bluuebunny/crossref_metadata_2025 huggingface dataset:
Questionnaire instrument to assess knowledge of chronic kidney disease clinical practice guidelines among internal medicine residents
Authors: Agrawal Varun , Barnes Michael A. , Ghosh Amit K. , McCullough Peter A.
Published: July 2009

Introduction  The National Kidney Foundation published Kidney Disease Outcomes Quality Initiative guidelines that recommend early detection and management of chronic kidney disease (CKD) and timely referral to a nephrologist. Many patients with CKD are seen by primary care doctors who maybe less experienced than a nephrologist to offer optimal early CKD care. It is not known whether postgraduate training adequately prepares a future internist in CKD management.

Methods  We developed a 15‐item questionnaire instrument to assess knowledge of CKD guidelines among internal medicine residents in USA using an online survey programme. We studied the validity and reliability measures of our instrument.

Results  The survey was completed by 166 PGY1 (postgraduate year one), 187 PGY2 and 126 PGY3. The questionnaire tested various aspects of CKD including definition, classification, identification of risk factors, laboratory evaluation, development of clinical action plan, identification of complications, anaemia and bone and mineral disorder, referral to a nephrologist and medication use. Validity was supported by the use of official guidelines and an expert panel of nephrologists to develop content and improvement in mean test performance with increasing level of training (PGY1 59.2 ± 13.5%, PGY2 62.6 ± 12.3% and PGY3 64.3 ± 12.2%; P = 0.002). The reliability coefficient for the questionnaire instrument (Cronbach's α) was 0.69.

Conclusion  Our brief questionnaire is a valid and reliable instrument to assess knowledge of CKD guidelines among internal medicine residents and identify specific gaps for improvement.
What can complexity do for diabetes management? Linking theory to practice
Authors: Cooper Helen C. , Geyer Robert
Published: July 2009

Background  Diabetes presents a multifaceted picture with its rapidly rising prevalence associated with changing demographics and increasing levels of obesity in the developed world. Deaths from diabetes are predicted to rise by 25% over the next 10 years. The enormity of this public health challenge has been recognized the world over, but little attention has been paid to the theoretical frameworks underpinning practical management.

Aim  This paper aims to introduce complexity theory and discuss its practical application to diabetes, focusing on a single ‘tool’ to provide an example of how theory can be linked to practice.

Application  Critics have questioned the all inclusive nature of complexity seeing it as an intangible concept that fails to offer anything new to health care. However, few have appraised its practical application to a chronic disease that is currently managed using an outdated, linear, reduce and resolve model which fails to address the multiple interacting systems inherent within this condition.

Discussion  This article proposes that complexity theory provides an interprofessional perspective for describing and understanding the processes involved, and provides working ‘tools’ for patients, carers and practitioners that capture the reality of managing this chronic disease in modern life.
Autonomy in relation to health among people with intellectual disability: a literature review
Authors: Wullink M. , Widdershoven G. , Van Schrojenstein Lantman‐de Valk H. , Metsemakers J. , Dinant G.‐J.
Published: July 2009

Background  Since the 1990s, individualisation, participation, normalisation and inclusion have been the main principles of care for people with intellectual disability (ID). Autonomy has become an important issue for these people. This review of the literature tried to answer the question: how do people with ID exercise autonomy in relation to health?

Method  Searches in Cochrane, Medline and PsycINFO were based on the following aspects of autonomy: self‐determination, independence, self‐regulation and self‐realisation.

Results  Thirty‐nine of 791 articles met our criteria, including 14 on self‐determination, seven on independence, 15 on self‐regulation and three on self‐realisation.

Conclusions  In spite of decades of promoting autonomy, the exercise of autonomy in relation to health has so far rarely been an issue in the literature.
Gaussian‐Taylor signal‐to‐noise ratio estimation for scanning electron microscope images
Authors: SIM K.S. , LEE J.K. , LAI M.A. , TSO C.P.
Published: July 2009

A new and robust parameter estimation technique, named Gaussian‐Taylor interpolation, is proposed to predict the signal‐to‐noise ratio (SNR) of scanning electron microscope images. The results of SNR and variance estimation values are tested and compared with piecewise cubic Hermite interpolation, quadratic spline interpolation, autoregressive moving average and moving average. Overall, the proposed estimations for noise‐free peak and SNR are most consistent and accurate to within a certain acceptable degree compared with the others.
Older women's experiences of depression: a hermeneutic phenomenological study
Authors: ALLAN J. , DIXON A.
Published: July 2009

Accessible summary

This study describes what it was like for four older women to live with depression . . . Each woman was interviewed up to three times and we found:

Depression had a major effect on the women's beliefs about themselves, resulting in a self‐loathing and a feeling of failure.

The women's self‐loathing caused them to believe that other people thought badly of them, which led them to withdraw from family and friends.

Consequently, these older women were unable to be in meaningful relationships with other people. This contributed to them feeling alone and isolated.

The findings were supported by the themes of: self‐loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being‐alone; misinterpreting self and other people; the stigma of mental illness – society and self; and seeking understanding from other people. The older women in this study were more able to talk to other people when met with understanding. The study identifies ways nurses can develop relationships with older women who have depression and how they can best help them. Nurses can build relationships based on understanding and trust by being caring, empathetic and respectful. When nurses and other people demonstrate a willingness to listen and understand the older woman's world then relationships are established. The findings can be a resource for older women with depression and people who want to understand depression from the perspective of older women who have experienced it . . . 

This hermeneutic phenomenological study, informed by Max van Manen and Martin Heidegger, describes what it is like for four older women to live with depression. Each participant was interviewed up to three times. Interviews were semi‐structured, audiotaped and transcribed verbatim. Data were analysed using van Manen's methodological themes and Heidegger's philosophical concepts of Being‐in‐the‐world and Being‐with‐others. The themes that emerged were: self‐loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being‐alone; misinterpreting self and other people; the stigma of mental illness – society and self; and seeking understanding from other people. The findings revealed that depression had a major effect on the women's beliefs about themselves, resulting in a self‐loathing and a feeling of failure. The participants described how their self‐loathing caused them to believe that other people thought badly of them, which led to their withdrawal. Their inability to connect contributed to them feeling alone and isolated. These women were more able to talk to other people when they were met with understanding. This has implications for the therapeutic nurse–patient relationship, which is fundamental to mental health nursing, because the relationship should be based upon an understanding of the patient's world.
Systemic absorption of oral vancomycin in a peripheral blood stem cell transplant patient with severe graft‐versus‐host disease of the gastrointestinal tract
Authors: Pogue J.M. , DePestel D.D. , Kaul D.R. , Khaled Y. , Frame D.G.
Published: July 2009

Abstract
:
Oral vancomycin is often considered the drug of choice for severe Clostridium difficile‐associated disease due to both its efficacy and pharmacokinetics. The potential for absorption is not well described in patients with impaired gastrointestinal (GI) mucosa. We describe a case of significant and potentially toxic absorption of oral vancomycin in a peripheral blood stem cell transplant patient with grade IV graft‐versus‐host disease (GVHD) of the GI tract. In patients with GI GVHD clinicians need to be aware of the potential for oral absorption and, in select cases, monitoring of levels may be appropriate.
Site of Intrauterine Artificial Insemination in the Bitch does not Affect Sperm Distribution within the Uterus
Authors: Fukushima FB , Malm C , Henry M , Gheller VA , Serakides R , Neves MM , Macedo SP , Figueiredo MS , Andrade MEJ , Chaves MS , Silva MX , Rezende CMF , Melo EG
Published: July 2009

Contents

The aim of this study was to evaluate the distribution of frozen–thawed spermatozoa within the uterine lumen and oviducts following intrauterine laparoscopic deposition at two sites. Twelve bitches of unknown reproductive history were randomly distributed into two groups. Semen (3 ml containing 300 × 106 frozen–thawed spermatozoa) was infused at the uterine body (UB group) or at the cranial tip of the left uterine horn. A 22‐G catheter was used to access the uterine lumen. Sperm cell distribution was evaluated after ovariohysterectomy performed 3 h after artificial insemination (AI). There was no difference between groups in mean time to perform AI. Spermatozoa were detected in all uterine segments, including the tip of both horns, but none was detected in the oviduct. The 22‐G catheter facilitated deposition of semen in the uterine lumen, particularly at the UB site. Sperm cell distribution occurred evenly along both horns, independent of the site of semen deposition.
Erosive mucosal lichen planus and secondary epiphora responding to systemic cyclosporin A treatment
Authors: Boyce Aaron E , Marshman Gillian , Mills Richard AD
Published: July 2009

Erosive mucosal lichen planus (LP) is a well‐established variant of LP characterized by the formation of ulcerative lesions predominantly involving the oral and genital mucosae. Less commonly, this condition may involve oesophageal and/or ocular mucosal surfaces, and case reports within the ophthalmology literature have recently confirmed the potential for this condition to affect the nasolacrimal ducts. We report the case of a woman with severe cicatrizing mucosal LP and ocular symptoms secondary to presumed nasolacrimal duct involvement. We also report the potential for this newly appreciated manifestation of LP to respond to systemic cyclosporin A.
Recurrent keratoacanthoma with vascular invasion: A diagnostic and management dilemma
Authors: Kurien Anil , Henderson Christopher , Lee Simon
Published: July 2009

A 71‐year‐old man with chronic renal failure and on peritoneal dialysis presented with recurrence of multiple keratotic nodules along a surgical scar. This was 6 months after the excision of a recurrent keratotic nodule reported as squamous cell carcinoma from the same site. The lesions were initially reported as squamous cell carcinomas, but on review of histology were consistent with keratoacanthomas. One of the keratoacanthomas showed vascular invasion. These responded well to low‐dose acitretin at 10 mg three times per week and the patient stayed in remission after 18 months of follow up.
Refractory subacute cutaneous lupus erythematosus successfully treated with rituximab
Authors: Kieu Violet , O'Brien Timothy , Yap Lee‐Mei , Baker Christopher , Foley Peter , Mason Graham , Prince H Miles , McCormack Christopher
Published: July 2009

A 48‐year‐old woman presented with pruritic, scaly, annular plaques over her upper back and chest that were clinically, serologically and histologically characteristic of subacute cutaneous lupus erythematosus (SCLE). She failed to respond to conventional treatment, which included high‐dose hydroxychloroquine, methotrexate, prednisolone, chloroquine, acitretin, thalidomide, dapsone and azathioprine. Subsequently treated with intravenous rituximab 375 mg/m2 weekly for 4 weeks, she remained on adjuvant oral hydrochloroquine 600 mg daily and topical clobetasol propionate 0.05% ointment as required. Clearing of annular plaques was noted 8 weeks after the initial course of rituximab. By 12 weeks there were no new lesions and only post‐inflammatory hyperpigmentation remained. Both hyper‐ and hypopigmentation, which is more common, are consistent with SCLE lesion regression. Skin lesions recurred 11 months later; however, no further lesions occurred after re‐introduction of rituximab therapy. The treatment was well tolerated. A maintenance regimen of rituximab, 375 mg/m2 every 8 weeks for 2 years, was commenced 3 months after completing the second course of treatment, with ongoing disease remission. Rituximab appears to have activity in refractory SCLE and clinical trials are required to further assess this potential therapy.
Toxic epidermal necrolysis and neutropaenia: Complications of omeprazole
Authors: Thakor Avnesh S , Burke Ailbhe , Handfield‐Jones Susan , Sinha Ayush , Palmer Mike , Burns Alys
Published: July 2009

Worldwide, proton pump inhibitors (PPI) are one of the most frequently prescribed drugs; however, up to 70% of patients taking these drugs have no appropriate indication. Although PPI are relatively well tolerated, they are not free from side‐effects and several life‐threatening complications are associated with them. In the present report, a 43‐year‐old woman presented to her general practitioner with an erythematous rash over her face and chest, having been started on omeprazole for chronic abdominal bloating. Over the next 24 h she became increasingly unwell and was admitted to hospital with shortness of breath, pyrexia and the rash spreading over her back, arms and legs. Vesicles had now started to appear within the erythematous regions over her upper body and within 24 h the rash became confluent and desquamative, spreading to involve her entire body. A diagnosis of toxic epidermal necrolysis (TEN) was made. Despite supportive treatment within a critical care setting, she became neutropaenic and her skin loss became more extensive, resulting in 95% epidermal detachment. This case highlights that TEN is a life‐threatening condition associated with a high incidence of morbidity and mortality. Optimal management requires early diagnosis and transfer to a specialized unit. Clinicians need to be aware that PPI are not free from side‐effects and that their routine prescription should be strongly discouraged.
Repigmentation and curling of hair after acitretin therapy
Authors: Seckin Dilek , Yildiz Ayfer
Published: July 2009

Drug‐induced hair colour and texture changes have been reported rarely. We describe a 70‐year‐old woman with psoriasis who noticed darkening of her previously white hair, which also gained a curly appearance after 6 months of acitretin treatment. We present this case to emphasize that acitretin can be added to the list of drugs that induce changes in hair colour and texture.
Granuloma faciale successfully treated with topical tacrolimus
Authors: Patterson Clare , Coutts Ian
Published: July 2009

Granuloma faciale (GF) is a benign chronic condition characterized by recurrent plaques and nodules most commonly found on the face. We report a man with a 6‐month history of plaques on his forehead and preauricular area consistent with GF that responded to twice‐daily application of topical tacrolimus ointment, and who remains in remission 1 year later. This case supports previous reports of the successful use of topical tacrolimus in treating GF.
Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods study
Authors: Nagel Tricia , Robinson Gary , Condon John , Trauer Tom
Published: July 2009

Objective:  To develop and evaluate a culturally adapted brief intervention for Indigenous people with chronic mental illness.

Design:  A mixed methods design in which an exploratory phase of qualitative research was followed by a nested randomised controlled trial.

Setting:  Psycho‐education resources and a brief intervention, motivational care planning (MCP), were developed and tested in collaboration with aboriginal mental health workers in three remote communities in northern Australia.

Participants:  A total of 49 patients with mental illness and 37 carers were recruited to a randomised controlled trial that compared MCP (n = 24) with a clinical control condition (treatment as usual, n = 25).

Intervention:  The early treatment group received MCP at baseline and the late treatment group received delayed treatment at six months.

Main outcome measures:  The primary outcome was mental health problem severity as measured by the health of the nation outcome scales. Secondary measures of well‐being (Kessler 10), life skills, self‐management and substance dependence were chosen. Outcome assessments were performed at baseline, six‐month, 12‐month and 18‐month follow up.

Results:  Random effects regression analyses showed significant advantage for the treatment condition in terms of well‐being with changes in health of the nation outcome scales (P < 0.001) and Kessler 10 (P = 0.001), which were sustained over time. There was also significant advantage for treatment for alcohol dependence (P = 0.05), with response also evident in cannabis dependence (P = 0.064) and with changes in substance dependence sustained over time.

Conclusions:  These results suggest that MCP is an effective treatment for Indigenous people with mental illness and provide insight into the experience of mental illness in remote communities.
Do rural hospitals lag behind urban hospitals in addressing community health needs? An analysis of recent trends in US community hospitals
Authors: Zhang Wanqing , Mueller Keith J. , Chen Li‐Wu
Published: July 2009

Objective:  This study examined whether rural and urban hospitals differ in their level of responsiveness to community health needs.

Design:  This study used a multivariate, longitudinal research design.

Research setting:  A cross‐sectional survey was the setting for this study.

Participants:  The participants were rural or urban hospitals in the United States.

Main outcome measures:  The dependent variables were selected from the American Hospital Association hospital survey questions that are related to community health needs. The independent variable was rural or urban location.

Results:  Rural hospitals improved more than urban hospitals in addressing community health needs from 1997 through 2006 for most of the indicators, especially in working with other providers to conduct a community health assessment. However, rural hospitals still lag significantly behind urban hospitals in tracking health information.

Conclusions:  This study suggests that rural hospitals do not lag behind urban hospitals in addressing community health needs. Further research is needed to understand the role of community hospitals in influencing local health delivery system activities regarding the potential community benefits and their impact on improving health of local populations.
Regional differences among employed nurses: A Queensland study
Authors: Henwood Tim , Eley Robert , Parker Deborah , Tuckett Anthony , Hegney Desley
Published: July 2009

Objective:  To ascertain differences in the working lives of geographically dispersed nurses.

Design:  Cross‐sectional.

Setting:  Registered, enrolled and assistants‐in‐nursing members of the Queensland Nurses' Union employed in nursing in Queensland, Australia.

Participants:  A total of 3000 members of the Union, equally stratified by sector (public, private, aged care). Among them, 1192 responded and 1039 supplied postcodes matching the Australian Standard Geographical Classification.

Main outcome measures:  Statistically significant differences in working lives of nurses employed in different geographical locations.

Results:  Nurses in outer regional/remote/very remote localities are more likely to be employed as permanent full‐time staff and self‐report higher levels of work stress. These levels could be explained by: lack of replacement staff for leave, longer working and on call hours and lack of support for new staff. Distance remains a major barrier to accessing continuing professional education. However, outer regional/remote/very remote nurses were more likely to be provided employer support for professional education. Inner regional nurses were more likely to work part time, would work more hours if offered and were more likely to have taken a break from nursing as a result of family commitments.

Conclusion:  The data confirm that current policies are not addressing the differences in the working lives of geographically dispersed nurses. Policies addressing orientation, mentoring and workloads should be implemented to address these issues.
What stresses remote area nurses? Current knowledge and future action
Authors: Lenthall Sue , Wakerman John , Opie Tess , Dollard Maureen , Dunn Sandra , Knight Sabina , MacLeod Martha , Watson Colin
Published: July 2009

Objective:  Review and synthesise the literature identifying the stresses experienced by remote area nurses (RANs). Identify interventions implemented to address identified stresses. Explore the use of the job demands–resources (JD‐R) model.

Methods:  A comprehensive literature review was conducted using the meta‐databases Ovid and Informit.

Setting:  Remote Australian primary health care centres.

Results:  The reported demands experienced by RANs can be grouped into four themes: (i) the remote context; (ii) workload and extended scope of practice; (iii) poor management; and (iv) violence in the workplace and community. In this high‐demand, low‐resource context, the JD‐R model of occupational stress is particularly pertinent to examining occupational stress among RANs. The demands on RANs, such as the isolated geographical context, are immutable. However, there are key areas where resources can be enhanced to better meet the high level of need. These are: (i) adequate and appropriate education, training and orientation; (ii) appropriate funding of remote health services; and (iii) improved management practices and systems.

Conclusion:  There is a lack of empirical evidence relating to stresses experienced by RANs. The literature identifies some of the stresses experienced by RANs as unique to the remote context, while some are related to high demands coupled with a deficit of appropriate resources. Use of models, such as the JD‐R model of occupational stress, might assist in identifying key areas where resources can be enhanced to better meet the high level of need and reduce RANs' levels of stress.
Review article: Coagulation cascade and therapeutics update: Relevance to nephrology. Part 1: Overview of coagulation, thrombophilias and history of anticoagulants
Authors: ADAMS REBECCA L C , BIRD ROBERT J
Published: July 2009

Coagulation involves the regulated sequence of proteolytic activation of a series of zymogens to achieve appropriate and timely haemostasis in an injured vessel, in an environment that overwhelmingly favours an anticoagulant state. In the non‐pathological state, the inciting event involves exposure of circulating factor VII/VIIa to extravascularly expressed tissue factor, which brings into motion the series of steps which results in amplification of the initial stimulus, culminating in the conversion of fibrinogen to fibrin and clot formation. The precisely synchronized cascade of events is counter‐balanced by a system of anticoagulant mechanisms, which serve to ensure that the haemostatic effect is regulated and does not extend inappropriately. Conversely, in pathological states, these events can escape normal control mechanisms, due to either inherited or acquired defects, which lead to thrombosis. Current anticoagulant therapy, although based on medications that have been in existence for upwards of 80 years, is moving towards targeted therapy for specific coagulation factors and events in the coagulation cascade, based on the current knowledge of the main triggers and key events within the series of reactions that culminates in haemostasis. It remains to be seen whether these newer medications will become first‐line therapies for thrombosis in the coming decade. This review aims to elucidate the main events within the coagulation cascade as it is currently understood to operate in vivo, with a brief discussion focusing on hypercoagulable states, and also a short review of the history of anticoagulants as they relate to this model.
Associations between functional tooth number and physical complaints of community‐residing adults in a 15‐year cohort study
Authors: Fukai Kakuhiro , Takiguchi Toru , Ando Yuichi , Aoyama Hitoshi , Miyakawa Youko , Ito Gakuji , Inoue Masakazu , Sasaki Hidetada
Published: July 2009

Background:  Oral function influences various general health and organ diseases. We wondered if physical complaints of unknown origin were related to oral function.

Methods:  Five thousand five hundred and eighty‐four community residents (2206 men and 3378 women, aged 40–89 years) on the Miyako Islands, Okinawa Prefecture, Japan, were recruited for the baseline study in 1987 and followed up for 15 years. Physical complaints and functional tooth numbers were assessed for the baseline study in 1987 by dentists and followed up for 15 years. Physical complaints of unknown origin included shoulder stiffness, lower back pain, pain of upper extremity, pain of lower extremity, neuralgia, ear ringing, difficult of hearing, dizziness and sleeping difficulties.

Results:  Physical complaints were significantly associated with functional tooth number in the baseline study. There were no systematic differences between physical complaints and functional tooth number among different age groups. Physical complaints did not influence the survival rates in either men or women.

Conclusion:  Oral function may be related to physical complaints. Dental care may be one of the targets to treat these physical complaints of unknown origin.
Comprehensive geriatric assessment of elderly highlanders in Qinghai, China I: Activities of daily living, quality of life and metabolic syndrome
Authors: Matsubayashi Kozo , Kimura Yumi , Sakamoto Ryota , Wada Taizo , Ishimoto Yasuko , Hirosaki Mayumi , Konno Akiko , Chen Wingling , Ishine Masayuki , Kosaka Yasuyuki , Wada Chizu , Nakatsuka Masahiro , Otsuka Kuniaki , Fujisawa Michiko , Wang Hongxing , Dai Qingxiang , Yang Airong , Gao Jidong , Li Zhanquan , Qiao Haisheng , Zhang Yongshou , Ge Ri Li , Okumiya Kiyohito
Published: July 2009

Aim:  To reveal the comparison of comprehensive geriatric functions of elderly highlanders in Qinghai Plateau in China among three different ethnic groups.

Methods:  Activities of daily living (ADL), screening‐based depression, quality of life (QOL) and checking‐up of metabolic syndrome including community‐based oral glucose tolerance test were assessed in 393 community‐dwelling elderly subjects aged 60 years or more (247 Han elderly subjects, 49 Mongolian ones and 97 Tibetan ones).

Results:  Tibetan elderly highlanders were more disabled in ADL, but had higher QOL than Han elderly ones in Qinghai Plateau. Blood pressure measurements, rate of hypertension and hemoglobin concentrations in Tibetan elderly highlanders were lower than Han ones. Rates of diabetes and impaired glucose tolerance in elderly highlanders were relatively lower than other Asian elderly lowlanders.

Conclusion:  Prevalence of metabolic syndrome in elderly highlanders in Qinghai was still not high, however, we should pay attention to its tendency related with socialglobalism in the near future. Further investigation on physiological adaptability to hypoxic environment and human ageing phenomena in a global context may open a new research frontier for ageing science.
Shrub encroachment can reverse desertification in semi‐arid Mediterranean grasslands
Authors: Maestre Fernando T. , Bowker Matthew A. , Puche María D. , Belén Hinojosa M. , Martínez Isabel , García‐Palacios Pablo , Castillo Andrea P. , Soliveres Santiago , Luzuriaga Arántzazu L. , Sánchez Ana M. , Carreira José A. , Gallardo Antonio , Escudero Adrián
Published: July 2009

The worldwide phenomenon of shrub encroachment in grass‐dominated dryland ecosystems is commonly associated with desertification. Studies of the purported desertification effects associated with shrub encroachment are often restricted to relatively few study areas, and document a narrow range of possible impacts upon biota and ecosystem processes. We conducted a study in degraded Mediterranean grasslands dominated by Stipa tenacissima to simultaneously evaluate the effects of shrub encroachment on the structure and composition of multiple biotic community components, and on various indicators of ecosystem function. Shrub encroachment enhanced vascular plant richness, biomass of fungi, actinomycetes and other bacteria, and was linked with greater soil fertility and N mineralization rates. While shrub encroachment may be a widespread phenomenon in drylands, an interpretation that this is an expression of desertification is not universal. Our results suggest that shrub establishment may be an important step in the reversal of desertification processes in the Mediterranean region.
Lifestyle of Lactobacillus plantarum in the mouse caecum
Authors: Marco Maria L. , Peters Theodorus H. F. , Bongers Roger S. , Molenaar Douwe , Van Hemert Saskia , Sonnenburg Justin L. , Gordon Jeffrey I. , Kleerebezem Michiel
Published: July 2009

Lactobacillus plantarum is a common inhabitant of mammalian gastrointestinal tracts. Strains of L. plantarum are also marketed as probiotics intended to confer beneficial health effects upon delivery to the human gut. To understand how L. plantarum adapts to its gut habitat, we used whole genome transcriptional profiling to characterize the transcriptome of strain WCFS1 during colonization of the caeca of adult germ‐free C57Bl/6 J mice fed a standard low‐fat rodent chow diet rich in complex plant polysaccharides or a prototypic Western diet high in simple sugars and fat. Lactobacillus plantarum colonized the digestive tracts of these animals to high levels, although L. plantarum was found in 10‐fold higher amounts in the caeca of mice fed the standard chow. Metabolic reconstructions based on the transcriptional data sets revealed that genes involved in carbohydrate transport and metabolism form the principal functional group that is upregulated in vivo compared with exponential phase cells grown in three different culture media, and that a Western diet provides a more nutritionally restricted, growth limiting milieu for the microbe in the distal gut. A set of bacterial genes encoding cell surface‐related functions were differentially regulated in both groups of mice. This set included downregulated genes required for the d‐alanylation of lipoteichoic acids, extracellular structures of L. plantarum that mediate interactions with the host immune system. These results, obtained in a reductionist gnotobiotic mouse model of the gut ecosystem, provide insights about the niches (professions) of this lactic acid bacterium, and a context for systematically testing features that affect epithelial and immune cell responses to this organism in the digestive tract.
Host–virus shift of the sphingolipid pathway along an Emiliania huxleyi bloom: survival of the fattest
Authors: Pagarete António , Allen Michael J. , Wilson William H. , Kimmance Susan A. , De Vargas Colomban
Published: July 2009

The interactions between viruses and phytoplankton play a key role in shaping the ecological and evolutionary dynamics of oceanic ecosystems. One of the most fascinating examples of horizontal gene transfer between a eukaryotic host and its virus is a de novo sphingolipid biosynthesis pathway (SBP) found in the genomes of both Emiliania huxleyi and its coccolithovirus EhV‐86. Here, we focus on a natural E. huxleyi/coccolithovirus system off the coast of Norway and investigate the dynamics of host and virus homologous gene expression for two of the most important sphingolipid biosynthesis enzymes, serine palmitoyl transferase (SPT) and dihydroceramide desaturase (DCD). Transcriptional dynamics display three defined stages along E. huxleyi bloom formation and decline, with the coccolithovirus transcripts taking over and controlling the SBP in stages 2 and 3. The observed patterns fit the hypothesis according to which viral sphingolipids are involved in the timing and physical processes of virion release from the host cells. This study provides a unique insight into the transcriptional interplay of homologous metabolic pathways between virus and host during temporal progression of oceanic E. huxleyi blooms.
Corporate Governance in the Debate on CSR and Ethics: Sensemaking of Social Issues in Management by Authorities and CEOs
Authors: Fassin Yves , Van Rossem Annick
Published: July 2009

Manuscript Type: Empirical

Research Question/Issue: The goal of the present exploratory cognitive study is to uncover how opinion leaders – CEOs and other authorities in the domain of social issues in management – understand and differentiate the various concepts pertaining to corporate governance, corporate social responsibility (CSR), and business ethics. The present study with the Repertory Grid Technique (RGT) extends the analysis to the whole spectrum of social issues in management. For this research 41 RGT interviews were conducted in Belgium with top experts and CEOs of the Belgian economy and civil society.

Research Findings/Results: Both authorities and CEOs pragmatically and rather clearly differentiate the various concepts related to corporate governance, CSR, and business ethics. Our findings partially reject the confusion in terminology noticed in recent academic literature and in corporate communication, emphasizing increased vagueness and overlapping of the concepts around corporate governance, CSR, and business ethics.

Theoretical Implications: While CSR is seen as the best candidate for an umbrella term, no unified paradigm has yet to be achieved in the business and social field. Three basic concepts of corporate responsibility, corporate governance, and business ethics emerge as being complementary. Corporate governance has acquired an important place in the hierarchy of business and society concepts.

Practical Implications: Corporations cannot restrict their actions and communication regarding social issues in management to one single domain. Several complementary issues have to be addressed simultaneously. This combined multi‐dimensional approach will result in mutual reinforcements of the message.
Preserved Implicit Knowledge of a Forgotten Childhood Language
Authors: Bowers Jeffrey S. , Mattys Sven L. , Gage Suzanne H.
Published: July 2009

Previous research suggests that a language learned during early childhood is completely forgotten when contact to that language is severed. In contrast with these findings, we report leftover traces of early language exposure in individuals in their adult years, despite a complete absence of explicit memory for the language. Specifically, native English individuals under age 40 selectively relearned subtle Hindi or Zulu sound contrasts that they once knew. However, individuals over 40 failed to show any relearning, and young control participants with no previous exposure to Hindi or Zulu showed no learning. This research highlights the lasting impact of early language experience in shaping speech perception, and the value of exposing children to foreign languages even if such exposure does not continue into adulthood.
Color-Binding Errors During Rivalrous Suppression of Form
Authors: Hong Sang Wook , Shevell Steven K.
Published: July 2009

How does a physical stimulus determine a conscious percept? Binocular rivalry provides useful insights into this question because constant physical stimulation during rivalry causes different visual experiences. For example, presentation of vertical stripes to one eye and horizontal stripes to the other eye results in a percept that alternates between horizontal and vertical stripes. Presentation of a different color to each eye (color rivalry) produces alternating percepts of the two colors or, in some cases, a color mixture. The experiments reported here reveal a novel and instructive resolution of rivalry for stimuli that differ in both form and color: perceptual alternation between the rivalrous forms (e.g., horizontal or vertical stripes), with both eyes' colors seen simultaneously in separate parts of the currently perceived form. Thus, the colors presented to the two eyes (a) maintain their distinct neural representations despite resolution of form rivalry and (b) can bind separately to distinct parts of the perceived form.
INSTITUTIONAL RESEARCH ON PERFORMANCE MEASUREMENT AND MANAGEMENT IN THE PUBLIC SECTOR ACCOUNTING LITERATURE: A REVIEW AND ASSESSMENT
Authors: Modell Sven
Published: July 2009

This paper reviews the evolution of institutional research on performance measurement and management (PMM) in the public sector accounting literature. An assessment of the progress of this research programme is offered in light of some key developments in the broader neo‐institutional sociology (NIS) literature, such as the growing recognition of the role of embedded agency, the need to bridge institutional and rational choice explanations of action and the extension of empirical research across different levels of institutional fields. Some progress has been made in this respect and has contributed to shift the emphasis from a one‐sided focus on institutional effects on PMM, treating institutional pressures as largely exogenous, to recognize its more intricate roles as an outcome of, as well as a medium for, change. However, further research is required into the micro dynamics involved in transforming and reproducing PMM practices at different levels of analysis and how such practices become infused with meanings conditioned by higher‐order institutional logics across various levels of institutional fields. Some research strategies for addressing these issues are outlined.
MANAGING LOCAL PUBLIC DEBT IN TRANSITION COUNTRIES: AN ISSUE OF SELF‐CONTROL
Authors: Dafflon Bernard , Beer‐Tóth Krisztina
Published: July 2009

One and a half decades after the end of a centralised regime in Central and Eastern Europe, the policy literature on local debt management in transition economies reveals that there is a general confusion about the appropriate use of debt finance at the municipal level. The literature is mainly concerned with institutional borrowing restrictions and sanctions against excessive debt. Both emphasise the responsibility of the centre and consider local government unable to pursue a sound financial management without central patronage. Breaking with the traditional focus on budget discipline, this study advocates budget responsibility. Favourable credit ratings and compliance with legal norms are necessary but not sufficient conditions for municipalities to borrow. Successful financial management requires a more proactive attitude in which local governments adjust their investment policy to their financial capacity, assessing the costs and benefits of each investment project.
Standard Oriented Environmental Policy: Cost-Effectiveness and Incentives for ‘Green Technology’
Authors: Endres Alfred , Rundshagen Bianca
Published: July 2009

In their seminal 1971 paper, W. J. Baumol and W. E. Oates analyzed effluent charges and ‘command and control’ regarding their ability to attain a given standard of environmental quality at minimum cost. In the subsequent literature, transferable discharge permits (TDPs) have been added to the portfolio of standard oriented environmental policy instruments. We place these instruments in a dynamic context. Here, cost minimization is defined in an intertemporal setting allowing for induced technical change. It turns out that the relative performance of alternative policy instruments regarding their ‘dynamic cost-effectiveness’ crucially depends on the information available to the involved agents. Under adverse informational conditions, only a TDP system with future markets is dynamically cost-effective.
Remaining complaints 1 year after treatment for acute Lyme neuroborreliosis; frequency, pattern and risk factors
Authors: Ljøstad U. , Mygland Å.
Published: July 2009

Background and purpose:  To chart remaining complaints 1 year after treatment for neuroborreliosis, and to identify risk factors for a non‐favorable outcome.

Methods:  We followed patients treated for neuroborreliosis prospectively, and assessed outcome by a composite clinical score. The impact on outcome of clinical, demographic and laboratory factors were analyzed by univariate analyses and logistic regression.

Results:  Out of 85 patients 41 (48%) had remaining complaints; 14 had objective findings and 27 subjective symptoms. Remaining complaints were associated with pre‐treatment symptom duration ≥6 weeks (OR = 4.062, P = 0.044), high pre‐treatment cerebrospinal fluid (CSF) cell count (OR = 1.005, P = 0.001), and female gender (OR = 3.218, P = 0.025). Presence of CSF oligoclonal bands (OCBs) was not analyzed in the logistic regression model due to many missing observations, but was found to be more frequent both pre‐treatment (P = 0.004) and after 12 months (P = 0.015) among patients with remaining complaints as compared to patients with complete recovery. Further evaluation showed that objective remaining findings, and not subjective symptoms, were associated with pre‐treatment symptom duration ≥6 weeks.

No difference in outcome was observed between patients treated with IV ceftriaxone and patients treated with oral doxycycline.

Conclusion:  Remaining complaints are common after neuroborreliosis. The majority of the complaints are subjective. Pre‐treatment symptom duration ≥6 weeks, high pre‐treatment CSF cell count, and female gender seem to be risk factors for remaining complaints. Presence of CSF OCBs may also predict a non‐favorable outcome, but this should be further studied. Whether subjective and objective complaints are associated with different risk factors is also an issue for future studies.
Acoustic communication in crocodilians: from behaviour to brain
Authors: Vergne A. L. , Pritz M. B. , Mathevon N.
Published: July 2009

Crocodilians and birds are the modern representatives of Phylum Archosauria. Although there have been recent advances in our understanding of the phylogeny and ecology of ancient archosaurs like dinosaurs, it still remains a challenge to obtain reliable information about their behaviour. The comparative study of birds and crocodiles represents one approach to this interesting problem. One of their shared behavioural features is the use of acoustic communication, especially in the context of parental care. Although considerable data are available for birds, information concerning crocodilians is limited. The aim of this review is to summarize current knowledge about acoustic communication in crocodilians, from sound production to hearing processes, and to stimulate research in this field.

Juvenile crocodilians utter a variety of communication sounds that can be classified into various functional categories: (1) “hatching calls”, solicit the parents at hatching and fine‐tune hatching synchrony among siblings; (2) “contact calls”, thought to maintain cohesion among juveniles; (3) “distress calls”, induce parental protection; and (4) “threat and disturbance calls”, which perhaps function in defence. Adult calls can likewise be classified as follows: (1) “bellows”, emitted by both sexes and believed to function during courtship and territorial defence; (2) “maternal growls”, might maintain cohesion among offspring; and (3) “hisses”, may function in defence. However, further experiments are needed to identify the role of each call more accurately as well as systematic studies concerning the acoustic structure of vocalizations. The mechanism of sound production and its control are also poorly understood. No specialized vocal apparatus has been described in detail and the motor neural circuitry remains to be elucidated. The hearing capabilities of crocodilians appear to be adapted to sound detection in both air and water. The ear functional anatomy and the auditory sensitivity of these reptiles are similar in many respects to those of birds. The crocodilian nervous system likewise shares many features with that of birds, especially regarding the neuroanatomy of the auditory pathways. However, the functional anatomy of the telencephalic auditory areas is less well understood in crocodilians compared to birds.
Strategies of survival and resource exploitation in the Antarctic fellfield ecosystem
Authors: Block W. , Lewis Smith R. I. , Kennedy A. D.
Published: July 2009

Antarctic fellfields present organisms with a heterogeneous habitat characterised by a wide variety of environmental stresses. These include low temperatures, limited moisture availability, frequent and often rapid freeze‐thaw and hydration‐dehydration cycles, exposure to high photosynthetic photon flux density and ultraviolet (uv) irradiance, seasonal snow cover, high winds, cryoturbation and, depending on location south of the Antarctic Circle, considerable daylight in summer. Most of these factors vary both predictably and unpredictably in spatial and temporal planes. In response to this adverse environment, fellfield organisms have developed a variety of strategies to overcome physiological stress and to exploit the limited resources available during the short austral growing season. A high degree of synchronisation exists, so that investment in non‐essential activity and adaptations is minimised.

Here, we review the combined suites of co‐adapted traits used by different fellfield taxa to achieve energy acquisition, growth and reproduction under adverse levels of two principal limiting factors: low temperatures and the scarcity of water. To this end, a detailed characterisation of the Antarctic fellfield microenvironment is followed by a synthesis of available data on the morphology, physiology, life history and behaviour of successful Antarctic flora and fauna. Tolerance of low temperatures by fellfield organisms is achieved by elevation of standard metabolism, production and accumulation of cryoprotectants, supercooling, melanic pigmentation, behavioural avoidance, compact growth forms and synchronised reproduction and extended life cycles. Low moisture conditions are overcome by dehydration resistance, anhydrobiosis, development of resting stages and by behavioural avoidance of desiccating conditions.

Occupancy of the Antarctic fellfield habitat is considered to require the ability to respond rapidly to ephemeral resources and to tolerate severe environmental stresses. During summer, organisms rely on opportunism to maintain a positive energy balance. During winter, resistance adaptations are used to withstand the potentially lethal climate, especially in habitats not protected by snow cover. This deterministic framework has led to the selection of species that are genetically and physiologically pre‐adapted for resource acquisition yet sufficiently robust to withstand cold and desiccation stresses. Non‐adapted taxa fail to become established. Despite the environmental selection pressures, available evidence suggests that colonisation of the fellfield habitat has not required the evolution of any adaptations, only the refinement of those already possessed to an extent by some temperate forms. This has led to the convergence of survival strategies. It is hypothesised that, in the short term, the majority of Antarctic fellfield biota are able to absorb the predicted effects of a changing climate by their high levels of physiological tolerance and life‐cycle flexibility.