bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Screening and Evaluation Decision Support Systems: A Resource-Matching Approach
Authors: Tan Chuan-Hoo , Teo Hock-Hai , Benbasat Izak
Published: November 2009

This research explores how consumers use online decision aids with screening and evaluation support functionalities under varying product attribute-load conditions. Drawing on resource-matching theory, we conducted a 3 × 2 factorial experiment to test the interaction between decision aid features (i.e., low versus high-screening support, and aids with weight assignment and computation decision tools) and attribute load (i.e., large versus small number of product attributes) on decision performance. The findings reveal that: (1) where the decision aids render cognitive resources that match those demanded for the task environment, consumers will process more information and decision performance will be enhanced; (2) where the decision aids render cognitive resources that exceed those demanded for the task environment, consumers will engage in less task-related elaboration of decision-making issues to the detriment of decision performance; and (3) where the decision aids render cognitive resources that fall short of those demanded for the task environment, consumers will use simplistic heuristic decision strategies to the detriment of decision performance or invest additional effort in information processing to attain a better decision performance if they perceive the additional investments in effort to be manageable.
Improving Supply Chain Performance: Real-Time Demand Information and Flexible Deliveries
Authors: Shang Kevin H. , Zhou Sean X. , van Houtum Geert-Jan
Published: November 2009

In some supply chains, materials are ordered periodically according to local information. This paper investigates how to improve the performance of such a supply chain. Specifically, we consider a serial inventory system in which each stage implements a local reorder interval policy; i.e., each stage orders up to a local base-stock level according to a fixed-interval schedule. A fixed cost is incurred for placing an order. Two improvement strategies are considered: (1) expanding the information flow by acquiring real-time demand information and (2) accelerating the material flow via flexible deliveries. The first strategy leads to a reorder interval policy with full information; the second strategy leads to a reorder point policy with local information. Both policies have been studied in the literature. Thus, to assess the benefit of these strategies, we analyze the local reorder interval policy. We develop a bottom-up recursion to evaluate the system cost and provide a method to obtain the optimal policy. A numerical study shows the following: Increasing the flexibility of deliveries lowers costs more than does expanding information flow; the fixed order costs and the system lead times are key drivers that determine the effectiveness of these improvement strategies. In addition, we find that using optimal batch sizes in the reorder point policy and demand rate to infer reorder intervals may lead to significant cost inefficiency.
Mitigating Supply Risk: Dual Sourcing or Process Improvement?
Authors: Wang Yimin , Gilland Wendell , Tomlin Brian
Published: November 2009

Surveys suggest that supply chain risk is a growing issue for executives and that supplier reliability is of particular concern. A common mitigation strategy is for the buying firm to expend effort improving the reliability of its supply base. We explore a model in which a firm can source from multiple suppliers and/or exert effort to improve supplier reliability. For both random capacity and random yield types of supply uncertainty, we propose a model of process improvement in which improvement efforts (if successful) increase supplier reliability in the sense that the delivered quantity (for any given order quantity) is stochastically larger after improvement. We characterize the optimal procurement quantities and improvement efforts and generate managerial insights. For random capacity, improvement is increasingly favored over dual sourcing as the supplier cost heterogeneity increases, but dual sourcing is favored over improvement if the supplier reliability heterogeneity is high. In the random yield model, increasing cost heterogeneity can reduce the attractiveness of improvement, and improvement can be favored over dual sourcing if the reliability heterogeneity is high. A combined strategy (improvement and dual sourcing) can provide significant value if suppliers are very unreliable and/or capacity is low relative to demand.
Pricing and Dimensioning Competing Large-Scale Service Providers
Authors: Allon Gad , Gurvich Itai
Published: November 2009

The literature on many-server approximations provides significant simplifications toward the optimal capacity sizing of large-scale monopolists, but falls short of providing similar simplifications for a competitive setting in which each firm's decision is affected by its competitors' actions. In this paper, we introduce a framework that combines many-server heavy-traffic analysis with the notion of epsilon-Nash equilibrium and apply it to the study of equilibria in a market with multiple large-scale service providers that compete on both prices and response times. In an analogy to fluid and diffusion approximations for queueing systems, we introduce the notions of fluid game and diffusion game. The proposed framework allows us to provide first-order and second-order characterization results for the equilibria in these markets. We use our results to provide insights into the price and service-level choices in the market and, in particular, into the impact of market scale on the interdependence between these two strategic decisions.
‘Your charge is to me a plesure’: Manipulation, Gareth, Lynet, and Malory
Authors: Ackerman Felicia Nimue
Published: November 2009

Analytic philosophy offers a new perspective for viewing Gareth’s manipulation of Lynet in Malory’s Morte Darthur .
Where the "Bad" Girls Are (Contained): Representations of the 1950s Female Juvenile Delinquent in Children's Literature and Ladies' Home Journal
Authors: Caponegro Ramona
Published: November 2009

Despite the national panic over juvenile delinquency in the United States in the 1950s, the female juvenile delinquent was—and remains—largely ignored. When she is noticed, her actions are psychoanalytically perceived as so contained, particularly within her relationship with her father, that her agency is perceived as limited and, therefore, supposedly less worthy of attention. Nevertheless, this paper examines the representations of female juvenile delinquents in 1950s issues of Ladies' Home Journal and in three books for children: Hal Ellson's Tomboy (1950), Anne Alexander's The Pink Dress (1959), and Elizabeth George Speare's The Witch of Blackbird Pond (1958).
The evolution of fertility expectations over the life course
Authors: Hayford Sarah R.
Published: November 2009

In low-fertility contexts, how many children people have is largely a product of how many children they want. However, the social, institutional, and individual factors that influence how many children people want are not well understood. In particular, there is scant evidence about how fertility expectations change over the life course. This article provides an empirical description of changes in women's expected fertility over the entire span of childbearing years. Using data from the National Longitudinal Survey of Youth, 1979 cohort, group-based trajectory analysis illuminates common patterns in the evolution of fertility intentions and identifies individual characteristics associated with these patterns. Factors related to family formation, such as marriage and whether a woman has a child at an early age, are found to be the most consistent correlates of patterns of change in expected family size.
The increasing risk of poverty across the American life course
Authors: Sandoval Daniel A. , Rank Mark R. , Hirschl Thomas A.
Published: November 2009

This article extends the emerging body of life course research on poverty by empirically identifying the incidence, chronicity, and age pattern of American poverty and how these dimensions have changed during the period 1968-2000. Using the Panel Study of Income Dynamics, we construct a series of life tables that estimate the risk of poverty for adults during their 20s, 30s, 40s, 50s, 60s, and 70s, and compare these estimates for Americans in the 1970s, 1980s, and 1990s. Our empirical results suggest that the risk of acute poverty increased substantially, particularly in the 1990s. This observed increase was especially pronounced for individuals in their 20s, 30s, and 40s; for all age groups with respect to extreme poverty; and for white males. On the other hand, the risk of chronic poverty declined during the 1990s (as measured by the percentage of the poor who experienced five or more years of poverty within a 10-year interval). The results in this article tell a very different story than the Census Bureau's yearly cross-sectional rates, which have shown little overall change in the U.S. poverty rate during this 30-year period. In contrast, a life course approach reveals a rising economic risk of acute poverty for individuals, one that is consistent with recent observations and research suggesting that a growing number of Americans will eventually find themselves in an economically precarious position.
Care for the Most Vulnerable Children in Tanzania: A Faith-Based Model of Care and Support for Children Affected by HIV
Authors: Mmbando Paul , Hartwig Kari A. , Hofgren Berit , DiSorbo Phil , Smith Shelley , Hartwig Kristopher N.
Published: November 2009

In the fight against HIV and AIDS in sub-Saharan Africa, the plight of orphaned and vulnerable children was long overlooked. The first United Nations report on orphans and vulnerable children did not emerge until 2002 after more than two generations of children and youth had struggled to survive with limited family, institutional, or government support. The major social determinants of health for infants and children with one or more parents dying or dead from HIV include pervasive poverty, weak community social support systems, lack of policy commitment by governments or foreign donors, lack of access to anti-retroviral drugs, limited access to schools, and gender. In this paper, we present a model of care and support to the most vulnerable children (MVC) affected by HIV that brings together faith-based institutions in partnership with the government and community volunteers in 13 rural districts of Tanzania. Although still being implemented, the project has a number of valuable lessons learned for program managers, donors, and researchers working with faith-based organizations in the development and delivery of services to the most vulnerable children in a resource-limited setting.
Urban and Rural Differences Across Countries in Child Mortality in Sub-Saharan Africa
Authors: Anyamele Okechukwu D.
Published: November 2009

The purpose of this study is to investigate and document the differences between urban and rural areas across countries in sub-Saharan Africa (SSA) with respect to child mortality. We use recent data from Demographic and Health Surveys on 11 selected countries in SSA. Socioeconomic variables of household wealth, level of education of the mother, access to clinics, and other environmental variables are used as control variables in measuring the differences. The study employs logit regression to enable the use of the odds ratio to interpret differences across the urban and rural areas in SSA.
No Family Left Behind: The Example of Community-Based Pneumonia Care in Haiti
Authors: Lewis Judy , Gebrian Bette
Published: November 2009

The Haitian Health Foundation (HHF) in Jeremie, Haiti conducted an intervention combating childhood bacterial pneumonia. HHF treated 60,000 episodes of respiratory illness in 15 years. The same care model is used for vaccinations, exclusive breastfeeding, diarrheal disease, congenital syphilis, and newborn care.
Community Case Management of Childhood Illness in Nicaragua: Transforming Health Systems in Underserved Rural Areas
Authors: George Asha , Menotti Elaine P. , Rivera Dixmer , Montes Irma , Reyes Carmen María , Marsh David R.
Published: November 2009

While social factors broadly determine health outcomes, strategic health workforce innovations such as community case management (CCM) can redress social inequalities in access to health care. Community case management enables trained health workers to assess children, diagnose common childhood infections, administer medicines, and monitor life-saving treatment in the poor, remote communities where they reside. This article reports on research that combined focus group discussions and key informant interviews to examine the perceptions of multiple stakeholders, with monitoring data, in order to assess programmatic results, limitations, and lessons learned in implementing CCM in Nicaragua. We found that CCM increases the use of curative services by poor children with pneumonia, diarrhea, or dysentery by five to six-fold over facility-based services. Apart from dramatically increasing geographic access to treatment for underserved groups, our qualitative research suggests that Nicaragua’s CCM model also addresses the managerial challenges and social relations that underpin good quality of care, care-giver knowledge and awareness, and community mobilization, all health system-strengthening factors that are central to equitably and effectively improving child health. While our findings are promising, we suggest areas for further operational research to strengthen CCM program learning and functioning.
Fostering Resilience in Children at Risk through a Cultural Therapy Intervention in Kingston, Jamaica
Authors: Robertson-Hickling Hilary , Paisley Vanessa , Guzder Jaswant , Hickling Frederick W.
Published: November 2009

This report explores an initiative in Kingston, Jamaica to foster resilience in children in an inner-city community plagued by violence and other social problems. This initiative was undertaken by CARIMENSA, the Caribbean Institute for Mental Health and Substance Abuse.
A Randomized Community Intervention to Improve Hypertension Control among Mexican Americans: Using the Promotoras de Salud Community Outreach Model
Authors: Balcazar Hector G. , Byrd Theresa L. , Ortiz Melchor , Tondapu Sumanth R. , Chavez Monica
Published: November 2009

The objectives of this study were: 1) to evaluate the acceptance, effectiveness, and sustainability of a promotora (community health worker) pilot program to improve hypertension control among medically underserved Mexican Americans of the El Paso, Texas area, and 2) to demonstrate improvements in clinical measures of blood pressure, BMI and waist circumference, self-reported behaviors and changes in attitudes and beliefs about blood pressure among Mexican American hypertensives. Participants were eligible if they had been diagnosed with hypertension and if they were willing to be randomized as either participants in the intervention or as controls. A total of 58 participants enrolled in the intervention group and 40 participants served as controls. This was a 9-week promotora intervention. Health behavior constructs and clinical data were measured pre-post intervention. Perceived benefits, and two heart-healthy behaviors (salt and sodium, and cholesterol and fat) were shown to be statistically significantly different between the intervention and control groups.
Sources and Types of Social Support that Influence Engagement in HIV Care among Latinos and African Americans
Authors: George Sheba , Garth Belinda , Wohl Amy Rock , Galvan Frank H. , Garland Wendy , Myers Hector F.
Published: November 2009

The change in HIV from acute to chronic disease due to the introduction of HAART in the mid-1990s increased the importance of its successful management and imposed substantial lifestyle adjustments on HIV-positive people and their support networks. Few studies have examined the sources and types of social support and the areas of care relevant for engagement in HIV treatment among HIV-positive Latinos and African Americans. This paper reports the results of 24 semi-structured in-depth interviews that were conducted with HIV-positive African American and Latino women and men who have sex with men. Formal networks were found to be more critical for engagement in HIV-specific medical care; specifically, study participants relied primarily on health care providers for support in accessing and maintaining illness-specific care. In contrast, informal networks (family and friends) were crucial for other general subsistence care, such as emotional, household-related, and financial support.
Alcohol Use, Comorbidities, and Receptivity to Treatment in Hispanic Farmworkers in Primary Care
Authors: Cherry Donna J. , Rost Kathryn
Published: November 2009

Primary care is a promising setting for alcohol screening and intervention with low-income Hispanic farmworkers, yet no research has been conducted that estimates the prevalence of harmful and hazardous drinking, psychiatric comorbidities, or receptivity to treatment in this population. This study investigates rates of alcohol misuse, depression, anxiety, somatization, and cigarette use in a convenience sample of low-income Hispanic farmworkers and farmworker spouses in Florida making walk-in visits to a rural community health center. Results indicated a high prevalence of alcohol use but also a strong willingness to receive treatment. Forty-four percent (44%) screened positive for harmful and hazardous alcohol use; over half (58%) screened positive for one or more comorbidity risks. Receptivity to alcohol treatment was high (75%). These results strongly support the need for and potential utility of alcohol intervention in primary care for this population.
Promoting Better Oral Health Practices among Aboriginal Taiwanese Adolescents: A School Based Oral Health Education Intervention Program
Authors: Yang Yi-Hsin , Sue Rouh-Lan , Warnakulasuriya Saman , Dasanayake Ananda P.
Published: November 2009

The purpose of this study was to test the efficacy of an educational program aimed at improving oral health knowledge and behaviors in junior high school students in indigenous communities in Taiwan. Two junior high schools were randomly selected. Students in the intervention school received an oral health education program. Both groups received structured questionnaires to assess their oral health practices and risk behaviors at baseline and after the intervention. The intervention group had statistically significant positive changes in their oral health knowledge (p<.001), an increase in tooth-brushing frequency (p<.001), and a decrease in tobacco use (p=.01). Most (87%) students considered the educational program excellent or good . Carefully designed health education programs delivered within schools in areas with limited access to health care can improve the students’ knowledge and reduce their risk behaviors which may prove to be a mechanism that ultimately reduces health disparities.
Reduction in Maternal and Child Mortality in Sub-Saharan Africa: The Yo-Yo Effect in Delivering on the Promises
Authors: Mwalali Philip , Ngui Emmanuel
Published: November 2009

Trends in maternal and child mortality (MCM) in sub-Saharan Africa do not follow the patterns seen in developed nations or match the funds and effort invested so far. This paper critically explores trends in MCM, global efforts to reduce MCM, and some of the underlying policies and programmatic issues that have shaped the slow progress or failure in reducing MCM in sub-Saharan Africa. We describe a “yo-yo” effect in policies and funding of Maternal and Child Health, Family Planning, and HIV/AIDS/STI programs in the region, and how this yo-yo effect may limit sustained community level reductions in MCM. We conclude by highlighting how renewed interest in the Alma-Ata declaration, particularly its primary health care concepts with their strong emphasis on horizontally integrated linkage of programs and resources, greater community involvement in program design and implementation, and economic development can contribute to sustainable reductions in MCM in the region.
Multiple Switching in Medicaid Managed Care: A Proportional Hazards Model
Authors: Brandon William P. , Sundaram Rajeshwari , Dunham Ashley A.
Published: November 2009

This case study (n=41,969) aims to discover managerially useful predictors of multiple switching among HMOs in a Medicaid managed care population observed over 33 months. Cox’s proportional hazards model was used to analyze eligibility data for the entire population, claims data for Medicaid services received during six months prior to HMO enrollment (sample n=2,474) and telephone interviews (sample n=656). Each analytic stage involved four comparisons: (1) enrollees with one switch compared with enrollees with no switches; (2) enrollees with multiple switches compared with those having no switches; (3) in relation to making the first switch, enrollees with multiple switches compared with those having one switch; and (4) in relation to making the second switch, multiple compared with those having one switch. Interruptions (which were independent of switches) predicted switching versus non-switching. Medical claims and, weakly, greater age were associated with multiple switching. Managers can use these three predictors to reduce switching and multiple switching. The finding that switching was associated with greater utilization before HMO enrollment contradicts findings for employer-sponsored insurance, but a possible explanation is offered.
Addressing the Social Determinants of Children’s Health: A Cliff Analogy
Authors: Jones Camara Phyllis , Jones Clara Yvonne , Perry Geraldine S. , Barclay Gillian , Jones Camille Arnel
Published: November 2009

This paper presents a “Cliff Analogy” illustrating three dimensions of health intervention to help people who are falling off of the cliff of good health: providing health services, addressing the social determinants of health, and addressing the social determinants of equity. In the terms of the analogy, health services include an ambulance at the bottom of the cliff, a net or trampoline halfway down, and a fence at the top of the cliff. Addressing the social determinants of health involves the deliberate movement of the population away from the edge of the cliff. Addressing the social determinants of equity acknowledges that the cliff is three-dimensional and involves interventions on the structures, policies, practices, norms, and values that differentially distribute resources and risks along the cliff face. The authors affirm that we need to address both the social determinants of health, including poverty, and the social determinants of equity, including racism, if we are to improve health outcomes and eliminate health disparities.
The Impact of Mass Incarceration on Outpatients in the Bronx: A Card Study
Authors: Shah Minesh P. , Edmonds-Myles Sadiqa , Anderson Matthew , Shapiro Miriam E. , Chu Carolyn
Published: November 2009

Objective . We examined the impact of arrest and incarceration on primary care patients in the Bronx, New York.
Methods . Patients at three clinics were asked eight questions concerning current and past involvement in criminal proceedings, arrest, and incarceration.
Results . One hundred eighteen patients were surveyed. Eleven (9%) patients were currently involved in criminal proceedings. Twenty-one (18%) currently had a family member in jail or prison. Twenty-nine (25%) reported ever being arrested; 65 (55%) reported that they or a family member had been arrested. Twenty-one (18%) had been incarcerated; 60 (51%) reported they or a family member had spent time in jail or prison. For most variables, rates were higher for men and the adults accompanying children at pediatric visits. Clinicians reported positive experiences discussing incarceration.
Conclusions . Involvement with the criminal justice system was common among our patients. Discussion of incarceration did not appear to have a negative impact on the clinical relationship.
Learning How to Measure the Well-Being of OVC in a Maturing HIV/AIDS Crisis
Authors: Wallis Allan , Dukay Victor
Published: November 2009

The HIV/AIDS epidemic in Africa is frequently referred to as a crisis while the principal U.S. program to address it is labeled emergency relief. These terms trigger specific policy responses and corresponding evaluation activities. In this article, three stages in the response to HIV/AIDS are distinguished: awareness, emergency, and structural integration. In the awareness phase, emphasis is on defining and then estimating the affected population. In the emergency phase, evaluation activity is focused on demonstrating accountability for the assistance provided; and finally, in the structural integration phase, concern shifts to demonstrating the impact of assistance on improving the recipients’ well-being. The shifting focus of evaluation is discussed in terms of how to measure the impact of aid on the well-being of orphaned and vulnerable children. A case study based on work in rural Tanzania is presented and then discussed in term of its broader implications for evaluating future aid.
Social Determinants of Children’s Health in Urban Areas in India
Authors: Agarwal Siddharth , Srivastava Aradhana
Published: November 2009

Children of the urban poor in India suffer a much poorer health status than the urban non-poor, influenced to a large extent by social determinants. In this paper, National Family Health Survey-3 (2005–06) data were analyzed to assess the health status of urban poor children vis-à-vis the non-poor, and to identify the social determinants precipitating disparities. The analysis shows sharp disparity between child health indicators between urban poor and non-poor. Key findings include under-five mortality per thousand (urban poor 72.7 and non-poor 41.8) and children under-five underweight for age (urban poor 47% and non-poor 26.2%). Significant demographic and social correlates of child health in urban areas included poverty, gender, caste status, religion, mother’s educational attainment, occupational status of parents, and women’s autonomy in the household. They influenced different facets of child health, such as nutritional status and access to immunization.
Orthotopic testicular transplantation in mice
Authors: Li Jianhui , Savolainen Hannu , Tan FuQing , Zheng Shusen
Published: November 2009

A method of revascularized orthotopic testicular transplantation (OTT) was developed in mice. The left testis was selected as donor graft for the operation due to less variation in anatomy. There were three groups: 1) a control group (n=24), 2) a group of castrated mice (n=24), and 3) a group in which OTT (n=24) was performed. Morphologically, the transplanted testes showed active spermatogenesis and normal structure of epididymis at 4 and 5 weeks. The function of the transplants was examined by RIA at designed time points. LH, FSH, and testosterone showed return to normal levels at 4 weeks. To our knowledge, this is the first report of successful revascularized OTT in mice. The model may prove useful in research in reproductive medicine, especially using knockout and transgenic mice.
Package information leaflets as potential contributors to the curative effect
Authors: Komsa Ildikó , Köteles Ferenc , Bárdos György
Published: November 2009

Vizsgálatunkban arra voltunk kíváncsiak, hogy vény nélkül kapható fájdalomcsillapító szerek esetében a hatást leíró részek különbözősége, a szövegekben előforduló pozitív szuggesztiók befolyásolhatják-e a betegek gyógyszerválasztását.15 recept nélkül megvásárolható (OTC), nem-szteroid gyulladáscsökkentő (NSAID) betegtájékoztatójának gyógyhatásokat leíró részét („Mi az XXX tabletta és mire használható?”) értékeltettük 200 alsóéves egyetemi hallgatóval (18 és 25 év között, átlagéletkor: 19,76 ± 1,495 év; 38% férfi) az érthetőség és az észlelt hatásosság szempontjából.A betegtájékoztatók között mind az érthetőség, mind az észlelt hatásosság szempontjából szignifikáns különbségeket találtunk. Az értékelést pozitívan befolyásolta a szöveg terjedelme (a szavak és karakterek száma), a felsorolt panaszok és betegségek, valamint a hatásosságra vonatkozó kifejezések (szuggesztiók) száma. A választást az érthetőség és a hasznos információk mennyisége befolyásolta a legerősebben. A legjobbnak értékelt leírások terjedelme az átlagosnál hosszabb volt, valamint több hatást és tünetleírást tartalmazott.A betegtájékoztatók számos hasznos (placebo, informálás, a betegek védelme) és potenciálisan káros (nocebo: mellékhatások leírása) hatással is bírnak.Az intelligens gyógyszertervezés keretein belül, a biztonságos és hatásos gyógyszerhasználat érdekében, a mellékhatások leírása mellett a gyógyító hatásokkal kapcsolatos teljesebb körű informálásra és a pozitív szuggesztiókra is érdemes lenne több figyelmet fordítani.
80 years’ history of psychology in the University of Szeged (1929–2009)
Authors: Pataki Márta , Polyák Kamilla , Németh Dezső , Szokolszky Ágnes
Published: November 2009

Imre Sándor, a pedagógia professzora az 1920-as évek közepén felismerte, hogy külön intézetet kellene alapítani a pszichológiaoktatás számára a szegedi egyetemen. 1926 októberében felterjesztette kérelmét a bölcsészkari vezetés felé, Málnási Bartók György, a Filozófia Tanszék professzora támogatása mellett. 1929. december 18-án Klebelsberg Kuno vallás- és közoktatásügyi miniszter megalapította a Pedagógia Lélektani Intézetet a szegedi egyetemen, és kinevezte az új intézet élére Várkonyi Hildebrand Dezső (1988–1971) bencés paptanárt. Ezzel Magyarországon elsőként alakult pszichológiai intézet egyetemi kereteken belül. A cikk a szegedi lélektan intézményes történetét követi végig a Várkonyi vezette intézet megalakulásától napjainkig.
Urocortin 2 induces potent long-lasting inhibition of cardiac sympathetic drive despite baroreflex activation in conscious sheep
Authors: Charles Christopher J , Jardine David L , Rademaker Miriam T , Richards A Mark
Published: November 2009

Emerging evidence suggests that the urocortin (UCN) peptides contribute to pressure and volume regulation with possible involvement in the pathophysiology of cardiovascular disease. We have recently reported that i.v. UCN1 potently inhibits cardiac sympathetic nerve activity (CSNA) in normal sheep. However, little is known about possible interactions between UCN2 and the sympathetic nervous system. Accordingly, we have examined the effects of i.v. UCN2 on CSNA, hemodynamics, and plasma catecholamines in normal conscious sheep. Bolus i.v. administration of UCN2 (25 and 100 μg) resulted in the expected hemodynamic actions including transient falls in arterial pressure (P=0.016) and more sustained rises in heart rate (P<0.001) and cardiac output (P<0.001) and falls in peripheral resistance (P<0.001). CSNA burst frequency showed a biphasic response (P<0.001) with an acute rise followed by a more prolonged fall. CSNA burst area and incidence showed prolonged, dose-dependent falls in response to UCN2 administration (all P<0.001). UCN2 also induced a short-lived rise in plasma norepinephrine levels (P=0.006). The marked rise in heart rate in response to UCN2 is preserved in sheep undergoing pharmacological ganglionic blockade with hexamethonium. In conclusion, this is the first study to report the effects of UCN2 on SNA and indicates potent inhibition of sympathetic traffic to the heart despite a generalized baroreceptor-induced activation of sympathetic activity. These findings suggest an important role for UCN2 in cardiovascular homeostasis and warrant further investigation for potential therapeutic applications in acute myocardial injury and heart disease.
Interview With Francine Shapiro: Historical Overview, Present Issues, and Future Directions of EMDR
Authors: Luber Marilyn , Shapiro Francine
Published: November 2009

This interview with Dr. Francine Shapiro, originator and developer of Eye Movement Desensitization and Reprocessing (EMDR), provides an overview of the history and evolution of EMDR from its inception to current findings and utilization, as well as future directions in research and clinical development. Dr. Shapiro discusses the psychological traditions that informed the development of EMDR and the Adaptive Information model, as well as the implications for current treatment. The rationale for the application of EMDR to a wide range of disorders is discussed, as well as its integration with other therapeutic approaches. Topics include research on the role of eye movements, the use of EMDR with combat veterans, somatoform disorders, attachment issues, and the distinct features of EMDR that have allowed it to be used for crisis intervention worldwide.
Evidence of the Efficacy of EMDR With Children and Adolescents in Individual Psychotherapy: A Review of the Research Published in Peer-Reviewed Journals
Authors: Adler-Tapia Robbie , Settle Carolyn
Published: November 2009

Research on psychotherapy with children is generally underrepresented in the empirical literature. Currently, there are four randomized clinical trials (RCT) evaluating EMDR in individual psychotherapy with traumatized children—two for children diagnosed with PTSD and two for children presenting with symptoms of posttraumatic stress. Since the first case studies of EMDR with children were published in 1993, 19 studies were identified that met the inclusion criteria for this review. The gold standards identified by Foa and Meadows (1997) to assess the methodology of studies designed to treat trauma were applied to the research on EMDR with children. This analysis discusses the challenges to conducting research on psychotherapy with children including the debate regarding the assessment and diagnosis of PTSD in children. Recommendations for future studies designed with methodological rigor are suggested to investigate the efficacy of EMDR with children who have experienced trauma and other mental health symptoms and diagnoses.
EMDR in the Treatment of Medically Unexplained Symptoms: A Systematic Review
Authors: van Rood Yanda R. , de Roos Carlijn
Published: November 2009

This systematic review presents evidence for the effectiveness of eye movement desensitization and reprocessing (EMDR) in the treatment of a diverse range of medically unexplained symptoms (MUS). Theoretical underpinning, variations in interventions, methodological issues, and outcomes are discussed, and implications for future research and clinical practice are presented. Considering the limited number of reported case series and the lack of controlled studies, it might be concluded that EMDR for MUS is only in its infancy. The preliminary results suggest that EMDR might be an effective treatment for MUS and somatoform disorders, particularly when they are related to trauma. To date, the results for phantom limb pain are the most promising.
EMDR and the Treatment of Complex PTSD: A Review
Authors: Korn Deborah L.
Published: November 2009

The diagnosis of posttraumatic stress disorder (PTSD) covers a wide range of conditions, ranging from patients suffering from a one-time traumatic accident to those who have been exposed to chronic traumatization and repeated assaults beginning at an early age. While EMDR and other trauma treatments have been proven efficacious in the treatment of simpler cases of PTSD, the effectiveness of treatments for more complex cases has been less widely studied. This article examines the body of literature on the treatment of complex PTSD and chronically traumatized populations, with a focus on EMDR treatment and research. Despite a still limited number of randomized controlled studies of any treatment for complex PTSD, trauma treatment experts have come to a general consensus that work with survivors of childhood abuse and other forms of chronic traumatization should be phase-oriented, multimodal, and titrated. A phase-oriented EMDR model for working with these patients is presented, highlighting the role of resource development and installation (RDI) and other strategies that address the needs of patients with compromised affect tolerance and self-regulation. EMDR treatment goals, procedures, and adaptations for each of the various treatment phases (stabilization, trauma processing, reconnection/development of self-identity) are reviewed. Finally, reflections on the strengths and unique advantages of EMDR in treating complex PTSD are offered along with suggestions for future investigations.
Use of phenol red thread tests to evaluate tear production in clinically normal Amazon parrots and comparison with Schirmer tear test findings
Authors: Storey Eric S. , Carboni Deborah A. , Kearney Michael T. , Tully Thomas N.
Published: November 2009

Objective—To determine phenol red thread test (PRTT) values in eyes of clinically normal Hispaniolan Amazon parrots before and after topical application of an ophthalmic anesthetic agent and compare findings with Schirmer tear test (STT) values.

Design—Evaluation study.

Animals—24 Amazona ventralis parrots from a research colony.

Procedures—On 4 occasions (1-week intervals), all birds underwent a thorough ophthalmic examination of both eyes, which included (in sequence) performance of a PRTT and an STT; topical ocular application of proparacaine hydrochloride; and performance of another PRTT and another STT. Correlations between PRTT and STT values recorded with and without topical anesthesia were assessed.

Results—Without topical anesthesia, mean ± SD PRTT value was 12.5 ± 5.0 mm/15 s (range, 1 to 25 mm/15 s). With topical anesthesia, the PRTT value was 12.6 ± 5.4 mm/15 s (range, 2 to 24 mm/15 s). Without topical anesthesia, mean STT value was 7.9 ± 2.6 mm/min (range, 0 to 13 mm/min). With topical anesthesia, the STT value was 5.1 ± 3.3 mm/min (range, 0 to 18 mm/min). The correlation of PRTT and STT values recorded with or without topical anesthesia was weak (r = 0.51 and r = 0.32, respectively).

Conclusions and Clinical Relevance—Results indicated that the PRTT and STT were both viable methods for measurement of tear production in Hispaniolan Amazon parrots. Topical application of an ophthalmic anesthetic agent did not have a significant effect on the PRTT values but significantly decreased the STT values.
Evaluation of deafness in American Paint Horses by phenotype, brainstem auditory-evoked responses, and endothelin receptor B genotype
Authors: Magdesian K. Gary , Williams D. Colette , Aleman Monica , LeCouteur Richard A. , Madigan John E.
Published: November 2009

Objective—To evaluate deafness in American Paint Horses by phenotype, clinical findings, brainstem auditory-evoked responses (BAERs), and endothelin B receptor (EDNBR) genotype.

Design—Case series and case-control studies.

Animals—14 deaf American Paint Horses, 20 suspected-deaf American Paint Horses, and 13 nondeaf American Paint Horses and Pintos.

Procedures—Horses were categorized on the basis of coat color pattern and eye color. Testing for the EDNBR gene mutation (associated with overo lethal white foal syndrome) and BAERs was performed. Additional clinical findings were obtained from medical records.

Results—All 14 deaf horses had loss of all BAER waveforms consistent with complete deafness. Most horses had the splashed white or splashed white–frame blend coat pattern. Other patterns included frame overo and tovero. All of the deaf horses had extensive head and limb white markings, although the amount of white on the neck and trunk varied widely. All horses had at least 1 partially heterochromic iris, and most had 2 blue eyes. Ninety-one percent (31/34) of deaf and suspected-deaf horses had the EDNBR gene mutation. Deaf and suspected-deaf horses were used successfully for various performance events. All nondeaf horses had unremarkable BAER results.

Conclusions and Clinical Relevance—Veterinarians should be aware of deafness among American Paint Horses, particularly those with a splashed white or frame overo coat color pattern, blend of these patterns, or tovero pattern. Horses with extensive head and limb markings and those with blue eyes appeared to be at particular risk.
Dendritic Cells Secrete the Immunosuppressive HLA-G Molecule upon CTLA4-Ig Treatment: Implication in Human Renal Transplant Acceptance
Authors: Bahri Rajia , Naji Abderrahim , Menier Catherine , Charpentier Bernard , Carosella Edgardo D. , Rouas-Freiss Nathalie , Durrbach Antoine
Published: November 2009

CTLA4-Ig (Belatacept) is a new recombinant molecule that interferes with the signal of T lymphocyte activation and prevents acute rejection after renal transplantation. HLA-G acts as a naturally tolerogenic molecule in humans. In this study, we analyzed whether HLA-G contributes to CTLA4-Ig-mediated graft acceptance. Our results demonstrate that patients treated with CTLA4-Ig displayed significantly higher soluble HLA-G (sHLA-G) plasma concentrations (72 ± 14 ng/ml) than patients treated with calcineurin inhibitors (5 ± 1 ng/ml) or healthy donors (5 ± 5 ng/ml). Notably, sHLA-G purified from plasma of CTLA4-Ig-treated patients was biologically active as it inhibited allogeneic T cell proliferation in vitro. Dendritic cells (DC) were identified as one of the cellular sources of sHLA-G in CTLA4-Ig-treated patients. Supporting this observation, we showed that DC generated in vitro in presence of CTLA4-Ig released sHLA-G in response to allostimulation. These CTLA4-Ig-treated DC acted as tolerogenic APC through sHLA-G secretion as they suppressed T cell alloproliferation, which could be restored by using a neutralizing anti-HLA-G Ab. These data define a novel pathway by which CTLA4-Ig immunomodulates allogenic response through posttranscriptional regulation of HLA-G expression in DC. CTLA4-Ig-mediated HLA-G release appears as a critical factor in T cell alloresponse inhibition, thereby contributing to the immunosuppressive effect and graft acceptance.
IL-9 Regulates Pathology during Primary and Memory Responses to Respiratory Syncytial Virus Infection
Authors: Dodd Jonathan S. , Lum Eda , Goulding John , Muir Roshell , Van Snick Jacques , Openshaw Peter J. M.
Published: November 2009

IL-9 is a cytokine of great current interest associated with allergic/Th2 responses. High levels of IL-9 are present in bronchial secretions from infants with respiratory syncytial virus (RSV) bronchiolitis. To test its effects in RSV disease with a Th2 profile, BALB/c mice were vaccinated with recombinant vaccinia virus expressing the RSV G protein. On RSV challenge, immunized mice developed augmented disease characterized by enhanced pulmonary Th2 and local IL-9 production peaking on days 7–10 of RSV infection. Depletion with anti-IL-9 Ab at vaccination or RSV challenge enhanced viral clearance. Depletion only at challenge had no effect on disease severity, whereas depletion at immunization and challenge enhanced Th1 responses, inhibited virus-specific IgG1 production, and enhanced disease severity. By contrast, depletion of IL-9 at immunization boosted IgG2a and inhibited the Th2 response and disease during subsequent infection without a concomitant increase in type 1 cytokines. Adoptive transfer of secondary memory CD4 T cells from the spleens of IL-9-depleted mice into naive recipients replicated many of the effects of depletion, indicating that IL-9 acts via CD4 T cells. Therefore, IL-9 is a previously unknown but key modulator of antiviral immunity, regulating T and B cell responses and having potent and specific effects on viral lung disease.
SHP-2 Expression Negatively Regulates NK Cell Function
Authors: Purdy Amanda K. , Campbell Kerry S.
Published: November 2009

Src homology region 2-containing protein tyrosine phosphatase-2 (SHP-2) is required for full activation of Ras/ERK in many cytokine and growth factor receptor signaling pathways. In contrast, SHP-2 inhibits activation of human NK cells upon recruitment to killer cell Ig-like receptors (KIR). To determine how SHP-2 impacts NK cell activation in KIR-dependent or KIR-independent signaling pathways, we employed knockdown and overexpression strategies in NK-like cell lines and analyzed the consequences on functional responses. In response to stimulation with susceptible target cells, SHP-2-silenced NK cells had elevated cytolytic activity and IFN-γ production, whereas cells overexpressing wild-type or gain-of-function mutants of SHP-2 exhibited dampened activities. Increased levels of SHP-2 expression over this range significantly suppressed microtubule organizing center polarization and granzyme B release in response to target cells. Interestingly, NK-target cell conjugation was only reduced by overexpressing SHP-2, but not potentiated in SHP-2-silenced cells, indicating that conjugation is not influenced by physiological levels of SHP-2 expression. KIR-dependent inhibition of cytotoxicity was unaffected by significant reductions in SHP-2 levels, presumably because KIR were still capable of recruiting the phosphatase under these limiting conditions. In contrast, the general suppressive effect of SHP-2 on cytotoxicity and cytokine release was much more sensitive to changes in cellular SHP-2 levels. In summary, our studies have identified a new, KIR-independent role for SHP-2 in dampening NK cell activation in response to tumor target cells in a concentration-dependent manner. This suppression of activation impacts microtubule organizing center-based cytoskeletal rearrangement and granule release.
Peroxisome Proliferator-Activated Receptor γ Ligands Enhance Human B Cell Antibody Production and Differentiation
Authors: Garcia-Bates Tatiana M. , Baglole Carolyn J. , Bernard Matthew P. , Murant Thomas I. , Simpson-Haidaris Patricia J. , Phipps Richard P.
Published: November 2009

Protective humoral immune responses critically depend on the optimal differentiation of B cells into Ab-secreting cells. Because of the important role of Abs in fighting infections and in successful vaccination, it is imperative to identify mediators that control B cell differentiation. Activation of B cells through TLR9 by CpG-DNA induces plasma cell differentiation and Ab production. Herein, we examined the role of the peroxisome proliferator-activated receptor (PPAR)γ/RXRα pathway on human B cell differentiation. We demonstrated that activated B cells up-regulate their expression of PPARγ. We also show that nanomolar levels of natural (15-deoxy-Δ12,14-prostaglandin J2) or synthetic (rosiglitazone) PPARγ ligands enhanced B cell proliferation and significantly stimulated plasma cell differentiation and Ab production. Moreover, the addition of GW9662, a specific PPARγ antagonist, abolished these effects. Retinoid X receptor (RXR) is the binding partner for PPARγ and is required to produce an active transcriptional complex. The simultaneous addition of nanomolar concentrations of the RXRα ligand (9-cis-retinoic acid) and PPARγ ligands to CpG-activated B cells resulted in additive effects on B cell proliferation, plasma cell differentiation, and Ab production. Furthermore, PPARγ ligands alone or combined with 9-cis-retinoic acid enhanced CpG-induced expression of Cox-2 and the plasma cell transcription factor BLIMP-1. Induction of these important regulators of B cell differentiation provides a possible mechanism for the B cell-enhancing effects of PPARγ ligands. These new findings indicate that low doses of PPARγ/RXRα ligands could be used as a new type of adjuvant to stimulate Ab production.