio of Der p1‐specific IgA/IgE was significantly lower in asthmatic children when compared with children with allergic rhinitis and controls (p = 0.029, p < 0.001, respectively). Der p1‐specific IgG1, IgG4, IgE and IgA levels of asthmatic children with duration of disease of ≥4 yr were significantly higher than those with disease duration of <4 yr. IgA/IgE ratio was not significantly different in those two groups of asthmatics. We concluded that although all of the specific antibody levels increased with longer duration of asthma, IgA/IgE ratio remains to be low in asthmatic children allergic to HDM.
Educational clinical case series for pediatric allergy and immunology: Allergic proctocolitis, food protein‐induced enterocolitis syndrome and allergic eosinophilic gastroenteritis with protein‐losing gastroenteropathy as manifestations of non‐IgE‐mediated cow's milk allergy
Authors: Maloney Jennifer , Nowak‐Wegrzyn Anna
Published: June 2007

Cow's milk protein allergy is the most common food allergy in infants and young children. It is estimated that up to 50% of pediatric cow's milk allergy is non‐IgE‐mediated. Allergic proctocolitis is a benign disorder manifesting with blood‐streaked stools in otherwise healthy‐appearing infants who are breast‐ or formula‐fed. Symptoms resolve within 48–72 h following elimination of dietary cow's milk protein. Most infants tolerate cow's milk by their first birthday. Food protein‐induced enterocolitis syndrome presents in young formula‐fed infants with chronic emesis, diarrhea, and failure to thrive. Reintroduction of cow's milk protein following a period of avoidance results in profuse, repetitive emesis within 2–3 h following ingestion; 20% of acute exposures may be associated with hypovolemic shock. Treatment of acute reactions is with vigorous hydration. Most children become tolerant with age; attempts of re‐introduction of milk must be done under physician supervision and with secure i.v. access. Allergic eosinophilic gastroenteritis affects infants as well as older children and adolescents. Abdominal pain, emesis, diarrhea, failure to thrive, or weight loss are the most common symptoms. A subset of patients may develop protein‐losing enteropathy. Fifty percent of affected children are atopic and have evidence of food‐specific IgE antibody but skin prick tests and serum food‐IgE levels correlate with response to elimination diet poorly. Elemental diet based on the amino‐acid formula leads to resolutions of gastrointestinal eosinophilic inflammation typically within 6 wk.
Number of Coronary Ostia in Syrian Hamsters (Mesocricetus auratus) with Normal and Anomalous Coronary Arteries
Authors: Durán A. C. , Fernández M. C. , Fernández B. , Fernández‐Gallego T. , Arqué J. M. , Sans‐Coma V.
Published: June 2007

Little attention is being paid to the presence of accessory coronary artery ostia in man and non‐human mammals due to their limited clinical relevance. However, information about their frequency and the cardiac territories irrigated by the vessels arising from them is of interest to obtain an accurate survey of the establishment of the coronary artery system in each species. The aim here was to compare the incidence and significance of the accessory coronary ostia in Syrian hamsters with normal coronary arteries and several coronary anomalies characterized by the absence of a left coronary artery originating from the left aortic sinus. The hearts from 2829 hamsters were examined using a corrosion‐cast technique, micro‐dissection, histochemical techniques, and scanning electron microscopy. Overall, 148 specimens displayed accessory ostia. A limited number of them belonged to the conal artery which supplies the wall of the right ventricular outflow tract. The other accessory ostia led to the septal artery, a vessel which irrigates the most part of the interventricular septum. The incidence of accessory ostia in normal and anomalous coronary artery patterns was quite similar. This suggests that the morphogenetic deviations producing the coronary artery anomalies reported in this study do not alter the connections of the septal and conal arteries to the aorta. The present observations lead to the notion that in the Syrian hamster, the septal artery should be regarded as a third coronary artery.
Occurrence of pathogenic fungi in soil of burrows of rats and of other sites in bamboo plantations in India and Nepal
Authors: Gugnani H. C. , Paliwal‐Joshi A. , Rahman H. , Padhye A. A. , Singh T. S. K. , Das T. K. , Khanal B. , Bajaj R. , Rao S. , Chukhani R.
Published: June 2007

This study examined 215 samples of soil from burrows of rats, other sites in bamboo plantations in different parts of India and Nepal by dilution plating and mouse passage technique for occurrence of Penicillium marneffei and other pathogenic fungi. None of the samples including 25 collected from the burrows of a bamboo rat (Cannomys badius) known to be a carrier of P. marneffei, was positive for the fungus. Among the pathogenic fungi recovered were four isolates of Pseudallescheria boydii (including one from Nepal), two of Trichosporon asteroides, one of Scytalidium hyalinum, 23 isolates of Trichophyton mentagrophytes var. mentagrophytes (including two from Nepal), and two of Microsporum gypseum. Fourteen of the 23 isolates of T. mentagrophytes var. mentagrophytes when tested with the mating types of Arthroderma vanbreuseghemii were found to be of the ‘+’ mating type. The frequent recovery of this dermatophyte from soils of bamboo plantations in several parts of India is remarkable. The study also demonstrates for the first time the occurrence of P. boydii and T. mentagrophytes var. mentagrophytes in Nepalese soil. Among the other fungi recovered were several isolates of species of Aspergillus, Penicillium, Paecilomyces, Fusarium, Chrysosporium, Acremonium, Rhizopus, Mucor, Geotrichum, Trichosporon and Rhodotorula.
MORAL DELIBERATION AND OPERATIVE RIGHTS: A RESPONSE TO MARY MAGADA‐WARD AND CYNTHIA GAYMAN
Authors: COLAPIETRO VINCENT
Published: June 2007

Abstract: The aim of this article is to show how intimately connected Beth J. Singer's theory of operative rights is with her understanding of the deliberative process. I thus argue against Cynthia Gayman's effort to set in contrast Singer's theory of rights and Dewey's characteristic emphasis on reflective morality. Since I take the value of Singer's approach to be most evident in its relevance to the abortion debate as an ongoing deliberation, I question whether Mary Magada‐Ward sufficiently appreciates the dialogical and deliberative emphases of Singer's stance. My goal, however, is not so much to argue against either Gayman or Magada‐Ward as it is to argue for taking Singer's position even more seriously than either author does. In particular, I want to highlight the finely nuanced character of Singer's philosophical intervention in the debate regarding abortion, especially stressing certain features that Gayman and Magada‐Ward overlook.
ON THE RELIABILITY OF MORAL AND INTELLECTUAL VIRTUES
Authors: BAEHR JASON
Published: June 2007

Abstract: I examine here whether reliability is a defining feature of (moral or intellectual) virtues. I argue (1) that reliability is not a defining feature of a virtue where virtues are conceived (as they often are) as “personal excellences,” but (2) that there is another (also intuitive and familiar) conception of a virtue according to which reliability is a defining feature. I also argue (3) that even on the former conception, a certain rational belief pertaining to reliability is essential and (4) that reliability itself, while not a defining feature of a virtue thus conceived, nevertheless is a concomitant of it.
REPLY TO JULIA DRIVER, TIMM TRIPLETT, AND KATHLEEN WALLACE
Authors: GERT BERNARD
Published: June 2007

Abstract: Julia Driver, Timm Triplett, and Kathleen Wallace challenge my account of moral arrogance, and Triplett and Wallace challenge its application to the problem of abortion. I try to show here that Driver's attempt to defend consequentialism from my charge that it promotes moral arrogance is successful only if consequentialism explicitly gives up what has been considered one of its major virtues. I acknowledge that Triplett has uncovered some unclarity in my claim that the moral acceptability of abortion is an unresolvable moral issue. I also acknowledge that Wallace has uncovered some unclarity in my account of moral arrogance. After clarifying that account, I try to meet her challenge to defend my claim that it is not morally arrogant for a state to place some restrictions on abortions.
DIVINE CAUSALITY AND THE NATURE OF THEOLOGICAL QUESTIONING
Authors: JANZ PAUL D.
Published: June 2007

To be alive as embodied human beings in the world means to be both conceptually or ratiocinatively aware, and sensibly or causally aware. However, under a still powerful influence of idealism, theology over the past two centuries has virtually abandoned the causal and sensibly‐embodied attentiveness to its subject‐matter (revelation) as demanded by the incarnation. It has instead often come to comport itself one‐sidedly, in essentially analytical or linguistically self‐guaranteeing ways, and has thereby lost its contingent and genuinely vulnerable incarnational “edge” at the center of life. This essay tries to restore a properly twofold attentiveness through a reinvigoration of the traditional view of revelation as the divinely causal reality of God in the world.
TOWARDS A POETICS OF THEOLOGICAL CREATIVITY: ROWAN WILLIAMS READS AUGUSTINE'S DE DOCTRINA AFTER DERRIDA
Authors: McCURRY JEFFREY
Published: June 2007

Rejecting both a conservative theological method seeking retrieval and reiteration of theological claims from the Christian tradition and a liberal theological method of seeking the translation of theological claims into a modern idiom, Rowan Williams pursues a theological poetics of “traditioned creativity.” By viewing the texts of the Christian tradition less as deposits of truth to be plumbed and more as scripts to be performed in ways inflected by contemporary concerns, Williams can write theology that is both profoundly “traditioned” and innovative. This article shows how Williams pursues this distinctive program of theological poesis by attending to his reading of Augustine's De Doctrina Christiana in light of Derrida's reflections on the place of the economy of difference and deferral in all reading and interpretation.
CHRISTIAN ORTHODOXY AND RELIGIOUS PLURALISM: A RESPONSE TO TERRENCE W. TILLEY
Authors: D'COSTA GAVIN
Published: June 2007

Terrence W. Tilley has argued that Dominus Iesus, published by the Roman Catholic Congregation from the Doctrine of Faith in 2000, legitimates a de jure form of religious pluralism which is compatible and acceptable to orthodox Catholic faith. This claim is inspected and criticised on both textual and logical grounds. Textually, Tilley is found guilty of incorporating that which he wishes to prove in his premises. The argument advanced thus clarifies the teachings of Dominus Iesus and also indicates the problem with Jacques Dupuis’ position.
Setting up the first genitourinary clinic in Malta and an audit of the initial performance
Authors: Schembri G. , Carabot P.
Published: June 2007

Background  The first genitourinary (GU) clinic was set up in Malta in January 2000. An audit was conducted to evaluate the demand for such a service and its effectiveness during the first 6 years after its introduction.

Method  Case notes from the first 6 years were reviewed, and data were collected for gender, age, sexual orientation, symptoms, diagnosis, condom use, referral source, total number of attendances, and contact tracing.

Results  The total number of attendances increased from 760 in the first year to 1832 in 2005. The male to female ratio decreased from 2.3 in 2000 to 1.6 in 2005, as more females attended. The number of partners treated per index case was 0.25. Eighty per cent of attendees were self‐referred; 16% were referred by their general practitioner (GP). Only 10% admitted to using a condom regularly. Twenty‐nine per cent of asymptomatic attendees in 2005 were diagnosed with a sexually transmitted infection (STI). Fifty‐three cases of gonorrhoea were diagnosed by the GU clinic during the first 6 years, with 17% of isolates showing resistance to ciprofloxacin in 2005. A total of 38 cases of syphilis were diagnosed compared to only a handful of cases reported in the 25 years prior to the introduction of the service.

Conclusions  The increasing attendance, as revealed by this audit, reflects a growing demand for the service offered by the GU clinic in Malta. Numerous STIs are being diagnosed and treated, including syphilis, which has re‐emerged in Malta as it has in the rest of Europe. The prevalence of ciprofloxacin‐resistant gonorrhoea has been increasing, a trend that has also been documented in other European countries. In addition to successful management of STIs, the GU clinic would further benefit from a public health campaign aimed at encouraging asymptomatic sexually active individuals to attend for an STI screen, while simultaneously promoting responsible sexual behaviour.
Aerobic exercise intensity and time of stressor administration influence cardiovascular responses to psychological stress
Authors: Alderman Brandon L. , Arent Shawn M. , Landers Daniel M. , Rogers Tracie J.
Published: June 2007

This study examined cardiovascular responses as a function of time following exercise in which participants were exposed to a laboratory stressor. Ninety (42 women) young (18–35 years old) nonsmoking normotensive participants engaged in 30 min of high and low intensity (75–80% and 50–55% VO2 max) aerobic exercise and a sedentary control condition. Participants were randomly assigned to a laboratory stressor 5, 30, or 60 min following the exercise bout. Results indicate that low and high intensity exercise significantly reduce heart rate (HR) and systolic and diastolic blood pressure reactivity and HR recovery values. An inverse relationship between intensity of exercise and subsequent cardiovascular reactivity was found. These findings suggest attenuated stress responses following acute exercise depend both on exercise intensity and the time of exposure to psychological stress following exercise.
Two stimuli are better than one: Combination rules for prepulse inhibition revisited
Authors: Krauter E. Evan , Avery Bridgette C. , Avery Michael C.
Published: June 2007

Stimuli that precede elicitation of the startle reflex can inhibit that reflex. J. R. Ison, M. Zuckerman, and J. M. Russo (1975), measuring the startle reflex in the rat, showed that the effect of combining two inhibiting stimuli was greater than that of either alone. They also demonstrated that this combination effect could be described by using the rule for adding the probability of independent events, expressing the effect of each prestimulus as the proportion of the response inhibited by that stimulus. The purpose of this research was to extend those findings using the startle blink in humans. In two experiments, participants encountered trials in which two stimuli (p1 and p2) were given in succession, ending with a blink‐eliciting noise (S). In Experiment 1 (N=18) p1 was a synchronous tone and a word (appearing on a computer screen), and p2 was a blink‐eliciting noise identical to S. In Experiment 2 (N=30), p1 was a soft tone and p2 was a word. For both experiments, two stimuli were more inhibiting than one, and the effect of combining p1 and p2 was accurately described by the Ison et al. combination rule.
Sixteen new polymorphic microsatellite markers isolated for red‐legged partridge (Alectoris rufa) and related species
Authors: FERRERO M. E. , GONZÁLEZ‐JARA P. , BLANCO‐AGUIAR J. A. , SÁNCHEZ‐BARBUDO I. , DÁVILA J. A.
Published: June 2007

We developed and tested 16 new polymorphic microsatellite markers for the red‐legged partridge (Alectoris rufa): four dinucleotide, two trinucleotide, eight tetranucleotide and two pentanucleotide repeat loci. The number of alleles per locus ranged from two to 21, observed heterozygosity was from 0.03 to 1.00 and expected heterozygosity was comprised between 0.18 and 0.91. Cross‐specific amplification in others members of the Phasianidae family highlighted the potential usefulness of these molecular markers for the study of related species.
Napoleon Bonaparte, Political Prodigy
Authors: Brown Howard G.
Published: June 2007

The multiple roles, images and interpretations of Napoleon make it difficult to develop a scholarly consensus about the nature of his rule. The essence of Napoleonic rule derives from a triangular relationship between Napoleon Bonaparte, the post‐revolutionary French state and the Napoleonic Empire. Recent scholarship highlights the nature of the post‐revolutionary French state and the impact of the Grand Empire on Europe. Even so, Napoleon remains central. His relentless warmongering required massive conscription, the cutting edge of the modern state, and produced the main contradictions of the Empire. No wonder the nature of his rule remains controversial.
Media Naturalness and Online Learning: Findings Supporting Both the Significant‐ and No‐Significant‐Difference Perspectives
Authors: Kock Ned , Verville Jacques , Garza Vanessa
Published: June 2007

Is the use of an online course delivery format, when compared with the more traditional face‐to‐face format, good or bad in the context of university education? Those who subscribe to the no‐significant‐difference perspective argue that online delivery is good, because it allows students with time and geographic distance constraints to obtain the education that they need, with no significant negative impact on the quality of the learning experience. Others argue that online delivery is bad, advocating a version of the competing significant‐difference perspective, because the electronic communication media used for online delivery are not rich or natural enough to enable effective learning. This study contrasted students perceptions and grades in two different sections of the same course: one delivered entirely online and the other delivered face to face. Data were collected and analyzed at two points in time, namely, at the middle and end of a long semester. The study found support for both the no‐significant‐ and significant‐difference perspectives. At the middle of the semester, students in the online condition perceived communication ambiguity as significantly higher, and also obtained significantly lower grades, than students in the face‐to‐face condition. At the end of the semester, no significant differences were found.
Perceptions of Business Students' Feature Requirements in Educational Web Sites
Authors: Hazari Sunil , Johnson Barbara
Published: June 2007

There is paucity of original research that explains phenomena related to content organization and site design of educational Web sites. Educational Web sites are often used to provide Web‐based instruction, which itself is a relatively recent phenomenon for business schools, and additional research is needed in this area. Educational Web sites are designed with a different set of criteria as compared with other sites, such as those having an e‐commerce or marketing focus. More research is needed to build a theoretical foundation for feature requirements in educational Web sites. As in any new approach to teaching and learning, critical issues need to be examined before Web‐based instruction is fully integrated into teaching processes. When developing educational Web sites, features that support pedagogy should be given primary consideration. It is therefore important to identify key elements that will have maximum impact on learning. Using Q‐sort analysis (a type of Factor Analysis), this study investigated feature requirements of educational Web sites as perceived by business students. Based on the analysis of user requirements in relation to several variables that were identified from a review of literature, group characteristics emerged from students' responses. Similarities and differences between groups were investigated, and implications of these results for development of educational Web sites are presented in this study.