bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacological dose of α-tocopherol induces cardiotoxicity in Wistar rats determined by echocardiography and histology
Authors: Nascimento Maria Carolina MO , Matsubara Beatriz B , Matsubara Luiz S , Correa Camila R , Pereira Elenize J , Moreira Priscila L , Carvalho Flavio A , Burini Caio H , Padovani Carlos R , Yeum Kyung-Jin , Ferreira Ana Lucia A
Published: February 2011

The effect of pharmacological dose of α-tocopherol on heart health was determined in Wistar rats. Animals were randomly assigned to either C (control, n = 11) or E (α-tocopherol, n = 11) group. Animals received corn oil (C) or α-tocopherol dissolved in corn oil (250 mg α-tocopherol/[kg body wt/day]) (E) by gavage for a 7-week period. Rats underwent echocardiogram and were analyzed for cardiomyocyte histology and cardiac α-tocopherol absorption at the end of the study period. As compared to the C group, α-tocopherol-supplemented group showed significantly ( p < 0.05) lower body weight (E, 412.8 g vs C, 480.3 g) and total cardiac weight (E, 0.94 g vs C, 1.08 g); cardiomyocyte histological impairment; smaller left ventricle (LV) (LV end-diastolic diameter (E, 7.22 mm vs C, 7.37 mm), lower LV systolic [left ventricle fractional shortening (E, 47.6% vs C, 53.6%) and ejection fraction ratio (E, 85.4 vs C, 89.9)] and diastolic [early peak velocities of diastolic transmitral flow (E, 64.6 cm/sec vs C, 75.1 cm/sec)] function. The α-tocopherol uptake in target tissue was confirmed by determination of α-tocopherol concentration medians in cardiac tissue (E, 109.91 nmol/kg vs C, 52.09 nmol/kg). The current study indicates that pharmacological dose of α-tocopherol supplementation can induce cardiotoxicity in healthy rats.
Lessons Learned From Translators and Interpreters From the Dinka Tribe of Southern Sudan
Authors: Baird Martha B.
Published: February 2011

This article discusses the methodological challenges associated with working with translators and interpreters from the Dinka tribe of southern Sudan during an ethnographic study with refugee Dinka women who were resettled with their children in the United States. Navigating the cultural differences between the researcher, the translator, and the interpreters provided a deeper understanding about the culture of the study population. The lessons learned included the importance of cultural congruence between the interpreters and participants; the education, training, and experience of the interpreters; and the difficulties encountered in preparing interpreters according to university institutional review board requirements. Cultural differences such as time perception and communication and literacy styles were negotiated throughout each phase of the study. The most valuable lesson learned from this experience was the importance of the relationship between the researcher, the translator, and the interpreters as well as between the interpreters and participants to achieve credibility and trustworthiness of the study results.
Using American Sign Language Interpreters to Facilitate Research Among Deaf Adults: Lessons Learned
Authors: Sheppard Kate
Published: February 2011

Background: Health care providers commonly discuss depressive symptoms with clients, enabling earlier intervention. Such discussions rarely occur between providers and Deaf clients. Most culturally Deaf adults experience early-onset hearing loss, self-identify as part of a unique culture, and communicate in the visual language of American Sign Language (ASL). Communication barriers abound, and depression screening instruments may be unreliable. Purpose: To train and use ASL interpreters for a qualitative study describing depressive symptoms among Deaf adults. Method: Training included research versus community interpreting. During data collection, interpreters translated to and from voiced English and ASL. Results: Training eliminated potential problems during data collection. Unexpected issues included participants asking for “my interpreter” and worrying about confidentiality or friendship in a small community. Conclusions: Lessons learned included the value of careful training of interpreters prior to initiating data collection, including resolution of possible role conflicts and ensuring conceptual equivalence in real-time interpreting.
Translating Questions for Use With Samoan Adults: Lessons Learned
Authors: Siaki Leilani A.
Published: February 2011

The purpose of this article was to present the process of translating questions about perceived risk for diabetes into Samoan and describe important cultural adaptations to the modified Brislin’s translation model for cross-cultural research. With the assistance of a culture broker and several Samoan translators, 14 questions were translated into the Samoan language. Cultural adaptations included using a group approach, working with a matai, and following protocols such as fa’alavelave. Questions were back-translated and then pilot tested. Results from the pilot testing supported the use of these cultural modifications in the translation model.
Working With Translators and Interpreters in Research: Lessons Learned
Authors: Jones Elaine G. , Boyle Joyceen S.
Published: February 2011

The purpose of this special section is to describe culturally competent approaches for working with translators or interpreters who participate in transcultural studies. This article provides background for three exemplars of lessons learned in working with translators in transcultural studies: (a) the resettlement transition experiences of women from the Dinka tribe of Southern Sudan (Baird), (b) Samoans’ risk for heart disease (Siaki), and (c) culturally Deaf adults’ perceptions about depression (Sheppard). Capitalizing the word “Deaf” has gained wide acceptance to indicate a linguistic minority of people who have a hearing loss and use American Sign Language, a hallmark of Deaf culture. In each case, the individual researcher made adaptations to the usual processes of translation/back-translation when appropriate to the cultural context and the specific situations of the translators. Although these lessons were learned during research-related activities, they may apply to other circumstances when nurses work with bilingual/bicultural translators (e.g., translating consent forms or communicating with persons who have limited literacy in their native language).
Physical Violence in the Workplace Among Jordanian Hospital Nurses
Authors: AbuAlRub Raeda Fawzi , Al-Asmar Ali Hasan
Published: February 2011

Purpose: Lack of policies and assertive legislations on workplace violence has placed Jordanian nurses at frequent risk for workplace violence. The purposes of this research were to (a) investigate the level of physical violence and the complaints and responses of Jordanian hospital nurses to such violence and (b) describe workplace policies that deal with violence and recommend policy directions. Design: A descriptive exploratory survey was used to investigate physical workplace violence among a convenience sample of 420 Jordanian nurses. Data were collected by a self-administered questionnaire that was developed in 2003 by the International Labour Organization, International Council of Nurses, World Health Organization, and Public Services International. Results: The findings indicated that 22.5% of the participants were exposed to physical workplace violence. The contributing factors as indicated by the participants were related to the administration, staff, security, patients and families, and the public. Discussion/Conclusion: Participants who had experienced workplace violence were very dissatisfied with the manner in which the incidents were handled. Implications: It is important to investigate consequences of workplace violence on the satisfaction of employees and the quality of heath care service. Instituting appropriate policies and legislations would minimize workplace violence.
How to Prescribe Tai Chi Therapy
Authors: Allen Jennifer , Meires Jan
Published: February 2011

Exercise has been shown to positively influence quality of life for people with a wide variety of medical illnesses. Tai chi, a slow and graceful form of exercise and meditation, has been offered as the ideal exercise for diverse conditions such as chronic heart failure and for breast cancer survivors. In one recent study, tai chi was found to improve exercise capacity, sleep stability, and quality of life in heart failure patients. Another study focusing on breast cancer survivors revealed tai chi to be superior to psychosocial support in increasing aerobic capacity, muscular strength, flexibility, and quality of life. Primary care providers can play a vital role in encouraging their patients with chronic illnesses to participate in safe forms of exercise such as tai chi in order to improve their healing experience, physical function, and overall quality of life.
The Development of a Spanish Language Instrument to Measure Genetic Knowledge of Diabetes Mellitus Type 2
Authors: Mudd Gia T.
Published: February 2011

Purpose: The purpose of this study was to develop a Spanish-language measure of genetic knowledge relevant to type 2 diabetes for use with members of the ethnically heterogeneous U.S. Latino community. Design: Review of the literature and expert content analysis guided initial instrument development. The instrument was pretested in three cognitive interview waves with 36 Latinos representative of Mexican, Central and South American, and Cuban heritage. Interview analysis indicated potential sources of response error and guided an iterative process of instrument refinement. Results: Difficulties associated with item interpretation, grammatical structure, and comprehension were identified. Analysis indicated that revisions improved item quality and enhanced cultural and linguistic appropriateness of the instrument. Conclusions: Field testing suggested initial validity of a Spanish-language instrument to measure genetic knowledge relative to type 2 diabetes. Implications for Practice: A Spanish-language measure of genetic knowledge can guide nursing interventions that support culturally appropriate integration of genetics into health care.
An Integrative Review of the Current Knowledge of Cardiovascular Disease and Associated Risk Factors in the Old Order Amish
Authors: Gillum Deborah R. , Staffileno Beth A.
Published: February 2011

Purpose: To review the uniqueness of the Amish culture and evaluate the published research on cardiovascular disease and associated risk factors in the Amish. Method: A computerized database search from January 1999 to January 2009 was conducted using the search terms Amish and cardiovascular. Results: The majority of published research is based on the Amish in Lancaster County, Pennsylvania; is genetically based; and did not make recommendations for health care practices in the Amish. Conclusions: Studies that focus on cardiovascular disease in the Amish outside Lancaster County, Pennsylvania, and that study cardiovascular health care practices of the Amish are needed to develop culturally specific educational interventions.
The Work of Language Interpretation in Health Care: Complex, Challenging, Exhausting, and Often Invisible
Authors: McDowell Liz , Messias DeAnne K. Hilfinger , Estrada Robin Dawson
Published: February 2011

The value of qualified language interpretation services for limited-English-proficient patients is gaining increasing recognition by policy makers and researchers in the United States. Yet the actual work experiences of health care interpreters have not been adequately studied. The purpose of this qualitative research was to explore the work experiences of formal and informal interpreters ( n = 27). The core narrative finding from the interview data was the complex, challenging, exhausting, and often invisible work of language interpretation. Critical examination of health care interpreters’ complex work and interactions with patients, providers, and administrators is needed to provide more effective and integrated services for limited-English-proficient patients.
The Cultural Context of Smoking Among Immigrants From the Former Soviet Union
Authors: Baker Cathy J. , Fortney Christine A. , Wewers Mary Ellen , Ahijevych Karen L.
Published: February 2011

The purpose of this descriptive, qualitative study was to gain understanding of the cultural context of smoking among immigrants from former Soviet Union countries now living in the Midwest United States. Semistructured interviews were conducted in focus group or individual settings ( N = 14), including smokers and former smokers recruited from community settings. Social factors and stress management strongly motivated smoking behavior. Personal willpower was the most helpful cessation strategy, with firm lack of openness to pharmacologic approaches. Top past stressors included food insecurity and societal unrest, with the top current stressors being acculturative issues. The importance of social connectedness and the relatively low priority of prevention were also themes. Based on these interviews, interventions should include acculturative stress management and maintaining social connectedness, while addressing life experiences in the insecurity of basic needs. Smoking cessation interventions that are tailored beyond just language use and address these specific issues are suggested.
The Impact of Basic-Level Parent Engagements on Student Achievement: Patterns Associated with Race/Ethnicity and Socioeconomic Status (SES)
Authors: Dalun Zhang  , Hsu Hsien-Yuan , Kwok Oi-man , Benz Michael , Bowman-Perrott Lisa
Published: February 2011

Strong empirical evidence exists in general education that links parent involvement to student academic achievement, but such evidence is lacking in special education. Moreover, most prior research investigated parent involvement as a broadly defined term that included various types of parent engagements. As a result, it is difficult to estimate the effect of some specific parent engagements. Using data from the Special Education Elementary Longitudinal Study (SEELS), this study examined influences of race/ethnicity and socioeconomic status on basic-level parent engagements in school and home settings (i.e., participation in school activities, talking to their child about his/her experiences in school, and expectations for the child to graduate from high school) and the relationship of these engagements to student achievement. Engagement at home was found to have a positive impact on student achievement, but participation in school activities did not significantly affect student achievement. Discussion and implications of these findings, and recommendations for future research are provided.
Trends in Hospice Utilization Across Age Among the Veteran Population
Authors: Frahm Kathryn A. , Barnett Scott D. , Brown Lisa M.
Published: February 2011

Hospice is a major expansion area within the Veterans Health Administration (VHA). The objective of this retrospective study was to explore trends in hospice utilization among older veterans receiving services at the end of life over a 4-year (2006-2009) time period. Reviewing trends, the number of veterans receiving hospice services increased annually, with 5779 veterans receiving services during 2009, up from 1742 veterans in 2006. The total cost of providing hospice rose dramatically, increasing from $1.98 million in 2006 to $5.91 million in 2009. More funds were spent on younger veterans, with an average of $1.5 million spent on veterans aged 55 to 64 and less than $400,000 spent on veterans aged 85 and older. Findings highlight the growing need and demand for hospice within the VHA to provide end-of-life services.
Calcifying Nested Stroma-Epithelial Tumor of the Liver: A Case Report and Review of Literature
Authors: Yan Wang  , Jing Zhou  , Huang Wen-Bing , Qiu Rao  , Ma Heng-Hui , Zhou Xiao-Jun
Published: February 2011

Calcifying nested stromal—epithelial tumor (CNSET) of the liver is extremely rare. This tumor is characterized by nests of epithelial and spindle cells, an associated desmoplastic stroma, as well as variable calcifications and ossifications. Only 24 cases have been reported in the literature whereas none has been reported in Asian descendants. The authors report the first case of CNSET in a 34-year-old Asian woman and provide detailed histological and clinical follow-up data. Compared with those reported earlier, the present case with a history of oral contraceptive use displayed most typical features and the oldest age of onset. A retrospective study was made and the characteristics of CNSET were summarized.
Tizanidine (Zanaflex)
Authors: Kaddar Nisrin , Vigneault Patrick , Pilote Sylvie , Patoine Dany , Simard Chantale , Drolet Benoit
Published: February 2011

Background: Tizanidine (Zanaflex) is a centrally acting imidazoline muscle relaxant that is structurally similar to clonidine (α2-adrenergic agonist) but not to other myorelaxants such as baclofen or benzodiazepines. Interestingly, cardiac arrhythmias and QT interval prolongation have been reported with tizanidine. Objective: To evaluate the effects of tizanidine on cardiac ventricular repolarization. Methods: (1) Whole-cell patch-clamp experiments: HERG- or KCNQ1+KCNE1-transfected cells were exposed to tizanidine 0.1-100 µmol/L (n = 29 cells, total) to assess drug effect on the rapid (IKr) and slow (IKs) components of the delayed rectifier potassium current. (2) Langendorff retroperfusion experiments: isolated hearts from male Hartley guinea pigs (n = 6) were exposed to tizanidine 1 µmol/L to assess drug-induced prolongation of monophasic action potential duration measured at 90% repolarization (MAPD90). (3) In vivo wireless cardiac telemetry experiments: guinea pigs (n = 6) implanted with radio transmitters were injected a single intraperitoneal (ip) dose of tizanidine 0.25 mg/kg and 24 hours electrocardiography (ECG) recordings were made. Results: (1) Patch-clamp experiments revealed an estimated IC50 for tizanidine on IKr above 100 µmol/L. Moreover, tizanidine 1 µmol/L had hardly any effect on IKs (5.23% ± 4.54% inhibition, n = 5 cells). (2) While pacing the hearts at stimulation cycle lengths of 200 or 250 ms, tizanidine 1 µmol/L prolonged MAPD90 by 8.22 ± 2.03 (6.7%) and 11.70 ± 3.08 ms (8.5%), respectively (both P < .05 vs baseline). (3) Tizanidine 0.25 mg/kg ip caused a maximal 11.93 ± 1.49 ms prolongation of corrected QT interval (QTc), 90 minutes after injection. Conclusion: Tizanidine prolongs the QT interval by blocking IKr. Patients could be at risk of cardiac proarrhythmia during impaired drug elimination, such as in case of CYP1A2 inhibition during drug interactions.
Race and Regionalism: The Structure of Local Government and Racial Disparity
Authors: Lewis James H. , Hamilton David K.
Published: February 2011

How opportunity is distributed among its component racial groups in a metropolitan region is an important question and is likely to become more so as regions become denser economically and socially. The extent to which governmental structure contributes to racial sorting has been debated since the development of public choice theory. To evaluate how various structural, political, and historical factors affect the relative distribution of opportunity between racial groups in urban regions of the United States, the authors apply a cross-sectional approach, comparing regional characteristics at the time of the 2000 census. Their analysis of the correlates and determinants of racial disparities suggests that these factors collectively explain significant amounts of regional variation with respect to residential racial segregation, cost and quality of housing, and income. The number of local governments and fiscal power diffusion explain some racial disparity. Larger size of black population in a region is associated with less segregation, but more economic disparity while the opposite tends to be true for Hispanics.More liberal state policies and political culture occur where metropolitan black-white segregation is higher. Higher central city incomes appear to decrease segregation while higher suburban income increases it.
Ventricular fibrillation as a likely consequence of capecitabine-induced coronary vasospasm
Authors: Shah NR , Shah A , Rather A
Published: February 2011

Capecitabine is a member of the fluoropyrimidine family of chemotherapeutic agents that selectively delivers 5-fluorouracil (5-FU) to tumors. It is increasingly used as part of combined modality treatment for gastrointestinal malignancies. Cardiotoxicity has been documented to occur with 5-FU, but due to an expansion in capecitabine use, reports exist of its propensity to coronary vasospasm. We report the case of a 28-year-old man, with no preceding angina, presenting with a reversible episode of ventricular fibrillation (VF) at rest in his fifth course of capecitabine chemotherapy for metastatic colorectal cancer. Emergency resuscitation successfully restored spontaneous circulation, with initial ST segment elevation in the inferolateral leads on electrocardiogram prompting emergency coronary angiography. This demonstrated normal coronary arteries. ST segments normalized post-angiography and the patient rapidly recovered with no myocardial damage sustained. An implantable cardioverter-defibrillator was placed for secondary prevention of sudden death, and capecitabine was implicated as the cause of coronary vasospasm which resulted in his presentation of VF. To our knowledge, this is the first episode of VF as a consequence of suspected capecitabine-induced coronary vasospasm occurring at rest. Our case highlights the potential for severe cardiotoxic consequences of capecitabine including sudden death from VF, and given the multi-disciplinary approach to managing oncology patients, health professionals should be aware of this.
Understanding the experiences and emotional needs of unaccompanied asylum-seeking adolescents in the UK
Authors: Groark Claire , Sclare Irene , Raval Hitesh
Published: February 2011

For adolescents who flee to the UK seeking asylum, the experience of leaving their home country puts them at risk of developing mental health problems. Although there is a research base exploring the mental health of asylum-seeking children and adolescents who arrive with their families, there is in contrast very little focusing on the mental health needs of children and adolescents who arrive in the UK alone. There has been ongoing debate about whether current theoretical models for understanding reactions to trauma and loss are helpful in supporting unaccompanied asylum-seeking children and adolescents with complex psychological and social issues as a result of fleeing their home countries. This article draws on young people’s own understanding of their experiences of seeking asylum in the UK using a qualitative semi-structured interview. It attempts to develop a more contextually relevant understanding of their emotional reactions to adversity and to consider the sorts of support required. Interpretative Phenomenological Analysis was used to provide an in-depth understanding of six young asylum seekers’ experiences, exploring themes of loss, negotiating a new life, psychological distress and the process of adjustment. Psychological interventions and future service provision for this group are discussed.
Translation and standardization of the HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents) scale in a Greek sample
Authors: Adamis Dimitrios , Giannakopoulou Dimitra F. , Konstantopoulou Aegli , Michailides Michael
Published: February 2011

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) is a brief measure of outcomes. Evidence for the effectiveness of patient treatments conducted in mental health services is limited in Greece. Thus, in an attempt to employ an easily administered and valid outcome measure, to assess outcomes in clinical practice for children and adolescents, but also to be able to compare the results across countries, the HoNOSCA was the measure of choice. In this study we have translated and validated it in a Greek sample. We have investigated the inter-rater reliability, intraclass correlation, concurrent validity, and clinical change across time, of the HoNOSCA Greek translation. The results show that the Greek translation of HoNOSCA is a reliable and valid instrument. It can be used for clinical, managerial, research and audit purposes, but, most importantly, to facilitate multinational clinical research and comparison of data with other countries.
Exploring views on satisfaction with life in young children with chronic illness: An innovative approach to the collection of self-report data from children under 11
Authors: Christie Deborah , Romano Gabriella , Barnes Jacqueline , Madge Nicola , Nicholas David B. , Koot Hans M. , Armstrong Daniel F. , Shevlin Mark , Kantaris Xenya , Khatun Hasina , Sutcliffe Alastair G.
Published: February 2011

The objective of this study was to explore young children’s views on the impact of chronic illness on their life in order to inform future development of a patient-based self-report health outcome measure. We describe an approach to facilitating self-report views from young children with chronic illness. A board game was designed in order to obtain qualitative data from 39 children with a range of chronic illness conditions and 38 healthy controls ranging in age from 3 to 11 years. The format was effective in engaging young children in a self-report process of determining satisfaction with life and identified nine domains. The board game enabled children aged 5–11 years with chronic illness to describe the effects of living with illness on home, family, friends, school and life in general. It generated direct, non-interpreted material from children who, because of their age, may have been considered unable or limited their ability to discuss and describe how they feel. Obtaining this information for children aged 4 and under continues to be a challenge.
Diet and sleep in children with attention deficit hyperactivity disorder: Preliminary data in Australian children
Authors: Blunden Sarah Lee , Milte Catherine M , Sinn Natalie
Published: February 2011

Sleep disturbances are common and consequential in children with attention deficit hyperactivity disorder (ADHD). Diet also influences ADHD symptoms. Interrelationships between diet, sleep and behaviour in children diagnosed with ADHD are little studied. We investigated, via parental report, the relationships between sleep and diet in 88 Australian children aged 6—13 years old ( M = 8.94, SD = 1.78). This pilot data shows that 30 per cent of the children had sleep disturbance (≥ 2 standard deviations above the mean) with significant relationships between ADHD symptoms, sleep disturbance and diet. Parents who reported more sleep disturbance also reported a higher intake of carbohydrate, fats, and, most particularly, sugar which was also a significant predictor of night time sweating. These findings suggest an interrelationship between diet and sleep in children with ADHD. Given that both sleep and dietary intake are potentially modifiable behaviours within treatment regimes of children with ADHD, further investigation is needed.
Health disparities in low-income families with infants and toddlers: Needs and challenges related to disability
Authors: Swanson Mark E , Wall Shavaun , Kisker Ellen , Peterson Carla
Published: February 2011

This study examines disparities in health status, health care utilization, insurance coverage and satisfaction in US low-income parents of infants and toddlers with disabilities compared to low-income parents of children without disabilities. The Early Head Start Research and Evaluation Project is a longitudinal study involving 2087 families in 17 communities across the United States. Families completed interviews at enrollment and at 7, 16, and 28 months after enrollment. Descriptive analyses were conducted to characterize children’s status in terms of health, health care use, and insurance coverage. Children with disabilities were more likely to experience poor health and to use more health care services. Parents of children with disabilities were more likely to report that medical care was inadequate. Hispanic children were less likely to experience excellent health. Hispanic parents were less likely to have health insurance or to report that their medical care was adequate. Low-income parents of young children with disabilities perceived their children as less healthy, more vulnerable and needing more health services. This study demonstrates the importance of providing accessible, culturally-competent services to this vulnerable population.
Health-related quality of life (HRQOL) in Latino families experiencing pediatric asthma
Authors: Garro Adrienne
Published: February 2011

The purpose of the present study was to examine health-related quality of life (HRQOL) in Latino children with asthma and their parents. Twenty-six parents completed the Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ), the Health Status and Activities Questionnaire for Children with Asthma (HSAQ) and four subscales from the Family Environment Scale. The results indicated that, overall, neither children with asthma nor their parents showed significant impairments in their HRQOL, though higher illness severity was associated with lower child quality of life and lower parent quality of life related to activity limitations. Other child and family variables, including dimensions of family functioning, did not correlate significantly with HRQOL. However, child and parent HRQOL were significantly associated with each other. This study provides additional context for understanding the experiences of Latino families dealing with pediatric asthma.
Residents’ perspectives on safety support needs in different types of housing areas
Authors: Kullberg Agneta , Nordqvist Cecilia , Timpka Toomas , Lindqvist Kent
Published: February 2011

Background: Knowledge about conditions that are understood to support safety is important for planning residential safety promotion in interactions with residents. How residents themselves perceive and reason about their own safety needs has seldom been investigated in Scandinavia. Aim: To identify factors perceived to be necessary to feel safe by residents in areas with blocks of flats and detached houses. Methods: Residents in a Swedish municipality were asked an open-ended question on the research topic by a mail survey; 787 residents provided narrative data that were fed into a summative qualitative and quantitative content analysis. Results: A stable social structure in the housing area was perceived to be the central factor in a safety-supportive residential environment. Whereas maintenance of good and reassuring relations was emphasised in detached housing areas, support for management of poor or even fear-provoking neighbour relations was requested from areas with blocks of flats. This finding emphasises the need to reduce the differential exposure to safety-related factors in the living environment. Conclusions: The results of our study encourage the continued use of a setting-orientated safety promotion approach in which residents and other stakeholders are involved. The policy recommendation that can be drawn from the study is that both the subjective and objective dimensions of safety should be identified and considered when developing local safety promotion interventions in community contexts.
Efficacy of Interventions for Improving Antiretroviral Therapy Adherence in HIV/AIDS Cases at PIMS, Islamabad
Authors: Uzma Qudsia , Emmanuel Faran , Ather Uzma , Zaman Shakila
Published: February 2011

It is imperative to prove efficacy of tailored interventions and translate the efficacious ones into clinical strategies for achieving good ART adherence. ART adherence among registered HIV/AIDS cases at HIV treatment centre, Pakistan Institute of Medical Sciences, Islamabad was assessed through RCT. Study duration was 10 weeks; eligible subjects (N = 76) were randomly halved; Intervention Group (IG) received trial interventions i.e. subject involvement, weekly phone reminders in addition to routine counselling, while Comparison group received routine counselling only. Self-reported adherence (SRA) questionnaire and pill identification test (PIT) conducted at both baseline and follow-up in addition to CD4 count and viral load. ITT using ANOVA; McNemar’s test for variables with before-after assessments within a group. Results showed significant differences in ≥95% SRA, ≥95% Adherence on PIT, Viral load test of <50 copies per cubic mm. These interventions should be included in the overall treatment strategy for HIV/AIDS in Pakistan.
Comparison of the Effectiveness of Low-Dose Indinavir/Ritonavir (IDV/r)- versus Atazanavir/Ritonavir (ATV/r)-Based Generic Antiretroviral Therapy in NNRTI-Experienced HIV-1-Infected Patients in India
Authors: Patel Atul K. , Patel Ketan K. , Naik Eknath , Jingyi Duan  , Ranjan Rajiv , Patel Jagdish K. , Salihu Hamisu M.
Published: February 2011

Background: Currently, data on the effectiveness of second-line antiretroviral regimens using indinavir/ritonavir (IDV/r) and atazanavir/ritonavir (ATV/r) along with 2 nucleoside reverse transcriptase inhibitor (NRTI) in resource-poor settings is limited. Methods: Observational follow-up study on 441 patients who experienced treatment failure to first-line nonnucleoside reverse transcriptase inhibitor (NNRTI)-based treatment. Multivariate Cox Proportional Hazards Model was used to assess comparative effectiveness of treatment regimens. Results: A total of 63 patients (14.8%) had failed second line treatments, of which 53 patients (17.2%) were using IDV/r while 10 patients (8.5%) were on ATV/r. After adjusting for age, weight, gender, and baseline CD4 count, patients who took IDV/r were more than twice as likely to experience treatment failure as compared to those who were on ATV/r (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.14, 4.15). Successful response to second-line therapy was not different between the 2 treatment groups when patients weighed less than 55 kg at baseline (log rank P value = 1.00) in contrast to the individuals weighing ≥55 kg (P < .0001). Conclusion: We found that successful response to second-line therapy was twice as likely in the ATV/r group; however, this difference was eliminated in patients less than 55 kg.
Cryptococcal Meningitis in an HIV-Positive Pregnant Woman
Authors: Nayak Seema U. , Talwani Rohit , Gilliam Bruce , Taylor Gregory , Ghosh Mayurika
Published: February 2011

Cryptococcal meningitis is uncommon in pregnant HIV-infected women. The clinical care of an HIV-1 positive pregnant woman with cryptococcal meningitis whose pathology has been previously reported is reviewed to highlight the treatment of the disease and some of the challenges associated with antifungal therapy during pregnancy, including the teratogenicity of antifungal agents, their variable pharmacokinetics in pregnancy, the lack of well-defined treatment duration for such infections, and host factors including compliance. This patient’s disease relapsed due to nonadherence after an initial course of intravenous amphotericin. Subsequently, she was successfully treated, with a favorable fetal outcome, with another 2 weeks of amphotericin B, followed by consolidation and maintenance with fluconazole and antiretroviral treatment. This case highlights and reviews the complexities of the management of cryptococcal meningitis in HIV-infected pregnant women.
Barriers to Antiretroviral Treatment in Ethiopia: A Qualitative Study
Authors: Balcha Taye T. , Jeppsson Anders , Bekele Abera
Published: February 2011

Objective: Ethiopia has made meaningful headway in improving access to HIV care and treatment but client attrition remains a daunting challenge. The objective of this study was to describe the major reasons of patient attrition from treatment at hospital and health center levels in Oromia region of Ethiopia. Methods: This qualitatively designed study was based on semistructured interview with antiretroviral therapy (ART) service providers and focus group discussions with ART clients. The participants were recruited purposively to obtain robust and programmatically important information on in retention HIV care and treatment. Findings: The analysis identified four major themes: antiretroviral (ARV) medications as ‘‘long-term life support,’’ free ART as ‘‘expensive,’’ regular follow up as ‘‘devotion to a life-long crisis management,’’ and expansion of free ART as ‘‘sharing the new hope,’’ Conclusion: The finding clearly illustrated that while financial constraints and some sociocultural factors impede adherence, disclosure, community support, and decentralization of ART to primary health care units enhance retention in care and treatment.
An elevated level of BNP in plasma is related to the development of good collateral circulation in coronary artery disease
Authors: Xi Wei-Wei , Cheng Gang , Lv Shumin , Gao Qinqin , Bu Gang , Zhou Ying , Xu Geng
Published: February 2011

Objective: B-type natriuretic peptide (BNP) was recently demonstrated to be a potential stimulator of angiogenesis and arteriogenesis. The correlation between BNP level and collateral formation in patients with coronary artery disease (CAD) has not been reported.

Methods and results: The study included 311 consecutive patients who underwent coronary angiography were divided into three groups according to coronary angiography and collateral formation: normal group (100 patients with normal coronary angiographic findings); poor collateral group (116 patients with at least one coronary stenosis of ≥75% without visible collateral circulation); and good collateral group (95 patients with at least one coronary stenosis of ≥75% with well-developed collateral circulation). Collateral score was analyzed using the Cohen–Rentrop classification. Plasma BNP levels were 45.77 ± 4.66 pg/ml, 116.40 ± 28.15 pg/ml, and 254.20 ± 42.85 pg/ml for patients in normal, poor collateral, and good collateral groups, respectively. Plasma BNP levels in the latter were significantly higher than in the normal group ( p < 0.01) and poor collateral group ( p < 0.05). There were no significant differences between the good collateral group and poor collateral group when compared with left ventricular ejection fraction (LVEF), left ventricular dimensions at end diastole (LVEDd), age, severity of angiographic disease, and other cardiovascular risk factors. After adjustment in the multiple ordinal logistic regression model, plasma BNP levels showed a strong independent association with collateral Cohen–Rentrop score (χ2 = 5.636, OR = 1.002, 95% CI 1.000–1.004, p = 0.018).

Conclusions: An elevated level of BNP in plasma is independently associated with collateral development; patients with good collaterals tend to have a higher BNP level.
Lenalidomide targets clonogenic side population in multiple myeloma: pathophysiologic and clinical implications
Authors: Jakubikova Jana , Adamia Sophia , Kost-Alimova Maria , Klippel Steffen , Cervi David , Daley John F. , Cholujova Dana , Kong Sun-Young , Leiba Merav , Blotta Simona , Ooi Melissa , Delmore Jake , Laubach Jacob , Richardson Paul G. , Sedlak Jan , Anderson Kenneth C. , Mitsiades Constantine S.
Published: February 2011

Recurrence of multiple myeloma (MM) after therapy suggests the presence of tumor-initiating subpopulations. In our study, we performed flow cytometry–based Hoechst 33342 staining to evaluate the existence of a MM population with stem-like features known as side population (SP) cells. SP cells exhibit substantial heterogeneity in MM cell lines and primary MM cells; express CD138 antigen in MM cell lines; display higher mRNA expression and functional activity of ABCG2 transporter; and have a higher proliferation index compared with non-SP cells. We observed evidence for clonogenic potential of SP cells, as well as the ability of SP cells to regenerate original population. Moreover, SP cells revealed higher tumorigenicity compared with non-SP cells. Importantly, lenalidomide decreased the percentage and clonogenicity of SP cells, and also induced phosphorylation changes in Akt, GSK-3α/β, MEK1, c-Jun, p53, and p70S6K in SP cells. Adherence to bone marrow stromal cells (BMSCs) increased the percentage, viability, and proliferation potential of SP cells. Lenalidomide and thalidomide abrogated this stimulatory effect of BMSCs and significantly decreased the percentage of SP cells. Our studies demonstrate a novel mechanism of action for lenalidomide, namely targeting SP fraction, providing the framework for new therapeutic strategies targeting subpopulations of MM cells including presumptive stem cells.
An embryonic stage–specific enhancer within the murine β-globin locus mediates domain-wide histone hyperacetylation
Authors: Fromm George , Cadiz-Rivera Brenda , de Vries Christina , Getman Michael , McGrath Kathleen E. , Kingsley Paul D. , Fields Jennifer , Fiering Steven , Bulger Michael
Published: February 2011

In mammalian nuclei, a select number of tissue-specific gene loci exhibit broadly distributed patterns of histone modifications, such as histone hyperacetylation, that are normally associated with active gene promoters. Previously, we characterized such hyperacetylated domains within mammalian β-globin gene loci, and determined that within the murine locus, neither the β-globin locus control region nor the gene promoters were required for domain formation. Here, we identify a developmentally specific erythroid enhancer, hypersensitive site-embryonic 1 (HS-E1), located within the embryonic β-globin domain in mouse, which is homologous to a region located downstream of the human embryonic ϵ-globin gene. This sequence exhibits nuclease hypersensitivity in primitive erythroid cells and acts as an enhancer in gain-of-function assays. Deletion of HS-E1 from the endogenous murine β-globin locus results in significant decrease in the expression of the embryonic β-globin genes and loss of the domain-wide pattern of histone hyperacetylation. The data suggest that HS-E1 is an enhancer that is uniquely required for β-like globin expression in primitive erythroid cells, and that it defines a novel class of enhancer that works in part by domain-wide modulation of chromatin structure.
PrPSc spreading patterns in the brain of sheep linked to different prion types
Authors: Wemheuer Wiebke M , Benestad Sylvie L , Wrede Arne , Wemheuer Wilhelm E , Brenig Bertram , Bratberg Bjørn , Schulz-Schaeffer Walter J
Published: February 2011

Scrapie in sheep and goats has been known for more than 250 years and belongs nowadays to the so-called prion diseases that also include e.g. bovine spongiform encephalopathy in cattle (BSE) and Creutzfeldt-Jakob disease in humans. According to the prion hypothesis, the pathological isoform (PrPSc) of the cellular prion protein (PrPc) comprises the essential, if not exclusive, component of the transmissible agent. Currently, two types of scrapie disease are known - classical and atypical/Nor98 scrapie. In the present study we examine 24 cases of classical and 25 cases of atypical/Nor98 scrapie with the sensitive PET blot method and validate the results with conventional immunohistochemistry. The sequential detection of PrPSc aggregates in the CNS of classical scrapie sheep implies that after neuroinvasion a spread from spinal cord and obex to the cerebellum, diencephalon and frontal cortex via the rostral brainstem takes place. We categorize the spread of PrPSc into four stages: the CNS entry stage, the brainstem stage, the cruciate sulcus stage and finally the basal ganglia stage. Such a sequential development of PrPSc was not detectable upon analysis of the present atypical/Nor98 scrapie cases. PrPSc distribution in one case of atypical/Nor98 scrapie in a presumably early disease phase suggests that the spread of PrPSc aggregates starts in the di- or telencephalon. In addition to the spontaneous generation of PrPSc, an uptake of the infectious agent into the brain, that bypasses the brainstem and starts its accumulation in the thalamus, needs to be taken into consideration for atypical/Nor98 scrapie.
Staphylococcus aureus seroproteomes discriminate ruminant isolates causing mild or severe mastitis
Authors: Le Maréchal Caroline , Jardin Julien , Jan Gwenaël , Even Sergine , Pulido Coralie , Guibert Jean-Michel , Hernandez David , François Patrice , Schrenzel Jacques , Demon Dieter , Meyer Evelyne , Berkova Nadia , Thiéry Richard , Vautor Eric , Le Loir Yves
Published: February 2011

Staphylococcus aureus is a major cause of mastitis in ruminants. In ewe mastitis, symptoms range from subclinical to gangrenous mastitis. S. aureus factors or host-factors contributing to the different outcomes are not completely elucidated. In this study, experimental mastitis was induced on primiparous ewes using two S. aureus strains, isolated from gangrenous (strain O11) or subclinical (strain O46) mastitis. Strains induced drastically distinct clinical symptoms when tested in ewe and mice experimental mastitis. Notably, they reproduced mild (O46) or severe (O11) mastitis in ewes. Ewe sera were used to identify staphylococcal immunoreactive proteins commonly or differentially produced during infections of variable severity and to define core and accessory seroproteomes. Such SERological Proteome Analysis (SERPA) allowed the identification of 89 immunoreactive proteins, of which only 52 (58.4%) were previously identified as immunogenic proteins in other staphylococcal infections. Among the 89 proteins identified, 74 appear to constitute the core seroproteome. Among the 15 remaining proteins defining the accessory seroproteome, 12 were specific for strain O11, 3 were specific for O46. Distribution of one protein specific for each mastitis severity was investigated in ten other strains isolated from subclinical or clinical mastitis. We report here for the first time the identification of staphylococcal immunogenic proteins common or specific to S. aureus strains responsible for mild or severe mastitis. These findings open avenues in S. aureus mastitis studies as some of these proteins, expressed in vivo, are likely to account for the success of S. aureus as a pathogen of the ruminant mammary gland.
Cellular stress-induced up-regulation of FMRP promotes cell survival by modulating PI3K-Akt phosphorylation cascades
Authors: Jeon Se Jin , Seo Jung Eun , Yang Sung-Il , Choi Ji Woong , Wells David , Shin Chan Young , Ko Kwang Ho
Published: February 2011

Background

Fragile X syndrome (FXS), the most commonly inherited mental retardation and single gene cause of autistic spectrum disorder, occurs when the Fmr1 gene is mutated. The product of Fmr1, fragile X linked mental retardation protein (FMRP) is widely expressed in HeLa cells, however the roles of FMRP within HeLa cells were not elucidated, yet. Interacting with a diverse range of mRNAs related to cellular survival regulatory signals, understanding the functions of FMRP in cellular context would provide better insights into the role of this interesting protein in FXS. Using HeLa cells treated with etoposide as a model, we tried to determine whether FMRP could play a role in cell survival.

Methods

Apoptotic cell death was induced by etoposide treatment on Hela cells. After we transiently modulated FMRP expression (silencing or enhancing) by using molecular biotechnological methods such as small hairpin RNA virus-induced knock down and overexpression using transfection with FMRP expression vectors, cellular viability was measured using propidium iodide staining, TUNEL staining, and FACS analysis along with the level of activation of PI3K-Akt pathway by Western blot. Expression level of FMRP and apoptotic regulator BcL-xL was analyzed by Western blot, RT-PCR and immunocytochemistry.

Results

An increased FMRP expression was measured in etoposide-treated HeLa cells, which was induced by PI3K-Akt activation. Without FMRP expression, cellular defence mechanism via PI3K-Akt-Bcl-xL was weakened and resulted in an augmented cell death by etoposide. In addition, FMRP over-expression lead to the activation of PI3K-Akt signalling pathway as well as increased FMRP and BcL-xL expression, which culminates with the increased cell survival in etoposide-treated HeLa cells.

Conclusions

Taken together, these results suggest that FMRP expression is an essential part of cellular survival mechanisms through the modulation of PI3K, Akt, and Bcl-xL signal pathways.