bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulatory T cells and chronic immune activation in human immunodeficiency virus 1 (HIV-1)-infected children
Authors: Freguja R , Gianesin K , Mosconi I , Zanchetta M , Carmona F , Rampon O , Giaquinto C , De Rossi A
Published: March 2011

The function of CD4+ T cells with regulatory activity (Tregs) is the down-regulation of immune responses. This suppressive activity may limit the magnitude of effector responses, resulting in failure to control human immunodeficiency virus 1 (HIV-1) infection, but may also suppress chronic immune activation, a characteristic feature of HIV-1 disease. We evaluated the correlation between viral load, immune activation and Tregs in HIV-1-infected children. Eighty-nine HIV-1-infected children (aged 6–14 years) were included in the study and analysed for HIV-1 plasmaviraemia, HIV-1 DNA load, CD4 and CD8 cell subsets. Treg cells [CD4+ CD25highCD127lowforkhead box P3 (FoxP3high)] and CD8-activated T cells (CD8+CD38+) were determined by flow cytometry. Results showed that the number of activated CD8+CD38+ T cells increased in relation to HIV-1 RNA plasmaviraemia (r = 0·403, P < 0·0001). The proportion of Tregs also correlated positively with HIV-1 plasmaviraemia (r = 0·323, P = 0·002), but correlated inversely with CD4+ cells (r = −0·312, P = 0·004), thus suggesting a selective expansion along with increased viraemia and CD4+ depletion. Interestingly, a positive correlation was found between the levels of Tregs and CD8+CD38+ T cells (r = 0·305, P = 0·005), and the percentage of Tregs tended to correlate with HIV-1 DNA load (r = 0·224, P = 0·062). Overall, these findings suggest that immune activation contributes to the expansion of Treg cells. In turn, the suppressive activity of Tregs may impair effector responses against HIV-1, but appears to be ineffective in limiting immune activation.
Birth seasonality and offspring production in threatened neotropical primates related to climate
Authors: WIEDERHOLT RUSCENA , POST ERIC
Published: March 2011

Given the threatened status of many primate species, the impacts of global warming on primate reproduction and, consequently, population growth should be of concern. We examined relations between climatic variability and birth seasonality, offspring production, and infant sex ratios in two ateline primates, northern muriquis, and woolly monkeys. In both species, the annual birth season was delayed by dry conditions and El Niño years, and delayed birth seasons were linked to lower birth rates. Additionally, increased mean annual temperatures were associated with lower birth rates for northern muriquis. Offspring sex ratios varied with climatic conditions in both species, but in different ways: directly in woolly monkeys and indirectly in northern muriquis. Woolly monkeys displayed an increase in the proportion of males among offspring in association with El Niño events, whereas in northern muriquis, increases in the proportion of males among offspring were associated with delayed onset of the birth season, which itself was related, although weakly, to warm, dry conditions. These results illustrate that global warming, increased drought frequency, and changes in the frequency of El Niño events could limit primate reproductive output, threatening the persistence and recovery of ateline primate populations.
Gas composition of baled grass silage as influenced by the amount, stretch, colour and type of plastic stretch‐film used to wrap the bales, and by the frequency of bale handling
Authors: McEniry J. , Forristal P. D. , O’Kiely P.
Published: March 2011

The effectiveness of the polyethylene stretch‐film barrier to air infiltration is the major factor affecting the preservation of silage in bales. Three separate experiments investigated the effects of the number of layers of stretch‐film cover, film colour, stretch extent, film type and frequency of bale handling on gas composition, surface mould growth and conservation characteristics of baled grass silages. Monitoring gas composition in bales during ensiling proved useful for assessing the success with which wrapped bales were stored anaerobically. Under good storage conditions the early stages of ensiling were characterized by the rapid reduction of O2 concentration in the bale and the creation of a CO2‐rich environment. However, wrapping bales in only two layers of stretch‐film failed to create the anaerobic conditions required for a successful fermentation and the inhibition of visible fungal growth. In contrast, a minimum of four layers of stretch‐film were required to achieve suitably anaerobic conditions, but the additional benefits of applying more layers were relatively small. Under temperate climatic conditions with moderate solar radiation, film colour had little effect on the gas composition in baled silage. Likewise, the extent of stretching applied to the film at wrapping and film type had no influence on gas composition, baled silage quality or mould development. However, frequent mechanical handling of bales after wrapping had a negative effect on gas composition and surface mould growth, and thus should be kept to a minimum.
Role of exercise and physical activity on haemophilic arthropathy, fall prevention and osteoporosis
Authors: FORSYTH A. L. , QUON D. V. , KONKLE B. A.
Published: March 2011

Summary.  In older men with haemophilia, arthropathy resulting from a lifetime of intra‐articular bleeding contributes to the loss of independence and increased morbidity that occurs with age. A regular exercise programme that incorporates aerobics, strength training and balance and flexibility activities is a key component of successful ageing, helping to improve functional mobility and reduce the risk of falls, osteoporosis and osteoporotic fractures. Because of the special challenges associated with haemophilia, which include both the underlying coagulopathy and, in many cases, extensive joint damage, patients beginning an exercise regimen should be referred to appropriately trained physiotherapists (preferably someone associated with a haemophilia treatment centre) for evaluation, education and instruction and follow‐up. Various assistive devices may make exercise easier to perform and more comfortable.
KUD – a scale for clinical evaluation of moderate‐to‐severe dementia
Authors: Ericsson Iréne , Malmberg Bo , Langworth Sven , Haglund Anders , Almborg Ann‐Helene
Published: March 2011

Aim. To develop a test of cognitive performance in persons with moderate‐to‐severe dementia.

Background. Various instruments are used to assess the course of dementia and to evaluate treatments in persons with dementia. Most neuropsychological assessments are inappropriate for measuring cognitive abilities in persons with severe dementia, because these persons perform at floor level in such measurements.

Design. A cross‐sectional research design.

Methods. The test (Clinical Evaluation of Moderate‐to‐Severe Dementia; Swedish acronym: KUD) was developed from a pool of 25 test items with the final KUD consisting of 15 items. Reliability and validity were established using 220 subjects (with various dementia diagnoses) with scores of Mini‐Mental State Examination between 0–20. Approximately two weeks after the first test, 116 of the original 220 subjects were retested.

Results. A factor analysis with the 15‐item scale revealed an interaction factor comprising three items and a cognitive performance factor with 12 items. The internal consistence reliability was 0·93 for the KUD (Cronbach’s alpha). Test–retest reliability was also high (0·92) and correlation between the KUD and the MMSE (≤20) was high (r = 0·80).

Conclusion. The KUD seems to be a valid, reliable performance‐based assessment scale for measuring cognitive performance in persons with MMSE score below 12 or 15 points.

Relevance to clinical practice. It is of outmost interest that cognitive performance can be easily followed for persons with moderate‐to‐severe dementia in, for example, drug therapies and other therapies, but also in terms of treatment of and support to the person based on his or her abilities.
First‐time mothers: social support, maternal parental self‐efficacy and postnatal depression
Authors: Leahy‐Warren Patricia , McCarthy Geraldine , Corcoran Paul
Published: March 2011

Aims and objectives.  To examine the relationships between social support, maternal parental self‐efficacy and postnatal depression in first‐time mothers at 6 weeks post delivery.

Background.  Social support conceptualised and measured in different ways has been found to positively influence the mothering experience as has maternal parental self‐efficacy. No research exists which has measured the relationships between social support, underpinned by social exchange theory and maternal parental self‐efficacy using a domain‐specific instrument, underpinned by self‐efficacy theory and postnatal depression, with first‐time mothers at 6 weeks post delivery.

Design.  A quantitative correlational descriptive design was used.

Method.  Data were collected using a five‐part questionnaire package containing a researcher developed social support questionnaire, the Perceived Maternal Parental Self‐Efficacy Scale and the Edinburgh Postnatal Depression Scale. Four hundred and ten mothers completed questionnaires at 6 weeks post delivery.

Results.  Significant relationships were found between functional social support and postnatal depression; informal social support and postnatal depression; maternal parental self‐efficacy and postnatal depression and informal social support and maternal parental self‐efficacy at 6 weeks post delivery.

Conclusion.  Nurses and midwives need to be aware of and acknowledge the significant contribution of social support, particularly from family and friends in positively influencing first‐time mothers’ mental health and well‐being in the postpartum period. The development of health care policy and clinical guidelines needs to define and operationalise social support to enhance maternal parental self‐efficacy.

Relevance to clinical practice.  These findings suggest that nurses and midwives need to be cognisant of the importance of social support for first‐time mothers in both enhancing maternal parental self‐efficacy and reducing postnatal depressive symptomatology in the early postpartum period.
The response scale for the intellectual disability module of the WHOQOL: 5‐point or 3‐point?
Authors: Fang J. , Fleck M. P. , Green A. , McVilly K. , Hao Y. , Tan W. , Fu R. , Power M.
Published: March 2011

Objective  To deal with the question of whether a 5‐point response Likert scale should be changed to a 3‐point scale when used in the field testing of people with intellectual disabilities (IDs), which was raised after the pilot study of World Health Organization Quality of Life (WHOQOL)‐DIS, a module being developed with the World Health Organization measure of quality of life for disabilities.

Methods  Three possible ways were used to generate hypothetical data by merging a 5‐point scale into a 3‐point scale. The analyses were based on both item response theory and classical measurement theory. The partial credit model for polytomous response was performed for item evaluation; the confirmatory factor analysis was used to check construct validity, the Cronbach's alpha for domain reliability, and correlation analyses for the relationship between the 5‐point scale and the generated 3‐point scale.

Results  Most items with a 5‐point response scale had disordered response options and/or unequal‐length intervals between successive response options; these deficiencies were removed or improved without decline of validity and reliability in the hypothetical data of 3‐point scales.

Conclusion  Instead of the 5‐point scale, a 3‐point scale could be used for IDs in the field test of developing the module WHOQOL‐DIS.
Initial validation of the Chinese Quality of Life Questionnaire – Intellectual Disabilities (CQOL‐ID): a cultural perspective
Authors: Wong P. K. S. , Wong D. F. K. , Schalock R. L. , Chou Y‐C.
Published: March 2011

Background  In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire – Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith.

Methods  People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity.

Results  A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40‐item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self‐determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P < 0.000, P < 0.01 and P < 0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α = 0.79).

Conclusions  Initial validity tests indicated that the Chinese Quality of Life Questionnaire – Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made.
Reduced reproductive success of hatchery coho salmon in the wild: insights into most likely mechanisms
Authors: THÉRIAULT VÉRONIQUE , MOYER GREGORY R. , JACKSON LAURA S. , BLOUIN MICHAEL S. , BANKS MICHAEL A.
Published: March 2011

Supplementation of wild salmonids with captive‐bred fish is a common practice for both commercial and conservation purposes. However, evidence for lower fitness of captive‐reared fish relative to wild fish has accumulated in recent years, diminishing the apparent effectiveness of supplementation as a management tool. To date, the mechanism(s) responsible for these fitness declines remain unknown. In this study, we showed with molecular parentage analysis that hatchery coho salmon (Oncorhynchus kisutch) had lower reproductive success than wild fish once they reproduced in the wild. This effect was more pronounced in males than in same‐aged females. Hatchery spawned fish that were released as unfed fry (age 0), as well as hatchery fish raised for one year in the hatchery (released as smolts, age 1), both experienced lower lifetime reproductive success (RS) than wild fish. However, the subset of hatchery males that returned as 2‐year olds (jacks) did not exhibit the same fitness decrease as males that returned as 3‐year olds. Thus, we report three lines of evidence pointing to the absence of sexual selection in the hatchery as a contributing mechanism for fitness declines of hatchery fish in the wild: (i) hatchery fish released as unfed fry that survived to adulthood still had low RS relative to wild fish, (ii) age‐3 male hatchery fish consistently showed a lower relative RS than female hatchery fish (suggesting a role for sexual selection), and (iii) age‐2 jacks, which use a sneaker mating strategy, did not show the same declines as 3‐year olds, which compete differently for females (again, implicating sexual selection).
Mutations in β′ subunit of Escherichia coli RNA polymerase perturb the activator polymerase functional interaction required for promoter clearance
Authors: Swapna Ganduri , Chakraborty Atanu , Kumari Vandana , Sen Ranjan , Nagaraja Valakunja
Published: March 2011

Transcription activator C employs a unique mechanism to activate mom gene of bacteriophage Mu. The activation process involves, facilitating the recruitment of RNA polymerase (RNAP) by altering the topology of the promoter and enhancing the promoter clearance by reducing the abortive transcription. To understand the basis of this multi‐step activation mechanism, we investigated the nature of the physical interaction between C and RNAP during the process. A variety of assays revealed that only DNA‐bound C contacts the β′ subunit of RNAP. Consistent to these results, we have also isolated RNAP mutants having mutations in the β′ subunit which were compromised in C‐mediated activation. Mutant RNAPs show reduced productive transcription and increased abortive initiation specifically at the C‐dependent mom promoter. Positive control (pc) mutants of C, defective in interaction with RNAP, retained the property of recruiting RNAP to the promoter but were unable to enhance promoter clearance. These results strongly suggest that the recruitment of RNAP to the mom promoter does not require physical interaction with C, whereas a contact between the β′ subunit and the activator, and the subsequent allosteric changes in the active site of the enzyme are essential for the enhancement of promoter clearance.
The Chromobacterium violaceum type III effector CopE, a guanine nucleotide exchange factor for Rac1 and Cdc42, is involved in bacterial invasion of epithelial cells and pathogenesis
Authors: Miki Tsuyoshi , Akiba Kinari , Iguchi Mirei , Danbara Hirofumi , Okada Nobuhiko
Published: March 2011

The type III secretion system (T3SS) encoded by Chromobacterium pathogenicity islands 1 and 1a (Cpi‐1/‐1a) is critical for Chromobacterium violaceum pathogenesis. T3SS‐dependent virulence is commonly characterized by type III effector virulence function, but the full repertoire of the effector proteins of Cpi‐1/‐1a T3SS is unknown. In this study, we showed that expression of Cpi‐1/‐1a T3SS is controlled by the master regulator CilA. We used transcriptional profiling with DNA microarrays to define CilA regulon and identified genes encoding T3SS effectors whose translocation into host cells was dependent on Cpi‐1/‐1a T3SS. From these effectors, we found that CopE (CV0296) has similarities to a guanine nucleotide exchange factor (GEF) for Rho GTPases in its C‐terminal portion. The N‐terminal portions (1–81 amino acids) of CopE and a CivB as a putative chaperone were required for its translocation. CopE specifically activates Rac1 and Cdc42 followed by the induction of actin cytoskeletal rearrangement. Interestingly, C. violaceum invades human epithelial HeLa cells in a Cpi‐1/‐1a‐encoded T3SS‐ and CopE‐dependent manner. Finally, C. violaceum strains lacking copE and expressing a CopE–G168V deficient in GEF activity were attenuated for virulence in mice, suggesting that CopE contributes to the virulence of this pathogen.
Opportunistic non‐BK viral disease after renal transplantation: a game of numbers
Authors: Gupta A. , Khaira A.
Published: March 2011

A. Gupta, A. Khaira. Opportunistic non‐BK viral disease after renal transplantation: a game of numbers Transpl Infect Dis 2011: 13: 329–330. All rights reserved
Acute appendicitis in the immediate perioperative period following renal transplant
Authors: Hughes D.B. , Coppolino A. , Kapur S. , Leeser D.B.
Published: March 2011

D.B. Hughes, A. Coppolino III, S. Kapur, D.B. Leeser. Acute appendicitis in the immediate perioperative period following renal transplant. Transpl Infect Dis 2011: 13: 656–657. All rights reserved
The effect of FFP:RBC ratio on morbidity and mortality in trauma patients based on transfusion prediction score
Authors: Borgman M. A. , Spinella P. C. , Holcomb J. B. , Blackbourne L. H. , Wade C. E. , Lefering R. , Bouillon B. , Maegele M.
Published: March 2011

Background and Objectives  The empiric use of a high plasma to packed red‐blood‐cell [fresh frozen plasma:red‐blood‐cells (FFP:RBC)] ratio in trauma resuscitation for patients with massive bleeding has become well accepted without clear or objective indications. Increased plasma transfusion is associated with worse outcome in some patient populations. While previous studies analyse only patients who received a massive transfusion, this study analyses those that are at risk to receive a massive transfusion, based on the trauma‐associated severe haemorrhage (TASH) score, to objectively determine which patients after severe trauma would benefit or have increased complications by the use of a high FFP:RBC ratio.

Methods  Multicentre retrospective study from the Trauma Registry of the German Trauma Society. Multivariate logistic regression and statistical risk adjustments utilized in analyses.

Results  A high ratio of FFP:RBC in the ≥15 TASH group was independently associated with survival, with an odds ratio of 2·5 (1·6–4·0), while the <15 TASH group was associated with increased multi‐organ failure, 47% vs. 38%, (P < 0·005).

Conclusions  A predictive model of massive transfusion upon admission might be able to rapidly identify which severe trauma patients would benefit or have increased complications from the immediate application of a high ratio of FFP:RBCs. This study helps to identify the appropriate population for a prospective, interventional trial.
Differential Translation of Duck‐ and Rabbit‐Globin Messenger RNAs in Reticulocyte‐Lysate Systems
Authors: Stewart Andrew G. , Gander Eugen S. , Morel Carlos , Luppis Benedetta , Scherrer Klaus
Published: March 2011

A 9 to 10‐S messenger RNA was purified from duck immature erythrocyte polyribosomes and found to direct the synthesis of several duck globin chains in a rabbit reticulocyte‐lysate protein‐synthesising system. The ability to compete with the endogenous rabbit globin mRNA was, however, very low. On the other hand, rabbit 9‐S RNA, when put into a duck immature erythrocyte‐lysate cell‐free system, was translated with high efficiency, effectively depressing the translation of the endogenous duck mRNA.

These experiments lead us to conclude that between duck and rabbit messengers there are fundamental differences in the RNA structure at or near the initiation sites leading to their respective abilities to be recognised and translated with different efficiencies in cell‐free systems.
Phytophthora ramorum is a generalist plant pathogen with differences in virulence between isolates from infectious and dead‐end hosts
Authors: Hüberli D. , Garbelotto M.
Published: March 2011

Variation in virulence was examined among isolates of Phytophthora ramorum from epidemiologically important or infectious (non‐oak) and transmissive dead‐end (oak) hosts from North America. Twelve isolates representative of the genetic, geographic and host range of P. ramorum in the western United States were inoculated on leaves of Umbellularia californica (bay laurel or bay) and stems of Quercus agrifolia (coast live oak). In spite of extreme genetic similarity among the isolates employed, and even within the same genotype, significant differences in lesion size were measured, suggesting virulence in this pathogen is also controlled by epigenetic factors. A strong positive correlation between lesion size on bay laurel and coast live oak provides experimental evidence P. ramorum is a generalist pathogen that lacks host specificity. Isolates from non‐transmissive oaks were significantly less pathogenic both on oaks and bays than isolates from infectious hosts. These results are essential to further our understanding of the epidemiology and evolutionary potential of this pathogen. A quantitative differential in virulence of isolates from hosts with different epidemiological roles has been described for many animal diseases, but is a novel report for a plant disease.
Chromium supplementation and substitution of barley grain with corn: effects on metabolite and hormonal responses in periparturient dairy cows
Authors: Sadri H. , Rahmani H. R. , Khorvash M. , Ghorbani G. R. , Bruckmaier R. M.
Published: March 2011

Thirty‐two multiparous Holstein cows were used to investigate the effects of chromium‐l‐methionine (Cr‐Met) supplementation and dietary grain source on metabolic indices throughout the periparturient period. Cows were fed a total mixed ration with the concentrate portion based on ground barley (barley based diet, BBD) – or ground corn (corn‐based diet, CBD) from 21 days before anticipated calving through 28 days after calving. The Cr‐Met was supplemented at dosages of 0 or 0.08 mg of Cr/kg of metabolic body weight throughout the experiment. Thus, treatments were in a 2 (Cr‐Met) × 2 (grain sources) factorial arrangement. Plasma glucose, non‐esterified fatty acids, triglyceride, very low‐density lipoprotein, blood urea nitrogen (BUN), insulin, glucagon, cortisol and insulin‐like growth factor‐I (IGF‐I) concentrations were not affected by chromium supplementation on calving day (d 0). However, there was a trend for decreased β‐hydroxybutyrate (BHBA) and increased cholesterol on d 0 in cows fed the Cr supplemented diet. On d 21 postpartum (wk 3 p.p.), plasma glucagon concentration tended to be greater in cows fed the Cr supplemented diet. However, other plasma metabolite and hormone measures were not affected by Cr supplementation in wk 3 p.p. There was no effect of grain source on d 0 plasma metabolic and endocrine measures. In wk 3 p.p., a significant difference was found only for plasma concentration of glucagon that was higher for cows fed the BBD compared with the CBD. There was an interaction of Cr‐Met supplementation and grain source in wk 3 p.p. plasma concentration of BUN to decrease in CBD and increase in BBD, supplemented with Cr‐Met. No Cr by grain interactions were observed for other plasma metabolic variables on d 0 and in wk 3 p.p. These results indicate that Cr‐Met supplementation and substituting barley grain with corn throughout the transition period have only moderate effects on metabolic and endocrine parameters.
Dispersal ability of marked, irradiated olive fruit flies [Bactrocera oleae (Rossi) (Diptera: Tephritidae)] in arid regions
Authors: Rempoulakis P. , Nestel D.
Published: March 2011

The dispersal of marked, irradiated olive fruit flies originating from a hybrid laboratory strain was studied in an olive groove located in the arid regions of southern Israel. Release–recapture experiments (eight in total) were conducted throughout a period of 5 months (July–December 2008). In each experiment, ca. 5000 flies were released. Recapture of flies was conducted using a grid of 30 yellow sticky traps set in expanding semicircles from the centre of release. Service of traps was conducted 3 and 15 days after the release. Fly quality and adult food type (only sucrose and protein + sucrose) before release was also investigated. Results point at an average dispersal distance of marked, irradiated olive flies of ca. 50 m. Pre‐release adult diet did not affect dispersal ability. Fly recovery averaged ca. 3.5% during summer and ca. 1.5% during autumn. Most of the recovery concentrated during the first 3 days after releases, suggesting low survival of the released flies afterwards. As inferred from circular statistics, direction of dispersal was non‐random with a significant directionality to the north‐west. Results are discussed in view of environmental temperatures and wind direction.
Estimation of the reproductive number for the 2009 pandemic H1N1 influenza in rural and metropolitan New South Wales
Authors: Buckley David , Bulger David
Published: March 2011

Objective:  During the early stages of pandemics, when resource planning occurs, the epidemiological parameters of the agent are often poorly described. These estimates are typically derived from metropolitan centres. This paper examines the spread of the 2009 pandemic H1N1 virus in rural and regional New South Wales compared with metropolitan centres.

Design:  Retrospective statistical analysis of longitudinal data.

Setting:  Ecological examination of spread of influenza in the general community of New South Wales, Australia.

Participants:  Number of notified infections with novel pandemic H1N1 influenza in rural/regional (n = 241) and metropolitan (n = 1788) health service areas of New South Wales during the period 1 June 2009 and 12 July 2009.

Main outcome measures:  A comparison of the reproductive number for the 2009 pandemic H1N1 in rural/regional and metropolitan New South Wales.

Results:  The reproductive number of the pandemic H1N1 in rural New South Wales was 1.26 (95% confidence interval (CI), 1.22–1.30) compared with estimates of metropolitan New South Wales of 1.28 (95% CI, 1.26–1.30). This difference was not statistically significant (P = 0.314). These estimates are lower than those previously published and of the order of magnitude typically observed with seasonal flu. This was consistent with the clinical observations in Greater Southern Area Health Service.

Conclusion:  The apparent invariance in the rate of spread of influenza between rural and metropolitan areas should provide rural health care providers with confidence in metropolitan derived estimates when planning in future influenza pandemics.
Measuring rural allied health workforce turnover and retention: What are the patterns, determinants and costs?
Authors: Chisholm Marita , Russell Deborah , Humphreys John
Published: March 2011

Objectives:  To measure variations in patterns of turnover and retention, determinants of turnover, and costs of recruitment of allied health professionals in rural areas.

Design:  Data were collected on health service characteristics, recruitment costs and de‐identified individual‐level employment entry and exit data for dietitians, occupational therapists, physiotherapists, podiatrists, psychologists, social workers and speech pathologists employed between 1 January 2004 and 31 December 2009.

Setting:  Health services providing allied health services within Western Victoria were stratified by geographical location and town size. Eighteen health services were sampled, 11 participated.

Main outcome measures:  Annual turnover rates, stability rates, median length of stay in current position, survival probabilities, turnover hazards and median costs of recruitment were calculated.

Results:  Analysis of commencement and exit data from 901 allied health professionals indicated that differences in crude workforce patterns according to geographical location emerge 12 to 24 months after commencement of employment, although the results were not statistically significant. Proportional hazards modelling indicated profession and employee age and grade upon commencement were significant determinants of turnover risk. Costs of replacing allied health workers are high.

Conclusions:  An opportunity for implementing comprehensive retention strategies exists in the first year of employment in rural and remote settings. Benchmarks to guide workforce retention strategies should take account of differences in patterns of allied health turnover and retention according to geographical location. Monitoring allied health workforce turnover and retention through analysis of routinely collected data to calculate selected indicators provides a stronger evidence base to underpin workforce planning by health services and regional authorities.
Factors affecting Israeli nurses' reports of violence perpetrated against them in the workplace: A test of the theory of planned behaviour
Authors: Natan Merav Ben , Hanukayev Anna , Fares Saruji
Published: March 2011

Ben Natan M, Hanukayev A, Fares S. International Journal of Nursing Practice 2011; 17: 141–150

Factors affecting Israeli nurses' reports of violence perpetrated against them in the workplace: A test of the theory of planned behaviour

Violence against nurses in the workplace is universal. Violence has negative implications for nurses, their patients and the medical facility. Nonetheless, violent incidents are only infrequently reported (20–25%). A correlational design was used to examine whether the guiding conceptual model, constructed of the variables: assailant traits, victim traits and type of violence, succeeds in predicting a nurse's decision to report violence perpetrated against them in the workplace. Data were gathered with a structured questionnaire, constructed specifically for the current research and based on the literature review and research model. The research population was sampled by convenience sampling and consisted of nurses from general hospitals in northern and central Israel of 220 nurses, of whom nearly 72% (n = 158) had experienced violent incidents over the past year, mainly verbal abuse by patients' relatives. Only 26.6% (n = 42) reported violent incidents in written form. Most reports were submitted to the nurse in charge of the department. Correlations were found between assailant traits (identity and mental state) and victim traits (sociodemographic characteristics and attitudes on and perceptions of reporting) and intention and actual report. Nurses' normative beliefs regarding reporting violence had the greatest effect on intention to report.
Paediatric ward nurses' action intentions and attitudes towards quit smoking interventions and their knowledge on second‐hand smoke
Authors: Chan Kim Geok , Upi Helen , Gani Rosena , Chang Kam Hock
Published: March 2011

Chan KG, Upi H, Gani R, Chang KH. International Journal of Nursing Practice 2011; 17: 181–186

Paediatric ward nurses' action intentions and attitudes towards quit smoking interventions and their knowledge on second‐hand smoke

This survey study investigated the paediatric ward nurses for their action intentions and attitudes towards quit smoking‐related interventions (QSRI), and knowledge related to effects of children's exposure to second‐hand smoke (SHS) (n = 267). Results indicate that less than 2% of the nurses smoked, and a majority had a positive attitude towards QSRI. A majority also indicated that they would only assess children's parents' smoking status depending on the child's diagnosis on admission. The total mean scores for two knowledge items are relatively lower than the others. More than half of the participants (66%) indicated ‘no’ to ‘documenting smoking status’. Differences in responses of the participants across the hospitals were statistically significant, χ2 (2, n = 267) = 11.190, P < 0.05. About half of the participants did not know of any existing quit smoking clinics. The variation in the nurses' action intention towards various QSRI may be attributed to their busy workload and varying perceptions towards QSRI as a nursing priority. Results indicate the needs for knowledge related to impacts of children's exposure to SHS to be integrated into the basic nursing curriculum, support and affirmation from ward managers in the clinical settings to promote the initiatives to integrate QSRI in paediatric nursing settings.
Anesthetizing the obese child
Authors: Mortensen Anette , Lenz Katja , Abildstrøm Hanne , Lauritsen Torsten L. B.
Published: March 2011

The prevalence of childhood obesity is increasing. The focus of this review is the special anesthetic considerations regarding the perioperative management of obese children. With obesity the risk of comorbidity such as asthma, obstructive sleep apnea, hypertension, and diabetes increases. The obese child has an increased risk of perioperative complications especially related to airway management and ventilation. There is a significantly increased risk of difficult mask ventilation and perioperative desaturation. Furthermore, obesity has an impact on the pharmacokinetics of most anesthetic drugs. This has important implications on how to estimate the optimal drug dose. This article offers a review of the literature on definition, prevalence and the pathophysiology of childhood obesity and provides suggestions on preanesthetic evaluation, airway management and dosage of the anesthetic drugs in these patients. The authors highlight the need of supplemental studies on various areas of the subject.
EASY MONEY OR HARD TIMES? HEALTH AND 401(k) LOANS
Authors: WELLER CHRISTIAN E. , WENGER JEFFREY B.
Published: March 2011

Rising health care costs and declining personal savings rates are nearly synonymous with household medical debt. For some, defined contribution (DC) retirement savings plans provide a ready source of funds to meet these medical debts. We examine whether health status and health insurance coverage predict the likelihood of having a DC loan using data from the Federal Reserve's triennial Survey of Consumer Finances (SCF) from 1989 to 2007. We find that poor health raises the likelihood that a household will borrow from their DC plans, even controlling for other forms of debt, access to credit, and whether households are covered by health insurance. Our estimates of the amount of the DC loan, taking selection effects into account, indicate that DC loan amounts are also influenced by health status; those with poor health borrow more from their DC plans. Apart from health status, once a household decides to borrow from their retirement funds, race and education also influence how much to borrow. We argue that public policy can improve the long‐term financial retirement security of households by offering more opportunities to save for medical emergencies, while cautiously maintaining the opportunity to borrow from DC plans. (JEL D12, D14, D91)
THE EFFECTS OF TEENAGE FATHERHOOD ON YOUNG ADULT OUTCOMES
Authors: FLETCHER JASON M. , WOLFE BARBARA L.
Published: March 2011

This paper uses national longitudinal data and several new empirical strategies to examine the consequences of teenage fatherhood. The key contribution is to compare economic outcomes of young fathers to young men whose partners experienced a miscarriage rather than a live birth. The results suggest that teenage fatherhood decreases years of schooling and the likelihood of receiving a high school diploma and increases general educational development receipt. Teenage fatherhood also appears to increase early marriage and cohabitation, and has mixed short‐term effects on several labor market outcomes. (JEL J13, J24, J10)
Preschoolers joke with jokers, but correct foreigners
Authors: Hoicka Elena , Akhtar Nameera
Published: March 2011

Thirty‐ and 36‐month‐old English speakers’ (N = 106) ability to produce jokes, distinguish between humorous and sincere intentions, and distinguish between English‐ and foreign‐language speakers, was examined in two tasks. In the Giving task, an experimenter requested one of two familiar objects, and a confederate always gave her the wrong object. In the Naming task, the confederate mislabeled familiar objects. In the English‐speaking conditions, the confederate laughed after doing the wrong thing (English‐Humor) or said, ‘There!’ (English‐Sincere). In the Foreign conditions, the French‐ or Italian‐speaking confederate laughed (Foreign‐Humor) or said, ‘D’accord!’ or ‘Va bene!’ (Foreign‐Sincere). When preschoolers were subsequently requested to give and name the same objects and a new set of familiar objects they were significantly more likely to imitate and ‘do the wrong thing’ in the Humor versus Sincere, and in the English versus Foreign conditions.
IDENTIFYING HARMS
Authors: HARROSH SHLOMIT
Published: March 2011

Moral disagreements often revolve around the issue of harm to others. Identifying harms, however, is a contested enterprise. This paper provides a conceptual toolbox for identifying harms, and so possible wrongdoing, by drawing several distinctions. First, I distinguish between four modes of human vulnerability, forming four ways in which one can be in a harmed state. Second, I argue for the intrinsic disvalue of harm and so distinguish the presence of harm from the fact that it is instrumental to or constitutive of a valued act, practice or way of life. Finally, I distinguish between harm and wrongdoing, arguing that while harm is a normative concept requiring justification, not all harmed states are automatically unjustified. The advantage of this view is that it refocuses the moral debate on the normative issues involved while establishing a common basis to which both sides can agree: the presence of harm to others.
STRATEGIC EQUILIBRIA IN A MODEL OF ECONOMIC GROWTH WITH INPUT INTERDEPENDENCE
Authors: Larrosa Juan M.C.
Published: March 2011

Two countries face a strategic interdependence in producing intermediate goods. Producing these intermediate goods requires both domestic capital and another imported intermediate good. Individually, both economies determine a balanced growth path by taking into account this interdependence in different grades of awareness. By allowing for strategic interactions in the analysis, we adapted a two‐agent dynamic setting and find an interior Markov perfect equilibrium as well as an open‐loop equilibrium reflecting these different degrees of reaction. We find that main results resemble each other but growth rates will be higher when strategies are dynamically updated.
ECONOMIC AND ENVIRONMENTAL EFFECTS OF REFILL PACKS
Authors: Chang Ming‐Chung , Hu Jin‐Li , Lee Mei‐Yu
Published: March 2011

It is common sense that refill packs can increase the repeated use of durable goods, reduce resource waste and be conducive to environmental protection. However, their existence also has an economic effect. For instance, we find that the profit of a monopolistic firm will increase as a result of selling the refill packs when the depreciation rate of the durable good is low. In an extension of the model, we point out that there is an entrant that competes with the incumbent in relation to the composite goods and the refill packs. In order to compete in terms of the prices of the composite goods, the incumbent sells the refill packs not only to increase profit, but also to reduce the amount of waste resulting from the durable goods. As for competing in regard to the prices of the refill packs, if the cost of the composite goods is small, then the incumbent's profit from selling the composite goods will increase. By comparing two extensions of the model, we find that the environmental effect of the price competition in regard to the refill packs is greater than the environmental effect of the price competition in relation to the composite goods.
CONSUMPTION (IN)EFFICIENCY AND FINANCIAL ACCOUNT MANAGEMENT
Authors: Saygılı Hülya
Published: March 2011

Consumption may be inefficient when a household cannot choose the optimal bundle of goods at a minimum cost. After discussing alternative approaches, this paper proposes the use of money metric indirect utility function motivated by Feenstra and Varian in measuring consumption inefficiency. Then, Bamoul–Tobin transactions demand for money model is extended to show how household ability to manage its income, expenditure and financial accounts may affect consumption inefficiency. Results of the stochastic cost frontier approach, which is employed in estimation and the prediction of the European Union household consumption inefficiency, suggest that household expenditure performance is partly explained by the changes in the consumption efficiency and the efficiency is not independent of financial account management.
Central Limit Theorems for the Non‐Parametric Estimation of Time‐Changed Lévy Models
Authors: FIGUEROA‐LÓPEZ JOSÉ E.
Published: March 2011

Abstract.  Let {Zt}t0 be a Lévy process with Lévy measure ν and let be a random clock, where g is a non‐negative function and is an ergodic diffusion independent of Z. Time‐changed Lévy models of the form are known to incorporate several important stylized features of asset prices, such as leptokurtic distributions and volatility clustering. In this article, we prove central limit theorems for a type of estimators of the integral parameter β(ϕ):=∫ϕ(x)ν(dx), valid when both the sampling frequency and the observation time‐horizon of the process get larger. Our results combine the long‐run ergodic properties of the diffusion process with the short‐term ergodic properties of the Lévy process Z via central limit theorems for martingale differences. The performance of the estimators are illustrated numerically for Normal Inverse Gaussian process Z and a Cox–Ingersoll–Ross process .
South African Mixed‐race Children's and Mothers' Judgments and Reasoning about Children's Nurturance and Self‐determination Rights
Authors: Ruck Martin D. , Tenenbaum Harriet , Willenberg Ingrid
Published: March 2011

This study examined the understanding of children's rights in 63 (9‐, 11‐, and 13‐year‐olds) mixed‐race South African children and their mothers. In individual semi‐structured interviews participants responded to hypothetical vignettes in which children's nurturance and self‐determination rights conflicted with parental authority in the home. Participants were required to decide whether they should support the story characters' rights and provide justifications for their responses. Findings indicated that both children and mothers were more likely to endorse children's nurturance than self‐determination rights. In contrast to previous research, no significant differences were found between children and mothers in terms of support for either type of right. In terms of reasoning, both children's and mothers' responses revealed distinct patterns of thinking influenced by the type of right under consideration. The findings are discussed with reference to the available western and non‐western literature on children's understanding of rights. Limitations, implications, and directions for future research are considered.
The Continuity of Consciousness
Authors: Rashbrook Oliver
Published: March 2011

Abstract: In this paper I discuss two puzzles that concern the sense in which consciousness can be described as ‘continuous’. The first puzzle arises out of recent work by Dainton and Tye, both of whom appear to oscillate between ascribing the property of ‘continuity’ to the stream of experience, and ascribing it to the objects of experience. The second puzzle concerns the notion that the stream of consciousness could be in some sense unreal or illusory—a puzzle stemming from the thought that some of the brain processes underlying consciousness do not exhibit continuity. I argue that these problems can be solved by distinguishing between three possible bearers of the property of ‘continuity’—(1) the State of Consciousness, (2) the Stream of Experience, and (3) what is represented by experience—and two different senses of ‘continuity’—‘strict’ and ‘extreme’ continuity. I conclude by providing a positive account of the continuity of consciousness, according to which the State of Consciousness exhibits ‘strict’ continuity, and the Stream of Experience exhibits ‘extreme’ continuity.
Radio‐guided surgery: advantages of a new portable γ‐camera (Sentinella®) for intraoperative real time imaging and detection of sentinel lymph nodes in cutaneous malignancies
Authors: Stoffels I. , Poeppel T. , Boy C. , Mueller S. , Wichmann F. , Dissemond J. , Schadendorf D. , Rosenbaum‐Krumme S. , Klode J.
Published: March 2011

Background  The histological status of the sentinel lymph node (SLN) is one of the most relevant prognostic factors for the overall survival of patients with cutaneous malignancies, independent of tumour depth of the primary tumour.

Objectives  Our study seeks to evaluate the reliability and medical benefit of SLN excision (SLNE) performed with a portable γ‐camera for intraoperative real time imaging of SLN.

Methods  Therefore our study compares the visualization of SLN performed with preoperative lymphoscintigraphy and preoperative SPECT/CT with the intraoperative real time imaging of SLN performed with a new portable γ‐camera (Sentinella®) in 60 patients who were treated with a SLNE for early stage melanoma (n = 38), high risk cutaneous squamous cell carcinoma (n = 16), Merkel cell carcinoma (n = 4), sebaceous gland carcinoma (n = 1), and sweat glands carcinoma or porocarcinoma (n = 1).

Results  Sixty patients were enrolled in this study. The portable γ‐camera visualized all 126 preoperatively identified SLN. 23 additional SLN (15.4%) in 15 patients were only identified using the portable γ‐camera. Two of these additional SLN showed metastatic involvement.

Conclusion  The portable γ‐camera is an innovative imaging technique, reliable and providing additional information in the detection of SLN. Therefore SLNE with intraoperative γ‐camera use is an attractive option to improve the detection of SLN in cutaneous malignancies and could help to reduce false negative SLN results.